Priya's written article on diabetes

Priya's written article on diabetes

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  DIABETES Diabetes is achronic, progressive disease characterized by the abnormal metabolism of carbohydrates, proteins and fats leading to hyperglycemic state. The disease is more prevalent among Hispanics, Native Americans, Pacific islanders and African Americans. Frequent urination, excessive thirst and hunger are the main acute symptoms of any type of diabetes. TYPES Diabetes includes 4 clinical classes. A) Type 1: This occurs when the body's immune system attacks and destroys certain cells in the pancreas called beta cells. But when the beta cells are destroyed, no insulin can be produced, and the glucose stays in the blood instead, where it can cause serious damage to all the organ systems of the body. B) Type 2: In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Obesity, weight gain in adulthood and physical inactivity are the environmental factors affecting the progression of diabetes. C) Gestational Diabetes: This is the diabetes developed during the pregnancy. D) Other specific types of diabetes: These are caused by genetic defects in beta- cell function or insulin action, diseases of the pancreas or induced by drugs or chemicals. DIAGNOSING DIABETES- 4 TESTING OPTIONS A1C >6.5% Acute symptoms plus casual plasma glucose >200mg/dL (11.1 mmol/L) Fasting plasma glucose >126 mg/dL (7.0 mmol/L) 2-hour plasma glucose >200 mg/dL (11.1 mmol/L) during OGTT (75-g glucose) DIANOSIS OF PREDIABETES Impaired Fasting Plasma Glucose (IFG) 100gm/dL to 125 gm/dL Impaired Glucose Tolerance (IGT) 2 hours OGTT values of 140mg/dL to 199 mg/dL KEY CONCEPTS AND FACTS ON TYPE 2 DIABETES • Diabetics need to check their blood sugar before and after exercising. Diabetics who do not check their blood sugar run the risk of hypoglycemia. DIABETES AWARENESS FOR YOU AND YOUR FAMILY Priya Merin Mathew, RN, MSN/Ed, CDE, CMSRN
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  • Cautions withdiabetes Medications in older adults: Be aware of how your diabetes medicines affect your kidney and liver functions. Know the signs and symptoms of high and low blood sugar. Older people are more at risk of low sugar while on insulin. • Monitoring total grams of carbohydrate intake is the key strategy in achieving the glucose control. 30-45 grams carbohydrate for females and 45-60gms carbohydrate for males is what the recommended amount. • The energy per gram is as follows: Carbohydrate - 4 Calories, Fats - 9 Calories and Protein - 4 Calories. • It is recommended that persons with diabetes include foods containing 25-30 grams fiber per day. • Many food products containing non-nutritive sweeteners may also contain energy and carbohydrate from other sources that need to be accounted for. Whether you decide to use Stevia or Splenda, you can get health benefits without the risks if you just use a little moderation in your diet. • 150 minutes of accumulated moderate intensity aerobic physical activity per week as well as resistance training (it is a form of strength training in which each effort is performed against a specific opposing force generated by resistance) 3 times per week is recommended for glycemic control and weight loss. • Excessive amounts of alcohol (3 or more drinks per day) on a consistent basis can contribute to high sugars. Moderate amounts of alcohol (less than 1 drink per day for adult women and less than 2 drinks per day for adult men) ingested with food have minimal, if any, effect on glucose and insulin concentrations. • A moderate weight loss of 5% to 10% can reduce the risk of developing type 2 diabetes and improve glycemia in individuals who are insulin resistant and that have pre-diabetes. A healthy eating plan consists of multiple servings of fruits and vegetables, whole grains, legumes, low-fat dairy foods, fish, lean meats, poultry and healthy fats. • Low-carbohydrate meals are not recommended for diabetic persons as foods containing carbohydrates are important components of a healthy eating pattern when consumed in the recommended portions. • Daily Vitamin D supplementation is a vital component that plays a role in many diseases like diabetes and cardiovascular diseases although it has not been prospectively proven. • Women with diabetes must strive for normal sugars during the first 10 weeks after conception to protect the fetus during organogenesis and avoid peri-natal complications and birth defects. • Know your blood cholesterol goal: LDL (bad cholesterol) less than 100mg/dL (if you don’t have heart disease), LDL less than 70mg/dL if you already have heart disease), HDL (good cholesterol) more than 40mg/dL in men and more than 50mg/dL in women, triglycerides less than 150mg/dL. • Get a dilated eye exam by an eye care specialist every year and have a urine test for protein
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  (micro albumin test)done every year. Have a blood test for serum creatinine done at least once a year. • You can help keep your nerves and blood vessels healthy by managing your ABCs– that is, your: A1C Blood pressure Cholesterol level. • You can raise your blood sugar about 50 milligrams of glucose per deciliter (mg/dl) with 15 grams of fast-acting carbohydrate. Examples include 4 glucose tablets, 1/2 cup of fruit juice, 6 or 7 Lifesavers candies, or 1/2 cup of regular soda. • No fruit recommended after 5-6pm (dinner time) and no snack at bedtime unless the bedtime sugar is <110. DIABETES CARE SCHEDULE EVERY 3 MONTHS EVERY 6 MONTHS EVERY YEAR Regular office visits A1C test (If your blood sugar is not stable) Blood pressure check Weight check Foot check A1C test (If your blood sugar is stable) Dental Exam Physical Exam Comprehensive Foot Exam Blood cholesterol and blood fat tests Kidney tests Dilated eye exam Flu shot REFERENCES Common questions about blood sugar (cited 2012 March 8). On the internet at http://www.ghc.org/healthAndWellness/index.jhtml?item=/common/healthAndWellness/conditions/diabet es/monitorFAQ.html. Mensing Carole , RN, MA, CDE, FAADE, “The Art and Science of Diabetes Self-Management Education Desk Reference” by AADE, 2nd edition, 2011; 3-759 American Association of Diabetes Educators. “Caring for your diabetes”, November ’10, pg 3- 26.