Diabetes ABCs

Diabetes ABCs: P

Pre-diabetes
By Paula Cerqueira, Dietetic Intern

P

Pre-diabetes is a condition in which a person’s blood sugar levels are higher than what is considered to be normal, but not quite high as to denote diabetes.  According to the CDC, about 1 in 3 American adults have pre-diabetes.  Of those with pre-diabetes, 1/3 to 1/2 will develop diabetes within 5-10 years without intervention.

When people are in a pre-diabetic state, they may begin to develop significant cardiovascular and nerve damage.  However, diabetes is not an inevitable diagnosis.  Pre-diabetes can serve as an opportunity to develop healthy habits to prevent the progression to Type 2 Diabetes.  With such lifestyle changes as following a healthy diet, weight loss of 5% to 10% of body weight, at least 150 minutes per week of exercise, and not smoking you may be able to bring your blood sugar level back to normal.

Reviewed by Debra Powers, MS, RD, CDE, LDN, Senior Clinical Nutritionist

Pancreas

The pancreas is a small organ located behind the stomach.  Its main function is to produce enzymes used to digest food.  The pancreas also produces insulin, a hormone the body uses to move glucose out of the blood stream and into cells for energy.  For people with diabetes, the pancreas either does not produce enough insulin (or none at all) or the body is unable to use the insulin it produces properly.

(Reviewed by MGH Diabetes Center)
Diabetes ABCs

Diabetes ABCs: O

Oral Glucose Tolerance Test

O

An Oral Glucose Tolerance Test is a test done in the healthcare provider’s office to measure how the body manages glucose over time.  Though most often used to check for gestational diabetes, it can also be used to test for diabetes/pre-diabetes in people who are not pregnant.  After taking a fasting glucose reading, a sugary drink is consumed and blood sugar is checked again, usually at the one and two hour mark.  These results show how well the body handles glucose – elevated blood sugar in either check can indicate diabetes.

(Content reviewed by MGH Diabetes Center)
Diabetes ABCs

Diabetes ABCs: N

Neuropathy

N

Neuropathy is damage to the nerves, the fibers used to transmit messages from the brain to other parts of the body.  A common complication of diabetes, diabetic neuropathy can develop over time as high blood sugar damages nerve fibers.  Neuropathy can affect all parts of the body but peripheral neuropathy, the most common form of diabetic neuropathy, affects the feet, legs, arms and hands.  Symptoms can include tingling or numbness, difficulty feeling hot/cold, pain and sensitivity to touch.  Keeping your blood sugar in good control can help prevent developing or worsening neuropathy.

(Content reviewed by MGH Diabetes Center)
Diabetes ABCs

Diabetes ABCs: M

Metformin
By Eileen B. Wyner, NP
Bulfinch Medical Group

Metformin is an oral medication, also known as Glucophage, used for the management of Type 2 Diabetes. It is in a class of medications called biguanides and is considered the first drug of choice for diabetes management. It is usually taken in divided doses twice a day and may be used alone or in conjunction with other oral medications or insulin. Metformin’s method of action is to make the body work more efficiently to manage blood sugar. It helps the body’s response to insulin and decreases the amount of glucose that the liver produces and releases into the system

MODY (Maturity Onset Diabetes of the Young)

By Eileen B. Wyner, NP
Bulfinch Medical Group

This is a rare form of diabetes that runs strongly in families and it is inherited from one of the parents. This genetic abnormality causes a disruption in insulin production. MODY usually develops before age 25. MODY can be treated with diet and medications as needed.

Diabetes ABCs

Diabetes ABCs: L

Lantus
By Eileen B. Wyner, NP
Bulfinch Medical Group

L

Lantus (also called Glargine) is a long acting, man-made version of human insulin that is meant to be taken daily to regulate both Type 1 and Type 2 Diabetes. It’s available by prescription and should be taken at about the same time daily to keep the blood sugar stable. It works like a time release capsule, slowly releasing insulin into the blood stream to control blood sugar. The dose can be adjusted as needed to ensure good diabetes control. It should never be mixed with other insulins.

Diabetes ABCs

Diabetes ABCs: K

Ketones

Letter K

When the body is unable to get energy from glucose – often because there’s not enough insulin to move it out of the blood and into the cells – it starts to break down fat for fuel.  Ketones are substances created during this fat breakdown.  A buildup of ketones is harmful and can lead to a serious condition called ketoacidosis.  There are some at-home test kits you can use to check for ketones in the urine.  Test for ketones if you have high blood sugar (greater than 300 mg/dL); are sick, feel nauseous, or are vomiting; or if you are overly thirsty.  Contact your healthcare provider if results show moderate or large ketones present.

(Content reviewed by MGH Diabetes Center)
Diabetes ABCs

Diabetes ABCs: J

Jokes/Humor

J“Why did the chicken cross the road?”  Diabetes is a full time  job.  There are meals to plan, carbs to count, medications to take, exercise to fit in . . . and that’s on top of everything you have to do for work and family.  It’s a lot to juggle, and a lot of added stress.  At times like these, laughter really is the best medicine.  Find something that makes you laugh – a good joke, a funny movie or a clever YouTube video – and come back to it whenever you need a quick stress buster.

(Content reviewed by MGH Diabetes Center)
Diabetes ABCs

Diabetes ABCs: I

Insulin
By Eileen B. Wyner
Bulfinch Medical Group

Letter I

Insulin is a hormone produced by the beta cells of the pancreas. Insulin helps glucose move from the bloodstream into the cells of the liver, skeletal muscles, and fat tissue where it is stored for action as an energy source. People with diabetes have sustained a disruption in the workings of the beta cells so they are not producing insulin as well as they used to, meaning their blood sugar values are variable. They may be able to manage this with diet, exercise, or oral medications. There are times when insulin injections will be needed. Insulin cannot be taken as a pill as it would be broken down during digestion just like the protein in food, so it must be injected into the fat under your skin for it to get into your blood system.

Insulin Resistance

By Eileen B. Wyner
Bulfinch Medical Group

Insulin resistance occurs when some of the body’s cells don’t respond efficiently to the insulin it produces. The causes aren’t completely clear but family history, decreased physical activity, and weight gain are clearly factors. Insulin is the key that opens up the cells so glucose can enter and provide the energy they require to stay healthy and do their job.  Insulin resistance is a risk factor for heart disease and Type 2 Diabetes.

Diabetes ABCs

Diabetes ABCs: H

Hyperglycemia and Hypoglycemia
By Paula Cerqueira, Dietetic Intern

H

Hyperglycemia is the medical term for high blood sugar.  It occurs when the pancreas produces too little insulin, or when the body becomes resistant to insulin.  Hyperglycemia happens every now and then to all people living with diabetes.  If your blood glucose values are consistently running higher than the norm, talk with your healthcare provider.

Hypoglycemia is low blood sugar (< 70 mg/dL) and results from too much insulin and too little sugar in the blood. If blood glucose drops below 50 mg/dL, this could result in unconsciousness, a condition sometimes called insulin shock or coma.  Hypoglycemia can be caused by skipping or delaying meals, eating too few carbohydrates, exercising longer or more strenuously than normal, taking too much insulin and drinking alcohol.  It’s important to learn to identify the symptoms of hypoglycemia so you can treat it quickly.  Symptoms include: shakiness, dizziness, sweating, hunger, headache, pale skin color, sudden moodiness, seizure, and confusion.  Hypoglycemia can be treated by following the 15/15 guideline to raise blood glucose above 70 mg/dL – test blood sugar, consume 15 g of carbohydrate and test blood sugar in 15 minutes.  If blood sugar remains low, consume an additional 15 g of carbohydrate and test blood glucose in 15 minutes and then in 60 minutes. Once normal, consume a regular meal.  Fifteen grams of carbohydrate is about 4 oz of juice, 6 oz of soft drink, 5 hard candies, 4 glucose tablets, or 1 tablespoon sugar.

(Post reviewed by Debra Powers, MS, RD, CDE, LDN, Senior Clinical Nutritionist)
Diabetes ABCs

Diabetes ABCs: G

Glucagon
By Eileen B. Wyner, NP
Bulfinch Medical Group

G

Glucagon is a hormone produced in the pancreas.  It’s used to raise very low blood sugar and is available as a prescription medication to be given as an injection into the thigh. It comes as a powder and liquid that needs to be mixed up right before using it.  Glucagon is given to a person who is unconscious from severe low blood sugar and should be administered as soon as possible after determining this situation. This is an urgent medical situation and 911 should be called.