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.
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 ancestors were a few generations ago. Being overweight and physically inactive are key risk factors for developing prediabetes and type 2 diabetes. It is now predicted that by the year 2050, one out of every three adults will have diabetes. It’s time to turn those trend lines around.
The Centers for Disease Control and Prevention (CDC) say, “Obesity-related conditions including heart disease, stroke, and type 2 diabetes are among the leading causes of preventable death.” Very convincing studies from all around the globe show that lifestyle interventions can delay or prevent diabetes. Those lifestyle interventions are also at the core of treating diabetes and are focused on improving dietary patterns, exercise habits, and weight management.
Diabetes can go undetected for many years, so screening is critically important. The CDC estimates that 25 percent of people with blood-glucose levels in the diabetes range remain undiagnosed, and an alarming 90 percent of people in the prediabetes range don’t realize that their glucose levels are elevated. This chapter identifies the risk factors and potential symptoms of diabetes, the diagnostic and classification criteria, and where to go next if you’re diagnosed.
We rely on foods to provide our bodies with energy, vitamins, minerals, and essential nutrients. On the most basic level, food and water are required for survival, but food is so much more than just a way to survive. We savor and enjoy food. We have cultural traditions, family recipes, and memories associated with food. Friends and relatives socialize around dinner tables and celebrate holidays and special occasions over meals.
When you’re diagnosed with diabetes, the focus on food shifts, and the next thing you know you are being asked to read food labels and break out the measuring cups. Your vocabulary expands to include the words “pancreas,” “insulin,” “carbohydrate,” and “blood glucose.” The good news is diabetes is manageable, now more than ever before. The first step in successfully managing your diabetes is to understand how the body is supposed to work and what has gone awry if you’ve developed diabetes. The following sections cover these topics.
Seeing how the body is supposed to process carbs
Human bodies need fuel to function. Glucose is the primary fuel source for the brain and red blood cells. It is also the preferred fuel source for muscles. Carbohydrate-containing foods provide glucose through the process of digestion and absorption. Glucose travels throughout the body via the bloodstream to all awaiting organs, tissues, and cells. For more on that process, see Chapter 4.
When all systems are working properly, a hormone called insulin helps the glucose move from the bloodstream into the cells where it’s burned for energy. The pancreas is the organ that makes and secretes insulin. Think of insulin as a “key” that has to unlock the cells to allow the glucose in. Insulin is supposed to bind to an insulin receptor on the surface of the cell. Once the insulin and the receptor are coupled, then the glucose may enter the cell. See Figure 2-1.
© John Wiley & Sons, Inc.
FIGURE 2-1: Insulin allows glucose to enter the cell.
If you have diabetes, it means either you don’t make enough insulin, or the insulin you make simply doesn’t work effectively. The next section elaborates further.
Discovering what causes diabetes
The surface of the pancreas has insulin-producing cells called beta-cells or islet cells. In the case of type 1 diabetes, the beta-cells are destroyed so they are no longer able to produce insulin. Without insulin, glucose cannot properly nourish the body.
