Question: What is diabetes?
Answer: Most of the food we eat is turned into glucose (sugar) for our body to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose enter the cells of our bodies. When you have diabetes, your body either does not produce enough insulin, or cannot use the insulin it does produce as well as it should. This causes glucose to build up in your blood. Left untreated, diabetes can cause serious complications including heart disease, blindness, kidney failure, loss of feeling to the hands and feet and lower extremity amputations. Diabetes is the seventh leading cause of death in the North America. Question: What are the types of Diabetes?
Answer: The three main kinds of diabetes are type 1, type 2, and gestational diabetes. Type 1 Diabetes This was formerly called juvenile diabetes or insulin-dependent diabetes. It is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. Treatment for Type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol. Type 1 diabetes may account for 5 to 10 percent of all diagnosed cases of diabetes Type 2 Diabetes This was formerly called adult-onset or non-insulin-dependent diabetes (NIDDM) and is the most common form of diabetes. People can develop Type 2 diabetes at any age, even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Being overweight and inactive increases the chances of developing Type 2 diabetes. Usually treatment ranges from combinations of taking diabetic medicines, making wise food choices, exercising regularly, taking aspirin daily, and controlling blood pressure and cholesterol. Type 2 diabetes may account for about 90 to 95 percent of all diagnosed cases of diabetes Gestational diabetes Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop Type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Question: What causes diabetes?
Answer: . In Type 1 diabetes, the cause is connected to auto-immune, genetic and environmental factors. In Type 2 diabetes, the risk factors include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity and race/ethnicity. Findings indicate African Americans, Hispanic/Latino Americans, American Indians and some Asian Americans and Pacific Islanders are at particularly high risk for Type 2 diabetes. Question: Is there a cure for diabetes? Not at this time. However,
Answer: In response to the growing health burden of diabetes, the diabetic community has three alternatives: prevent diabetes; cure diabetes; and take better care of people with diabetes to prevent devastating complications. The U.S. Department of Health and Human Services is actively pursuing all three approaches. Question: How can type 2 diabetes be prevented?
Answer: Although people with diabetes can prevent or delay complications by keeping blood glucose (sugar) levels close to normal, preventing or delaying the development of Type 2 diabetes in the first place is even better. The results of a major federally funded study, the Diabetes Prevention Program (DPP), show how to do so. This study of 3,234 people at high risk for diabetes showed that moderate diet and exercise resulting in a 5- to 7-percent weight loss can delay and possibly prevent Type 2 diabetes. Study participants were overweight and had higher than normal levels of blood glucose (sugar), a condition called pre-diabetes (impaired glucose tolerance). Both pre-diabetes and obesity are strong risk factors for type 2 diabetes. Since a high risk for diabetes was identified among some minority groups, about half of the DPP participants were African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino. The DPP tested two approaches to preventing diabetes: a healthy eating and exercise program (lifestyle changes), and the diabetes drug metformin. People in the lifestyle modification group exercised about 30 minutes a day 5 days a week (usually by walking) and lowered their intake of fat and calories. Those who took the diabetes drug metformin received standard information on exercise and diet. A third group received only standard information on exercise and diet. The results showed that people in the lifestyle modification group reduced their risk of getting Type 2 diabetes by 58 percent. Average weight loss in the first year of the study was 15 pounds. Lifestyle modification was even more effective in those 60 and older. They reduced their risk by 71 percent. People receiving metformin reduced their risk by 31 percent. Question: What are the signs and symptoms of Type 2 diabetes?
Answer: Many people have no signs or symptoms. Symptoms can also be so mild that you might not even notice them. Nearly six million people in the United States have Type 2 diabetes and do not know it. Here is what to look for:
* Increased thirst
* Increased hunger
* Fatigue
* Increased urination, especially at night
* Weight loss
* Blurred vision
* Sores that do not heal Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as blurry vision or heart trouble. It is important to find out early if you have diabetes because treatment can prevent damage to the body from diabetes. Question: What does it mean to have pre-diabetes?
Answer: It means you are at risk for getting Type 2 diabetes and heart disease. The good news is if you have pre-diabetes you reduce the risk of getting diabetes and even return to normal blood glucose (sugar) levels. With modest weight loss and moderate physical activity, you delay or prevent Type 2 diabetes. Question: Why should I test my blood glucose (sugar) level?
Answer: Testing your blood glucose (sugar) level will show you how food, physical activity and diabetes medications are affecting your blood glucose (sugar). The readings from these tests will help you manage your diabetes day by day, or even hour by hour! Keep a record of your test results to review with your health care provider. By keeping your blood glucose (sugar) level as close to normal as possible, you may also help yourself prevent the onset, or lessen the severity of diabetes-related health complications. Question: What is an A1c (HbA1c) test?
Answer: This is a simple blood test that will show how well you have controlled your blood glucose (sugar) levels over the last 2 - 3 months. The A1c test shows if your average glucose level is too high, or even too low. The National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) recommends that you ask your health care provider for an A1c test at least twice a year, more often if your blood glucose (sugar) level stays too high, or if your treatment plan changes. Question: Why should I pay close attention to the health of my feet?
Answer: Poorly controlled blood glucose (sugar) can cause nerve damage, circulation problems and infections that, in turn, cause serious foot problems for people with diabetes. There is a lot you can do to prevent the onset of these complications. Wash your feet daily and pat them dry, trim your toenails carefully, treat corns and calluses gently, and wear properly fitting shoes. Ask your health care provider to check your feet at least four times a year, and ask if you might benefit from wearing shoes made especially for people with diabetes. Question: What is diabetic retinopathy?
Answer: Diabetic retinopathy is a complication of diabetes that damages the eye’s retina. It affects half of all Americans with diabetes. With timely treatment, blindness can be prevented in a large percentage of those affected. It is very important to have an eye examination through dilated pupils at least once a year. If you notice any change in your vision, talk to your health care provider immediately. Question: What questions should I ask my doctor to help me improve my blood glucose (sugar) control?
Answer: Here are a few questions to guide you.
1. How often, and under what conditions, should I test my blood glucose (sugar)? What should I do with the results? What patterns should I try to achieve?
2. What is my A1c level? (HbA1c is the test that measures your average blood glucose (sugar) level over the previous 2-3 months.)
3. How can I get my A1c into the normal range?
4. What effect has diabetes had on my eyes, heart, kidneys, and feet?
5. Do I have microalbuminuria (the detection of tiny amounts of albumin in urine indicating early kidney disease) as a result of diabetes?
6. How should I take care of my feet?
7. When should I meet with a dietitian to review what I eat?
8. What exercises are best for me? What adjustments to my food or insulin should I make if I plan to exercise?
9. What should my family and friends do if my blood glucose (sugar) drops so low that I need their help?
10. Are there any diabetes support groups I can attend in my area? Question: Where can I get financial assistance for my diabetes care IN THE USA?
Answer: Medicare is a federal program that provides health care services for people aged 65 or older. People who are disabled, or who have become disabled, can also apply for Medicare. Coverage is available for people of all ages with kidney failure. To learn if you are eligible, call the Medicare Hotline listed below. Medicare covers glucose monitors, batteries, test strips, lancets, lancing devices, control solution, insulin pumps, and even insulin when it is used in a pump. Medicaid is a state program that helps pay medical costs for people with low incomes and limited resources. Medicaid programs vary from state to state. Most of your healthcare costs may be covered if you qualify for both Medicare and Medicaid. States also have programs that pay some or all the recipient’s Medicare premiums, and may also pay Medicare deductibles and other co-insurance for those who have Medicare and whose income is below a certain amount. Health Care Providers: Always be honest with your health care providers. Tell them if you are unable to pay for food, medicines or diabetes supplies. Ask them if they know of any local programs that can assist you. Your health care provider may be able to give you information about additional resources, or refer you to a social services program. Question: What are some outside sources for diabetes information?
Answer: National Diabetes Education Program
Faye L. Wong, MPH, RD
Associate Director for Diabetes Education
770-488-5037
(fax) 770-488-5966
flw2@cdc.gov Diabetes Outreach Program
301-496-6110: (fax) 301-496-7422; gallivanj@hq.niddk.nih.gov
American Association of Diabetes Educators
100 West Monroe, 4th Floor
Chicago, IL 60603
800-338-3633 for names of diabetes educators
312-424-2426 to order publications American Diabetes Association
1660 Duke Street
Alexandria VA 22314
800-232-3472 or 703-549-1500
800-ADA-ORDER to order publications toll free
ADA's D.I.A.L. Program (Diabetes Information and Action Line)
800-342-2383 or 800-DIABETES American Dietetic Association
National Center for Nutrition and Dietetics
216 West Jackson Boulevard, Suite 800,
Chicago, IL 60606-6995
800-366-1655 Consumer Nutrition Hotline (Spanish speaker available)
800-745-0775 Medical Eye Care for the Nation's
Disadvantaged Senior Citizens
The Foundation of the American Academy of Ophthalmology
P.O. Box 429098
San Francisco, CA 94142-9098
800-222-EYES (3937) Canadian Diabetes Association
P.O. Box 12013 Station BRM B
Toronto, ON M7Y 2L3
1-800-226-8464
1-416-363-3373
info@diabetes.ca TESTING Your Blood Glucose Levels
You may need to test your own blood glucose (sugar) on a regular basis to help control your diabetes. To control your diabetes, you must know your blood glucose (sugar) numbers. Testing your blood glucose is the only way to know whether your blood glucose is too high, too low, or just right. There are two different tests to measure your blood glucose (sugar):
1. A finger-stick test you do yourself using a blood glucose (sugar) meter that measures your blood glucose at the time you test. For pricing on machines, strips and related supplies click.
2. The hemoglobin A1c test (pronounced he-me-glo-bin A-one-C) measures your blood glucose control over the last 2-3 months. According to the NIDDK (National Institute of Diabetes & Digestive & Kidney Diseases), an A1c test is the best way to know if your blood glucose is under control.
• You need both tests to get a complete picture of your blood glucose control.
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