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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.

Benefits of Controlled Blood Glucose Levels

The findings from a Veterans Affairs Diabetes Trial have showed that lowering blood sugar levels to near normal through intensive treatment may reduce the risk of cardiovascular disease and heart attacks for Type 2 diabetics, but only if treatment is begun relatively soon after diagnosis and if severe episodes of low blood sugar can be avoided. Data from three studies were presented over the weekend at a San Francisco meeting of the American Diabetes Assn., and although many questions remain unanswered, some generalizations are becoming possible.

All three studies suggest that the greatest reduction in the risk of heart attacks and cardiovascular disease is achieved by lowering cholesterol levels and by controlling high blood pressure. Controlling glucose can at best provide only a small further reduction in risk that may take many years to become apparent. But that does not mean that control of blood glucose levels is not a good idea.

Data from two of the studies confirmed that such control reduces the risk of kidney and eye disease, also complications of diabetes. New data from the VA study also show that severe hypoglycemic events should be avoided at all costs. And finally, data from the three studies may ease concerns about the oral diabetes drug rosiglitazone. An analysis last year of many previous studies suggested that the drug, sold under the brand name Avandia, increases the risk of heart attacks and death. But the new studies showed no such effects from the drug, which is still in wide use

What is Pre-diabetes?

Pre-diabetes means that the cells in your body are becoming resistant to insulin and your blood glucose levels are higher than they should be. Since the levels aren’t as high as they would be if you had Type 2 diabetes, the term “pre-diabetes” is used. Your doctor may also call this condition “impaired fasting glucose” or “impaired glucose tolerance. According to the Center of Disease Control and Prevention, 41 million adult Americans between the ages of 40 and 74 have pre-diabetes.

There are several risk factors. The risk factors are the same for pre-diabetes as they are for Type 2 diabetes. Some of them are being overweight or obese, having a sedentary lifestyle, family history, age, or having a previous diagnosis of gestational diabetes.

Often there are no signs or symptoms for pre-diabetes. Many times it is discovered during a routine physical with basic screening for fasting blood glucose levels. The normal level is below 100 mg/dl. If it’s 100 to 125 mg/dl, this indicates that you have impaired fasting glucose or pre-diabetes. Over 126 mg/dl most likely means a diagnosis of Type 2 diabetes.

If you are diagnosed with pre-diabetes, it will put you at a higher risk for Type 2 diabetes in the future. But it doesn’t have to mean that you will get Type 2 diabetes. A healthy lifestyle change can lower your risk and improve the way your body uses insulin. A low fat diet and calories can help you lose weight. The less fat and more muscle you have, the less resistant to insulin you will be. Exercising regularly not only helps you to lose weight, but also help lower your blood glucose level by using glucose as energy.

Vitamin D Linked to Developing Diabetes?

A report in the Archives of Disease in Childhood says there are a number of clues suggesting a link between low vitamin D  Zipitis of Stockport National Health Service Foundation Trust and Dr. A. K. Akobeng of Booth Hall Children’s Hospital have reviewed all published research on vitamin D supplementation and diabetes risk. Overall, they found, infants who were supplemented with Vitamin D were 29 percent less likely to develop type 1 diabetes than children who had not received supplements.

Proper clinical trials are required to determine the optimal dose and formulation of vitamin D, as well as when and for how long children should be given the supplements, Zipitis and Akobeng conclude. In the meantime, Zipitis said, “I would advise parents to encourage their pediatricians to prescribe vitamin D supplements for their infants. However, parents can also obtain these over the counter and provided they are used as per manufacturer instructions they should be extremely safe to use.”

Remission of Type 2 Diabetes With Early Treatment

Type 2 diabetes affects over 250 million people worldwide. Intensive insulin therapy through daily injections is typically started late in the course of the disease. But researchers in China found that if this treatment is undertaken before the body loses the ability to control sugar levels in the blood, patients recover normal levels faster and are less at risk of remission.A team led by Jianping Weng of Sun Yat-Sen University in Guangzhou divided nearly 400 patients aged 25 to 70 with Type 2 diabetes into three groups. Two groups received intensive insulin therapy. The third group was given standard oral diabetic drugs. Treatment was stopped when regular blood glucose control had been restored for two weeks, after which patients regulated sugar levels through diet and exercise alone.

The study found that more patients in the two insulin-intensive groups hit normal levels, and did so faster, in four to six days rather than nine, compared to the control group. Also significant, remission rates were nearly twice as high in the first two groups.

A second study showed that a controlled diet and exercise over six years prevented or delayed diabetes onset by up to an additional 14 years. The two studies were published in the British journal The Lancet.

Insulin Pump and Skin Problems

Insulin pumps are popular with children and teens, it helps them control type 1 diabetes. It has been reported that many of them have experienced skin problems at the infusion catheter insertion site. Although, few report thinking about stopping insulin pump therapy because of these problems.Insulin pump therapy has several advantages over insulin shots, including better control of glucose metabolism, Dr. Louise S. Conwell and colleagues from the Hospital for Sick Children in Toronto and colleagues note in The Journal of Pediatrics this month. “Over the years, studies have suggested that both injections and insulin pumps may cause dermatologic problems”, they add. “In the early days of insulin pump therapy, many patients developed infection and inflammation at the catheter site, but no study has looked at these complications in patients using modern pumps and rapid-acting insulin-like drugs.”

Conwell and colleagues surveyed 50 patients with type 1 diabetes who had used insulin pumps for longer than 6 months. 94 percent have reported scars smaller than 3 millimeters in diameter, two-thirds had swelling, just under two-thirds had lesions under the skin, and 42 percent had fat lumps under the skin.

The researchers reported that the thinner the patient, the more likely he or she was to have dermatologic complications of insulin pump use. Although, there was no relationship between long-term blood sugar control and risk of skin problems. Only 4 percent of parents and 2.4 percent of patients said they considered stopping insulin pump therapy because of related skin problems.

Mediterranean Diet May Protect You From Diabetes

A Mediterranean diet emphasizes olive oil, vegetables, fruits, nuts, cereals, legumes and fish, and deemphasizes meat and dairy products. A new Spanish study is suggesting that this diet may protect you against developing type 2 diabetes.

The study was published in the British Medical Journal. The researchers tracked the diets of 13,380 Spanish university graduates with no history of diabetes. Participants filled out a 136-item food questionnaire, which measured their entire diet (including their intake of fats), their cooking methods and their use of dietary supplements.

During an average of 4.4 years of follow-up, the team found that people who adhered to a Mediterranean diet had a lower risk of developing type 2 diabetes. In fact, those who stuck very closely to the diet reduced their risk by 83 percent. Moreover, the people who tended to stick closest to the diet were those with factors that put them at the highest risk for developing diabetes, such as being older, having a family history of diabetes and being an ex-smoker. These people were expected to have a higher rate of diabetes, but when they adhered to the Mediterranean diet this was not the case, the researchers noted. 

It is believed that one key factor that might be responsible for the protective effect of the Mediterranean diet is its emphasis on olive oil for cooking, frying, putting on bread and mixing in salad dressings. “There are reams of epidemiological studies that have shown an association of the Mediterranean eating pattern with better health overall,” one of the researchers said. “This study adds more fuel to the argument to make better choices in the types of fats we choose to eat and adding more vegetables to our plates.”

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