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| Pre-diabetes is blood glucose (sugar) that is higher than the normal but not high enough to be diabetes. Almost all people who have it develop diabetes. There are two types of pre-diabetes: impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Impaired glucose tolerance is when the blood sugar level is between 140-199 mg/dl 2 hours after a meal. Impaired fasting glucose is when the fasting blood sugar level is 100-125 mg/dl. Both forms can damage your health. This should be taken seriously to prevent complications. |
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| Diabetes happens when your body is unable to make enough insulin or is unable to use the insulin correctly. Insulin helps get the blood sugar into the cells. The cells use blood sugar for energy. The pancreas is the organ that makes insulin. |
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| | There are several types of Diabetes.
Type 1 Diabetes is when the body stops making insulin. The cause of this is not very well understood. This usually happens to people less then 40. |
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| | Type 2 Diabetes is the more common type. It happens when the body does not use the insulin it makes very well or doesn’t make quite enough insulin. This usually happens to people over 40. Some children and young adults do get this kind of diabetes. |
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| | Gestational Diabetes is diabetes diagnosed during pregnancy. After the pregnancy is over the blood sugar returns to normal. This type of diabetes also places you at higher risk for developing type 2 diabetes later in life. |
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| Diabetes can be diagnosed by a simple blood test. There are two types of test that are used fasting plasma glucose and oral glucose tolerance test. |
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| | A normal fasting plasma glucose test is less than 100 mg/dl. |
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| | A normal oral glucose tolerance test is less than140 mg/dl. |
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| There are many things that play a part in getting diabetes. |
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| | Being overweight
Being inactive
Relatives with diabetes
Prior gestational diabetes
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| | People who are overweight and less active become resistant to insulin. The body is not able to use insulin correctly. The body tries to make up for this by telling the pancreas to make more insulin. After a while the pancreas will burn out. |
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| Some people do not notice anything wrong. Other people may have some or all of the following symptoms: |
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| | Feeling tired
Lack of energy
Urinating often
Feeling very thirsty
Feeling very hungry
Headache
Blurred vision
Losing weight without trying
Pain in the stomach
Body aches
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| | When blood sugar gets very high you may develop weakness, nausea, vomiting, trouble breathing, and passing out. |
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| Diabetes can damage the nerves and blood vessels everywhere in your body. It is the number one cause of blindness, kidney failure, and foot and leg loss. It is a major cause of heart attack and stroke. It can lead to difficulty with sexual arousal and bladder control. Controlling diabetes can reduce the chances of getting these complications. |
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| Diet
Eating a more healthy diet is one way to control your sugar levels. There is no “diabetic” diet. Your dietitian, Diabetes Educator, or doctor will work with you to review your eating habits. Together you can work on ways to eat healthier and control your blood sugar. You may also have goals for weight loss, or cholesterol and blood pressure control. Healthy eating for diabetes helps these goals as well. An eating plan for diabetes is a healthy one for everyone in the family. For more information see “Sample Menu”. |
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| | Exercise
Before starting on any exercise program talk to your Doctor and Diabetes Educator. If you do not exercise regularly start slowly. You need to build up to 30-60 minutes of exercise daily. Strength training is recommended 2 to 3 times per week so your muscles can rest between work outs. Strength training uses exercise bands, weights and even canned goods for lifting and pulling. Aerobic exercise includes walking, running, swimming and biking. For more ideas see “Exercise Tips”. |
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| | Medications.
There are many medicines used to treat diabetes. There are both pills and insulin. Pills help your body make more insulin or use the insulin you make. There are also different types of insulin. Insulin requires giving yourself a small shot. You and your Doctor will decide which medications are right for you. Remember, that after some time, your body will not make enough insulin. If you do not make enough insulin, then you will need to take insulin. This does not mean you have failed to control your diabetes. Your body just can’t make enough. Make sure you discuss how and when to take your medications with your Doctor or Diabetes Educator so that you get the best result from taking them. |
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| | Blood Sugar Testing.
Checking your blood sugar on a regular basis is an important part of your treatment plan. When you are first diagnosed your Diabetes Educator and doctor may recommend you test up to 4 times a day. Testing your blood sugar before and after meals and exercise helps you learn how your body responds to certain foods and activities. Once blood sugars are controlled your Doctor may decrease how often you test.
There are many different types of machines on the market to test your blood sugar. Make sure you talk to your Diabetes Educator and doctor to discuss which would be right for you. |
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| A1c (HgbA1c or Hemoglobin A1c).
A1C is a blood test that shows your average blood sugar over a period of 2-3 months. The goal for your A1C is under 6.5%. This is about a blood sugar of a 135 mg/dl or less. Using both the A1C and your home blood sugar log you and your doctor can get a good idea of your blood sugar control. You and your doctor will use these to make changes to your treatment plan. |
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| | Cholesterol Screening.
High Cholesterol increases risk for heart attack and stroke. People with diabetes are at higher risk for heart attack and stroke. Your doctor looks at LDL cholesterol, HDL cholesterol, and triglycerides. |
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| | LDL (low density lipoprotein) is “bad” cholesterol. LDL clogs up your vessels. The goal for LDL is less than 100 mg/dl.
HDL (high density lipoprotein) is “good” cholesterol. HDL helps keep the LDL from clogging up your vessels. The goal for HDL is more than 45 mg/dl for men and more than 55 mg/dl for women.
Triglycerides may also clog your blood vessels and make LDL rise. The goal for triglycerides is less than 150 mg/dl. |
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| | If these levels are normal this test should be repeated yearly. If these levels are not at target then you and your Doctor will decide on the next step. |
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| | Urine microalbumin or urine protein.
These urine tests show early kidney damage. You doctor can give you medication to protect you kidneys.
If these levels are normal then the urine test should be repeated every year. |
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| | Dilated Eye Exam.
This test is done by an Eye Doctor (Ophthalmologist). The eye doctor can tell if there is damage to the retina (back of the eye) and blood vessels in the eye. The vessels can become weak and bleed easily causing damage to your retina. Finding these problems and treating them early can help you keep your vision.
You should see the eye specialist at least once a year.
Foot Exam
The doctor will not only look at your feet but may also test your feet with a monofilament (that is a piece of fishing line like material attached to a card or pen) to test the fine sensation of your feet. This test is done to find out if there is a decrease in feeling to your feet or sores on your feet. This can lead to loss of that toe, foot or leg. Be sure to take off your shoes and socks when in your Doctors’ exam room so you both remember to check your feet.
This test should be done at least once a year. |
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| When you are first told you have diabetes your Doctor will probably want to see you fairly often. It may be as often as once a month or every 3 months. This is done so you and your Doctor can make sure your treatment plan is working or to discuss ways to change. More visits will be needed if you are ill. Once your blood sugars are under good control for 6-12 months your Doctor MAY decide that you need to visit twice a year. You and your Doctor will decide how often you will need to be seen. |
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| 1.Make an appointment with a Diabetes Educator.
2.Make the changes that you and your Diabetes Educator have discussed.
3.Take the medicines exactly as directed by your Doctor and Diabetes Educator.
4.Test your blood sugar levels as instructed by your Diabetes Educator and Doctor.
5.Keep a record of your blood sugar levels to discuss with your Diabetes Educator and Doctor.
6.Bring you blood sugar log to your appointments with your doctor and diabetes educator.
7.Keep your scheduled Doctor appointments.
8.Stop smoking. If you don’t smoke, don’t start. Ask for help to quit. There are options available.
9.Take good care of your feet. If you have any problems with your feet see your Doctor or a Foot Doctor (Podiatrist).
10.Get a Diabetic Eye Exam at least once a year.
11.See your Dentist at least once a year.
12.Get recommended immunizations
13.You are the only one that can control your diabetes but you are not alone. You have a team to help you. DON’T GIVE UP. YOU CAN DO IT. This is a lot of work and information to learn. You don’t have to do this all at once. Take some time to understand all these steps. Ask for the resources that are available to help you reach your goals. |
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| Unfortunately, there is no cure for diabetes. However, you can control diabetes and live a normal life. This does require a permanent lifestyle change. Some people can control diabetes with diet and exercise. Other people may also need medicines. |
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| Metabolic Syndrome is a condition that may turn into diabetes. Metabolic Syndrome also puts you at a higher risk for Heart Disease and Stroke. |
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| | Your Doctor will determine if you have Metabolic Syndrome by looking at the following things. |
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| | Waist Size. Over 35 inches for women and over 40 inches for men.
Blood Pressure. A blood pressure of 130/80 or higher.
Blood Sugar. A fasting blood sugar of 100 to 125.
HDL (the good cholesterol). A level under 55 for women and under 45 for men.
Triglycerides. A level of 150 or higher. |
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| | If you have 3 of these 5 things you may have Metabolic Syndrome. |
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| Your doctor can order blood tests to look at your HDL, triglyceride, and fasting blood sugar levels. You can have your blood pressure checked. You can use a tape measure to find your waist size. If you have any 3 of the above indicators, you may have metabolic syndrome. |
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| The first step is to talk to your Doctor and Diabetes Educator. You will need to make a change in your exercise and eating habits. Both will help decrease your weight and waist size. Diet changes and exercise will also decrease triglycerides and blood sugar and raise the HDL. |
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| | The biggest thing you can do is to take control and be an active partner in your health care. Only you can take the steps needed to change your lifestyle. |
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| 1. What I should do before a visit to my doctor.
- Identify and write down the most important problem with your diabetes. Do you have a problem with your medications for example?
- Write down any symptoms you have. Examples are feeling tired, lack of energy, urinating often, feeling very thirsty, or feeling very hungry.
- Write down a list of all the medicines you are taking. Include medicines you bought over the counter and herbal supplements.
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| | 2. What I should do during my visit with the doctor.
- Be exact about what is bothering you now.
- Describe how long your symptoms have been a problem.
- Remember to take off your shoes so your doctor can check your feet.
- Tell your doctor if you have had a recent eye exam.
- Ask your doctor to explain anything you don’t understand.
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| | 3. What I should do after the visit.
- Write down what you have been told is the current problem.
- Write down any changes to your diet, exercise, medication, or blood sugar testing.
- For any medications or treatments you are given, write down how long you are to take it, how it will help you, and what happens if you don’t take the medication and/or treatment.
- Write down when you are to come back for your next visit or if you are to call your doctor.
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| American Diabetes Association: All about Diabetes.
Centers for Disease Control: Diabetes and Me
National Institutes of Health: Introduction to Diabetes
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