The Role Of Food In Diabetes Management
It is important to understand how food impacts blood glucose for children with diabetes.
Food causes blood glucose to go up. Insulin causes blood glucose to go down. Too much food with not enough insulin can cause blood glucose to go too high. Not enough food with too much insulin can cause blood glucose to go too low. Further, the type and amount of food will affect how much and how quickly the blood glucose goes up. Balancing food and insulin together can help keep blood glucose in a normal range.
Carbohydrates, also known as carbs, are an important source of energy. They are also the main nutrient the body turns into blood glucose, also known as blood sugar. Everyone needs to eat some carbohydrates to stay healthy. Common carbohydrate foods include: bread, crackers, cereal, pasta, rice, fruit, and milk.
- Carbohydrates that are high in fiber such as whole grains, fruits, and vegetables slow digestion and contribute to a feeling of fullness. High-fiber food can also reduce spikes in blood glucose after eating.
- Processed carbohydrates that are low in fiber can raise blood sugars too high. Eating fewer processed carbohydrates helps manage blood glucose levels.
A dietitian can help determine the right amount of carbohydrates and types for your child.
A healthy diet can mean different things to different people. A dietitian is very important to help with meal planning and understanding the right balance of foods for your child.
Treating Type 1 Diabetes
It’s important that diabetes is diagnosed as early as possible. If left untreated, type-1 diabetes is a life-threatening condition. It’s essential that treatment is started early.
Diabetes can’t be cured, but treatment aims to keep your blood glucose levels as normal as possible and control your symptoms, to prevent health problems developing later in life.
If you’re diagnosed with diabetes, you’ll be referred to a diabetes care team for specialist treatment and monitoring.
As your body can’t produce insulin, you’ll need regular insulin injections to keep your glucose levels normal. You’ll be taught how to do this and how to match the insulin you inject to the food you eat, taking into account your blood glucose level and how much exercise you do.
Insulin injections come in several different forms, with each working slightly differently. You’ll most likely need a combination of different insulin preparations.
Insulin is given to some patients by a continuous infusion of fast acting insulin . This is where a small device constantly pumps insulin into your bloodstream through a plastic tube that’s inserted under the skin with a needle.
There are alternatives to insulin injections and pumps, but they’re only suitable for a small number of patients. They are:
Symptoms And Risk Factors
It can take months or years for enough beta cells to be destroyed before symptoms of type 1 diabetes are noticed. Type 1 diabetes symptoms can develop in just a few weeks or months. Once symptoms appear, they can be severe.
Some type 1 diabetes symptoms are similar to symptoms of other health conditions. Dont guessif you think you could have type 1 diabetes, see your doctor right away to get your blood sugar tested. Untreated diabetes can lead to very seriouseven fatalhealth problems.
Risk factors for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes, though family history is known to play a part.
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How Is Diabetes Treated
Treatments for diabetes depend on your type of diabetes, how well controlled your blood glucose level is and your other existing health conditions.
- Type 1 diabetes: If you have this type, you must take insulin every day. Your pancreas no longer makes insulin.
- Type 2 diabetes: If you have this type, your treatments can include medications , insulin and lifestyle changes such as losing weight, making healthy food choices and being more physically active.
- Prediabetes: If you have prediabetes, the goal is to keep you from progressing to diabetes. Treatments are focused on treatable risk factors, such as losing weight by eating a healthy diet and exercising . Many of the strategies used to prevent diabetes are the same as those recommended to treat diabetes .
- Gestational diabetes: If you have this type and your glucose level is not too high, your initial treatment might be modifying your diet and getting regular exercise. If the target goal is still not met or your glucose level is very high, your healthcare team may start medication or insulin.
Oral medications and insulin work in one of these ways to treat your diabetes:
- Stimulates your pancreas to make and release more insulin.
- Slows down the release of glucose from your liver .
- Blocks the breakdown of carbohydrates in your stomach or intestines so that your tissues are more sensitive to insulin.
- Helps rid your body of glucose through increased urination.
Can Prediabetes Type 2 Diabetes And Gestational Diabetes Be Prevented
Although diabetes risk factors like family history and race cant be changed, there are other risk factors that you do have some control over. Adopting some of the healthy lifestyle habits listed below can improve these modifiable risk factors and help to decrease your chances of getting diabetes:
- Eat a healthy diet, such as the Mediterranean or Dash diet. Keep a food diary and calorie count of everything you eat. Cutting 250 calories per day can help you lose ½ pound per week.
- Get physically active. Aim for 30 minutes a day at least five days a week. Start slow and work up to this amount or break up these minutes into more doable 10 minute segments. Walking is great exercise.
- Lose weight if you are overweight. Dont lose weight if you are pregnant, but check with your obstetrician about healthy weight gain during your pregnancy.
- Lower your stress. Learn relaxation techniques, deep breathing exercises, mindful meditation, yoga and other helpful strategies.
- Limit alcohol intake. Men should drink no more than two alcoholic beverages a day women should drink no more than one.
- Get an adequate amount of sleep .
- Take medications to manage existing risk factors for heart disease or to reduce the risk of developing Type 2 diabetes as directed by your healthcare provider.
- If you think you have symptoms of prediabetes, see your provider.
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What Oral Medications Are Approved To Treat Diabetes
Over 40 medications have been approved by the Food and Drug Administration for the treatment of diabetes. Its beyond the scope of this article to review all of these drugs. Instead, well briefly review the main drug classes available, how they work and present the names of a few drugs in each class. Your healthcare team will decide if medication is right for you. If so, theyll decide which specific drug are best to treat your diabetes.
Diabetes medication drug classes include:
Many oral diabetes medications may be used in combination or with insulin to achieve the best blood glucose control. Some of the above medications are available as a combination of two medicines in a single pill. Others are available as injectable medications, for example, the GLP-1 agonist semaglutide and lixisenatide .
Always take your medicine exactly as your healthcare prescribes it. Discuss your specific questions and concerns with them.
Other Forms Of Diabetes
In 1% to 5% of people who have diabetes, other conditions might be the cause. These include diseases of the pancreas, certain surgeries and medications, and infections. In these cases, your doctor might want to keep an eye on your blood sugar levels.
American Diabetes Association: “Frequently Asked Questions about Pre-Diabetes,” “Type 2 Diabetes,” “The Dangerous Toll of Diabetes,” tion: “Gestational Diabetes,” “About Insulin and Other Drugs.”
National Library of Medicine: “Diabetes.”
National Diabetes Education Project: “About Diabetes and Pre-Diabetes.”
National Diabetes Information Clearinghouse : “National Diabetes Statistics, 2011.”
Merck Manual Consumer Version: âDiabetes Mellitus .â
CDC: âAbout Diabetes,â âPrediabetes: Your Chance to Prevent Type 2 Diabetes.â
World Journal of Diabetes: âType 2 diabetes mellitus in children and adolescents.â
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What Kind Of Doctor Treats Diabetes
Endocrinology is the specialty of medicine that deals with hormone disturbances, and both endocrinologists and pediatric endocrinologists manage patients with diabetes. People with diabetes may also be treated by family medicine or internal medicine specialists. When complications arise, people with diabetes may be treated by other specialists, including neurologists, gastroenterologists, ophthalmologists, surgeons, cardiologists, or others.
Which Type Of Diabetes Do I Have
In some cases, it may not be clear which type of diabetes you have. If your doctor cannot be sure which type of diabetes you have, they may run one or more tests to help determine your diabetes type
Learn about the differences between type 1 and type 2 diabetes
There are a number of different types of diabetes. In this video we look at 5 of the most common types of diabetes.
Type 2 diabetes is the most common form of diabetes amongst adults about 85% of people with diabetes in the UK have type 2 diabetes. Type 1 diabetes is the second most common approximately 15% of people with diabetes in the UK have type 1. There are also other less common types of diabetes including gestational diabetes, LADA and MODY.
The risk of type 2 diabetes increases with age, meaning that most people who develop type 2 diabetes are usually middle aged or older. However, type 2 diabetes can develop earlier in adulthood or even childhood. Diabetes UK reports that obesity accounts for over 80% of the overall risk of developing Type 2 diabetes.
Other risk factors include having a close family member with type 2 diabetes, being of African/Caribbea, South Asian or Middle Eastern descent, or having high blood pressure and/or cholesterol. Type 2 diabetes can be treated with diet and exercise alone, or with tablets, insulin or other injectable medication.
The symptoms of type 2 diabetes come on slowly and may take months or years to appear.
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What Are The Early Signs Of Kidney Disease In Patients With Diabetes
The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in your doctors office show evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.
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Causes Of Type 1 Diabetes
Type 1 diabetes is an autoimmune condition, where the immune system mistakes the cells in your pancreas as harmful and attacks them.
Without insulin, your body will break down its own fat and muscle, resulting in weight loss. This can lead to a serious short-term condition called diabetic ketoacidosis. This is when the bloodstream becomes acidic, you develop dangerous levels of ketones in your blood stream and become severely dehydrated.
This results in the body being unable to produce insulin, which is required to move glucose out of the blood and into your cells to be used for energy. This is called Type 1 diabetes.
Read more about the causes of type 1 diabetes
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What Are The Different Types Of Diabetes
The types of diabetes are:
- Type 1 diabetes: This type is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed. Up to 10% of people who have diabetes have Type 1. Its usually diagnosed in children and young adults . It was once better known as juvenile diabetes. People with Type 1 diabetes need to take insulin every day. This is why it is also called insulin-dependent diabetes.
- Type 2 diabetes: With this type, your body either doesnt make enough insulin or your bodys cells dont respond normally to the insulin. This is the most common type of diabetes. Up to 95% of people with diabetes have Type 2. It usually occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes. Your parents or grandparents may have called it having a touch of sugar.
- Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
- Gestational diabetes: This type develops in some women during their pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes you’re at higher risk of developing Type 2 diabetes later on in life.
Less common types of diabetes include:
Diabetes insipidus is a distinct rare condition that causes your kidneys to produce a large amount of urine.
Are Some People More Likely To Develop Type 2 Diabetes Than Others
A person who has a highly inflammatory diet and carries excess adiposity around their central organs is more likely to get type 2 diabetes, says Dr. Christofides. Excess weight and obesity are risk factors for type 2 diabetes, but how your body stores and manages weight can also be an early indicator of risk.
Research has shown that people who carry too much fat around their middle are more prone to health risks such as type 2 diabetes. Certain communities also show a greater propensity for developing type 2 diabetes, including people who are Black, Latinx, Asian, and Indigenous.
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What Is Diabetes Mellitus
When you eat a carbohydrate, your body turns it into a sugar called glucose and sends that to your bloodstream. Your pancreas releases insulin, a hormone that helps move glucose from your blood into your cells, which use it for energy.
When you have diabetes and donât get treatment, your body doesnât use insulin like it should. Too much glucose stays in your blood, a condition usually called high blood sugar. This can cause health problems that may be serious or even life-threatening.
Thereâs no cure for diabetes. But with treatment and lifestyle changes, you can live a long, healthy life.
Diabetes comes in different forms, depending on the cause.
Conditions Linked With Type 1 Diabetes
Type 1 diabetes is an autoimmune disease, meaning that the bodys immune system mistakes its own cells for invading pathogens that need to be destroyed.
People with type 1 diabetes tend to have a higher risk of having other autoimmune diseases than the rest of the population.
Other autoimmune diseases include:
- Autoimmune thyroid disease
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We Need A Strategy Now
Although people with type 1 or type 2 diabetes have different journeys, including whether or not they experience symptoms, there is one issue that unites all people living with the disease. Canada has no strategy to address one of the most significant health-care crisis of our time.
With no dedicated support or action to tackle the diabetes epidemic, it means that, every 24 hours:
- more than 20 Canadians die of diabetes-related complications
- 480 more Canadians are diagnosed with this devastating disease
- 14 Canadians have a lower limb amputation
- our health care system spends $75 million treating diabetes
Preeclampsia And Gestational Hypertension
A population-based, retrospective cohort study of 1,010,068 pregnant women examined the association between preeclampsia and gestational hypertension during pregnancy and the risk of developing diabetes post partum. Results showed the incidence rate of diabetes per 1000 person-years was 6.47 for women with preeclampsia and 5.26 for those with gestational hypertension, compared with 2.81 in women with neither condition. Risk was further elevated in women with preeclampsia or gesntational hypertension comorbid with gestational diabetes.
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People With Difficulty Maintaining Blood Glucose Levels
The term brittle diabetes has been used to refer to people who have dramatic recurrent swings in blood glucose levels, often for no apparent reason. However, this term is no longer used. People with type 1 diabetes may have more frequent swings in blood glucose levels because insulin production is completely absent. Infection, delayed movement of food through the stomach, and other hormonal disorders may also contribute to blood glucose swings. In all people who have difficulty controlling blood glucose, doctors look for other disorders that might be causing the problem and also give people additional education on how to monitor diabetes and take their drugs.
Other Terms You May Hear
While these arent official types of diabetes, you may sometimes hear these terms when talking about diabetes. They include:
- Monogenic diabetes. This includes both MODY and neonatal diabetes, and refers to any type of diabetes thats caused by genetic changes.
- Type 3c diabetes. This is sometimes used to refer to diabetes caused by other conditions, such as cystic fibrosis and pancreatic cancer.
- Latent autoimmune diabetes in adults . This is sometimes referred to as type 1.5 diabetes. Some experts think of it as a subtype of type 1 diabetes. While it is an autoimmune disease like type 1, LADA progresses more slowly. Its often misdiagnosed as type 2 diabetes because you may still be able to produce insulin for some time.
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Type 2 Diabetes Mellitus
Type 2 diabetes is far more common than type 1 diabetes, accounting for about 90 percent of all cases. The frequency of type 2 diabetes varies greatly within and between countries and is increasing throughout the world. Most patients with type 2 diabetes are adults, often older adults, but it can also occur in children and adolescents. There is a stronger genetic component to type 2 diabetes than to type 1 diabetes. For example, identical twins are much more likely to both develop type 2 diabetes than to both develop type 1 diabetes, and 7 to 14 percent of people whose mother or father has type 2 diabetes will also develop type 2 diabetes this estimate increases to 45 percent if both parents are affected. In addition, it is estimated that about half of the adult Pima Indian population in Arizona has type 2 diabetes, whereas in the entire United States it is estimated that about 10 percent of the population has type 2 diabetes.
Many patients with type 2 diabetes are asymptomatic, and they are often diagnosed with type 2 diabetes when routine measurements reveal high blood glucose concentrations. In some patients the presence of one or more symptoms associated with the long-term complications of diabetes leads to a diagnosis of type 2 diabetes. Other patients present with symptoms of hyperglycemia that have been present for months or with the sudden onset of symptoms of very severe hyperglycemia and vascular collapse.