Diabetes and Carb Counting For Dummies. Shafer Sherri

People with type 1 diabetes rely on insulin for life. Prior to 1921 when insulin was first discovered and made available for use, type 1 diabetes was a fatal disease. Insulin is essential for transporting glucose (fuel) into cells. Chapter 6 explains the importance of matching insulin doses with carbohydrate intakes. Take all insulin doses as prescribed. Insulin omission can lead to diabetic ketoacidosis, which is a potentially life-threatening condition. Look at the physiology behind the process in Chapter 4.

      Insulin isn’t just for treating type 1 diabetes; many people with type 2 diabetes use insulin to manage their diabetes. Type 2 diabetes is a state of insulin resistance and oftentimes a concurrent deficiency in insulin production. When diet and exercise fail to adequately control glucose levels, medications are required. There are several classes of diabetes medications. Some stimulate insulin production, while others improve the way insulin works. Medications can decrease the amount of glucose released by the liver, increase the amount of glucose excreted in the urine, or delay the digestion of glucose. Whether it takes one medication or multiple medications, the goal is blood-glucose control because that’s how you prevent complications.

      Some people struggle with medication adherence. It may be due to the number of medications prescribed or the dosing schedule. Pill caddies that separate morning and evening doses assist with remembering meds. Another reason for missing meds is simply a lack of perceived benefit. Many people with diabetes feel fine. Feeling good is important, but knowing your ABCs is important. That means know your A1C, Blood pressure, and Cholesterol results. Those numbers are a window into what is happening in your body.

      

There is no denying that well-controlled diabetes and cardiovascular health have big payoffs. If you wait until you feel bad before you decide to adhere to the medication regimen prescribed, you might wait too long. Discuss any side effects with your provider. Your doctor can decide whether a different dose or a different medication would be more appropriate.

       Monitoring your blood-glucose levels

      Home blood-glucose monitors are amazing little machines. Apply a tiny droplet of blood, and within five seconds, you know the result. Glucose meters have been available for home use only since the 1980s. In the scope of things, that’s a relatively short period of time. Prior to glucose monitoring, people with diabetes checked their urine glucose levels, which was a grossly inaccurate way to attempt to evaluate blood-glucose levels. Back in the diabetes “dark ages,” people didn’t have the tools and technologies to safely manage diabetes, so some people developed complications.

      

Monitoring your blood glucose and knowing how to respond to those numbers can greatly reduce the risks of diabetes-related complications. Ask your healthcare provider how often you should check and what your targets are. Keep records and share the results with your diabetes team. Diabetes management decisions are based on glucose results. When your numbers aren’t in target ranges, don’t get discouraged. There’s no such thing as good numbers or bad numbers. All numbers are useful. Managing diabetes is somewhat like solving a puzzle; each and every piece of the puzzle is important.

      Chapter 23 provides tips on glucose monitoring and takes a look at another glucose measurement, A1C, which provides information on your average glucose control for the previous three-month period.

       Managing stress

      Most people encounter stressful situations from time to time. Finding healthy ways to cope with stress before small problems fester, grow, and get out of hand is important. If stress goes unchecked, it can contribute to anxiety, low mood, a feeling of hopelessness, or depression. Chronic conditions such as diabetes can contribute to stress and may have an additive effect to life’s other challenges. Talking about it helps. Confide in friends, family, support groups, and your diabetes healthcare team.

      Physical activity is a wonderful outlet. Exercise increases natural chemicals that improve mood. Hobbies, arts, crafts, volunteer work, and faith-based gatherings are other positive ways to relieve pressure and boost mood. When you’re feeling blue, think about some of your favorite people and your best memories. Keep the self-talk in your head positive. Don’t focus on your shortcomings; recount your successes instead.

      

If you can’t shake the funk and the stress is preventing you from taking care of yourself, seek the help of a mental-health specialist.

       Discovering how to problem-solve

      Part of diabetes self-management is understanding how to assess a situation and decide the best course of action. Understanding cause and effect allows you to make adjustments to steer outcomes in the direction you desire. When something goes awry, reflect carefully on the chain of events that led up to the issue. If you can decipher the cause, you can formulate a solution. Over time you gain experience, which makes it easier to predict outcomes and make adjustments to your diabetes care. Your diabetes team can help you learn how to make informed decisions. There will still be things that happen unexpectedly from time to time because that’s just how life is. You can’t plan for all scenarios, but you can be prepared for most.

      

Problem-solving means reflecting and trying to figure out why things didn’t go as planned. Formulate a new plan or make adjustments to the old plan. Execute your plan, pay attention, and see whether things improve.

       Reducing risk with healthy behaviors and regular medical checkups

      Taking care of your diabetes is an investment in your future health and quality of life. Diabetes complications are preventable. Follow these guidelines:

      ❯❯ Eat right and exercise.

      ❯❯ Don’t smoke. Smokers are more likely to develop serious diabetes-related complications.

      ❯❯ Limit alcohol. Alcohol can cause profound hypoglycemia for some people with diabetes (see Chapter 11).

      ❯❯ Stay up to date on medical visits and health screenings.

      ❯❯ Get a handle on hypertension. High blood pressure increases the risk of health problems because it can damage small and large blood vessels.

      ❯❯ Have the necessary bloodwork needed to monitor diabetes, heart health, and other medical conditions.

      ❯❯ See your doctor regularly (every three months or as your doctor advises).

      ❯❯ Get your flu shot and have your eyes and kidneys checked annually.

      ❯❯ Keeping healthy will keep you happy, so show your smile to your dentist at least every six months.

Chapter 2

      Exploring the Diabetes-Carb Connection

      IN THIS CHAPTER

      ❯❯ Getting to the bottom of the causes, symptoms, and types of diabetes

      ❯❯ Knowing and modifying your risk factors and receiving a diagnosis

      ❯❯ Discovering how regulating carb intake is part of the treatment

      Twenty-nine million Americans have diabetes. About 90–95 percent have type 2 diabetes, while 5–10 percent have type 1 diabetes. A couple other forms of diabetes make up a smaller percentage of cases. Eighty-six million American adults – over one-third of the population – have prediabetes, a condition of elevated glucose levels but not yet a diagnosis of diabetes.

      If you rewind the clock by 50 to 100 years, diabetes was not nearly as prevalent as it is today. The societal trend is that Americans are now heavier and less active than our