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All About Diabetes

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 20.8 million people in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

Major Types of Diabetes (Top)

Type 1 diabetes
Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.

Gestational diabetes
Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases in the United States each year.

Pre-diabetes
Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 41 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes.

Services

• Diabetes Self-management Training (DSMT):
  Individual and group teaching provided by a registered nurse and dietician designed to assist people who have diabetes in acquiring the knowledge and skills needed to manage the disease.
• Medical Nutrition Therapy (MNT):
  Nutritional diagnostic, therapeutic, and counseling services provided by a nutritional professional for the purpose of managing diabetes.
• Coordination of care with other professionals in field of diabetes ( i.e. Podiatrist, Ophthalmologist, Exercise Specialist)

Content

Topics covered are based on each participant’s individual learning needs in the following areas:

• Diabetes disease process and treatment options
• Nutritional management
• Physical activity
• Medications (if applicable)
• Monitoring
• Acute complications
• Chronic complications
• Goal setting and problem solving
• Psychosocial adjustment
• Preconception, pregnancy and Gestational diabetes (if applicable)

Teaching time necessary to cover all content areas is generally 6-10 hours.

Each participant is encouraged to invite a family member, friend, neighbor, or co-worker to learn about diabetes with them.

Patty's Q&A Corner (Top)

Q: How do I know whether my blood glucose meter and strips are working right?
R: Do a control test.

Q: How is this done?
R: A “control” test is done just like a regular glucose test, except control solution is used instead of blood.

Q: What is meant by the word “control?”
R: The manufacturer knows how much sugar was put into the control solution, so it is a known or “controlled” amount.

Q: Where do I find the range of numbers that is expected if my meter and strips are working right?
R: The control range is found on the bottle of strips. Some meters have a “Hi” sugar solution to confirm that the meter is working in the high ranges, and a “Lo” sugar solution to check the lower glucose concentrations. Be sure to compare the results for the “Hi” or “Lo” bottle with the correct control range on the bottle of strips.

Q: When should a control test be done?

• If the meter is new.
• When a new bottle of strips is used.
• Once a week to check on the equipment.
• If the meter was dropped.
• Anytime the results are doubted or don’t agree with the way you feel.

If you want to make sure you are performing tests correctly.

Q: How do I care for the control solution?
Make sure the brand of control solution exactly matches the brand of the meter.
When you first open the bottle, write the date on the label. The solution is good for only three months from the date opened or until the expiration date on the bottle, whichever comes first.
Never use control solution that has expired.
Always close the control solution tightly.
For accurate results, before you apply a drop of solution to a test strip, roll the bottle to mix the contents, squeeze one drop onto a paper towel, then wipe the bottle tip clean.

Q: Why does all of this matter so much?
A: A control test tells you if your blood glucose test results are accurate. If the result is not accurate, the information is, at the least, useless, and could actually be dangerous. The pain and effort of doing a blood test is wasted if the reading
Q. What is the Hemoglobin A1C Test?

A. According to H. Peter Chase, M.D. of the Barbara Davis Center at the University of Colorado, “This test is the most valuable way to monitor blood sugar levels over time. Hemoglobin is the protein in red blood cells that carries oxygen to various parts of the body. If the blood sugar is high, sugar attaches to the hemoglobin and remains there for the life of the red blood cell (an average of 2-3 months). The sugar doesn’t come off if a low blood sugar occurs. This test has been used since the 1970’s. It has been called “an answer to prayer”, because before its discovery, no one really knew if they were in good blood sugar control.

Q. What does the hemoglobin A, C number mean?

A. HbA1C is reported as a percentage. People without diabetes run 4-6%. The American Diabetes Association has suggested a goal of below 7% for adults with diabetes.

Q. Why is it so important?

A. Research has shown that for every 1% the HbA1C moves toward 7%, there is a 35% drop in the risk for eye, kidney, and nerve complications from diabetes! For every 1% drop in the HbA1C, there is a 14% drop in the risk of heart attack or stroke!

Q. How often should the HbA1C test be done?

A. The test should be done every 3 months if the level is over 7%. When a person consistently has readings less than 7%, the frequency of the test can be lengthened to every 6 months.

My most recent HbA1C level: _________________
Date drawn: ________________________________

If you don’t know when you had your last HbA1C test or what your level was, please call your provider’s clinic and ask. You can then make plans to get the lab test updated, and of course, USE THE INFORMATION to make decisions about how to treat the diabetes.