Diabetes is the result of a metabolic disorder in which blood sugar (glucose) levels are above normal.
A fasting blood sugar test measures the amount of sugar (glucose) in your blood after you fast for eight hours. Your fasting blood sugar is normal if it’s 70 mg/dL to 100 mg/dL.
If your fasting blood sugar is 100 mg/dL to 125 mg/dL, you may have pre-diabetes.
A fasting blood sugar value by itself doesn’t help distinguish between type 1 and type 2 diabetes. But a fasting blood glucose of 126 mg/dL or higher is consistent with either type 1 or type 2 diabetes when accompanied by classic symptoms of diabetes.
Symptoms of Diabetes
Symptoms of diabetes include increased thirst or hunger, frequent urination, weight loss or blurred vision.
Your doctor may repeat this and other tests on a different day to confirm their diagnosis. Complications from diabetes include serious heart complications, loss of limb, kidney failure and blindness.
Types of Diabetes
Diabetes mellitus (sugar diabetes) is an inherited disorder of metabolism that comes in two distinct forms: type I (juvenile-onset) and type II (adult-onset).
Type I (juvenile-onset) begins in childhood or adolescence, is more severe, requires regular injections of insulin to prevent death, and is an autoimmune disorder.
The goal of juvenile-onset diabetics should be to reduce their insulin requirement to a minimum while maintaining the best possible health, especially of the cardiovascular system, through attention to diet, exercise, and stress reduction.
Type II (adult-onset) older adults, is less severe, not autoimmune in origin, and often can be controlled by maintaining normal weight and eating sensibly or by taking oral medication.
The goal of adult-onset diabetics should be to avoid insulin shots and other prescribed medication altogether, keeping the disease in control by adhering to a healthy lifestyle.
Insulin-dependent diabetics are not as likely to be able to get off insulin completely and should never attempt to do so on their own, although they may be able to reduce their insulin requirement through natural therapies and lifestyle modification.
What is Insulin?
Insulin is produced in the Islets of Langerhans (in the pancreas) and is a polypeptide hormone that regulates carbohydrate metabolism. Apart from being the primary effector in carbohydrate homeostasis, it has effects on fat metabolism. It can change the liver’s ability to release fat stores. Insulin’s concentration (more or less, presence or absence) has extremely widespread effects throughout the body.
Insulin is used medically in some forms of diabetes mellitus. Patients with type 1 diabetes mellitus depend on exogenous insulin (commonly injected subcutaneously) for their survival because of an absolute deficiency of the hormone. Patients with type 2 diabetes mellitus have either relatively low insulin production or insulin resistance or both, and a small fraction of type 2 diabetics eventually require insulin when other medications become inadequate in controlling blood glucose levels.
1. Diabetes affects millions and millions of people in the United States according to the American Diabetes Association.
2. Heart Disease is the leading cause of diabetes – related deaths.
3. Approximately 73% of adults with diabetes have high blood pressure and or use prescription medications for hypertension.
4. Diabetes is the leading cause of new cases of blindness among adults 20 – 74 years old.
5. Nutrition can play a vital role in people with diabetes, especially for those with adult onset diabetes ( type 2 diabetes).
6. Mexican-Americans are almost twice as likely and non-Hispanic blacks are almost 50% more likely to develop diabetic retinopathy as non-Hispanic whites.
7. About 60% to 70% of people with diabetes have mild to severe forms of nerve system damage.
8. More than 60% of non-traumatic lower limb amputations occur in people with diabetes.
9. In 2002, 44,400 people with diabetes began treatment for end-stage renal disease.
10. A total of 153,730 people where living on chronic dialysis or with a kidney transplant.
The Glycemic Index
Not all carbohydrate foods are created equal, in fact they behave quite differently in our bodies. The glycemic index or GI describes this difference by ranking carbohydrates according to their effect on our blood glucose levels.
Choosing low GI carbs – the ones that produce only small fluctuations in our blood glucose and insulin levels – is the secret to long-term health reducing your risk of heart disease and diabetes and is the key to sustainable weight loss.
Glycemic Index Range
Low GI = 55 or less
Medium GI = 56 – 69
High GI = 70 or more
Glycemic Load Range
Low GL = 10 or less
Medium GL = 11- 19
High GL = 20 or more
Glycemic Load Per Day
Low GL < 80
High GL > 120
Foods with a high GI score contain rapidly digested carbohydrate, which produces a large rapid rise and fall in the level of blood glucose (this is not good). In contrast, foods with a low GI score contain slowly digested carbohydrate, which produces a gradual, relatively low rise in the level of blood glucose (this is good).
Managing Your Diabetes
Body awareness is very important in managing diabetes. See you doctor regularly. Signs and symptoms can arise that may seem completely unrelated, when in fact they could be. Do not allow your pride or ego to get in the way of your physical health.
1. Proper eye care should be maintained. If any changes in vision, sudden loss, dizziness, blurring or pain in or around the eyes occur, see your doctor right away. Retinopathy, eye infections and blindness are more common in diabetics. Eye Exam: Dilated eye exam – yearly.
2. Thyroid problems are more common with diabetes. Tell you doctor if swelling or pain around the neck or throat occur.
3. Lung infections, pneumonia and influenza are more common in diabetics. If you are a smoker, quit now!
4. Heart disease is a major cause of death in diabetics. Tell your doctor if you are experiencing weakness, shortness of breath, swelling, dizziness, palpitations, or other sensations in the chest. Blood pressure: each regular diabetes visit.
5. Bladder infections and other bladder issues can be due to complications from diabetes. Urine Test: Microalbumin measurement – yearly (based on the HEDIS Diabetes Criteria).
6. Kidney failure is the lead cause of death among diabetics. Nephropathy is caused by blood vessel damage, which disrupts the kidney’s filtering system. Ask your doctor what you can do to reduce the risk.
7. Foot care is most important. Exam you feet daily. Notify your doctor if you have ANY signs of tingling, sticking, sharp, stabbing or dull pain. Also if you have unexplained pain, spots or loss of normal sensation. Neuropathy or nerve damage is a particular trait of diabetes. Problems can often occur at the big toe. Foot ulcers, if left untreated, can infect the bone and lead to amputation. Foot Exam: Check feet at each regular diabetes visit Comprehensive foot exam – at least yearly (more often in patients with high risk foot conditions).
8. Loss of sexual function. High blood pressure, heart disease and issues of circulation can effect nerves. Damage can occur, which can inhibit orgasm. Infection, vaginal dryness in women or erectile dysfunction in men can all be complications from diabetes.
9. Peripheral nerve damage can occur anywhere, but particularly at the joints and extremities.
10. Take your readings as much as possible! Keep a watch on hemoglobin A1c and blood fats to see if eating more sweets leads these number on an unhealthy up swing. There are three distinctly different times of day to consider testing blood sugars.
First thing in the morning, before meals, and after meal blood sugar numbers can each reveal a wealth of information to help solve the mystery of blood sugar numbers. Blood Test: A1c (glycosylated hemoglobin) At least 2 times a year if stable Quarterly, if treatment changes or you are not meeting your goals.
11.Keep your blood fats in target range such as total cholesterol, LDL, HDL and triglycerides.
12. Pay attention to good hygiene and skin care. Eat a proper balance of nutritionally low GI foods. Weight: Each regular diabetes visit.
Testing Blood Sugar Levels
Most people who have diabetes know they should be testing their blood sugar on a regular basis. However, many of them do not realize what the numbers mean and simply go through the motions of testing. Without realizing when to test and how important these numbers actually are.
First thing in the morning is known as a FASTING blood sugar. It should be taken soon after rising; before food, drink, exercise, or medications of any kind.
Normal is less than 100. Goal is 70 – 115
A before meal blood sugar is known as PREPRANDIAL. This means before lunch or before supper. At this point in your day, you’ve usually had something to eat and drink, you’ve usually had some activity or exercise, and you’ve probably taken some type of medications. All these things can effect your blood sugar numbers. This is different than a FASTING blood sugar test taken before breakfast, medications, or exercise.
Normal is less than 100. Goal is 100 – 120
An after meal blood sugar is known as POSTPRANDIAL and means after a meal. Timing is important on this reading because it should be taken 1 ½ hours to 2 hours after a meal.
Normal less than 140. Goal less than 160