Commonly Asked Questions and Answers
How is diabetes diagnosed?
What should my HemoglobinA1c (HgA1c or A1C) level be?
How often should I check my blood glucose?
Do I have to take insulin?
Does diabetes cause other complications?
Do I have to give up sugar?
How do I prepare for sudden illnesses?
How should I take care of my eyes and feet?
How does my blood pressure affect diabetes?
Can diabetes go away?
Diabetes is diagnosed when a blood glucose test measures more than 126 mg/dl (fasting) or 200 mg/dl (two hours after consuming a glucose drink) or casual blood glucose over 200 with diabetes symptoms. You should repeat the test to confirm results; in the case of casual blood glucose, take a fasting or oral glucose test.
People with risk factors for diabetes - including excess weight, high HDL cholesterol and high triglycerides, member of a high-risk group and high-blood pressure - should get tested regularly.
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Ideally, your A1c should measure below seven. If it measures above seven and closer to eight or above, you may need to make changes in your treatment plan. To track your progress, you should get your hemoglobin A1c tested two to four times per year. (Hemoglobin A1c measures blood glucose control over a 2-3 month period.)
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To be sure, ask your doctor how often you should check your blood glucose. If you are treating your diabetes through diet and exercise or oral medication, diet and exercise, you should probably check your blood glucose level at least twice daily. If you take insulin, check your blood glucose four times daily. This will help you assess how well your meal and exercise plan and medication are working to stabilize blood sugar. Blood sugar levels of 180 two hours after eating or above 140 before eating are considered high.
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People with type 2 diabetes either produce inadequate insulin or have insulin resistance (which means the cells have difficulty responding to insulin) or both. Treatment for type 2 diabetes usually begins with a change in diet and exercise. However, very overweight, inactive diabetics may have such high blood glucose levels that they may initially need insulin to bring blood sugar under control. Once they follow a treatment plan, they may no longer require insulin.
A variety of oral and injectable medications exist that can help the body produce more insulin or better use the insulin it does have. Sometimes, despite their best efforts to follow a treatment plan, diabetics still need insulin to control blood sugar.
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If blood sugar isn't kept in check, diabetes can lead to a number of serious complications, including heart attacks, strokes, kidney disease, blindness, blood vessel disease that can require amputations, nerve damage and impotence in men. However, a recent study conducted over a 10-year period showed that patients can reduce the risk of complications by 50% or more when their blood sugar measures as close to normal as possible.
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No. Over the past 10 years, medical opinion about sugar consumption and diabetes has changed. Scientists no longer believe that simple sugars raise blood sugar more quickly than complex carbohydrates. According to current thinking, you should limit your total daily carbohydrate intake rather than cut out sugar.
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When you're sick, the body releases hormones that can raise blood sugar and make it harder to keep it in check. It's critical to keep taking your insulin. If you need to take over-the-counter medications, such as cough medicines, check labels to see if the medications contain sugar. Some medications (such as aspirin in high doses and some antibiotics) lower blood sugar, while others (such as decongestants and other cold-care products) raise it.
Your healthcare team can help you prepare a plan in advance to deal with sudden illnesses, including how much medication to take, how often to check blood sugar and ketones, substances that are made when the body breaks down fat for energy, and how to eat. Make sure you keep the phone numbers of your healthcare team handy.
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As a diabetic, you risk eye and foot problems, so check both regularly. In particular, it's critical that you get a yearly eye exam that includes dilating your pupils to detect signs of eye disease. Diabetics face a higher risk of eye complications, such as retinopathy, macular edema, and cataracts.
Your doctor should check your feet at least once a year. Symptoms of foot problems can include decreased feeling in the feet, cramps when walking, cuts and scratches that heal slowly, redness in the feet when sitting and whiteness when propped up, lack of hair growth on legs and feet and leg or feet pain. Doctors advise daily checks for cuts or injuries in order to prevent infection or other problems.
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High blood pressure poses a risk for strokes. Since diabetics have a higher risk for strokes, you should check your blood pressure twice a year. If your blood pressure is higher than 130/80, discuss it with your doctor. If pressure remains high, consider treatment options such as a low-sodium diet, increased exercise and/or taking blood pressure medication.
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Currently no cure exists for diabetes. But you can effectively control it. Research has shown that healthy lifestyle changes such as weight loss can decrease the need for medication. But even if symptoms diminish and blood glucose measures normal, the disease is still present. However, you'll significantly lower your risk of complications.
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Thursday
November 20, 2008
Tip of the Day
Regular exercise increases the number of insulin receptor sites on cells, making the body more sensitive to insulin.
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