DIABETES

Health Topics:

DIABETES
Type 1 Diabetes
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More In-Depth Information
• Topic Overview
• Cause
• Symptoms
• What Happens
• What Increases Your Risk
• When To Call a Doctor
• Exams and Tests
• Treatment Overview
• Prevention
• Home Treatment
• Medications
• Surgery
• Other Treatment
• Other Places To Get Help
• Related Information
• References
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Topic Overview
From Healthwise
Is this topic for you?
This topic has general information about type 1 diabetes for people who do not have the disease. If you want to learn how to manage type 1 diabetes, one of the following topics may meet your needs:
• Type 1 Diabetes: Recently Diagnosed, if you have been told recently that you or your child has type 1 diabetes.
• Type 1 Diabetes: Living With the Disease, if you or your child age 12 or older has type 1 diabetes. If you have not read the topic Type 1 Diabetes: Recently Diagnosed, you may want to read it first.
• Type 1 Diabetes: Children Living With the Disease, if your child age 11 or younger has type 1 diabetes. If you have not read the topic Type 1 Diabetes: Recently Diagnosed, you may want to read it first.
• Type 1 Diabetes: Living With Complications, if you have complications, such as eye, kidney, heart, nerve, or blood vessel disease caused by diabetes.

If you are looking for information about type 2 diabetes, see the topic Type 2 Diabetes.
What is type 1 diabetes?
Type 1 diabetes is a disease that starts when the pancreas stops making insulin. Insulin lets blood sugar—also called glucose—enter the body's cells to be used for energy. Without insulin, the cells can't get the sugar they need, and too much sugar builds up in the blood.
Diabetes can cause sudden or long-term problems. If the body doesn't have enough insulin and the blood sugar gets very high, a sudden and very serious problem called diabetic ketoacidosis can happen. This can be deadly. Over time, high blood sugar can damage the eyes, heart, blood vessels, nerves, and kidneys.
Type 1 diabetes can occur at any age, but it usually starts in children or young adults. That’s why it used to be called juvenile diabetes.
Type 1 diabetes is different from type 2 diabetes, which is the most common form of the illness. In type 1, the body stops making insulin. In type 2, the body does not make enough insulin, or the body can't use insulin the right way. All people with type 1 diabetes need to take insulin. Some people with type 2 diabetes also need insulin, but most people can use diet, exercise, and medicine in pills to treat that illness.
There isn't a cure for type 1 diabetes. But with treatment, people can live long and healthy lives.
What causes type 1 diabetes?
The body makes insulin in beta cells, which are in a part of the pancreas called the islet (say “EYE-let”) tissue. Type 1 diabetes starts because the body destroys the beta cells. Experts don't know why this happens.
Some people have a greater chance of getting type 1 diabetes, because they have a parent, brother, or sister who has it. But most people with the illness don't have a family history of it.
Other things that increase the risk of getting type 1 diabetes are being white and having islet cell antibodies in the blood.
What are the symptoms?
Symptoms of diabetes are:
• Being very thirsty.
• Urinating a lot.
• Losing weight without trying.
• Being hungrier than usual (sometimes).
These symptoms usually appear over a few days to weeks. Sometimes people notice symptoms after an illness, such as the flu. They may think that the diabetes symptoms are because of the flu, so they don't seek medical care soon enough.
If a person waits too long to get medical care, he or she may get symptoms of diabetic ketoacidosis. Symptoms of this problem include:
• Flushed, hot, dry skin.
• Not feeling hungry.
• Belly pain.
• Vomiting.
• A strong, fruity breath odor.
• Fast and shallow breathing.
• Restlessness, drowsiness, or trouble waking up.
• Confusion.
How is type 1 diabetes diagnosed?
A doctor asks questions about the person’s health and does a physical exam. A blood test measures the person’s glucose.
Some people are diagnosed with type 1 diabetes because they have symptoms of diabetic ketoacidosis.
How is it treated?
Treatment for type 1 diabetes focuses on keeping blood sugar levels as close to the normal range as possible. A person with type 1 diabetes needs to:
• Take insulin through daily shots or an insulin pump.
• Eat a healthy diet that spreads carbohydrate throughout the day.
• Check blood sugar levels several times a day.
• Get regular exercise.
When a small child has diabetes, the parents have the responsibility for blood sugar control. As the child grows, he or she can take over more of the diabetes care.
Treatment may change based on the results of daily home blood sugar tests and other tests or exams.
Can type 1 diabetes be prevented?
There is no way to prevent type 1 diabetes. But studies are being done to find ways to prevent or delay diabetes in people who are most likely to get it.
Tight control of blood sugar and blood pressure can help people with type 1 diabetes prevent or delay problems with their eyes, kidneys, heart, blood vessels, and nerves.
Frequently Asked Questions
Learning about type 1 diabetes: • What is type 1 diabetes?
• What causes it?
• What happens in type 1 diabetes?
• Can I prevent type 1 diabetes?
• What are the symptoms?
• What increases my risk?
• How common is it?
• What's the difference between type 1 and type 2 diabetes?

Being diagnosed: • Who can diagnose type 1 diabetes?
• How is it diagnosed?

Getting treatment: • How is it treated?

Ongoing concerns: • Can I prevent complications?

Living with type 1 diabetes: • How can I care for myself?
• When should I call my doctor?

Author: Caroline Rea, RN, BS, MS
Last Updated: September 17, 2008

Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Matthew I. Kim, MD - Endocrinology & Metabolism


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Type 2 DiabetesContent provided by:

More In-Depth Information
• Topic Overview
• Frequently Asked Questions
• Cause
• Symptoms
• What Happens
• What Increases Your Risk
• When to Call a Doctor
• Exams and Tests
• Treatment Overview
• Prevention
• Home Treatment
• Medications
• Surgery
• Other Treatment
• Other Places To Get Help
• Related Information
• References
• Credits

Topic Overview
From Healthwise
Is this topic for you?
This topic has general information about type 2 diabetes for people who do not have the disease. If you want to learn how to manage type 2 diabetes, one of the following topics may meet your needs:
• Type 2 Diabetes: Recently Diagnosed, if you have been told recently that you have type 2 diabetes.
• Type 2 Diabetes: Living With the Disease, if you have type 2 diabetes.
• Type 2 Diabetes in Children, if your child has type 2 diabetes.
• Type 2 Diabetes: Living With Complications, if you have eye, kidney, heart, nerve, or blood vessel disease caused by your diabetes.
If you are looking for information about type 1 diabetes, see the topic Type 1 Diabetes.
What is type 2 diabetes?
Type 2 diabetes is a lifelong disease that happens when the cells of the body can't use insulin the right way or when the pancreas can't make enough insulin. Insulin lets blood sugar—also called glucose—enter the body’s cells to be used for energy. When insulin is not able to do its job, the cells can't get the sugar they need, and too much sugar builds up in the blood. Over time, this extra sugar in the blood can damage your eyes, heart, blood vessels, nerves, and kidneys.
More and more adults and children are getting type 2 diabetes. This is largely because of bad eating habits and a lack of physical activity. It is important to know if you or your children are at risk for type 2 diabetes and to know what you can do to help prevent the disease.
What causes type 2 diabetes?
You can get type 2 diabetes if:
• Your body does not respond as it should to insulin. This makes it hard for your cells to get sugar from the blood for energy. This is called insulin resistance.
• Your pancreas does not make enough insulin.
Your weight, how active you are, and your family history all affect the way your body responds to insulin. If you are overweight, get little or no exercise, or have family members with diabetes, you have a greater chance of getting type 2 diabetes.
What are the symptoms?
Some people don't have symptoms, especially when diabetes is diagnosed early. This is because the blood sugar level may rise so slowly that a person may not know that anything is wrong. Other people may have symptoms, such as:
• Being very thirsty.
• Urinating a lot.
• Losing weight without trying.
• Having blurry vision.
• Feeling hungrier or more tired than usual.
Sometimes a person finds out that he or she has type 2 diabetes during a regular medical checkup. Or people may find out that they have the disease during an appointment for another health problem such as high blood pressure, an infection, or a wound that heals slowly. Some people don't find out that they have diabetes until they have a complication from the disease, such as vision problems, kidney disease, nerve disease, or heart and blood vessel problems.
How is type 2 diabetes diagnosed?
If your doctor thinks that you have type 2 diabetes, he or she will ask you questions about your medical history, do a physical exam, and order a blood glucose test. A blood glucose test is a blood test that measures the amount of sugar in your blood. The test is usually done first thing in the morning, before you eat or drink anything.
How is it treated?
The key to treating type 2 diabetes is controlling blood sugar levels. All of the following help to lower blood sugar:
• Eating healthy foods
• Losing weight, if you are overweight
• Getting regular exercise
• In some cases, taking medicines
Treatment for diabetes also includes checking blood sugar levels to make sure that the disease is under control. It is important to watch for signs of high and low blood sugar. Both can cause problems and need to be treated.
People with diabetes need regular checkups to make sure that the treatment is working and that they do not get more serious health problems.
Can type 2 diabetes be prevented?
If you are at risk for type 2 diabetes or if you have prediabetes, you may prevent diabetes by getting regular exercise and paying attention to what and how much you eat. If you are overweight, losing a little weight (10 to 20 pounds) can go a long way toward preventing or delaying the disease.
Author: Caroline Rea, RN, BS, MS
Last Updated: August 3, 2007

Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Matthew I. Kim, MD - Endocrinology & Metabolism


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3. Gestational Diabetes
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More In-Depth Information
• Topic Overview
• Health Tools
• Frequently Asked Questions
• Cause
• Symptoms
• What Happens
• What Increases Your Risk
• When to Call a Doctor
• Exams and Tests
• Treatment Overview
• Prevention
• Home Treatment
• Medications
• Other Treatment
• Other Places To Get Help
• Related Information
• References
• Credits

Topic Overview
From Healthwise
What is gestational diabetes?
If your blood sugar level first becomes too high when you are pregnant, you have gestational diabetes. It usually goes away after the baby is born.
High blood sugar can cause problems for you and your baby. Your baby may grow too large, which can cause problems during delivery. Your baby may also be born with low blood sugar. But with treatment, most women with gestational diabetes are able to control their blood sugar and give birth to healthy babies.
Women who have had gestational diabetes are more likely than other women to develop type 2 diabetes later on. You may be able to prevent or reduce the severity of type 2 diabetes by staying at a healthy weight, eating healthy foods, and increasing your physical activity.
What causes gestational diabetes?
The pancreas makes a hormone called insulin. Insulin helps your body properly use and store the sugar from the food you eat. This keeps your blood sugar level in a safe range. When you are pregnant, the placenta makes hormones that can make it harder for insulin to work. This is called insulin resistance.
A pregnant woman can get diabetes when her pancreas cannot make enough insulin to keep her blood sugar levels within a safe range.
What are the symptoms?
Because gestational diabetes does not cause symptoms, you need to be tested for the condition. This is usually done between the 24th and 28th weeks of pregnancy.1 You may be surprised if your test shows a high blood sugar. It is important for you to be tested for gestational diabetes, because high blood sugar can cause problems for both you and your baby.
Sometimes, a pregnant woman who has symptoms has been living with another type of diabetes without knowing it. If you have symptoms from another type of diabetes, they may include:
• Increased thirst.
• Increased urination.
• Increased hunger.
• Blurred vision.
Pregnancy causes most women to urinate more often and to feel more hungry, so having these symptoms does not always mean that a woman has diabetes. Talk with your doctor if you have these symptoms, so that you can be tested for diabetes at any time during pregnancy.
How is gestational diabetes diagnosed?
Almost all women are tested for gestational diabetes between the 24th and 28th weeks of pregnancy. If your doctor thinks you are more likely to get gestational diabetes, you may be tested earlier.
Gestational diabetes is diagnosed with two blood tests. In the first test, your blood sugar level is tested 1 hour after you drink a small cup of a sweet liquid. If your blood sugar is too high, you will need to do a longer, 3-hour glucose test. If your blood sugar is still above a certain level, you have gestational diabetes.
How is it treated?
Many women with gestational diabetes can control their blood sugar level by changing the way they eat and by exercising regularly. These healthy choices can also help prevent gestational diabetes in future pregnancies and type 2 diabetes later in life.
Treatment for gestational diabetes also includes checking your blood sugar level at home and seeing your doctor regularly.
You may need to give yourself insulin shots to help control your blood sugar. This man-made insulin adds to the insulin that your body makes.
Author: Caroline Rea, RN, BS, MS
Last Updated: December 4, 2007

Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Lois Jovanovic, MD - Endocrinology



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Managing Diabetes and Your Diet
No matter how clear the principles of healthy eating may be, putting them into practice can be downright confusing. Here's some help.
By EatingWell, EatingWell.com
1 | 2 | 3 | 4 | Next >
No matter how clear the principles of healthy eating may be, putting them into practice can be downright confusing. How does "30 percent of calories from fat" or "2 Carbohydrate Servings" translate to what's on your plate? And where does your eating plan come in when your only choice for a meal is a convenience store? In this section, we'll address many of the issues that may come up in everyday eating.
Start with Your Team
Many resources can point you toward good eating, including guidelines from the American Diabetes Association and the International Diabetes Center. But for the most practical advice that applies to your own health situation and lifestyle, start with a diabetes specialist. This person is likely to be a Registered Dietitian (RD) and/or a Certified Diabetes Educator (CDE)—both are experts in translating the abstract principles of nutrition into real-life eating.
Divide and Conquer


Getting started on eating better would be much easier if there were a simple, "big picture" image of what a sensible eating pattern looks like. The current debate about the relevance of the U.S. Department of Agriculture's Food Guide Pyramid, as well as the many competing pyramids produced by others, is a case in point. But one method is winning converts and praise across the board—perhaps because of its utter simplicity. Call it the "Divide Your Plate" strategy:
• Imagine a plate and divide it in half. Fill one half with vegetables, and divide the other half into two quarters.
• Fill one quarter with a lean protein, such as fish, skinless poultry, beans or tofu.
• Fill the other quarter with a grain-based or starchy side dish, preferably whole grains, like brown rice, whole-wheat pasta or a slice of whole-grain bread.
What this method lacks in precision it more than makes up for in good sense. If you focus on making most of your meals look this way, you'll automatically be following sound nutrition guidelines and choosing appropriate portions—without having to pull out a nutrition guide or a measuring cup every time.



A Primer on Portion Size
A key first step in building sound eating habits is to understand what reasonable portions of foods look like. For most of us, that requires a bit of re-education—and downscaling.
Many nutrition authorities believe our ability to estimate correct portions is deteriorating—largely because we are becoming used to the ever-bigger food helpings served up to us in restaurants and other venues. From soft drinks to muffins, the foods we buy in the marketplace are almost always larger than standard portion sizes—sometimes two to eight times bigger. Consider "standard"-size bagels: not long ago, they averaged 2 to 3 ounces; today, they can weigh in at up to 7 ounces. That's equivalent to seven slices of bread, and that's just at breakfast! Restaurant-size helpings of pasta, too, can be big enough to feed a family of six. Imagine what your blood-glucose levels would look like if you considered either of these carbohydrate bonanzas as a "single serving."
The insidious effect of these overblown portions is that larger helpings almost always encourage us to eat more. Several studies have shown that when adults and children are repeatedly served bigger-than-normal portions of food, they tend to eat more—regardless of how hungry they were when they sat down. This is standard procedure in restaurants, where we almost always feel compelled to clean our plates, but it also happens at home, when we serve ourselves the supersized portions we've come to perceive as "normal." No wonder our nation's obesity rate has risen in parallel with rising average portion sizes.
The best way to reclaim normal portion sizes, say experts, is by measuring them out repeatedly until it becomes instinctive. To begin, ask your diabetes-care team to provide a food list or a standard food guide that includes portion sizes. The American Diabetes Association is another good information source.
Use measuring cups and spoons and, if needed, a kitchen scale to portion out your foods. Don't forget to measure the serving utensils you use, so you'll know how "one ladleful" of soup or stew measures up. Take note of how the food looks on a plate—and try to use the same plate each time you eat that item, so you'll have a second visual reference. Continue practicing and measuring until the portions become second nature to you. This can take a few days or a few weeks; some people might opt for always measuring rather than eyeballing. It's a good idea to recheck your portion-size skills every so often, as they tend to creep up with time.
What does a portion look like?
• 1 teaspoon oil = The tip of your thumb
• 1 tablespoon salad dressing = Your whole thumb
• 2 tablespoons peanut butter = A Ping-Pong ball
• 1 to 2 ounces nuts = Your cupped hand
• 1 1/2 ounces cheese = A 9-volt battery
• 1/2 cup cottage cheese = A tennis ball
• 1 cup cereal = A baseball
• 1 small baked potato = A computer mouse
• 3-ounce serving of meat, fish or poultry = A cassette tape
• 1 standard pancake or waffle = A 4-inch DVD
Eating on Schedule, and When Life Gets in the Way
Eating at regular intervals helps ensure that your blood-glucose levels are fairly constant, so your diabetes food plan likely includes designated times for eating breakfast, lunch, dinner and, if appropriate, snacks. If you're taking insulin or other glucose-lowering medications, it's even more important to stay within those time ranges. But disruptions can throw off the best-laid plans, particularly when you're eating away from home: planes get delayed, dinner takes longer than anticipated to cook, food deliveries arrive late.
If you are within 30 minutes to an hour of your designated mealtime, there's probably no need for concern. But what should you do if a mealtime gets delayed, or moved up, significantly? Most people with diabetes carry a supply of emergency snacks or glucose to help them handle these situations (see 10 possibilities at left); your diabetes-care team can help you create your own contingency plan. Some general rules:
• If you have to eat earlier than planned, save one Carbohydrate Serving for your regular mealtime.
• If you have to wait to eat a meal, have one Carbohydrate Serving at your usual mealtime, then eat the rest of the meal later. Or, if you usually have a snack later on, have the snack at your mealtime and eat the meal during your snack time.

Snacking—Green Light or Red?
It wasn't so long ago that people with diabetes were told they needed snacks to help them manage their diabetes—timing snacks to offset drops in their blood glucose caused by insulin and other diabetes medications. But today's diabetes medication choices are much more flexible, so snacks aren't strictly necessary; the decision to snack, or not, is up to you. If you manage your glucose better by eating more frequent, smaller meals, you'll want to include some planned-for snacks in your daily routine. If there's a time of day when your blood-glucose levels tend to drop regularly, a small snack can help tide you over.
That said, a go-ahead on snacking isn't a green light to nosh uncontrollably. The keys are to consider snacks as mini-meals, and to make room for them in the rest of your day's eating. Ideally, they can complement your other meals, supplying nutrients rather than just empty calories. Get in the habit of snacking on vegetables (especially nonstarchy ones like cucumbers and cut-up bell peppers), and you'll painlessly boost your vegetable intake.
You don't have to include protein, carbohydrate and fat at every snack, but it helps make them more balanced, substantial and satisfying. A good guide to aim for is 1 or 2 Carbohydrate Servings in your snack.
Eating on the Road
Having diabetes shouldn't keep you from traveling, but it does require you to plan ahead. Be sure your diabetes supplies and medications are up to date, and carry them with you rather than in checked luggage, so you don't risk losing them. It's a good idea to include a copy of your prescriptions plus a letter from your doctor identifying you as a person with diabetes. Pack some nonperishable snacks to keep you going if your meals are delayed, such as the suggestions on page 26. And, if you'll be crossing time zones, check with your diabetes specialist about adjusting your mealtimes and medications.
The biggest challenge, though, is finding something to eat in new territory. Again, planning ahead is the answer. Call a hotel before your visit and ask about area restaurants; pack a portable meal with you on the train or plane—or, if a meal will be served en route, ask if you can pre-order a "diabetes" or "heart-healthy" meal instead. If you're driving, use travel guides to plot a route where you'll have access to accommodating restaurants, farmers' markets, grocery stores and other easy venues for nutritious food. And even if your only choice is a fast-food rest stop, you still have plenty of options. You can ask for nutrition information if you're not sure about how an item adds up in your food plan; most fast-food restaurants have this information available.


Skip the Soft Drinks
Enticing, big-bucks ad campaigns make soft drinks look like a fabulous way to quench thirst—but the reality is anything but refreshing. The average 12-ounce can of regular soda supplies about 150 calories and 38 grams of carbohydrate—the equivalent of more than 9 teaspoons of sugar. And most of us drink all those calories and carbohydrate without noticing: studies show that when people have soft drinks with meals, they don't compensate for the extra, liquid calories by eating less solid food. So drinking soda regularly is a prescription for overconsumption.
Another reason to avoid soda: it may raise the risk of developing diabetes. A recent report from the Nurses' Health Study, which surveyed the health behaviors of over 51,000 women, found that those who drank one or more regular sodas a day were twice as likely to develop diabetes during the study period as women who drank less than one can a month. Even when the researchers took such factors as weight, diet and lifestyle differences into account, they still found that the soda drinkers were 1.3 times more likely to develop diabetes.
If you have a regular soft drink habit, switching to diet soda is a start. It makes sense to also focus on finding calorie-free ways to quench thirst or wash down your meals—like sparkling water or plain water, nature's best refresher.

Alcohol and Diabetes
In your diabetes treatment counseling, you were probably warned to limit your intake of alcohol, because when consumed without food, alcohol can cause low-blood-glucose episodes and, in large amounts, raise blood pressure. At the same time, you've no doubt seen reports that a daily drink can help reduce the risk of heart disease and stroke—two diseases that pose more problems for people with diabetes. Moderate drinking is even associated with lower risk of type 2 diabetes. What can you conclude from this conflicting advice?
According to the American Diabetes Association, recommendations for people who have their diabetes under control are no different from those aimed at the general population: If you choose to drink, limit it to two drinks a day for men and one daily drink for women. If you're pregnant, have high blood triglycerides (over 500 mg/deciliter) or a history of alcohol problems in your family, it makes sense to stay away from alcohol altogether.
The limits are there for a reason; for people with diabetes, there are real risks associated with going beyond them. The first is low blood glucose. When your liver is processing alcohol, it can't make new glucose. This can cause your blood-glucose levels to drop, sometimes sharply—if you're drinking on an empty stomach and are taking insulin or diabetes drugs. Worse, this effect can last for as long as 12 to 16 hours after you drink, depending on how long it takes your body to process the alcohol. And low blood glucose can make you feel and act tipsy, so you could be doubly impaired.
So, make sure to eat something whenever you decide to drink—and take it slow. For a good model, think of the healthy way many Mediterraneans enjoy alcohol: slowly sipped throughout a meal, rather than served alone in cocktails. It's a good idea to check your blood glucose regularly after you've had a drink too.
Another issue to consider is alcohol's effects on your heart, which can be a double-edged sword. When alcohol is enjoyed in small amounts, like the ones defined as "one drink" (15 grams of alcohol equal to 12 ounces beer, or 5 ounces wine, or 1 1/2 ounces spirits), it doesn't affect blood pressure, and in fact might reduce heart problems by boosting heart-healthy HDL cholesterol and by improving sensitivity to insulin. But increase the amount of daily alcohol, and the risk of high blood pressure rises sharply—on a graph, it follows a J-shaped curve.
Alcohol in moderation, enjoyed with food to decrease the risk of low blood glucose, might help your heart, but talk with your health-care providers to determine the best strategy for you. If you're not a drinker now, there's no reason to start. If it's heart disease or diabetes risk you want to avoid, there are plenty of nonalcoholic ways to do it.
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Exams and Tests
From Healthwise
If your doctor thinks that you may have diabetes, he or she will order a couple of blood glucose tests. Blood glucose tests are blood tests that measure how much sugar is in your blood. Usually, they are done first thing in the morning, before you eat or drink anything.
To make a diagnosis of type 2 diabetes, your doctor will use your blood test results and the American Diabetes Association's criteria. He or she also will ask you questions about your medical history and do a physical exam.
If your blood sugar level is above normal but below the level for diabetes, you have prediabetes and are at risk for developing type 2 diabetes. For more information on prediabetes, see the topic Prediabetes.
Other tests
A home blood sugar test or a urine test for sugar are not the best ways to learn whether you have diabetes. However, after you are diagnosed, you may use home blood sugar tests to check your own blood sugar levels.
Along with your home blood sugar tests, your health professional will give you a hemoglobin A1c (glycohemoglobin) test after you start treatment for diabetes. This test finds your average blood sugar level over the previous 2 to 3 months. The A1c test adds to the information from your home blood sugar tests to help you keep track of your blood sugar control.
After you are diagnosed with type 2 diabetes or prediabetes, you may have a thorough exam of your cardiovascular system to check for any heart problems.
Early detection
You can use the American Diabetes Association's risk test for diabetes to see whether you are at risk for developing type 2 diabetes.
If you are age 45 or older, the American Diabetes Association recommends that you be tested for diabetes every 3 years. The United States Preventive Services Task Force (USPSTF) recommends testing for diabetes in people who have either high cholesterol or high blood pressure. Talk with your doctor about your risk factors and how often you need to be tested.
The American Diabetes Association recommends that you be tested more often or begin testing at a younger age if you:3
• Have a parent, brother, or sister who has type 2 diabetes.
• Are overweight (have a body mass index, or BMI, of 25 or higher). See the body mass index (BMI) chart for adults or the same chart in metric to determine your BMI.
• Are African American, Hispanic, Native American, Asian American, or Pacific Islander.
• Have prediabetes.
• Have high blood pressure.
• Have high cholesterol.
• Have a history of gestational diabetes or have delivered a baby who weighed 9 lb (4 kg) or more.





Medications
From Healthwise
Some people with type 2 diabetes need medicine to help their bodies make more insulin, to decrease insulin resistance, or to slow down how quickly their body absorbs carbohydrate.
You may take no medicine, one medicine, or a few medicines. Some people need medicine for short periods of time, while others always need to take medicine. How much medicine you need depends on how well you can keep your blood sugar within a safe range.
Some people who have type 2 diabetes take medicines for high blood pressure or high cholesterol. They may also take aspirin to prevent a heart attack, a stroke, or other large blood vessel diseases (macrovascular disease).
Author: Caroline Rea, RN, BS, MS
Last Updated: August 3, 2007

Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Matthew I. Kim, MD - Endocrinology & Metabolism




High cholesterol
Cholesterol is a type of fat (lipid) that the body needs for many important functions, such as producing new cells. High cholesterol increases the risk of developing heart disease and stroke.
High cholesterol is caused by eating a diet that is too high in cholesterol and saturated fat or by having an inherited condition that causes elevated cholesterol levels.
Treatment includes eating a more healthful diet, increasing physical activity, and possibly taking cholesterol-lowering medicines.
A blood test can determine whether you have high cholesterol. Cholesterol is measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).
• A total cholesterol level of less than 200 mg/dL (5.17 mmol/L) is desirable.
• 200 to 239 (5.17 to 6.18) is considered borderline-high cholesterol.
• 240 (6.21) or higher is considered high cholesterol.

High blood pressure (hypertension)
High blood pressure, or hypertension, is a condition in which the force of blood against artery walls is too strong. Over time, high blood pressure can damage the arteries, heart, and kidneys and can lead to heart disease and stroke.
High blood pressure can be treated effectively with lifestyle changes and medications that can reduce the risk of complications.
Blood pressure readings consist of an upper number and a lower number (such as 120 over 90 or 120/90). The upper number is systolic blood pressure; the lower number is diastolic blood pressure. Blood pressure readings are measured in units called millimeters of mercury (mm Hg). Normal blood pressure is 119 mm Hg systolic over 79 mm Hg diastolic or below.
A person has high blood pressure (hypertension) when either or both of the following are present:
• The top number (systolic) is 140 mm Hg or higher.
• The bottom number (diastolic) is 90 mm Hg or higher.


Author: Jeannette CurtisCaroline Rea, RN, BS, MS
Medical Review: Patrice Burgess, MD - Family Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Last Updated: May 25, 2007

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