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How Often Should Type 1 Diabetics Eat

5 Ways Type 1 Diabetes Is Different From Type 2

5 Ways Type 1 Diabetes Is Different From Type 2

When people hear that you have diabetes, they start to make assumptions that aren't always accurate. A lot of the confusion stems from the fact that there are two main types, yet many people don't understand how they're different. (Want to pick up some healthier habits? Sign up to get daily healthy living tips delivered straight to your inbox!) As someone with type 1 diabetes—I was diagnosed with it nearly 40 years ago—I'm all too familiar with the disease. I lived with it as a child, teen, and adult, and when I decided to have kids I had to figure out how to manage the condition while being pregnant. (I even wrote a book about it, Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby.) Having type 1 diabetes means I'm in the minority: Of the approximately 29 million Americans who have diabetes, only 1.25 million have type 1. Most have type 2, which is a totally different form. "Comparing type 1 to type 2 is like comparing apples to tractors," says Gary Scheiner, a Pennsylvania-based certified diabetes educator and author of Think Like a Pancreas. "The only thing they really have in common is that both involve an inability to control blood sugar levels." Here are 5 important distinctions. 1. Type 1 is an autoimmune disease; type 2 isn't. Diabetes happens when your body has trouble with insulin, a hormone that helps convert sugar from the food you eat into energy. When there isn’t enough insulin in your body, sugar builds up in the bloodstream and can make you sick. People with type 1 and type 2 both face this problem, but how they arrived there is quite different. If you have type 1, you don't make any insulin at all. That's because type 1 is an autoimmune disease in which your immune system attacks and destroys the insulin-making cells in your Continue reading >>

Diabetes And Kidney Disease (stages 1-4)

Diabetes And Kidney Disease (stages 1-4)

What is diabetes? Diabetes happens when your body does not make enough insulin or cannot use insulin properly. Insulin is a hormone. It controls how much sugar is in your blood. A high level of sugar in your blood can cause problems in many parts of your body, including your heart, kidneys, eyes, and brain. Over time, this can lead to kidney disease and kidney failure. There are two main types of diabetes. Type 1 diabetes generally begins when people are young. In this case, the body does not make enough insulin. Type 2 diabetes is usually found in adults over 40, but is becoming more common in younger people. It is usually associated with being overweight and tends to run in families. In type 2 diabetes, the body makes insulin, but cannot use it well. What is chronic kidney disease (CKD)? Your kidneys are important because they keep the rest of your body in balance. They: Remove waste products from the body Balance the body’s fluids Help keep blood pressure under control Keep bones healthy Help make red blood cells. When you have kidney disease, it means that the kidneys have been damaged. Kidneys can get damaged from a disease like diabetes. Once your kidneys are damaged, they cannot filter your blood nor do other jobs as well as they should. When diabetes is not well controlled, the sugar level in your blood goes up. This is called hyperglycemia. Hyperglycemia (high blood sugar) can cause damage to many parts of your body, especially the kidneys, heart, blood vessels, eyes, feet, nerves. Diabetes can harm the kidneys by causing damage to: Blood vessels inside your kidneys. The filtering units of the kidney are filled with tiny blood vessels. Over time, high sugar levels in the blood can cause these vessels to become narrow and clogged. Without enough blood, the kid Continue reading >>

Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?

Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?

In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>

How To Counsel Type 1 Diabetes Patients Who Exercise?

How To Counsel Type 1 Diabetes Patients Who Exercise?

How to Counsel Type 1 Diabetes Patients Who Exercise? This feature requires the newest version of Flash. You can download it here . Anne L. Peters, MD: Hi. I'm Dr Anne Peters. I am here today with Dr Bruce Bode to talk about exercise as part of the treatment for diabetes. Let's start the discussion. You and I both take care of lots of athletes. How do you teach someone how to take care of a person who is taking insulin? Bruce W. Bode, MD: As you know, exercise is an insulin sensitizer; it makes insulin work better. In type 2 diabetes, you always want to get your patients to walk because it improves insulin action. In type 1 diabetes, they don't make insulin, so they need to take insulin to survive. You have to balance the insulin with their food intake. When they exercise, you're going to need less insulin because they will have improved insulin action and sensitivity. For people with type 1 diabetes who want to exercise, and especially those who want to get into extreme exercise like running a marathon, you have to help them and guide them. You have to balance the insulin with glucose levels. You have to have the right amount of insulin and match it with carbohydrates as best as you can. The rule of thumb is that you always start exercise when your glucose level is above 90 mg/dL and preferably don't start exercise if your glucose level is above 250 mg/dL because that means you are relatively insulin-deficient. If you are starting at 90 mg/dL, you might want to take 10-20 g of carbohydrate before you start, even juice or something. Then, the key is that you need to monitor the glucose in response. If somebody is doing aerobic exercise like running or walking, and over time they start to fall, that means that they have too much insulin on board. You have to cover that Continue reading >>

Answers About Type 1 And Exercise

Answers About Type 1 And Exercise

Photo by Poby In today’s Well column, I write about the amazing accomplishments of Team Type 1, a cycling team comprised of athletes with Type 1 diabetes that just won the 3,000-mile Race Across America. After writing about the team, several readers asked specific questions about how the riders managed exercise and insulin needs. As a result, I’ve invited two experts to answer your questions about Type 1 and exercise –and anything else you might want to know about diabetes. Answering your questions this week will be: Dr. Robin Goland, director of the Naomi Berrie Diabetes Center at Columbia University Medical Center. Dr. Goland, associate professor of medicine at Columbia, also leads a clinical research program in diabetes. Dr. Goland has a B.A. from Harvard University and an M.D. from Columbia University College of Physicians & Surgeons. She also regularly treats several patients who are marathoners and triathletes. Phil Southerland, a founder of Team Type 1 cycling. Mr. Southerland, 27, was diagnosed with Type 1 at 7 months of age and is now a competitive cyclist and marathoner, and has twice competed in the Race Across America. Read the full story, “A 3,000-Mile Triumph, Spurred On by Diabetes.” And then, please send your questions about Type 1, exercise or any other diabetes-related issue. (Update: This post is no longer accepting questions, but readers can continue to discuss and post comments. Hopefully your questions are answered in the many responses below.) Scroll through all the comments to see questions answered in bold faced type. Or click on the following links to see all the questions we’ve answered. Does it ever get easier to manage Type 1 and exercise? How often should patients with Type 1 be checked for celiac disease? Are there any tricks t Continue reading >>

7 Things You Need To Know About Exercising With Diabetes

7 Things You Need To Know About Exercising With Diabetes

If there’s one thing people with diabetes know, it’s that regular exercise requires more than just discipline and hard work. Mismanaging your blood sugar, diet and exercise intensity levels can have adverse and unpredictable effects on your body. This month, we spoke with Dr. Jonathon R. Fowles, an exercise physiologist at the Centre of Lifestyle Studies at Acadia University, to help answer some common questions about exercising with diabetes: 1) How often should I exercise? “Regardless of whether you have type 1 or type 2 diabetes, the CDA recommends 150 minutes a week of moderate to vigorous exercise,” Fowles says. “You should be combining both aerobic (running, swimming etc.) and anaerobic (resistance training, weight lifting) activity.” 2) What are the benefits? “People with type 2 diabetes can expect to lower their AIC levels after a couple months of meeting the guidelines, and drastically reduce the progression of their diabetes, as well as their cardiovascular risk,” Fowles says. For people with type 1 diabetes, Fowles says the benefits are a little different. “The combination of exercise with insulin can be quite dramatic. People with type 1 diabetes should communicate openly with their diabetes educator or physician, to learn the interaction between exercise, food and insulin," he says. “The evidence isn’t quite as strong for glucose regulation for people with type 1 diabetes, but it’s definitely beneficial for their cardiovascular risk reduction, overall health and quality of life.” 3) Why is anaerobic exercise important? While the treadmill or tennis court may be tempting if you’re looking to lose weight, Fowles says building muscle is essential for all people with diabetes, especially as they age. “Most of your blood glucose is Continue reading >>

Type 1 Diabetes Treatments

Type 1 Diabetes Treatments

Type 1 diabetes treatment is all focused on maintaining your goal blood glucose levels. The various ways of taking care of your type 1 diabetes are all supposed to work together to keep your blood glucose level from going too low (hypoglycemia) or too high (hyperglycemia). By taking insulin, paying attention to what you eat, monitoring your blood glucose levels, and exercising, you will also help prevent long-term complications from diabetes (such as diabetic neuropathy or diabetic retinopathy). Insulin Insulin is the mainstay of type 1 diabetes treatment. Because your body doesn’t make insulin, you must give it to your body so that it can effectively use glucose. There are many types of insulin available, and your diabetes treatment team will work with you to figure out the best insulin plan. Throughout your life, this insulin plan can readjust to better fit your needs. Insulin is injected, although you can use an insulin pump that gives you a continuous stream of insulin. (Talk to your doctor about this type 1 diabetes treatment option.) If you are injecting insulin, you will, most likely, do several injections a day. Again, your diabetes treatment team will walk you through how to inject insulin and how often you should be using it. You can learn more about insulin in our article on insulin basics. It explains the different types of insulin and how they work to help you control your blood glucose levels. Blood Glucose Monitoring By regularly checking and noting your blood glucose levels, you will know if you are meeting your type 1 diabetes treatment goals—the range your blood glucose levels should be in (as explained to you by your doctor). Blood glucose monitoring helps you and your doctor know if your insulin, diet, and exercise plans are working to adequately Continue reading >>

Blood Sugar Testing: Why, When And How

Blood Sugar Testing: Why, When And How

Blood sugar testing is an important part of diabetes care. Find out when to test your blood sugar level, how to use a testing meter, and more. If you have diabetes, self-testing your blood sugar (blood glucose) can be an important tool in managing your treatment plan and preventing long-term complications of diabetes. You can test your blood sugar at home with a portable electronic device (glucose meter) that measures sugar level in a small drop of your blood. Why test your blood sugar Blood sugar testing — or self-monitoring blood glucose — provides useful information for diabetes management. It can help you: Judge how well you're reaching overall treatment goals Understand how diet and exercise affect blood sugar levels Understand how other factors, such as illness or stress, affect blood sugar levels Monitor the effect of diabetes medications on blood sugar levels Identify blood sugar levels that are high or low When to test your blood sugar Your doctor will advise you on how often you should check your blood sugar level. In general, the frequency of testing depends on the type of diabetes you have and your treatment plan. Type 1 diabetes. Your doctor may recommend blood sugar testing four to eight times a day if you have type 1 diabetes. You may need to test before meals and snacks, before and after exercise, before bed, and occasionally during the night. You may also need to check your blood sugar level more often if you are ill, change your daily routine or begin a new medication. Type 2 diabetes. If you take insulin to manage type 2 diabetes, your doctor may recommend blood sugar testing two or more times a day, depending on the type and amount of insulin you need. Testing is usually recommended before meals, and sometimes before bedtime. If you manage type 2 Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Type 1 diabetes (previously called insulin-dependent or juvenile diabetes) is usually diagnosed in children, teens, and young adults, but it can develop at any age. If you have type 1 diabetes, your pancreas isn’t making insulin or is making very little. Insulin is a hormone that enables blood sugar to enter the cells in your body where it can be used for energy. Without insulin, blood sugar can’t get into cells and builds up in the bloodstream. High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes. Type 1 diabetes is less common than type 2—about 5% of people with diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes, but it can be managed by following your doctor’s recommendations for living a healthy lifestyle, controlling your blood sugar, getting regular health checkups, and getting diabetes self-management education. Shakiness Nervousness or anxiety Sweating, chills, or clamminess Irritability or impatience Dizziness and difficulty concentrating Hunger or nausea Blurred vision Weakness or fatigue Anger, stubbornness, or sadness If your child has type 1 diabetes, you’ll be involved in diabetes care on a day-to-day basis, from serving healthy foods to giving insulin injections to watching for and treating hypoglycemia (low blood sugar; see below). You’ll also need to stay in close contact with your child’s health care team; they will help you understand the treatment plan and how to help your child stay healthy. Much of the information that follows applies to children as well as adults, and you can also click here for comprehensive information about managing your child’s type 1 diabetes. Causes Type 1 diabetes is caused by an autoimmune reaction (the body attacks itself by mistak Continue reading >>

10 Tips For Teenagers To Live Well With Type 1 Diabetes

10 Tips For Teenagers To Live Well With Type 1 Diabetes

Twitter Summary: @asbrown1 shares his top 10 tips for living w/ #T1D, straight from presentation to 100+ teens at #CWDFFL15 At the Children with Diabetes Friends For Life Conference this month, I had the incredible opportunity to speak to ~100 teenagers with diabetes. My talk, “10 Tips for Living Well with Type 1,” was a lot of fun to put together, and our team thought diaTribe readers might be interested in seeing it. I agonized over how to present this so that it wouldn’t come across as a lecture – even my teenage self would not react well to some of the advice (“Sleep seven hours a night? Hah! I have sports plus exams plus the next level to beat in Halo 3!”). I concluded that the best thing I could do was make this session a conversation, but ground it in lessons I’ve learned over time. Thankfully, I also had the amazing FFL staff by my side to help guide the discussion. The session reminded me of something that I intuitively know but often forget: each person’s diabetes is completely different, and what works for me won’t work for everyone. And equally important, what works for me may change over time – it certainly has since I was a teenager. I’m sharing the slides below in case they’re useful, but my biggest hope is that it gets you thinking about your own diabetes. What motivates you? What drags you down? What can you do better today? Who can you reach out to for support? Let us what you think by email or on Twitter. As the oldest of six kids, I had a lot of responsibility from a young age, and my Mom was also a very hands-off parent; both helped me take the reins of my diabetes from an early age. I hope everyone can find the right balance between taking care of their own diabetes, but also relying on their parents for support when needed. Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Coeliac disease is more common in people who have Type 1 diabetes If you have coeliac disease and Type 1 diabetes, you should get guidance from a dietitian about how to manage your diet. Coeliac disease is more common in people who have Type 1 diabetes because they are both autoimmune diseases. Between 4 and 9% of people with Type 1 diabetes will also have coeliac disease. There is no increased risk of coeliac disease in people with Type 2 diabetes. Diagnosis For most people, Type 1 diabetes is diagnosed before coeliac disease, although it can happen the other way around. Some people with Type 1 diabetes appear to have mild or no obvious symptoms of coeliac disease, but their gut lining will still be damaged when they eat gluten. Coeliac disease can be missed in people with Type 1 diabetes as the symptoms of ill health can be attributed to the diabetes. When coeliac disease is diagnosed before diabetes, the symptoms of diabetes tend to be more severe and there is a higher likelihood of other autoimmune diseases.1 Recurrent hypoglycaemia can be a sign of coeliac disease in people with Type 1 diabetes.2 In children, having diabetes and growth problems may mean they also have coeliac disease.3 Some people with Type 1 diabetes may test negative for coeliac disease early in their diagnosis, but then positive at a later stage. British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) recommended that children with Type 1 diabetes should be retested after three years or if symptoms occur. However, we would refer to the updated NICE guidelines which recommend that people with Type 1 diabetes should be tested for coeliac disease at diagnosis and retested if any symptoms of coeliac disease develop. If you have concerns speak with your GP. How coeliac dise Continue reading >>

The Truth About The So-called

The Truth About The So-called "diabetes Diet"

Despite all the publicity surrounding new research and new nutrition guidelines, some people with diabetes still believe that there is something called a "diabetic diet." For some, this so-called diet consists of avoiding sugar, while others believe it to be a strict way of eating that controls glucose. Unfortunately, neither are quite right. The "diabetes diet" is not something that people with type 1 or type 2 diabetes should be following. "That just simply isn't how meal planning works today for patients with diabetes," says Amy Campbell, MS, RD, LDN, CDE, a nutritionist at Joslin and co-author of 16 Myths of a Diabetic Diet. "The important message is that with proper education and within the context of healthy eating, a person with diabetes can eat anything a person without diabetes eats," Campbell states. What's the truth about diabetes and diet? We know now that it is okay for people with diabetes to substitute sugar-containing food for other carbohydrates as part of a balanced meal plan. Prevailing beliefs up to the mid-1990s were that people with diabetes should avoid foods that contain so-called "simple" sugars and replace them with "complex" carbohydrates, such as those found in potatoes and cereals. A review of the research at that time revealed that there was relatively little scientific evidence to support the theory that simple sugars are more rapidly digested and absorbed than starches, and therefore more apt to produce high blood glucose levels. Now many patients are being taught to focus on how many total grams of carbohydrate they can eat throughout the day at each meal and snack, and still keep their blood glucose under good control. Well-controlled blood glucose is a top priority because other research studies have concluded that all people with diab Continue reading >>

Snacking When You Have Diabetes

Snacking When You Have Diabetes

Learning how to count the carbohydrates that you eat (carb counting) helps you plan what to eat. It will also keep your blood sugar under control. Your health care provider may tell you to eat a snack at certain times of the day, most often at bedtime. This helps keep your blood sugar from getting too low at night. Other times, you may have a snack before or during exercise for the same reason. Ask your provider about the snacks you can and you can't have. Needing to snack to prevent low blood sugar has become much less common because of new types of insulin that are better at matching the insulin your body needs at specific times. If you have type 2 diabetes and are taking insulin and often need to snack during the day, your doses of insulin may be too high and you should talk to your provider about this. You will also need to ask about what snacks to avoid. Your provider can tell you if you should snack at certain times to keep from having low blood sugar. This will be based on your: Diabetes treatment plan from your provider Expected physical activity Lifestyle Low blood sugar pattern Most often, your snacks will be easy to digest foods that have 15 to 45 grams of carbohydrates. Snack foods that have 15 grams (g) of carbohydrates are: Half cup (107 g) of canned fruit (without the juice or syrup) Half banana One medium apple One cup (173 g) melon balls Two small cookies Ten potato chips (varies with size of chips) Six jelly beans (varies with size of pieces) Having diabetes does not mean that you must stop eating snacks. It does mean that you should know what a snack does to your blood sugar. You also need to know what healthy snacks are so you can choose a snack that will not raise your blood sugar or make you gain weight. Ask your provider about what snacks you can Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells. Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy. Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is serious. Continue reading >>

Diabetes Type 1

Diabetes Type 1

The point of all treatment for Type 1 diabetes is to keep the level of glucose in your bloodstream as close as possible to normal. The nearer you get to achieving this, the better you will feel, especially in the long term. What do the results of a blood glucose test tell you? When you do a blood test you are measuring whether your previous insulin dose was right for you. For example, doing a test just before lunch will tell you how your morning injection of fast-acting insulin matched the carbohydrate you ate for breakfast. It's important to remember that lots of other things, like exercise, can affect the way insulin works, and a blood test can help you understand that and learn what your body does. People are usually recommended to test before each meal and before bed, and more often when they are ill because illness can sometimes make blood sugar rise very quickly. You should always test before driving, to make sure your blood sugar is not too low (hypo). Among the young people we talked to, the number of blood tests they did per day varied. In this summary young people talked about their reasons for checking their blood glucose levels more often than their doctors recommended, for doing them regularly, less often or not at all. Doing regular blood glucose tests Some of the young people we talked to have always tested their blood glucose regularly and this pattern hasn't change since diagnosis. Their main attitude is that it's something they have to do if they want to control their diabetes. Those who inject insulin every time they eat know that it's very important to check their glucose levels, to see how much insulin they need. They tend not to find anything difficult or unpleasant about doing the test. A few of them keep a diary to record their glucose results. A Continue reading >>

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