Blood sugar control is at the center of any diabetes treatment plan. High blood sugar, or hyperglycemia, is a major concern, and can affect people with both type 1 and type 2 diabetes . There are two main kinds: Fasting … Continue reading
When you have diabetes, your blood sugar (glucose) levels are consistently high. Over time, this can damage your body and lead to many other problems. How much sugar in the blood is too much? Why is high blood sugar so … Continue reading
Questions About Insulin for and from Your Doctor If you were buying a car, you wouldn’t dream of leaving the showroom without first asking the salesperson how safe it is, how well it drives, and how to operate it. If … Continue reading
Manage Diabetes Through Diet
With both type 1 and type 2 diabetes, you can help manage your glucose level with diet. Monitoring carbohydrates is key because carbs strongly affect your blood sugar. The best diet includes a variety of vegetables, fruits, and meats, as well as nuts, dairy, and grains. When you live with diabetes it may be a good idea to divide your food for the day evenly across three meals and healthy snacks.
Preventing High Blood Sugar After Meals
To prevent your blood sugar from soaring after meals, follow your meal plan and be aware of your diet, particularly how many carbs you eat and portion sizes. Research shows that a high-fiber diet — 25 to 35 grams a day — can help reduce your risk of type 2 diabetes by controlling blood sugar. Make sure you exercise, take your medicine, and test your blood sugar regularly.
The Good Exercise Effect
Regular, moderate exercise can positively affect blood sugar, especially with type 2 diabetes. Exercise improves your body’s sensitivity to insulin and stimulates your liver and muscles to use glucose. One study found improvement in blood sugars after strength training, which usually involves lifting weights to build muscle.
While regular exercise can help control blood sugars, it can cause your sugar to drop. To help keep your levels in check, your doctor may recommend you test your blood sugar before and after exercise. If exercise makes your blood sugar dip, don’t avoid exercise. Instead, have healthy snacks — like fruit — with you to avoid a serious drop.
Avoiding Low Blood Sugar or Hypoglycemia
Juice, fruit, hard candy, or glucose tablets are all sources of quick sugar that can help if you’re feeling the effects of low blood sugar. Feeling tired, weak, or shaky are telltale signs. When your blood sugar drops, your goal should be to get at least 15-20 grams of sugar or carbs. Avoid foods with sugar in combination with fat, like chocolate. Fat can slow your body’s ability to get the carbs it needs quickly enough.
Stress and Smoking Can Affect Diabetes
Many other things can affect your diabetes, including your stress level and unhealthy habits like smoking. Stress can send your blood sugar level soaring. Try yoga or meditation or find time to de-stress with a relaxing hobby. Smoking increases your chances of developing diabetes-related complications like foot problems, nerve damage, and eye, heart, vascular, and kidney disease.
Other Life Stresses That Affect Blood Sugar
- Be cautious when drinking alcohol. If you drink, only do so if your blood sugar is stable.
- When sick, test your blood sugar more often, stay hydrated, and try to eat regularly.
- Travel and changes in time zones can also affect your diabetes by disrupting your schedule. Test your sugars before and after meals. Speak with your doctor about making adjustment to medication as needed.
FOLLOW YOUR TREATMENT PLAN
It’s essential to follow your treatment plan, including exercise and diet, and take your medication as directed. Type 1 diabetes is treated with insulin or an insulin pump, sometimes with another injectable medication. Type 2 is often treated with oral and/or injectable medications like insulin or drugs that help insulin work. Your doctor customizes your treatment plan with your age, body, and lifestyle in mind.
Treating Diabetes With Insulin
With diabetes, your body often doesn’t make enough insulin to control blood sugars. Doctors may prescribe insulin based on how long you’ve had diabetes and what type you have, your blood glucose level, your overall health and lifestyle, and what other medicine you take. When you have diabetes, giving yourself insulin injections and checking your blood sugar can become a part of everyday life.
Medications That Work With Insulin
When you take insulin, you might still need help from other medications to improve your blood sugar. Oral medications for type 2 diabetes can increase insulin in the body or improve how well it works. An injectable medication for type 1 and type 2 diabetes mimics the effects of the hormone amylin. It improves blood sugar by decreasing glucose absorption after you eat and by decreasing appetite.
Tips for Injecting Insulin
When you start taking insulin, a medical professional will teach you how to inject yourself, and you’ll practice with her until you’re comfortable. When doing shots, rotate where you inject to avoid building up scar tissue. For example, give yourself your shot on one side of your abdomen at breakfast, the other side at lunch, and in your leg at dinner. Avoid injecting near your joints, groin, navel, middle abdomen, or scars.
Different Types of Insulin
Insulin types vary depending on how fast they work, when they peak, and how long they last. Rapid-acting, short-acting, and pre-mixed insulin are timed to meals. Long-acting and intermediate-acting are not timed to meals. The glucose-lowering effects of these insulins can last up to 24 hours.
Timing Mealtime Insulin
If you take shorter-acting and pre-mixed insulin, timing is important. It must be working in your system while food is being absorbed in order to avoid hypoglycemia. Rapid-acting insulin is taken right before or immediately after meals. Short-acting insulin is taken 30 to 60 minutes prior to meals. Pre-mixed insulin is taken twice a day before meals.
When You’ve Had Too Much Insulin
If you’ve had too much insulin, or you haven’t eaten and you’re on insulin, you can become hypoglycemic. If you start experiencing symptoms — feeling tired, weak, or shaky — you usually can treat mild hypoglycemia by eating or drinking something with sugar, such as juice, or taking glucose tablets. Be sure to tell your doctor about your hypoglycemic episode. Sometimes the amount of insulin you take may need adjusting.
For More Control, Pumps May Help
If you’re having trouble regulating your insulin and blood sugar, you may want to consider an insulin pump. They come with a programmable dose calculator to easily control your insulin dosage and help maintain steady blood sugar. No matter how you take your medication, know you can always ask your doctor for help in controlling your blood sugar. Together you can find ways to find the right balance between diet, exercise, and medication.
Getting a Better Measure of Blood Sugar Control
In addition to home glucose testing, one of the best ways to know if your diabetes is under control is to ask your doctor for an A1c test. This test can track your average blood sugar level over the past 3 months. The goal is to achieve a level of less than 6.5%. If your result is too high, your doctor may suggest medication or adjust medication you already take. Experts recommend an A1c test every 2-3 months.
Reviewed by Andrew Seibert, MD on October 21, 2011. © 2011 WebMD, LLC. All rights reserved.
What is diabetic nephropathy?
Nephropathy means kidney disease or damage. Diabetic nephropathy is damage to your kidneys caused by diabetes. In severe cases it can lead to kidney failure. But not everyone with diabetes has kidney damage.
What causes diabetic nephropathy?
The kidneys have many tiny blood vessels that filter waste from your blood. High blood sugar from diabetes can destroy these blood vessels. Over time, the kidney isn’t able to do its job as well. Later it may stop working completely. This is called kidney failure.
For reasons doctors don’t yet understand, only some people who have diabetes get kidney damage. Out of 100 people with diabetes, as many as 40 will get kidney damage.1
Certain things make you more likely to get diabetic nephropathy. If you also have high blood pressure or high cholesterol, or if you smoke, your risk is higher. Also, Native Americans, African Americans, and Hispanics (especially Mexican Americans) have a higher risk.2
What are the symptoms?
There are no symptoms in the early stages. So it’s important to have regular urine tests to find kidney damage early. Sometimes early kidney damage can be reversed.
The first sign of kidney damage is a small amount of protein in the urine, which is found by a simple urine test.
As damage to the kidneys gets worse, your blood pressure rises. Your cholesterol and triglyceride levels rise too. As your kidneys are less able to do their job, you may notice swelling in your body, at first in your feet and legs.
How is diabetic nephropathy diagnosed?
The problem is diagnosed using simple tests that check for a protein called albumin in the urine. Urine does not usually contain protein. But in the early stages of kidney damage-before you have any symptoms-some protein may be found in your urine, because your kidneys aren’t able to filter it out the way they should.
Finding kidney damage early can keep it from getting worse. So it’s important for people with diabetes to have regular testing.
- If you have type 1 diabetes, get a urine test every year after you have had diabetes for 5 years.
- If your child has diabetes, yearly testing should begin when your child is 10 years old and has had diabetes for 5 years.
- If you have type 2 diabetes, start yearly testing at the time you are diagnosed with diabetes.
How is it treated?
The main treatment is medicine to lower your blood pressure and prevent or slow the damage to your kidneys. These medicines include:
- Angiotensin-converting enzyme inhibitors, also called ACE inhibitors.
- Angiotensin II receptor blockers, also called ARBs.
You may need to take more than one medicine, especially if you also have high blood pressure.
And there are other steps you can take. For example:
- Work with your doctor to keep your blood pressure down, usually below 130/80.
- Work with your doctor to keep your cholesterol level as close to a healthy level as you can. You may need to take medicines for this.
- Keep your heart healthy by eating a low-fat diet and exercising regularly. Preventing heart disease is important, because people with diabetes are 2 to 4 times more likely to die of heart and blood vessel diseases. And people with kidney disease are at an even higher risk for heart disease.
- Watch how much protein you eat. Eating too much is hard on your kidneys. If diabetes has affected your kidneys, limiting how much protein you eat may help you preserve kidney function. Talk to your doctor or dietitian about how much protein is best for you.
- Watch how much salt you eat. Eating less salt helps keep high blood pressure from getting worse.
- Don’t smoke or use other tobacco products.
How can diabetic nephropathy be prevented?
The best way to prevent kidney damage is to keep your blood sugar in your target range and your blood pressure at a target of less than 130/80 mm Hg. You do this by staying at a healthy weight, exercising regularly, and taking your medicines as directed.
At the first sign of protein in your urine, you can take high blood pressure medicines to keep kidney damage from getting worse.