Sunday 10 April 2011

10 Tips For Maintaining a Low Carb Diabetic Diet

Carb counting takes a bit of practice, but it’s a great way to learn about eating well with diabetes. We’ve compiled a list of 11 ideas from which you can pick and choose, straight from people who deal with diabetes every day.

Accept Your Condition.

You can’t ignore that you have diabetes. You may feel fine, but uncontrolled diabetes can wreak havoc on your body that you won’t see for years. Learn how to treat it now. You may find it helpful to go to a nutritionist. Everything that you eat matters, it’s a pain in the ass that you can’t just stick anything in your mouth, but it’s a manageable disease if you choose to manage it.

Educate Yourself.

Attend classes at clinics and hospitals, Diabetes expositions or anything your doctor, endocrinologist, or certified diabetes educator suggests. Read everything you can get your hands on, visit websites and never stop learning.

Start Small.

There are just a handful of key things you need for carb counting. Know the insulin-to-carb ratio and  know what one unit of insulin does to your blood sugar without eating.
 
Begin At Home.

Start out at home and gradually work your way up to dining out. It’s always easier to eat at home than it is to eat at a restaurant because you always know the ingredients.

Test Often

After you eat, test how your body reacts. You may have to do an awful lot of testing at the beginning before and after meals. If you go on vacation or go out to eat, test before and after to see what impact something you've never tried before is having.

Ask For Help
Surround yourself with people that will help you.

Learn From Setbacks
If you do cheat, try to remember why you cheated and learn from it. Try to be ready for next time.

Learn The Inside Outs Of The Nutrition Facts Labels On Food.

Outside of fresh fruits, vegetables, and dairy, do not consider buying a food without a label. It is easier to dose insulin when the carbs are listed on the outside of the package.

Keep It Simple.

Try to find things that you really enjoy. There is comfort in keeping it simple. For instance if you  have a certain salad dressing on my salad that you like, stick to it. It’s simpler that way.

Be Consistent

It’s not that you have to eat the same thing every day, but it pays to think twice before deviating from your normal food habits. The trick is to be consistent with the volumes of food you eat. If you eat 100 grams of carbs at one meal, you’re going to be injecting a lot of insulin and that’s where you get into trouble, risking these high errors.

Find A Technique That Works And Use It.

For instance, some might find a carb counting book inefficient. But there are apps that you can look up carbohydrate counts of food. They can tell you how many carbs are in everything, some will also do recipes for you. It will let you know all the nutrition information for one serving.

Use Blood Sugar Testing To Reach Goals?

For over a century, the ability to measure blood sugar in a laboratory has existed, but to measure blood sugar in a self collected sample of blood from a fingertip has only been around for a few decades or so.

These days it only takes a few seconds to collect a tiny dot of blood and get a blood sugar reading almost instantly. Despite how relatively easy this is to do, most diabetics fight to put this information to good use.

There are many different blood sugar meters are on the market, with most sharing some common features. Most require minute amounts of blood collected from the sides of the fingertips (the least sensitive areas to poke), or even from areas such as the forearm.

Modern diabetic meter readings take as little as five seconds. Most meters feature a built in memory chip, and clocks that allow the user to log special events; like medicine, exercise, food, or illness.

Whether diabetic or not human blood sugars are in constant flux, it’s just a question of how much. Lower limit for randomly collected sugar levels in nondiabetic adults range from 60 mg/dl to as high as 200 mg/dl at the upper end. However even nondiabetics can occasionally have readings outside these ranges and not be diabetic.

A blood sugar meter can’t be used to diagnose diabetes, but if there is a suspicion of abnormal blood sugar based on a meter reading in a nondiabetic, that person must see a doctor to get a proper evaluation.

The aim of all diabetics is to minimize the state of flux in their blood sugar levels and make their sugar patterns more like that of a non-diabetic. Therefore, everything you are taught as a diabetic and all the diabetic supplies and medications you are prescribed should be applied as instruments and or strategies to achieve this result.

Use your tools to reach your goals each and every day as best as you can. But since a single blood sugar reading is a small part of a larger picture, the smart diabetic knows that every piece of information can and should be put together to form a bigger picture of their overall diabetes control.

There are some significant points in time when a sugar check is more likely to give useful information. The first is before eating meals or snacking, as food is almost always going to increase blood sugars. Being aware of how much your blood sugars can rise with food can empower you in improving choices with medication doses, such as insulin, and food choices.

The second important time to check blood sugar is after eating. To be precise, between 2 and 3 hours after eating. In nondiabetics, the blood sugar two to three hours after eating is always under 140 mg/dl. While such an objective is not always reachable with all diabetics, it’s still something to target.

One other time of importance to be aware of your blood sugar level, is in the A.M. after waking up. This is commonly referred to as the fasting glucose. This is the reading that any diabetic wants to make sure is in range, since the first sugar level reading of the day usually sets the tone for how things will go the rest of the day.

There is an old diabetes proverb that says “fix the fasting first”, meaning that when dealing with totally out of control blood sugar levels it’s best to get control of the overnight readings before making changes to the daytime management.

Is All That Bleeding And Checking A Waste Of Money?

Most of us are know about diabetic testing involving stabbing a finger to draw blood, smearing that blood on a glucose test strip and inserting it into a machine. The diabetic meter then tells you what your blood sugar level is. Some people repeat this exercise up to eight or ten times per day.

What if all this does almost nothing to control your disease, makes you anxious and is a waste of money? Is all that bleeding and checking is a waste of time and money?

According to recent independent health information, it proposes that frequent checking of blood glucose by people who don't use insulin, is not a good idea. It leads to unneccesary anxiety as well as unnecessary spending of hundreds of millions of dollars annually on even the most affordable diabetic supplies.

Blood sugar testing is requirement for insulin-dependent diabetics. These are people who are born with diabetes or develop it as a child. However, more than 80 per cent of the people with diabetes are type-2 diabetics who generally develop it in adulthood and need to control their blood sugars by modifying their diet and exercising.

Some drugs might help to prevent the ramifications of diabetes but frequent testing of their blood sugar?



Diabetic Testing Supplies Industry

Over the past 10 years, the marketing of blood testing for type-2 diabetics has intensified, with more emphasis on getting mildly diabetic people to test and retest, causing them to obsess about their numbers.

No one wants to needlessly test their blood every day, yet fearmongering rhetoric continues to drive people to test their blood sugars frequently, with warnings that doing so will prevent kidney disease, or blindness -even though that is simply not true.

Originally inspired by an article on diabetes.org

Saturday 9 April 2011

Diabetic Ketoacidosis Treatments

What is Diabetic Ketoacidosis?

Diabetic ketoacidosis is a diabetic complication that occurs when the body uses fat instead of glucose as a fuel source because the body does not have enough insulin. Ketones, (byproducts of fat breakdown) build up in the body.

Causes, incidence, and risk factors Of Diabetic Ketoacidosis

People with type 1 diabetes lack a hormone in the body used to process glucose (blood sugar) for energy. When glucose is not available, body fat is broken down for this energy instead.

As these fats are broken down, a type of acid called ketones build up in the blood and urine. In excessive levels, ketones are poisonous, This condition is known as ketoacidosis.

Blood glucose levels rise (usually higher than 300 mg/dL) because the liver produces glucose to try to combat the problem. However the cells cannot pull in that glucose without insulin.

Diabetic ketoacidosis may lead to a diagnosis of type 1 diabetes, because it is often the first symptom that causes a person to see a doctor. It can also be the result of increased insulin needs in someone already diagnosed with type 1 diabetes.

Infection, trauma, heart attack, or surgery can lead to diabetic ketoacidosis in such cases. Missing doses of insulin can also lead to ketoacidosis in people with diabetes.

People with type 2 diabetes can develop ketoacidosis, but it is rare. It is usually triggered by a severe illness. People of Hispanic and African-American ethnicity seem to be more likely to have ketoacidosis as a complication of type 2 diabetes.

Symptoms Of Diabetic Ketoacidosis

The warning signs that you are becoming very sick might include:
  • Deep, rapid breathing
  • Dry skin and mouth
  • Flushed face
  • Fruity breath (breath odor)
  • Nausea and vomiting
  • Stomach pain
Other symptoms that can occur include:
  • Fatigue
  • Frequent urination or thirst for a day or more
  • Mental stupor that may progress to coma
  • Muscle stiffness or aching
  • Shortness of breath
  • Abdominal pain
  • Breathing difficulty while lying down
  • Decreased appetite
  • Decreased consciousness
  • Headache

Symptoms and Testing for Diabetic Ketoacidosis

Ketone testing may be used in type 1 diabetes to screen for early ketoacidosis. The ketones test is done using a urine sample. Ketone testing is usually done at the following times:

  • When the blood sugar is higher than 240 mg/dL
  • During an illness such as pneumonia, heart attack, or stroke
  • When nausea or vomiting occur
  • During pregnancy
Other tests that may be done to diagnose ketoacidosis include:
  • Arterial blood gas
  • Blood glucose test
  • Blood pressure measurement
  • Amylase blood test
  • Potassium blood test

This disease may also affect the results of CO2 tests, CSF collection, potassium urine tests, magnesium phosphorus and sodium blood tests, sodium urine test and urine pH.

Diabetic Ketoacidosis Treatment

The goal of Diabetic Ketoacidosis treatment is to correct the high blood glucose level by giving the patient more insulin. Equally important is to replace fluids lost through excessive vomiting and urination. You may be able to recognize the early warning signs and make appropriate corrections at home before the condition gets worse. Most of the time, you will need to go to the hospital. At the hospital, an insulin replacement will be given, fluids and electrolytes will be replaced and the  cause of the condition (such as infection) will be found and treated.

Expectations Of Diabetic Ketoacidosis

Acidosis can lead to severe illness or death. Improved therapy for young people with diabetes has decreased the death rate from this condition. However, it remains a significant risk in the elderly, and in people who fall into a coma when treatment has been delayed.

Complications of Diabetic Ketoacidosis include a buildup of fluid in the brain, heart attack and death of bowel tissue due to low blood pressure or renal failure.


This condition can become a medical emergency. Call your health care provider if you notice early symptoms of diabetic ketoacidosis. Be sure to go to the emergency room or call the local emergency number if you experience decreased consciousness, difficulty breathing, fruity breath, mental stupor, nausea or vomiting

Prevention Of Diabetic Ketoacidosis 

People with diabetes should learn to recognize the early warning signs and symptoms of ketoacidosis. In people with infections or who are on insulin pump therapy, measuring urine ketones can give more information than glucose measurements alone.
Insulin pump users need to check often to see that insulin is still flowing through the tubing, and that there are no blockages, kinks, or disconnections.

References

1.Eisenbarth GS, Polonsky KS, Buse JB. Type 1 Diabetes Mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 31.