Learning About Diabetes

Diabetes is a chronic disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy. About 16 million Americans have diabetes (6% of the population). Of that 16 million, about 5.4 million do not know that they have the disease.

Type 1 diabetes develops when the body no longer makes insulin and accounts for 5-10% of all cases of diabetes. Type 2 diabetes develops when insulin is not properly used by the body and accounts for 90-95 percent of all cases. Gestational diabetes can occur in women who are pregnant when the pregnancy hormones affect the way that the body uses insulin.

Signs and symptoms of diabetes are associated with a rise in blood sugar levels and include fatigue, increased thirst, increased urination and blurred vision. In addition to elevated blood sugar many individuals will also have elevated blood pressure and blood lipids (cholesterol and triglycerides), and may struggle controlling their weight.

Diabetes is managed though food intake, exercise and medication as needed. Ongoing monitoring of how well the diabetes is controlled and methods to manage the disease usually change over time.

Individuals newly diagnosed with diabetes are usually delighted to learn that healthy eating to control blood sugar is what everyone should be eating to maintain good health. The focus today is on eating a wide variety of food, eating several smaller meals throughout the day, distributing carbohydrate foods across the day for energy, using unsaturated fats and filling up on high fiber foods. Gone are the days of severe restrictions with lists of “forbidden” foods. Maintaining weight or a gradual loss of 10 to 20 pounds helps most people gain better control of their blood sugar. Sweets in small portions can be used as part of a balanced diet. Most people avoid “super” sweets like regular soda because of their rapid rise in blood sugar levels.

Great Food Choices include:

• Whole Grains — packed with energy and fiber they provide the fuel for an active lifestyle. Whole wheat breads and pasta, whole grain cereals and brown rice are good examples.
• Fresh Fruit — loaded with vitamins, minerals, fiber, antioxidents and phytochemicals, this carbohydrate source provides energy while maintaining good health. Small amounts eaten through the day will limit the rise in blood sugar from this carbohydrate source.
• Vegetables — like their counterpart fruit, vegetables provide plenty of nutrients. Their lower carbohydrate and calorie content is an added benefit. A generous portion at most meals add the color crunch and flavor to round out a meal. A variety of fresh, frozen or “No added salt” canned vegetables are also good to have available.
• Lean Protein — protein is a necessary nutrient in our healthy diet. The trick is getting the protein without a high dose of animal fat (saturated fat) that often comes with it. Excellent lean proteins include skinless chicken and turkey, fish, soy products, lean cuts of beef or pork and low-fat cheese.
• Fats — the monounsaturated fats are the best choice in this category. Olive and canola oil, avocados, nuts and nut butters are good examples. Limiting use of saturated fats that raise cholesterol levels is important. Saturated (animal) fats to avoid include: butter, cream, lard, shortening and bacon fat. In addition, palm and coconut oil are also saturated.

Exercise or activity is a powerful tool in maintaining good health. Not only does exercise reduce insulin resistance and lower blood sugar, it helps manage your weight, lower cholesterol and blood sugar, it helps manage your weight, lower cholesterol and blood pressure, strengthen muscles, relieve stress and improve self-confidence and self-esteem. With all of those benefits, setting aside 30 minutes 5 days a week to “move” is hard to resist. Walking, biking, swimming, dancing, and skating are all examples of great aerobic exercises.

Despite the best efforts to control diabetes with diet and exercise, many individuals still may need medications to address the problems associated with the production or use of the hormone insulin.

Type 2 diabetes is associated with “insulin resistance” or “decreased insulin production.” Insulin resistance is the inability of the cells in the body to take up and use insulin. If the cells are not able to use the insulin then glucose (sugar) is not used either. There are several medications available today that improve insulin sensitivity.

Decreased insulin production occurs gradually. Initially, changes in diet and exercise can help the body compensate for the reduced insulin production. Eventually most individuals will need help making more insulin or need to take injections of insulin. There are several medications that increase insulin release.

Type 1 diabetes develops when the beta cells of the pancreas stop producing insulin. This results in an individuals absolute dependence on taking insulin injections to survive. There are many formulations of insulin that can be used to fit each persons lifestyle and needs. Insulin is not a “one-size-fits-all” type of medication. The type of insulin and timing of injections is tailored for each individual. Even the way to inject the insulin varies from person to person. The traditional syringe is often replaced with reusable or disposable pens or even the insulin pump, and possibly soon inhaled insulin.

Diabetes lasts a lifetime so one of the biggest challenges is staying abreast of all that is new in the treatment of diabetes. Educating one self, family and friends can help manage all the aspects of this chronic disease. Armed with information you can make the wisest decisions on how to manage diabetes and live a healthy life.

The Diabetes Care Team provides support and education though certified diabetes educators, nurses and dietitians. They provide regular classes and seminars to help individuals monitor and control their diabetes. This department has been a service available at Longmont Clinic since 1994.