Diabetes: Getting Down to the Basics In Summary Part 2 of 2

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What happens if I do not control my diabetes?

The complications of diabetes can be devastating. Both forms of diabetes ultimately lead to high blood sugar levels, a condition called hyperglycemia. The damage that hyperglycemia causes to your body is extensive and includes:

Damage to the retina from diabetes (diabetic retinopathy) is a leading cause of blindness.

Diabetes predisposes people to high blood pressure and high cholesterol and triglyceride levels. These independently and together with hyperglycemia increase the risk of heart disease, kidney disease, and other blood vessel complications.

Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis), chronic diarrhea, and an inability to control heart rate and blood pressure with posture changes.
Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of kidney failure.

Damage to the nerves from diabetes (diabetic neuropathy) is a leading cause of lack of normal sensation in the foot, which can lead to wounds and ulcers, and all too frequently to foot and leg amputations.
Diabetes accelerates atherosclerosis or “hardening of the arteries”, and the formation of fatty plaques inside the arteries, which can lead to blockages or a clot (thrombus), which can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).

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Hypoglycemia, or low blood sugar, occurs from time to time in most people with diabetes. It results from taking too much diabetes medication or insulin, missing a meal, doing more exercise than usual, drinking too much alcohol, or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times. Headache, feeling dizzy, poor concentration, tremors of hands, and sweating are common symptoms of hypoglycemia. You can faint or have a seizure if blood sugar level gets too low.

Diabetic ketoacidosis is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or a relative deficiency of insulin) over time creates a buildup in the blood of acidic waste products called ketones. High levels of ketones can be very harmful. This typically happens to people with type 1 diabetes who do not have good blood glucose control. Diabetic ketoacidosis can be precipitated by infection, stress, trauma, missing medications like insulin, or medical emergencies like stroke and heart attack.

Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly and often leads to dehydration so severe that it can cause seizures, coma, even death. This syndrome typically occurs in people with type 2 diabetes who are not controlling their blood sugar levels or have become dehydrated or have stress, injury, stroke, or medications like steroids.

My doctor says I have pre-diabetes? What is that?

Pre-diabetes is a common condition related to diabetes. In people with pre-diabetes, the blood sugar level is higher than normal but not high enough to be considered diabetes. Pre-diabetes increases your risk of getting type 2 diabetes and of having heart disease or a stroke. Pre-diabetes can be reversed without insulin or medication by losing a modest amount of weight and increasing your physical activity. This can prevent, or at least delay, onset of type 2 diabetes. When associated with certain other abnormalities, it is also called the metabolic syndrome.

What are normal blood glucose levels? The amount of glucose (sugar) in your blood changes throughout the day and night. Your levels will vary depending upon when, what and how much you have eaten, and whether or not you have exercised. The American Diabetes Association categories for normal blood sugar levels are the following, based on how your glucose levels are tested:

A fasting blood glucose test: This test is performed after you have fasted (no food or liquids other than water) for eight hours. A normal fasting blood glucose level is less than 100 mg/dl. A diagnosis of diabetes is made if your blood glucose reading is 126 mg/dl or higher. (In 1997, the American Diabetes Association lowered the level at which diabetes is diagnosed to 126 mg/dl from 140 mg/dl.)

A “random” blood glucose test can be taken at any time. A normal blood
glucose range is in the low to mid 100s. A diagnosis of diabetes is made if your blood glucose reading is 200 mg/dl or higher and you have symptoms of disease such as fatigue, excessive urination, excessive thirst or unplanned weight loss.

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Another test called the oral glucose tolerance test may be performed instead. For this test, you will be asked, after fasting overnight, to drink a sugar-water solution. Your blood glucose levels will then be tested over several hours. In a person without diabetes, glucose levels rise and then fall quickly after drinking the solution. In a person with diabetes, blood glucose levels rise higher than normal and do not fall as quickly.

A normal blood glucose reading two hours after drinking the solution is less than 140 mg/dl, and all readings between the start of the test until two hours after the start are less than 200 mg/dl. Diabetes is diagnosed if your blood glucose levels are 200 mg/dl or higher.

What else do I need to do if I have diabetes?

People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.

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Diabetes, and its precursor, the metabolic syndrome, can lead to a multitude of problems if not adequately controlled. These include vascular diseases that result in heart attack and stroke, kidney damage leading to kidney failure, damage to nerves (neuropathy), retinal damage leading to blindness, high blood pressure, and various metabolic defects such as high triglycerides or high cholesterol. It is therefore crucial to control the diabetes as well as all the other risk factors for artery diseases that cause heart attack and stroke.

To do this, your doctor will insist on a good diet and regular exercise. Medications are added to lower the blood sugar, and if these are inadequate, insulin or other injectable medication will be required. The medications that treat diabetes may cause depletion of folic acid, which in turn can cause a high homocysteine, which is a risk factor for artery disease that underlies heart attack and stroke. You can shift the risks in your favor by taking NutraMD Diabetes Essential Nutrients along with your doctor prescribed medications.

Donald Ford, MD, Diplomate of the American Board Internal Medicine. Dr. Ford has practiced general internal medicine for the past 22 years. He is a native Texan and trained at Baylor University, the University of Texas Medical School at Houston, and Scott and White in Temple. He is a Clinical Assistant professor at Baylor College of Medicine. In addition to general Internal Medicine, his practice includes travel medicine, vascular disease prevention, and Integrative Medicine with nutrients. He has been interested in the body’s ability to heal itself since medical school, and has used nutrients throughout his career to help patients use less prescription medication, or avoid it altogether. While he sees the tremendous value prescription medications can provide, he is also aware of the value and place for nutrients. http://www.essential-nutrients.net

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