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To take care of diabetes,
you need to learn about the tools available to control it. Many people don’t feel sick when
diagnosed with diabetes, but it is a serious condition. Diabetes care focuses on
“self-management”. By learning
about diabetes, and how your food choices, your activity, and medications work,
you can have a full, healthy life.
Diabetes is diagnosed
when blood glucose (BG) levels are found to be above normal. One test to diagnose diabetes is called
the fasting plasma glucose test. A
blood sample is taken after an 8 hour fast, usually before breakfast. A normal fasting result is
65-110 mg/dl. Values at or above 126 mg/dl more than
once are diagnostic of diabetes. Another test is a random plasma glucose test. A non-fasting BG over 200 mg/dl along
with classic symptoms of diabetes is diagnostic. “Classic symptoms” include excessive
thirst, excessive urination, and excessive hunger. If BG isn’t corrected, it means a higher
risk of long term complications, and not feeling your best.
Even results above
normal, but lower than the level for diagnosis is of concern. The lifestyle changes for diabetes
control can decrease the chance of small elevations turning into diabetes.
There are two main
types of diabetes; Type 1 and Type 2. Blood sugar levels being too high are the common thread of both
types. The underlying problem is
not enough insulin, or the body not being able to use insulin very well.
How our bodies use food for fuel…
To understand diabetes, it
helps to know how food and insulin work together to get energy from our
food.
After food is swallowed, it
goes into the stomach, then intestine. The
intestine is where the carbohydrate in foods are changed into the simple sugar
called glucose. From there, it goes
into your bloodstream. Glucose in
the blood is called "blood glucose" or "blood sugar". This is our bodies best fuel
source.
As the bloodstream carries
glucose through the body, blood passes through the pancreas. The glucose in the blood
normally triggers your pancreas into making and releasing insulin. Insulin is the hormone made by the beta
cells of the pancreas that triggers cells to take in glucose.
The sugar and insulin
traveling
in the blood pass through the liver. Normally the liver will
store 20 - 30 % of the glucose coming from a meal. The storage form of glucose is called glycogen. Glycogen stores are used for
energy when we haven’t eaten for a while, or during exercise. Between meals and over night, the liver
will allow its stored glycogen to return to the blood as glucose.
The remaining glucose is
burned for energy, stored in our muscles as glycogen, or changed and stored as
fat.
Glucose is used for energy
by our cells. In order for cells to get
glucose, insulin attaches to special receptors on most cell membranes. When insulin attaches, the receptor
sends a message inside the cell that tells the cell to pick up glucose. This
system keeps blood glucose in a normal range, between 65 - 140 mg/dL (depending
on the last time eaten).
You now
have an introduction to normal digestion, absorption, and how we use food for
energy. The following reviews how
the normal system is changed with both Type 1 and Type 2 diabetes, and how we
can fix it.
In Summary:
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A meal plan which helps with weight loss and keeps
your blood glucose from going too high.
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A regular activity program to help lower your blood
glucose.
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If blood glucose levels remain elevated, talk to your
doctor to get started on diabetes medication.
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Tobacco cessation if you use any form of tobacco.
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A plan to keep your blood fats and blood pressure in
the target ranges.
These all work together to reduce your risk factors.
When your best efforts at nutrition and activity aren't able
to keep your glucose, blood pressure and lipids controlled, then medications are
your next step to control.
Having control of your
health risk factors is more important than the method it takes to achieve your
targets. Most people with type 2
diabetes eventually need medications, as type 2 diabetes is a progressive
disease.
The closer to normal your
blood glucose is, the better you will feel - now and in the future.
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