Frequently Asked Questions about Diabetes

Can diabetes go away?
Currently no cure exists for diabetes. Type 1 diabetes is a deficiency of the pancreas to produce insulin, so insulin injections are necessary to sustain life. Type 2 diabetes is more common; the pancreas can produce some insulin, but not enough for the diet and size of the body, and/or the insulin functions poorly due to insulin resistance. Research has shown that healthy lifestyle changes such as weight loss and exercise can decrease the need for medication for type 2 diabetes. Even if symptoms diminish and blood glucose measures normal, the disease is still present. Your risk of complications of diabetes is lower if your blood glucose control is improved.

Do I have to give up sugar?
No, you can find a way to use sugar sparingly in your diet. Sugar is a carbohydrate, and all carbohydrates raise blood sugar. The amount and type of carbohydrate, as well as what else you eat with it, will alter the rise of blood sugar in speed and level. The goal of blood glucose control is to keep blood sugar between 90 and 140 mg/dl.  A healthy balanced diet, portion control and blood sugar monitoring can help you achieve these goals while including most foods in your diet.  Some people use the glycemic index of foods to better understand the effect of food on their blood glucose. 

What are the signs of diabetes?
Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all.

Do I have to take insulin?
People with type 1 diabetes must take insulin to sustain life. People with type 2 diabetes either produce inadequate insulin or have insulin resistance (which means the cells have difficulty responding to insulin) or both. Treatment for type 2 usually begins with a change in diet and exercise. However, very overweight, inactive newly diagnosed people with diabetes may have such a high blood glucose level that they may initially need insulin to bring blood glucose under control. Many people with type 2 diabetes can manage their diabetes with lifestyle changes and oral medications. Diabetes is a progressive disease, and in spite of a person’s best efforts, he may need insulin to control blood glucose at some time.

Does diabetes cause other complications?
If blood sugar is not kept in check, diabetes can lead to a number of serious complications, including heart attacks, strokes, kidney disease, blindness, blood vessel disease that can require amputations, nerve damage and impotence in men. However, a recent study conducted over a 10-year period showed that patients can reduce the risk of complications by 50% or more when their blood sugar measures as close to normal as possible.

If diabetes is not managed, what problems might occur?
Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, and heart, gums and teeth. If you have diabetes, you are more likely than someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others.

The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure, and cholesterol and avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health.

Can diabetes be prevented?
The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that making modest lifestyle changes can prevent or delay type 2 diabetes in people at risk for the disease.
In the Diabetes Prevention Program (DPP), a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases, researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week.
The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent.

How do I prepare for sudden illnesses?
When you are sick, the body releases hormones that can raise blood glucose and make it harder to keep in check. Discuss a “Sick Day Plan” with your doctor. If on insulin, continue to take it - as well as check your blood glucose more often. You should have urine strips to check your urine for ketones. Oral medications for diabetes may or may not be discontinued, depending on your doctor`s advice. Check your over-the-counter medications for sugar and be aware that other cold care products can raise or lower your blood sugar. Keep your blood sugar log handy so when you call the doctor, you can provide him/her with useful information.

How does my blood pressure affect diabetes?
High blood pressure poses a risk for strokes. Since diabetics have a higher risk for strokes, you should check your blood pressure twice a year. If your blood pressure is higher than 130/80, discuss it with your doctor. If pressure remains high, consider treatment options such as a low-sodium diet, increased exercise and/or taking blood pressure medication.

How is diabetes diagnosed?
Diabetes is diagnosed when a blood glucose test measures more than 126 mg/dl (fasting) or 200 mg/dl (two hours after consuming a glucose drink) or a random blood glucose over 200 with diabetic symptoms. The test should be repeated to confirm results. Some doctors may order a glucose tolerance test, in which you drink a glucose solution and have your blood sugar tested before and every hour after for 4 hours. The hemoglobin A1C test is now approved for diagnosing diabetes (now used for diabetes management). An “A 1C” of 6.5 percent or greater is an indication of diabetes. People with risk factors for diabetes - family history, excess weight, high LDL cholesterol, and high triglycerides - should be tested regularly.

How often should I check my blood glucose?
To be sure, ask your doctor how often you should check your blood glucose. If you are treating your diabetes through diet and exercise or oral medication, diet and exercise, you should probably check your blood glucose level at least twice daily. If you take insulin, check your blood glucose four times daily. This will help you assess how well your meal and exercise plan and medication are working to stabilize blood sugar. Blood sugar levels of 180 two hours after eating or above 140 before eating are considered high.

What types of exercise should I do, and how often?
People with diabetes should do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements.
do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week.
stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity.
Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.)

How should I take care of my eyes and feet?
As a diabetic, you risk eye and foot problems, so check both regularly. In particular, it is critical that you get a yearly eye exam that includes dilating your pupils to detect signs of eye disease. Diabetics face a higher risk of eye complications, such as retinopathy, macular edema, and cataracts.

Your doctor should check your feet at least once a year. Symptoms of foot problems can include decreased feeling in the feet, cramps when walking, cuts and scratches that heal slowly, redness in the feet when sitting and whiteness when propped up, lack of hair growth on legs and feet and leg or feet pain. Doctors advise daily checks for cuts or injuries in order to prevent infection or other problems.

What should my HemoglobinA1c (HgA1c or A1C) level be?
Ideally, your A1c should measure below seven. If it measures above seven and closer to eight or above, you may need to make changes in your treatment plan. To track your progress, you should get your hemoglobin A1c tested two to four times per year. (Hemoglobin A1c measures blood glucose control over a 2-3 month period.)

If I have diabetes, should I avoid all sweets and sugars?
If you have diabetes you should limit the amount of fats and sweets you eat. These foods have calories, but not much nutrition. Some contain saturated fats and cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and keep your blood glucose and blood fats under control.
It is okay to have sweets once in a while. Try having sugar-free popsicles, diet soda, fat-free ice cream or frozen yogurt, or sugar-free hot cocoa mix to satisfy a "sweet tooth." Remember, fat-free and low sugar foods still have calories. Talk with your diabetes educator about how to fit sweets into your meal plan.

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