Diagnosis 2

Le diabète, la recherche et l'accompagnement.

Diabetes, Research and Support

All you need to know about diabetes: 20 important terms

 

Type 1, type 2, hypo- and hyperglycaemia… if you've received a diabetes diagnosis, don't get confused: here's our diabetes glossary.

27 October 2014 | Diagnosis

 

Just been diagnosed with diabetes and have no idea what exactly is wrong with you? Have a friend or family member with the illness and want to understand what they’re going through a little better? Don’t worry, you’re not expected to know everything about diabetes right from the word go. In fact even if most people have a rough idea of what diabetes is, it remains one of the most misunderstood and least well known chronic illnesses in society.

 

We’ve compiled a glossary of terms you’ll need to know in order to understand the illness. Here are the 20 words you need to know about diabetes.

 

Type I Diabetes: Type 1 diabetes is usually diagnosed in childhood. If you suffer from type I diabetes, your pancreas isn’t able to produce enough insulin and your blood sugar levels rise. The treatment for type I diabetes is taking insulin daily.

 

Type II Diabetes: If you suffer from type II diabetes, your pancreas produces insulin but your body has developed a resistance to its effects. This means that the amount of insulin you produces isn’t enough to control your blood sugar levels, and your body develops an “insulin resistance”.

 

Gestational Diabetes: Gestational diabetes occurs during pregnancy. Around 10% of all pregnant women develop gestational diabetes and it usually disappears after giving birth.

 

Beta cells: Beta cells are cells located in the pancreas and that are responsible for the production of insulin in your body.

Insulin: Insulin is a hormone produced by the beta cells in the pancreas. Its main function is to send blood sugar to the cells so that your body can use it as a source of energy.

 

Glucose: Also known as blood sugar, glucose is the sugar in your blood which is the key energy source for your body. In the digestion process your body turns carbohydrates into sugar to fuel your body.

 

Glucometer (glucose meter): A glucometer is a small portable device for diabetic people to measure the level of blood sugar in their bodies. After pricking the skin with a needle, a small drop of blood is collected on a disposable test strip. A few seconds later, the meter displays a number that represents the blood sugar level.

 

Hypoglycaemia: Hypoglycaemia is a state of abnormally low blood sugar levels, sometimes known as “insulin shock”. It usually occurs when the glucose level is under 3-4mmol/L (60-70mg/dl), although it can sometimes happen at higher levels.

Hyperglycaemia (High blood sugar): Etymologically the Greek prefix “hyper” means “too much”; “glyc” means “sweet” and “emia” means “of blood”. It shouldn’t be confused with hypoglycaemia which means low blood sugar level, as hyperglycaemia occurs when your blood sugar level is higher than normal.

 

Hypertension (High blood pressure): Hypertension or high blood pressure occurs when the blood pressure is higher than normal and the blood pumps itself through the blood vessels with a stronger force. Hypertension damages the heart, blood vessels and increases the risk of heart attacks and strokes. Diabetic people are at higher risk of high blood pressure than the population as a whole.

 

Glycaemic control: The steps you take to maintain your blood sugar within the established normal limits.

Diabetic coma: A diabetic coma is when a person with diabetes loses consciousness due to particularly severe hypoglycaemia.

Diabetic Ketoacidosis (DKA): Diabetic ketoacidosis is a serious complication of diabetes requiring emergency treatment, resulting from a severe lack of insulin and extremely high blood sugar levels. The symptoms include nausea, vomiting, stomach pain, fruity-smelling breath, and rapid, deep breathing. If you experience these symptoms, go to A&E immediately.

 

Acanthosis nigricans: This is a skin disorder which causes the skin to go dark and thick and is usually found in the body’s, like the armpits or knees. It is common in people that have an insulin resistance.

 

Polyphagia: Polyphagia refers to an abnormal increase in hunger that is one of the first symptoms of diabetes. Along with polydipsia (an increased feeling of thirst), it’s one of the most common symptoms of untreated diabetes.

 

Polydipsia: Polydipsia is the medical term for increased thirst. If you suffer from polydipsia no matter how much you drink, you never satisfy your thirst. It’s also one of the first signs of suffering from diabetes.

 

Nutritionist: A nutritionist is a professional who advises you on what you should and shouldn’t eat. A diabetic person usually consults a nutritionist to support their treatment and to understand the role their diet plays, along with their medication.

 

Lipid Analysis: Diabetes can cause high levels of triglycerides in the blood which, in turn, increase the risk of heart disease. In addition, it’s also important to control cholesterol levels to prevent cardiovascular disease. By analysing and controlling levels of lipids you can avoid further health issues.

 

Retinopathy: Diabetes increases the risk of abnormalities in the blood vessels of the retina (the back of the eye), and if not treated in time can cause significant sight loss. In addition, people with diabetes are more likely to develop glaucoma and other eye problems. Therefore, it’s recommended that a people with diabetes have regular eye tests – at least once a year – and make sure to have the back of the eye inspected. Generally there are no symptoms until the problem is already advanced, so it’s essential to catch it early.

 

Diet , Symptoms , Diagnosis , Medication

 

Author: Editorial Team

 

© People Who Global, iStock.com, /Kislev

 

Diabetes: Is gastroparesis the problem?

 

Struggling with heartburn, bloating and nausea? If so, you might have gastroparesis – a condition a lot of people with diabetes are affected

 

8 February 2016 | Diagnosis

 

A lot of people with diabetes also have an associated disorder called gastroparesis – a condition in which the stomach takes longer than usual to empty of food. Interestingly gastroparesis is actually a type of neuropathy (nerve damage) affecting the vagus nerve and the muscles in the stomach and intestine – stopping them from functioning as they should. The conditionslows or stops the movement of food, leading to discomfort and a variety of associated complications.

 

The high blood sugar levels associated with diabetes can damage the vagus nerve, thereby provoking the gastric disorder.

Symptoms of gastroparesis

 

The symptoms most commonly associated with gastroparesis includenausea, vomiting up undigested food, heartburn, quickly feeling full-up when eating, weight-loss, poor appetite and bloating (or abdominal distension).

 

Effect of gastroparesis on diabetes

 

When the food that has accumulated in the stomach finally passes to the small intestine and is absorbed, blood sugar levels rise. As gastric emptying is erratic, controlling the blood sugar levels (and the diabetes itself) is much more difficult. In addition, the fact that the food remains in the stomach longer than it should, can cause bacteria to build-up. There is also the risk the food in the stomach will harden, turning into solid masses known as bezoars, which are potentially very dangerous as they can lodge in (and block) the passageway into the small intestine.

 

Gastroparesis: Diagnosis

 

When a doctor suspects gastroparesis they generally start by recommending the following tests:

 

- Esophagogastroduodenoscopy: Commonly referred to as agastroscopy, this test involves using a small camera (inserted down the throat) to inspect the lining of the oesophagus, stomach and duodenum (the first part of the small intestine).

 

- Gastric emptying study: This test involves eating food containing a small portion of radioisotopes (a radioactive material that shows up on the scanner) and then using an external camera to monitor the progress of the food and the speed at which it leaves the stomach.

 

- Esophagogastroduedenal transit study: The person is given a contrast material and then a series of radiographies are used to examine the oesophagus, stomach and intestine.

 

Gastroparesis: Treatment

If you have diabetes-related gastroparesis, the top priority is to get your blood sugar levels under control. There are a variety of treatment options that can help with this. These include prescribing oral medications (to increase movement through the digestive system), insulin and dietary modifications (governing what is eaten and when). Most doctors tend to recommend eating little but often (i.e. five to six small meals a day), favouring foods that are low in both fat and fibre.

 

If you find you’re stuggling to maintain a healthy weight your doctor may decide to recommend supplementing your diet with enteral nutrition (tube feeding), as liquid foods are easier to digest.

 

Symptoms , Diagnosis , Medication , Technology , Public Healthcare , Private Healthcare

Author: Editorial Team

 

© People Who Global, iStock.com

 

Diabetes and cholesterol

 

If you have diabetes, lowering your triglyceride and bad cholesterol levels is the best way to protect yourself from a heart attack.

 

18 April 2016 | Diagnosis

 

If you have diabetes, you probably already know that you're at greater risk of heart disease than most. While too much sugar in itself is bad for the health of your heart, type 1 and type 2 diabetes can raise your triglyceride and cholesterol levels, which also increases the likelihood of heart disease.

 

The combination of these (and other) factors is devastating, as statistics show that two thirds of people with diabetes will die from some kind of heart condition.

 

So, if you have diabetes, you’ll need to make sure you’re getting your cholesterol and triglyceride levels tested regularly. To avoid associated complications, doctors recommend keeping your triglyceride and "bad cholesterol" levels low and your “good cholesterol” levels high.

 

What exactly is good cholesterol and bad cholesterol?

 

Cholesterol is a fatty substance that is synthesised in the liver and circulates in the blood. It is vitally important to the proper functioning of the body, as it is needed in the production of digestive bile acids, vitamin D, thyroid hormones and sex hormones. As we will address later, the problem comes when there’s too much cholesterol circulating in the bloodstream – a condition that is referred to in the medical profession ashypercholesterolemia.

 

Cholesterol is transported by special molecules called lipoproteins. When you get your blood tested it's these lipoproteins (rather than the cholesterol itself) that are measured. There are two types of lipoproteins:

 

-Low-density lipoprotein (LDL). Low-density lipoproteins transport cholesterol to the cells. They are often referred to as "bad cholesterol", as excess LDLs are deposited on the walls of the arteries – thereby increasing a person’s risk of heart attack and other heart problems.

 

-High-density lipoproteins (HDL). High-density lipoproteins are sometimes referred to as "good cholesterol" because they help to protect against a variety of heart complaints. Their function is to collect left-over cholesterol and return it to the liver, where it is destroyed.

 

Triglycerides are another type of fat that circulates in the blood. Having too many triglycerides in the bloodstream increases the risk of heart problems and pancreatitis.

 

What’s considered to be a safe cholesterol level?

 

As we've already explained, people with diabetes tend to be more prone to cardiovascular problems than the general population. Because of this, doctors believe that the recommended LDL level should be lower for people with diabetes than for others – i.e. below 100 mg/dL (as opposed to the 130 mg/dL for people without diabetes).

Triglyceride levels should stay below 150 mg/dL and good cholesterol or HDL levels should exceed 40 mg/dL for men and 50 mg/dl for women.

 

What can you do to lower your bad cholesterol level?

 

When it comes to battling cholesterol, there are certain things that are out of your control. Some people are genetically predisposed to accumulating bad cholesterol in their blood and it is a well-known fact that women who have gone through menopause tend to have higher bad cholesterol levels than men of the same age.

 

The good news however, is that there are a number of things you can control. And fortunately, they are the same for both conditions – namely a diet that is low in fat (especially saturated fats found in red meat, industrially produced baked goods and processed meats), a healthy body weight and regular physical activity.

 

By controlling these three areas you will be able to effectively manage your diabetes, reduce your cholesterol levels, improve your blood pressure and protect against complications caused by being overweight or obese. It’s really just a matter of taking the initiative!

Diagnosis , Psychological aspects , Symptoms , Medication , Non-pharmacological treatments , Exercise , Diet

 

Author: Editorial Team

 

© People Who Global, iStock.com

 

Hyperglycaemia – High blood sugar

Find out all you need to know about hyperglycaemia (high blood sugar) – including its symptoms, causes, diets and treatments.

17 March 2016 | Diagnosis

 

If you or a loved one has diabetes you probably already know that a sudden spike in blood sugar level is called hyperglycaemia. Anyone with type 1 or type 2 diabetes is at risk of experiencing hyperglycaemia, which is why they should take special care to get their blood sugar tested regularly (as they will need to take immediate action to rectify a high reading).

 

While a couple of high readings on your blood glucose metre don’t necessarily indicate a serious problem, a prolonged high reading should give cause for concern, as hyperglycaemia has been associated with some very serious complications. Fortunately, by keeping a strict watch on their blood sugar levels, most people with diabetes are able to avoid the majority of these complications.

 

Symptoms

 

During hyperglycaemia, people with diabetes tend to get hungrier and thirstier than usual, with their mouth continuing to feel dry no matter how much they drink. Other symptoms include: frequent urination, blurry vision, tiredness and lethargy and weight loss (despite the fact that they are eating as much or more than usual). The symptoms of hyperglycaemia generally only become obvious after several days of significantly high blood sugar levels (i.e. over 200 mg/dl). As time goes on, the symptoms become more and more pronounced. Interestingly, people who have had type 2 diabetes for a number of years often find they don’t notice any physical changes during hyperglycaemia.

 

Causes

 

Hyperglycaemia can be caused by a variety of situations. If the diabetes can usually be controlled with very little effort, the most likely cause of hyperglycaemia is an infection. When your body is invaded by pathogenic agents it responds by producing molecules to fight them off. This triggers a rise in blood sugar levels, which, in turn, leads to hyperglycaemia.

 

Hyperglycaemia can also be brought on by hormonal changes that take place when the person is exposed to stressful situations. Cortisol (the anti-stress hormone), is involved in the secretion of insulin. So, a lot of medications containing this particular molecule, such as the corticoid-based topical creams that are used to treat the pain associated with arthritis, can also cause a person’s blood sugar levels to rise.

 

And last but not least, hyperglycaemia can also be brought on by changes to a person’s eating habits or exercise regime. When a person with diabetes consumes food or drink with a high glycaemic load (i.e. with a high sugar or carb content) like cakes, pastries, ice-cream or sugary drinks, their blood sugar level will rise.

 

Blood sugar levels also tend to rise when you aren’t getting enough exercise(or when you aren’t doing as much as you usually do). That being said, hyperglycaemia can also be triggered by too much high-intensity exercise. Especially if you’re exercising when your blood sugar levels are high and your insulin levels low – like after a meal, for example.

 

How do I control hyperglycaemia?

 

The best way to avoid the complications associated with hyperglycaemia is to get your blood sugar levels tested regularly. As you no doubt already know, the ideal blood sugar level is between 80 and 120 mg/dl before meals and below 180 mg/dl after meals.

 

If you notice several high readings in a row, the best thing to do is to cut back on how much you eat. As a general rule, exercise will help you get occasional spikes back under control. However, exercise is contraindicated whenever the reading is above 240 mg/dl.

 

A reading of 240 mg/dl or above could well be a sign that your body has gone into ketosis. In other words, your body is unable to access the glucose and so has started metabolising body fat instead. To check for ketosis, you will need to take a ketone test to see whether or not there are ketones in your urine. If the results come back positive you should avoid all physical activity and go to your nearest A&E immediately. When left untreated there is the risk the hyperglycaemia will lead to diabetic ketoacidosis – a potentially life-threatening complication.

 

When amending your eating habits and exercise regime is not enough to bring the hyperglycaemia under control, your doctor will likely recommend modifying how much insulin or diabetes medication you are taking, as well as when you take it.

 

Remember, you should never make any adjustments to your treatment without first consulting with your doctor. Doing so could put your health at considerable risk. One thing you can change on your own however, is your attitude – as long as you take a responsible approach to managing your illness there’s no reason it should hold you back.

 

Symptoms , Diagnosis , Medication , Health professionals , Non-pharmacological treatments

 

Author: Editorial Team

 

© People Who Global, iStock.com

 

True or False? Myths about diabetes

When it comes to diabetes, everyone seems to have an opinion on what to eat. But can you really believe everything you hear?

14 February 2016 | Diagnosis

 

How many times have you heard people say things like – “You shouldn’t eat so much sugar: you’ll give yourself diabetes” or “Oh, you’ve been diagnosed with diabetes, what a shame, you won’t be able to eat your favourite foods anymore.” Well, the good news is that there’s no need to panic – it’s not true, (although you’d probably guessed that much already). While most times it’s glaringly obvious that what you’re hearing is false, things aren’t always so clear-cut, as some myths have been around for so long we’ve come to accept them as gospel.

 

So, if you’re having a hard time telling fact from fiction, just take a look at the following five myths and things will soon become clear...

 

Myth 1: "Carbs are bad for people with diabetes”

 

False! While it’s true that consuming carbohydrates does raise your blood sugar levels, this doesn’t mean you can’t eat them. In fact, carbohydrates are an essential part of a healthy, balanced diet. You just have to keep in mind that some carbohydrates are better for you than others. Wholegrain foods and fruit and veg are the best, as they are high in fibre and contain a lot of the vitamins and nutrients the body needs in order to function well.

 

Myth 2: "Protein is better for you than carbs"

 

As carbs can have quite a pronounced effect on blood sugar levels, a lot of people decide that the safest option is to avoid them – opting instead for protein whenever possible. While you may feel justified in this assumption, you should be aware that eating too much protein has also been linked to a variety of complications.

 

The main problem is that many of the foods that are rich in protein – like meat for example – also tend to be quite high in fat. And eating too much fat can increase the risk of heart attack. Ideally, people with diabetes should look to obtain around 15 to 20% of their daily calorie intake from protein.

 

Myth 3: "You can carry on eating what you want – you just have to adjust your insulin accordingly”

 

Ok, ok, let’s get one thing straight here... When you’re given insulin to control your diabetes, you’re taught to adjust the amount administered according to the quantity of food you consume. This does not mean however, that you can eat whatever you like and then try to fix it later by upping the amount of insulin you give yourself. As with most medications, insulin works best when it is taken in regular, stable doses.

 

Myth 4: "If you have diabetes you should avoid sweeteners – they’re dangerous”

 

Artificial sweeteners sweeten food much more than sugar – which means you can get the same effect with less. Using sweeteners instead of sugar will help you cut down on the amount of calories you consume.

 

While artificial sweeteners provide people with diabetes with a safe way to sweeten their food, there are a variety of options out there, and nutritionists generally recommend certain ones over others. Saccharine for example, is believed to be a good option, as it has a much greater sweetening effect than sucrose and doesn’t affect your blood sugar levels.

 

Natural sweeteners, like the herb stevia, are another good option, as they are much sweeter than sugar – with a tablespoon and a half of stevia being the equivalent of one cup of sugar. Stevia has also been seen to have vasodilator, diuretic and cardiotonic effects (in other words it helps control your blood pressure, stops fluid build-up and regulates heartbeat). When it comes to stevia however, it seems to be a ‘love it or hate it’ situation, as some become instant addicts, while others can’t stand the bitter/metalicky taste. You’ll just have to try it for yourself to see where you stand.

 

Myth 5: "If you have diabetes, you can’t enjoy desserts "

 

Wrong. There are so many things you can do to keep enjoying your dessert. Try the following for example:

 

•Make your desserts using artificial sweeteners instead of sugar.

•Cut back on how much you eat. Eat one scoop of ice-cream instead of two. Or split dessert with a friend!

•Make your puddings healthier by preparing them with fruit, and vegetable oil instead of butter.

•Try broadening your horizons. There’s more to life than cake or ice-cream – why not give fresh fruit, yogurt or wholegrain cereals a go instead?

 

So, now you know the truth behind diabetes, you should be able to start using your diet to control your blood sugar levels. And if you supplement a balanced diet with a bit of exercise, you won’t just have good health – you’ll have the body to match.

 

Diet , Symptoms , Non-pharmacological treatments

 

Author: Editorial Team

 

© People Who Global, Oriol Alegret, /Erikreis

 

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