What is Diabetes

Diabetes is a metabolic disorder that effects the body's ability to produce and use insulin. When we eat, glucose is absorbed in the body from the intake of carbohydrates. Glucose is extremely important for energy, our muscle cells use it to walk, our brain cells use it to think and our nerve cells use it to feel. All of our cells in our body need glucose for energy. Glucose remains in the bloodstream until being brought to the cells by a hormone called insulin. Insulin is produced in the beta cells of the pancreas and is the key that unlocks the door so that glucose can enter the cells. Once glucose enters the cell, it is changed into energy and used by the body or is stored for later use in the form of glycogen or fat. In diabetes, there is either no insulin produced or there is not enough insulin. The body may also not be able to use it efficiently. When there is a lack of insulin, glucose builds up in the blood stream, causing hyperglyemia. 

 

How is it diagnosed?

A normal fasting blood sugar should be 70-110. Impaired fasting should be 111-125. To be diagnosed with diabetes, a fasting blood sugar over 126 needs to occur twice. A blood sugar (not fasting) over 200 would also be criteria if the patient has symptoms. 

 

What are the risk factors?

1. Family history, weight, race, age, pregnancy, trauma, stress

2. Overweight/ central obesity

3. Inactivity

4. High triglycerides

5. Pima Indians, Asian, Hispanic, African and Native American's

6. History of large babies

7. Gestational diabetes during pregnancy

 

Type I Diabetes:

This type of diabetes occurs when the pancreas is unable to produce insulin. 5-10% of patients have this absolutely insulin deficiency. People with this type of diabetes are usually diagnosed early in life, but some have an initial onset in their early 40's. It develops suddenly and hereditary and weight do not play a role. The only treatment for this type of diabetes is insulin. Patients must always check their blood sugars to make sure that they are in normal range and are being controlled by their insulin. 

 

Type II Diabetes:

This type of diabetes occurs when something is wrong with the cell membrane leading to increased resistance to insulin or there is decreased production of insulin by the pancreas. About 90% of patients have this type. It develops gradually and usually after age 40. 80% of type II diabetics are overweight. While lifestyle changes can better control the disease, insulin is usually still needed to keep the blood sugar in track. 

 

Hyperglycemia:

Hyperglycemia is when the blood sugar is over 200. Reasons for hyperglycemia could be not enough insulin, too much food, infection, emotional stress, poor food choices or forgetting medication. Symptoms include extreme thirts, frequent urination, dry skin, hunger, blurred vision, drowsiness, decreased healing, frequent infections, weight loss, fatigue, muscle cramps and impotence. The treatment is to test blood sugar frequently and to call the doctor over 300mg/dl. 

 

Hypoglycemia:

Hypoglycemia is a diabetic emergency and occurs when the blood sugar drops below 70. Symptoms include shakiness, sweating, confusion, irritability, blurred vision, rapid heart rate, lightheadedness, nausea, headaches, weakness, lack of coordination, seizures, and tingling in the lips and tongue. Treatment is to take 15-20 grams of glucose. Recheck blood sugar after 15 minutes and take another 15 g of gucose if still low. After a normal reading, eating a small snack is important. 

 

What is healthy eating for a diabetic?

There are two things that decrease blood sugar (exercise and medicine) and one thing to increase it (food). Focusing on what you eat is critical to a diabetic patient. They should eat on a regular schedule, not skip meals, eat similar amounts of carbohydrates at each meal and eat every 3-4 hours. Breakfast should include 45 grams carbohydrate, 1 oz protein and 5 grams of fat. A snack between breakfast and lunch and lunch and dinner should be 15 g of carbohydrate. Lunch should include 45 g of carbohydrate, 2 oz protein and 5 grams of fat. Dinner should include 45 g carbohydrate, 3 oz protein, and 10 g of fat.  Good carbohydrates are whole grain flours, whole grains (such as brown rice), whole-grain bread, baked sweet potato, corn tortillas, etc. Good vergetable carbohydrates include fresh vegetables, plain frozen vegetables, low sodium or unsalted canned vegetables, lettuces, kale, spinach and arugula. Good fruit carbohdyrates include plain frozen fruit, fresh fruit, sugar free fruit and 100% fruit juice. Milk, yogurt and cheese should be low fat or non fat. Protein should be lean meats that are baked and grilled, not fried. Fats should be unsaturated and this includes nuts and olive oil. At least half of the grains each day should be 100% whole grain. A daily meal plan should also include 25 mg of fiber for women and 38 mg for men. Total calories for women should be around 1500 calories and for men it should be 1800 calories.