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DIABETES MANAGEMENT

Diabetes Management

What is Diabetes?

Keystone Physical Medicine offers a team of specialists that can treat and manage your diabetes effectively. Our team has helped over a thousand patients with this disease. We have countless clinical hours of experience and specialized training in this area. Keystone Physical Medicine offers different types of Diabetic care ranging from 100% natural to more aggressive invasive procedures.

Diabetes is a micro-vascular disease and can affect any organ in the body. High levels of glucose within the vasculature can lead to kidney disease, heart disease, blindness, erectile dysfunction, stroke, neuropathy, gastroparesis and infection.

We always tell people that sugar is like bacteria and if you have high sugars, you are more likely to have infections and will not heal as well if you are injured or have surgery.

People with type 2 Diabetes — the majority of folks — typically also suffer from obesity, hypertension, hyperlipidemia, hypercholesterolemia as well as depression.

Types of Diabetes

TYPE 1 DIABETES occurs when the pancreas no longer makes any insulin. It is an auto- immune disease, meaning that the body’s immune system destroyed the cells in the pancreas that make insulin. As a result, individuals with type 1 Diabetes need to take insulin with insulin injections or an insulin pump.

TYPE 2 DIABETES occurs when the body becomes resistant to the insulin it is producing. While these individuals still make insulin, they cannot make enough to meet their needs. Type 2 diabetes does progress over time as the body loses the ability to make sufficient amounts of insulin. As a result, most patients with type 2 diabetes will need medication changes over time, including the eventual need for insulin injections.

GESTATIONAL DIABETES occurs during pregnancy due to the pregnancy hormones cause the body to become resistant to insulin. Most women can compensate and make more insulin to meet their needs, but some women cannot. The result is high blood sugar during pregnancy. The diabetes generally goes away after the baby is delivered but these women are higher risk of developing type 2 diabetes in the next 10 – 15 years.

Diabetes Common Symptoms

The following symptoms of diabetes are typical. However, some people with type 2 diabetes have symptoms so mild that they go unnoticed.

  • High urinating frequency
  • Feeling very thirsty
  • Feeling very hungry – even though you are eating
  • Extreme fatigue
  • Blurry vision
  • Cuts/bruises that are slow to heal
  • Weight loss - even though you are eating more (type 1)
  • Tingling, pain, or numbness in the hands/feet (type 2)

 

diabetes_1How is Diabetes Managed?

At our Keystone Physical Medicine Clinic, our approach is to managing Diabetes is through healthy eating, physical activity, medications (if necessary), self-monitoring blood glucose, diabetes education, and proper follow up care.

We create customized care plans dependent on your specific needs. Diabetes is a very complex disease; therefore your care plan will change over time dependent on your condition.

 

Eating Healthy

Despite all the publicity surrounding new research and new nutrition guidelines, some people with diabetes still believe that there is something called a "diabetic diet."

For some, this so-called diet consists of avoiding sugar, while others believe it to be a strict way of eating that controls glucose. Unfortunately, neither are quite right.

The "diabetes diet" is not something that people with type 1 or type 2 diabetes should be following. "That just simply isn't how meal planning works today for patients with diabetes," says Amy Campbell, MS, RD, LDN, CDE.

We know now that it is okay for people with diabetes to substitute sugar-containing food for other carbohydrates as part of a balanced meal plan.

Prevailing beliefs up to the mid-1990s were that people with diabetes should avoid foods that contain so-called "simple" sugars and replace them with "complex" carbohydrates, such as those found in potatoes and cereals.

A review of the research at that time revealed that there is relatively little scientific evidence to support the theory that simple sugars are more rapidly digested and absorbed than starches, and therefore more apt to produce high blood glucose levels.

Now, many patients are being taught to focus on how many total grams of carbohydrate they can eat throughout the day at each meal and snack, and still keep their blood glucose under good control.

Well-controlled blood glucose is a top priority because other research studies have concluded that all people with diabetes can cut their risk of developing diabetes complications such as heart disease, stroke, kidney and eye disease, nerve damage, and more, by keeping their blood glucose as closely controlled as possible.

It is all about being consistent with healthy food choices and portion control. Following the guidelines may not only help you remain healthy, but may even improve your health as a result of having new motivation to care for yourself.

Carbohydrates are the nutrients that turns directly into glucose. No matter the form, starch or sugar, they all turn to glucose and enter your bloodstream after you eat. That does not mean that carbohydrates are bad. You need carbohydrates, but it is important to control your portions of carbohydrate containing foods.

A registered dietitian may visit you while you are in the hospital to discuss more detailed nutrition guidelines including how many carbohydrates you should eat at your meals and/or snacks. A personal meal plan is set-up for you by your diabetes care team before you leave our clinic.diabetes_2

Healthy Eating Tips

  • Avoid concentrated, liquid carbohydrates such as regular soda pop and fruit juice.
  • Limit milk to 1 cup (8 oz.) at a serving.
  • Limit starches such as pasta, rice, potatoes, corn, peas, and dried beans to a serving about the size of a tennis ball.
  • Limit sweets and desserts.
  • Increase your intake of non-starchy vegetables such as lettuce, tomatoes, celery, cucumber, carrots, broccoli, summer squash, and cauliflower.
  • Look at your plate. Try changing to 1/2 the plate as non-starchy vegetables, 1/4 plate as starch, and 1/4 plate as protein.
  • While protein and fat do not raise blood glucose, they do affect weight and cholesterol. Since diabetes is strongly linked to heart disease, it is important to also follow heart healthy eating guidelines.
  • When choosing protein, avoid fatty cuts of meat. Try to eat lean sources such as fish and poultry as well as lean cuts of beef and pork. Dried beans are also a good source of protein.
  • Limit added fats such as butter, margarine, mayonnaise, salad dressing, and sour cream.

 

Physical Activity

While physical activity is good for everyone, it has added benefits for individuals with diabetes and is essential to its management.

Exercise helps control diabetes, but it can also help slow the progression of it. Physical activity is like a free medication. It helps the body use insulin more efficiently and thus helps lower blood glucose. It also helps control weight and cholesterol.

The goal is to work up to 30 – 60 minutes, 5 – 7 days per week. The key is to start slow and increase as tolerated.

Before beginning physical activity, check with your diabetes management provider about any special limitations you may have. Your diabetes care team can also give you suggestions on setting up a plan to set goals and increase your activity level.

Medications

Most individuals will need some type of medication to manage their diabetes. In many cases, a combination of medications is needed. There are many options available depending upon the type of diabetes you have. Our team here at Keystone Physical Medicine wants to help.

The only option available for type 1 diabetes is insulin. There are many types of insulin available and it is important to work with your diabetes care team to find the right insulin routine for you.

The options are many for individuals with type 2 diabetes including oral medications, non-insulin injectables, as well as insulin. All help control diabetes in different ways. You will receive information before you leave our clinic regarding your specific medications.

Hemoglobin A1C

During your check up at Keystone Physical Medicine our professionals may order a blood test called a hemoglobin A1c may have been done. This important test tells you what your average blood glucose has been over the past 2 – 3 months.

Glucose that is in your blood permanently attaches to your red blood cells. Because red blood cells live in the body for about 90 days, the A1c test result represents an average blood sugar level over a 3-month period of time.

The higher your A1c test results, the greater the amount of sugar in your blood. High blood sugar levels over a long period of time may increase your risk of diabetes complications. Your A1c goal may be customized by your diabetes care provider at Keystone Physical Medicine.

Self-Monitoring Blood Glucose

You can have high blood sugar on some days and low blood sugar on others, and the average could be a “good” A1c reading. That’s why it’s still important to check your own blood sugar daily, as well as having an A1c test done.

Checking your blood sugar gives you information needed to make good decisions about your care. The results from testing can show how different foods, activities, medications, and life can affect your blood sugar.

This information can help you plan for meals and snacks, physical activity, traveling, and medication adjustments. Blood sugar levels can change throughout the day and night.
As a result, varying the times when you test can reveal a great deal about your diabetes management. The key is looking for trends in the results.

Ongoing Diabetes Care

Once you leave Keystone Physical Medicine, it will be important to follow up with your diabetes care provider to resume regular diabetes care. Because diabetes affects your entire body, it is important to have the following tests performed to check for problems.

Early intervention is very important to reversing or slowing the progression of a complication in order to have a positive outcome.

Diabetes is truly linked to everything; and blood glucose levels are altered by everything. Our team at Keystone Physical Medicine wants to help. Please call us today for your diabetic consultation at (208) 426-9200.

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