“Blood Sugar Basics: Terms You Should Know”

 

HYPO-GLUCO-WHAT? Start getting into the subject of blood sugar, and you may feel like you are speaking another language! Here are some of the most common words and phrases you might hear when you are talking to your doctor about metabolic syndrome, insulin resistance, or diabetes.

BLOOD GLUCOSE: Glucose is a kind of sugar that your cells use for energy. Your body makes it from the food you eat and delivers it to your cells through your blood. A "blood sugar" level -- or how much glucose is in your blood -- is usually measured in milligrams per deciliter (mg/dL).

GLUCOSE METER: A device that measures your blood sugar. First you put a test strip in the meter. Then you prick your fingertip with a lancet, a gizmo with a spring inside that pops a small needle out against your skin to get a drop of blood. You touch the test strip to the blood, and your number will show up on the display. Read the directions for your model to make sure you are using it right.

HYPERGLYCEMIA AND HYPOGLYCEMIA: These are the doctors' way of saying your blood sugar is high or low. (A good way to remember the difference is that "O" sound is in both "hypo-" and "low.") Usually hyperglycemia is over 160 mg/dL, but your doctor may have set a different target for you. Sometimes people have high blood sugar in the very early morning, called "dawn phenomenon." Hypoglycemia is usually less than 70 mg/dL; you could pass out if it is severe.

SOMOGYI EFFECT: Also called the "rebound effect," it is when your blood glucose gets really high after it's been really low, typically while you were sleeping. If it happens a lot, you might need to check your blood sugar in the middle of the night. You can often prevent the Somogyi effect by having a snack in the evening or adjusting your insulin.

PANCREAS: A gland about the size of your hand, just below and behind your stomach. Groups of cells called islets (sometimes called islets of Langerhans) make hormones and digestive juices that help you break down and use food. Its beta cells make insulin, and its alpha cells make glucagon.

INSULIN: The hormone that helps your cells use glucose. If your pancreas does not make any or cannot make enough, you can take man-made insulin. Types of insulin describe how fast and how long they work: rapid-acting, regular or short-acting, intermediate-acting, and long-acting. You may need more than one kind to control your blood sugar.

INJECTION: How you get insulin into your body. One way is a shot with a needle and syringe. The syringe has two parts: the tube where the insulin goes, and the plunger, the part you push down. Insulin pens look a lot like the pens you write with. You fill one with cartridges, dial up the dose, and give the shot. Jet injectors use high pressure instead of a needle to push the insulin through your skin in a burst.

INSULIN PUMP: You wear or carry this device next to your body. A thin tube connects it to a needle that goes just under your skin. The pump gives a trickle of insulin all day long to help keep your blood glucose steady. You can also program a dose of insulin at mealtime or when your blood sugar is too high. It is more common for people with type 1 diabetes to use one, but someone with type 2 might, too.

BASAL INSULIN: Think of the word "base" to remember what this is: a background insulin. It is not a kind of insulin, but rather a reason for taking it. Also called "basal insulin replacement," it helps keep your blood glucose steady between meals and overnight. People with type 1 diabetes take a basal insulin because their pancreas is broken. People with type 2 diabetes might or might not need it.

BOLUS INSULIN: It sounds like "bonus," and that's sort of what it is: insulin that someone with diabetes takes when they eat or when they need to bring their blood glucose down. It might be a different kind than their basal or background insulin. People who use insulin pumps get a bolus infusion. A shot of insulin is a bolus injection.

GLUCAGON: Another hormone your pancreas makes. It works the opposite of insulin and raises your blood glucose. It also comes in a kit for a low blood glucose emergency in case you cannot eat or drink to get your blood sugar back up. If you have passed out or you are having a seizure, someone else can give you a shot.

INSULIN RESISTANCE: This is how doctors describe what happens when your cells do not use insulin right, even if you have plenty of it. You usually cannot tell you have insulin resistance, but it leads to prediabetes and diabetes because glucose can't get from your blood into your cells. It is linked to obesity, high blood pressure, and high cholesterol. Losing weight can help turn it around.

PREDIABETES: Blood glucose that is higher than normal but not high enough to be diabetes. It's also called impaired glucose tolerance and impaired fasting glucose. If you have it, you're more likely to get type 2 diabetes. You can lower your chances by losing weight, being more active, or taking a diabetes drug called metformin.

DIABETES MELLITUS: This is the disease that people usually mean when they say "diabetes," when your body has trouble using or cannot use the glucose in your blood for energy. With type 1, your body's natural defenses destroy the beta cells in your pancreas that make insulin. With type 2, your pancreas doesn't make enough insulin, or your body can't use it well.

GESTATIONAL DIABETES: Pregnant women can get a kind of diabetes mellitus that usually goes away after they give birth. Watching what you eat and being active will help keep your blood sugar down and you and your baby healthy. Some women also need to take insulin. Having gestational diabetes once makes you more likely to get it again, as well as to develop type 2 diabetes later.

'BRITTLE' DIABETES: An older term for diabetes that is hard to control because your blood glucose changes between high and low very quickly. Sometimes this is called "labile" or unstable diabetes.

DIABETES INSIPIDUS: Problems in your pituitary gland or kidneys cause this kind of diabetes. You will have normal blood glucose, but you'll be very thirsty, feel weak, and pee a lot.

DIABETIC KETOACIDOSIS: "DKA" is an emergency that happens when you have a lot of glucose in your blood but very little insulin. To get energy, your body breaks down fat instead, which makes ketones. If those build up in your blood, you could go into a coma and die.

FASTING BLOOD GLUCOSE TEST: Your doctor checks your blood glucose after you have not eaten for 8 to 12 hours. This test is used to diagnose prediabetes and diabetes. You may get one even if you already know you have diabetes, to keep tabs on it.

ORAL GLUCOSE TOLERANCE TEST: Another test that helps your doctor diagnose prediabetes and diabetes. You do not eat anything the night before. To start the test, your doctor will get a sample of your blood. Then you will drink a sugary drink, and they will take a few more blood samples over the next 2 or 3 hours. The results tell your doctor how your body uses glucose. Sometimes, the test is called by its initials: OGTT.

A1C: This test - also called a hemoglobin A1c, HbA1c, or glycohemoglobin test - measures the "average" amount of sugar in your blood over the past 2 to 3 months. It tells you how much glucose has been sticking to your red blood cells. The result is a percentage, and the number you want depends on your age and health. For example, an A1c at or below 7% can lower an adult's chances of getting more problems from the disease.

ENDOCRINOLOGIST: A doctor that specializes in glands and in hormones like insulin. If you have recently been diagnosed with diabetes, you're having trouble managing it or you have complications because of it, or you use an insulin pump, you may need to see an endocrinologist.

DIABETES EDUCATOR: A health care professional who has the knowledge and experience to teach and support someone with prediabetes or diabetes to prevent or manage the condition. They can be doctors, nurses, dietitians, mental health professionals, fitness professionals, or pharmacists. The letters "CDE" after their name stand for "certified diabetes educator" and mean they have met standards and passed a written test.

PREPRANDIAL AND POSTPRANDIAL: These are fancy ways to say, "before eating" and "after eating." They usually refer to testing your blood sugar or the glucose reading when you did. Comparing the numbers helps to see how your body reacts to food. Preprandial is just before a meal. Postprandial is 1 to 2 hours afterward.

CARBOHYDRATE: Along with protein and fat, this is one of three kinds of nutrients in your food. "Carbs," for short, include sugars and starches. They are the main source of fuel for your body. Healthy carbs are whole grains, fruits, and vegetables. Unhealthy carbs are foods with added sugars and few vitamins and minerals -- things like cookies, soda, and candy.

CARB COUNTING: A way of planning what to eat. You keep track of the number (or grams) of carbohydrates in your food. Carb counting can help your figure out how much insulin to take.

GLYCEMIC INDEX: Not all carbs are the same. This ranking system helps you compare foods by how fast they will raise blood glucose. Carbs boost it quickly, while eating protein, fat, or fiber at the same time offsets their effect. The glycemic load takes the serving size into account, too, to give you a better idea of how your blood sugar will be affected.

EXCHANGE LISTS: A meal-planning system that groups foods as carbs, meat and meat alternatives, or fats. The idea is that you can switch out specific serving sizes of different foods within the groups to get the same basic nutrition.

REVIEWED BY: Michael Dansinger, MD, WebMD on August 05, 2019

SOURCES:

Joslin Diabetes Center: "Diabetes Glossary."

UCSF Diabetes Education Online: "Monitoring Your Blood," "Diabetes Glossary."

American Diabetes Association: "Common Terms," "Insulin Basics."

Cleveland Clinic: "Glossary of Diabetes Terms."

KidsHealth: "Dictionary: Bolus."

Memorial Sloan Kettering Cancer Center: "How to Give an Emergency Glucagon Injection to Treat Low Blood Sugar."

National Institute of Diabetes and Digestive and Kidney Diseases: "Principle 2: Manage Prediabetes, Prevent Type 2 Diabetes," "The A1C Test & Diabetes," "Carbohydrate Counting & Diabetes."

CDC: "Diabetes Home: Glossary of Terms."

Diabetes Forecast: "The 'Brittle Diabetes' Debate."

UConn Health: "Endocrinology."

National Certification Board for Diabetes Educators: "Welcome to the National Certification Board for Diabetes Educators."

Harvard Health Publications: "Glycemic index and glycemic load for 100+ foods."

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“15 Exercise Tips for People With Type 2 Diabetes”

 

These tips will help you ease back into exercise and find a workout plan that works for you.

GET A MOVE ON: Exercise is safe—and highly recommended—for most people with type 2 diabetes, including those with complications. Along with diet and medication, exercise will help you lower blood sugar and lose weight. However, the prospect of diving into a workout routine may be intimidating. If you're like many newly diagnosed type 2 diabetics, you may not have exercised in years. If that's the case, don't worry: It's fine to start slow and work up. These tips will help you ease back into exercise and find a workout plan that works for you.

TRY QUICK WORKOUTS: As long as you're totaling 30 minutes of exercise each day, several brief workouts are fine, says George Griffing, MD, professor of endocrinology at the Saint Louis University School of Medicine in St. Louis. "We need people with diabetes up and moving," Dr. Griffing says. "If you can do your exercise in one 30-minute stretch, fine. But if not, break it up into increments you can manage that add up to at least 30 minutes each day."

FOCUS ON OVERALL ACTIVITY: Increase activity in general—such as walking or climbing stairs—rather than a particular type of exercise. However, don't rely on housework or other daily activity as your sole exercise. Too often, people overestimate the amount of exercise they get and underestimate the amount of calories they consume. (A step-counting pedometer can help.)

GET A PEDOMETER: Stanford University researchers conducted a review of 26 studies looking at the use of pedometers as motivation for physical activity. Published in 2007, the review found that people who used a pedometer increased their activity by 27%. Having a goal of 10,000 steps a day (about five miles) was important, even if the goal wasn't reached. Pedometer users lost more weight, had a greater drop in blood pressure, and walked about 2,500 steps more per day than those who didn't use a pedometer.

WORK OUT WITH A FRIEND: Working out with friends can be an important motivator, particularly for people over 60, according to Vicki Conn, PhD, the associate dean for research at the University of Missouri in Columbia, Mo., who has studied diabetes and exercise. Having a friend call or setting up an exercise "contract" with a buddy may help. "One of the things we found with our meta-analysis is that behavioral strategies work better; that means setting up some sort of stimulus in the environment where you exercise," says Conn.

SET SPECIFIC, ATTAINABLE GOALS: For example, you might set a goal of walking 10 minutes every Monday, Wednesday, and Saturday. "That doesn't sound like a lot, but...setting up very specific goals like that helps people a lot more than telling people, 'Gee, you've got to exercise more,' " says Conn.

REWARD YOURSELF: Rather than focusing on the bad things that could happen if you don't exercise, reward yourself for reaching your goals. You might say "OK, if I exercise 10 minutes, three times a week for the next three weeks, I'll call my sister-in-law who lives in Australia," says Conn. Don't hold out for weight loss as an emotional "reward." Focus on other benefits, such as having more energy or enjoying the outdoors when you walk.

USE VISUAL CUES: Put a note on the refrigerator or keep your walking shoes next to the back door as a reminder to go for a walk and it'll be more likely to happen.

WRITE IT ALL DOWN: Write down your goals, be specific, and keep a record every time you do exercise, says Conn. Record on your calendar every day whether you exercised for 10 or 15 minutes or more.

JOIN A CLASS: A class is good because there is an exercise leader and someone to call for emergency help, if necessary, says Conn. For many seniors, there are free gym memberships and wellness programs included in their Medicare plans." "There is a structured experience exercising and they will learn how their body will react and then they will grow more confident to go out and exercise on their own," she says.

DON’T SET GOALS TOO HIGH: "It's much better to set a lower goal and be successful at it," says Conn. "That increases one's sense of confidence. Then you can set a slightly higher goal the next time. You are much more likely to be successful if you start with small, easily attainable goals and gradually increase them."

LOOK AT THE BIG PICTURE: Working up to a moderate amount of exercise quickly isn't that important in terms of your health. "What really matters is next year, you are doing it all the time," says Conn. "Getting there eventually in a way that you are able to stay with it is what is important because it is long-term behavior change that has health consequences."

CHANGE ONE BEHAVIOR AT A TIME: You're more likely to be successful if you focus on changing one behavior at a time, rather than everything at once (like taking medication, checking your feet, switching your diet, and exercising). "What we found—and this is across many studies with thousands of people—if the study focuses only on changing one behavior, namely exercise, they get twice as much of an improvement in their hemoglobin A1C," says Conn.

GET AN EXERCISE PRESCRIPTION: In this case, a fitness or exercise physiologist can measure how physically fit you are and prescribe a specific intensity of exercise and how to progress to the next level. "It's based on that individual's fitness stake," says Conn. "For a person that is very unfit, and has not been exercising, the exercise prescription will be at a low moderate intensity and then move to a slightly higher intensity and longer duration."

CONNECT WITH A MENTOR OR BECOME ONE: Ask your doctor or diabetes educator to match you with a person with type 2 diabetes who has been successful at exercising and/or losing weight. They may have exercise or weight loss tips that work.

TEST YOURSELF REGULARLY: Keep up with your hemoglobin A1C and blood glucose testing. Good test results can encourage you to keep with an exercise program, even when it feels tedious.

Health Magazine, Updated December 17, 2020

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.
 
"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the Health Magazine and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the Health Magazine and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Health Magazine and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. Health Magazine and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by Health Magazine, Health Magazine employees, others appearing on the Site at the invitation of Health Magazine, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk. 

“Type 1 vs. Type 2 Diabetes: What Is the Difference?”

Diabetes is a chronic condition affecting many Americans, but there are some important differences between type 1 and type 2 diabetes. Here's what you need to know about symptoms, diagnosis, treatment and management of diabetes.

If you live in America, you undoubtedly know someone who lives with diabetes-the Centers for Disease Control and Prevention (CDC) reports that about 1 in 10 Americans has diabetes. Of these roughly 30 million people, only 1.2 million have type 1 diabetes, and the remaining 29 million have type 2 diabetes. While there are similarities between these two types of diabetes, they're actually two distinct conditions, each with unique symptoms and management protocols. Here's what you need to know about the differences (and similarities) between type 1 and type 2 diabetes.

Both type 1 and type 2 diabetes have to do with the hormone insulin.

Without getting too deep in biochemistry, it's important to know that insulin is a hormone secreted by the pancreas when levels of blood glucose (blood sugar) in the body are high-that is, right after a meal or snack that contains carbohydrates, which are made of glucose and other sugars. In a nutshell, insulin tells your body to shuttle glucose to cells for energy, and to store glucose in the liver and other tissues. When this happens, your blood sugar levels lower, your body gets the energy it needs, and any leftover glucose is stored and saved for when you need energy between meals.

IN TYPE 1 DIABETES, YOUR BODY DOESN’T PRODUCE INSULIN:

"Type 1 diabetes is due to not producing any insulin," says Grenye O’Malley, M.D., an endocrinologist at the Mount Sinai Diabetes Center and an assistant professor at the Icahn School of Medicine at Mount Sinai. "The most common cause is an autoimmune process in which your body attacks your own pancreas." Without insulin, your body doesn't know to use glucose for energy (or storage), even after you've eaten and there's plenty of glucose in your blood. In fact, your liver ends up releasing more glucose into your blood-because glucose isn't being shuttled to your liver for energy and storage, it thinks you're starving. So, your blood sugar stays high (this is called hyperglycemia), and other cells don't get the energy they need, which can lead to serious health problems. "Type 1 is typically diagnosed at a younger age, but it can be diagnosed at any age," O'Malley says. Doctors and scientists aren't exactly sure what causes type 1 diabetes, but it's likely a genetic condition, and it isn't caused by diet or other lifestyle factors. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a patient with type 1 will experience symptoms like increased hunger and thirst, frequent urination, fatigue, blurred vision, numbness or tingling in the hands and feet, sores that don't heal, and unexplained weight loss. If a patient shows these symptoms, a doctor will likely test glucose using one of three tests: a fasting plasma glucose test, an oral glucose tolerance test or a random plasma glucose test. Glucose levels of 126 or above for the fasting plasma glucose test, or 200 or above for the oral glucose tolerance or random plasma glucose tests, are indicative of diabetes. After diagnosis and with proper management, these symptoms should disappear.

IN TYPE 2 DIABETES, YOUR BODY PRODUCES INSULIN, BUT IT DOESN’T WORK PROPERLY:

"In type 2 diabetes, you produce insulin, but the main issue is that the rest of your body does not listen to it," O'Malley explains. "We call this insulin resistance." When blood sugar is high and insulin is released, your body ignores it. Just like in type 1 diabetes, your blood sugar stays high, your liver releases even more glucose, and other cells don't get the energy they need.
"With time, some patients with type 2 diabetes may start to produce less insulin, but not to the same extent as with type 1," O'Malley says.

Although some people are genetically predisposed to developing type 2 diabetes, lifestyle factors also play a role. According to the NIDDK, a person is more likely to develop type 2 diabetes if they are overweight or obese, have high blood pressure, have high cholesterol or are not physically active. People over the age of 45, or with a history of heart attack or stroke, are also more likely to develop the disease.

Although people with type 2 diabetes sometimes experience the same symptoms as those with type 1 diabetes prior to diagnosis, many have no symptoms at all. Doctors routinely test for diabetes using blood glucose tests in patients over 45, or patients with two or more other risk factors, according to the NIDDK. As in type 1 diabetes, glucose levels of 126 or above for the fasting plasma glucose test, or 200 or above for the oral glucose tolerance or random plasma glucose tests, are indicative of diabetes.

An important side note here: These blood glucose tests can also be used to diagnose "prediabetes," a precursor to type 2 diabetes that affects more than 80 million Americans. Glucose levels of 100 to 125 for the fasting plasma glucose test, or 140 to 199 for the oral glucose tolerance test, are indicative of prediabetes. If a patient has prediabetes, a doctor will recommend lifestyle changes like healthier eating and maybe weight loss to prevent the onset of type 2 diabetes.

BECAUSE OF THEIR DIFFERENT CAUSES, THE TREATMENT PLANS FOR TYPE 1 AND TYPE 2 DIABETES ARE ALSO SLIGHTLY DIFFERENT:

"People with type 1 diabetes need multiple insulin injections a day or a continuous infusion through an insulin pump," O'Malley says. They also need to check their blood sugar regularly, usually by pricking a finger and using a glucose monitor to test a drop of blood. "Type 1 is not yet reversible; people with type 1 diabetes need to be on insulin for the rest of their lives," O'Malley says.

In both type 1 and type 2 diabetes, regular exercise and a balanced diet are also important for keeping blood sugar levels relatively steady, according to the American Diabetes Association. People with diabetes should work with a registered dietitian to find a sustainable way of eating that balances carbohydrate intake throughout the day.

In type 2 diabetes, it's possible for some patients to manage the condition with diet alone, O'Malley says. In fact, type 2 diabetes is sometimes reversible with proper diet and weight maintenance. But, O'Malley says this reversal can be difficult to maintain long-term. "I focus on how to control diabetes, as opposed to reversing it."

Although some people with type 2 diabetes might use insulin injections for treatment (as in type 1 diabetes), this isn't common. Instead, patients are often prescribed medications meant to keep blood sugar levels low and/or improve insulin sensitivity.

In both types of diabetes, O'Malley recommends that patients try to keep their blood pressure and cholesterol in a healthy range, quit smoking, exercise regularly and periodically have their doctor check for abnormalities in major areas affected by diabetes: heart, kidneys, eyes and feet. All of this minimizes the risks of diabetes.

ULTIMATELY, THE GOAL IN MANAGING BOTH TYPES OF DIABETES IS TO KEEP BLOOD SUGAR LEVELS STEADY OVER TIME:

The goal of diabetes treatment-whether through insulin injections, medication or proper diet-is to keep blood sugar levels as steady as possible to minimize potential complications. All people with diabetes should see a doctor for an A1C test two to four times a year, according to the NIDDK. The test results show average blood glucose level over the past three months, and the goal for many people with diabetes is for that level to remain below 7%.
Diabetes is a chronic condition, and both types of diabetes require long-term treatment. But with proper management, patients can lead long, healthy lives.

BY: Christine Byrne, Health Magazine, August 28, 2019 

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the Health Magazine and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the Health Magazine and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Health Magazine and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. Health Magazine and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by Health Magazine, Health Magazine employees, others appearing on the Site at the invitation of Health Magazine, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.