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: 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: F

Fasting Blood Sugar
By Eileen B. Wyner NP
Bulfinch Medical Group

F

Fasting blood sugar is a test to determine how much glucose (sugar) is in a blood sample after an overnight fast. Typically, this test is done after 12 hours without any food or liquids except water. The fasting blood glucose test is commonly used to detect diabetes mellitus and may be done as part of a routine medical exam. A result less than 99 mg/dL is normal.

Diabetes ABCs

Diabetes ABCs: E

Exercise
By Paula Cerqueira, Dietetic Intern 

E

Exercise is an integral part of diabetes management. It helps improve blood glucose control in the long run; reduces insulin resistance; increases insulin sensitivity for up to 72 hours after an activity session; promotes modest weight loss and weight maintenance; lowers blood pressure, LDL (bad) cholesterol and triglycerides; decreases risk of heart disease and stroke; and reduces stress, anxiety and depression.

In order to get the greatest benefits from your workouts, it’s recommended that you participate in 150 minutes per week of moderately intense physical activity, such as: walking at a brisk pace, jogging, swimming, bicycling, playing tennis or using an elliptical.

While exercise is an important part of any diabetes treatment plan, it needs to be started carefully.  Check in with your healthcare provider before starting an exercise program. For those who take insulin or medication that stimulates insulin production, it’s critical to check your blood sugar levels before, after, and during your workout to avoid dangerous blood sugar fluctuations.

Prior to exercise, if your blood sugar is below 80 mg/dL, it may be too low to safely do moderate physical activity.  Eat a small carbohydrate-containing snack, such as a medium piece of fruit or a slice of toast, before you begin your workout.  If your blood sugar levels are greater than 250 mg/dL, you should test your urine for ketones (a byproduct of fat metabolism). Hormones associated with exercise can further raise blood ketones and cause a drop in your blood pH.  Wait to exercise until urine ketones are at a low level. Contact your healthcare provider with any questions regarding exercise and/or your diabetes care plan.

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

Diabetes ABCs: D

Diabetic ketoacidosis
by Eileen B. Wyner, NP
Bulfinch Medical Group Letter D

Diabetic ketoacidosis occurs when the body cannot use sugar (glucose) as a fuel source because there is no (or not enough) insulin. Fat is used for fuel instead and the byproducts of this fat breakdown, called ketones, build up in the body. This is a potentially life threatening condition that can happen in both Type 1 and Type 2 Diabetes, although it is very rare in the latter. Symptoms may include fatigue, fruity breath, stomach pain, nausea and vomiting, and blood sugar greater than 300 mg/dL. Immediate medical attention is required to treat these symptoms.

Dawn Phenomenon
by Eileen B. Wyner, NP
Bulfinch Medical Group

This phenomenon is one factor responsible for morning hyperglycemia in people with both Type 1 and Type 2 Diabetes. It also occurs in people without diabetes. It is caused by the early morning (4 a.m. to 8 a.m.) surge of hormones such as growth hormone and cortisol. The hyperglycemia in people with diabetes is a result of insufficient insulin production required to maintain normal blood glucose values.

Diabetes ABCs

Diabetes ABCs: Intro

Letter A

Today we’re launching a new blog series called Diabetes ABCs.  Our aim with this series is to provide a growing resource of common diabetes-related terms, define what they mean and explain what role they play in diabetes management.

We’ll feature two letters each week, starting with A and working through to Z.  This series will be constantly expanding, so if there’s a term you’d like us to cover (or one you think we left out) let us know either by leaving a comment or e-mailing us at:  diabetesviews@partners.org.

Without further ado, let’s launch right in with our first letter and term:

A1C

A1C (which is short for hemoglobin A1C or HbA1C) is a measurement of your average blood sugar for the past three months, which provides a “big picture” of how well your treatment plan is working.  Sugar in the blood sticks to a protein in red blood cells called hemoglobin, and the hemoglobin is said to be “glycated.”  The A1C test measures how much glycated hemoglobin there is in the blood.  Your care team can use these results to see how well blood sugars have been controlled and make adjustments in your treatment plan if needed.  An A1C less than 7% is usually the goal for a person with diabetes.  Remember though, your A1C is an average blood sugar and doesn’t replace daily blood sugar checks.

(Content reviewed by MGH Diabetes Center) 

Health

Happy New Year!

It’s hard to believe this year is almost over, isn’t it?  In two days, we’ll be saying “goodbye” to 2010 and “hello” to 2011.  However you will be celebrating the coming year, if you plan on including alcohol in the festivities there are a couple things to keep in mind to ensure you ring in the New Year safely.   

As with candy and sweet treats, alcohol is fine in moderation—but it’s still a good idea to check with your health care provider first and follow their advice regarding alcohol consumption.  Because alcohol can cause hypoglycemia, especially when combined with some oral Diabetes medications, make sure your blood sugar is in a safe range before taking your first sip and be sure to test your blood sugar frequently to ensure your levels stay safe.  Also, avoid drinking on an empty stomach—have a healthy meal and/or snack along with your drink. 

Alcoholic drinks can be high in calories and some types of alcohol including beer and some wines contain carbohydrates that can affect your blood sugar (as do many popular mixers: soda, juice, etc).  Make sure you know what you’re drinking and talk with your Diabetes care team about including alcohol in your meal plan.

Above all, we wish you a safe and happy New Year! 

(Information reviewed by MGH Nutrition Department)