Living with Diabetes: Ten Facts About Diabetes Mellitus You Should Know
Have You or a Loved One Been Diagnosed with Diabetes?
A diabetes diagnosis can be overwhelming. I know.
It was nearly 10 years ago when I found out that I had diabetes. At the time, the doctors thought it was merely Gestational Diabetes and would go away when my twins were delivered 2 months later. However, my blood glucose levels were so high that I was placed on insulin and required to test my blood sugar 6 times a day (before and after each meal).
While we hoped that the diabetes would "go away" after delivering the babies, I continued to have signs and symptoms of diabetes for months. Unfortunately, I rationalized the extreme thirst, hunger, exhaustion and blurred vision to the trials of raising four young children, including infant twins. However, when I finally tested my blood in May 2003, my blood glucose level was 550 mg/dl - significantly above the 200 mg/dl that is usually required for a diagnosis of diabetes.
My diagnosis was Type 1 diabetes - called Juvenile Diabetes, or Insulin-Dependent Diabetes. The disease had been brought on by an auto-immune reaction in which my body attacked the healthy cells in my pancreas (Beta cells) that produce insulin. Unlike Type 2 diabetes, in which a person's body is unable to produce adequate amounts of insulin for the food ingested, a person with Type 1 does not make any insulin at all and cannot cure or "reverse" the disease on their own.
How is Living with Diabetes Possible?
Managing diabetes - whether Type 1 or Type 2 - requires frequent measuring of blood glucose levels, taking appropriate medication and ensuring proper exercise and a healthy diet.
Its very possible to live with diabetes, whether you are the patient or a family member or friend. Yes, the disease is serious. However, for those that take it seriously and manage it in full consideration of the fact that it can be a life-threatening condition will generally enjoy a long and healthy life, absent any other complications.
Be sure to consult with your own doctor to discuss potential complications or other matters that may increase the requirements for living with diabetes under your own, unique circumstances.
Living with Diabetes: Nick Jonas
1. Its Not All About Sugar
My first cousin was diagnosed with Type 1 diabetes at the age of 9, about 20 years ago. At that time, we didn't understand the disease at all. In fact, I remember my cousin's first Halloween after the diagnosis when my mom sent sugar-free candy to Ryan.
As a diabetic myself, I know that sugar-free alternatives for any common food are not "diabetic-safe." Instead of thinking about sugar, you need to consider carbohydrates. These nutrients are rapidly converted in the body into glucose, which is fuel for your cells. When a person lacks adequate insulin, ingestion of carbohydrates can raise blood sugar to dangerous levels.
Its not all about sugar. Look at the nutrition facts on food labels and count carbs instead.
3. Many Factors Play into Blood Glucose Levels
Its not just what you eat that affects blood glucose levels. Consider the following:
- Adequate sleep
- Hormone levels
- Fiber or fat in diet
- Drug or alcohol use
- Mental health
2. Fiber Affects Absorption of Carbs
Any diabetic or nutritionist can tell you that high fiber foods - usually those that are fresh and not processed - will affect the absorption of carbohydrates.
What this means is that eating a fresh apple will be different than eating applesauce, even if both servings have the same number of grams of carbohydrates. Same goes for bread, pasta, and vegetables. This is one of the reasons that whole wheat pasta is healthier than "white" pasta.
Whole grains and fiber help slow or prevent a blood sugar "spike," which evens out the highs and lows experienced by people with diabetes and/or hypoglycemia. The longer it takes your body to digest and process the foods you eat (unless due to high levels of fact - see below) the better health you can expect. Avoiding the extreme ups and downs of blood sugar levels will make anyone feel better!
4. You Might not be able to Diet and Exercise it Away
This myth drives me crazy!
Not only is it untrue with respect to people with Type 1 diabetes, who have suffered an auto-immune reaction, but many people with Type 2 diabetes also have the disease as a result of heredity, instead of lifestyle choices.
For example, my paternal grandfather is 89 years old. He is 5 feet, 9 inches tall and weighs only 140 pounds. Yet, he has had Type 2 diabetes for the past 5 years. He is so slight that we worry about him fading away. Our biggest challenge is to help him keep weight on, without causing him to lose more weight due to an erroneous match of medicine to carbohydrate ingestion.
Bottom line is that, whether you have Type 1 or Type 2 diabetes, you may not be able to reverse it with diet and exercise. Some of it depends on heredity and age. Other times, the further the disease has progressed, the less likely it is to turn it around.
Do You or a Loved One Have Diabetes?
5. Water, Hormones and Age Play a Big Role
Of these three factors, the only one you can control is water consumption. Dehydration causes stress on the body, which can, in turn, raise blood glucose levels.
Yet, hormones and aging are two additional factors over which we have no control. I know that my cousin had significant high blood sugar issues when he went through puberty. I also understand that women going through menopause may experience otherwise unexplained swings in blood glucose levels. At the age of 43, I am not there yet, but believe me, I am watching and waiting!
Diabetes Books on Amazon
6. High Fat Meals Slow Absorption and Cause Later Spikes in Blood Glucose
Since I was diagnosed with diabetes, there are three things that I simply cannot eat: pizza, french fries and potato chips.
Yes, I can try to enjoy these favorites, but I generally have significant problems dosing my insulin appropriately to avoid highs and lows.
With an insulin pump, you can "spread out" a shot so that the insulin does not peak too early or too late. However, I can tell you that estimating the amount of carbs and fat in a "typical" restaurant meal is very difficult. Even after 10 years, I still tend to underestimate.
Even when cooking at home, it can be tough. If only all recipes could come with a reliable "Nutrition Facts," plus guidance as to what constitutes a single serving. Many people struggle with underestimating the amount of food they are actually consuming!
High fat meals like pizza, fries, chips, "Chinese food" and many Italian food options take more time than usual to digest. This means that diabetics who dose insulin or other medications to peak within 1-2 hours after a meal may suffer a low on the early side, then have high blood sugar 3-4 hours later.
Personally, I find that high fat meals are just too difficult to predict in advance. Accordingly, I rarely enjoy items that I used to love years ago. Probably because I simply cannot love them without worry and guilt.
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7. The Effects of Exercise Last Longer than you might Think
How ironic that one of the treatments most frequently prescribed - exercise - can actually cause you to suffer hypoglycemia, or low blood sugar.
I am a marathon runner. After any episode of exercise lasting 2 hours or longer, I often have to watch my blood glucose levels more closely for the rest of the day.
After prolonged intense exercise, your muscles will continue to uptake glucose at a more efficient rate. Dehydration comes into play, as well as potentially decreased appetite.
Be sure to talk with your doctor about exercise and also test more frequently than usual before an afterward. At times, your blood sugar can actually spike into hyperglycemia due to the stress of the exercise itself. No one can predict how they will react to intensive exercise when they have diabetes. Your best bet is to keep close tabs on your levels for at least 12-24 hours afterward.
9. Doctors Only Know a Fraction of the Variables that Affect Blood Glucose Levels
When I was diagnosed with diabetes in 2003, my endocrinologist told m then that medical doctors only know a fraction of the variables that affect blood glucose levels.
In other words, we know that what you eat, how much you exercise, your age, hormone levels, stress, etc. can have an impact on whether you have hypoglycemia or hyperglycemia. However, you can have the exact same "day," with respect to each of these variables, and your levels will be different.
Some of it may have to do with the amount and quality of sleep. Other factors could have to do with the intensity of exercise and any change in muscle to fat ratio in your body. Could the lunar cycle have something to do with it? Who knows!
The bottom line is that there are thousands, if not millions of factors that come into play in our daily lives - all of which affect potential blood sugar levels.
8. Stress Plays a Big Role in Blood Glucose Levels
Do you know what happens when you are under stress and/or have an illness?
Your body releases stored glucose as it is used to doing for thousands of years, in a fight or flight response.
Many years ago, humans adapted to living, hunting and surviving in the wild by developing a response that allowed them to key into stressful situations in which they would have to literally run for their lives.
When a predator arrived on the scene, we did not have to immediately fuel up in order to be able to run away. Rather, stored glucose in our livers would be released - dumped into our blood stream - to give us a quick source of fuel to use in running away or fighting.
While we do not face similar stresses in the wild these days, our bodies are still attuned to the effects of stress hormones, which are released in modern day circumstances. The flight or fight response causes a quick rise in blood glucose levels, even if we do not use that energy to run away.
The daily stress that we experience in the 21st century is vastly different than that experienced by our ancestors many years ago. However, the physiological response is just the same!
Blood Sugar Levels and Diabetics
10. Close Monitoring is your Best Bet
Whether you have Type 1 or Type 2 Diabetes, keeping a close watch on your blood glucose levels is your best bet to staying healthy.
Personally, I have been frustrated with my insurance company's reluctance to pay for enough diabetes test strips to keep my healthy.
If you hare experiencing a similar situation, have your doctor contact your insurance to prescribe a certain amount of test strips to help you appropriately manage your diabetes. At a minimum, you should test 4-6 times a day, whether you are Type 1 or Type 2. If you have Type 1 diabetes and are active, you may need to test 8-10 times per day. Be sure to factor in 1-2 test strips per day that might be "lost" due to error messages.
No matter your circumstances, close monitoring of your blood glucose levels can help you prevent extreme highs and lows that may result in more serious conditions if not immediately addressed. If you do not feel like you have the freedom to frequently monitor blood sugar levels, you could downplay or explain away symptoms, including hunger, thirst, confusion, tiredness, etc.
Believe me - after having lived with diabetes for 10 years, I have mistaken the symptoms for "normal' and vice versa many times, just because I didn't want to test my blood glucose
Don't fall into the same trap! Be safe and healthy!