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Kidney disease - resources Resources - kidney disease Summary The following organizations are good resources for information on kidney disease: National Institute of Diabetes and Digestive and Kidney Disease -- www.niddk.nih.gov/health-information/kidney-disease National Kidney Foundation -- www.kidney.org American Kidney Fund -- www.kidneyfund.org American Geriatrics Society's Health in Aging Foundation -- www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/ Review Date 11/12/2016 Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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what does kidney disease look like
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Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.
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Diabetic Kidney Disease What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes.Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.Your kidneys are located in the middle of your back, just below your rib cage.When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.Watch a video about Diabetes and Kidney Disease.What are other names for diabetic kidney disease?Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if yourblood glucose is too high blood pressure is too highAfrican Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.You are also more likely to develop kidney disease if you have diabetes andsmoke don’t follow your diabetes eating plan eat foods high in salt are not active are overweight have heart disease have a family history of kidney failureIf you have diabetes, you are more likely to develop kidney disease if you have high blood pressure. How can I tell if I have diabetic kidney disease? Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.You should get tested every year for kidney disease if youhave type 2 diabetes have had type 1 diabetes for more than 5 yearsHealth care professionals use blood and urine tests to check for kidney disease. How can I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall.Reach your blood glucose goalsYour health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.Protect your kidneys by keeping your blood glucose under control.Control your blood pressureBlood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.Protect your kidneys by keeping your blood pressure under control.Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.Develop or maintain healthy lifestyle habitsHealthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy:Stop smoking. Work with a dietitian to develop a diabetes meal plan and limit salt and sodium. Make physical activity part of your routine. Stay at or get to a healthy weight. Get enough sleep. Aim for 7 to 8 hours of sleep each night.Learn more about these tips to manage diabetes.Take medicines as prescribedMedicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure.Talk to your health care professional or pharmacist about all of the medicines you take, including over-the-counter medicines. How can I cope with the stress of managing my diabetes? Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Does diabetic kidney disease get worse over time? Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure.If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. Diabetic Kidney Disease [1] Afkarian M, Zelnick LR, Hall YN, et.al. Clinical manifestations of kidney disease among US adults with diabetes. Journal of the American Medical Association. 2016;316(6):602–610.
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Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.
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Type 2 diabetes may be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. ... If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes.
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Diabetes Diabetes - type 1 Diabetes - type 2 Diabetes - gestational Type 1 diabetes Type 2 diabetes Gestational diabetes Diabetes mellitus Summary Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested and absorbed: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: Type 1 diabetes is less common. It can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause of the failure to make enough insulin is unknown. Type 2 diabetes is more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. Not all people with type 2 diabetes are overweight or obese. There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease. Symptoms A high blood sugar level can cause several symptoms, including: Blurry vision Excess thirst Fatigue Frequent urination Hunger Weight loss Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period. People may be very sick by the time they are diagnosed. After many years, diabetes can lead to other serious problems. These problems are known as diabetes complications, and include: Eye problems, including trouble seeing (especially at night), light sensitivity, and blindness Sores and infections of the leg or foot, which if untreated, can lead to amputation of the leg or foot Damage to nerves in the body, causing pain, tingling, a loss of feeling, problems digesting food, and erectile dysfunction Kidney problems, which can lead to kidney failure Weakened immune system, which can lead to more frequent infections Increased chance of having a heart attack or stroke Exams and Tests A urine analysis may show high blood sugar. But a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL (11.1 mmol/L). To confirm the diagnosis, one or more of the following tests must be done. Blood tests: Fasting blood glucose level. Diabetes is diagnosed if the fasting glucose level is higher than 126 mg/dL (7.0 mmol/L) on two different tests. Levels between 100 and 126 mg/dL (5.5 and 7.0 mmol/L) are called impaired fasting glucose or prediabetes. These levels are risk factors for type 2 diabetes. Hemoglobin A1c (A1C) test. Normal is less than 5.7%; prediabetes is 5.7% to 6.4%; and diabetes is 6.5% or higher. Oral glucose tolerance test. Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a sugar drink (this test is used more often for type 2 diabetes). Screening for type 2 diabetes in people who have no symptoms is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 3 years. Overweight adults (BMI of 25 or higher) who have other risk factors such as having high blood pressure, or having a mother, father, sister or brother with diabetes. Adults over age 45, repeated every 3 years. Treatment Type 2 diabetes can sometimes be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. Some cases of type 2 diabetes can also be improved with weight loss surgery. There is no cure for type 1 diabetes (except for a pancreas or islet cell transplant). Treating either type 1 diabetes or type 2 diabetes involves nutrition, activity and medicines to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a certified diabetes educator (CDE). Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk for kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes. Support Groups Many resources can help you understand more about diabetes. If you have diabetes, you can also learn ways to manage your condition and prevent diabetes complications. Outlook (Prognosis) Diabetes is a lifelong disease for most people who have it. Tight control of blood glucose can prevent or delay diabetes complications. But these problems can occur, even in people with good diabetes control. Possible Complications After many years, diabetes can lead to serious health problems: You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body. Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. Nerves in your body can get damaged, causing pain, tingling, and numbness. Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. Your immune system can weaken, which can lead to frequent infections. Prevention Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% of your body weight can reduce your risk. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people. Review Date 2/22/2018 Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.
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Ask your provider about getting exercise: - Before I start, do I need to have my heart checked? My eyes? My feet? - What type of exercise program should I do? What type of activities should I avoid? - When should I check my blood sugar when I exercise? What should I bring with me when I exercise? Should I eat before or during exercise? Do I need to adjust my medicines when I exercise? ... Ask your provider about meeting with a dietitian. Questions for the dietitian may include: - What foods increase my blood sugar the most? - What foods can help me with my weight loss goals? ... How often should I check my blood sugar level at home? Should I do it at different times of the day? What is too low? What is too high? What should I do if my blood sugar is too low or too high? ... Ask your provider about symptoms that you are having if they have not been discussed.
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Type 2 diabetes - what to ask your doctor What to ask your provider about diabetes - type 2 Summary Type 2 diabetes is a lifelong disease that causes a high level of sugar (glucose) in your blood. It can damage your organs. It can also lead to a heart attack or stroke and cause many other health problems. You can do many things to control your symptoms, prevent damage due to diabetes, and make your life better. Below are questions you may want to ask your health care provider to help you take care of your diabetes. Questions Ask your provider to check the nerves, skin, and pulses in your feet. Also ask these questions: How often should I check my feet? What should I do when I check them? What problems should I call my provider about? Who should trim my toenails? Is it OK if I trim them? How should I take care of my feet every day? What type of shoes and socks should I wear? Should I see a foot doctor (podiatrist)? Ask your provider about getting exercise: Before I start, do I need to have my heart checked? My eyes? My feet? What type of exercise program should I do? What type of activities should I avoid? When should I check my blood sugar when I exercise? What should I bring with me when I exercise? Should I eat before or during exercise? Do I need to adjust my medicines when I exercise? When should I next have an eye doctor check my eyes? What eye problems should I call my doctor about? Ask your provider about meeting with a dietitian. Questions for the dietitian may include: What foods increase my blood sugar the most? What foods can help me with my weight loss goals? Ask your provider about your diabetes medicines: When should I take them? What should I do if I miss a dose? Are there any side effects? How often should I check my blood sugar level at home? Should I do it at different times of the day? What is too low? What is too high? What should I do if my blood sugar is too low or too high? Should I get a medical alert bracelet or necklace? Should I have glucagon at home? Ask your provider about symptoms that you are having if they have not been discussed. Tell your provider about blurred vision, skin changes, depression, reactions at injection sites, sexual dysfunction, tooth pain, muscle pain, or nausea. Ask your provider about other tests you may need, such as cholesterol, A1C, and a urine test to check for kidney problems. Ask your provider about vaccinations you should have like the flu shot, hepatitis B, or pneumonia vaccines. How should I take care of my diabetes when I travel? Ask your provider how you should take care of your diabetes when you are sick: What should I eat or drink? How should I take my diabetes medicines? How often should I check my blood sugar? When should I call the provider? Review Date 7/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.
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You can do many things to control your symptoms, prevent damage due to diabetes, and make your life better. .. Ask your provider about getting exercise: - Before I start, do I need to have my heart checked? My eyes? My feet? - What type of exercise program should I do? What type of activities should I avoid? - When should I check my blood sugar when I exercise? What should I bring with me when I exercise? Should I eat before or during exercise? Do I need to adjust my medicines when I exercise? ... Ask your provider about meeting with a dietitian. Questions for the dietitian may include: - What foods increase my blood sugar the most? - What foods can help me with my weight loss goals? ... How often should I check my blood sugar level at home? Should I do it at different times of the day? What is too low? What is too high? What should I do if my blood sugar is too low or too high? ... Ask your provider about symptoms that you are having if they have not been discussed.
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Type 2 diabetes - what to ask your doctor What to ask your provider about diabetes - type 2 Summary Type 2 diabetes is a lifelong disease that causes a high level of sugar (glucose) in your blood. It can damage your organs. It can also lead to a heart attack or stroke and cause many other health problems. You can do many things to control your symptoms, prevent damage due to diabetes, and make your life better. Below are questions you may want to ask your health care provider to help you take care of your diabetes. Questions Ask your provider to check the nerves, skin, and pulses in your feet. Also ask these questions: How often should I check my feet? What should I do when I check them? What problems should I call my provider about? Who should trim my toenails? Is it OK if I trim them? How should I take care of my feet every day? What type of shoes and socks should I wear? Should I see a foot doctor (podiatrist)? Ask your provider about getting exercise: Before I start, do I need to have my heart checked? My eyes? My feet? What type of exercise program should I do? What type of activities should I avoid? When should I check my blood sugar when I exercise? What should I bring with me when I exercise? Should I eat before or during exercise? Do I need to adjust my medicines when I exercise? When should I next have an eye doctor check my eyes? What eye problems should I call my doctor about? Ask your provider about meeting with a dietitian. Questions for the dietitian may include: What foods increase my blood sugar the most? What foods can help me with my weight loss goals? Ask your provider about your diabetes medicines: When should I take them? What should I do if I miss a dose? Are there any side effects? How often should I check my blood sugar level at home? Should I do it at different times of the day? What is too low? What is too high? What should I do if my blood sugar is too low or too high? Should I get a medical alert bracelet or necklace? Should I have glucagon at home? Ask your provider about symptoms that you are having if they have not been discussed. Tell your provider about blurred vision, skin changes, depression, reactions at injection sites, sexual dysfunction, tooth pain, muscle pain, or nausea. Ask your provider about other tests you may need, such as cholesterol, A1C, and a urine test to check for kidney problems. Ask your provider about vaccinations you should have like the flu shot, hepatitis B, or pneumonia vaccines. How should I take care of my diabetes when I travel? Ask your provider how you should take care of your diabetes when you are sick: What should I eat or drink? How should I take my diabetes medicines? How often should I check my blood sugar? When should I call the provider? Review Date 7/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Iron Overdose Um...i took 25 iron pills...what do i do...this was last night
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If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
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Iron overdose Ferrous sulfate overdose Ferrous gluconate overdose Ferrous fumarate overdose Summary Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone takes more than the normal or recommended amount of this mineral. This can be by accident or on purpose. Iron overdose is especially dangerous for children. A severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. If the child eats too many pediatric multivitamins, the effect is usually minor. This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Iron can be harmful in large amounts. Where Found Iron is an ingredient in many mineral and vitamin supplements. Iron supplements are also sold by themselves. Types include: Ferrous sulfate (Feosol, Slow Fe) Ferrous gluconate (Fergon) Ferrous fumarate (Femiron, Feostat) Other products may also contain iron. Symptoms Below are symptoms of an iron overdose in different parts of the body. AIRWAYS AND LUNGS Buildup of fluids in the lungs STOMACH AND INTESTINES Black, and possibly bloody stools Diarrhea Liver damage Metallic taste in mouth Nausea Vomiting blood HEART AND BLOOD Dehydration Low blood pressure Fast and weak pulse Shock NERVOUS SYSTEM Chills Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose) Convulsions Dizziness Drowsiness Fever Headache Lack of desire to do anything SKIN Bluish-colored lips and fingernails Flushing Loss of color from the skin (pallor) Note: Symptoms may go away in a few hours, then return again after 1 day or later. Before Calling Emergency Have this information ready: Person's age, weight, and condition Name of the product (ingredients and strength, if known) Time it was swallowed Amount swallowed If the medicine was prescribed for the person Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room Take the container to the hospital with you, if possible. The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. Tests that may done include: Blood and urine tests, including tests to check iron levels ECG (electrocardiogram, or heart tracing) X-ray to detect and track iron tablets through the stomach and intestines Treatment may include: Fluids through a vein (by IV) Medicine to help remove iron from the body and treat symptoms Endoscopy -- camera and tube placed down the throat to view the esophagus and the stomach and to remove pills or stop internal bleeding Whole bowel irrigation with a special solution to quickly flush the iron through the stomach and intestines (taken by mouth or through a tube through the nose into the stomach) Breathing support, including tube through the mouth into the lungs and connected to a breathing machine (ventilator) Outlook (Prognosis) There is a good chance of recovery if the person's symptoms are gone 48 hours after the iron overdose. But, severe liver damage can occur 2 to 5 days after the overdose. Some people have died up to a week after an iron overdose. The more quickly the person receives treatment, the better the chance for survival. Iron overdose can be very severe in children. Children may sometimes eat large amounts of iron pills because they look like candy. Many manufacturers have changed their pills so they no longer look like candy. Review Date 10/8/2017 Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know
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SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells.
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SLC4A1-associated distal renal tubular acidosis classic distal renal tubular acidosis renal tubular acidosis type I RTA, classic type Description SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells. Frequency The prevalence of SLC4A1-associated distal renal tubular acidosis is unknown. The condition is most common in Southeast Asia, especially Thailand. Causes Both the autosomal dominant and autosomal recessive forms of SLC4A1-associated distal renal tubular acidosis are caused by mutations in the SLC4A1 gene. This gene provides instructions for making the anion exchanger 1 (AE1) protein, which transports negatively charged atoms (anions) across cell membranes. Specifically, AE1 exchanges negatively charged atoms of chlorine (chloride ions) for negatively charged bicarbonate molecules (bicarbonate ions). The AE1 protein is found in the cell membrane of kidney cells and red blood cells. In kidney cells, the exchange of bicarbonate through AE1 allows acid to be released from the cell into the urine. In red blood cells, AE1 attaches to other proteins that make up the structural framework (the cytoskeleton) of the cells, helping to maintain their structure. The SLC4A1 gene mutations involved in either form of SLC4A1-associated distal renal tubular acidosis lead to production of altered AE1 proteins that cannot get to the correct location in the cell membrane. In the autosomal dominant form of the condition, gene mutations affect only one copy of the SLC4A1 gene, and normal AE1 protein is produced from the other copy. However, the altered protein attaches to the normal protein and keeps it from getting to the correct location, leading to a severe reduction or absence of AE1 protein in the cell membrane. In autosomal recessive distal renal tubular acidosis, both copies of the SLC4A1 gene are mutated, so all of the protein produced from this gene is altered and not able to get to the correct location. Improper location or absence of AE1 in kidney cell membranes disrupts bicarbonate exchange, and as a result, acid cannot be released into the urine. Instead, the acid builds up in the blood in most affected individuals, leading to metabolic acidosis and the other features of complete distal renal tubular acidosis. It is not clear why some people develop metabolic acidosis and others do not. Researchers suggest that in individuals with incomplete distal renal tubular acidosis, another mechanism is able to help regulate blood acidity (pH) and keep metabolic acidosis from developing. In red blood cells, interaction with a protein called glycophorin A can often help the altered AE1 protein get to the cell membrane where it can perform its function, which explains why most people with SLC4A1-associated distal renal tubular acidosis do not have blood cell abnormalities. However, some altered AE1 proteins cannot be helped by glycophorin A and are not found in the cell membrane. Without AE1, the red blood cells are unstable; breakdown of these abnormal red blood cells may lead to hemolytic anemia. Some people have nonhereditary forms of distal renal tubular acidosis; these forms can be caused by immune system problems or other conditions that damage the kidneys. These individuals often have additional signs and symptoms related to the original condition. Inheritance Pattern SLC4A1-associated distal renal tubular acidosis can have different patterns of inheritance. It is usually inherited in an autosomal dominant pattern, which means one copy of the altered SLC4A1 gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family. Less commonly, SLC4A1-associated distal renal tubular acidosis has an autosomal recessive pattern of inheritance, which means a mutation must occur in both copies of the SLC4A1 gene for the condition to develop. This pattern occurs with certain types of SLC4A1 gene mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Sources for This Page Alper SL. Molecular physiology and genetics of Na+-independent SLC4 anion exchangers. J Exp Biol. 2009 Jun;212(Pt 11):1672-83. doi: 10.1242/jeb.029454. Review.
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know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know
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Both the autosomal dominant and autosomal recessive forms of SLC4A1-associated distal renal tubular acidosis are caused by mutations in the SLC4A1 gene. ... the acid builds up in the blood in most affected individuals, leading to metabolic acidosis and the other features of complete distal renal tubular acidosis. It is not clear why some people develop metabolic acidosis and others do not. Researchers suggest that in individuals with incomplete distal renal tubular acidosis, another mechanism is able to help regulate blood acidity (pH) and keep metabolic acidosis from developing. ... Some people have nonhereditary forms of distal renal tubular acidosis; these forms can be caused by immune system problems or other conditions that damage the kidneys. These individuals often have additional signs and symptoms related to the original condition.
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SLC4A1-associated distal renal tubular acidosis classic distal renal tubular acidosis renal tubular acidosis type I RTA, classic type Description SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells. Frequency The prevalence of SLC4A1-associated distal renal tubular acidosis is unknown. The condition is most common in Southeast Asia, especially Thailand. Causes Both the autosomal dominant and autosomal recessive forms of SLC4A1-associated distal renal tubular acidosis are caused by mutations in the SLC4A1 gene. This gene provides instructions for making the anion exchanger 1 (AE1) protein, which transports negatively charged atoms (anions) across cell membranes. Specifically, AE1 exchanges negatively charged atoms of chlorine (chloride ions) for negatively charged bicarbonate molecules (bicarbonate ions). The AE1 protein is found in the cell membrane of kidney cells and red blood cells. In kidney cells, the exchange of bicarbonate through AE1 allows acid to be released from the cell into the urine. In red blood cells, AE1 attaches to other proteins that make up the structural framework (the cytoskeleton) of the cells, helping to maintain their structure. The SLC4A1 gene mutations involved in either form of SLC4A1-associated distal renal tubular acidosis lead to production of altered AE1 proteins that cannot get to the correct location in the cell membrane. In the autosomal dominant form of the condition, gene mutations affect only one copy of the SLC4A1 gene, and normal AE1 protein is produced from the other copy. However, the altered protein attaches to the normal protein and keeps it from getting to the correct location, leading to a severe reduction or absence of AE1 protein in the cell membrane. In autosomal recessive distal renal tubular acidosis, both copies of the SLC4A1 gene are mutated, so all of the protein produced from this gene is altered and not able to get to the correct location. Improper location or absence of AE1 in kidney cell membranes disrupts bicarbonate exchange, and as a result, acid cannot be released into the urine. Instead, the acid builds up in the blood in most affected individuals, leading to metabolic acidosis and the other features of complete distal renal tubular acidosis. It is not clear why some people develop metabolic acidosis and others do not. Researchers suggest that in individuals with incomplete distal renal tubular acidosis, another mechanism is able to help regulate blood acidity (pH) and keep metabolic acidosis from developing. In red blood cells, interaction with a protein called glycophorin A can often help the altered AE1 protein get to the cell membrane where it can perform its function, which explains why most people with SLC4A1-associated distal renal tubular acidosis do not have blood cell abnormalities. However, some altered AE1 proteins cannot be helped by glycophorin A and are not found in the cell membrane. Without AE1, the red blood cells are unstable; breakdown of these abnormal red blood cells may lead to hemolytic anemia. Some people have nonhereditary forms of distal renal tubular acidosis; these forms can be caused by immune system problems or other conditions that damage the kidneys. These individuals often have additional signs and symptoms related to the original condition. Inheritance Pattern SLC4A1-associated distal renal tubular acidosis can have different patterns of inheritance. It is usually inherited in an autosomal dominant pattern, which means one copy of the altered SLC4A1 gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family. Less commonly, SLC4A1-associated distal renal tubular acidosis has an autosomal recessive pattern of inheritance, which means a mutation must occur in both copies of the SLC4A1 gene for the condition to develop. This pattern occurs with certain types of SLC4A1 gene mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Sources for This Page Alper SL. Molecular physiology and genetics of Na+-independent SLC4 anion exchangers. J Exp Biol. 2009 Jun;212(Pt 11):1672-83. doi: 10.1242/jeb.029454. Review.
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know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know
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SLC4A1-associated distal renal tubular acidosis can have different patterns of inheritance. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family.
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SLC4A1-associated distal renal tubular acidosis classic distal renal tubular acidosis renal tubular acidosis type I RTA, classic type Description SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells. Frequency The prevalence of SLC4A1-associated distal renal tubular acidosis is unknown. The condition is most common in Southeast Asia, especially Thailand. Causes Both the autosomal dominant and autosomal recessive forms of SLC4A1-associated distal renal tubular acidosis are caused by mutations in the SLC4A1 gene. This gene provides instructions for making the anion exchanger 1 (AE1) protein, which transports negatively charged atoms (anions) across cell membranes. Specifically, AE1 exchanges negatively charged atoms of chlorine (chloride ions) for negatively charged bicarbonate molecules (bicarbonate ions). The AE1 protein is found in the cell membrane of kidney cells and red blood cells. In kidney cells, the exchange of bicarbonate through AE1 allows acid to be released from the cell into the urine. In red blood cells, AE1 attaches to other proteins that make up the structural framework (the cytoskeleton) of the cells, helping to maintain their structure. The SLC4A1 gene mutations involved in either form of SLC4A1-associated distal renal tubular acidosis lead to production of altered AE1 proteins that cannot get to the correct location in the cell membrane. In the autosomal dominant form of the condition, gene mutations affect only one copy of the SLC4A1 gene, and normal AE1 protein is produced from the other copy. However, the altered protein attaches to the normal protein and keeps it from getting to the correct location, leading to a severe reduction or absence of AE1 protein in the cell membrane. In autosomal recessive distal renal tubular acidosis, both copies of the SLC4A1 gene are mutated, so all of the protein produced from this gene is altered and not able to get to the correct location. Improper location or absence of AE1 in kidney cell membranes disrupts bicarbonate exchange, and as a result, acid cannot be released into the urine. Instead, the acid builds up in the blood in most affected individuals, leading to metabolic acidosis and the other features of complete distal renal tubular acidosis. It is not clear why some people develop metabolic acidosis and others do not. Researchers suggest that in individuals with incomplete distal renal tubular acidosis, another mechanism is able to help regulate blood acidity (pH) and keep metabolic acidosis from developing. In red blood cells, interaction with a protein called glycophorin A can often help the altered AE1 protein get to the cell membrane where it can perform its function, which explains why most people with SLC4A1-associated distal renal tubular acidosis do not have blood cell abnormalities. However, some altered AE1 proteins cannot be helped by glycophorin A and are not found in the cell membrane. Without AE1, the red blood cells are unstable; breakdown of these abnormal red blood cells may lead to hemolytic anemia. Some people have nonhereditary forms of distal renal tubular acidosis; these forms can be caused by immune system problems or other conditions that damage the kidneys. These individuals often have additional signs and symptoms related to the original condition. Inheritance Pattern SLC4A1-associated distal renal tubular acidosis can have different patterns of inheritance. It is usually inherited in an autosomal dominant pattern, which means one copy of the altered SLC4A1 gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family. Less commonly, SLC4A1-associated distal renal tubular acidosis has an autosomal recessive pattern of inheritance, which means a mutation must occur in both copies of the SLC4A1 gene for the condition to develop. This pattern occurs with certain types of SLC4A1 gene mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Sources for This Page Alper SL. Molecular physiology and genetics of Na+-independent SLC4 anion exchangers. J Exp Biol. 2009 Jun;212(Pt 11):1672-83. doi: 10.1242/jeb.029454. Review.
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Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.
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Cardiac amyloidosis (Treatment): Your health care provider may tell you to make changes to your diet, including limiting salt and fluids. You may need to take water pills (diuretics) to help your body get rid of excess fluid. Medicines including digoxin, calcium-channel blockers, and beta-blockers may be used in people with atrial fibrillation. People with cardiac amyloidosis may be extra sensitive to side effects of these drugs. Other treatments may include: - Chemotherapy - Implantable cardioverter-defibrillator (AICD) - Pacemaker, if there are problems with heart signals - Prednisone, an anti-inflammatory medicine A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant.
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Cardiac amyloidosis Amyloidosis - cardiac Primary cardiac amyloidosis - AL type Secondary cardiac amyloidosis - AA type Stiff heart syndrome Senile amyloidosis Summary Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly. Causes Amyloidosis is a group of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these proteins replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis. Cardiac amyloidosis ("stiff heart syndrome") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical type of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical signals move through the heart (conduction system). This can lead to abnormal heartbeats (arrhythmias) and faulty heart signals (heart block). The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of another medical problem causing inflammation. Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40. Symptoms Some people may have no symptoms. When present, symptoms may include: Excessive urination at night Fatigue, reduced exercise ability Palpitations (sensation of feeling heartbeat) Shortness of breath with activity Swelling of the abdomen, legs, ankles, or other part of the body Trouble breathing while lying down Exams and Tests The signs of cardiac amyloidosis can be related to a number of different conditions. This can make the problem hard to diagnose. Signs may include: Abnormal sounds in the lung (lung crackles) or a heart murmur Blood pressure that is low or drops when you stand up Enlarged neck veins Swollen liver The following tests may be done: Chest or abdomen CT scan (considered the "gold standard" to help diagnose this condition) Coronary angiography Electrocardiogram (ECG) Echocardiogram Magnetic resonance imaging (MRI) Nuclear heart scans (MUGA, RNV) Positron emission tomography (PET) An ECG may show problems with the heartbeat or heart signals. It may also show low signals (called "low voltage"). A cardiac biopsy is used to confirm the diagnosis. A biopsy of another area, such as the abdomen, kidney, or bone marrow, is often done as well. Treatment Your health care provider may tell you to make changes to your diet, including limiting salt and fluids. You may need to take water pills (diuretics) to help your body get rid of excess fluid. The provider may tell you to weigh yourself every day. A weight gain of 3 or more pounds (1 kilogram or more) over 1 to 2 days can mean there is too much fluid in the body. Medicines including digoxin, calcium-channel blockers, and beta-blockers may be used in people with atrial fibrillation. However, the drugs must be used with caution, and the dosage must be carefully monitored. People with cardiac amyloidosis may be extra sensitive to side effects of these drugs. Other treatments may include: Chemotherapy Implantable cardioverter-defibrillator (AICD) Pacemaker, if there are problems with heart signals Prednisone, an anti-inflammatory medicine A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant. Outlook (Prognosis) In the past, cardiac amyloidosis was thought to be an untreatable and rapidly fatal disease. However, the field is changing rapidly. Different types of amyloidosis can affect the heart in different ways. Some types are more severe than others. Many people can now expect to survive and experience a good quality of life for several years after diagnosis. Possible Complications Complications may include: Atrial fibrillation or ventricular arrhythmias Congestive heart failure Fluid buildup in the abdomen (ascites) Increased sensitivity to digoxin Low blood pressure and dizziness from excessive urination (due to medicine) Sick sinus syndrome Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of impulses through the heart muscle) When to Contact a Medical Professional Call your provider if you have this disorder and develop new symptoms such as: Dizziness when you change position Excessive weight (fluid) gain Excessive weight loss Fainting spells Severe breathing problems Review Date 5/16/2018 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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What is Nephrotic Syndrome. What are its causes and cures?
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To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life. Treatments may include any of the following: - Keeping blood pressure at or below 130/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. - Corticosteroids and other drugs that suppress or quiet the immune system. - Treating high cholesterol to reduce the risk of heart and blood vessel problems. A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed. - A low-salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem. - Low-protein diets may be helpful. Your health care provider may suggest a moderate-protein diet (1 gram [gm] of protein per kilogram [kg] of body weight per day). - Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. - Taking blood thinner drugs to treat or prevent blood clots.
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Nephrotic syndrome Nephrosis Summary Nephrotic syndrome is a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, increased blood clot risk, and swelling. Causes Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults. In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: Cancer Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis Genetic disorders Immune disorders Infections (such as strep throat, hepatitis, or mononucleosis) Use of certain drugs It can occur with kidney disorders such as: Focal and segmental glomerulosclerosis Glomerulonephritis Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females. Symptoms Swelling (edema) is the most common symptom. It may occur: In the face and around the eyes (facial swelling) In the arms and legs, especially in the feet and ankles In the belly area (swollen abdomen) Other symptoms include: Skin rash or sores Foamy appearance of the urine Poor appetite Weight gain (unintentional) from fluid retention Seizures Exams and Tests The health care provider will perform a physical exam. Laboratory tests will be done to see how well the kidneys are working. They include: Albumin blood test Blood chemistry tests, such as basic metabolic panel or comprehensive metabolic panel Blood urea nitrogen (BUN) Creatinine - blood test Creatinine clearance - urine test Urinalysis Fats are often also present in the urine. Blood cholesterol and triglyceride levels may be high. A kidney biopsy may be needed to find the cause of the disorder. Tests to rule out various causes may include the following: Antinuclear antibody Cryoglobulins Complement levels Glucose tolerance test Hepatitis B and C antibodies HIV test Rheumatoid factor Serum protein electrophoresis (SPEP) Syphilis serology Urine protein electrophoresis (UPEP) This disease may also change the results of the following tests: Vitamin D level Serum iron Urinary casts Treatment The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life. Treatments may include any of the following: Keeping blood pressure at or below 130/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. Corticosteroids and other drugs that suppress or quiet the immune system. Treating high cholesterol to reduce the risk of heart and blood vessel problems -- A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed. A low-sodium diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem. Low-protein diets may be helpful. Your provider may suggest a moderate-protein diet (1 gram of protein per kilogram of body weight per day). Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. Taking blood thinner drugs to treat or prevent blood clots. Outlook (Prognosis) Outcome varies. Some people recover from the condition. Others develop long-term kidney disease and need dialysis and eventually a kidney transplant. Possible Complications Health problems that may result from nephrotic syndrome include: Acute kidney failure Hardening of the arteries and related heart diseases Chronic kidney disease Fluid overload, heart failure, fluid buildup in lungs Infections, including pneumococcal pneumonia Malnutrition Renal vein thrombosis When to Contact a Medical Professional Call your provider if: You develop symptoms of nephrotic syndrome, including swelling in face, belly, or arms and legs, or skin sores You're being treated for nephrotic syndrome, but your symptoms don't improve New symptoms develop, including cough, decreased urine output, discomfort with urination, fever, severe headache Go to the emergency room or call the local emergency number (such as 911) if you have seizures. Prevention Treating conditions that can cause nephrotic syndrome may help prevent the syndrome. Review Date 8/1/2017 Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?
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Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium
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Dehydration Vomiting - dehydration Diarrhea - dehydration Diabetes - dehydration Stomach flu - dehydration Gastroenteritis - dehydration Excessive sweating - dehydration Summary Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much of your body's fluid is lost or not replaced. Severe dehydration is a life-threatening emergency. Causes You can become dehydrated if you lose too much fluid, do not drink enough water or fluids, or both. Your body may lose a lot of fluid from: Sweating too much, for example, from exercising in hot weather Fever Vomiting or diarrhea Urinating too much (uncontrolled diabetes or some medications, like diuretics, can cause you to urinate a lot) You might not drink enough fluids because: You do not feel like eating or drinking because you are sick You are nauseated You have a sore throat or mouth sores Older adults and people with certain diseases, such as diabetes, are also at higher risk for dehydration. Symptoms Signs of mild to moderate dehydration: Thirst Dry or sticky mouth Not urinating much Darker yellow urine Dry, cool skin Headache Muscle cramps Signs of severe dehydration: Not urinating, or very dark yellow or amber-colored urine Dry, shriveled skin Irritability or confusion Dizziness or lightheadedness Rapid heartbeat Rapid breathing Sunken eyes Listlessness Shock (not enough blood flow through the body) Unconsciousness or delirium Exams and Tests Your health care provider will look for these signs of dehydration: Low blood pressure. Blood pressure that drops when you stand up after lying down. White finger tips that do not return to a pink color after your provider presses the fingertip. Skin that is not as elastic as normal. When the provider pinches it into a fold, it may slowly sag back into place. Normally, skin springs back right away. Rapid heart rate. Your provider may do lab tests such as: Blood tests to check kidney function Urine tests to see what may be causing dehydration Other tests to see what may be causing dehydration (blood sugar test for diabetes) Treatment To treat dehydration: Try sipping water or sucking on ice cubes. Try drinking water or sports drinks that contain electrolytes. Do not take salt tablets. They can cause serious complications. Ask your provider what you should eat if you have diarrhea. For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). The provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. Outlook (Prognosis) If you notice signs of dehydration and treat it quickly, you should recover completely. Possible Complications Untreated severe dehydration may cause: Death Permanent brain damage Seizures When to Contact a Medical Professional You should call 911 if: The person loses consciousness at any time. There is any other change in the person's alertness (for example, confusion or seizures). The person has a fever over 102F (38.8C). You notice symptoms of heatstroke (such as rapid pulse or rapid breathing). The person's condition does not improve or gets worse despite treatment. Prevention To prevent dehydration: Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated. Review Date 9/5/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?
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Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium
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Dehydration Vomiting - dehydration Diarrhea - dehydration Diabetes - dehydration Stomach flu - dehydration Gastroenteritis - dehydration Excessive sweating - dehydration Summary Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much of your body's fluid is lost or not replaced. Severe dehydration is a life-threatening emergency. Causes You can become dehydrated if you lose too much fluid, do not drink enough water or fluids, or both. Your body may lose a lot of fluid from: Sweating too much, for example, from exercising in hot weather Fever Vomiting or diarrhea Urinating too much (uncontrolled diabetes or some medications, like diuretics, can cause you to urinate a lot) You might not drink enough fluids because: You do not feel like eating or drinking because you are sick You are nauseated You have a sore throat or mouth sores Older adults and people with certain diseases, such as diabetes, are also at higher risk for dehydration. Symptoms Signs of mild to moderate dehydration: Thirst Dry or sticky mouth Not urinating much Darker yellow urine Dry, cool skin Headache Muscle cramps Signs of severe dehydration: Not urinating, or very dark yellow or amber-colored urine Dry, shriveled skin Irritability or confusion Dizziness or lightheadedness Rapid heartbeat Rapid breathing Sunken eyes Listlessness Shock (not enough blood flow through the body) Unconsciousness or delirium Exams and Tests Your health care provider will look for these signs of dehydration: Low blood pressure. Blood pressure that drops when you stand up after lying down. White finger tips that do not return to a pink color after your provider presses the fingertip. Skin that is not as elastic as normal. When the provider pinches it into a fold, it may slowly sag back into place. Normally, skin springs back right away. Rapid heart rate. Your provider may do lab tests such as: Blood tests to check kidney function Urine tests to see what may be causing dehydration Other tests to see what may be causing dehydration (blood sugar test for diabetes) Treatment To treat dehydration: Try sipping water or sucking on ice cubes. Try drinking water or sports drinks that contain electrolytes. Do not take salt tablets. They can cause serious complications. Ask your provider what you should eat if you have diarrhea. For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). The provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. Outlook (Prognosis) If you notice signs of dehydration and treat it quickly, you should recover completely. Possible Complications Untreated severe dehydration may cause: Death Permanent brain damage Seizures When to Contact a Medical Professional You should call 911 if: The person loses consciousness at any time. There is any other change in the person's alertness (for example, confusion or seizures). The person has a fever over 102F (38.8C). You notice symptoms of heatstroke (such as rapid pulse or rapid breathing). The person's condition does not improve or gets worse despite treatment. Prevention To prevent dehydration: Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated. Review Date 9/5/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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who is at higher risk for calcium overdose?
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Calcium carbonate overdose: Calcium carbonate is commonly found in antacids (for heartburn) and some dietary supplements. Calcium carbonate overdose occurs when someone takes more than the normal or recommended amount of a product containing this substance. This can be by accident or on purpose. Calcium carbonate is not very poisonous. Recovery is quite likely. But, long-term overuse is more serious than a single overdose, because it can cause kidney damage. Few people die from an antacid overdose. Keep all medicines in child-proof bottles and out of the reach of children.
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Calcium carbonate overdose Tums overdose Calcium overdose Summary Calcium carbonate is commonly found in antacids (for heartburn) and some dietary supplements. Calcium carbonate overdose occurs when someone takes more than the normal or recommended amount of a product containing this substance. This can be by accident or on purpose. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Calcium carbonate can be dangerous in large amounts. Where Found Products that contain calcium carbonate are certain: Antacids (Tums, Chooz) Mineral supplements Hand lotions Vitamin and mineral supplements Other products may also contain calcium carbonate. Symptoms Symptoms of a calcium carbonate overdose include: Abdominal pain Bone pain Coma Confusion Constipation Depression Diarrhea Headache Irregular heartbeat Loss of appetite Muscle twitching Nausea, vomiting Thirst Home Care Seek medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to. Before Calling Emergency Have this information ready: Person's age, weight, and condition The name of the product (ingredients and strength, if known) When it was swallowed The amount swallowed Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison control. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room Take the container with you to the hospital, if possible. The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Tests that may be done include: Blood and urine tests Chest x-ray ECG (electrocardiogram, or heart tracing) Treatment may include: Intravenous fluids (through a vein) Medicine to treat symptoms Activated charcoal Laxatives Tube through the mouth into the stomach to empty the stomach (gastric lavage) Breathing support, including tube through the mouth into the lungs and connected to a ventilator (breathing machine) Outlook (Prognosis) Calcium carbonate is not very poisonous. Recovery is quite likely. But, long-term overuse is more serious than a single overdose, because it can cause kidney damage. Few people die from an antacid overdose. Keep all medicines in child-proof bottles and out of the reach of children. Review Date 9/23/2017 Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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how to prevent diabetes
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Diabetes (Prevention): Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people.
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Diabetes Diabetes - type 1 Diabetes - type 2 Diabetes - gestational Type 1 diabetes Type 2 diabetes Gestational diabetes Diabetes mellitus Summary Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested and absorbed: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: Type 1 diabetes is less common. It can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause of the failure to make enough insulin is unknown. Type 2 diabetes is more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. Not all people with type 2 diabetes are overweight or obese. There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease. Symptoms A high blood sugar level can cause several symptoms, including: Blurry vision Excess thirst Fatigue Frequent urination Hunger Weight loss Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period. People may be very sick by the time they are diagnosed. After many years, diabetes can lead to other serious problems. These problems are known as diabetes complications, and include: Eye problems, including trouble seeing (especially at night), light sensitivity, and blindness Sores and infections of the leg or foot, which if untreated, can lead to amputation of the leg or foot Damage to nerves in the body, causing pain, tingling, a loss of feeling, problems digesting food, and erectile dysfunction Kidney problems, which can lead to kidney failure Weakened immune system, which can lead to more frequent infections Increased chance of having a heart attack or stroke Exams and Tests A urine analysis may show high blood sugar. But a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL (11.1 mmol/L). To confirm the diagnosis, one or more of the following tests must be done. Blood tests: Fasting blood glucose level. Diabetes is diagnosed if the fasting glucose level is higher than 126 mg/dL (7.0 mmol/L) on two different tests. Levels between 100 and 126 mg/dL (5.5 and 7.0 mmol/L) are called impaired fasting glucose or prediabetes. These levels are risk factors for type 2 diabetes. Hemoglobin A1c (A1C) test. Normal is less than 5.7%; prediabetes is 5.7% to 6.4%; and diabetes is 6.5% or higher. Oral glucose tolerance test. Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a sugar drink (this test is used more often for type 2 diabetes). Screening for type 2 diabetes in people who have no symptoms is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 3 years. Overweight adults (BMI of 25 or higher) who have other risk factors such as having high blood pressure, or having a mother, father, sister or brother with diabetes. Adults over age 45, repeated every 3 years. Treatment Type 2 diabetes can sometimes be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. Some cases of type 2 diabetes can also be improved with weight loss surgery. There is no cure for type 1 diabetes (except for a pancreas or islet cell transplant). Treating either type 1 diabetes or type 2 diabetes involves nutrition, activity and medicines to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a certified diabetes educator (CDE). Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk for kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes. Support Groups Many resources can help you understand more about diabetes. If you have diabetes, you can also learn ways to manage your condition and prevent diabetes complications. Outlook (Prognosis) Diabetes is a lifelong disease for most people who have it. Tight control of blood glucose can prevent or delay diabetes complications. But these problems can occur, even in people with good diabetes control. Possible Complications After many years, diabetes can lead to serious health problems: You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body. Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. Nerves in your body can get damaged, causing pain, tingling, and numbness. Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. Your immune system can weaken, which can lead to frequent infections. Prevention Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% of your body weight can reduce your risk. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people. Review Date 2/22/2018 Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Diabetes (Is there anything I can do to prevent type 2 diabetes?): Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose.
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Diabetes Overview Diabetes is a disease in which blood sugar (glucose) levels in your body are too high. Diabetes can cause serious health problems, including heart attack or stroke, blindness, problems during pregnancy, and kidney failure. More than 13 million women have diabetes, or about one in 10 women ages 20 and older.1 What is diabetes? Diabetes is a disease caused by high levels of blood sugar (glucose) in your body. This can happen when your body does not make insulin or does not use insulin correctly. Insulin is a hormone made in the pancreas, an organ near your stomach. Insulin helps the glucose from food get into your body's cells for energy. If your body does not make enough insulin, or your body does not use the insulin correctly, the glucose stays and builds up in your blood. Over time, this extra glucose can lead to prediabetes or diabetes. Diabetes puts you at risk for other serious and life-threatening health problems, such as heart disease, stroke, blindness, and kidney damage. What are the different types of diabetes? The three main types of diabetes are: Am I at risk for diabetes? A risk factor is something that puts you at a higher risk for a disease compared with an average person. Risk factors for type 1 diabetes in women and girls include: Risk factors for type 2 diabetes in women and girls include:4 If you have any of these risk factors, talk to your doctor about ways to lower your risk for diabetes. You can also take the Diabetes Risk Test and talk about the results with your doctor. Who gets diabetes? Type 1 diabetes usually develops in childhood, but it can happen at any age. It is more common in whites than in other racial or ethnic groups. About 5% of adults with diabetes have type 1 diabetes.1 Genes you inherit from your parents play an important role in the development of type 1 diabetes. However, where you live may also affect your risk. Type 1 diabetes develops more often in winter and in people who live in colder climates. Type 2 diabetes is more common in adults, especially in people who are overweight and have a family history of diabetes. About 95% of adults with diabetes have type 2 diabetes.1 Type 2 diabetes is becoming more common in children and teens as more of them become overweight and obese.5 Do women of color need to worry about diabetes? Yes. Certain racial and ethnic groups have a higher risk for type 2 diabetes. These groups include: How does diabetes affect women differently than men? Diabetes affects women and men in almost equal numbers. However, diabetes affects women differently than men. Compared with men with diabetes, women with diabetes have:9 Does diabetes raise my risk for other health problems? Yes. The longer you have type 2 diabetes, the higher your risk for developing serious medical problems from diabetes. Also, if you smoke and have diabetes, you are even more likely to develop serious medical problems from diabetes, compared with people who have diabetes and do not smoke.11 The extra glucose in the blood that leads to diabetes can damage your nerves and blood vessels. Nerve damage from diabetes can lead to pain or a permanent loss of feeling in your hands, feet, and other parts of your body.12 Blood vessel damage from diabetes can also lead to: Women with diabetes are also at higher risk for: What causes diabetes? Researchers do not know the exact causes of type 1 and type 2 diabetes. Researchers do know that inheriting certain genes from your family can raise your risk for developing diabetes. Obesity is also a major risk factor for type 2 diabetes. Smoking can also cause type 2 diabetes. And the more you smoke the higher your risk for type 2 diabetes and other serious health problems if you already have diabetes.13 Weight loss can help control type 2 diabetes so that you are healthier. Quitting smoking can also help you control your blood sugar levels. Being a healthy weight and not smoking can help all women be healthier. But, obesity and smoking do not always cause diabetes. Some women who are overweight or obese or smoke never develop diabetes. Also, women who are a normal weight or only slightly overweight can develop diabetes if they have other risk factors, such as a family history of diabetes. What are the signs and symptoms of diabetes? Type 1 diabetes symptoms are usually more severe and may develop suddenly. Type 2 diabetes may not cause any signs or symptoms at first. Symptoms can develop slowly over time. You may not notice them right away. Common signs and symptoms of type 1 and type 2 diabetes include: Do I need to be tested for diabetes? Maybe. You should be tested for diabetes if you are between 40 and 70 years old and are overweight or obese. Your doctor may recommend testing earlier than age 40 if you also have other risk factors for diabetes. Also, talk to your doctor about diabetes testing if you have signs or symptoms of diabetes. Your doctor will use a blood test to see if you have diabetes. If the testing shows that your blood sugar levels are high, you can begin making healthy changes to your eating habits and getting more physical activity to help prevent diabetes. What is prediabetes? Prediabetes means your blood sugar (glucose) level is higher than normal, but it is lower than the diabetes range. It also means you are at higher risk of getting type 2 diabetes and heart disease. As many as 27 million American women have prediabetes.14 If you have prediabetes, you can make healthy changes, such as doing some type of physical activity on most days, to lower your risk of getting diabetes and return to normal blood sugar levels. Losing 7% of your body weight (or 14 pounds if you weigh 200 pounds) can lower your risk for type 2 diabetes by more than half. If you have prediabetes, get your blood glucose checked every year by a doctor or nurse.15 How is diabetes treated? Diabetes treatment includes managing your blood sugar levels to control your symptoms. You can help control your blood sugar levels by eating healthy and getting regular physical activity. With type 1 diabetes, you also will need to take insulin through shots or an insulin pump. Insulin cannot be taken as a pill. Type 2 diabetes treatment also may include taking medicine to control your blood sugar. Over time, people with type 2 diabetes make less and less of their own insulin. This may mean that you will need to increase your medicines or start taking insulin shots to keep your diabetes in control. Learn more about controlling diabetes at the National Diabetes Education Program website. Is there anything I can do to prevent type 1 diabetes? Researchers do not know how to prevent type 1 diabetes. Researchers are still looking for ways to prevent type 1 diabetes in women and girls by studying their close relatives who have diabetes. Is there anything I can do to prevent type 2 diabetes? Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose. Learn how to eat healthier and get more physical activity. Is it safe for women with diabetes to get pregnant? Yes. If you have type 1 or type 2 diabetes, you can have a healthy pregnancy. If you have diabetes and you want to have a baby, you need to plan ahead, before you get pregnant. Talk to your doctor before you get pregnant. He or she can talk to you about steps you can take to keep your baby healthy. This may include a diabetes education program to help you better understand your diabetes and how to control it during pregnancy. Did we answer your question about diabetes? For more information about diabetes, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources
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You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.
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Type 2 diabetes Noninsulin-dependent diabetes Diabetes - type II Adult-onset diabetes Diabetic - type 2 diabetes Oral hypoglycemic - type 2 diabetes High blood sugar - type 2 diabetes Summary Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. Causes Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy. When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes. Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way. Type 2 diabetes can also develop in people who are not overweight or obese. This is more common in older adults. Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease. Symptoms People with type 2 diabetes often have no symptoms at first. They may not have symptoms for many years. Early symptoms of diabetes caused by a high blood sugar level may include: Bladder, kidney, skin, or other infections that are more frequent or heal slowly Fatigue Hunger Increased thirst Increased urination Blurred vision After many years, diabetes can lead to serious health problems, and as a result, many other symptoms. Exams and Tests Your doctor may suspect that you have diabetes if your blood sugar level is higher than 200 milligrams per deciliter (mg/dL) or 11.1 mmol/L. To confirm the diagnosis, one or more of the following tests must be done. Fasting blood glucose level -- Diabetes is diagnosed if it is higher than 126 mg/dL (7.0 mmol/L) two different times. Hemoglobin A1c (A1C) test -- Diabetes is diagnosed if the test result is 6.5% or higher. Oral glucose tolerance test -- Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a special sugar drink. Diabetes screening is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years Overweight adults (BMI of 25 or higher) who have other risk factors, such as high blood pressure, or having a mother, father, sister or brother with diabetes Adults starting at age 45 every 3 years, or at a younger age if the person has risk factors If you have been diagnosed with type 2 diabetes, you need to work closely with your doctor. See your doctor as often as instructed. This may be every 3 months. The following exams and tests will help you and your doctor monitor your diabetes and prevent problems. Check the skin, nerves, and joints of your feet and legs. Check if your feet are getting numb (diabetic nerve disease). Have your blood pressure checked at least once a year (blood pressure goal should be 140/80 mm Hg or lower). Have your A1C tested every 6 months if your diabetes is well controlled. Have the test every 3 months if your diabetes is not well controlled. Have your cholesterol and triglyceride levels checked once a year. Get tests once a year to make sure your kidneys are working well (microalbuminuria and serum creatinine). Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease. See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes. Your provider may want to check your vitamin B12 blood levels if you are taking the drug metformin. Treatment At first, the goal of treatment is to lower your high blood glucose level. Long-term goals are to prevent complications. These are health problems that can result from having diabetes. The most important way to treat and manage type 2 diabetes is by being active and eating healthy foods. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your doctor about seeing a diabetes nurse educator and a dietitian. LEARN THESE SKILLS Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include: How to test and record your blood glucose What, when, and how much to eat How to safely increase your activity and control your weight How to take medicines, if needed How to recognize and treat low and high blood sugar How to handle sick days Where to buy diabetes supplies and how to store them It may take several months to learn these skills. Keep learning about diabetes, its complications, and how to control and live well with the disease. Stay up-to-date on new research and treatments. Make sure you are getting information from trustworthy sources, such as your doctor and diabetes educator. MANAGING YOUR BLOOD SUGAR Checking your blood sugar level yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check. To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle, called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar. Your doctor or diabetes educator will help set up a testing schedule for you. Your doctor will help you set a target range for your blood sugar numbers. Keep these factors in mind: Most people with type 2 diabetes only need to check their blood sugar once or twice a day. If your blood sugar level is under control, you may only need to check it a few times a week. You may test yourself when you wake up, before meals, and at bedtime. You may need to test more often when you are sick or under stress. You may need to test more often if you are having more frequent low blood sugar symptoms. Keep a record of your blood sugar for yourself and your doctor. Based on your numbers, you may need to make changes to your meals, activity, or medicines to keep your blood sugar level in the right range. Your doctor may recommend that you use a continuous glucose monitor (CGM) to measure blood sugar if: You are using insulin injections many times a day You have had an episode of severe low blood sugar Your blood sugar level varies a lot The CGM has a sensor that is inserted just under the skin to measure glucose in your tissue fluid every 5 minutes. HEALTHY EATING AND WEIGHT CONTROL Work closely with your health care providers to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your lifestyle and habits and should include foods that you like. Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes. Obese people whose diabetes is not well managed with diet and medicine may consider weight loss (bariatric) surgery. REGULAR PHYSICAL ACTIVITY Regular activity is important for everyone. It is even more important when you have diabetes. Exercise is good for your health because it: Lowers your blood sugar level without medicine Burns extra calories and fat to help manage your weight Improves blood flow and blood pressure Increases your energy level Improves your ability to handle stress Talk to your doctor before starting any exercise program. People with type 2 diabetes may need to take special steps before, during, and after physical activity or exercise, including adjusting doses of insulin if needed. MEDICINES TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medicine. Since these drugs help lower your blood sugar level in different ways, your doctor may have you take more than one drug. Some of the most common types of medicines are listed below. They are taken by mouth or injection. Alpha-glucosidase inhibitors Biguanides Bile acid sequestrants DPP-4 inhibitors Injectable medicines (GLP-1 analogs) Meglitinides SGLT2 inhibitors Sulfonylureas Thiazolidinediones You may need to take insulin if your blood sugar cannot be controlled with any of the above medicines. Most commonly, insulin is injected under the skin using a syringe, insulin pen, or pump. Another form of insulin is the inhaled type. Insulin cannot be taken by mouth because the acid in the stomach destroys the insulin. PREVENTING COMPLICATIONS Your doctor may prescribe medicines or other treatments to reduce your chance of developing some of the more common complications of diabetes, including: Eye disease Kidney disease Heart disease and stroke FOOT CARE People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make your feet less able to feel pressure, pain, heat, or cold. You may not notice a foot injury until you have severe damage to the skin and tissue below, or you get a severe infection. Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. To prevent problems with your feet: Stop smoking if you smoke. Improve control of your blood sugar. Get a foot exam by your doctor at least twice a year to learn if you have nerve damage. Ask your doctor to check your feet for problems such as a bunion or hammertoe. These need to be treated to prevent skin breakdown and ulcers. Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems. Treat minor infections, such as athlete's foot, right away. Use moisturizing lotion on dry skin. Make sure you wear the right kind of shoes. Ask your doctor what type of shoe is right for you. EMOTIONAL HEALTH Living with diabetes can be stressful. You may feel overwhelmed by everything you need to do to manage your diabetes. But taking care of your emotional health is just as important as your physical health. Ways to relieve stress include: Listening to relaxing music Meditating to take your mind off your worries Deep breathing to help relieve physical tension Doing yoga, taichi, or progressive relaxation Feeling sad or down (depressed) or anxious sometimes is normal. But if you have these feelings often and they're getting in the way of managing your diabetes, talk with your health care team. They can find ways to help you feel better. Support Groups There are many diabetes resources that can help you understand more about type 2 diabetes. You can also learn ways to manage your condition so you can live well with diabetes. Outlook (Prognosis) Diabetes is a lifelong disease and there is no cure. Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar level. Possible Complications After many years, diabetes can lead to serious health problems: You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. Your feet and skin can develop sores and infections. If the wounds do not heal properly, your foot or leg may need to be amputated. Infections can also cause pain and itching in the skin. Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. Nerves in your body can get damaged, causing pain, tingling, and numbness. Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. When to Contact a Medical Professional Call 911 right away if you have: Chest pain or pressure Fainting, confusion or unconsciousness Seizure Shortness of breath These symptoms can quickly get worse and become emergency conditions (such as seizures, hypoglycemic coma or hyperglycemic coma). Also call your doctor if you have: Numbness, tingling, or pain in your feet or legs Problems with your eyesight Sores or infections on your feet Symptoms of high blood sugar (extreme thirst, blurry vision, dry skin, weakness or fatigue, the need to urinate a lot) Symptoms of low blood sugar (weakness or fatigue, trembling, sweating, irritability, trouble thinking clearly, fast heartbeat, double or blurry vision, uneasy feeling) Frequent feelings of depression or anxiety Prevention You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease. Review Date 2/22/2018 Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Preventing Diabetes Problems (How can I prevent hypoglycemia if I have diabetes?): If you are taking insulin, a sulfonylurea, or a meglitinide, using your diabetes management plan and working with your health care team to adjust your plan as needed can help you prevent hypoglycemia. The following actions can also help prevent hypoglycemia:Knowing your blood glucose level can help you decide how much medicine to take, what food to eat, and how physically active to be. Your health care team may adjust your diabetes medicines or other aspects of your management plan. Learn about balancing your medicines, eating plan, and physical activity to prevent hypoglycemia. Ask if you should have a glucagon emergency kit to carry with you at all times.
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Preventing Diabetes Problems Heart Disease and Stroke Diabetes can damage blood vessels and lead to heart disease and stroke. You can do a lot to prevent heart disease and stroke by managing your blood glucose, blood pressure, and cholesterol levels; and by not smoking. What is the link between diabetes, heart disease, and stroke? Over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop heart disease.1People with diabetes tend to develop heart disease at a younger age than people without diabetes. In adults with diabetes, the most common causes of death are heart disease and stroke. Adults with diabetes are nearly twice as likely to die from heart disease or stroke as people without diabetes.2The good news is that the steps you take to manage your diabetes also help to lower your chances of having heart disease or stroke. What else increases my chances of heart disease or stroke if I have diabetes? If you have diabetes, other factors add to your chances of developing heart disease or having a stroke.Smoking raises your risk of developing heart disease. If you have diabetes, it is important to stop smoking because both smoking and diabetes narrow blood vessels. Smoking also increases your chances of developing other long-term problems such as lung disease. Smoking also can damage the blood vessels in your legs and increase the risk of lower leg infections, ulcers, and amputation.If you have high blood pressure, your heart must work harder to pump blood. High blood pressure can strain your heart, damage blood vessels, and increase your risk of heart attack, stroke, eye problems, and kidney problems.Cholesterol is a type of fat produced by your liver and found in your blood. You have two kinds of cholesterol in your blood: LDL and HDL.LDL, often called “bad” cholesterol, can build up and clog your blood vessels. High levels of LDL cholesterol raise your risk of developing heart disease.Another type of blood fat, triglycerides, also can raise your risk of heart disease when the levels are higher than recommended by your health care team.Being overweight or obese can affect your ability to manage your diabetes and increase your risk for many health problems, including heart disease and high blood pressure. If you are overweight, a healthy eating plan with reduced calories often will lower your glucose levels and reduce your need for medications.Excess belly fat around your waist, even if you are not overweight, can raise your chances of developing heart disease.You have excess belly fat if your waist measuresmore than 40 inches and you are a man more than 35 inches and you are a womanLearn how to correctly measure your waist.A family history of heart disease may also add to your chances of developing heart disease. If one or more of your family members had a heart attack before age 50, you may have an even higher chance of developing heart disease.3You can’t change whether heart disease runs in your family, but if you have diabetes, it’s even more important to take steps to protect yourself from heart disease and decrease your chances of having a stroke. How can I lower my chances of a heart attack or stroke if I have diabetes? Taking care of your diabetes is important to help you take care of your heart. You can lower your chances of having a heart attack or stroke by taking the following steps to manage your diabetes to keep your heart and blood vessels healthy.Knowing your diabetes ABCs will help you manage your blood glucose, blood pressure, and cholesterol. Stopping smoking if you have diabetes is also important to lower your chances for heart disease.A is for the A1C test. The A1C test shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you do every day. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. High levels of blood glucose can harm your heart, blood vessels, kidneys, feet, and eyes.The A1C goal for many people with diabetes is below 7 percent. Some people may do better with a slightly higher A1C goal. Ask your health care team what your goal should be.B is for blood pressure. Blood pressure is the force of your blood against the wall of your blood vessels. If your blood pressure gets too high, it makes your heart work too hard. High blood pressure can cause a heart attack or stroke and damage your kidneys and eyes.The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be.C is for cholesterol. You have two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels. Too much bad cholesterol can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels.Ask your health care team what your cholesterol numbers should be. If you are over 40 years of age, you may need to take medicine such as a statin to lower your cholesterol and protect your heart. Some people with very high LDL (“bad”) cholesterol may need to take medicine at a younger age.S is for stop smoking. Not smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels, so your heart has to work harder.If you quit smokingyou will lower your risk for heart attack, stroke, nerve disease, kidney disease, eye disease, and amputation your blood glucose, blood pressure, and cholesterol levels may improve your blood circulation will improve you may have an easier time being physically activeIf you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the national quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov.Ask your health care team about your goals for A1C, blood pressure, and cholesterol, and what you can do to reach these goals.Developing or maintaining healthy lifestyle habits can help you manage your diabetes and prevent heart disease.Follow your healthy eating plan. Make physical activity part of your routine. Stay at or get to a healthy weight Get enough sleep.Learn more about these tips to manage diabetes.Watch a video about what you can do to keep your heart healthy.Managing diabetes is not always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress.Medicines may be an important part of your treatment plan. Your doctor will prescribe medicine based on your specific needs. Medicine may help youmeet your A1C (blood glucose), blood pressure, and cholesterol goals. reduce your risk of blood clots, heart attack, or stroke. treat angina, or chest pain that is often a symptom of heart disease. (Angina can also be an early symptom of a heart attack.)Ask your doctor whether you should take aspirin. Aspirin is not safe for everyone. Your doctor can tell you whether taking aspirin is right for you and exactly how much to take.Statins can reduce the risk of having a heart attack or stroke in some people with diabetes. Statins are a type of medicine often used to help people meet their cholesterol goals. Talk with your doctor to find out whether taking a statin is right for you.Talk with your doctor if you have questions about your medicines. Before you start a new medicine, ask your doctor about possible side effects and how you can avoid them. If the side effects of your medicine bother you, tell your doctor. Don’t stop taking your medicines without checking with your doctor first. How do doctors diagnose heart disease in diabetes? Doctors diagnose heart disease in diabetes based onyour symptoms your medical and family history how likely you are to have heart disease a physical exam results from tests and proceduresTests used to monitor your diabetes—A1C, blood pressure, and cholesterol—help your doctor decide whether it is important to do other tests to check your heart health. What are the warning signs of heart attack and stroke? pain or pressure in your chest that lasts longer than a few minutes or goes away and comes back pain or discomfort in one or both of your arms or shoulders; or your back, neck, or jaw shortness of breath sweating or light-headedness indigestion or nausea (feeling sick to your stomach) feeling very tiredTreatment works best when it is given right away. Warning signs can be different in different people. You may not have all of these symptoms.If you have angina, it’s important to know how and when to seek medical treatment.Women sometimes have nausea and vomiting, feel very tired (sometimes for days), and have pain in the back, shoulders, or jaw without any chest pain.People with diabetes-related nerve damage may not notice any chest pain.weakness or numbness of your face, arm, or leg on one side of your body confusion, or trouble talking or understanding dizziness, loss of balance, or trouble walking trouble seeing out of one or both eyes sudden severe headacheIf you have any one of these warning signs, call 9-1-1. You can help prevent permanent damage by getting to a hospital within an hour of a stroke. Heart Disease & Stroke The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. Low Blood Glucose (Hypoglycemia) Hypoglycemia occurs when your blood glucose drops too low. Certain diabetes medicines make low blood glucose more likely. You can prevent hypoglycemia by following your meal plan and balancing your physical activity, food, and medicines. Testing your blood glucose regularly can also help prevent hypoglycemia. What is hypoglycemia? Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in your blood drops below normal. For many people with diabetes, that means a level of 70 milligrams per deciliter (mg/dL) or less. Your numbers might be different, so check with your health care provider to find out what level is too low for you. What are the symptoms of hypoglycemia? Symptoms of hypoglycemia tend to come on quickly and can vary from person to person. You may have one or more mild-to-moderate symptoms listed in the table below. Sometimes people don’t feel any symptoms.Severe hypoglycemia is when your blood glucose level becomes so low that you’re unable to treat yourself and need help from another person. Severe hypoglycemia is dangerous and needs to be treated right away. This condition is more common in people with type 1 diabetes.Some symptoms of hypoglycemia during sleep arecrying out or having nightmares sweating enough to make your pajamas or sheets damp feeling tired, irritable, or confused after waking up What causes hypoglycemia in diabetes? Hypoglycemia can be a side effect of insulin or other types of diabetes medicines that help your body make more insulin. Two types of diabetes pills can cause hypoglycemia: sulfonylureas and meglitinides. Ask your health care team if your diabetes medicine can cause hypoglycemia.Although other diabetes medicines don’t cause hypoglycemia by themselves, they can increase the chances of hypoglycemia if you also take insulin, a sulfonylurea, or a meglitinide. What other factors contribute to hypoglycemia in diabetes? If you take insulin or diabetes medicines that increase the amount of insulin your body makes—but don’t match your medications with your food or physical activity—you could develop hypoglycemia. The following factors can make hypoglycemia more likely:When you eat foods containing carbohydrates, your digestive system breaks down the sugars and starches into glucose. Glucose then enters your bloodstream and raises your blood glucose level. If you don’t eat enough carbohydrates to match your medication, your blood glucose could drop too low.If you skip or delay a meal, your blood glucose could drop too low. Hypoglycemia also can occur when you are asleep and haven’t eaten for several hours.Increasing your physical activity level beyond your normal routine can lower your blood glucose level for up to 24 hours after the activity.Alcohol makes it harder for your body to keep your blood glucose level steady, especially if you haven’t eaten in a while. The effects of alcohol can also keep you from feeling the symptoms of hypoglycemia, which may lead to severe hypoglycemia.When you’re sick, you may not be able to eat as much or keep food down, which can cause low blood glucose. Learn more about taking care of your diabetes when you’re sick. How can I prevent hypoglycemia if I have diabetes? If you are taking insulin, a sulfonylurea, or a meglitinide, using your diabetes management plan and working with your health care team to adjust your plan as needed can help you prevent hypoglycemia. The following actions can also help prevent hypoglycemia:Knowing your blood glucose level can help you decide how much medicine to take, what food to eat, and how physically active to be. To find out your blood glucose level, check yourself with a blood glucose meter as often as your doctor advises.Hypoglycemia unawareness. Sometimes people with diabetes don’t feel or recognize the symptoms of hypoglycemia, a problem called hypoglycemia unawareness. If you have had hypoglycemia without feeling any symptoms, you may need to check your blood glucose more often so you know when you need to treat your hypoglycemia or take steps to prevent it. Be sure to check your blood glucose before you drive.If you have hypoglycemia unawareness or have hypoglycemia often, ask your health care provider about a continuous glucose monitor (CGM). A CGM checks your blood glucose level at regular times throughout the day and night. CGMs can tell you if your blood glucose is falling quickly and sound an alarm if your blood glucose falls too low. CGM alarms can wake you up if you have hypoglycemia during sleep.Your meal plan is key to preventing hypoglycemia. Eat regular meals and snacks with the correct amount of carbohydrates to help keep your blood glucose level from going too low. Also, if you drink alcoholic beverages, it’s best to eat some food at the same time.Physical activity can lower your blood glucose during the activity and for hours afterward. To help prevent hypoglycemia, you may need to check your blood glucose before, during, and after physical activity and adjust your medicine or carbohydrate intake. For example, you might eat a snack before being physically active or decrease your insulin dose as directed by your health care provider to keep your blood glucose from dropping too low.Tell your health care team if you have had hypoglycemia. Your health care team may adjust your diabetes medicines or other aspects of your management plan. Learn about balancing your medicines, eating plan, and physical activity to prevent hypoglycemia. Ask if you should have a glucagon emergency kit to carry with you at all times. How do I treat hypoglycemia? If you begin to feel one or more hypoglycemia symptoms, check your blood glucose. If your blood glucose level is below your target or less than 70, eat or drink 15 grams of carbohydrates right away. Examples includefour glucose tablets or one tube of glucose gel 1/2 cup (4 ounces) of fruit juice—not low-calorie or reduced sugar* 1/2 can (4 to 6 ounces) of soda—not low-calorie or reduced sugar 1 tablespoon of sugar, honey, or corn syrup 2 tablespoons of raisinsWait 15 minutes and check your blood glucose again. If your glucose level is still low, eat or drink another 15 grams of glucose or carbohydrates. Check your blood glucose again after another 15 minutes. Repeat these steps until your glucose level is back to normal.If your next meal is more than 1 hour away, have a snack to keep your blood glucose level in your target range. Try crackers or a piece of fruit. *People who have kidney disease shouldn’t drink orange juice for their 15 grams of carbohydrates because it contains a lot of potassium. Apple, grape, or cranberry juice are good options.If you take acarbose or miglitol along with diabetes medicines that can cause hypoglycemia, you will need to take glucose tablets or glucose gel if your blood glucose level is too low. Eating or drinking other sources of carbohydrates won’t raise your blood glucose level quickly enough. Low Blood Glucose (Hypoglycemia) Someone will need to give you a glucagon injection if you have severe hypoglycemia. An injection of glucagon will quickly raise your blood glucose level. Talk with your health care provider about when and how to use a glucagon emergency kit. If you have an emergency kit, check the date on the package to make sure it hasn’t expired.If you are likely to have severe hypoglycemia, teach your family, friends, and coworkers when and how to give you a glucagon injection. Also, tell your family, friends, and coworkers to call 911 right away after giving you a glucagon injection or if you don’t have a glucagon emergency kit with you.If you have hypoglycemia often or have had severe hypoglycemia, you should wear a medical alert bracelet or pendant. A medical alert ID tells other people that you have diabetes and need care right away. Getting prompt care can help prevent the serious problems that hypoglycemia can cause. Nerve Damage (Diabetic Neuropathy) Diabetic neuropathy is nerve damage that can result from diabetes. Different types of nerve damage affect different parts of your body. Managing your diabetes can help prevent nerve damage that affects your feet and limbs, and organs such as your heart. Nerve Damage (Diabetic Neuropathy) Kidney Disease Diabetic kidney disease, also called diabetic nephropathy, is kidney disease caused by diabetes. You can help protect your kidneys by managing your diabetes and meeting your blood pressure goals. What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes.Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.Watch a video about Diabetes and Kidney Disease.Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if yourblood glucose is too high blood pressure is too highAfrican Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.You are also more likely to develop kidney disease if you have diabetes andsmoke don’t follow your diabetes eating plan eat foods high in salt are not active are overweight have heart disease have a family history of kidney failure How can I tell if I have diabetic kidney disease? Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.You should get tested every year for kidney disease if youhave type 2 diabetes have had type 1 diabetes for more than 5 years How can I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall.Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.Healthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy:Stop smoking. Work with a dietitian to develop a diabetes meal plan and limit salt and sodium. Make physical activity part of your routine. Stay at or get to a healthy weight. Get enough sleep. Aim for 7 to 8 hours of sleep each night.Learn more about these tips to manage diabetes.Medicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure. How can I cope with the stress of managing my diabetes? Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Does diabetic kidney disease get worse over time? Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure.If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. Kidney Disease Foot Problems Diabetes can cause nerve damage and poor blood flow, which can lead to serious foot problems. Common foot problems, such as a callus, can lead to pain or an infection that makes it hard to walk. Get a foot checkup at each visit with your health care team. How can diabetes affect my feet? Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected.Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a bad infection never heals. The infection might lead to gangrene.Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg. A surgeon may perform an amputation to prevent a bad infection from spreading to the rest of your body, and to save your life. Good foot care is very important to prevent serious infections and gangrene.Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcot’s foot. Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a “rocker bottom.” What can I do to keep my feet healthy? Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should include foot care. A foot doctor, also called a podiatrist, and other specialists may be part of your health care team.Include these steps in your foot care plan:You may have foot problems, but feel no pain in your feet. Checking your feet each day will help you spot problems early before they get worse. A good way to remember is to check your feet each evening when you take off your shoes. Also check between your toes. If you have trouble bending over to see your feet, try using a mirror to see them, or ask someone else to look at your feet.Look for problems such ascuts, sores, or red spots swelling or fluid-filled blisters ingrown toenails, in which the edge of your nail grows into your skin corns or calluses, which are spots of rough skin caused by too much rubbing or pressure on the same spot plantar warts, which are flesh-colored growths on the bottom of the feet athlete’s foot warm spotsIf you have certain foot problems that make it more likely you will develop a sore on your foot, your doctor may recommend taking the temperature of the skin on different parts of your feet. A “hot spot” can be the first sign that a blister or an ulcer is starting.Cover a blister, cut, or sore with a bandage. Smooth corns and calluses as explained below.Wash your feet with soap in warm, not hot, water. Test the water to make sure it is not too hot. You can use a thermometer (90° to 95° F is safe) or your elbow to test the warmth of the water. Do not soak your feet because your skin will get too dry.After washing and drying your feet, put talcum powder or cornstarch between your toes. Skin between the toes tends to stay moist. Powder will keep the skin dry to help prevent an infection.Thick patches of skin called corns or calluses can grow on the feet. If you have corns or calluses, talk with your foot doctor about the best way to care for these foot problems. If you have nerve damage, these patches can become ulcers.If your doctor tells you to, use a pumice stone to smooth corns and calluses after bathing or showering. A pumice stone is a type of rock used to smooth the skin. Rub gently, only in one direction, to avoid tearing the skin.Do NOTcut corns and calluses use corn plasters, which are medicated pads use liquid corn and callus removersCutting and over-the counter corn removal products can damage your skin and cause an infection.To keep your skin smooth and soft, rub a thin coat of lotion, cream, or petroleum jelly on the tops and bottoms of your feet. Do not put lotion or cream between your toes because moistness might cause an infection.Trim your toenails, when needed, after you wash and dry your feet. Using toenail clippers, trim your toenails straight across. Do not cut into the corners of your toenail. Gently smooth each nail with an emery board or nonsharp nail file. Trimming this way helps prevent cutting your skin and keeps the nails from growing into your skin.Have a foot doctor trim your toenails ifyou cannot see, feel, or reach your feet your toenails are thick or yellowed your nails curve and grow into the skinIf you want to get a pedicure at a salon, you should bring your own nail tools to prevent getting an infection. You can ask your health care provider what other steps you can take at the salon to prevent infection.Wear shoes and socks at all times. Do not walk barefoot or in just socks – even when you are indoors. You could step on something and hurt your feet. You may not feel any pain and may not know that you hurt yourself.Check the inside of your shoes before putting them on, to make sure the lining is smooth and free of pebbles or other objects.Make sure you wear socks, stockings, or nylons with your shoes to keep from getting blisters and sores. Choose clean, lightly padded socks that fit well. Socks with no seams are best.Wear shoes that fit well and protect your feet. Here are some tips for finding the right type of shoes:Walking shoes and athletic shoes are good for daily wear. They support your feet and allow them to “breathe.” Do not wear vinyl or plastic shoes, because they do not stretch or “breathe.” When buying shoes, make sure they feel good and have enough room for your toes. Buy shoes at the end of the day, when your feet are the largest, so that you can find the best fit. If you have a bunion, or hammertoes, which are toes that curl under your feet, you may need extra-wide or deep shoes.1 Do not wear shoes with pointed toes or high heels, because they put too much pressure on your toes. If your feet have changed shape, such as from Charcot’s foot, you may need special shoes or shoe inserts, called orthotics. You also may need inserts if you have bunions, hammertoes, or other foot problems.When breaking in new shoes, only wear them for a few hours at first and then check your feet for areas of soreness.Medicare Part B insurance and other health insurance programs may help pay for these special shoes or inserts. Ask your insurance plan if it covers your special shoes or inserts.If you have nerve damage from diabetes, you may burn your feet and not know you did. Take the following steps to protect your feet from heat:Wear shoes at the beach and on hot pavement. Put sunscreen on the tops of your feet to prevent sunburn. Keep your feet away from heaters and open fires. Do not put a hot water bottle or heating pad on your feet.Wear socks in bed if your feet get cold. In the winter, wear lined, waterproof boots to keep your feet warm and dry.Try the following tips to improve blood flow to your feet:Put your feet up when you are sitting. Wiggle your toes for a few minutes throughout the day. Move your ankles up and down and in and out to help blood flow in your feet and legs. Do not wear tight socks or elastic stockings. Do not try to hold up loose socks with rubber bands. Be more physically active. Choose activities that are easy on your feet, such as walking, dancing, yoga or stretching, swimming, or bike riding. Stop smoking.Smoking can lower the amount of blood flow to your feet. If you smoke, ask for help to stop. You can get help by calling the national quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to SmokeFree.gov.Ask your health care team to check your feet at each visit. Take off your shoes and socks when you’re in the exam room so they will remember to check your feet. At least once a year, get a thorough foot exam, including a check of the feeling and pulses in your feet.Get a thorough foot exam at each health care visit if you havechanges in the shape of your feet loss of feeling in your feet peripheral artery disease had foot ulcers or an amputation in the past1Ask your health care team to show you how to care for your feet. When should I see my health care provider about foot problems? Call your health care provider right away if you havea cut, blister, or bruise on your foot that does not start to heal after a few days skin on your foot that becomes red, warm, or painful—signs of a possible infection a callus with dried blood inside of it,which often can be the first sign of a wound under the callus a foot infection that becomes black and smelly—signs you might have gangreneAsk your provider to refer you to a foot doctor, or podiatrist, if needed. Foot Problems The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. Eye Disease Diabetes can damage your eyes and lead to low vision and blindness. The best way to prevent eye disease is to manage your blood glucose, blood pressure, and cholesterol; and to not smoke. Also, have a dilated eye exam at least once a year. What is diabetic eye disease? Diabetic eye disease is a group of eye problems that can affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.Over time, diabetes can cause damage to your eyes that can lead to poor vision or even blindness. But you can take steps to prevent diabetic eye disease, or keep it from getting worse, by taking care of your diabetes.The best ways to manage your diabetes and keep your eyes healthy are tomanage your blood glucose, blood pressure, and cholesterol, sometimes called the diabetes ABCs If you smoke, get help to quit smoking have a dilated eye exam once a yearOften, there are no warning signs of diabetic eye disease or vision loss when damage first develops. A full, dilated eye exam helps your doctor find and treat eye problems early—often before much vision loss can occur. How does diabetes affect my eyes? Diabetes affects your eyes when your blood glucose, also called blood sugar, is too high.In the short term, you are not likely to have vision loss from high blood glucose. People sometimes have blurry vision for a few days or weeks when they’re changing their diabetes care plan or medicines. High glucose can change fluid levels or cause swelling in the tissues of your eyes that help you to focus, causing blurred vision. This type of blurry vision is temporary and goes away when your glucose level gets closer to normal.If your blood glucose stays high over time, it can damage the tiny blood vessels in the back of your eyes. This damage can begin during prediabetes, when blood glucose is higher than normal, but not high enough for you to be diagnosed with diabetes. Damaged blood vessels may leak fluid and cause swelling. New, weak blood vessels may also begin to grow. These blood vessels can bleed into the middle part of the eye, lead to scarring, or cause dangerously high pressure inside your eye.Most serious diabetic eye diseases begin with blood vessel problems. The four eye diseases that can threaten your sight areThe retina is the inner lining at the back of each eye. The retina senses light and turns it into signals that your brain decodes, so you can see the world around you. Damaged blood vessels can harm the retina, causing a disease called diabetic retinopathy.In early diabetic retinopathy, blood vessels can weaken, bulge, or leak into the retina. This stage is called nonproliferative diabetic retinopathy.If the disease gets worse, some blood vessels close off, which causes new blood vessels to grow, or proliferate, on the surface of the retina. This stage is called proliferative diabetic retinopathy. These abnormal new blood vessels can lead to serious vision problems.The part of your retina that you need for reading, driving, and seeing faces is called the macula. Diabetes can lead to swelling in the macula, which is called diabetic macular edema. Over time, this disease can destroy the sharp vision in this part of the eye, leading to partial vision loss or blindness. Macular edema usually develops in people who already have other signs of diabetic retinopathy.Glaucoma is a group of eye diseases that can damage the optic nerve—the bundle of nerves that connects the eye to the brain. Diabetes doubles the chances of having glaucoma, which can lead to vision loss and blindness if not treated early.Symptoms depend on which type of glaucoma you have. Learn more about glaucoma.The lenses within our eyes are clear structures that help provide sharp vision—but they tend to become cloudy as we age. People with diabetes are more likely to develop cloudy lenses, called cataracts. People with diabetes can develop cataracts at an earlier age than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes. How common is diabetic eye disease? About one in three people with diabetes who are older than age 40 already have some signs of diabetic retinopathy.1 Diabetic retinopathy is the most common cause of vision loss in people with diabetes. Each person’s outlook for the future, however, depends in large part on regular care. Finding and treating diabetic retinopathy early can reduce the risk of blindness by 95 percent.Your chances of developing glaucoma or cataracts are about twice that of someone without diabetes. Who is more likely to develop diabetic eye disease? Anyone with diabetes can develop diabetic eye disease. Your risk is greater withhigh blood glucose that is not treated high blood pressure that is not treatedHigh blood cholesterol and smoking may also raise your risk for diabetic eye disease.Some groups are affected more than others. African Americans, American Indians and Alaska Natives, Hispanics/Latinos, Pacific Islanders, and older adults are at greater risk of losing vision or going blind from diabetes.If you have diabetes and become pregnant, you can develop eye problems very quickly during your pregnancy. If you already have some diabetic retinopathy, it can get worse during pregnancy. Changes that help your body support a growing baby may put stress on the blood vessels in your eyes. Your health care team will suggest regular eye exams during pregnancy to catch and treat problems early and protect your vision.Diabetes that occurs only during pregnancy, called gestational diabetes, does not usually cause eye problems. Researchers aren't sure why this is the case.Your chances of developing diabetic eye disease increase the longer you have diabetes. What are the symptoms of diabetic eye disease? Often there are no early symptoms of diabetic eye disease. You may have no pain and no change in your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy.When symptoms do occur, they may includeblurry or wavy vision frequently changing vision—sometimes from day to day dark areas or vision loss poor color vision spots or dark strings (also called floaters) flashes of lightTalk with your eye doctor if you have any of these symptoms. When should I see a doctor right away? Call a doctor right away if you notice sudden changes to your vision, including flashes of light or many more spots (floaters) than usual. You also should see a doctor right away if it looks like a curtain is pulled over your eyes. These changes in your sight can be symptoms of a detached retina, which is a medical emergency. How do doctors diagnose eye problems from diabetes? Having a full, dilated eye exam is the best way to check for eye problems from diabetes. Your doctor will place drops in your eyes to widen your pupils. This allows the doctor to examine a larger area at the back of each eye, using a special magnifying lens. Your vision will be blurry for a few hours after a dilated exam.Your doctor will alsotest your vision measure the pressure in your eyesYour doctor may suggest other tests, too, depending on your health history.Most people with diabetes should see an eye care professional once a year for a complete eye exam. Your own health care team may suggest a different plan, based on your type of diabetes and the time since you were first diagnosed. How do doctors treat diabetic eye disease? Your doctor may recommend having eye exams more often than once a year, along with management of your diabetes. This means managing your diabetes ABCs, which include your A1c, blood pressure, and cholesterol; and quitting smoking. Ask your health care team what you can do to reach your goals.Doctors may treat advanced eye problems with medicine, laser treatments, surgery, or a combination of these options.Your doctor may treat your eyes with anti-VEGF medicine, such as aflibercept, bevacizumab, or ranibizumab. These medicines block the growth of abnormal blood vessels in the eye. Anti-VEGF medicines can also stop fluid leaks, which can help treat diabetic macular edema.The doctor will inject an anti-VEGF medicine into your eyes during office visits. You'll have several treatments during the first few months, then fewer treatments after you finish the first round of therapy. Your doctor will use medicine to numb your eyes so you don’t feel pain. The needle is about the thickness of a human hair.Anti-VEGF treatments can stop further vision loss and may improve vision in some people.Laser treatment, also called photocoagulation, creates tiny burns inside the eye with a beam of light. This method treats leaky blood vessels and extra fluid, called edema. Your doctor usually provides this treatment during several office visits, using medicine to numb your eyes. Laser treatment can keep eye disease from getting worse, which is important to prevent vision loss or blindness. But laser treatment is less likely to bring back vision you’ve already lost compared with anti-VEGF medicines.There are two types of laser treatment:Focal/grid laser treatment works on a small area of the retina to treat diabetic macular edema. Scatter laser treatment, also called panretinal photocoagulation (PRP), covers a larger area of the retina. This method treats the growth of abnormal blood vessels, called proliferative diabetic retinopathy.Vitrectomy is a surgery to remove the clear gel that fills the center of the eye, called the vitreous gel. The procedure treats problems with severe bleeding or scar tissue caused by proliferative diabetic retinopathy. Scar tissue can force the retina to peel away from the tissue beneath it, like wallpaper peeling away from a wall. A retina that comes completely loose, or detaches, can cause blindness.During vitrectomy, a clear salt solution is gently pumped into the eye to maintain eye pressure during surgery and to replace the removed vitreous. Vitrectomy is done in a surgery center or hospital with pain medicine.In a surgery center or hospital visit, your doctor can remove the cloudy lens in your eye, where the cataract has grown, and replace it with an artificial lens. People who have cataract surgery generally have better vision afterward. After your eye heals, you may need a new prescription for your glasses. Your vision following cataract surgery may also depend on treating any damage from diabetic retinopathy or macular edema. What can I do to protect my eyes? To prevent diabetic eye disease, or to keep it from getting worse, manage your diabetes ABCs: your A1c, blood pressure, and cholesterol; and quit smoking if you smoke. Read more information on how to manage diabetes.Also, have a dilated eye exam at least once a year—or more often if recommended by your eye care professional. These actions are powerful ways to protect the health of your eyes—and can prevent blindness.The sooner you work to manage your diabetes and other health conditions, the better. And, even if you’ve struggled in the past to manage your health, taking better care of yourself now can protect your eyes for the future. It’s never too late to begin. What if I already have some vision loss from diabetes? Ask your eye care professional to help you find a low vision and rehabilitation clinic. Special eye care professionals can help you manage vision loss that cannot be corrected with glasses, contact lenses, medicine, or surgery. Special devices and training may help you make the most of your remaining vision so that you can continue to be active, enjoy hobbies, visit friends and family members, and live without help from others. Eye Disease Gum Disease and Other Dental Problems Diabetes can lead to problems in your mouth, such as infection, gum disease, or dry mouth. To help keep your mouth healthy, manage your blood glucose, brush your teeth twice a day, see your dentist at least once a year, and don’t smoke. Gum Disease & Other Dental Problems Sexual and Urologic Problems Having diabetes can increase your chance of having bladder problems and changes in sexual function. Following your diabetes management plan is important to help prevent or delay sexual and urologic problems. Diabetes and Sexual Problems Both men and women with diabetes can develop sexual problems because of damage to nerves and small blood vessels. When a person wants to lift an arm or take a step, the brain sends nerve signals to the appropriate muscles. Nerve signals also control internal organs like the heart and bladder, but people do not have the same kind of conscious control over them as they do over their arms and legs. The nerves that control internal organs are called autonomic nerves, which signal the body to digest food and circulate blood without a person having to think about it. The body's response to sexual stimuli is also involuntary, governed by autonomic nerve signals that increase blood flow to the genitals and cause smooth muscle tissue to relax. Damage to these autonomic nerves can hinder normal function. Reduced blood flow resulting from damage to blood vessels can also contribute to sexual dysfunction. What sexual problems can occur in men with diabetes? Erectile dysfunction is a consistent inability to have an erection firm enough for sexual intercourse. The condition includes the total inability to have an erection and the inability to sustain an erection.Estimates of the prevalence of erectile dysfunction in men with diabetes vary widely, ranging from 20 to 75 percent. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Research suggests that erectile dysfunction may be an early marker of diabetes, particularly in men ages 45 and younger.In addition to diabetes, other major causes of erectile dysfunction include high blood pressure, kidney disease, alcohol abuse, and blood vessel disease. Erectile dysfunction may also occur because of the side effects of medications, psychological factors, smoking, and hormonal deficiencies.Men who experience erectile dysfunction should consider talking with a health care provider. The health care provider may ask about the patient's medical history, the type and frequency of sexual problems, medications, smoking and drinking habits, and other health conditions. A physical exam and laboratory tests may help pinpoint causes of sexual problems. The health care provider will check blood glucose control and hormone levels and may ask the patient to do a test at home that checks for erections that occur during sleep. The health care provider may also ask whether the patient is depressed or has recently experienced upsetting changes in his life.Treatments for erectile dysfunction caused by nerve damage, also called neuropathy, vary widely and range from oral pills, a vacuum pump, pellets placed in the urethra, and shots directly into the penis, to surgery. All of these methods have advantages and disadvantages. Psychological counseling to reduce anxiety or address other issues may be necessary. Surgery to implant a device to aid in erection or to repair arteries is usually used as a treatment after all others fail.Retrograde ejaculation is a condition in which part or all of a man's semen goes into the bladder instead of out the tip of the penis during ejaculation. Retrograde ejaculation occurs when internal muscles, called sphincters, do not function normally. A sphincter automatically opens or closes a passage in the body. With retrograde ejaculation, semen enters the bladder, mixes with urine, and leaves the body during urination without harming the bladder. A man experiencing retrograde ejaculation may notice that little semen is discharged during ejaculation or may become aware of the condition if fertility problems arise. Analysis of a urine sample after ejaculation will reveal the presence of semen.Poor blood glucose control and the resulting nerve damage can cause retrograde ejaculation. Other causes include prostate surgery and some medications.Retrograde ejaculation caused by diabetes or surgery may be helped with a medication that strengthens the muscle tone of the sphincter in the bladder. A urologist experienced in infertility treatments may assist with techniques to promote fertility, such as collecting sperm from the urine and then using the sperm for artificial insemination. What sexual problems can occur in women with diabetes? Many women with diabetes experience sexual problems. Although research about sexual problems in women with diabetes is limited, one study found 27 percent of women with type 1 diabetes experienced sexual dysfunction. Another study found 18 percent of women with type 1 diabetes and 42 percent of women with type 2 diabetes experienced sexual dysfunction.Sexual problems may includedecreased vaginal lubrication, resulting in vaginal dryness uncomfortable or painful sexual intercourse decreased or no desire for sexual activity decreased or absent sexual responseDecreased or absent sexual response can include the inability to become or remain aroused, reduced or no sensation in the genital area, and the constant or occasional inability to reach orgasm.Causes of sexual problems in women with diabetes include nerve damage, reduced blood flow to genital and vaginal tissues, and hormonal changes. Other possible causes include some medications, alcohol abuse, smoking, psychological problems such as anxiety or depression, gynecologic infections, other diseases, and conditions relating to pregnancy or menopause.Women who experience sexual problems or notice a change in sexual response should consider talking with a health care provider. The health care provider will ask about the patient's medical history, any gynecologic conditions or infections, the type and frequency of sexual problems, medications, smoking and drinking habits, and other health conditions. The health care provider may ask whether the patient might be pregnant or has reached menopause and whether she is depressed or has recently experienced upsetting changes in her life. A physical exam and laboratory tests may also help pinpoint causes of sexual problems. The health care provider will also talk with the patient about blood glucose control.Prescription or over-the-counter vaginal lubricants may be useful for women experiencing vaginal dryness. Techniques to treat decreased sexual response include changes in position and stimulation during sexual relations. Psychological counseling may be helpful. Kegel exercises that help strengthen the pelvic muscles may improve sexual response. Studies of drug treatments are under way. Diabetes and Urologic Problems Urologic problems that affect men and women with diabetes include bladder problems and urinary tract infections. Sexual & Urologic Problems
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Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week.
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Diabetes What is Diabetes? Too Much Glucose in the Blood Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type 1, type 2, and gestational diabetes. The result of type 1 and type 2 diabetes is the same: glucose builds up in the blood, while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, oftentimes leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation. Type 1 Diabetes Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Type 2 Diabetes Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. Gestational Diabetes Some women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Although this form of diabetes usually goes away after the baby is born, a woman who has had it and her child are more likely to develop diabetes later in life. Prediabetes Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Signs of Diabetes Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. How Many Have Diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) If Diabetes is Not Managed Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, heart, gums and teeth. If you have diabetes, you are more likely than people without diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure and cholesterol and to avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Risk Factors Diabetes is a serious, life-long disease. It can lead to problems such as heart disease, stroke, vision loss, kidney disease, and nerve damage. More than 8 million people in the United States have type 2 diabetes and don’t know it. Many people don’t find out they have diabetes until they are faced with problems such as blurry vision or heart trouble. Certain factors can increase your risk for diabetes, and it’s important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body’s own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a person’s risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Learn more about the causes of type 2 diabetes. Prediabetes and Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. People with prediabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Prediabetes is increasingly common in the U.S. adult population. In 2012, about 86 million people in the U.S. had pre-diabetes, and 51% of those 65 or older had prediabetes. Learn more about prediabetes. Gestational Diabetes Some women develop diabetes during the late stages of pregnancy. This is called gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it has a lifelong risk for developing diabetes, mostly type 2. Prevention The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that type 2 diabetes can be prevented or delayed in people at risk for the disease. Preventing type 2 diabetes can mean a healthier and longer life without serious complications from the disease such as heart disease, stroke, blindness, kidney failure, and amputations. Preventing Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes. The good news is that if you have prediabetes, there are ways to reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes Benefits of Weight Loss and Exercise The Diabetes Prevention Program (DPP) is a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases. DPP researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The drug metformin reduced the risk of type 2 diabetes by 34 percent but was more effective in younger and heavier adults. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) The benefits of weight loss and regular exercise have long-lasting value. In a DPP follow-up trial known as the Diabetes Prevention Program Outcome Study (DPPOS), people at risk of type 2 diabetes who kept off the weight they had lost and who continued to exercise regularly delayed the onset of type 2 diabetes by about 4 years. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. How to Lower Your Risk Making modest lifestyle changes can help prevent or delay type 2 diabetes in people who are at risk. Here are some tips. Reach and Maintain a Reasonable Body Weight Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. The Body Mass Index chart (seen here) can be used to find out whether someone is normal weight, overweight, or obese. Body mass index is a measurement of body weight relative to height for adults age 20 or older. To use the chart - find the person's height in the left-hand column - move across the row to find the number closest to the person's weight - find the number at the top of that column - The number at the top of the column is the person’s BMI. find the person's height in the left-hand column move across the row to find the number closest to the person's weight find the number at the top of that column The number at the top of the column is the person’s BMI. The words above the BMI number indicate whether the person is normal weight, overweight, or obese. People who are overweight or obese should consider talking with a health care provider about ways to lose weight and reduce the risk of diabetes. The BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle. Waist Measurement. In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for type 2 diabetes. This is true even if a person’s body mass index (BMI) falls within the normal range. To measure the waist, a person should - place a tape measure around the bare abdomen just above the hip bone - make sure the tape is snug but isn’t digging into the skin and is parallel to the floor - relax, exhale, and measure. place a tape measure around the bare abdomen just above the hip bone make sure the tape is snug but isn’t digging into the skin and is parallel to the floor relax, exhale, and measure. Make Healthy Food Choices What you eat has a big impact on your weight and overall health. By developing healthy eating habits, you can help manage your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Here are more tips for eating well with diabetes. - Make a diabetes meal plan with help from your health care team. - Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. - Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. - Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. - Drink water instead of juice and regular soda. - When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. Make a diabetes meal plan with help from your health care team. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. Drink water instead of juice and regular soda. When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. For more about healthy eating and older adults see "Eating Well as You Get Older." Be Physically Active Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways. It - helps you lose weight - controls your cholesterol and blood pressure - improves your body's use of insulin. helps you lose weight controls your cholesterol and blood pressure improves your body's use of insulin. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. For more information on exercise and older adults, see Exercises to Try or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Signs and Diagnosis Diabetes is often called a "silent" disease because it can cause serious complications even before you have symptoms. Symptoms can also be so mild that you don’t notice them. An estimated 8 million people in the United States have type 2 diabetes and don’t know it, according to 2012 estimates by the Centers for Disease Control and Prevention (CDC). Common Signs Some common symptoms of diabetes are: - being very thirsty - frequent urination - feeling very hungry or tired - losing weight without trying - having sores that heal slowly - having dry, itchy skin - loss of feeling or tingling in the feet - having blurry eyesight. being very thirsty frequent urination feeling very hungry or tired losing weight without trying having sores that heal slowly having dry, itchy skin loss of feeling or tingling in the feet having blurry eyesight. Signs of type 1 diabetes usually develop over a short period of time. The signs for type 2 diabetes develop more gradually. Tests for Diabetes The following tests are used to diagnose diabetes or prediabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. - An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. Get more details about tests for diabetes. Who Should Get Tested? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. See risk factors for type 2 diabetes. Why Early Detection is Important Diabetes is a serious disease that can lead to a number of health problems such as heart disease, stroke, vision problems, kidney disease and even death. Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as a heart attack or stroke. Finding out early if you have diabetes is important because treatment can prevent or delay the complications of the disease. Diet and Exercise Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. People with type 1 diabetes manage their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can manage blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both. Diabetes is a progressive disease and, over time, people with diabetes may need both lifestyle modification and medications. Follow a Meal Plan Making healthy food choices is very important to help keep your blood glucose level under control. A registered dietitian can work with you to develop a healthy eating plan. He or she can help you design a meal plan that takes into consideration various factors including your weight and daily physical activity, blood glucose levels, other health conditions and medications. If you are overweight, a plan to help you achieve a weight that is right for you will help manage your blood glucose. Your dietitian can help you plan meals to include foods that you and your family like to eat and that are good for you. (Watch the video to learn about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What to Eat People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in your target range, and prevent or delay heart and blood vessel disease. For more information on nutrition and older adults, see Eating Well As You Get Older. Get Regular Physical Activity Regular physical activity is important for people with diabetes. Being physically active has been shown to improve blood glucose levels in older people whose levels are high. Exercise is especially good for people with diabetes because it - helps manage weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps manage weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Safety First Before you begin physical activity, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some activities like weightlifting may not be safe. Your health care team can help you find safe ways to be active. For tips on safety issues older adults should consider before starting a new exercise program, see Exercise: Safety First Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to be physically active. You can even get exercise when you clean house or work in your garden. How Much? How Often? Try to be active almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) To see examples of exercises for older adults, see Exercises to Try. Or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Medications Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Diabetes pills and insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. People with type 1 diabetes control their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Taking Diabetes Pills If your body is still making some insulin, but not enough to keep your blood glucose levels under control, you may need diabetes pills. Some medications are taken once a day; others must be taken more often. Ask your health care team when you should take your pills. Remember to take your medicines every day, even when you feel well. Be sure to tell your doctor if your pills make you feel sick or if you have any other problems. Remember, diabetes pills don't lower blood glucose all by themselves. You will still want to follow a meal plan and exercise to help lower your blood glucose. Taking Insulin You need insulin if your body has stopped making insulin or if your body doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. Insulin can't be taken as a pill. It is usually taken by shots or with an insulin pump or insulin pen. Insulin pumps are small machines, usually worn on the hip, that contain insulin and deliver small steady doses of insulin throughout the day, Some pumps are attached directly to the skin. Other people use an insulin pen, which holds a cartridge of insulin that is dialed to the prescribed dose of insulin and then injected. Sometimes, people who take diabetes pills may need insulin shots for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose. Get more information about taking diabetes medicines. Know Your Diabetes ABCs Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol A is for the A1C test B is for Blood pressure C is for Cholesterol The A1C Test The A1C test (A-one-C), also called the hemoglobin A1C test, shows overall blood glucose for the past 3 months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. If your A1C is above your target goal, take action. You may need a change in your meal plan, your level of physical activity, or the medications you take to lower your chance of getting diabetes problems like heart disease or kidney damage. Talk with your health care provider about your A1C goal and how to reach it. Learn more about the A1C test. Check Your Blood Pressure High blood pressure makes your heart work too hard. This can lead to a stroke and other problems such as kidney disease. Your blood pressure should be checked at every doctor visit. The target blood pressure for most people with diabetes is less than 140/90 but may be different for you. Talk with your health care provider about your blood pressure goal. Learn about ways to check your blood pressure. Have Your LDL Cholesterol Checked Low density lipoprotein, or LDL cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Learn more about lowering LDL cholesterol. Stop Smoking Smoking and diabetes are a dangerous mix. Smoking raises your risk for many diabetes problems. If you quit smoking, - you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation - your cholesterol and blood pressure levels might improve - your blood circulation will improve. you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation your cholesterol and blood pressure levels might improve your blood circulation will improve. If you smoke, stop smoking. Ask for help so that you don’t have to do it alone. You can start by calling 1–800–QUITNOW or 1–800–784–8669. For more on how to quit smoking, see Quitting Smoking for Older Adults. Manage Your Diabetes Every Day Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Know What To Do Every Day To manage your diabetes, here are things to do every day. - Take your medicines. - Keep track of your blood glucose (blood sugar). - Check your blood pressure if your doctor advises. - Check your feet. - Brush your teeth and floss. - Stop smoking. - Eat well. - Be active. Take your medicines. Keep track of your blood glucose (blood sugar). Check your blood pressure if your doctor advises. Check your feet. Brush your teeth and floss. Stop smoking. Eat well. Be active. (Watch the video to learn more about what one woman does to manage her diabetes every day. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Take Your Diabetes Medicines People with type 1 diabetes control their blood sugar with insulin -- delivered either by injection or with a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Ask your doctor if you need to take aspirin every day to prevent a heart attack or stroke. Keep Track of Your Blood Glucose One of the best ways to find out how well you are taking care of your diabetes is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medication. Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three a day or even more. You may be told to check before eating, before bed, and sometimes in the middle of the night. Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for some of the supplies and equipment you need to check your glucose levels. See what diabetes supplies and services Medicare covers. Check Your Blood Pressure Check your blood pressure if your doctor advises and keep a record of it. You can check your pressure at home with a home blood pressure measurement device or monitor. Blood pressure monitors can be bought at discount chain stores and drug stores. When you are taking your blood pressure at home, sit with your back supported and your feet flat on the floor. Rest your arm on a table at the level of your heart. Check with your health care provider to make sure you are using the monitor correctly. Check Your Feet Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. Brush Your Teeth and Floss People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose also can make tooth and gum problems worse. You can even lose your teeth. Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. Learn more about how diabetes can affect your mouth and teeth. Stop Smoking If you smoke, stop. Smoking raises your risk for many diabetes problems, including heart attack and stroke. Ask for help to quit. Call 1-800 QUITNOW (1-800-784-8669). For more information on smoking and older adults, see Quitting Smoking for Older Adults. Eat Well People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in a desirable range, and prevent or delay heart and blood vessel disease. For more on healthy eating, see Small Steps for Eating Healthy Foods. Be Active Try to exercise almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercise: How to Get Started or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be sure to check with your doctor before starting an exercise program. Other Areas To Manage Here are other areas to manage if you have diabetes. - Take care of your eyes. - Protect your kidneys. - Protect your skin. - Learn how to cope with stress. Take care of your eyes. Protect your kidneys. Protect your skin. Learn how to cope with stress. Take Care of Your Eyes High blood glucose and high blood pressure from diabetes can hurt your eyes. It can even cause blindness, or other painful eye problems. Here are ways to prevent diabetes eye problems. - Keep your blood glucose and blood pressure as close to normal as you can. - Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Keep your blood glucose and blood pressure as close to normal as you can. Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Learn more about eye disease and diabetes. Protect Your Kidneys High blood glucose and high blood pressure may damage the kidneys. Damaged kidneys do not do a good job of filtering out wastes and extra fluid. Here are ways to prevent diabetes kidney problems. - Keep your blood glucose and blood pressure as close to your target goal as you can. - Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. - Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Keep your blood glucose and blood pressure as close to your target goal as you can. Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Learn more about keeping your kidneys healthy. Protect Your Skin Skin care is very important, too. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean and taking care of minor cuts and bruises. Learn How To Cope With Stress Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music. Frequently Asked Questions What is diabetes? Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. What is the difference between type 1 and type 2 diabetes? Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Learn more about type 1 diabetes here. Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. How many people have diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) What is prediabetes? Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. In 2012, about 86 million people in the U.S. had prediabetes, and 51% of those 65 or older had prediabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Why can I do about prediabetes? Studies have shown that most people with prediabetes develop type 2 diabetes within a few years, unless they change their lifestyle. Most people with prediabetes don’t have any symptoms. Your doctor can test your blood to find out if your blood glucose levels are higher than normal. Losing weight—at least 5 to 10 percent of your starting weight—can prevent or delay diabetes or even reverse prediabetes. That’s 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting the amount of calories and fat you consume and by being physically active at least 30 to 60 minutes every day. Physical activity also helps your body use the hormone insulin properly. Your body needs insulin to use glucose for energy. Medicine can help control the amount of glucose in your blood. Ask your doctor if medicine to control glucose is right for you. Learn more about prediabetes here. What are the signs of diabetes? Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. What causes diabetes? Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body's own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the insulin-producing cells in the pancreas in people with type 1 diabetes. However, many believe that both genetic factors and environmental factors are involved. Studies now are underway to identify these factors and prevent type 1 diabetes in people at risk. Type 2 diabetes—the most common form of diabetes—is caused by a combination of factors, including insulin resistance, a condition in which the body’s muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. Get more details about who should be tested for diabetes. If diabetes is not managed, what problems might occur? Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, and heart, gums and teeth. If you have diabetes, you are more likely than someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure, and cholesterol and avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Who is at risk for developing type 2 diabetes? Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Can diabetes be prevented? The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that making modest lifestyle changes can prevent or delay type 2 diabetes in people at risk for the disease. In the Diabetes Prevention Program (DPP), a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases, researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What kind of meal plan should a person with diabetes follow? Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. This plan, often called medical nutrition therapy, will include regular monitoring by your dietitian and education about how to adjust your eating habits as the need occurs. Medical nutrition therapy is usually covered by insurance or Medicare as long as your doctor refers you. Your dietitian can help you plan meals that include foods that you and your family like and that are good for you. Your healthy eating plan will include - breads, cereals, rice, and whole grains - fruits and vegetables - meat and meat substitutes - dairy products - healthy fats. breads, cereals, rice, and whole grains fruits and vegetables meat and meat substitutes dairy products healthy fats. Your plan will also help you learn how to eat the right amount, or portions, of food. Making good food choices will - help you reach and stay at a healthy weight - keep your blood glucose, blood pressure, and cholesterol levels under control - prevent heart and blood vessel disease. help you reach and stay at a healthy weight keep your blood glucose, blood pressure, and cholesterol levels under control prevent heart and blood vessel disease. (Watch the video to learn more about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) If I have diabetes, should I avoid all sweets and sugars? If you have diabetes you should limit the amount of fats and sweets you eat. These foods have calories, but not much nutrition. Some contain saturated fats and cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and keep your blood glucose and blood fats under control. It is okay to have sweets once in a while. Try having sugar-free popsicles, diet soda, fat-free ice cream or frozen yogurt, or sugar-free hot cocoa mix to satisfy a "sweet tooth." Remember, fat-free and low sugar foods still have calories. Talk with your diabetes educator about how to fit sweets into your meal plan. Who should be tested for diabetes? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. Get more information about tests for diabetes. How do doctors diagnose diabetes and pre-diabetes? Doctors use the following tests to diagnose diabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. - An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. How do I manage my diabetes every day? People with type 1 diabetes control their blood sugar with insulin -- either with shots or an insulin pen. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some people may need to take both, along with lifestyle modification. (Watch the video to learn how one woman manages her type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) To manage your diabetes, here are things to do every day. - Take your medicines for diabetes and for any other health problems, even when you feel good. Take your medicines for diabetes and for any other health problems, even when you feel good. - Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. - Check your blood pressure if your doctor advises and keep a record of it. Check your blood pressure if your doctor advises and keep a record of it. - Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. - Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. - Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) - Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. - Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. How should I take care of my feet? Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. How can diabetes affect my teeth and gums? People with diabetes can have tooth and gum problems more often if their blood glucose stays high. Glucose is present in your saliva—the fluid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful bacteria grow. These bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease and bad breath. The most common mouth problems from diabetes are - gingivitis (unhealthy or inflamed gums) - periodontitis (an infection of the gums) - thrush or candidiasis - dry mouth - oral burning (a burning sensation inside the mouth). gingivitis (unhealthy or inflamed gums) periodontitis (an infection of the gums) thrush or candidiasis dry mouth oral burning (a burning sensation inside the mouth). How can I protect my teeth and gums? Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. What kinds of medication do people take for diabetes? Controlling blood glucose (blood sugar) is the best defense against the serious complications of diabetes. Insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. You need insulin if your body has stopped making insulin or if it doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. If your body makes insulin but the insulin doesn't lower your blood glucose, you may need diabetes pills. What are the ABCs of diabetes? Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol, as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol. A is for the A1C test B is for Blood pressure C is for Cholesterol. - The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. - B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. - C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Ask your health care team - what your A1C, blood pressure, and cholesterol numbers are. - what your ABCs should be. - what you can do to reach your target. what your A1C, blood pressure, and cholesterol numbers are. what your ABCs should be. what you can do to reach your target. How should I work with my health care team to manage my diabetes? See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goals. If you have diabetes, take these steps. At each visit, be sure you have a - blood pressure check - foot check - weight check - review of your self-care plan. blood pressure check foot check weight check review of your self-care plan. Two times each year, get - an A1C test. It may be checked more often if it is over 7. an A1C test. It may be checked more often if it is over 7. Once each year, be sure you have a - cholesterol test - triglyceride (try-GLISS-er-ide) test - a type of blood fat - complete foot exam - dental exam to check teeth and gums. Tell your dentist you have diabetes. - dilated eye exam to check for eye problems - flu shot - urine and a blood test to check for kidney problems. cholesterol test triglyceride (try-GLISS-er-ide) test - a type of blood fat complete foot exam dental exam to check teeth and gums. Tell your dentist you have diabetes. dilated eye exam to check for eye problems flu shot urine and a blood test to check for kidney problems. At least once, get a - pneumonia (nu-MOH-nya) shot. pneumonia (nu-MOH-nya) shot. If you have Medicare, ask your health care team if Medicare will cover some of the costs for - learning about healthy eating and diabetes self-care - special shoes, if you need them - medical supplies - diabetes medicines. learning about healthy eating and diabetes self-care special shoes, if you need them medical supplies diabetes medicines. (Watch the video for important things to remember when visiting your health care team. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Why is exercise important in controlling diabetes? Exercise is especially good for people with diabetes because it - helps control weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps control weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises may not be safe. Your health care team can help you find safe exercises. What types of exercise should I do, and how often? People with diabetes should - do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. - do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. - stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercises To Try or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Always talk with a doctor before starting a new physical activity program. What steps can I take to lose weight to prevent or delay type 2 diabetes? Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. If you are overweight or obese, choose sensible ways to reach and maintain a reasonable body weight. - Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. - Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Does Medicare help pay for services and supplies for people with diabetes? Medicare helps pay for certain services and supplies for people with diabetes who have Medicare Part B. All require a doctor's prescription. The diabetes-related services and supplies that are covered include - blood sugar monitor and supplies - an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. - dilated eye examinations to check for diabetic eye diseases - glaucoma screening - flu and pneumonia shots - diabetes self-management training - medical nutrition therapy services. blood sugar monitor and supplies an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. dilated eye examinations to check for diabetic eye diseases glaucoma screening flu and pneumonia shots diabetes self-management training medical nutrition therapy services. Get more information about the diabetes supplies and services covered by Medicare. You can also contact the Centers for Medicare and Medicaid Services at 1-800-MEDICARE, or 1-800-633-4227. TTY users dial 1-877-486-2048.
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what are the risk factors of type ii diabetes
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Certain factors can increase your risk for diabetes, and its important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the bodys own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a persons risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels --
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Diabetes What is Diabetes? Too Much Glucose in the Blood Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type 1, type 2, and gestational diabetes. The result of type 1 and type 2 diabetes is the same: glucose builds up in the blood, while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, oftentimes leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation. Type 1 Diabetes Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Type 2 Diabetes Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. Gestational Diabetes Some women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Although this form of diabetes usually goes away after the baby is born, a woman who has had it and her child are more likely to develop diabetes later in life. Prediabetes Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Signs of Diabetes Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. How Many Have Diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) If Diabetes is Not Managed Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, heart, gums and teeth. If you have diabetes, you are more likely than people without diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure and cholesterol and to avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Risk Factors Diabetes is a serious, life-long disease. It can lead to problems such as heart disease, stroke, vision loss, kidney disease, and nerve damage. More than 8 million people in the United States have type 2 diabetes and don’t know it. Many people don’t find out they have diabetes until they are faced with problems such as blurry vision or heart trouble. Certain factors can increase your risk for diabetes, and it’s important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body’s own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a person’s risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Learn more about the causes of type 2 diabetes. Prediabetes and Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. People with prediabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Prediabetes is increasingly common in the U.S. adult population. In 2012, about 86 million people in the U.S. had pre-diabetes, and 51% of those 65 or older had prediabetes. Learn more about prediabetes. Gestational Diabetes Some women develop diabetes during the late stages of pregnancy. This is called gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it has a lifelong risk for developing diabetes, mostly type 2. Prevention The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that type 2 diabetes can be prevented or delayed in people at risk for the disease. Preventing type 2 diabetes can mean a healthier and longer life without serious complications from the disease such as heart disease, stroke, blindness, kidney failure, and amputations. Preventing Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes. The good news is that if you have prediabetes, there are ways to reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes Benefits of Weight Loss and Exercise The Diabetes Prevention Program (DPP) is a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases. DPP researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The drug metformin reduced the risk of type 2 diabetes by 34 percent but was more effective in younger and heavier adults. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) The benefits of weight loss and regular exercise have long-lasting value. In a DPP follow-up trial known as the Diabetes Prevention Program Outcome Study (DPPOS), people at risk of type 2 diabetes who kept off the weight they had lost and who continued to exercise regularly delayed the onset of type 2 diabetes by about 4 years. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. How to Lower Your Risk Making modest lifestyle changes can help prevent or delay type 2 diabetes in people who are at risk. Here are some tips. Reach and Maintain a Reasonable Body Weight Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. The Body Mass Index chart (seen here) can be used to find out whether someone is normal weight, overweight, or obese. Body mass index is a measurement of body weight relative to height for adults age 20 or older. To use the chart - find the person's height in the left-hand column - move across the row to find the number closest to the person's weight - find the number at the top of that column - The number at the top of the column is the person’s BMI. find the person's height in the left-hand column move across the row to find the number closest to the person's weight find the number at the top of that column The number at the top of the column is the person’s BMI. The words above the BMI number indicate whether the person is normal weight, overweight, or obese. People who are overweight or obese should consider talking with a health care provider about ways to lose weight and reduce the risk of diabetes. The BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle. Waist Measurement. In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for type 2 diabetes. This is true even if a person’s body mass index (BMI) falls within the normal range. To measure the waist, a person should - place a tape measure around the bare abdomen just above the hip bone - make sure the tape is snug but isn’t digging into the skin and is parallel to the floor - relax, exhale, and measure. place a tape measure around the bare abdomen just above the hip bone make sure the tape is snug but isn’t digging into the skin and is parallel to the floor relax, exhale, and measure. Make Healthy Food Choices What you eat has a big impact on your weight and overall health. By developing healthy eating habits, you can help manage your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Here are more tips for eating well with diabetes. - Make a diabetes meal plan with help from your health care team. - Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. - Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. - Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. - Drink water instead of juice and regular soda. - When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. Make a diabetes meal plan with help from your health care team. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. Drink water instead of juice and regular soda. When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. For more about healthy eating and older adults see "Eating Well as You Get Older." Be Physically Active Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways. It - helps you lose weight - controls your cholesterol and blood pressure - improves your body's use of insulin. helps you lose weight controls your cholesterol and blood pressure improves your body's use of insulin. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. For more information on exercise and older adults, see Exercises to Try or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Signs and Diagnosis Diabetes is often called a "silent" disease because it can cause serious complications even before you have symptoms. Symptoms can also be so mild that you don’t notice them. An estimated 8 million people in the United States have type 2 diabetes and don’t know it, according to 2012 estimates by the Centers for Disease Control and Prevention (CDC). Common Signs Some common symptoms of diabetes are: - being very thirsty - frequent urination - feeling very hungry or tired - losing weight without trying - having sores that heal slowly - having dry, itchy skin - loss of feeling or tingling in the feet - having blurry eyesight. being very thirsty frequent urination feeling very hungry or tired losing weight without trying having sores that heal slowly having dry, itchy skin loss of feeling or tingling in the feet having blurry eyesight. Signs of type 1 diabetes usually develop over a short period of time. The signs for type 2 diabetes develop more gradually. Tests for Diabetes The following tests are used to diagnose diabetes or prediabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. - An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. Get more details about tests for diabetes. Who Should Get Tested? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. See risk factors for type 2 diabetes. Why Early Detection is Important Diabetes is a serious disease that can lead to a number of health problems such as heart disease, stroke, vision problems, kidney disease and even death. Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as a heart attack or stroke. Finding out early if you have diabetes is important because treatment can prevent or delay the complications of the disease. Diet and Exercise Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. People with type 1 diabetes manage their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can manage blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both. Diabetes is a progressive disease and, over time, people with diabetes may need both lifestyle modification and medications. Follow a Meal Plan Making healthy food choices is very important to help keep your blood glucose level under control. A registered dietitian can work with you to develop a healthy eating plan. He or she can help you design a meal plan that takes into consideration various factors including your weight and daily physical activity, blood glucose levels, other health conditions and medications. If you are overweight, a plan to help you achieve a weight that is right for you will help manage your blood glucose. Your dietitian can help you plan meals to include foods that you and your family like to eat and that are good for you. (Watch the video to learn about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What to Eat People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in your target range, and prevent or delay heart and blood vessel disease. For more information on nutrition and older adults, see Eating Well As You Get Older. Get Regular Physical Activity Regular physical activity is important for people with diabetes. Being physically active has been shown to improve blood glucose levels in older people whose levels are high. Exercise is especially good for people with diabetes because it - helps manage weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps manage weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Safety First Before you begin physical activity, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some activities like weightlifting may not be safe. Your health care team can help you find safe ways to be active. For tips on safety issues older adults should consider before starting a new exercise program, see Exercise: Safety First Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to be physically active. You can even get exercise when you clean house or work in your garden. How Much? How Often? Try to be active almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) To see examples of exercises for older adults, see Exercises to Try. Or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Medications Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Diabetes pills and insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. People with type 1 diabetes control their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Taking Diabetes Pills If your body is still making some insulin, but not enough to keep your blood glucose levels under control, you may need diabetes pills. Some medications are taken once a day; others must be taken more often. Ask your health care team when you should take your pills. Remember to take your medicines every day, even when you feel well. Be sure to tell your doctor if your pills make you feel sick or if you have any other problems. Remember, diabetes pills don't lower blood glucose all by themselves. You will still want to follow a meal plan and exercise to help lower your blood glucose. Taking Insulin You need insulin if your body has stopped making insulin or if your body doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. Insulin can't be taken as a pill. It is usually taken by shots or with an insulin pump or insulin pen. Insulin pumps are small machines, usually worn on the hip, that contain insulin and deliver small steady doses of insulin throughout the day, Some pumps are attached directly to the skin. Other people use an insulin pen, which holds a cartridge of insulin that is dialed to the prescribed dose of insulin and then injected. Sometimes, people who take diabetes pills may need insulin shots for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose. Get more information about taking diabetes medicines. Know Your Diabetes ABCs Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol A is for the A1C test B is for Blood pressure C is for Cholesterol The A1C Test The A1C test (A-one-C), also called the hemoglobin A1C test, shows overall blood glucose for the past 3 months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. If your A1C is above your target goal, take action. You may need a change in your meal plan, your level of physical activity, or the medications you take to lower your chance of getting diabetes problems like heart disease or kidney damage. Talk with your health care provider about your A1C goal and how to reach it. Learn more about the A1C test. Check Your Blood Pressure High blood pressure makes your heart work too hard. This can lead to a stroke and other problems such as kidney disease. Your blood pressure should be checked at every doctor visit. The target blood pressure for most people with diabetes is less than 140/90 but may be different for you. Talk with your health care provider about your blood pressure goal. Learn about ways to check your blood pressure. Have Your LDL Cholesterol Checked Low density lipoprotein, or LDL cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Learn more about lowering LDL cholesterol. Stop Smoking Smoking and diabetes are a dangerous mix. Smoking raises your risk for many diabetes problems. If you quit smoking, - you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation - your cholesterol and blood pressure levels might improve - your blood circulation will improve. you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation your cholesterol and blood pressure levels might improve your blood circulation will improve. If you smoke, stop smoking. Ask for help so that you don’t have to do it alone. You can start by calling 1–800–QUITNOW or 1–800–784–8669. For more on how to quit smoking, see Quitting Smoking for Older Adults. Manage Your Diabetes Every Day Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Know What To Do Every Day To manage your diabetes, here are things to do every day. - Take your medicines. - Keep track of your blood glucose (blood sugar). - Check your blood pressure if your doctor advises. - Check your feet. - Brush your teeth and floss. - Stop smoking. - Eat well. - Be active. Take your medicines. Keep track of your blood glucose (blood sugar). Check your blood pressure if your doctor advises. Check your feet. Brush your teeth and floss. Stop smoking. Eat well. Be active. (Watch the video to learn more about what one woman does to manage her diabetes every day. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Take Your Diabetes Medicines People with type 1 diabetes control their blood sugar with insulin -- delivered either by injection or with a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Ask your doctor if you need to take aspirin every day to prevent a heart attack or stroke. Keep Track of Your Blood Glucose One of the best ways to find out how well you are taking care of your diabetes is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medication. Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three a day or even more. You may be told to check before eating, before bed, and sometimes in the middle of the night. Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for some of the supplies and equipment you need to check your glucose levels. See what diabetes supplies and services Medicare covers. Check Your Blood Pressure Check your blood pressure if your doctor advises and keep a record of it. You can check your pressure at home with a home blood pressure measurement device or monitor. Blood pressure monitors can be bought at discount chain stores and drug stores. When you are taking your blood pressure at home, sit with your back supported and your feet flat on the floor. Rest your arm on a table at the level of your heart. Check with your health care provider to make sure you are using the monitor correctly. Check Your Feet Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. Brush Your Teeth and Floss People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose also can make tooth and gum problems worse. You can even lose your teeth. Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. Learn more about how diabetes can affect your mouth and teeth. Stop Smoking If you smoke, stop. Smoking raises your risk for many diabetes problems, including heart attack and stroke. Ask for help to quit. Call 1-800 QUITNOW (1-800-784-8669). For more information on smoking and older adults, see Quitting Smoking for Older Adults. Eat Well People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in a desirable range, and prevent or delay heart and blood vessel disease. For more on healthy eating, see Small Steps for Eating Healthy Foods. Be Active Try to exercise almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercise: How to Get Started or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be sure to check with your doctor before starting an exercise program. Other Areas To Manage Here are other areas to manage if you have diabetes. - Take care of your eyes. - Protect your kidneys. - Protect your skin. - Learn how to cope with stress. Take care of your eyes. Protect your kidneys. Protect your skin. Learn how to cope with stress. Take Care of Your Eyes High blood glucose and high blood pressure from diabetes can hurt your eyes. It can even cause blindness, or other painful eye problems. Here are ways to prevent diabetes eye problems. - Keep your blood glucose and blood pressure as close to normal as you can. - Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Keep your blood glucose and blood pressure as close to normal as you can. Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Learn more about eye disease and diabetes. Protect Your Kidneys High blood glucose and high blood pressure may damage the kidneys. Damaged kidneys do not do a good job of filtering out wastes and extra fluid. Here are ways to prevent diabetes kidney problems. - Keep your blood glucose and blood pressure as close to your target goal as you can. - Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. - Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Keep your blood glucose and blood pressure as close to your target goal as you can. Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Learn more about keeping your kidneys healthy. Protect Your Skin Skin care is very important, too. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean and taking care of minor cuts and bruises. Learn How To Cope With Stress Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music. Frequently Asked Questions What is diabetes? Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. What is the difference between type 1 and type 2 diabetes? Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Learn more about type 1 diabetes here. Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. How many people have diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) What is prediabetes? Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. In 2012, about 86 million people in the U.S. had prediabetes, and 51% of those 65 or older had prediabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Why can I do about prediabetes? Studies have shown that most people with prediabetes develop type 2 diabetes within a few years, unless they change their lifestyle. Most people with prediabetes don’t have any symptoms. Your doctor can test your blood to find out if your blood glucose levels are higher than normal. Losing weight—at least 5 to 10 percent of your starting weight—can prevent or delay diabetes or even reverse prediabetes. That’s 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting the amount of calories and fat you consume and by being physically active at least 30 to 60 minutes every day. Physical activity also helps your body use the hormone insulin properly. Your body needs insulin to use glucose for energy. Medicine can help control the amount of glucose in your blood. Ask your doctor if medicine to control glucose is right for you. Learn more about prediabetes here. What are the signs of diabetes? Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. What causes diabetes? Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body's own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the insulin-producing cells in the pancreas in people with type 1 diabetes. However, many believe that both genetic factors and environmental factors are involved. Studies now are underway to identify these factors and prevent type 1 diabetes in people at risk. Type 2 diabetes—the most common form of diabetes—is caused by a combination of factors, including insulin resistance, a condition in which the body’s muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. Get more details about who should be tested for diabetes. If diabetes is not managed, what problems might occur? Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, and heart, gums and teeth. If you have diabetes, you are more likely than someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure, and cholesterol and avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Who is at risk for developing type 2 diabetes? Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Can diabetes be prevented? The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that making modest lifestyle changes can prevent or delay type 2 diabetes in people at risk for the disease. In the Diabetes Prevention Program (DPP), a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases, researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What kind of meal plan should a person with diabetes follow? Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. This plan, often called medical nutrition therapy, will include regular monitoring by your dietitian and education about how to adjust your eating habits as the need occurs. Medical nutrition therapy is usually covered by insurance or Medicare as long as your doctor refers you. Your dietitian can help you plan meals that include foods that you and your family like and that are good for you. Your healthy eating plan will include - breads, cereals, rice, and whole grains - fruits and vegetables - meat and meat substitutes - dairy products - healthy fats. breads, cereals, rice, and whole grains fruits and vegetables meat and meat substitutes dairy products healthy fats. Your plan will also help you learn how to eat the right amount, or portions, of food. Making good food choices will - help you reach and stay at a healthy weight - keep your blood glucose, blood pressure, and cholesterol levels under control - prevent heart and blood vessel disease. help you reach and stay at a healthy weight keep your blood glucose, blood pressure, and cholesterol levels under control prevent heart and blood vessel disease. (Watch the video to learn more about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) If I have diabetes, should I avoid all sweets and sugars? If you have diabetes you should limit the amount of fats and sweets you eat. These foods have calories, but not much nutrition. Some contain saturated fats and cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and keep your blood glucose and blood fats under control. It is okay to have sweets once in a while. Try having sugar-free popsicles, diet soda, fat-free ice cream or frozen yogurt, or sugar-free hot cocoa mix to satisfy a "sweet tooth." Remember, fat-free and low sugar foods still have calories. Talk with your diabetes educator about how to fit sweets into your meal plan. Who should be tested for diabetes? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. Get more information about tests for diabetes. How do doctors diagnose diabetes and pre-diabetes? Doctors use the following tests to diagnose diabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. - An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. How do I manage my diabetes every day? People with type 1 diabetes control their blood sugar with insulin -- either with shots or an insulin pen. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some people may need to take both, along with lifestyle modification. (Watch the video to learn how one woman manages her type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) To manage your diabetes, here are things to do every day. - Take your medicines for diabetes and for any other health problems, even when you feel good. Take your medicines for diabetes and for any other health problems, even when you feel good. - Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. - Check your blood pressure if your doctor advises and keep a record of it. Check your blood pressure if your doctor advises and keep a record of it. - Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. - Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. - Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) - Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. - Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. How should I take care of my feet? Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. How can diabetes affect my teeth and gums? People with diabetes can have tooth and gum problems more often if their blood glucose stays high. Glucose is present in your saliva—the fluid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful bacteria grow. These bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease and bad breath. The most common mouth problems from diabetes are - gingivitis (unhealthy or inflamed gums) - periodontitis (an infection of the gums) - thrush or candidiasis - dry mouth - oral burning (a burning sensation inside the mouth). gingivitis (unhealthy or inflamed gums) periodontitis (an infection of the gums) thrush or candidiasis dry mouth oral burning (a burning sensation inside the mouth). How can I protect my teeth and gums? Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. What kinds of medication do people take for diabetes? Controlling blood glucose (blood sugar) is the best defense against the serious complications of diabetes. Insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. You need insulin if your body has stopped making insulin or if it doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. If your body makes insulin but the insulin doesn't lower your blood glucose, you may need diabetes pills. What are the ABCs of diabetes? Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol, as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol. A is for the A1C test B is for Blood pressure C is for Cholesterol. - The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. - B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. - C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Ask your health care team - what your A1C, blood pressure, and cholesterol numbers are. - what your ABCs should be. - what you can do to reach your target. what your A1C, blood pressure, and cholesterol numbers are. what your ABCs should be. what you can do to reach your target. How should I work with my health care team to manage my diabetes? See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goals. If you have diabetes, take these steps. At each visit, be sure you have a - blood pressure check - foot check - weight check - review of your self-care plan. blood pressure check foot check weight check review of your self-care plan. Two times each year, get - an A1C test. It may be checked more often if it is over 7. an A1C test. It may be checked more often if it is over 7. Once each year, be sure you have a - cholesterol test - triglyceride (try-GLISS-er-ide) test - a type of blood fat - complete foot exam - dental exam to check teeth and gums. Tell your dentist you have diabetes. - dilated eye exam to check for eye problems - flu shot - urine and a blood test to check for kidney problems. cholesterol test triglyceride (try-GLISS-er-ide) test - a type of blood fat complete foot exam dental exam to check teeth and gums. Tell your dentist you have diabetes. dilated eye exam to check for eye problems flu shot urine and a blood test to check for kidney problems. At least once, get a - pneumonia (nu-MOH-nya) shot. pneumonia (nu-MOH-nya) shot. If you have Medicare, ask your health care team if Medicare will cover some of the costs for - learning about healthy eating and diabetes self-care - special shoes, if you need them - medical supplies - diabetes medicines. learning about healthy eating and diabetes self-care special shoes, if you need them medical supplies diabetes medicines. (Watch the video for important things to remember when visiting your health care team. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Why is exercise important in controlling diabetes? Exercise is especially good for people with diabetes because it - helps control weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps control weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises may not be safe. Your health care team can help you find safe exercises. What types of exercise should I do, and how often? People with diabetes should - do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. - do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. - stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercises To Try or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Always talk with a doctor before starting a new physical activity program. What steps can I take to lose weight to prevent or delay type 2 diabetes? Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. If you are overweight or obese, choose sensible ways to reach and maintain a reasonable body weight. - Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. - Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Does Medicare help pay for services and supplies for people with diabetes? Medicare helps pay for certain services and supplies for people with diabetes who have Medicare Part B. All require a doctor's prescription. The diabetes-related services and supplies that are covered include - blood sugar monitor and supplies - an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. - dilated eye examinations to check for diabetic eye diseases - glaucoma screening - flu and pneumonia shots - diabetes self-management training - medical nutrition therapy services. blood sugar monitor and supplies an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. dilated eye examinations to check for diabetic eye diseases glaucoma screening flu and pneumonia shots diabetes self-management training medical nutrition therapy services. Get more information about the diabetes supplies and services covered by Medicare. You can also contact the Centers for Medicare and Medicaid Services at 1-800-MEDICARE, or 1-800-633-4227. TTY users dial 1-877-486-2048.
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what are the risk factors of type ii diabetes
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Researchers don't fully understand why some people develop type 2 diabetes and others don't. It's clear, however, that certain factors increase the risk, including: - Weight. Being overweight is a primary risk factor for type 2 diabetes. - Fat distribution. If your body stores fat primarily in your abdomen, your risk of type 2 diabetes is greater than if your body stores fat elsewhere, such as your hips and thighs. - Inactivity. The less active you are, the greater your risk of type 2 diabetes. - Family history. The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes. - Race. Although it's unclear why, people of certain races - including blacks, Hispanics, American Indians and Asian-Americans - are more likely to develop type 2 diabetes than whites are. - Age. The risk of type 2 diabetes increases as you get older, especially after age 45.
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Type 2 diabetes Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin - a hormone that regulates the movement of sugar into your cells - or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: - Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink - and urinate - more than usual. - Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. - Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. - Fatigue. If your cells are deprived of sugar, you may become tired and irritable. - Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. - Slow-healing sores or frequent infections. Type 2 diabetes affects your ability to heal and resist infections. - Areas of darkened skin. Some people with type 2 diabetes have patches of dark, velvety skin in the folds and creases of their bodies - usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance. When to see a doctor See your doctor if you notice any type 2 diabetes symptoms. Causes Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. Exactly why this happens is unknown, although genetics and environmental factors, such as excess weight and inactivity, seem to be contributing factors. How insulin works Insulin is a hormone that comes from the gland situated behind and below the stomach (pancreas). - The pancreas secretes insulin into the bloodstream. - The insulin circulates, enabling sugar to enter your cells. - Insulin lowers the amount of sugar in your bloodstream. - As your blood sugar level drops, so does the secretion of insulin from your pancreas. The role of glucose Glucose - a sugar - is a main source of energy for the cells that make up muscles and other tissues. - Glucose comes from two major sources: food and your liver. - Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin. - Your liver stores and makes glucose. - When your glucose levels are low, such as when you haven't eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range. In type 2 diabetes, this process doesn't work well. Instead of moving into your cells, sugar builds up in your bloodstream. As blood sugar levels increase, the insulin-producing beta cells in the pancreas release more insulin, but eventually these cells become impaired and can't make enough insulin to meet the body's demands. In the much less common type 1 diabetes, the immune system destroys the beta cells, leaving the body with little to no insulin. Risk factors Researchers don't fully understand why some people develop type 2 diabetes and others don't. It's clear, however, that certain factors increase the risk, including: - Weight. Being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue you have, the more resistant your cells become to insulin. However, you don't have to be overweight to develop type 2 diabetes. - Fat distribution. If your body stores fat primarily in your abdomen, your risk of type 2 diabetes is greater than if your body stores fat elsewhere, such as your hips and thighs. - Inactivity. The less active you are, the greater your risk of type 2 diabetes. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. - Family history. The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes. - Race. Although it's unclear why, people of certain races - including blacks, Hispanics, American Indians and Asian-Americans - are more likely to develop type 2 diabetes than whites are. - Age. The risk of type 2 diabetes increases as you get older, especially after age 45. That's probably because people tend to exercise less, lose muscle mass and gain weight as they age. But type 2 diabetes is also increasing dramatically among children, adolescents and younger adults. - Prediabetes. Prediabetes is a condition in which your blood sugar level is higher than normal, but not high enough to be classified as diabetes. Left untreated, prediabetes often progresses to type 2 diabetes. - Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing type 2 diabetes increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you're also at risk of type 2 diabetes. - Polycystic ovarian syndrome. For women, having polycystic ovarian syndrome - a common condition characterized by irregular menstrual periods, excess hair growth and obesity - increases the risk of diabetes. Complications Type 2 diabetes can be easy to ignore, especially in the early stages when you're feeling fine. But diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Controlling your blood sugar levels can help prevent these complications. Although long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening. Some of the potential complications of diabetes include: - Heart and blood vessel disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of arteries (atherosclerosis) and high blood pressure. - Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar can eventually cause you to lose all sense of feeling in the affected limbs. Damage to the nerves that control digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue. - Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which often eventually requires dialysis or a kidney transplant. - Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma. - Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation. - Hearing impairment. Hearing problems are more common in people with diabetes. - Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. - Alzheimer's disease. Type 2 diabetes may increase the risk of Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. The exact connection between these two conditions still remains unclear. Diagnosis To diagnose type 2 diabetes, you'll be given a: - Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions - such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) - that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: - Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. - Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. - Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes. A reading of 200 mg/dL (11.1 mmol/L) or higher after two hours may indicate diabetes. The American Diabetes Association recommends routine screening for type 2 diabetes beginning at age 45, especially if you're overweight. If the results are normal, repeat the test every three years. If the results are borderline, ask your doctor when to come back for another test. Screening is also recommended for people who are under 45 and overweight if there are other heart disease or diabetes risk factors present, such as a sedentary lifestyle, a family history of type 2 diabetes, a personal history of gestational diabetes or blood pressure above 140/90 millimeters of mercury (mm Hg). If you're diagnosed with diabetes, the doctor may do other tests to distinguish between type 1 and type 2 diabetes - since the two conditions often require different treatments. After the diagnosis A1C levels need to be checked between two and four times a year. Your target A1C goal may vary depending on your age and other factors. However, for most people, the American Diabetes Association recommends an A1C level below 7 percent. Ask your doctor what your A1C target is. Compared with repeated daily blood sugar tests, the A1C test is a better indicator of how well your diabetes treatment plan is working. An elevated A1C level may signal the need for a change in your medication, meal plan or activity level. In addition to the A1C test, your doctor will take blood and urine samples periodically to check your cholesterol levels, thyroid function, liver function and kidney function. The doctor will also assess your blood pressure. Regular eye and foot exams also are important. Treatment Management of type 2 diabetes includes: - Healthy eating - Regular exercise - Possibly, diabetes medication or insulin therapy - Blood sugar monitoring These steps will help keep your blood sugar level closer to normal, which can delay or prevent complications. Healthy eating Contrary to popular perception, there's no specific diabetes diet. However, it's important to center your diet on these high-fiber, low-fat foods: - Fruits - Vegetables - Whole grains You'll also need to eat fewer animal products, refined carbohydrates and sweets. Low glycemic index foods also may be helpful. The glycemic index is a measure of how quickly a food causes a rise in your blood sugar. Foods with a high glycemic index raise your blood sugar quickly. Low glycemic index foods may help you achieve a more stable blood sugar. Foods with a low glycemic index typically are foods that are higher in fiber. A registered dietitian can help you put together a meal plan that fits your health goals, food preferences and lifestyle. He or she can also teach you how to monitor your carbohydrate intake and let you know about how many carbohydrates you need to eat with your meals and snacks to keep your blood sugar levels more stable. Physical activity Everyone needs regular aerobic exercise, and people who have type 2 diabetes are no exception. Get your doctor's OK before you start an exercise program. Then choose activities you enjoy, such as walking, swimming and biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes of aerobic exercise five days of the week. Stretching and strength training exercises are important, too. If you haven't been active for a while, start slowly and build up gradually. A combination of exercises - aerobic exercises, such as walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week - often helps control blood sugar more effectively than either type of exercise alone. Remember that physical activity lowers blood sugar. Check your blood sugar level before any activity. You might need to eat a snack before exercising to help prevent low blood sugar if you take diabetes medications that lower your blood sugar. Monitoring your blood sugar Depending on your treatment plan, you may need to check and record your blood sugar level every now and then or, if you're on insulin, multiple times a day. Ask your doctor how often he or she wants you to check your blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Sometimes, blood sugar levels can be unpredictable. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to food, exercise, alcohol, illness and medication. Diabetes medications and insulin therapy Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways. Examples of possible treatments for type 2 diabetes include: - Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. It works by improving the sensitivity of your body tissues to insulin so that your body uses insulin more effectively. Metformin also lowers glucose production in the liver. Metformin may not lower blood sugar enough on its own. Your doctor will also recommend lifestyle changes, such as losing weight and becoming more active. Nausea and diarrhea are possible side effects of metformin. These side effects usually go away as your body gets used to the medicine. If metformin and lifestyles changes aren't enough to control your blood sugar level, other oral or injected medications can be added. - Sulfonylureas. These medications help your body secrete more insulin. Examples of medications in this class include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible side effects include low blood sugar and weight gain. - Meglitinides. These medications work like sulfonylureas by stimulating the pancreas to secrete more insulin, but they're faster acting, and the duration of their effect in the body is shorter. They also have a risk of causing low blood sugar, but this risk is lower than with sulfonylureas. Weight gain is a possibility with this class of medications as well. Examples include repaglinide (Prandin) and nateglinide (Starlix). - Thiazolidinediones. Like metformin, these medications make the body's tissues more sensitive to insulin. This class of medications has been linked to weight gain and other more-serious side effects, such as an increased risk of heart failure and fractures. Because of these risks, these medications generally aren't a first-choice treatment. Rosiglitazone (Avandia) and pioglitazone (Actos) are examples of thiazolidinediones. - DPP-4 inhibitors. These medications help reduce blood sugar levels, but tend to have a modest effect. They don't cause weight gain. Examples of these medications are sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta). - GLP-1 receptor agonists. These medications slow digestion and help lower blood sugar levels, though not as much as sulfonylureas. Their use is often associated with some weight loss. This class of medications isn't recommended for use by itself. Exenatide (Byetta) and liraglutide (Victoza) are examples of GLP-1 receptor agonists. Possible side effects include nausea and an increased risk of pancreatitis. - SGLT2 inhibitors. These are the newest diabetes drugs on the market. They work by preventing the kidneys from reabsorbing sugar into the blood. Instead, the sugar is excreted in the urine. Examples include canagliflozin (Invokana) and dapagliflozin (Farxiga). Side effects may include yeast infections and urinary tract infections, increased urination and hypotension. - Insulin therapy. Some people who have type 2 diabetes need insulin therapy as well. In the past, insulin therapy was used as a last resort, but today it's often prescribed sooner because of its benefits. Because normal digestion interferes with insulin taken by mouth, insulin must be injected. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night. Often, people with type 2 diabetes start insulin use with one long-acting shot at night. Insulin injections involve using a fine needle and syringe or an insulin pen injector - a device that looks similar to an ink pen, except the cartridge is filled with insulin. There are many types of insulin, and they each work in a different way. Options include: - Insulin glulisine (Apidra) - Insulin lispro (Humalog) - Insulin aspart (Novolog) - Insulin glargine (Lantus) - Insulin detemir (Levemir) - Insulin isophane (Humulin N, Novolin N) Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health. In addition to diabetes medications, your doctor might prescribe low-dose aspirin therapy as well as blood pressure and cholesterol-lowering medications to help prevent heart and blood vessel disease. Bariatric surgery If you have type 2 diabetes and your body mass index (BMI) is greater than 35, you may be a candidate for weight-loss surgery (bariatric surgery). Blood sugar levels return to normal in 55 to 95 percent of people with diabetes, depending on the procedure performed. Surgeries that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss surgeries. Drawbacks to the surgery include its high cost, and there are risks involved, including a risk of death. Additionally, drastic lifestyle changes are required and long-term complications may include nutritional deficiencies and osteoporosis. Pregnancy Women with type 2 diabetes may need to alter their treatment during pregnancy. Many women will require insulin therapy during pregnancy. Cholesterol-lowering medications and some blood pressure drugs can't be used during pregnancy. If you have signs of diabetic retinopathy, it may worsen during pregnancy. Visit your ophthalmologist during the first trimester of your pregnancy and at one year postpartum. Signs of trouble Because so many factors can affect your blood sugar, problems sometimes arise that require immediate care, such as: - High blood sugar (hyperglycemia). Your blood sugar level can rise for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication. Check your blood sugar level often, and watch for signs and symptoms of high blood sugar - frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea. If you have hyperglycemia, you'll need to adjust your meal plan, medications or both. - Hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Signs and symptoms of this life-threatening condition include a blood sugar reading higher than 600 mg/dL (33.3 mmol/L), dry mouth, extreme thirst, fever greater than 101 F (38 C), drowsiness, confusion, vision loss, hallucinations and dark urine. Your blood sugar monitor may not be able to give you an exact reading at such high levels and may instead just read "high." HHNS is caused by sky-high blood sugar that turns blood thick and syrupy. It tends to be more common in older people with type 2 diabetes, and it's often preceded by an illness or infection. HHNS usually develops over days or weeks. Call your doctor or seek immediate medical care if you have signs or symptoms of this condition. - Increased ketones in your urine (diabetic ketoacidosis). If your cells are starved for energy, your body may begin to break down fat. This produces toxic acids known as ketones. Watch for thirst or a very dry mouth, frequent urination, vomiting, shortness of breath, fatigue and fruity-smelling breath. You can check your urine for excess ketones with an over-the-counter ketones test kit. If you have excess ketones in your urine, consult your doctor right away or seek emergency care. This condition is more common in people with type 1 diabetes but can sometimes occur in people with type 2 diabetes. - Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, inadvertently taking more medication than usual or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you're taking insulin. Check your blood sugar level regularly, and watch for signs and symptoms of low blood sugar - sweating, shakiness, weakness, hunger, dizziness, headache, blurred vision, heart palpitations, slurred speech, drowsiness, confusion and seizures. If you develop hypoglycemia during the night, you might wake with sweat-soaked pajamas or a headache. Due to a natural rebound effect, nighttime hypoglycemia might cause an unusually high blood sugar reading first thing in the morning. If you have signs or symptoms of low blood sugar, drink or eat something that will quickly raise your blood sugar level - fruit juice, glucose tablets, hard candy, regular (not diet) soda or another source of sugar. Retest in 15 minutes to be sure your blood glucose levels have normalized. If they haven't, treat again and retest in another 15 minutes. If you lose consciousness, a family member or close contact may need to give you an emergency injection of glucagon, a hormone that stimulates the release of sugar into the blood. Lifestyle and home remedies Careful management of type 2 diabetes can reduce your risk of serious - even life-threatening - complications. Consider these tips: - Commit to managing your diabetes. Learn all you can about type 2 diabetes. Make healthy eating and physical activity part of your daily routine. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it. - Schedule a yearly physical exam and regular eye exams. Your regular diabetes checkups aren't meant to replace regular physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications, as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma. - Identify yourself. Wear a necklace or bracelet that says you have diabetes. - Keep your immunizations up to date. High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor will likely recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) also recommends the hepatitis B vaccination if you haven't previously received this vaccine and you're an adult age 19 to 59 with type 1 or type 2 diabetes. The CDC advises vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes and haven't previously received the vaccine, talk to your doctor about whether it's right for you. - Take care of your teeth. Diabetes may leave you prone to more-serious gum infections. Brush your teeth at least twice a day, floss your teeth once a day and schedule regular dental exams. Consult your dentist right away if your gums bleed or look red or swollen. - Pay attention to your feet. Wash your feet daily in lukewarm water. Dry them gently, especially between the toes, and moisturize with lotion. Check your feet every day for blisters, cuts, sores, redness and swelling. Consult your doctor if you have a sore or other foot problem that isn't healing. - Keep your blood pressure and cholesterol under control. Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Medication also may be needed. - If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco. - If you drink alcohol, do so responsibly. Alcohol, as well as drink mixers, can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so in moderation and always with a meal. The recommendation is no more than one drink daily for women, no more than two drinks daily for men age 65 and younger, and one drink a day for men over 65. If you're on insulin or other medications that lower your blood sugar, check your blood sugar before you go to sleep to make sure you're at a safe level. Alternative medicine Numerous alternative medicine substances have been shown to improve insulin sensitivity in some studies, while other studies fail to find any benefit for blood sugar control or in lowering A1C levels. Because of the conflicting findings, no alternative therapies are recommended to help with blood sugar management. If you decide to try an alternative therapy, don't stop taking the medications that your doctor has prescribed. Be sure to discuss the use of any of these therapies with your doctor to make sure that they won't cause adverse reactions or interact with your medications. No treatments - alternative or conventional - can cure diabetes. So it's critical that people who are using insulin therapy for diabetes don't stop using insulin unless directed to do so by their physicians.
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what are the risk factors of type ii diabetes
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You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk.
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Risk Factors for Type 2 Diabetes Risk Factors for Type 2 Diabetes You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk.
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what can cause hypoglycemia
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Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Hypoglycemia may also happen if you don't eat as much food as usual after taking diabetes medication, or if you exercise more than you normally would. Possible causes, without diabetes Hypoglycemia in people without diabetes is much less common. Causes may include the following: - Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications may cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), which is used to treat malaria. - Excessive alcohol consumption. Drinking heavily without eating can block your liver from releasing stored glucose into your bloodstream, causing hypoglycemia. - Some critical illnesses.
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Hypoglycemia Overview Hypoglycemia is a condition caused by a very low level of blood sugar (glucose), your body's main energy source. Hypoglycemia is often related to the treatment of diabetes. However, a variety of conditions - many rare - can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn't a disease itself - it's an indicator of a health problem. Immediate treatment of hypoglycemia is necessary when blood sugar levels are at 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter (mmol/L) or below. Treatment involves quick steps to get your blood sugar level back into a normal range either with high-sugar foods or drinks or with medications. Long-term treatment requires identifying and treating the underlying cause of hypoglycemia. Symptoms If blood sugar levels become too low, signs and symptoms may include: - An irregular heart rhythm - Fatigue - Pale skin - Shakiness - Anxiety - Sweating - Hunger - Irritability - Tingling sensation around the mouth - Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: - Confusion, abnormal behavior or both, such as the inability to complete routine tasks - Visual disturbances, such as blurred vision - Seizures - Loss of consciousness People with severe hypoglycemia may appear as if they're intoxicated. They may slur their words and move clumsily. When to see a doctor Seek a doctor's help immediately if: - You have what may be symptoms of hypoglycemia and you don't have diabetes. - You have diabetes and hypoglycemia isn't responding to treatment. Initial treatment of hypoglycemia is drinking juice or regular soft drinks, eating candy or taking glucose tablets. If this treatment doesn't raise your blood sugar and improve your symptoms, contact your doctor right away. Seek emergency help if: - Someone with diabetes or a history of recurring hypoglycemia has symptoms of severe hypoglycemia or loses consciousness Causes Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Blood sugar regulation But to understand how hypoglycemia happens, it helps to know how your body normally processes blood sugar. When you eat, your body breaks down carbohydrates from foods - such as bread, rice, pasta, vegetables, fruit and milk products - into various sugar molecules, including glucose. Glucose is the main energy source for your body, but it can't enter the cells of most of your tissues without the help of insulin - a hormone secreted by your pancreas. When glucose levels rise, certain cells (beta cells) in your pancreas release insulin. This allows glucose to enter the cells and provide the fuel your cells need to function properly. Any extra glucose is stored in your liver and muscles in the form of glycogen. If you haven't eaten for several hours and your blood sugar level drops, another hormone from your pancreas called glucagon signals your liver to break down the stored glycogen and release glucose back into your bloodstream. This keeps your blood sugar level within a normal range until you eat again. Aside from your liver breaking down glycogen into glucose, your body also has the ability to manufacture glucose. This process occurs primarily in your liver, but also in your kidneys. Possible causes, with diabetes People with diabetes may not make enough insulin (type 1 diabetes) or may be less responsive to it (type 2 diabetes). As a result, glucose tends to build up in the bloodstream and may reach dangerously high levels. To correct this problem, someone with diabetes may take insulin or other drugs to lower blood sugar levels. But too much insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycemia. Hypoglycemia may also happen if you don't eat as much food as usual after taking diabetes medication, or if you exercise more than you normally would. Possible causes, without diabetes Hypoglycemia in people without diabetes is much less common. Causes may include the following: - Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications may cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), which is used to treat malaria. - Excessive alcohol consumption. Drinking heavily without eating can block your liver from releasing stored glucose into your bloodstream, causing hypoglycemia. - Some critical illnesses. Severe illnesses of the liver, such as severe hepatitis, can cause hypoglycemia. Disorders of the kidney, which can keep your body from properly excreting medications, can affect glucose levels due to a buildup of those medications. Long-term starvation, as may occur in the eating disorder anorexia nervosa, can result in the depletion of substances your body needs to generate glucose (gluconeogenesis), causing hypoglycemia. - Insulin overproduction. A rare tumor of the pancreas (insulinoma) may cause overproduction of insulin, resulting in hypoglycemia. Other tumors may result in excessive production of insulin-like substances. Enlargement of beta cells of the pancreas that produce insulin (nesidioblastosis) may result in excessive insulin release, causing hypoglycemia. - Hormone deficiencies. Certain disorders of the adrenal glands and the pituitary gland can result in a deficiency of key hormones that regulate glucose production. Children may experience hypoglycemia if they have a deficiency of growth hormone. Hypoglycemia after meals Hypoglycemia usually occurs when you haven't eaten (when you're in a fasting state), but that's not always the case. Sometimes hypoglycemia occurs after meals because the body produces more insulin than is needed. This type of hypoglycemia, called reactive or postprandial hypoglycemia, may occur in people who have had stomach surgery. It may also occur in people who haven't had this surgery. Complications If you ignore the symptoms of hypoglycemia too long, you may lose consciousness. That's because your brain needs glucose to function properly. Recognize the signs and symptoms of hypoglycemia early because untreated hypoglycemia can lead to: - Seizure - Loss of consciousness - Death Hypoglcemia can also contribute to: - Falls - Injuries - Motor vehicle accidents Hypoglycemia unawareness Over time, repeated episodes of hypoglycemia can lead to hypoglycemia unawareness. The body and brain no longer produce signs and symptoms that warn of a low blood sugar, such as shakiness or irregular heartbeats. When this happens, the risk of severe, life-threatening hypoglycemia is increased. Undertreated diabetes If you have diabetes, episodes of low blood sugar are uncomfortable and can be frightening. Repeated episodes of hypoglycemia may cause you to take less insulin to ensure that your blood sugar level doesn't go too low. But long-term high blood sugar levels can be dangerous too, possibly causing damage to your nerves, blood vessels and various organs. Diagnosis If you use insulin or another diabetes medication known to lower blood sugar, and you have signs and symptoms of hypoglycemia, test your blood sugar levels with a blood glucose meter. If the result shows low blood sugar (under 70 mg/dL), treat accordingly. If you don't use medications known to cause hypoglycemia, your doctor will want to know: - What were your signs and symptoms? You may not exhibit signs and symptoms of hypoglycemia during your initial visit with your doctor. In this case, your doctor may have you fast overnight (or for a longer period). This will allow low blood sugar symptoms to occur so that he or she can make a diagnosis. It's also possible that you'll need to undergo an extended fast in a hospital setting. Or if your symptoms occur after a meal, your doctor will want to test your glucose levels after a meal. - What is your blood sugar level when you're having symptoms? Your doctor will draw a sample of your blood to be analyzed in the laboratory. - Do your symptoms disappear when blood sugar levels increase? In addition, your doctor will likely conduct a physical examination and review your medical history. Treatment Treatment of hypoglycemia involves: - Immediate initial treatment to raise your blood sugar level - Treatment of the underlying condition that's causing your hypoglycemia to prevent it from recurring Immediate initial treatment The initial treatment depends on your symptoms. Early symptoms can usually be treated by consuming 15 to 20 grams of a fast-acting carbohydrate. Fast-acting carbohydrates are foods that are easily converted to sugar in the body, such as glucose tablets or gel, fruit juice, regular - not diet - soft drinks, and sugary candy such as licorice. Foods containing fat or protein aren't good treatments for hypoglycemia, because they affect the body's absorption of sugar. Recheck blood sugar levels 15 minutes after treatment. If blood sugar levels are still under 70 mg/dL (3.9 mmol/L), treat with another 15 to 20 grams of fast-acting carbohydrate, and recheck the blood sugar level again in 15 minutes. Repeat these steps until the blood sugar is above 70 mg/dL (3.9 mmol/L). Once the blood sugar levels are back to normal, it's important to have a snack or meal to help stabilize your blood sugar. This also helps the body replenish glycogen stores that may have been depleted during hypoglycemia. If your symptoms are more severe, impairing your ability to take sugar by mouth, you may need an injection of glucagon or intravenous glucose. Do not give food or drink to someone who is unconscious, as he or she may aspirate these substances into the lungs. If you're prone to severe episodes of hypoglycemia, ask your doctor if a home glucagon kit might be appropriate for you. In general, people with diabetes who are treated with insulin should have a glucagon kit for low blood sugar emergencies. Family and friends need to know where to find the kit, and need to be taught how to use it before an emergency occurs. Treatment of the underlying condition Preventing recurrent hypoglycemia requires your doctor to identify the underlying condition and treat it. Depending on the underlying cause, treatment may involve: - Medications. If a medication is the cause of your hypoglycemia, your doctor will likely suggest changing the medication or adjusting the dosage. - Tumor treatment. A tumor in your pancreas is treated by surgical removal of the tumor. In some cases, partial removal of the pancreas is necessary.
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what does kidney disease look like
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Signs and symptoms of kidney disease may include: - Nausea - Vomiting - Loss of appetite - Fatigue and weakness - Sleep problems - Changes in how much you urinate - Decreased mental sharpness - Muscle twitches and cramps - Swelling of feet and ankles - Persistent itching - Chest pain, if fluid builds up around the lining of the heart - Shortness of breath, if fluid builds up in the lungs - High blood pressure (hypertension) that's difficult to control Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred. Make an appointment with your doctor if you have any signs or symptoms of kidney disease.
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Chronic kidney disease Overview Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body. In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired. Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant. Chronic kidney disease care at Mayo Clinic Symptoms Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include: - Nausea - Vomiting - Loss of appetite - Fatigue and weakness - Sleep problems - Changes in how much you urinate - Decreased mental sharpness - Muscle twitches and cramps - Swelling of feet and ankles - Persistent itching - Chest pain, if fluid builds up around the lining of the heart - Shortness of breath, if fluid builds up in the lungs - High blood pressure (hypertension) that's difficult to control Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred. Make an appointment with your doctor if you have any signs or symptoms of kidney disease. If you have a medical condition that increases your risk of kidney disease, your doctor is likely to monitor your blood pressure and kidney function with urine and blood tests during regular office visits. Ask your doctor whether these tests are necessary for you. Causes Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years. Diseases and conditions that cause chronic kidney disease include: - Type 1 or type 2 diabetes - High blood pressure - Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis), an inflammation of the kidney's filtering units (glomeruli) - Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney's tubules and surrounding structures - Polycystic kidney disease - Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers - Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back up into your kidneys - Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis) Risk factors Factors that may increase your risk of chronic kidney disease include: - Diabetes - High blood pressure - Heart and blood vessel (cardiovascular) disease - Smoking - Obesity - Being African-American, Native American or Asian-American - Family history of kidney disease - Abnormal kidney structure - Older age Complications Chronic kidney disease can affect almost every part of your body. Potential complications may include: - Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema) - A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart's ability to function and may be life-threatening - Heart and blood vessel (cardiovascular) disease - Weak bones and an increased risk of bone fractures - Anemia - Decreased sex drive, erectile dysfunction or reduced fertility - Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures - Decreased immune response, which makes you more vulnerable to infection - Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium) - Pregnancy complications that carry risks for the mother and the developing fetus - Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival Diagnosis As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you've been diagnosed with high blood pressure, if you've taken a medication that might affect kidney function, if you've noticed changes in your urinary habits, and whether you have any family members who have kidney disease. Next, your doctor performs a physical exam, also checking for signs of problems with your heart or blood vessels, and conducts a neurological exam. For kidney disease diagnosis, you may also need certain tests and procedures, such as: - Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood. - Urine tests. Analyzing a sample of your urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease. - Imaging tests. Your doctor may use ultrasound to assess your kidneys' structure and size. Other imaging tests may be used in some cases. - Removing a sample of kidney tissue for testing. Your doctor may recommend a kidney biopsy to remove a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that's inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what's causing your kidney problem. Treatment Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure. Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If your kidneys become severely damaged, you may need treatment for end-stage kidney disease. Treating the cause Your doctor will work to slow or control the cause of your kidney disease. Treatment options vary, depending on the cause. But kidney damage can continue to worsen even when an underlying condition, such as high blood pressure, has been controlled. Treating complications Kidney disease complications can be controlled to make you more comfortable. Treatments may include: - High blood pressure medications. People with kidney disease may experience worsening high blood pressure. Your doctor may recommend medications to lower your blood pressure - commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers - and to preserve kidney function. High blood pressure medications can initially decrease kidney function and change electrolyte levels, so you may need frequent blood tests to monitor your condition. Your doctor will likely also recommend a water pill (diuretic) and a low-salt diet. - Medications to lower cholesterol levels. Your doctor may recommend medications called statins to lower your cholesterol. People with chronic kidney disease often experience high levels of bad cholesterol, which can increase the risk of heart disease. - Medications to treat anemia. In certain situations, your doctor may recommend supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with added iron. Erythropoietin supplements aid in production of more red blood cells, which may relieve fatigue and weakness associated with anemia. - Medications to relieve swelling. People with chronic kidney disease may retain fluids. This can lead to swelling in the legs, as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body. - Medications to protect your bones. Your doctor may prescribe calcium and vitamin D supplements to prevent weak bones and lower your risk of fracture. You may also take medication known as a phosphate binder to lower the amount of phosphate in your blood, and protect your blood vessels from damage by calcium deposits (calcification). - A lower protein diet to minimize waste products in your blood. As your body processes protein from foods, it creates waste products that your kidneys must filter from your blood. To reduce the amount of work your kidneys must do, your doctor may recommend eating less protein. Your doctor may also ask you to meet with a dietitian who can suggest ways to lower your protein intake while still eating a healthy diet. Your doctor may recommend follow-up testing at regular intervals to see whether your kidney disease remains stable or progresses. Treatment for end-stage kidney disease If your kidneys can't keep up with waste and fluid clearance on their own and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant. - Dialysis. Dialysis artificially removes waste products and extra fluid from your blood when your kidneys can no longer do this. In hemodialysis, a machine filters waste and excess fluids from your blood. In peritoneal dialysis, a thin tube (catheter) inserted into your abdomen fills your abdominal cavity with a dialysis solution that absorbs waste and excess fluids. After a period of time, the dialysis solution drains from your body, carrying the waste with it. - Kidney transplant. A kidney transplant involves surgically placing a healthy kidney from a donor into your body. Transplanted kidneys can come from deceased or living donors. You'll need to take medications for the rest of your life to keep your body from rejecting the new organ. You don't need to be on dialysis to have a kidney transplant. For some who choose not to have dialysis or a kidney transplant, a third option is to treat kidney failure with conservative measures. However, once you have complete kidney failure, your life expectancy generally would be only a few months. Potential future treatments Regenerative medicine holds the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair. Regenerative medicine approaches include: - Boosting the body's natural ability to heal itself - Using healthy cells, tissues or organs from a living or deceased donor to replace damaged ones - Delivering specific types of cells or cell products to diseased tissues or organs to restore tissue and organ function For people with chronic kidney disease, regenerative medicine approaches may be developed in the future to help slow progression of the disease. Lifestyle and home remedies As part of your treatment for chronic kidney disease, your doctor may recommend a special diet to help support your kidneys and limit the work they must do. Ask your doctor for a referral to a dietitian who can analyze your current diet and suggest ways to make your diet easier on your kidneys. Depending on your situation, kidney function and overall health, your dietitian may recommend that you: - Avoid products with added salt. Lower the amount of sodium you eat each day by avoiding products with added salt, including many convenience foods, such as frozen dinners, canned soups and fast foods. Other foods with added salt include salty snack foods, canned vegetables, and processed meats and cheeses. - Choose lower potassium foods. Your dietitian may recommend that you choose lower potassium foods at each meal. High-potassium foods include bananas, oranges, potatoes, spinach and tomatoes. Examples of low-potassium foods include apples, cabbage, carrots, green beans, grapes and strawberries. Be aware that many salt substitutes contain potassium, so you generally should avoid them if you have kidney failure. - Limit the amount of protein you eat. Your dietitian will estimate the appropriate number of grams of protein you need each day and make recommendations based on that amount. High-protein foods include lean meats, eggs, milk, cheese and beans. Low-protein foods include vegetables, fruits, breads and cereals.
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Polycystic kidney disease symptoms can include: - High blood pressure - Back or side pain - Headache - A feeling of fullness in your abdomen - Increased size of your abdomen due to enlarged kidneys - Blood in your urine - Kidney stones - Kidney failure - Urinary tract or kidney infections It's not uncommon for people to have polycystic kidney disease for years without knowing it.
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Polycystic kidney disease Overview Polycystic kidney disease (PKD) is an inherited disorder in which clusters of cysts develop primarily within your kidneys, causing your kidneys to enlarge and lose function over time. Cysts are noncancerous round sacs containing fluid. The cysts vary in size, and they can grow very large. Having many cysts or large cysts can damage your kidneys. Polycystic kidney disease also can cause cysts to develop in your liver and elsewhere in your body. The disease can cause serious complications, including high blood pressure and kidney failure. PKD varies greatly in its severity, and some complications are preventable. Lifestyle changes and treatments might help reduce damage to your kidneys from complications. Polycystic kidney disease care at Mayo Clinic Symptoms Polycystic kidney disease symptoms can include: - High blood pressure - Back or side pain - Headache - A feeling of fullness in your abdomen - Increased size of your abdomen due to enlarged kidneys - Blood in your urine - Kidney stones - Kidney failure - Urinary tract or kidney infections It's not uncommon for people to have polycystic kidney disease for years without knowing it. If you develop some of the signs and symptoms of polycystic kidney disease, see your doctor. If you have a first-degree relative - parent, sibling or child - with polycystic kidney disease, see your doctor to discuss screening for this disorder. Causes Abnormal genes cause polycystic kidney disease, which means that in most cases, the disease runs in families. Rarely, a genetic mutation occurs on its own (spontaneous), so that neither parent has a copy of the mutated gene. The two main types of polycystic kidney disease, caused by different genetic flaws, are: - Autosomal dominant polycystic kidney disease (ADPKD). Signs and symptoms of ADPKD often develop between the ages of 30 and 40. In the past, this type was called adult polycystic kidney disease, but children can develop the disorder. Only one parent needs to have the disease for it to pass to the children. If one parent has ADPKD, each child has a 50 percent chance of getting the disease. This form accounts for about 90 percent of cases of polycystic kidney disease. - Autosomal recessive polycystic kidney disease (ARPKD). This type is far less common than is ADPKD. The signs and symptoms often appear shortly after birth. Sometimes, symptoms don't appear until later in childhood or during adolescence. Both parents must have abnormal genes to pass on this form of the disease. If both parents carry a gene for this disorder, each child has a 25 percent chance of getting the disease. Complications Complications associated with polycystic kidney disease include: - High blood pressure. Elevated blood pressure is a common complication of polycystic kidney disease. Untreated, high blood pressure can cause further damage to your kidneys and increase your risk of heart disease and stroke. - Loss of kidney function. Progressive loss of kidney function is one of the most serious complications of polycystic kidney disease. Nearly half of those with the disease have kidney failure by age 60. PKD can interfere with the ability of your kidneys to keep wastes from building to toxic levels, a condition called uremia. As the disease worsens, end-stage kidney (renal) failure may result, necessitating ongoing kidney dialysis or a transplant to prolong your life. - Pregnancy complications. Pregnancy is successful for most women with polycystic kidney disease. In some cases, however, women may develop a life-threatening disorder called preeclampsia. Those most at risk have high blood pressure before they become pregnant. - Growth of cysts in the liver. The likelihood of developing liver cysts for someone with polycystic kidney disease increases with age. While both men and women develop cysts, women often develop larger cysts. Female hormones might contribute to cyst development. - Development of an aneurysm in the brain. A balloonlike bulge in a blood vessel (aneurysm) in your brain can cause bleeding (hemorrhage) if it ruptures. People with polycystic kidney disease have a higher risk of aneurysm. People with a family history of aneurysm seem to be at highest risk. - Heart valve abnormalities. As many as 1 in 4 adults with polycystic kidney disease develops mitral valve prolapse. When this happens, the valve no longer closes properly, which allows blood to leak backward. - Colon problems. Weaknesses and pouches or sacs in the wall of the colon (diverticulosis) may develop in people with polycystic kidney disease. - Chronic pain. Pain is a common symptom for people with polycystic kidney disease. It often occurs in your side or back. The pain can also be associated with a urinary tract infection, a kidney stone or a malignancy. Diagnosis For polycystic kidney disease, certain tests can detect the size and number of kidney cysts you have and evaluate the amount of healthy kidney tissue, including: - Ultrasound. During an ultrasound, a wandlike device called a transducer is placed on your body. It emits sound waves that are reflected back to the transducer - like sonar. A computer translates the reflected sound waves into images of your kidneys. - CT scan. As you lie on a movable table, you're guided into a big, doughnut-shaped device that projects thin X-ray beams through your body. Your doctor is able to see cross-sectional images of your kidneys. - MRI scan. As you lie inside a large cylinder, magnetic fields and radio waves generate cross-sectional views of your kidneys. Treatment Treating polycystic kidney disease involves dealing with the following signs, symptoms and complications in their early stages: - High blood pressure. Controlling high blood pressure can delay the progression of the disease and slow further kidney damage. Combining a low-sodium, low-fat diet that's moderate in protein and calorie content with not smoking, increasing exercise and reducing stress may help control high blood pressure. However, medications are usually needed to control high blood pressure. Medications called angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) are often used to control high blood pressure. - Pain. You might be able to control the pain of polycystic kidney disease with over-the-counter medications containing acetaminophen. For some people, however, the pain is more severe and constant. In rare cases, your doctor might recommend surgery to remove cysts if they're large enough to cause pressure and pain. - Bladder or kidney infections. Prompt treatment of infections with antibiotics is necessary to prevent kidney damage. - Blood in the urine. You'll need to drink lots of fluids, preferably plain water, as soon as you notice blood in your urine to dilute the urine. Dilution might help prevent obstructive clots from forming in your urinary tract. - Kidney failure. If your kidneys lose their ability to remove waste products and extra fluids from your blood, you'll eventually need either dialysis or a kidney transplant. - Aneurysms. If you have polycystic kidney disease and a family history of ruptured brain (intracranial) aneurysms, your doctor may recommend regular screening for intracranial aneurysms. If an aneurysm is discovered, surgical clipping of the aneurysm to reduce the risk of bleeding may be an option, depending on its size. Nonsurgical treatment of small aneurysms may involve controlling high blood pressure and high blood cholesterol, as well as quitting smoking.
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Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease. Kidney damage caused by diabetes usually occurs slowly, over many years.
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Diabetic Kidney Disease What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes.Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.Your kidneys are located in the middle of your back, just below your rib cage.When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.Watch a video about Diabetes and Kidney Disease.What are other names for diabetic kidney disease?Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if yourblood glucose is too high blood pressure is too highAfrican Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.You are also more likely to develop kidney disease if you have diabetes andsmoke don’t follow your diabetes eating plan eat foods high in salt are not active are overweight have heart disease have a family history of kidney failureIf you have diabetes, you are more likely to develop kidney disease if you have high blood pressure. How can I tell if I have diabetic kidney disease? Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.You should get tested every year for kidney disease if youhave type 2 diabetes have had type 1 diabetes for more than 5 yearsHealth care professionals use blood and urine tests to check for kidney disease. How can I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall.Reach your blood glucose goalsYour health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.Protect your kidneys by keeping your blood glucose under control.Control your blood pressureBlood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.Protect your kidneys by keeping your blood pressure under control.Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.Develop or maintain healthy lifestyle habitsHealthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy:Stop smoking. Work with a dietitian to develop a diabetes meal plan and limit salt and sodium. Make physical activity part of your routine. Stay at or get to a healthy weight. Get enough sleep. Aim for 7 to 8 hours of sleep each night.Learn more about these tips to manage diabetes.Take medicines as prescribedMedicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure.Talk to your health care professional or pharmacist about all of the medicines you take, including over-the-counter medicines. How can I cope with the stress of managing my diabetes? Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Does diabetic kidney disease get worse over time? Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure.If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. Diabetic Kidney Disease [1] Afkarian M, Zelnick LR, Hall YN, et.al. Clinical manifestations of kidney disease among US adults with diabetes. Journal of the American Medical Association. 2016;316(6):602–610.
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The following organizations are good resources for information on kidney disease: - National Institute of Diabetes and Digestive and Kidney Disease -- www.niddk.nih.gov/health-information/kidney-disease - National Kidney Foundation -- www.kidney.org - American Kidney Fund -- www.kidneyfund.org - American Geriatrics Society's Health in Aging Foundation -- www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/ Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Kidney disease - resources Resources - kidney disease Summary The following organizations are good resources for information on kidney disease: National Institute of Diabetes and Digestive and Kidney Disease -- www.niddk.nih.gov/health-information/kidney-disease National Kidney Foundation -- www.kidney.org American Kidney Fund -- www.kidneyfund.org American Geriatrics Society's Health in Aging Foundation -- www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/ Review Date 11/12/2016 Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.
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Diabetic Kidney Disease What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes.Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.Your kidneys are located in the middle of your back, just below your rib cage.When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.Watch a video about Diabetes and Kidney Disease.What are other names for diabetic kidney disease?Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if yourblood glucose is too high blood pressure is too highAfrican Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.You are also more likely to develop kidney disease if you have diabetes andsmoke don’t follow your diabetes eating plan eat foods high in salt are not active are overweight have heart disease have a family history of kidney failureIf you have diabetes, you are more likely to develop kidney disease if you have high blood pressure. How can I tell if I have diabetic kidney disease? Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.You should get tested every year for kidney disease if youhave type 2 diabetes have had type 1 diabetes for more than 5 yearsHealth care professionals use blood and urine tests to check for kidney disease. How can I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall.Reach your blood glucose goalsYour health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.Protect your kidneys by keeping your blood glucose under control.Control your blood pressureBlood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.Protect your kidneys by keeping your blood pressure under control.Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.Develop or maintain healthy lifestyle habitsHealthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy:Stop smoking. Work with a dietitian to develop a diabetes meal plan and limit salt and sodium. Make physical activity part of your routine. Stay at or get to a healthy weight. Get enough sleep. Aim for 7 to 8 hours of sleep each night.Learn more about these tips to manage diabetes.Take medicines as prescribedMedicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure.Talk to your health care professional or pharmacist about all of the medicines you take, including over-the-counter medicines. How can I cope with the stress of managing my diabetes? Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Does diabetic kidney disease get worse over time? Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure.If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. Diabetic Kidney Disease [1] Afkarian M, Zelnick LR, Hall YN, et.al. Clinical manifestations of kidney disease among US adults with diabetes. Journal of the American Medical Association. 2016;316(6):602–610.
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Q:A study is conducted to assess the relationship between race and end-stage renal disease pathologists independently study specimens from 1,000 kidney biopsies. The first group of pathologists is aware of the race of the patient from whom the biopsy came, while the second group is blinded as to the patient’s race. The first group reports ‘hypertensive nephropathy’ much more frequently for black patients than the second group. Which of the following types of bias is most likely present in this study??
A:Confounding;B:Nonresponse bias;C:Recall bias;D:Referral bias
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Q:Which products of ADP degradation increase in concentration in the blood during multiple sprint sports??
A:Ammonia, hypoxanthine and uric acid.;B:Ammonia, urea and uric acid.;C:Ammonia, urea and creatinine.;D:Ammonia, urea and creatine.
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Q:Sodium bicarbonate ingestion improves middle distance running performance by:?
A:elevating the pH and buffering capacity of the extracellular fluid allowing a faster efflux of hydrogen ions from muscle.;B:reducing the pH and buffering capacity of the extracellular fluid allowing a faster efflux of hydrogen ions from muscle.;C:elevating the pH and buffering capacity of the extracellular fluid allowing a faster influx of hydrogen ions into muscle.;D:elevating the pre-exercise muscle pH.
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Q:The blood glucose concentration during 80-90 minutes of intermittent high intensity exercise:?
A:frequently rises by 1 - 3 mM.;B:remains relatively unchanged.;C:frequently falls by 1 - 3 mM.;D:falls to hypoglycaemic levels.
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input
| 2
| 3,459
| 99
| 10,379
|
Please answer the letter of option truthfully
|
instruction
| 0
| 3,471
| 99
| 10,413
|
A
|
output
| 1
| 3,471
| 99
| 10,414
|
Q:Sodium bicarbonate ingestion improves middle distance running performance by:?
A:elevating the pH and buffering capacity of the extracellular fluid allowing a faster efflux of hydrogen ions from muscle.;B:reducing the pH and buffering capacity of the extracellular fluid allowing a faster efflux of hydrogen ions from muscle.;C:elevating the pH and buffering capacity of the extracellular fluid allowing a faster influx of hydrogen ions into muscle.;D:elevating the pre-exercise muscle pH.
|
input
| 2
| 3,471
| 99
| 10,415
|
Please answer the letter of option truthfully
|
instruction
| 0
| 3,489
| 99
| 10,467
|
B
|
output
| 1
| 3,489
| 99
| 10,468
|
Q:Why would you need to carry out a bladder washout for a patient at home??
A:When their urine is clear.;B:When the catheter is blocked.;C:When the catheter is bypassing.;D:When the catheter is dirty.
|
input
| 2
| 3,489
| 99
| 10,469
|
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