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Diabetes Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. People with diabetes have high blood sugar. This is because: • Their pancreas does not make enough insulin • Their muscle, fat, and liver cells do not respond to insulin normally Diabetes affects more than 20 million Americans. There are many risk factors for type 2 diabetes, including: • Age over 45 years • A parent, brother, or sister with diabetes • Gestational diabetes or delivering a baby weighing more than 9 pounds • Heart disease • High blood cholesterol level • Obesity • Not getting enough exercise • Polycystic ovary disease (in women) Symptoms: High levels of sugar can cause several problems, including: • Blurry vision • Excessive thirst • Fatigue • Frequent urination • Hunger • Weight loss • Nausea • Vomiting Test & Diagnosis The following blood tests are used to diagnose diabetes: • Fasting blood glucose level – diabetes is diagnosed if higher than 126 mg/dL on two occasions. • Oral glucose tolerance test – diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours. • Random (non-fasting) blood glucose level – diabetes is suspected if higher than 200 mg/dL and accompanied by the classic diabetes symptoms of increased thirst, urination, and fatigue. (The test must be confirmed with a fasting blood glucose test). Persons with diabetes need to have their hemoglobin A1c (HbA1c) level checked every 3-6 months. The HbA1c is a measure of average blood glucose during the previous 2-3 months. It is a very helpful way to determine how well treatment is working. Treatment There is no cure for diabetes. Treatment involves medications, diet, and exercise to control blood sugar and prevent symptoms. If you have diabetes, your provider may tell you to regularly check your blood sugar levels at home. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes. The American Diabetes Association recommends keeping blood sugar levels in the range of: • 80 – 120 mg/dL before meals • 100 – 140 mg/dL at bedtime Regular exercise is especially important for people with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than those who do not exercise regularly. Here are some exercise considerations: • Always check with your provider before starting a new exercise program. • Ask your provider or nurse if you have the right footwear. • Choose an enjoyable physical activity that is appropriate for your current fitness level. • Exercise everyday, and at the same time of day, if possible. • Monitor blood glucose levels before eating and after exercise. • Carry food that contains a fast-acting carbohydrate in case you become hypoglycemic during exercise. • Carry a diabetes identification card and a cell phone in case of emergency. • Drink extra fluids that do not contain sugar before, during, and after exercise. You may need to change your diet or medication dose if you change exercise intensity or duration to keep blood sugar levels from going too high or low. People with diabetes are more likely to have foot problems. Diabetes can damage blood vessels and nerves and decrease the body’s ability to fight infection. To prevent injury to the feet, check and care for your feet everyday. Studies have shown that strict control of blood sugar, cholesterol, and blood pressure levels in persons with diabetes helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. When to contact a doctor Go to the emergency room or call 911 if you have the following symptoms: • Abdominal pain • Deep and rapid breathing • Increased thirst and urination • Loss of consciousness • Nausea • Sweet-smelling breath • Confusion • Seizures • Dizziness • Double Vision • Headache • Weakness • Lack of Coordination Prevention To prevent complications of diabetes, visit your health care provider at least four times a year. Talk about any problems you are having. Regularly have the following tests: • Have your blood pressure checked every year (blood pressure goals should be 130/80 mm/Hg or lower). • Have your glycosylated hemoglobin (HbA1c) checked every 6 months if your diabetes is well controlled, otherwise every 3 months. • Have your cholesterol and triglyceride levels checked yearly (aim for LDL levels below 100 mg/dL). • Get yearly tests to make sure your kidneys are working well. • Visit your ophthalmologist • See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes. • Make sure your health care provider inspects your feet at each visit. • Stay up-to-date with all of your vaccinations and get a flu shot every year in the fall. For more information visit: www.diabetes.org www.cdc.gov/diabetes/ www.diabetesselfmanagement.com www.diabetes.webmd.com www.medicinenet.com www.niminih.gov/medlineplus/diabetes.html