The Skinny on Diabetes
Type 1 diabetes is an autoimmune disorder, meaning that the body's immune system attacks its own pancreas affecting its ability to produce insulin; this usually happens at a young age. In this case scenario, insulin has to come into your body from outside a good example of which is an insulin pump. FYI not all autoimmune disorders happen at a young age.
Type 2 diabetes
Contrary to the popular belief, increased sugar consumption doesn't cause type 2 diabetes.
Just because type 2 diabetes is linked to high levels of blood sugar, it may seem logical to assume that eating too much sugar is the cause of diabetes. However, it's not that simple. High-sugar diet certainly increases risk of developing diabetes but doesn't directly cause it. There is no proven link between increased sugar consumption and developing diabetes.
By analogy, driving on the road can increase your risk for an accident, however it doesn't directly cause it. A multitude of other factors contribute to a possible accident however it isn't imminent. In other words, the mere fact of driving doesn't mean that an accident happening is a must.
What happens is that people develop insulin resistance. Here's how it works. When you consume sugar, it attaches to hemoglobin that delivers it to your body cells to be used for energy. Think about insulin as a key to open the door (of a cell) to let glucose in. In case of insulin resistance the door won't open and glucose can't get in. As a result, glucose builds up in the bloodstream instead of being absorbed by the cells. This is exactly what happens with type 2 diabetes.
It is believed that excess weight and physical inactivity largely contribute to the insulin resistance. Genetics play a role, as well.
How Type 2 diabetes is diagnosed: A1C test
It's done by a blood glucose test that can be affected by a multitude of variables.
The hemoglobin A1C test is also called HbA1C or glycated hemoglobin test. Hemoglobin is a substance found in the red blood cells which carry oxygen throughout your body. When your blood sugar level is elevated, sugar combines with hemoglobin making it "glycated" in which case scenario A1C test shows an elevated number. This test is being used to show how well your diabetes is being controlled. In reality however, it depends on a vast number of variables. This very test was used to diagnose my type 2 diabetes.
Since red blood cells live up to 3 months -- and then get replaced by the new ones that form, don't you worry -- A1C test should be done once in 3 months. In between, I rely on my good old fingersticks. I am not on insulin or any diabetes medications at this point.
For people without diabetes, the normal range for the A1C test is between 4% and 5.6%. A1C levels between 5.7% and 6.4% indicate increased risk of diabetes, and levels of 6.5% or higher indicate diabetes. The goal for people with diabetes is a A1C level less than 7%. The higher the A1C number is, the higher the risks of developing diabetes-related complications.
Blood sugar tests including A1C, is not a precise science and can vary depending on a multitude of variables. Food, activity, medication, illnesses, hormonal changes, or the ways your lab performs the actual test are just a few examples.
What affects blood sugar levels
A number of things. Food including how much, how often and the combination of the different kinds of food; physical activity, hormone levels is to name a few.
The whole idea of the Diabetic Diet that I firmly believe exists, is to deliver a steady supply of carbs every a couple of hours. We're talking about breakfast, snack, lunch, snack, dinner, snack. Carbs allowance is 3-4 per meal and 1-2 per snack. After a while of the hands-on carbs counting it becomes a second nature. For those wondering what I'm talking about, 1 carb = 15 g. Measuring cups help tremendously.
Carbs is short for the carbohydrates. There are simple and complex carbs. The simple carbs are known as bad carbs; they get digested quickly resulting in a blood sugar spike. Examples include sugar of all sorts and any dessert containing sugar or cane. The complex are the good ones; they get digested slower; they contain fiber that actually aids in blood sugar control. Examples of the good carbs include whole wheat bread, whole grain pasta, beans, oats, buckwheat, whole rye, whole-grain barley. Soluble fiber (oatmeal) helps control blood glucose levels, while insoluble (whole wheat bran) keeps your digestive tract working well. Another benefit of fiber is that it adds bulk to help make you feel full.
Caffeine can give blood sugar a jolt. Even if you don't add any sugar to your morning cup of coffee or tea, it can still drive up your blood glucose level. That's because the caffeine in these drinks exaggerates the body's response to carbohydrates, causing blood sugar to rise more than it normally would after meals.
Sugar-free food. It can actually contain sugar that causes your numbers go up. For a short time, I was proud of myself for being able to locate a 'sugar-free' pancake syrup that tasted just as sweet on my morning oatmeal. This pride however was short-lived once I discovered that it did in fact contain Sorbitol, an alcohol sugar. It's a simple sugar that will raise your blood sugar levels. Ditto for everything that ends with -ol. I don't know how the manufacturers get away with it. Needless to say, the bottle went to the trash and the remaining contents down the sewer. From that point on, I have made a habit of checking the ingredients of food that looks too good to be true, and everything else for this matter. Such as for example, diet pop from Aldi or Save-a-Lot. Both skip on caffeine but contain sugar.
Artificial Sweeteners such as Splenda. There's a split opinion about it; some research studies suggest that it elevates blood sugar level while the others have found to the opposite. I don't use Splenda, however if I did, I would've checked my blood sugar afterwards. I do extra sugar checks following each new food or a drink, just to be on the safe side.
Vinegar. A spoonful or two goes a long way. The website Diabetes in Control claims that 2 tablespoons of vinegar before a meal will dramatically reduce the spike in blood concentrations of insulin and glucose that come after a meal (type 2 diabetes). You of course don't have to actually drink vinegar; it can be used in form of a oil-and-vinegar or a vinaigrette salad dressing.
Water. Dehydration drives up blood sugar. When your body is short of fluids, the sugar in your circulation becomes more concentrated. When this happens, high blood sugar can cause you to urinate more, resulting in dehydration. So make sure to drink plenty of water. The rule of the thumb for us women is 8 by 8, meaning eight of 8 fl oz of water a day. The total is 64 fl oz aka half a gallon for the women.
Physical Activity. When you exercise, your muscles use sugar for energy, therefore regular physical activity helps your body use insulin more efficiently and your blood sugar levels to stay within the target range. Set up an exercise plan. However don't set up unrealistic expectations. If your diabetic educator insists that you jog every day that you know isn't happening, stick to staying physically active or an occasional jog. Consider your other conditions such as for example, my arthritis that sometimes can limit my physical activity.
Those on insulin or diabetic meds have to watch for hypoglycemia (low blood sugar) as physical activity can make it worse. Talk to your doctor; you might have to modify your meds or your diet. Your really need to know what to do if your blood sugar drops during exercise. Plan ahead.
If you have type 1 diabetes, try not to do vigorous physical activity when you have ketones in your blood or urine.
Hormones. Menstrual cycles can make your blood sugar levels fluctuate. This is due to the hormonal changes that lead to the temporary change in resistance to insulin and can last up to a few days and then drop off. Some women report higher blood sugar levels a few days prior to their period starting. During the period, the blood sugar can be either too high or too low; this varies on an individual basis and can even vary from one month to another so the pattern can be quite unpredictable. Trimming back on the carbohydrates or squeezing in some extra exercise might help. If you increase your insulin, be careful to avoid hypoglycemia (low blood sugar) as your insulin sensitivity can sometimes return quickly.
More Hormones. Pregnancy can affect blood glucose levels that is again, related to the hormonal changes, particularly hormones from the placenta. These hormones cause insulin resistance that in turn leads to glucose build up in the bloodstream also known as hyperglycemia. This is known as gestational diabetes that develops usually around the 24th week of pregnancy and usually goes away after pregnancy. This condition puts both the mother and the baby at risk, particularly for developing type 2 diabetes later on.
Medications including either over-the-counter or by prescription. For example, steroid drugs often used to treat inflammatory conditions, autoimmune disorders and asthma, can cause blood sugar levels to shoot up dramatically. Birth control pills, certain antidepressants, some diuretics, and nasal decongestants can also cause higher-than-normal readings. Other drugs can decrease blood sugar or interfere with your ability to recognize signs of low blood sugar. Check them here:
List of Drugs Affecting Blood Glucose
Morning Numbers. There's something called Dawn Phenomenon; it will cause a morning blood sugar spike even though your number was in the normal range when you went to bed the night before. Then at around 3 or 4 am your body releases certain hormones while and if you're asleep. These hormones might make your body less sensitive to insulin, hence the higher blood sugar number in the morning.
On the other hand, you may start the day with a low glucose level if you're taking too much insulin or a diabetic med at night and then not eating enough in the evening. I always make sure to have my evening snack of a cup of milk and 2 squares of graham crackers (2 carbs).
Stress or illness can spike your blood sugar. Lack of sleep or a restless night is seen by your body as a form of stress; this too can bring on a high or a low.
Weather. Hot or cold weather spell can bring on an unexpected high. Extreme temps can interfere with diabetes control. People with diabetes can vary in how their body responds to this. Some may see their blood sugar creep up on really hot days because it puts an extra stress on their system. Others, particularly those taking insulin, may experience the opposite effect. High temperatures cause blood vessels to dilate, which can enhance insulin absorption, potentially leading to low blood sugar. Try to stay indoors during the hottest part of the day, and monitor your blood sugar closely for changes when the mercury starts to rise.
Traveling. Skipping a few time zones during a long flight is a big concern for people with diabetes. This can disrupt your medication schedule, as well as your usual eating and sleeping habits, which can in turn interfere with blood sugar control. Pack healthy snacks, check your sugar more often, bring along a refillable water bottle so that you will stay hydrated. If you take insulin while going through the time zones, be sure to work out a medication schedule, plan ahead before your trip.
Please Note: wash your hands before checking your blood sugar. Testing after handling food can produce a false high result, because sugar residues on the skin can contaminate the blood sample.
Lotions and creams can also give inaccurate results. Today's blood sugar meters are highly sensitive because they use a very tiny draw of blood, which means it is very easy throw off the glucose concentration in the sample. If you can't get to a sink to give your hands a good scrub, using the second drop of blood, after wiping away the first, can improve testing accuracy.
