If you or someone you care for has recently been diagnosed with diabetes, you are no doubt experiencing a range of emotions. Fear, anger, denial, frustration, depression and uncertainty are just a few, and are very common. You are not alone. Don't panic. Diabetes is serious, but people with diabetes can live long, healthy, happy lives. This section of our Learning Center can help ease your fears and teach you more about living with diabetes and caring for someone with diabetes.
Click on the links below for a wealth of information that will help you better understand and manage your diabetes:
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Common misconceptions about diabetes 1. You can catch diabetes from someone else.No. Although we don't know exactly why some people develop diabetes, we know diabetes is not contagious. It can't be caught like a cold or flu. 2. People with diabetes can't eat sweets or chocolate.If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more "off limits" to people with diabetes, than they are to people without diabetes. 3. Eating too much sugar causes diabetes.No. Diabetes is caused by a combination of genetic and lifestyle factors. However, being overweight does increase your risk for developing type 2 diabetes. If you have a history of diabetes in your family, eating a healthy meal plan and regular exercise are recommended to manage your weight. 4. People with diabetes should eat special diabetic foods.A healthy meal plan for people with diabetes is the same as that for everyone - low in fat (especially saturated and trans fat), moderate in salt and sugar, with meals based on whole grain foods, vegetables and fruit. Diabetic and "dietetic" versions of sugar-containing foods offer no special benefit. They still raise blood glucose levels, are usually more expensive and can also have a laxative effect if they contain sugar alcohols. 5. You should only eat small amounts of starchy foods, such as bread, potatoes and pasta.Starchy foods are part of a healthy meal plan. What is important is the portion size. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. The key is portions. For most people with diabetes, having 3-4 servings of carbohydrate-containing foods is about right. Whole grain starchy foods are also a good source of fiber, which helps keep your gut healthy. 6. People with diabetes are more likely to get colds and other illnesses.No. You are no more likely to get a cold or another illness if you have diabetes. However, people with diabetes are advised to get flu shots. This is because any infection interferes with your blood glucose management, putting you at risk of high blood glucose levels and, for those with type 1 diabetes, an increased risk of ketoacidosis. 7. Insulin causes atherosclerosis (hardening of the arteries) and high blood pressure.No, insulin does not cause atherosclerosis. In the laboratory, there is evidence that insulin can initiate some of the early processes associated with atherosclerosis. Therefore, some physicians were fearful that insulin might aggravate the development of high blood pressure and hardening of the arteries. But it doesn't. 8. Insulin causes weight gain, and because obesity is bad for you, insulin should not be taken.Both the UKPDS (United Kingdom Prospective Diabetes Study) and the DCCT (Diabetes Control & Complications Trial) have shown that the benefit of glucose management with insulin far outweighs (no pun intended) the risk of weight gain. 9. Fruit is a healthy food. Therefore, it is ok to eat as much of it as you wish.Fruit is a healthy food. It contains fiber and lots of vitamins and minerals. Because fruit contains carbohydrate, it needs to be included in your meal plan. Talk to your dietitian about the amount, frequency and types of fruits you should eat. 10. You don't need to change your diabetes regimen unless your A1C is greater than 8%The better your glucose control, the less likely you are to develop complications of diabetes. An A1C in the sevens (7s), however, does not represent good control. The ADA goal is less than 7 percent. The closer your A1C is to the normal range (less than 6 percent), the lower your chances of complications. However, you increase your risk of hypoglycemia, especially if you have type 1 diabetes. Talk with your health care provider about the best goal for you. |
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Diabetes-related health concerns 1. How can diabetes affect cardiovascular health?Cardiovascular disease is the leading cause of early death among people with diabetes. Adults with diabetes are two to four times more likely than people without diabetes to have heart disease or experience a stroke. At least 65% of people with diabetes die from heart disease or stroke. About 70% of people with diabetes also have high blood pressure. 2. How are cholesterol, triglyceride, weight, and blood pressure problems related to diabetes?People with type 2 diabetes have high rates of cholesterol and triglyceride abnormalities, obesity, and high blood pressure, all of which are major contributors to higher rates of cardiovascular disease. Many people with diabetes have several of these conditions at the same time. This combination of problems is often called metabolic syndrome (formerly known as Syndrome X). The metabolic syndrome is often defined as the presence of any three of the following conditions: 1) excess weight around the waist; 2) high levels of triglycerides; 3) low levels of HDL, or "good," cholesterol; 4) high blood pressure; and 5) high fasting blood glucose levels. If you have one or more of these conditions, you are at an increased risk for having one or more of the others. The more conditions that you have, the greater the risk to your health. 3. How can I be "heart healthy" and avoid cardiovascular disease if I have diabetes?To protect your heart and blood vessels, eat right, get physical activity, don't smoke, and maintain healthy blood glucose, blood pressure, and cholesterol levels. Choose a healthy diet, low in salt. Work with a dietitian to plan healthy meals. If you're overweight, talk about how to safely lose weight. Ask about a physical activity or exercise program. Quit smoking if you currently do. Get a hemoglobin A1C test at least twice a year to determine what your average blood glucose level was for the past 2 to 3 months. Get your blood pressure checked at every doctor's visit, and get your cholesterol checked at least once a year. Take medications if prescribed by your doctor. 4. How can diabetes affect the eyes?In diabetic eye disease, high blood glucose and high blood pressure cause small blood vessels to swell and leak liquid into the retina of the eye, blurring the vision and sometimes leading to blindness. People with diabetes are also more likely to develop cataracts - a clouding of the eye's lens, and glaucoma - optic nerve damage. Laser surgery can help these conditions. 5. How can I keep my eyes healthy if I have diabetes?There's a lot you can do to prevent eye problems. A recent study shows that keeping your blood glucose level closer to normal can prevent or delay the onset of diabetic eye disease. Keeping your blood pressure under control is also important. Finding and treating eye problems early can help save sight. It is best to have an eye doctor give you a dilated eye exam at least once a year. The doctor will use eye drops to enlarge (dilate) your pupils to examine the backs of your eyes. Your eyes will be checked for signs of cataracts or glaucoma, problems that people with diabetes are more likely to get. Because diabetic eye disease may develop without symptoms, regular eye exams are important for finding problems early. Some people may notice signs of vision changes. If you're having trouble reading, if your vision is blurred, or if you're seeing rings around lights, dark spots or flashing lights, you may have eye problems. Be sure to tell your health care team or eye doctor about any eye problems you may have. 6. How can diabetes affect the kidneys?In diabetic kidney disease (also called diabetic nephropathy), cells and blood vessels in the kidneys are damaged, affecting the organs' ability to filter out waste. Waste builds up in your blood instead of being excreted. In some cases this can lead to kidney failure. When the kidneys fail, a person has to have his or her blood filtered through a machine (a treatment called dialysis) several times a week, or has to get a kidney transplant. 7. How can I keep my kidneys healthy if I have diabetes?There's a lot you can do to prevent kidney problems. A recent study shows that controlling your blood glucose can prevent or delay the onset of kidney disease. Keeping your blood pressure under control is also important. Diabetic kidney disease happens slowly and silently, so you might not feel that anything is wrong until severe problems have developed. Therefore, it is important to get your blood and urine checked for kidney problems each year. Your doctor can learn how well your kidneys are working by testing every year for microalbumin (a protein) in the urine. Microalbumin in the urine is an early sign of diabetic kidney disease. Your doctor can also do a yearly blood test to measure your kidney function. Go to the doctor if you develop a bladder or kidney infection; symptoms include cloudy or bloody urine, pain or burning when you urinate, an urgent need to urinate often, back pain, chills, or fever. 8. How can diabetes affect nerve endings?Having high blood glucose for many years can damage the blood vessels that bring oxygen to some nerves, as well as the nerve coverings. Damaged nerves may stop sending messages, or send messages too slowly or at the wrong times. Numbness, pain, and weakness in the hands, arms, feet and legs may develop. Problems may also occur in various organs, including the digestive tract, heart and sex organs. Diabetic neuropathy is the medical term for damage to the nervous system from diabetes. The most common type is peripheral neuropathy, which affects the arms and legs. An estimated 50% of those with diabetes have some form of neuropathy, but not all with neuropathy have symptoms. People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater the risk. The highest rates of neuropathy are among people who have had the disease for at least 25 years. Diabetic neuropathy also appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40. 9. How can I prevent nerve damage if I have diabetes?You can help keep your nervous system healthy by keeping your blood glucose as close to normal as possible, getting regular physical activity, not smoking, taking good care of your feet each day (see below), having your health care provider examine your feet at least 4 times a year, and getting your feet tested for nerve damage at least once a year. 10. Why is it especially important to take care of my feet if I have diabetes?Nerve damage, circulation problems, and infections can cause serious foot problems for people with diabetes. Sometimes nerve damage can deform or misshape your feet, causing pressure points that can turn into blisters, sores, or ulcers. Poor circulation can make these injuries slow to heal. Sometimes this can lead to amputation of a toe, foot, or leg. 11. What should I look for when I check my feet regularly?Look for cuts, cracks, sores, red spots, swelling, infected toenails, splinters, blisters, and calluses on the feet each day. Call your doctor if such wounds do not heal after one day. If you have corns and calluses, ask your doctor or podiatrist about the best way to care for them. Wash your feet in warm, not hot, water and dry them well. Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board. Rub lotion on the tops and bottoms of feet-but not between the toes-to prevent cracking and drying. Wear shoes that fit well. Break in new shoes slowly, by wearing them 1 to 2 hours each day for the first 1 to 2 weeks. Wear stockings or socks to avoid blisters and sores. Wear clean, lightly padded socks that fit well; seamless socks are best. Always wear shoes or slippers, because when you are barefoot it is easy to step on something and hurt your feet. Protect your feet from extreme heat and cold. When sitting, keep the blood flowing to your lower limbs by propping your feet up and moving your toes and ankles for a few minutes at a time. Avoid smoking, which reduces blood flow to the feet. Keep your blood sugar, blood pressure, and cholesterol under control by eating healthy foods, staying active, and taking your diabetes medicines. 12. How can diabetes affect the digestion?Gastroparesis, otherwise known as delayed gastric emptying, is a disorder where, due to nerve damage, the stomach takes too long to empty itself. It frequently occurs in people with either type 1 or type 2 diabetes. Symptoms of gastroparesis include heartburn, nausea, vomiting of undigested food, an early feeling of fullness when eating, weight loss, abdominal bloating, erratic blood glucose levels, lack of appetite, gastroesophageal reflux, and spasms of the stomach wall. 13. How can diabetes affect oral health?Because of high blood glucose, people with diabetes are more likely to have problems with their teeth and gums. And like all infections, dental infections can make your blood glucose go up. Sore, swollen, and red gums that bleed when you brush your teeth are a sign of a dental problem called gingivitis. Another problem, called periodontitis, happens when your gums shrink or pull away from your teeth. People with diabetes can have tooth and gum problems more often if their blood glucose stays high. Also, smoking makes it more likely for you to get a bad case of gum disease, especially if you have diabetes and are age 45 or older. People with diabetes are also prone to other mouth problems, like fungal infections, poor post-surgery healing, and dry mouth. 14. How can I keep my mouth, gums, and teeth healthy if I have diabetes?You can help maintain your oral health by keeping your blood glucose as close to normal as possible, brushing your teeth at least twice a day, and flossing once a day. Keep any dentures clean. Get a dental cleaning and exam twice a year, and tell your dentist that you have diabetes. Call your dentist with any problems, such as gums that are red, sore, bleeding, or pulling away from the teeth; any possible tooth infection; or soreness from dentures. 15. How can diabetes affect my sexual response?Many people with diabetic nerve damage have trouble having sex. For example, men can have trouble maintaining an erection and ejaculating. Women can have trouble with sexual response and vaginal lubrication. Both men and women with diabetes can get urinary tract infections and bladder problems more often than average. 16. How can diabetes affect my mood?Several studies suggest that diabetes doubles the risk of depression, although it's still unclear why. The psychological stress of having diabetes may contribute to depression, but diabetes' metabolic effect on brain function may also play a role. At the same time, people with depression may be more likely to develop diabetes. The risk of depression increases as more diabetes complications develop. When you are depressed, you do not function as well, physically or mentally; this makes you less likely to eat properly, exercise, and take your medication regularly. Psychotherapy, medication, or a combination of both can treat depression effectively. In addition, studies show that successful treatment for depression also helps improve blood glucose control. 17. How does diabetes affect how I respond to a cold or flu?Being sick by itself can raise your blood glucose. Moreover, illness can prevent you from eating properly, which further affects blood glucose. In addition, diabetes can make the immune system more vulnerable to severe cases of the flu. People with diabetes who come down with the flu may become very sick and may even have to go to a hospital. You can help keep yourself from getting the flu by getting a flu shot every year. Everyone with diabetes-even pregnant women-should get a yearly flu shot. The best time to get one is between October and mid-November, before the flu season begins.
18. What should I do when I am sick?Be sure to continue taking your diabetes pills or insulin. Don't stop taking them even if you can't eat. Your health care provider may even advise you to take more insulin during sickness. Test your blood glucose every four hours, and keep track of the results. Drink extra (calorie-free) liquids, and try to eat as you normally would. If you can't, try to have soft foods and liquids containing the equivalent amount of carbohydrates that you usually consume. Weigh yourself every day. Losing weight without trying is a sign of high blood glucose. Check your temperature every morning and evening. A fever may be a sign of infection. Call your health care provider or go to an emergency room if any of the following happen to you:
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Exercise and diabetes 1. Why is it important for people with diabetes to be physically active?Physical activity can help you control your blood glucose, weight, and blood pressure, as well as raise your "good" cholesterol and lower your "bad" cholesterol. It can also help prevent heart and blood flow problems, reducing your risk of heart disease and nerve damage, which are often problems for people with diabetes. 2. How much and how often should people with diabetes exercise?Experts recommend moderate-intensity physical activity for at least 30 minutes on 5 or more days of the week. Some examples of moderate-intensity physical activity are walking briskly, mowing the lawn, dancing, swimming, or bicycling.
If you are not accustomed to physical activity, you may want to start with a little exercise, and work your way up. As you become stronger, you can add a few extra minutes to your physical activity. Do some physical activity every day. It's better to walk 10 or 20 minutes each day than one hour once a week. Talk to your health care provider about a safe exercise plan. He or she may check your heart and your feet to be sure you have no special problems. If you have high blood pressure, eye, or foot problems, you may need to avoid some kinds of exercise. 3. What are some good types of physical activity for people with diabetes?Walking vigorously, hiking, climbing stairs, swimming, aerobics, dancing, bicycling, skating, skiing, tennis, basketball, volleyball, or other sports are just some examples of physical activity that will work your large muscles, increase your heart rate, and make you breathe harder - important goals for fitness. In addition, strength training exercises with hand weights, elastic bands, or weight machines can help you build muscle. Stretching helps to make you flexible and prevent soreness after other types of exercise. Do physical activities you really like. The more fun you have, the more likely you will do it each day. It can be helpful to exercise with a family member or friend. 4. Are there any safety considerations for people with diabetes when they exercise?Exercise is very important for people with diabetes to stay healthy, but there are a few things to watch out for. You should avoid some kinds of physical activity if you have certain diabetes complications. Exercise involving heavy weights may be bad for people with blood pressure, blood vessel, or eye problems. Diabetes-related nerve damage can make it hard to tell if you've injured your feet during exercise, which can lead to more serious problems. If you do have diabetes complications, your health care provider can tell you which kinds of physical activity would be best for you. Fortunately, there are many different ways to get exercise. Physical activity can lower your blood glucose too much, causing hypoglycemia, especially in people who take insulin or certain oral medications. Hypoglycemia can happen at the time you're exercising, just afterward, or even up to a day later. You can get shaky, weak, confused, irritable, anxious, hungry, tired, or sweaty. You can get a headache, or even lose consciousness. To help prevent hypoglycemia during physical activity, check your blood glucose before you exercise. If it's below 100, have a small snack. In addition, bring food or glucose tablets with you when you exercise just in case. It is not good for people with diabetes to skip meals at all, but especially not prior to exercise. After you exercise, check to see how it has affected your blood glucose level. If you take insulin, ask your health care provider if there is a preferable time of day for you to exercise, or whether you should change your dosage before physical activity, before beginning an exercise regimen.
On the other hand, you should not exercise when your blood glucose is very high because your level could go even higher. Do not exercise if your blood glucose is above 300, or your fasting blood glucose is above 250 and you have ketones in your urine. When you exercise, wear cotton socks and athletic shoes that fit well and are comfortable. After you exercise, check your feet for sores, blisters, irritation, cuts, or other injuries. Drink plenty of fluids during physical activity, since your blood glucose can be affected by dehydration. |
Weight lossDid you know that nearly 9 out of 10 people with newly-diagnosed type 2 diabetes are overweight? If you are overweight, losing some weight could help you better manage your diabetes. Losing weight and keeping it off is a real challenge for most people. That's why it's important to begin a weight loss program with the help of your health care team, including, if possible, a dietitian. You are most likely to succeed in your weight loss goals if you develop a plan and set realistic goals. Your weight loss goals need to be specific and attainable. This means that they outline exactly what you intend to do and that they are within your reach. For example, a goal of "walk more" is a good idea, but it is not specific. A goal of "run ten miles a day" is specific, but not may not be attainable. A goal of "walk 30 minutes a day, five days a week" is not only specific, but it is also attainable. Learn more about setting your goals. Rewarding yourself for sticking to your weight loss program is a good way to keep yourself motivated. Rewards need to be meaningful and realistic. Focus on giving yourself a reward for each step along the way. For example, reward yourself after sticking to the first week on your diet and exercise regimen. You might buy a new music CD or go to the movies. Bigger rewards, such as tickets to a concert or treating yourself to a vacation or a weekend trip, can be saved for reaching long-term goals. Your healthcare team - your first visitYour first visit to a doctor who will treat your diabetes should have four parts:
You need to be involved in devising your diabetes care plan. Otherwise, it's unlikely that the plan will fit into your life or that you will understand what you need to do. Is your diabetes care plan complete? If so, it should include:
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Our thanks to the American Diabetes Association for portions of this valuable information. More can be found at http://www.diabetes.org/about-diabetes.jsp.
