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Diabetes – Doctor recommendations for healthy blood sugars 

By Dr. Chantal Lewis, MD

So, the holidays have come and gone and many of us have been to family gatherings and other fun festivities where we have indulged in our favorite pastries, side dishes, libations, and entrees all of which were probably ladened with starch and sugar. Thankfully, the holidays, packed with all its sugary treats, only come once a year and most people have now turned their focus to getting back on track and eating healthy meals. In fact, this is the time when many people make new year’s resolutions to become fit. But some might ask the question what happens to all that sugar and starch that is consumed during the holidays and what happens if our bodies aren’t able to fully process all the sugary foods that we eat. Well, that brings us to the topic of diabetes- Here are some tips for healthy blood sugars.

Diabetes Mellitus

Diabetes mellitus is a chronic illness where the body does not properly process blood glucose.  In general, when an individual has diabetes, the pancreas does not produce enough insulin to process the sugar and starch it consumes. In other instances, the insulin that the body does produce is not as efficient with processing the blood sugar.  When a person develops diabetes their blood glucose becomes high. Typically, normal fasting blood sugar (which is blood sugar prior to eating the first meal of the day) is approximately 70 to 100. After eating the first meal of the day, blood sugar levels may be higher than100, but individuals who do not have diabetes or pre-diabetes are usually able to keep their blood sugars below 100.

Two Types of Diabetes

There are two types of diabetes, type one, and type two. Type one can be familial or genetic in nature and will generally occur in early childhood or during teenage years. Type one diabetes is caused by autoimmune destruction of the islet cells of the pancreas. Type two diabetes, which typically occurs in older adults, may not be familial and may develop as patients gain weight.  In type two diabetes there is insulin resistance. With insulin resistance, the body’s cells do not respond normally to insulin. While type two diabetes generally occurs in adults, it is now also seen in children who are obese.

Signs and symptoms of diabetes include but are not limited to weight loss, (mostly seen in type one diabetes), production of large volumes of urine, increased thirst, blurry vision, poor wound healing, and sometimes the development of dark, scaly skin patches. Individuals with these symptoms should consider being screened for diabetes. There are several ways to screen for diabetes. These include but are not limited to a fasting blood sugar test or a hemoglobin a1c test.

 A diagnosis of diabetes can be made when symptoms of high blood sugar are associated with a single non-fasting blood sugar measurement of 200 mg or greater or a fasting blood sugar of 126 or higher. More commonly, diabetes can be diagnosed with a hemoglobin a1c of 6.5% or greater. A hemoglobin a1c result represents an average of blood sugars over a three-month period. 

Treatment Options

Treatment options for diabetes include oral medication, injectable medication, and lifestyle changes. One common oral medication for diabetes is Metformin. Metformin decreases the production of sugar. It also decreases the amount of sugar the intestines absorb and increases insulin sensitivity. On the other hand, Insulin is an injectable medication used to treat diabetes. Patients with extremely high levels of blood sugar may require insulin. Injectable insulin can be long-acting. Common long-acting insulin is Lantus. Lantus may be injected once a day or twice a day. Long-acting insulin works all day to keep blood sugars at a normal level. Short-acting insulin, with common brands being Humalog and NovoLog, acts quickly and for short periods of time to lower blood sugar. They are typically given with meals or when a patient’s blood sugar spikes suddenly.

Lifestyle modifications can also be extremely helpful in treating diabetes. If an individual is overweight, regular exercise and losing weight can help with lowering blood sugar. Limiting intake of sweet and starchy foods can also help with keeping blood sugar normal.

If diabetes goes untreated and blood sugar remains high for extended periods of time, patients can experience complications. Complications of diabetes can include but are not limited to heart disease, stroke, loss of vision, and kidney disease, thus the importance of having healthy blood sugars.

Skilled Nurse Giving Insulin Shot to Diabetic Senior

Routine Health Assesments

Yearly health assessments with a primary care physician are a great opportunity to discuss symptoms of diabetes or screen for diabetes. The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type two diabetes in adults 40 to 70 years of age who are overweight or obese. While a diagnosis of diabetes can seem daunting, it can be adequately managed and if diagnosed early, can lead to fewer complications.  Individuals who are concerned or suspect that they may have diabetes should contact their physician sooner than later for appropriate consultation and screening. 

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This article is meant for educational purposes only and is not meant to take the place of medical advice from licensed medical professionals. 

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