Thursday, January 8, 2015

The ABC's of Diabetes

*I am not a medical professional.  The following is simply my own opinions and experiences and education on diabetes.*

Admission: Hundreds of thousands of diabetics are admitted to the hospital every year with diabetes listed as the primary illness. Most diabetics who do not know they are diabetic are admitted to the hospital with life threatening illness at the time of diagnosis.  Many diabetics who are considered uncontrolled suffer many diabetes related complications that can be fatal.

Beta Cells: These are located in the pancreas and produce and store insulin and amylin, and release them into the blood stream when needed.  In type 1 diabetics the beta cells are destroyed by the body's own immune system.  In type 2 diabetics the cells are too few or do not function adequately (and/or the body becomes resistant to insulin).

Carbohydrate: This is one source of energy in foods (others being fat and protein).  Carbohydrate raises blood sugar very quickly and there is no insulin that can counter the rise in blood sugar as quickly as carbohydrate raises it. It is best for diabetics to follow a very low carbohydrate diet in order to keep blood sugar regulated and avoid the "roller-coaster" effect (large rises and dips in blood sugar levels).

Dawn Phenomenon: An apparent reduction in the effectiveness of insulin in lowering or maintaining blood sugar due to rapid clearance of insulin from the bloodstream by the liver.  It may begin about an hour before arising in the morning and continue for 2-3 hours after awakening. - Taken directly from Dr. Bernstein's Diabetes Solution (4th edition)

Eating - Many diabetics have a love/hate relationship with food.  Diabetics must watch very closely what we eat and how much. For a diabetic sitting down to a meal is not just sit and eat, but also includes sometimes complex calculations of how much carbohydrate, protein, fat,  and calories are in the meal and how much insulin needs to be administered 10-40 minutes (depending on the type of insulin) before the meal to avoid any high blood sugar.  As you can imagine, a diabetic must know ahead of time exactly when the meal will be and what it will consist of so they can check their blood sugar, take the proper amount of insulin, and then finally eat.

Fat - It is a common misconception that all diabetics are overweight or that being overweight causes diabetes.  For type 1 diabetics weight has absolutely nothing to do with developing the disease, you either get it or you don't.  For type 2 diabetics being overweight can contribute to your risk of developing diabetes but being overweight does not directly cause diabetes and it is not strictly overweight people who develop type 2. Anybody can develop type 2...there are just certain things that can increase your risk, or decrease it.

Glucose - A naturally occurring sugar, which when measured in the blood is called blood sugar.  Glucose is the building block of most carbohydrates and of glycogen. - Taken directly from Dr. Bernstein's Diabetes Solution (4th edition) 

Hemaglobin A1c (HgbA1c) - A lab blood test that measures one's average blood sugar over the prior four months.  Diabetics usually have this test done every 3-6 months depending on their doctor's determination. The average non-diabetic will have an A1c of 4.5 (average blood sugar of 83) and there is absolutely no reason a diabetic can't reach and maintain that same number.  It is very difficult and a lot of constant hard work and self-discipline, but it can be done. Many doctors and organizations will say that any A1c between 4 and seven is healthy. This is a pretty controversial  subject, though.

Insulin Resistance: When the body becomes less sensitive to the effects of insulin on blood sugar.  This causes blood sugar to rise and requires much more insulin to regulate it.  This can lead to or be the result of a whole host of difficulties and complications.

Junk Drawer - Diabetes comes with a ton of paraphernalia. Most diabetics own at least one glucose monitor which comes with a lancing device, lancets, test strips, a case to carry it all in, and in many cases alcohol swabs, as well as maybe a continuous glucose monitor (CGM). Also there is insulin (many types, most diabetics use at least two types), syringes, pump and all the pump supplies. Many diabetics are on at least one pill either directly for diabetes or for any number of related complications. There are also glucose tablets, glucose gel, glucogon injections, all of which are to treat low blood sugar. There are many other useful and required tools for diabetes care.

Ketoacidosis: Caused by a combination of very high blood sugar and dehydration. This involves high blood levels of ketones, including acetone, and an acidification of the blood.  This is life threatening and requires immediate medical attention.

Lisinopril - A medication normally used to treat high blood pressure.  This drug, however, is often prescribed to diabetics in small doses to protect the kidneys from damage done by high blood sugar.

Maltodextrin: This is a mixture of sugars derived from corn syrup and is used as a sweetener in many foods.  This can raise blood sugar just as easily and drastically as table sugar and should be avoided by diabetics.

Neuropathy: There are several types of neuropathy, the two most common are peripheral neuropathy and autonomic neuropathy.  Neuropathies are not conditions only to be suffered by diabetics; there are many causes for neuropathy.  Any kind of neuropathy is generally defined as damage to nerves.  Both autonomic and peripheral neuropathy in diabetics is caused by high blood sugars.

Obituary: Diabetes is the seventh leading cause of death in the United States. This could be greatly reduced if diabetics and close family of diabetics were to become better educated about their disease and take action to live healthier.

Proliferative Diabetic Retinopathy: After years of chronically high blood sugar a diabetic can develop retinopathy.  This is a very serious condition of the retina that can lead to blindness if untreated.

Quiet:  Diabetes is a silent disease.  Walking down a busy street you would be unable to pick out the diabetics from the non-diabetics.  But we hear it, we feel it, we see it, we live it all day, everyday.

Renal Risk Profile: This is a series of lab tests every diabetic regularly has done to asses any damage done to the kidneys.  Diabetics are at high risk for kidney damage, disease, failure.

Syringe: A device every diabetic knows intimately.  Insulin dependent diabetics can take any number of injections a day depending on individual needs.  Also, all diabetics should have regular lab work done.

Type: There are many types of diabetes, type 1, type 2, LADA (latent autoimmune diabetes in adults), gestational, surgically induced diabetes, chemically induced diabetes.  Different types of diabetes means similar but not exactly the same.

Unit: A measure of the biological effectiveness of insulin at reducing blood sugar. The lines on the scale of an insulin syringe frequently measure increments of either 1/2 or one unit.

Vagus Nerve: This is the largest nerve in the body, and the main neural component of the part of the nervous system that regulates parasympathetic autonimic (involuntary) functions.  When a diabetic suffers autonomic neuropathy this means there is damage to the vagus nerve (as well as other).  As you can imagine, this can lead to many frightening and sometimes fatal issues.

Will Power: Being diabetic means living a life not quite the same as non-diabetics.  Diabetics must follow a strict diet.  Diabetics must check their blood sugar regularly and balance their diet, activities, and medications in order to maintain a normalized blood sugar level.  This lifestyle is essential to getting and staying healthy.  This lifestyle requires a lot of will power and self-discipline. 

X it out: There are a lot of things a diabetic should drop from their life (most of them foods).  Many diabetics hate this idea because they think it means depriving themselves of something they like.  It is best to think of it as choosing to live healthy and long...and pain free.

Years: It is hard to gage life expectancy in diabetics simply because there are so many factors such as type of diabetes, how long you've had it, how well you control it, etc.  But it is obvious that the more regulated you keep your blood sugar, and the healthier your lifestyle, the better your odds of living to a ripe old age.

Zzzz:  Get plenty of restful sleep, it's good for all of us, diabetic or not!

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