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Managing Diabetes

2010 Aaha Diabetes Management Guidelines For Dogs And Cats

2010 Aaha Diabetes Management Guidelines For Dogs And Cats

Renee Rucinsky, DVM, ABVP (Feline) (Chair) | Audrey Cook, BVM&:S, MRCVS, Diplomate ACVIM-SAIM, Diplomate ECVIM-CA | Steve Haley, DVM | Richard Nelson, DVM, Diplomate ACVIM | Debra L. Zoran, DVM, PhD, Diplomate ACVIM | Melanie Poundstone, DVM, ABVP - Download PDF - Introduction Diabetes mellitus (DM) is a treatable condition that requires a committed effort by veterinarian and client. This document provides current recommendations for the treatment of diabetes in dogs and cats. Treatment of DM is a combination of art and science, due in part to the many factors that affect the diabetic state and the animal's response. Each animal needs individualized, frequent reassessment, and treatment may be modified based on response. In both dogs and cats, DM is caused by loss or dysfunction of pancreatic beta cells. In the dog, beta cell loss tends to be rapid and progressive, and it is usually due to immune-mediated destruction, vacuolar degeneration, or pancreatitis.1 Intact females may be transiently diabetic due to the insulin-resistant effects of the diestrus phase. In the cat, loss or dysfunction of beta cells is the result of insulin resistance, islet amyloidosis, or chronic lymphoplasmacytic pancreatitis.2 Risk factors for both dogs and cats include insulin resistance caused by obesity, other diseases (e.g., acromegaly in cats, hyperadrenocorticism in dogs), or medications (e.g., steroids, progestins). Genetics is a suspected risk factor, and certain breeds of dogs (Australian terriers, beagles, Samoyeds, keeshonden3) and cats (Burmese4) are more susceptible. Regardless of the underlying etiology, diabetic dogs and cats are hyperglycemic and glycosuric, which leads to the classic clinical signs of polyuria, polydipsia (PU/PD), polyphagia, and weight loss. Increased fat mobi Continue reading >>

Family Health Online | From Managing Diabetes Magazine |diabetes | Managing Diabetes - Understanding And Controlling Your Disease

Family Health Online | From Managing Diabetes Magazine |diabetes | Managing Diabetes - Understanding And Controlling Your Disease

Understanding and controlling your disease As someone with diabetes, you must take responsibility for managing your disease. This may sound blunt but the message is too important to cushion softly. If you understand your disease, you will know the important things you need to do to care for yourself. The more you know, the wiser your decisions will be. Diabetes mellitus is probably as old as mankind. We know that the ancient Egyptians gave an accurate description of the condition. The name came from the way the Greeks described diabetes 2,500 years ago. Diabetes means a siphon or 'running through.' Mellitus refers to the sweetness of honey. People with diabetes urinated more often than normal and their urine was found to be sweet. Hence, people with these symptoms were said to have diabetes mellitus. Today we know more about the condition but the symptoms remain the same. Diabetes mellitus describes a group of disorders that have one feature in common. There is a greater than normal amount of sugar (glucose) in the blood. Glucose (the main sugar in the blood) is necessary for cells of the body to function properly. It is the main source of fuel for all cells and the only fuel for some. For instance, it is the only nutrient the brain can use as fuel. Glucose is supplied by the food that we eat and by the liver, which serves as a factory to manufacture it. Once in the blood, it can be carried to the tissues and used by all cells for energy. Insulin is a hormone that is produced in the pancreas. It is needed for the glucose to enter, and be used by, certain cells of the body (especially muscle). Without insulin, glucose stays in the blood where it accumulates. When the level of glucose gets too high, the diagnosis of diabetes is made. Ineffective insulin use can be due to Continue reading >>

10 Tips For Managing Diabetes

10 Tips For Managing Diabetes

Get your team together. Although your primary-care physician may have been the one to order blood-glucose testing, you need a team of professionals to guide you through all of diabetes’ medical details. Ideally your team will include your primary-care physician, an endocrinologist (a hormone specialist who understands the intricacies of insulin), a registered dietitian to help you fine-tune your eating plan, an ophthalmologist (an eye specialist who can look for diabetes-related signs of damage to the retina), a podiatrist (a foot-care specialist who can help prevent complications from diabetes-related nerve damage and skin sores), and a dentist to keep periodontal disease and other infections under control. Continue reading >>

Diabetes Management: How Lifestyle, Daily Routine Affect Blood Sugar

Diabetes Management: How Lifestyle, Daily Routine Affect Blood Sugar

Diabetes management requires awareness. Know what makes your blood sugar level rise and fall — And how to control these day-to-day factors. Keeping your blood sugar levels within the range recommended by your doctor can be challenging. That's because many things make your blood sugar levels change, sometimes unexpectedly. Following are some factors that can affect your blood sugar levels. Food Healthy eating is a cornerstone of healthy living — with or without diabetes. But if you have diabetes, you need to know how foods affect your blood sugar levels. It's not only the type of food you eat but also how much you eat and the combinations of food types you eat. What to do: Learn about carbohydrate counting and portion sizes. A key to many diabetes management plans is learning how to count carbohydrates. Carbohydrates are the foods that often have the biggest impact on your blood sugar levels. And for people taking mealtime insulin, it's crucial to know the amount of carbohydrates in your food, so you get the proper insulin dose. Learn what portion size is appropriate for each type of food. Simplify your meal planning by writing down portions for the foods you eat often. Use measuring cups or a scale to ensure proper portion size and an accurate carbohydrate count. Make every meal well-balanced. As much as possible, plan for every meal to have a good mix of starches, fruits and vegetables, proteins and fats. It's especially important to pay attention to the types of carbohydrates you choose. Some carbohydrates, such as fruits, vegetables and whole grains, are better for you than are others. These foods are low in carbohydrates and contain fiber that helps keep your blood sugar levels more stable. Talk to your doctor, nurse or dietitian about the best food choices and Continue reading >>

Diabetes Management

Diabetes Management

The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance. The pancreas of a person with type 2 diabetes may be producing normal or even abnormally large amounts of insulin. Other forms of diabetes mellitus, such as the various forms of maturity onset diabetes of the young, may represent some combination of insufficient insulin production and insulin resistance. Some degree of insulin resistance may also be present in a person with type 1 diabetes. The main goal of diabetes management is, as far as possible, to restore carbohydrate metabolism to a normal state. To achieve this goal, individuals with an absolute deficiency of insulin require insulin replacement therapy, which is given through injections or an insulin pump. Insulin resistance, in contrast, can be corrected by dietary modifications and exercise. Other goals of diabetes management are to prevent or treat the many complications that can result from the disease itself and from its treatment. Overview[edit] Goals[edit] The treatment goals are related to effective control of blood glucose, blood pressure and lipids, to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies. The targets are: HbA1c of 6%[1] to 7.0%[2] Preprandial blood Continue reading >>

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes MellitusTreatment & Management Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent, or at least slow, the development of complications. Microvascular (ie, eye and kidney disease) risk reduction is accomplished through control of glycemia and blood pressure; macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk reduction, through control of glycemia. New abridged recommendations for primary care providers The American Diabetes Association has released condensed recommendations for Standards of Medical Care in Diabetes: Abridged for Primary Care Providers , highlighting recommendations most relevant to primary care. The abridged version focusses particularly on the following aspects: Diagnosis and treatment of vascular complications Intensification of insulin therapy in type 2 diabetes The recommendations can be accessed at American Diabetes Association DiabetesPro Professional Resources Online, Clinical Practice Recommendations 2015 . [ 121 ] Type 2 diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. [ 2 ] Management includes the following: Appropriate self-monitoring of blood glucose (SMBG) Ideally, blood glucose should be maintained at near-normal levels (preprandial levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7%). However, focus on glucose alone does not provide adequate treatment for patients with diabetes mellitus. Treatment involves multiple goals (ie, Continue reading >>

Managing Diabetes: Six Healthy Steps With The Most Benefit

Managing Diabetes: Six Healthy Steps With The Most Benefit

Want to boost your overall health with diabetes? A Johns Hopkins expert offers healthy strategies to help you control your blood sugar, protect your heart, and more. Want more information, support, and advice about practical, everyday ways to stay healthy with diabetes? Ask your doctor about a diabetes self-management class near you. In a 2011 study from The Johns Hopkins University, people who took diabetes-education classes saw their A1C reduced by a significant 0.72 percent. About 17.7 million Americans with diabetes take medications—pills, injections, or both—to help keep their blood sugar within a healthy range, according to the Centers for Disease Control and Prevention. That’s important, and it’s important to take medication as prescribed, but don’t stop there. People with diabetes are two to four times more likely to have heart disease or a stroke than those without this chronic condition, according to the American Heart Association. “It’s very important to take care of your heart health too,” says Johns Hopkins diabetes expert Rita Rastogi Kalyani, M.D., M.H.S. “Making smart choices every day can help.” Kalyani recommends starting with these six critical steps today. Extra pounds? Lose a little. You don’t have to be a “biggest loser” or get an “extreme makeover” to enjoy big weight-loss benefits if you have diabetes. In a nationwide study of 5,145 people with type 2 diabetes, those who shed just 5 to 10 percent of their weight (for someone weighing 175 pounds, that’s a loss of 9 to 17.5 pounds) were three times more likely to lower their A1C (a test of long-term blood sugar control) by 0.5 percent, a significant drop. They were also 50 percent more likely to lower their blood pressure by 5 points and twice as likely to lower thei Continue reading >>

Living With Diabetes

Living With Diabetes

Managing diabetes is a daily challenge. There are so many variables to keep in mind -- food, exercise, stress, general health, etc. -- that keeping blood sugar levels in the desired range is a constant balancing act. We want to make managing diabetes easier. So, the DRI's Education Team hasdeveloped short brochures about the topics listed below -- offering useful tips on many of the day-to-day issues facing people living with diabetes. And, most of the materials are offered in English and Spanish. If you can benefit by learning about one or more of these subjects, just click on the title to expand. Do you know what foods have the greatest impact on your blood sugars? If you answered CARBOHYDRATE FOODS...youre right! Carbohydrates -- "carbs" -- are broken down into glucose. So if you eat too much of them, your blood sugar level may rise. For this reason, people with diabetes find it helpful to keep track of the carbs they eat in order to manage their blood sugars. Carb counting is easy. It just takes some practice at first. Caring for older people with diabetes requires special thought and consideration. The older individual is more likely to have other health problems and may be taking a variety of different medications. Many people are frightened to check their blood sugar -- or "blood glucose" -- levels because they do not want to see levels that are higher or lower than their target range. But, checking blood sugar at home, in school, and in the workplace is key to managing diabetes. It puts you in control of your diabetes. Remember, your blood sugar levels remain the same whether you know about them or not. Checking blood sugar levels is the most accurate way to see if your lifestyle changes and medications are helping you to better manage your diabetes. If levels Continue reading >>

How To Beat Type 2 Diabetes With Diet And Lifestyle Changes

How To Beat Type 2 Diabetes With Diet And Lifestyle Changes

It's no secret that type 2 diabetes is on the rise in the United States and around the world. But if you've been diagnosed with diabetes, there's a lot you can do to improve your health — and the best place to start is likely by making some changes to your lifestyle. “Basic principles of good health like eating right, exercising regularly, and maintaining a healthy weight can be as effective as medicine in the management of type 2 diabetes for most people,” says Sue McLaughlin, RD, CDE, lead medical nutrition therapist at Nebraska Medicine in Omaha. That's backed up by the Look AHEAD study, a large clinical trial funded by the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). The researchers found that over a four-year period, changes like eating a healthier diet and getting more exercise led to weight loss and improved diabetes control in 5,000 overweight or obese participants with type 2 diabetes. A December 2016 review in Diabetologia similarly found through 28 studies that participants who were able to achieve about 150 minutes per week of moderate activity lowered their risk of type 2 diabetes by 26 percent compared with nonactive participants. If you're ready to make positive changes to help control diabetes, here's how to get started. Improve Your Diet to Help You Treat Type 2 Diabetes Naturally Keeping close tabs on your diet is a major way to help manage type 2 diabetes. A healthy diet for people with type 2 diabetes includes fresh or frozen fruit and vegetables, whole grains, beans, lean meats, and low-fat or fat-free dairy. Focus on eating fruit and non-starchy vegetables, like broccoli, carrots, and lettuce, and having smaller portions of starchy foods, meats, and dairy products. Be especially careful about loading Continue reading >>

Special Report: Managing Diabetes

Special Report: Managing Diabetes

Diabetes has reached virtually epidemic levels in the modern world. In 2005 the U.S. Centers for Disease Control and Prevention estimated that about 7 percent of the American population (20.9 million people) had diabetes--and 6.2 million of them were unaware of it. More than 1.5 million people over the age of 20 will be diagnosed with it in the U.S. this year. About 21 percent of those older than 60 have the disease. Small wonder, then, given the severe complications associated with diabetes, that it continues to be the sixth leading cause of death in the U.S. And although diabetes was often called a disease of affluence in the past, it is now one of the fastest-rising health concerns in developing nations as well: the World Health Organization pegs the global total at more than 171 million cases. An unfortunate catch-22 of diabetes is that although the right diet and exercise can help with its prevention and management, diabetes itself can complicate both eating and physical activity. Patients may need to pay extra attention to taking meals on a regular schedule and to monitoring how exercise dehydrates them or lowers their blood glucose. Some may fail to comply consistently with prescribed regimens that seem inconvenient or unpleasant, thereby raising their risk of complications. But thanks to leaps in science's understanding of the disease, doctors now wield a diverse and growing arsenal of drugs and management technologies to fight the progression--and even onset--of illness. People with diabetes have more and better options than ever before for enjoying healthy, active, long lives. Background Diabetes is a disease in which too much of a sugar called glucose accumulates in the blood because of a breakdown in how the body makes or reacts to the hormone insulin. Insul Continue reading >>

5 Tips To Get Your Diabetes Under Control

5 Tips To Get Your Diabetes Under Control

Controlling your diabetes is a daily, weekly, monthly, and yearly challenge, but the effort is worth it. Right away you'll feel better and have more energy.The payoff? You'll live better longer with less risk of problems from diabetes like heart attacks, strokes, kidney failure, even blindness. The key to managing your diabetes is to keep your blood sugar levels as close to normal as possible. It sounds tough, but there are simple steps you can follow. Spot Check Your Sugar You and your doctor will have set a schedule to test your blood sugar. Add an extra check on top. Maybe at breakfast one day, lunch the next, and so on. It's like popping in unannounced. "If you're a supervisor and your workers know that you're only going to come once a day to check on them, chances are they're going to be well-behaved during that particular time and the rest of the day you're going to be doing other things," says Sethu Reddy, MD, chief of the adult diabetes section at the Joslin Diabetes Center in Boston. "If you spot check, you have a much better sense of how things are going." Use that information to adjust your eating and exercise to gain even better control if you need to. Count Carbs They can quickly send your blood sugar on a roller-coaster ride. That's why it's so important to keep track. Most women need 35-45 grams of carbs per meal while guys need 45-60 grams, says Jessica Crandall, a dietitian and spokesperson for the Academy of Nutrition and Dietetics. A cup of rice or pasta is about 45 grams. To make the most of them, pair your carbs with a protein, like nuts. Opt for high-fiber carbs. Both will slow digestion so you feel full without raising blood sugar. "Fiber is really important for blood-sugar control, but it's also a Roto-Rooter to clear out cholesterol building in Continue reading >>

Managing Diabetes In The Elderly: Go Easy, Individualize

Managing Diabetes In The Elderly: Go Easy, Individualize

Especially in frail, elderly patients, strict glycemic control should be emphasized less than avoiding malnutrition and hypoglycemia and achieving the best quality of life possible. The care of elderly patients with diabetes should be individualized, taking into account the patient's comorbidities, other medications, cognitive abilities, home care situation, and life expectancy. Especially in frail, elderly patients, there should be less emphasis on strict glycemic control than on avoiding malnutrition and hypoglycemia and achieving the best quality of life possible. KEY POINTS The diagnosis of diabetes in the elderly is often missed because its symptoms, such as dizziness, confusion, and nocturia, are often common and nonspecific. Elderly people at risk of malnutrition should have unrestricted meals and snacks; medications should be adjusted as necessary to control blood glucose levels. Tight control of blood glucose reduces the risk of death and diabetes-related complications but poses the risk of hypoglycemia. Continue reading >>

10 Tips For Managing Your Diabetes Treatment

10 Tips For Managing Your Diabetes Treatment

1 / 11 Follow These Steps to Better Manage Your Type 2 Diabetes Treatments There may be millions of people with diabetes, but your diabetes treatment plan should be specific to you. For instance, not everyone needs the same drugs — or needs drugs at all. Some people may prefer an insulin pen to more traditional injections, and some people might have to test their blood sugar eight times a day, while others only have to test it twice. But there are a few things that everyone who has been diagnosed with diabetes can do to manage their treatment. “It’s extremely important for individuals diagnosed with diabetes to remember that the condition can be managed, and that they should be an active participant in the plan,” says Cordialis Msora-Kasago, RD, a spokesperson for the Academy of Nutrition and Dietetics. “Through regular visits with physicians, dietitians, certified diabetes educators (CDEs), pharmacists, and other members of your healthcare team, you can develop a personalized plan that not only controls blood sugar but allows you to adopt the skills necessary for life-long management.” Early detection of an issue can often reduce the risk of more serious complications. So let your care team know when you notice fluctuations in your blood sugar. Just as you follow your blood sugar monitoring routine, take your diabetes medications on the exact schedule your doctor prescribed. Keep your doctor informed about everything you're taking and be honest with her or him. One of the best things you can do if you’re trying to manage your condition is to make changes in your diet and exercise habits. You may even be able to go off medication, says Arti Bhan, MD, division head of endocrinology at Henry Ford Health System in Detroit, Michigan, “but it will depend on p Continue reading >>

4 Steps To Manage Your Diabetes For Life

4 Steps To Manage Your Diabetes For Life

This publication has been reviewed by NDEP for plain language principles. Learn more about our review process. Actions you can take The marks in this booklet show actions you can take to manage your diabetes. Help your health care team make a diabetes care plan that will work for you. Learn to make wise choices for your diabetes care each day. Step 1: Learn about diabetes. What is diabetes? There are three main types of diabetes: Type 1 diabetes – Your body does not make insulin. This is a problem because you need insulin to take the sugar (glucose) from the foods you eat and turn it into energy for your body. You need to take insulin every day to live. Type 2 diabetes – Your body does not make or use insulin well. You may need to take pills or insulin to help control your diabetes. Type 2 is the most common type of diabetes. Gestational (jest-TAY-shun-al) diabetes – Some women get this kind of diabetes when they are pregnant. Most of the time, it goes away after the baby is born. But even if it goes away, these women and their children have a greater chance of getting diabetes later in life. You are the most important member of your health care team. You are the one who manages your diabetes day by day. Talk to your doctor about how you can best care for your diabetes to stay healthy. Some others who can help are: dentist diabetes doctor diabetes educator dietitian eye doctor foot doctor friends and family mental health counselor nurse nurse practitioner pharmacist social worker How to learn more about diabetes. Take classes to learn more about living with diabetes. To find a class, check with your health care team, hospital, or area health clinic. You can also search online. Join a support group — in-person or online — to get peer support with managing your Continue reading >>

Managing Diabetes

Managing Diabetes

You can manage your diabetes and live a long and healthy life by taking care of yourself each day. Diabetes can affect almost every part of your body. Therefore, you will need to manage your blood glucose levels, also called blood sugar. Managing your blood glucose, as well as your blood pressure and cholesterol, can help prevent the health problems that can occur when you have diabetes. How can I manage my diabetes? With the help of your health care team, you can create a diabetes self-care plan to manage your diabetes. Your self-care plan may include these steps: Ways to manage your diabetes Manage your diabetes ABCs Knowing your diabetes ABCs will help you manage your blood glucose, blood pressure, and cholesterol. Stopping smoking if you smoke will also help you manage your diabetes. Working toward your ABC goals can help lower your chances of having a heart attack, stroke, or other diabetes problems. A for the A1C test The A1C test shows your average blood glucose level over the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. B for Blood pressure The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be. C for Cholesterol You have two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels. Too much bad cholesterol can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. Ask your health care team what your cholesterol numbers should be. If you are over 40 years of age, you may need to take a statin drug for heart health. S for Stop smoking Not smoking is especially important for people with diabetes beca Continue reading >>

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