The Diabetes Pro

A recent study from Duke University Medical Center has shown that a moderate amount of exercise can reduce the risk of metabolic syndrome. Metabolic syndrome is a collection of factors that combine to put individuals at higher risk for developing heart disease, stroke, and, of interest to us, diabetes.

What are these risk factors? They include: a large waist circumference — over 40 inches in men, 35 inches in women; high levels of triglycerides –over 150; low amounts of HDL — below 40 in men, 50 in women; high blood pressure, and high blood sugar. If you’ve got 3 of the 5 factors, you can be diagnosed with metabolic syndrome.

As we are becoming increasingly sedentary — does anybody move anymore? — this is becoming an increasingly common diagnosis. However, according to the research team at Duke Medical Center, a person can lower risk of metabolic syndrome by exercise. They recommend walking 30 minutes a day, six days per week.

You’ll go approximately 11 miles in an average week, which sounds like quite a distance — but it works out to less than 2 miles a day. You’ll benefit even if you don’t make any dietary changes — just don’t start eating more! The most obvious result will be a trimmer waistline, but regular exercise can also help decrease blood pressure.

Every little bit helps. Duke cardiologist William Kraus said, “Some exercise is better than none; more exercise is generally better than less, and no exercise can be disastrous.”

Consistency is apparently more important than intensity: researchers posit that there may be more value in moderate exercise performed every day rather than intense exercise every few days.

What does a good diabetic diet mean? Surprisingly, it’s not what many people think. Being a diabetic does not mean an austere life of hardship, where you can’t enjoy any good stuff. Instead, what constitutes a sensible diet for a diabetic is, in large part, what’s a sensible diet for everyone else.

Eating a variety of foods is a good starting point: selecting from all four food groups is essential. The average American diet doesn’t include enough fruits and vegetables, relying instead on too much meat and grains. Achieving balance will help anyone’s diet.

Incorporating more fruits and vegetables is a wise nutritional choice. These items are low in fat — provided you don’t drench your green beans with half a stick of butter! — and also low in calories. Both help provide much needed fiber.

Food selection is one part of the equation: you want nutrient-dense, high-fiber foods. The amount you eat is also important. Pineapple might be a really healthy choice — but if you sit down and eat six cups of chopped pineapple, you’re going to be in real trouble. Not only are you going to send your sugar through the roof, you’re going to have the queen mother of all stomachaches! Moderation is key. If you’re working with a nutritionist or diet specialist, they can advise you on appropriate serving sizes to meet your dietary needs. Otherwise, you may want to start by reading the information here.

If there’s one piece of medical information everybody and their best friend is sure they’re an expert on, it’s what the symptoms of diabetes are. It’s well known that frequent urination and a constant thirst are common diabetes symptoms.

However, running to the bathroom six times a day doesn’t necessarily mean you’re diabetic. There are other causes for frequent urination, from drinking too much coffee to pregnancy and far beyond.

What you should look for, if you’re concerned about diabetes, is the following behaviors:

• frequent urination
• strong, constant thirst
• being very hungry
• a sense of tiredness or fatigue
• a sense of being irritable or ‘cranky’
• blurry vision
• unusual weight loss — you haven’t been eating less or doing more, and still, the pounds come off!

The key here is that none of these items, one time or in isolation, is necessarily a symptom of diabetes. You could be very hungry because you didn’t eat the day before — but as soon as you have a sandwich, you’re fine. What we’re talking about is a prolonged, repeating pattern of these symptoms.

This is information you need to share with your doctor. They’ll do tests, including an analysis of your blood sugar levels, to see if what appears to be the symptoms of diabetes is in fact that — or if the symptoms are related to another, unrelated condition.

Diabetes is in the news again — did you see? Two recent studies on people who are considered ‘pre-diabetic’ — exhibiting a tendency toward diabetes, yet without fully manifesting the disease — established that there are simple lifestyle changes one could make to stop or slow the progression toward diabetes.

Note that I said simple. Not easy. Nothing here is impossible, but some of it is challenging.

Still, when you consider the possibility of forestalling Type 2 Diabetes, it might be worth it to:

• Cut your fat intake. No more than 30% of your daily calories should be fat. In an average diet, that’s 50-60 grams of fat.
• Cut saturated fat intake down to less than 10% of your daily calories. This is the tough one: we’re looking at 15-20 grams of saturated fat. That’s not very much at all.
• Exercise! You knew that was coming. The goal is 2 ½ hours of moderately intensive exercise: get up and get moving. Playing video games is not exercising — and I don’t want to hear how fit your thumbs are!
• Eat more fiber. This is your fruits and veggies. Your mom was right: some stuff is good for you. You want at least 25 grams of fiber every day. Nuts, legumes and whole grains also offer fiber.
• Whole grains are your friend. Eat at least three servings every day (which will also help you achieve that whole eat more fiber thing). Whole grain intake helps with blood sugar control.
• Lose weight. Now, if you’re doing all this other stuff, the weight grain won’t be too tricky. Exercise more, a healthy diet, and increased fiber intake can help the pounds drop off. Even a small lose can have a huge positive effect.

The researchers found that individuals who followed these steps and received support from family members, friends, and study staffers were able to reduce their risk of developing Type 2 Diabetes by almost 60%. That’s the type of news we like to read about!

If you’re not pregnant, have never been pregnant, or have no interest in being pregnant, chances are you’re not concerned with gestational diabetes. However, for the estimated 4% of all pregnant women who have gestational diabetes, there are lots of questions and concerns about how this disease affects them and their baby during and after their pregnancy.

Gestational diabetes occurs when women who never had diabetes before manifest high blood sugar levels during pregnancy. Generally, this is diagnosed in the latter stages of pregnancy — the second or third trimester. Most women who are diagnosed with gestational diabetes are diagnosed between the 24^th and 28^th week of their pregnancy.

In some ways, gestational diabetes is similar to diabetes unrelated to pregnancy. Insulin levels are of paramount concern: when the mother cannot produce adequate amounts of insulin, excess blood sugar is the result. This can lead to hyperglycemia.

Gestational diabetes usually manifests after the baby has gone through some of the most critical developmental stages. This reduces the risks of certain types of birth defects, but there are still issues to be concerned about. Babies of mothers who have gestational diabetes may receive extra glucose from the mother’s elevated blood sugar levels. Babies use a tremendous amount of energy while they’re growing in their mother’s womb, but this is just too much for them to use. The excess is stored as fat.

We’ve all heard about big, bouncing babies — but the truth is a baby can be too large. Oversized babies can force a mother to have to have a C-section birth rather than a vaginal delivery. Additionally, these babies may have breathing problems and also have a higher risk of developing diabetes as children.

After the baby is delivered, gestational diabetes generally goes away. However, there are some factors that mothers with gestational diabetes need to be aware of. First and foremost, it is critical that a mother with gestational diabetes work closely with her health care provider to manage the condition. This helps optimize the chances for a healthy baby.

If a C-section delivery is required, the mother should be aware of the longer recovery period associated with this surgery.

Additionally, if a woman developed gestational diabetes during one of her pregnancies, she has a far greater chance of developing gestational diabetes during subsequent pregnancies. Close consultation with a health care provider is certainly recommended in these cases, to ensure that the mother’s condition is monitored.

Many women who have gestational diabetes go on to develop type 2 diabetes years later. There seems to be a link between the tendency to have gestational diabetes and type 2 diabetes. While obviously, there’s no way to definitely prevent diabetes, women who have gestational diabetes have an opportunity to make lifestyle choices which can help minimize the risk of developing type 2 diabetes further down the road. These healthy lifestyle choices can also help the family’s new baby start out life on a good nutritional footing, developing the habits now that will serve them well for a lifetime!

Most people don’t really know a whole lot about diabetes — but the one thing they think they know is the effect diabetes has on your vision. A surprising number of people are convinced that diabetics are destined to become blind — if not now, later.

That may have been true once — long ago, before medical technology had advanced to the point where it is now and people’s understanding of diabetes management evolved to today’s standard. The situation now is different. While people with diabetes do have a statistically higher chance of becoming blind than those without diabetes, many of the conditions that contributed to deteriorating vision or total vision loss can now be effectively managed or minimized.

One of the main vision-related conditions diabetics need to be concerned about is glaucoma. According to the American Diabetes Association, people with diabetes are 40% more likely to have glaucoma than people without diabetes.

What is glaucoma?

Glaucoma is the name of a group of eye diseases that adversely affect vision. In all of the glaucomas, pressure within the eye slowly damages the optic nerve, eventually destroying vision. The most common form of glaucoma is open angle glaucoma, which manifests no symptoms until the vision has already been damaged. There is no cure for open angle glaucoma, but the progression of the disease can be slowed in order to preserve vision.

Because open angle glaucoma has no symptoms — you can’t ‘feel it’ coming on — it is essential for all people, and especially diabetics, to have regular eye exams. These exams must include an optic nerve check and a check of the pressure in the eye, known as tonometry. Many individuals don’t care for the tonometry exam, finding it uncomfortable, but it is a momentary discomfort compared to the ongoing, permanent damage glaucoma can cause if left unchecked.

Other types of glaucoma: acute glaucoma, low-tension, congenital, and secondary glaucoma, are similar in nature to open angle glaucoma. Acute glaucoma is distinct because it usually manifests with severe pain and nausea to the patient.

For the best prognosis, glaucoma should be detected and treated early. Treatment for glaucoma generally begins with a course of eye drops. If the eye drop medication fails to halt the progression of the disease, laser surgery or traditional eye surgery are the recommended course of action. Obviously, each individual responds to the condition differently, and courses of treatment will be different for each patient.

The risk of glaucoma and other vision problems associated with diabetes make it essential for the diabetic to form a strong and lasting relationship with their ophthalmologist. The trained eyes of a medical professional are the best tool you have at your disposal to protect your vision Regular exams, coupled with the careful tracking of changes in your eyes, are the first line of defense against glaucoma. Glaucoma medicines are stronger and more effective than ever before, offering diabetics a wide range of tools to be used to preserve their vision.

DID YOU SEE IT?

Last week, on November 12, the cover story in USA Today was “Diabetes ‘revolution’ is cutting both ways”.  To summarize the article, it indicated that there are more people with diabetes these days than ever before, including those who have no idea they are truly diabetic.  That is the bad news, and the good news is that the complications from being diabetic have become much more minimal than ever before.   Doctors who once had a waiting room filled with the obvious victims of the complications from diabetes, now they open their doors, and are pleasantly surprised.  In the past, you would observe patients with poor eyesight, limbs missing, and those about to go on dialysis due to their kidneys failing.

While we have all the tools available to us to monitor and control our condition, there are unfortunately still those who fail to take advantage of what has opened the doors to much better control.  There is the blood sugar monitoring devices, many different types of insulin, syringes and needles which are smaller than we could have imagined years ago. Additionally, there is an array of  other means of control, such as the insulin pump.  I began pump therapy approximately 18 years ago, and I must admit I was very skeptical back then.  My first pump malfunctioned while I was on vacation, which was not the way I expected to spend during a time which should have been filled with relaxation and adventures.  Fortunately, the pump manufacturer flew in a replacement pump, but in the meantime, I was in a difficult position.  Yes, I survived the ordeal, but decided to go off that pump until I felt more confident.  The pumps today are amazing with features that do the calculating for you.

I hope, if you have not already done so, you will read the USA Today article and see for yourself how the management of diabetes has progressed.  Good luck!  

Step 1
When I think back to my life 47 years ago and the challenges of living with diabetes, I had no idea how almost uncivilized those times were.  The comparisons to today are monumental. 

Try to imagine the only way of gauging your blood sugar level was by testing the urine.  You would “pee” in a cup.  Then put a few drops of the urine into a test tube followed by dropping a tablet into the tube.  Then you watched the two combine while watching the combination begin to sizzle.  After the scientist — that would be me – would observe the bubbles calming down, there would be the high technology of shaking the two together.

The secret was in the wrist and the observer’s getting the visual color exactly right which would range from a blue to a yellow.  WOW, when you saw that blue, you could breathe easier now knowing that this scientific wonder, made you feel comfortable knowing that what was in your urine showed a negative sugar level!  Let’s go all the way down the scale to the yellow color – uh oh, are you in trouble!  So, what do you do now with these results, probably not one thing until your next doctor’s appointment!

Wait til my next “tell all” about the non-existence of at home self care, or rather the trial and error which consisted of crossing your fingers and believing you were actually on target, with what was available, for you the diabetic to monitor yourself.

So many thoughts and ideas continuously rush through me that I want to share with you, the reader.   As fellow diabetics, and/or family of, I am certain every day can be a challenge.  I know with me, it is the carb/insulin ratios.  Until now this was such a challenging ordeal to visualize and calculate the amounts.  Now, with my new pump, my life has been simplified.  In my next article, I will share with you what has transpired through the years with the advancements that are truly amazing.  You will not believe how it  used to be, and when you read some of the amazing improvements over the way it used to be!

I am that teenager who was diagnosed with diabetes and had no idea what to expect.  Did my life change – you bet it did – but now that I look back, it pretty much remained the same.  Join me as I let you in on some of my life experiences for almost 50 years!  I plan to make it worth the ride.