How to prevent diabetes

Monday, March 20, 2017

How and When to Test Your Blood Sugar With Diabetes

Most people with diabetes need to check their blood sugar (glucose) levels regularly. The results help you and your doctor manage those levels, which helps you avoid diabetes complications.

There are several ways to test your blood sugar:

From Your Fingertip: You prick your finger with a small, sharp needle (called a lancet) and put a drop of blood on a test strip. Then you put the test strip into a meter that shows your blood sugar level. You get results in less than 15 seconds and can store this information for future use. Some meters can tell you your average blood sugar level over a period of time and show you charts and graphs of your past test results. You can get blood sugar meters and strips at your local pharmacy.

Meters That Test Other Sites: Newer meters let you test sites other than your fingertip, such as your upper arm, forearm, base of the thumb, and thigh. You may get different results than from your fingertip. Blood sugar levels in the fingertips show changes more quickly than those in other testing sites. This is especially true when your blood sugar is rapidly changing, like after a meal or after exercise. If you are checking your sugar when you have symptoms of hypoglycemia, you should use your fingertip if possible, because these readings will be more accurate.

Continuous Glucose Monitoring System: These devices, also called interstitial glucose measuring devices, are combined with insulin pumps. They are similar to finger-stick glucose results and can show patterns and trends in your results over time.

When Should I Test My Blood Sugar?

You may need to check your blood sugar several times a day, such as before meals or exercise, at bedtime, before driving, and when you think your blood sugar levels are low.

Everyone is different, so ask your doctor when and how often you should check your blood sugar. If you're sick, you'll probably need to test your blood sugar more often.

What Affects Your Results

If you have certain conditions, like anemia or gout, or if it's hot or humid or you're at a high altitude, that can affect your blood sugar levels.

If you keep seeing unusual results, recalibrate your meter and check the test strips.

The chart below gives you an idea of where your blood sugar level should be throughout the day. Your ideal blood sugar range may be different from another person's and will change throughout the day.

Time of Test	Ideal for Adults With Diabetes
Before meals	70-130 mg/dL
After meals	Less than 180 mg/dL

Home Blood Glucose Monitoring and HbA1c

Monitoring your HbA1c level is also important for diabetes control. Many home glucose monitors can display an average blood glucose reading, which correlates with the HbA1c.

Average Blood Glucose Level (mg/dL)	HbA1c (%)
126	6
154	7
183	8
212	9
240	10
269	11
298	12

When Should I Call My Doctor About My Blood Sugar?

Ask your doctor about your target blood sugar range, and make a plan for how to handle blood sugar readings that are either too high or too low and when to call your doctor. Learn about the symptoms of high or low blood sugar, and know what you can do if you begin to have symptoms.

How Do I Record My Blood Sugar Test Results?

Keep good records of any blood, urine, or ketone tests you do. Most glucose monitors also have a memory. Your records can alert you to any problems or trends. These test records help your doctor make any needed changes in your meal plan, medicine, or exercise program. Bring these records with you every time you see your doctor.

Top 10 Ways to Stay Positive After Being Diagnosed with Diabetes

staying positive

Robertmiken 5:57 PM 0

Newly diagnosed and feeling overwhelmed? Check out these helpful ideas for staying positive as you learn to manage your diabetes care.

By Hope Warshaw, RD, CDE

1. Keep in Mind: You're Among Millions

Today, according to the U.S. Centers for Disease Control and Prevention (CDC), 29 million Americans live with diabetes. Around the world, according to the International Diabetes Federation (IDF), the number hovers in excess of 380 million people with diabetes, with an expected rise to a half-billion by 2030. So you are hardly alone!

And with millions of people dealing with diabetes and more health experts searching for ways to improve care, diabetes is constantly in the news. Read reliable sources for accurate, science-based information, and be cautious of false promises, quick fixes, and magic potions that advertise “diabetes cures.”

2. Celebrate the Robust Amount of Diabetes Research

Two realities fuel the flames of interest in and funding for diabetes research: the epidemics of obesity and type 2 diabetes, and the increase in people diagnosed with type 1 diabetes. For-profit businesses and nonprofit diabetes-related associations are working at breakneck speed to get the latest and greatest developments to market. This includes both finding cures in the distant future and zeroing in on new treatments and technologies just around the corner.

Promising technologies -- including making glucose monitoring and tracking easier and quicker and insulin-delivery devices simpler to use and carry -- are not far off. More new medications to lower and control blood sugar and delay the complications of diabetes are being developed than ever before. These new medications are aiming for less-frequent dosing, minimizing hypoglycemia (low blood sugar), and assisting with weight loss rather than causing weight gain.

3. Make Small Changes for BIG Rewards

There is no need to hit the pavement running or go on a rigid, unattainable diet to manage your diabetes. Research shows that a key to controlling type 2 diabetes in the early stages is to lose 10-20 pounds (5-7 percent of your body weight) and keeping those pounds at bay for years to come. In fact, losing just a few pounds, eating healthier, and walking a few times a week can cause blood sugar to plummet if you've caught type 2 early enough. Losing a few pounds can also lower blood pressure, improve blood lipids (cholesterol), and help a host of other health problems, such as sleep apnea. Weight loss after years of having type 2 diabetes might not be as impactful on your glucose levels, but healthy eating and exercise are always important for your health.

Realize that changing your lifelong eating and lifestyle habits takes time and effort. Set a few easy-to-accomplish goals to start. Experience success, then set a few other goals. Over time, you'll be amazed by the changes you've made. Keep in mind: success breeds success.

4. Partner with Your Provider

Diabetes is a 24/7/365 disease that requires continual treatment adjustments over the years. While you need to stay in the driver's seat for your day-to-day management, you'll want a health care provider who will work side by side with you as a partner in your efforts. Your provider should constantly strive to help you fine-tune your treatment to achieve your blood sugar, cholesterol, and blood-pressure goals. Search out a knowledgeable and up-to-date provider, one who knows and uses new medications, technologies, and behavior-change strategies. Make sure your provider knows the American Diabetes Association Standards of Care and orders the tests and checks you need to prevent or detect diabetes complications.

5. Find a Diabetes Educator

Why do you need to work with a diabetes educator? Diabetes educators can help you learn about diabetes, and specifically about your diabetes. They can help you set goals for behavior change, understand the meaning of your blood sugar results, and advocate for you with your other providers. Maybe most important of all, your diabetes educator can serve as your cheerleader or shoulder to cry on.

The most common place to find a diabetes educator or a diabetes education program is in hospital-based programs or in your primary care provider’s practice. Be on the lookout. More diabetes educators and programs are also cropping up in novel locations, such as pharmacies, supermarkets, food banks, and even online, where services may offer coaching or coaching coupled with a full diabetes education program.

Ask your provider for a referral for diabetes education. Medicare Part B and private health insurance plans generally cover diabetes education, also known as diabetes self-management education and support.

Exercises to Avoid When You Have Diabetes

Tips

Robertmiken 5:10 PM 0

Regular physical activity is an important part of a healthy lifestyle when you have diabetes. It is good for your cardiovascular system and can help control blood glucose levels. However, there are times when you need to be careful about exercising with diabetes. If you have certain diabetes complications, there are exercises that you should avoid. Michael See, MS, RCEP, Clinical Exercise Physiologist at Joslin Diabetes Center, discusses certain situations that may require you to modify your fitness program

The following complications may affect your exercise routine:.

Proliferative diabetic retinopathy (PDR)—Patients with diabetes and active PDR should avoid activities that involve strenuous lifting; harsh, high-impact activities; or placing the head in an inverted position for extended periods of time.

Diabetic peripheral neuropathy— Diabetic peripheral neuropathy may result in loss of sensation and position awareness of your feet. Repetitive exercise on insensitive feet can lead to ulceration and fractures. “Limit your choice of exercise to low impact or non-weight bearing activities,” says See.

Advanced kidney disease— Individuals with diabetes and advanced kidney disease can engage in moderate intensity activities, but should avoid strenuous activity.

High blood glucose levels— Individuals with type 1 diabetes should avoid exercise if fasting blood glucose is higher than 250 mg/dl and ketones are present. Caution should be used if glucose levels are higher than 300 and no ketones are present. Individuals with type 2 diabetes should avoid exercise if blood glucose is higher than 400 mg/dl. Monitoring blood glucose before, after and possibly during physical activity is necessary to keep blood glucose within an appropriate range.

Always consult with an exercise or health care professional before beginning any fitness program.

(Resoure: http://www.joslin.org/info/exercises_to_avoid_when_you_have_diabetes.html)

SGLT2 inhibitors show no significant risk of DKA, study reports

News

Robertmiken 9:00 PM 0

Adults with type 2 diabetes who take SGLT2 inhibitors are less likely to experience diabetic ketoacidosis (DKA) than those on insulin treatment, a study suggests.

These findings existed for those with type 2 diabetes either prescribed SGLT2 inhibitors as a single treatment or in combination with another drug.

Scientists from the Steno Diabetes Center, Copenhagen, Denmark examined 415,670 people with type 2 diabetes during 1995-2014, all of whom were treated with medication, including insulin.

They sought to evaluate the rates of DKA within patients to assess if any association could be made between DKA, a dangerous short-term complication, and SGLT2 inhibitors.

SGLT2 inhibitors work by helping the kidneys to lower blood glucose levels, with excess blood glucose removed through urine.

During follow-up, 4,045 first events of DKA were identified, but this incidence went on to decrease by 5.6 per cent per year.

The risk of DKA was highest for people on insulin, followed by people who were on a combination of insulin and oral diabetes drugs.

Those who filled prescriptions for SGLT2 inhibitors had no registered events of DKA, while six events of DKA occurred in those who were treated with an SGLT2 combination treatment.

The researchers said: "This is the first study to estimate nationwide incidence of DKA in type 2 diabetes with 20 years of follow-up and three million person-years of observation combined with prescription data.

"Compared with canagliflozin trials, our DKA incidence rates in the SGLT2 inhibitor-treated groups are higher, but the rates presented here indicate what we are likely to face in clinical practice; out of 1,000 people classified as having type 2 diabetes, one will be hospitalised with DKA each year, a potentially life-threatening acute situation, especially in the older population, demanding hospital admission and intensive treatment.

"The excess risk associated with SGLT2 inhibitor treatment was, however, not significant and is hardly clinically relevant."

The study has been published online in Diabetes Care.

(Resoure:http://www.diabetes.co.uk/news/2017/mar/sglt2-inhibitors-show-no-significant-risk-of-dka,-study-reports-95210322.html)

Whole-body vibration technique could help combat type 2 diabetes

News

Robertmiken 8:58 PM 0

Whole-body vibration (WBV) could help prevent obesity and type 2 diabetes, according to research.

WBV is a technique that involves standing, sitting or lying on a vibrating platform which transmits energy through the body, making the muscles contract and relax repeatedly.

In this new study, Augusta University researchers used mice to investigate whether regular WBV would produce similar benefits to exercise.

The animals were split into three different groups, receiving 20 of WBV per day, 45 minutes of exercise, or no exercise at all. The mice were followed for 12 weeks and weighed every seven days.

The findings showed there were similar weight loss benefits in the WBV and exercise group. Other benefits included greater muscle mass and improved insulin sensitivity.

Dr Meghan McGee-Lawrence, who led the research, said: "Our study is the first to show that whole-body vibration may be just as effective as exercise at combating some of the negative consequences of obesity and type 2 diabetes.

"While WBV did not fully address the defects in bone mass of the obese mice in our study, it did increase global bone formation, suggesting longer-term treatments could hold promise for preventing bone loss as well."

It is thought the WBV technique could potentially help some people in the future who are unable to exercise regularly, such as those with diabetic neuropathy.

But McGee-Lawrence noted that WBV is not suitable for replacing exercise as it doesn’t provide the cardiovascular or respiratory benefits of physical activity.

She added: "Because our study was conducted in mice, this idea needs to be rigorously tested in humans to see if the results would be applicable to people."

The findings appear online in the Endocrinology journal.

(Resoure:http://www.diabetes.co.uk/news/2017/mar/whole-body-vibration-technique-could-help-combat-type-2-diabetes-95217303.html)

CGM surpasses flash monitoring for reducing hypo unawareness in type 1 diabetes

News

Robertmiken 8:57 PM 0

A new UK study has revealed that continuous glucose monitoring (CGM) can help people with type 1 diabetes spot hypoglycemia more easily and promptly than flash monitoring.

We know from previous research that CGMs can measurably increase the amount of time spent in and above glucose target range as well as reduce the time below that same range in type 1 diabetes.

Adults with type 1 diabetes who have diminished awareness of hypoglycemia, which represent roughly a quarter of this population, are considered to be at high-risk for severe hypoglycemia.

This new study, presented last week at the Diabetes UK Professional Conference, shows that they are the ones susceptible to benefit the most from using a CGM.

Researchers also suggest that when it comes to improving hypoglycemia unawareness, CGMs may be a better choice than simply using an intermittent flash glucose monitor.

Although, the study comparing those two fairly different types of glucose monitoring was perhaps more likely to reach this conclusion. It was sponsored by Dexcom, the manufacturer of the widely used G5 CGM device.

This is not to say that flash glucose monitoring isn't an efficient way of self-monitoring blood sugars. Data from more than 50,000 users in previous studies support that the FreeStyle Libre significantly improves blood sugar control in type 1 diabetes.

And, the results of this new study actually show that Abbott's Freestyle Libre, used here for comparison, improved HbA1c levels and the amount of time spent in the target glucose range as much as the G5 did.

But, when looking at the impact on hypoglycemia and hypoglycemia awareness specifically, the G5 takes the lead and the benefits for users go well and beyond what the Freestyle Libre can offer.

This was assessed by the Gold score of impaired hypoglycemia awareness, a method used for quantifying awareness of hypoglycemia.

The study involved 40 participants with long-standing type 1 diabetes and hypo-unawareness who had never used CGMs. Those assigned to CGM experienced a reduction in the Gold score, whereas the score didn't budge for Freestyle Libre users.

The use of real-time CGM over the Freestyle Libre also reportedly minimised people's fear of hypoglycemia and worries of consequences it has for their entourage.

(Resoure:http://www.diabetes.co.uk/news/2017/mar/cgm-surpasses-flash-monitoring-for-reducing-hypo-unawareness-in-type-1-diabetes-95224572.html)

Lighter chicken, bacon and leek pies

recipes

Robertmiken 8:52 PM 0

Preparation time

less than 30 mins

Cooking time

30 mins to 1 hour

Serves

Serves 2

This chicken pie is easy to make and still feels like a proper pie - even though it's lower in calories. Serve with steamed veg, it's so filling you don't need anything else.

For this recipe you will need two individual pie dishes (about 400ml/14fl oz).

Each serving provides 344kcal, 41g protein, 12g carbohydrate (of which 8g sugars), 14g fat (of which 6g saturates), 3g fibre and 1.5g salt.

Ingredients

1 x 200g/7oz chicken breast
200ml/7fl oz semi-skimmed milk, plus a ½ tbsp extra to glaze
¼ onion, peeled
1 bay leaf
100g/3½oz reduced-calorie ready rolled puff pastry (about a 10x25cm piece)
low-calorie spray oil
2 bacon medallions, sliced into small pieces
200g/7oz button mushrooms, large ones cut in half
1 leek, chopped
1 tbsp plain flour
steamed broccoli, to serve

Recipe tips

Method

Put the chicken breast in a small pan (it needs to be a small pan so the chicken poaches in the milk). Add the milk, onion and bay leaf. Cover with a lid and simmer gently for 15 minutes, or until the chicken is cooked through.
Preheat the oven to 200C/180C Fan/Gas 6.
Divide the pastry into two equal rectangles and carefully roll them out until large enough to cover the top of two individual pie dishes. Place the upturned pie dishes on the pasty and cut around them to make the pie lids. Cut any excess pastry into strips and press them around the top edge of the pie dishes (this will help the lids stay in place as the pies bake). Cut a cross in the middle of the pastry lids and set aside.
Fry the bacon with one squirt of spray oil in a non-stick pan. When golden-brown, add the mushrooms and a tablespoon of water. Cook for 2-3 minutes then add the leeks. Cook for about 5 minutes breaking up the leeks as they soften.
Remove the chicken from the poaching milk. Strain and reserve the milk and chop the chicken into bite-sized pieces.
Stir the chicken into the vegetables. Add the flour and stir well. Cook for 2 minutes, then add the strained poaching milk stirring well to incorporate. Continue to cook for 2-3 minutes, or until the sauce has thickened just a little. Divide between the pie dishes.
Brush the pastry edges with a little milk and add the pie lids. Brush all over with more milk. Bake for 25 minutes, or until the pastry lid is golden-brown. Serve immediately with steamed broccoli.

Recipe Tips

Freeze any leftover pastry to use in other recipes.

Bacon medallions are the leanest cut of bacon, but you can buy regular bacon and cut off all the fat if you prefer.

Button mushrooms keep their shape well, but you can use other mushrooms if you prefer, just cut them into chunky pieces rather than slices.

To find out more about type 2 diabetes and get information on how to reduce your risk of this mostly preventable disease, read our iWonder guide.

(Resoure: http://www.bbc.co.uk/food/recipes/lighter_chicken_bacon_60415)