Archive for FAQs

Do Diabetes and alcohol Mix?

Have you ever wondered if diabetes and alcohol mix? While I will talk about some generalities, every diabetic may respond to alcohol differently. Some diabetics safely drink alcohol without problems while others have a number of issues. Monitor your diabetes closely and know what alcohol does to your body.

Alcohol and Blood Sugar Control

Alcohol actually has very little effect on overall control of your blood sugar. In general, most diabetics should follow the guidelines as non-diabetics if they want to drink:

  • Women should not exceed more than 1 drink per day
  • Men should not exceed more than 2 drinks per day

In this scenario a drink is equal to a:

  • 12 ounce beer
  • 5 ounce glass of wine
  • 1.5 ounce drink with spirits

If you choose to drink you will want to talk with your healthcare provider to make sure the alcohol will not interfere with your medication or another medical condition.

Low Blood Sugar Reaction

You are at risk for developing low blood sugar when you are on treatment (insulin or pills) and choose to drink alcohol.

In a normal person, low blood sugar triggers the liver to generate glucose from stored carbohydrate in the liver. However, alcohol inhibits the liver’s ability to do this. The liver senses alcohol as a toxin that it wants out of the body. As a result the liver does not produce glucose until the alcohol is out of the body.

You can decrease your risk of hypoglycemia by never drinking on an empty stomach. Drinking with food, either a meal or snack, is a much better option. Additionally, you should check your sugar before going to bed and consider eating something small before going to sleep to prevent a low blood sugar reaction in the middle of the night– you want your blood sugar between 100 and 140 mg/dl before going to sleep.

Alcohol, Weight gain, & Diabetes

If you are trying to lose weight or just keep your weight under control, alcohol will not be your best friend. Alcohol adds significant non nutritional calories. Light beer contains 100 calories, while a sweet drink like a margarita may have as many as 250 calories. Additionally, when your liver breaks down alcohol it gets turned into fat (think beer belly). If you are trying to lose weight and taking in significant amounts of alcohol, you may be making it very difficult for yourself to lose or even maintain your current weight.

Should I Not Drink At All?

While this is a personal decision, too much alcohol is bad for anyone. It diabetics it can increase risk of longer term complications like heart attack or stroke by increasing weight, cholesterol triglycerides, and blood pressure. On a more positive note, small amounts of alcohol may decrease risk of heart disease.

A Few Tips For Drinking When You Have Diabetes

Here are a few tips to help manage alcohol when you have diabetes:

  • Continue to eat regularly.
  • Wear a medical ID bracelet (you really do not someone thinking you are drunk wean you are having hypoglycemia).
  • Drink slowly
  • Try a light beer
  • Use a mixer of diet soda or water if you need a mixer
  • Be careful about driving after you drink alcohol
  • Consider delaying driving for several hours
  • Know the symptoms of hypoglycemia and make sure people you are out with do too.
  • Always have a source of sugar with you.
  • Test more often as you may not display your typical hypoglycemia symptoms

 

Drinking when you have diabetes is a personal decision. Make sure you take steps to learn how alcohol affects you and your diabetes. Talk with your doctor about the pros and cons of drinking as well as specific strategies to manage safely.

What Is Insulin Resistance?

What Is Insulin Resistance?

‘What is insulin resistance’ is a common question among patients newly diagnosed with diabetes or pre-diabetes. In this condition, your body still produces insulin, but it is not effective. This results in elevated blood glucose levels. In most patients, insulin resistance pre-dates an actual diagnosis of diabetes or pre-diabetes.

In fact, most patients will have insulin resistance for years before being diagnosed with pre-diabates or diabetes.

What Is Going On In The Body When I Have Insulin Resistance?

When you develop insulin resistance, cells in your body do not assist in uptake of blood glucose into muscle, fat, and other organs from the blood stream. Your body progressively requires higher insulin levels to get glucose from the bloodstream and into cells and organs that wish to use glucose for fuel.

Insulin is produced in the pancreas by beta cells. Blood glucose remains normal until the increased insulin levels are able to no longer counter act the insulin resistance or the beta cells cannot produce enough insulin to keep the bloodstream glucose normal.Over time the end result is elevate blood glucose levels, pre-diabetes, and then diabetes.

Type 2 Diabetes

Type 2 Diabetes

What Causes Insulin Resistance?

While your doctor can answer the ‘What is insulin resistance’ question, the ‘What is the the cause of insulin resistance’ is more difficult to answer. There are a number of different reasons experts believe that insulin resistance develops:

  • Obesity. Excess body fat is hypothesized to cause insulin resistance. Fat around the waist and belly fat are particularly problematic. Increased waist circumference and fat around the belly are associated with the production of hormones that increase insulin resistance. Increased waist circumference and belly fat are also associated with chronic inflammation that can be damaging to the body over long periods of time.
  • Inactivity. Inactivity has been shown in research studies to be associated with insulin resistance. Normally, muscles use stored glucose for energy and then take in more glucose from the blood stream. In fact, one of the reasons physical activity is good for you is that exercise makes muscles more sensitive to insulin.
  • Poor sleep. Sleep problems such as sleep apnea increase risk of obesity and insulin resistance. This is especially noted amongst night shift workers.
  • Genetics. Unlike the previously mentioned causes, you cannot do anything about your genetic risk. If your mom, dad, brother or sister have insulin resistance, you are more likely to develop insulin resistance.

    What Can I Do About Insulin Resistance?

    Woman exercising with dog

    Woman exercising with dog

    There are a number of things you can do to prevent progression to diabetes:

  • Change your lifestyle. Beginning an exercise program can make dramatic improvements. While many people shy away from exercise because of perceived barriers, walking for for as little as 30 minutes per day most days of the week can bring significant benefits. If you do this you will not only burn more calories, but also likely decrease caloric intake and fat.
    In the Diabetes Prevention Program, a federally funded program that looked to prevent diabetes in high risk individuals, patients losing 15 pounds reduced their risk of developing diabetes by 58% over a 3 year time frame.
    Increasing physical activity can help you:

    • Lose weight
    • Control glucose
    • Control blood pressure
    • Control cholesterol
  • Metformin. While not as successful as modifying risk factors, patients receiving metformin plus standard info about physical activity and diet decreased their risk of developing diabetes by 31% over a 3 year time frame.
  • Reduce risk. Insulin resistance increases your risk of cardiovascular disease. Not surprisingly, it is important to treat hypertension and high cholesterol in patients with insulin resistance. Additionally, smoking cessation is important in decreasing your risk of heart disease.

Sources

  • What Is Insulin Resistance?. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). Accessed September 10, 2013.
  • Weir, Gordon and Bonner-Weir, Susan. “Five Stages of Evolving Beta-Cell Dysfunction During Progression to Diabetes.” Diabetes 53 (2004): S16-S21.

How Much Can Decreasing My HbA1c Test Lower Complication Risk?

How Much Can Decreasing My HbA1c Test Lower Complication Risk?

Your HbA1c test results are directly related to your risk of developing complications from diabetes. Getting your diabetes under control can slow down progression towards complications such as diabetic eye problems such as retinopathy or kidney problems such as nephropathy. The greater your HbA1C test and the longer amount of time your HbA1c test is elevated, the greater your risk of complications.

What Is The HbA1c?

The HbA1c test measures how well your blood sugar has been controlled over the last several months. Unlike fasting glucose tests, this test is not affected by what you are eating today.

What Is a Normal HbA1c?

An HbA1c of 5.6% or less is normal. Prediabetes is associated with a HbA1c test of 5.7% to 6.4% and diabetes is diagnosed with a result of 6.5% or greater. Once you have been diagnosed with diabetes the goal is to keep your level below 7%.

How Does the HbA1c Test Affect My Risk of Diabetic Complications?

Lowering your HbA1c test by 1% decreases rate of any complication of diabetes by 21%. Additionally, each one percent you can lower your HbA1c test you can decrease the rates of:

  • Diabetes deaths by 21%.
  • Heart attack by 14%.
  • Microvascular disease like retinopathy or nephropathy by 37%.
  • Stroke by 12%.
  • Peripheral vascular disease by 43%.
  • Heart failure 16%.
  • Cataract Extraction by 19%.

What Does This Mean For Me

If you can get your HbA1c test under good control, you may never develop a diabetes complication or complications will develop more slowly. The lower you can get your HbA1c test the better. The longer your HbA1c test remains elevated, the risk for developing these becomes greater as well.

You probably will want to have a HbA1c test every 3 to 6 months . If your HbA1c test is in the pre diabetes range, your doctor may prescribe metformin in addition to lifestyle modifications. Otherwise, your doctor may recommend a new medicine or increase the dose of one you are already taking if your HbA1c is high.

What Can I Do If My HbA1c Test Is Elevated?

  • Lose weight.
  • Follow a meal plan
  • Increase your exercise
  • Take your medication as prescribed.
  • Take your medications regularly.

Sources:

* American Diabetes Association. Standards of medical care in diabetes–2012. Diabetes Care. 2011 Jan;35 Suppl 1:S11–63.

* Irene M Stratton,H Andrew W Neil, David R Matthews et. al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321:405.

How Prediabetes Is Different From Diabetes

How Prediabetes Is Different From Diabetes

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What You Need To Know & Do About Pre Diabetes

What You Need To Know About Pre Diabetes

  • Your blood sugar is too igh, but not yet high enough to cal diabetes..
  • You will not have symptoms, so you need to be tested..

What You Need To Do About Pre Diabetes

  • Losing weight (10% of your current body weight) is the best treatment.
  • Your doctor may prescribe medication.

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If you have prediabetes you are not alone. More than 41 million American also have prediabetes. In prediabetes your blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. In prediabetes, your body does not respond to insulin as it should. With prediabetes you are at an increased risk for developing diabetes in the next 10 years. Your doctor may also refer to prediabetes as impaired fasting glucose., or impaired glucose tolerance

How Is Prediabetes Diagnosed?
Basically, your blood sugar is higher than normal, but not yet elevated enough to make a diagnosis of diabetes.

A normal fasting blood glucose is 100 mg/dl. In prediabetes your blood sugar is between 100 and 125 mg/dl. Once your blood glucose is 126 mg/dl or above, you have a diagnosis of diabetes. Alternatively, your doctor may perform an oral dose tolerance test to diagnose prediabetes. Most people with prediabetes do not have symptoms of diabetes. Some patients with prediabetes have patches of dark skin on the back of the neck called acanthosis nigricans.

Should I Be Tested For Prediabetes?
You should be tested for prediabetes if you:

  • Are obese or overweight
  • Have a sedentary lifestyle
  • Have high blood pressure
  • Increased cholesterol
  • Have a close family member with diabetes
  • Have a history of gestational diabetes
  • Are in an ethnic group (African American, Hispanic, American Indian) with an increased risk for diabetes

Why Is Making a Diagnosis of Prediabetes Important?
Because you are at an increased risk for developing diabetes in the future, it is important to know if you have prediabetes. Even in prediabetes you have an increased risk of developing heart disease compare to someone without prediabetes.

What Is the Treatment For Prediabetes?
You can do something about prediabetes. Just because you have prediabetes does not mean you will automatically develop diabetes. Improving your lifestyle will decrease your risk and improve how your body uses insulin to lower your blood sugar. It is recommended that you:

  • Lose 5-10% of your body weight
  • Be physically active for 30 or more minutes most days of the week
  • Quit smoking
  • Get more Fiber
  • Decrease fast food
  • Eat more fruits and vegetables

Your doctor also may start you on a treatment such as metformin.

More Info

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