Diabetes
More than 10 million Canadians are living with diabetes or prediabetes. With more than 20 Canadians being newly diagnosed with the disease every hour of every day, chances are that diabetes affects you or someone you know. On June 27 starting at 10:00 am, Brampton Civic HospitaL will host a " DIABETES WELLNESS EXPO".
What is diabetes?
Diabetes is a chronic, often debilitating and sometimes fatal disease, in which the body either cannot produce insulin or cannot properly use the insulin it produces. Insulin is a hormone that controls the amount of glucose (sugar) in the blood. Diabetes leads to high blood sugar levels, which can damage organs, blood vessels and nerves. The body needs insulin to use sugar as an energy source.
What is the pancreas and what does it do?
The pancreas is an organ that sits behind the stomach and releases hormones into the digestive system. In the healthy body, when blood sugar levels get too high, special cells in the pancreas (called beta cells) release insulin. Insulin is a hormone and it causes cells to take in sugar to use as energy or to store as fat. This causes blood sugar levels to go back down.
Signs and Symptoms of Diabetes
There are many signs and symptoms that can indicate diabetes. Signs and symptoms can include the following:
· Unusual thirst
· Frequent urination
· Weight change (gain or loss)
· Extreme fatigue or lack of energy
· Blurred vision
· Frequent or recurring infections
· Cuts and bruises that are slow to heal
· Tingling or numbness in the hands or feet
· Trouble getting or maintaining an erection
If you have any of these symptoms, it is important to contact your health-care provider right away. Even if you don’t have symptoms, if you are 40 or older, you should still get checked.
It is important to recognize, however, that many people who have type 2 diabetes may display no symptoms.
Symptoms of diabetes in children
Diabetes affects children of all ages. Most children who develop diabetes do not have a family history of diabetes.
Symptoms of diabetes in your child could include:
· Drinking and going to the bathroom more frequently than usual
· Starting to wet the bed again
· Lack of energy
If you think your child might have diabetes, see a doctor today.
Diagnosis of diabetes
Speak with your doctor and ask him or her to test you for diabetes using one of the following tests. The amount of glucose (sugar) in your blood is measured in mmol/L.
Fasting blood glucose
You must not eat or drink anything except water for at least eight hours before this test. A test result of 7.0 mmol/L or greater indicates diabetes.
Random blood glucose
This test may be done at any time, regardless of when you last ate. A test result of 11.0 mmol/L or greater, plus symptoms of diabetes, indicates diabetes.
A1C
This test may be done at any time, regardless of when you last ate. A test result of 6.5 % or greater (in adults) and in the absence of factors that affect the accuracy of the A1C indicates diabetes.
Oral glucose tolerance test
You will be given a special sweetened drink prior to this blood test. A test result of 11.1 mmol/L or greater taken two hours after having the sweet drink indicates diabetes.
A second test must be done in all cases (except if you have acute signs and symptoms). Once diabetes has been diagnosed, ask your doctor to refer you for diabetes education. The Canadian Diabetes Association also has many resources to help you understand diabetes better and live a long and healthy life.
Type 1 Diabetes
About five to 10 per cent of people with diabetes have type 1 diabetes. Type 1 diabetes generally develops in childhood or adolescence, but can develop in adulthood. Type 1 diabetes is always treated with insulin. Meal planning also helps with keeping blood sugar at the right levels.
Type 1 diabetes also includes latent autoimmune diabetes in adults (LADA), the term used to describe the small number of people with apparent type 2 diabetes who appear to have loss of pancreatic beta cells due to some immune disorder.
Type 1 diabetes is a disease in which the pancreas does not produce any insulin. Insulin is a hormone that helps your body to control the level of glucose (sugar) in your blood. Without insulin, glucose builds up in your blood instead of being used for energy. Your body produces glucose and also gets glucose from foods like bread, potatoes, rice, pasta, milk and fruit.
The cause of type 1 diabetes remains unknown. It is not caused by eating too much sugar, and is not preventable. The current thought is that type 1 diabetes occurs when the body’s immune system destroys the cells that make insulin.
Insulin therapy
Insulin therapy is required for the treatment of type 1 diabetes.
There are a variety of insulins available to help manage diabetes. Insulin is injected by pen, syringe or pump. Your doctor will work with you to determine:
· The number of insulin injections you need per day
· The timing of your insulin injections
· The dose of insulin you need with each injection
The insulin treatment your doctor prescribes will depend on your goals, age, lifestyle, meal plan, general health and motivation. Social and financial factors may also need to be considered.
Your Action Plan
You can live a long and healthy life by keeping your blood glucose (sugar) levels in the target range set by you and your health-care provider.
You can do this by:
· Taking insulin as recommended (and other medications, if prescribed by your doctor)
· Monitoring your blood glucose (sugar) levels regularly using a home blood glucose meter*
· Eating healthy meals and snacks
· Enjoying regular physical activity
· Aiming for a healthy body weight
· Managing stress effectively
* Discuss with your health-care provider how often you should measure your blood glucose (sugar) level.
Who can help you?
Your health-care team is there to help you. Depending on your needs and the resources available in your community, your team may include a family doctor, diabetes educator (nurse and/or dietitian), endocrinologist, pharmacist, social worker, exercise physiologist, psychologist, foot care specialist, eye care specialist. They can answer your questions about how to manage diabetes and work with you to adjust your food plan, activity and medications. Remember, you are the most important member of your health-care team.
Support Available
A positive and realistic attitude toward your diabetes can help you manage it. Talk to others who have type 1 diabetes or their caregivers. Ask your local Canadian Diabetes Association branch about additional resources, joining a peer-support group or taking part in an information session.
Type 2 Diabetes
Type 2 diabetes occurs when the body can’t properly use the insulin that is released (called insulin insensitivity) or does not make enough insulin. As a result, sugar builds up in the blood instead of being used as energy. About 90 per cent of people with diabetes have type 2 diabetes. Type 2 diabetes more often develops in adults, but children can be affected. Depending on the severity of type 2 diabetes, it may be managed through physical activity and meal planning, or may also require medications and/or insulin to control blood sugar more effectively.
Type 2 diabetes is a disease in which your pancreas does not produce enough insulin, or your body does not properly use the insulin it makes. As a result, glucose (sugar) builds up in your blood instead of being used for energy. Your body gets glucose from foods like bread, potatoes, rice, pasta, milk and fruit. To use this glucose, your body needs insulin. Insulin is a hormone that helps your body to control the level of glucose (sugar) in your blood.
Your Action Plan
You can live a long and healthy life by keeping your blood glucose (sugar) levels in the target range set by you and your health-care provider. You can do this by:
· Eating healthy meals and snacks
· Enjoying regular physical activity
· Monitoring your blood glucose (sugar) using a home blood glucose meter*
· Aiming for a healthy body weight
· Taking diabetes medications including insulin and other medications, if prescribed by your doctor
· Managing stress effectively
Discuss with your health-care provider how often you should measure your blood glucose (sugar) level.
Help is Available
Your health-care team is there to help you. Depending on your needs and the resources available in your community, your team may include a family doctor, diabetes educator (nurse and/or dietitian), endocrinologist, pharmacist, social worker, exercise physiologist, psychologist, foot care specialist, eye care specialist. They can answer your questions about how to manage diabetes and work with you to adjust your food plan, activity and medications.
Remember, you are the most important member of your health-care team.
Support you need
A positive and realistic attitude towards your diabetes can help you manage it. Talk to others who have diabetes. Ask your local Canadian Diabetes Association branch about joining a peer-support group or taking part in an information session.
What is Gestational Diabetes?
A third type of diabetes, gestational diabetes, is a temporary condition that occurs during pregnancy. It affects approximately two to four per cent of all pregnancies (in the non-Aboriginal population) and involves an increased risk of developing diabetes for both mother and child.
Between three and 20 per cent of pregnant women develop gestational diabetes, depending on their risk factors. All pregnant women should be screened for gestational diabetes within 28 weeks of pregnancy.
In gestational diabetes mellitus your body cannot produce enough insulin to handle the effects of a growing baby and changing hormone levels. Insulin helps your body to control the level of glucose (sugar) in your blood. If your body cannot produce enough insulin, your blood glucose (sugar) levels will rise.
The good news
· Your baby will not be born with diabetes.
· Gestational diabetes can be managed and you can expect to have a happy, healthy baby.
What does gestational diabetes mean for my baby?
If left undiagnosed or untreated, gestational diabetes can lead to high blood glucose (sugar) levels. This increases the risk that your baby will weigh more than 4 kg (9lbs) and will have a difficult delivery. Gestational diabetes can also increase the risk of your baby becoming overweight and developing type 2 diabetes in the future.
What does gestational diabetes mean for me?
A diagnosis of gestational diabetes means you will be working closely with your health-care team to manage your blood glucose (sugar) levels and keep them in the target range. This will help you avoid complications in labour and delivery. After your baby is born, blood glucose (sugar) levels will usually return to normal. However, you are at greater risk for gestational diabetes in your next pregnancy and of developing type 2 diabetes in the future.
Risk factors for gestational diabetes
Being:
35 years of age or older
From a high-risk group (Aboriginal, Hispanic, South Asian, Asian and African)
Obese (BMI of 30kg/m2 or higher)
Giving birth to a baby that weighed more than four kilograms (nine pounds)
Using: Corticosteroid medication
Having: Prediabetes
Gestational diabetes in a previous pregnancy A parent, brother or sister with type 2 diabetes
Polycystic ovary syndrome (PCOS) or acanthosis nigricans (darkened patches of skin)
How is gestational diabetes managed?
Choose a healthy diet
Enjoy foods from all four of the food groups and spread out your foods by eating smaller meals and snacks. This will help you manage your blood glucose (sugar) levels and provide the best nutrition for you and your growing baby.
Achieve a normal pregnancy weight gain
The amount of weight you gain will vary depending on your weight before your pregnancy. Weight loss is not recommended. Talk to your health-care provider about appropriate weight gain for you.
Be physically active
Regular physical activity can help control your blood glucose (sugar) levels. It can also help you:
1. Boost your energy
2. Sleep better
3. Reduce stress
4. Reduce pregnancy discomfort
5. Prepare for childbirth
6. Get your body back faster after childbirth
Talk to your health-care provider about the right type and amount of activity for you.
Check your blood glucose at home
Checking your blood glucose (sugar) with a blood glucose (sugar) meter will help you and your health-care team manage your gestational diabetes.
Take insulin, if needed
Sometimes healthy eating and physical activity are not enough to manage blood glucose (sugar) levels and your health-care provider may recommend insulin injections for the duration of your pregnancy. Insulin will help keep your blood glucose (sugar) level within your target range. This will help to keep you and your baby in good health.
Your health-care team can answer your questions and support you through this important time in your life. Your team may include your doctor, nurse and dietitian, but remember: the most important member of your health-care team is you!
Managing Diabetes
People with diabetes can expect to live active, independent and vital lives if they make a lifelong commitment to careful diabetes management.
Key elements in diabetes management
· Education: Diabetes education is an important first step. All people with diabetes need to be informed about their condition.
· Physical activity: Regular physical activity helps your body lower blood glucose levels, promotes weight loss, reduces stress and enhances overall fitness.
· Nutrition: What, when and how much you eat all play an important role in regulating blood glucose levels.
· Weight management: Maintaining a healthy weight is especially important in the management of type 2 diabetes.
· Medication: Type 1 diabetes is always treated with insulin. Type 2 diabetes is managed through physical activity and meal planning and may require medications and/or insulin to assist your body in controlling blood glucose more effectively.
· Lifestyle management: Learning to reduce stress levels in day-to-day life can help people with diabetes better manage their disease.
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Blood pressure: High blood pressure can lead to eye disease, heart disease, stroke and kidney disease, so people with diabetes should try to maintain a blood pressure level at or below 130/80. To do this, you may need to change your eating and physical activity habits and/or take medication
LIVING WITH PREDIABETES
It is estimated that more than 5.7 million Canadians have prediabetes. Prediabetes refers to blood glucose levels that are higher than normal, but not yet high enough to be diagnosed as type 2 diabetes (i.e. a fasting blood glucose level of 7.0 mmol/L or higher). Nearly 50 per cent of those with prediabetes will go on to develop type 2 diabetes.
It is important to know if you have prediabetes, because research has shown that some long-term complications associated with diabetes—such as heart disease and nerve damage—may begin during prediabetes. Prediabetes offers a warning and gives us a chance to change the future.
Risk factors
Like type 2 diabetes, prediabetes can occur without you knowing it, so being aware of your risks and getting tested are important. This is especially true if you have prediabetes as part of the “metabolic syndrome,” meaning you also have high blood pressure, high levels of LDL cholesterol (the “bad” cholesterol) and triglycerides, low levels of HDL cholesterol (the “good” cholesterol) and excess fat around the waist.
The risk for type 2 diabetes is higher as you grow older, so the Canadian Diabetes Association recommends screening by testing fasting plasma glucose for everyone once they reach age 40 and every three years after that. If you have risk factors that increase the likelihood of developing type 2 diabetes, you should be tested more frequently or start regular screening earlier.
Ray of Hope
Research has shown that if you take steps to manage your blood glucose when you have prediabetes, you can delay or prevent type 2 diabetes from developing. You may be able to reduce blood glucose (sugar) levels with simple lifestyle changes, such as increasing your physical activity and enjoying a healthy, low-fat meal plan.
Losing even a modest amount of weight (five to 10 per cent of total body weight) through healthy eating and regular physical activity can make a huge difference in your health and quality of life.
When lifestyle changes are not enough to normalize blood glucose, your health-care provider might recommend that you use oral medication.
If you have prediabetes, you are at increased risk for heart disease or stroke. Your doctor may wish to also treat or counsel you about cardiovascular risk factors such as tobacco use, high blood pressure and high cholesterol.
The important thing to remember about prediabetes is that it doesn’t always lead to diabetes. If you have prediabetes, taking steps to manage your blood glucose gives you a chance to change your future to one that does not include type 2 diabetes.
It is important to be tested for diabetes if you are at risk. If left untreated or improperly managed, diabetes can result in a variety of complications, including heart attack, stroke, kidney failure, blindness, problems with erection (impotence) and amputation.
Complications of Diabetes
Anxiety disorders can be increased in individuals with diabetes compared with the general population and potentially impacts blood sugar control.
Celiac disease is a digestive disorder that commonly appears in people with type 1 diabetes.
Depression is more common in people with diabetes compared to the general population.
When you are first diagnosed with diabetes, it is normal to feel a wide range of emotions.
Eating disorders can lead to poor metabolic control, dangerously high or low blood sugar and long-term complications such as eye, kidney and nerve damage.
Good eye care is important for people with diabetes to prevent or delay eye damage (diabetic retinopathy).
People with diabetes are at very high risk of heart disease and stroke. Ask your doctor about the ABCDEs to reduce your risk. See February’s posting.
When blood pressure is high, it puts stress on the body. People with diabetes should have their blood pressure checked every time they visit their health-care team. Ideal is less than 130/80.
About one-third of people who have had diabetes for over 15 years will develop kidney disease, but good diabetes management and regular screening can prevent or delay the loss of kidney function.
Erectile dysfunction is a common sexual problem in men with diabetes. The first step in getting help is talking to your doctor.
Nerve damage is a long-term complication of diabetes. Exposure to high blood glucose (sugar) levels over an extended period of time causes damage to peripheral nerves.
LIVING WITH DIABETES
Taking Your Insulin - All people with type 1 diabetes and many with type 2 diabetes need insulin to manage their blood glucose (sugar) levels.
Dental Hygiene - Dental health is important for everyone, but poorly managed blood glucose (sugar) levels can lead to many dental problems.
Healthy Eating - Eating healthy meals and snacks is key to your well-being. Learn about portion control, meal planning, fats and more.
Physical Activity - Maintaining a combination of aerobic activity and resistance exercise is key to weight control and diabetes management.
Taking Care of your Feet - Foot problems are common in people with diabetes and can lead to serious complications, so good foot health is essential.
Ward off Heart Disease- Keep your heart healthy! Learn more about quitting smoking and managing your blood pressure.
Predisposition - Certain ethnic groups are at a higher risk of developing type 2 diabetes and its complications than the general population.
Weight Management - Maintaining a healthy weight can improve your overall health. Do you know your Body Mass Index (BMI) and waist circumference?
The health tips on this website are for informational purposes only, and they are not intended to be a substitute for professional medical advice.
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References
Canadian Diabetes Association
http://www.diabetes.ca/diabetes-and-you/living-with-type-2-diabetes
