Vitamin D Deficiency and Diabetes

There are a lot of things that are connected to diabetes.  Everything from imbalanced diet to lack of exercise is blamed for causing or increasing diabetes.  Under the diet category, researchers are now calling attention to Vitamin D deficiency as a contributor to diabetes.

Vitamin D is linked to sunlight.  One of the issues that helps create vitamin D deficiency is, logically, not getting outside enough or not drinking enough milk or eating enough foods that contain high levels of vitamin D.  Researchers have determined that many people who are deficient in vitamin D live in areas such as Main or Seattle where the weather keeps people inside most of the year. 

Vitamin D deficiency has increased to the point where the medical community is calling this deficiency an epidemic.  Since Vitamin D helps keep the immune system healthy and since we don’t produce vitamin D in our skin between the months of November to March, our levels drop and we need to build them up during the other months of the year.
The average fair-skinned person used to get the equivalent of 10,000 IU (international units) by spending 10 to 15 minutes outdoors a few times a week. This takes a good bit of work. Some climates have less sunlight than others and people either don’t spend enough time outdoors or wear sunscreen when they do, which prevents synthesis of vitamin D.
As a result, the American Academy of Pediatrics has doubled its recommended minimum daily intake of vitamin D for infants, children and teens from 200 IU to 400 IU.  For adults, the government recommends 200 IU of vitamin D each day up to age 50, 400 IU at 60 and 600 IU at 70.  Many researchers feel that those levels are much too low and that food sources, such as milk and salmon, do not provide enough vitamin D.
If you have pre diabetes or type 2 diabetes, be sure not to forget your vitamin D.  It will help your immune system stay that much stronger and help you feel better, despite diabetes or other ailments you have to deal with.

Diabetic Teen Laura C. – By Cassie S., Canfield, OH

We are entering the New Year and it is a time for looking forward.  Normally, the information contained here is original; however, the following information about a teenage girl named Laura gives positive insight into the life of a young person with diabetes.  Laura’s answers and ideas are honest and full of grace.  I hope they will bring information and hope to you, even if only a little. Here is the reprint of the article/interview: 

Laura is one of my good friends. I really admire her. She has diabetes but still lives the life of a normal teenager. She has to deal with all the struggles of diabetes along with those of life.

What exactly is diabetes?
There are two types of diabetes. I have type one. My body attacked my pancreas and it stopped producing ¬insulin.

What does insulin do?
Insulin allows sugars from food into the cells. If there is no insulin, there is too much sugar in the blood.

How does diabetes affect your diet?
At first, I had to eat foods that were sugar free. Then, I got a new doctor and he put me on an insulin pump. This ¬allows me to eat a wider range of foods but in moderation.

How does diabetes affect your physical activities?
When my blood sugar is good, it doesn’t affect me at all. When it is too high, I get very distracted, tired, and thirsty. When my blood sugar is low, I either get really tired or hyper.

Is diabetes hard to regulate?
Some days it is easy; some days it’s hard. It depends on my surroundings. My mood, the weather, anything I eat, and when I am sick are just a few things that determine if it will be hard to regulate that day.

What happens if your blood sugar gets way too high or way too low?
Luckily, I have never been too high. When it gets too high, you go into a ¬coma. When it’s too low, you have seizures. That has happened to me six or seven times. I am told that I clamp my teeth really tight. I don’t really ¬remember what happens. When I wake up there are usually paramedics surrounding me. I have also blacked out three or four times because my levels have been too low.

Who can get diabetes?
It is mostly genetic. Type 2 ¬diabetes usually affects people who are overweight or are older.

How does diabetes affect your ¬overall life?
It affects me every day because I have to go through stresses and irritations that come with it. When I work hard and control my blood sugar, it isn’t bad at all.

Is diabetes curable?
There are many cures being tested. They are ¬getting very close to a cure. But right now, there are just ways to treat the disease.

How will diabetes affect you in the future?
My college life will probably be ¬different. I will not be able to drink ¬alcohol. I will have to adopt a respon¬sible lifestyle.

As a diabetic, are there extra ¬precautions you must take?
Yes, everywhere I go I have to bring my testing supplies. I also have to make sure I have some kind of food with me. I test myself before driving or doing something that requires my full attention.

How old were you when you were diagnosed and how did you find out?
I was eight years old. For about a week I felt sick and I would have cravings for pop and sugary foods. I would always sleep. As soon as I tried to eat, I had no appetite. So, my mom scheduled a doctor’s appointment for me.

What happened the first time your blood sugar got too low?
My sister and I were playing hangman outside. I kept telling her I felt dizzy. She didn’t think anything of it. My sister told me to guess a letter so I said, “I guess H.” She said it was wrong. For some reason I didn’t care. I kept repeating “I guess H.” When we went inside the house my mom had ¬dinner ready. I threw the food on the floor and started running around the house screaming “I guess H!” When I came to, I couldn’t even remember playing hangman.

Have you ever felt embarrassed about your diabetes?
I usually don’t get embarrassed about it. There was, though, one time in sixth grade. My mom decided it would be a good idea to educate my peers about ¬diabetes. We went from class to class and I sat on a stool in the front of the room. My mom would point to me and say, “This is Laura. She has diabetes.” Some classes weren’t too bad; the kids seemed uninterested. The most embarrassing time was when kids asked questions at the end. I will always remember one kid asking, “What should I do if Laura runs out into the street?” It was probably the most embarrassing moment of my life.

This piece has also been published in Teen Ink’s monthly magazine.

Recognizing the Signs of Diabetes

Diabetes has become quite common in children and adults.  As a result, there are more and varied treatments including a variety of medications and a great deal of information regarding diet and exercise, which can often help control diabetes with little or no medication.

Diabetes can be quite insidious so it is often present long before a person knows that they have the disease.  There are signs and symptoms that can alert you to the possibility that you might have diabetes and need to check with your doctor. 

Three symptoms are usually classic symptoms of Type 1 diabetes.  The symptoms are frequent urination, increased or excessive thirst and increased appetite.  Sometimes symptoms develop quickly over a period of weeks or months, especially in children and young people.  Another symptom may be weight loss – even if the individual is eating well and eating more than usual.  Excessive fatigue that cannot be overcome can be a symptom, as well.

In Type 2 diabetes, the symptoms can be the same, however, they develop much more slowly and subtly and may not even be noticeable.  This is often a reason that people are not aware that they could be developing or have developed the disease, and do not realize they have diabetes until the disease is more advanced. 

Other issues that can help identify diabetes are dehydration (even though the person is drinking extra liquids), glucose in urine (determined by a urine test), vision changes – especially blurred vision – which can come on gradually (usually with Type 2) or rapidly (usually with Type 1) and should be addressed immediately to avoid permanent damage, and sometimes urea leading to very bad breath, rapid, deep breathing, nausea, vomiting and abdominal pain.

If you or your child/teen are experiencing any of these symptoms or a combination of them, it is important to see your doctor.  There are a few tests that doctors can use to determine what the problem is and if it is diabetes, as opposed to another medical issue or simply an imbalance.  The doctor will then determine how to treat your symptoms, which could include diet changes and/or medication or both.

There have been many advances in the diagnosis and treatment of diabetes.  If you are experiencing the symptoms discussed here, it is important for you to talk to your doctor about them so that you can stay healthy and keep your diabetes under control.

There is Help To Get Your Medication and Supplies

There are millions of individuals with chronic health conditions such as diabetes, heart disease, high blood pressure and more.  Their supplies and medication are expensive, and it’s not always easy to find help.  However, there is help available through an organization that was started by a nurse to help support those who struggle with the expense chronic illness.

 Recently, a report on the Today Show by the Association for the Advancement of Retired Persons (AARP) offered some staggering statistics related to Baby Boomers and Healthcare. There are about 78 million Baby Boomers living in the United States.  According to AARP, there are some statistics that are bleak.  Research shows that many Baby Boomers’ are quite worried about their ability to afford their Medical Care in 2009.  In fact, 21% surveyed stated they were “not very or not at all confident” and 23% stated they were “somewhat confident.”  As for being able to pay for prescription drugs in 2009, 17% surveyed stated they were “not very or not at all confident” and 22% stated they were “somewhat confident.”  

Many Boomers stated that they had to cut down on the amount of prescription medicationthey took or they had to skip doses because they could not afford them.  This was especially true of individuals between the age of 45-64. 

For those who have a chronic health condition, such as diabetes, many will require daily medication and other healthcare products including diabetic testing supplies, insulin, syringes, ostomy supplies and incontinence products.  The cost of such supplies varies significantly, from less than a hundred dollars per month to well into the thousands of dollars per month depending upon whether there are other chronic health conditions being treated.  Individuals dealing with these issues need to start looking at lower priced supplies and medication and alternative programs to help offset costs including applying for assistance through the drug companies.

There is also a new service called Baby Boomer Medical, Inc. and www.directbuymedical.com  which was started by a registered nurse who had helped people find affordable ways to get medicine and supplies for many years.   She states that “by focusing on this one healthcare need I am able to keep prices low as I am not constrained by the guidelines of Medicare or other Insurances.  By working with our healthcare product manufacturers we are able to offer multiple affordable healthcare product solutions as well as setting up product sampling for consumer trial before having to buy a product that might not be ideal for our customers’ need.” 

She also recommends that you shop around and” contact your product manufacturer, many of which will have clinical staff you can consult with.  They can help to insure you are using their products effectively and may be able to offer ways for you to optimize the use of their products.  Knowledge is power and asking is free, so seek out resources that are willing to work with you.”

It’s good to know that there is help available through someone -and her company – who truly understands the situation and who cares about the people she serves.

Emergency Kit for Diabetes

With threats of terrorist attacks and many natural disasters happening around the world, our awareness for the need to be prepared if a disaster strikes has recently increased. If you have diabetes it would be a good idea to create an emergency kit. It will only take a few minutes to collect what you need to be prepared for any unexpected event that may happen. The American Diabetes Association has prepared helpful tips on creating an emergency kit for people with diabetes.

They have suggested storing 3 days worth of diabetes supplies, which could include oral medication, insulin, insulin delivery supplies, lancets, extra batteries for your meter and/or pump, and a quick-acting source of glucose. All these items should be kept in an easy-to-identify container, and stored in a location that is easy to get to in an emergency. 

Your emergency supply kit should also contain a list of emergency contacts and, if you are a parent of a child in school or daycare, physician’s orders that may be on file with your child’s school or day care provider.  As always, it is a good idea to wear medical identification that will enable colleagues, school staff members, or emergency medical personnel to identify and address your medical needs.

If you are a parent of a child with diabetes, it is important that your child’s school has clearly identified the school staff members who will assist your child in the event of an emergency evacuation. For those who are away from home, consider informing your colleagues, friends, and family members about your diabetes and where your emergency supply kit is kept. 

Insulin Reaction & Hypoglycemia

An insulin reaction is an excessively low blood sugar level. This condition is also known as hypoglycemia when blood sugar levels are lower than 50 mg/dL. Insulin reactions result from an excess of insulin via an injection or an excess of an insulin-stimulating oral hypoglycemic agent. Insulin reactions are more common in people with severe diabetes.

There are many factors that might bring on an insulin reaction. Some of them are increased activity, late or missed meals, eating fewer carbohydrates than usual, drinking alcohol without eating or errors in insulin dosage. To treat low blood glucose you will need to bring glucose levels back to normal. This requires 10-15 grams of sugar and then keep levels normal with food.

People with diabetes who experience signs and symptoms of an insulin reaction should attempt to raise their blood sugar levels as quickly as possible. Sugar is not absorbed in the stomach so taking forms of sugar that will pass through rapidly and do not need to be digested first is necessary. Some acceptable forms of sugar include fruit juice, milk, 4 ounces of regular soda, glucose tablets, or table sugar with water. Some people with diabetes carry absorbable sugar wafers that contain glucose or dextrose. These are also to be used in an emergency. Sugar wafers dissolve and act quickly when chewed or placed in the cheek.

If you experience repeated episodes of insulin reaction, you should see your doctor to determine if an adjustment in insulin dose is required. This is also true if signs and symptoms suggest hypoglycemia is occurring at night. The inability to control morning glucose values and the worsening of the problem by increasing amounts of evening or long-acting insulin require an urgent visit to the doctor.

The Diabetic Foot

Diabetes can damage nerves, kidneys, eyes, and blood vessels. Diabetes can also lead to decreases in the body’s ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system is likely. This can cause foot problems and they can quickly become serious. With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired. These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot and sores commonly develop.

Damage to blood vessels and impairment of the immune system from diabetes make it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur. These infections can develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life threatening.

People with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur. Good control of blood sugar is the best way to prevent problems.
Diabetics need to learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problems. They should also learn what is reasonable to do at home as far as routine foot care, how to recognize when to call the doctor, and how to recognize when a problem has become serious enough to seek emergency treatment.

Diabetes Mellitus- Diabetic Eye Disease

Diabetes mellitus is one of the leading causes of irreversible blindness worldwide. It is the most common cause of blindness in people younger than 65 years. Also, diabetic eye disease encompasses a wide range of problems that can affect the eyes. Diabetes mellitus may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision. It can increases the risk of developing cataracts and glaucoma.

Some people may not even realize they have had diabetes mellitus for several years until they begin to experience problems with their eyes or vision. Severe diabetic eye disease most commonly develops in people who have had diabetes mellitus for many years, but they have had little or poor control of their blood sugars over that period of time. It may also result in heart disease, stroke, kidney failure, and circulatory abnormalities of the legs.

There are some important steps you can take to help prevent your development of this disease. You can try to avoid the problems associated with diabetes mellitus by taking care of yourself. Some easy things you can do is watch your diet, maintain a healthy weight, participate in an exercise program and do not smoke.

If you have already been diagnosed with diabetes mellitus there are some things you can do to keep it under control. You need to monitor your blood sugars and your glycosylated hemoglobin carefully and take your diabetes medications as prescribed. Even if you are not experiencing any symptoms due to your diabetes mellitus, you should have an annual eye examination by an ophthalmologist. If you note any significant changes in your vision other than a mild temporary blurring, you should contact your ophthalmologist immediately.

Diabetic Ketoacidosis

Diabetic ketoacidosis is usually seen in people who have type 1 diabetes. It is a state of inadequate insulin levels resulting in high blood sugar and accumulation of organic acids and ketones in the blood. It is also common to have severe dehydration and significant alterations of the body’s blood chemistry.  

Most often diabetic ketoacidosis happens in diabetics younger than 25 years, but the condition may occur in diabetics of any age. A person with diabetes can enter into a state of diabetic ketoacidosis for many reasons. Some of the most common are infection, missed insulin,  or newly diagnosed or previously unknown diabetes. There are various other causes like a heart attack, stroke, trauma, stress, and surgery. Five to ten percent of the time there is no identifiable cause.

There are several steps you can take to prevent diabetic ketoacidosis. Close monitoring and control of blood sugars, especially during times of infection, stress, trauma, or other serious illness will help. Also by taking insulin injections on time. Always contact your physician when you think it may be needed.

What is A1c Test?

In your the body sugar sticks, particularly to proteins. The red blood cells that circulate in the body live for about 3 months before they die off. When sugar sticks to these cells, it gives us an idea of how much sugar is around for the preceding 3 months. In most labs, the normal range is 4-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it’s less than 7.0%. The benefits of measuring A1c is that is gives a more reasonable view of what’s happening over the course of time, and the value does not bounce as much as finger stick blood sugar measurements.

Although there are no guidelines to use A1c as a screening tool, it gives the physician a good idea that someone is diabetic if the value is elevated. Right now, it is used as a standard tool to determine blood sugar control in patients known to have diabetes. The American Diabetes Association currently recommends an A1c goal of less than 7.0%.

Studies have shown that there is a 10% decrease in relative risk for every 1 % eduction in A1c. So, if a patients starts off with an A1c of 10.7 and drops to 8.2, though there are not yet at goal, they have managed to decrease their risk of microvascular complications by about 20%. The closer to normal the A1c, the lower the absolute risk for microvascular complications.

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