Editor

Type 1 is the type of diabetes most people develop before the age of 30. All people with type 1 must take insulin, because their bodies do not make enough of it.

Insulin helps your body to turn food into energy and is the key that unlocks cell walls to let sugar enter your cells.

Type 2 is the type of diabetes many adults develop after the age of 40, but it can develop at a younger age. For some people with type 2, glucose (sugar) levels can be controlled through healthy eating and the right amount of physical exercise. If these treatments do not work, you may have to take diabetes pills to lower your blood glucose, and possibly insulin if your body is not making enough.

It’s important to remember that diabetes medicines that lower blood glucose never take the place of healthy eating and exercise. Also, if your blood glucose gets too low more than a few times in a few days, call your doctor. And, finally, even if you don’t feel well, take your diabetes pills and/or insulin as prescribed, and if you can’t eat much, let your doctor know right away.

Glucose, a form of sugar, is the body’s main source of fuel. Hypoglycemia, or low blood sugar, happens when blood levels of glucose fall too low to supply your body’s activity.

Carbohydrates (sugars and starches) are the body’s main sources of glucose. When you are digesting food, glucose is absorbed into your blood stream. Your blood carries glucose to every cell in your body. Unused glucose is stored in your liver.

Hypoglycemia can be a diabetesrelated problem, a condition by itself, or as a complication of other health problems.

When you use insulin or diabetes pills to help control your blood glucose, you are at a greater risk for hypoglycemia. Taking too much medication, missing or delaying a meal, eating too little food for the amount of insulin taken, exercising too strenuously, drinking too much alcohol, or any combination of these factors can contribute to low blood sugar.

The symptoms of low blood sugar are weakness, sleepiness, confusion, hunger and dizziness. If you experience any of these symptoms, call your doctor right away.

Knowing what questions to ask your doctor will help you better manage your blood glucose (sugar) levels, and that will help you to prevent the onset of health problems that are often associated with diabetes. Following are questions you may want to ask your doctor at your next visit. You may even want to bring this list and a notepad with you.

1. How often, and under what conditions, should I test my blood glucose? What should I do with the results? What patterns should I try to achieve?
2. What is my HbA1c? (HbA1c is the test that measures your average blood glucose level over the last 3 months.)
3. How can I get my HbA1c into the normal range?
4. What effect has diabetes had on my eyes, kidneys, and feet?
5. Do I have microalbuminuria (the detection of tiny amounts of albumin in urine indicating early kidney disease) as a result of my diabetes?
6. How should I take care of my feet?
7. When should I meet with a dietitian to review what I eat?
8. What exercises are best for me? What adjustments to my food or insulin should I make if I plan to exercise?
9. What should my family and friends do if my blood sugar drops so low that I need their help?
10. Are there any diabetes support groups I can attend in my area?

Too much sugar in the blood can cause many different problems in your body, including heart disease, kidney damage, blindness, and loss of feeling in your feet and hands. If you work with your doctor or health care professional, these problems can be lessened, or in some cases, avoided.

Your doctor will tell you how often you should be testing your blood sugar with a blood glucose (sugar) meter. Write down the test results and keep a record. This will tell you how well you are controlling your sugar level through diet, exercise, and diabetes medications

The next time you visit your doctor, ask to have an HbA1c test. This is the test that will tell you what your average blood sugar level has been, overall, for the last three months. If the result is higher than 8%, you and your doctor should make adjustments in your treatment plan. If your result is 7% or lower, your current treatment plan is working well, and many of the problems that are a result of diabetes can be delayed or sometimes prevented.

Keep your blood pressure in the normal range. Your doctor may decide you have to take medication to achieve this, but it’s important. Normal blood pressure will help prevent damage to your heart, blood vessels, kidneys, and eyes.

Don’t smoke. Smoking can make heart and blood vessel problems worse, because it slows down your blood flow. If you smoke and find you cannot stop on your own, ask your doctor for help in quitting. Check your feet once a day for sores, blisters, hangnails and calluses. If you have a sore that won’t heal, see your doctor right away. 25% of all hospital admissions for people with diabetes are foot related. Wear shoes that fit well and are comfortable. There are special therapeutic shoes and heat molded inserts available for people with diabetes, and most insurance companies will cover much of the cost.

Blood sugar control: Exercise helps to lower blood sugar in two ways. First of all, exercise decreases insulin resistance, the hallmark of type 2 diabetes. Secondly, exercise increases glucose disposal. An exercising muscle simply uses more sugar than a resting muscle.

Today we have many types of insulin and delivery systems available to us. Which is right for you? Work with your doctor to determine if you need as few as one or as many as four or five injections per day. It will depend on what type of diabetes you have, your age and ability to manage low blood sugar reactions and your lifestyle.

Approximately 50 million Americans have hypertension. That is one out of every four adults. If you are African American, make that one out of three. High blood pressure tends to run in families. It strikes more often in people over 35 years old, and by age 65, more than half of us will have high blood pressure. Women are especially susceptible after menopause. Birth control pills may cause hypertension in some women. Although more common in adults, hypertension can still affect young adults and even children. People with type 2 diabetes are twice as likely to have hypertension.

The use of sugar, sweeteners, and sugar substitutes has often been a topic of hot debate. Until recently, using sugar has been discouraged in diabetic meal planning. Current scientific studies have not supported the necessity of completely abstaining from sugar, and now it’s becoming widely accepted that sugar may be used in moderation without causing deterioration in blood sugar control. Countless studies have investigated the safety profiles of artificial sweeteners.

At least half of all Americans are overweight or obese. Excess weight poses many health risks. Obesity increases the chance of developing numerous diseases, including:

• Type 2 diabetes
• Hypertension
• Lipid Abnormalities
• Coronary heart disease
• Peripheral vascular disease
• Stroke
• Gallbladder disease
• Osteoarthritis
• Sleep apnea and respiratory problems
• Certain cancers, including endometrial, breast, prostate, and colon