Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

Diabetes Management (high blood sugar)

Posted by admin on May 1st, 2013

“Diabetes is a chronic condition that can result in a multitude of complications if improperly managed. I want to help you learn how to live well with diabetes and avoid any complications of the disease”.

-Dr. Bella Zimilevich, MD

What is diabetes?

Diabetes mellitus, or simply, diabetes, is actually a group of diseases characterized by high blood sugar levels.

What causes diabetes?

Defects in the body’s ability to produce and/or use insulin results in diabetes. Sometimes these defects are genetic. Sometimes they are acquired later in life.

Type 1 diabetes occurs when the pancreatic cells are unable to produce insulin. Sometimes this kind of condition is referred to as “insulin-dependent” diabetes. In this type of diabetes, patients need to monitor the amount of glucose in their blood, and take insulin shots in order to maintain normal levels.

Type 2 diabetes is when patients are unable to use insulin properly. This is often called “insulin resistance” or ”relative” insulin deficiency. These patients may be treated with other medications to control blood sugar.

Gestational diabetes is a common, but serious, health condition in which pregnancy contributes to the onset of diabetes.

What is insulin?

Insulin is a hormone in the bloodstream that enables your body to metabolize or use energy derived from glucose (sugar).

Where does insulin come from?

Normally, insulin is produced in the pancreas.

What does insulin do?

Insulin is an important signaling molecule that tells the body what to do with glucose. Insulin tells the cells in the liver, muscle, and fat tissue to take up glucose from blood and convert it to glycogen, an energy storage molecule. Glycogen can be stored in the liver and muscles. Insulin also controls other body systems and regulates the amino acid uptake by cells.

Prediabetes

The importance of catching and treating diabetes early cannot be overstated. Even before blood glucose levels become high enough to be diagnosed as diabetes, abnormally high amounts of glucose in the blood can cause serious damage throughout the body. Because of the potential negative effects of high blood glucose, the term prediabetes has been defined to describe the condition that almost always precedes the development of full-blown diabetes.

If you do not already know what your blood sugar level is, or if you haven’t had it checked lately, it is best not to wait to call us for an appointment. If we can catch elevated blood sugar at this early “pre-diabetic” stage, it is possible for us to work together to achieve diabetes management.

Diabetes is common

According to the latest figures from the American Diabetes Association, more than 25.8 million children and adults in the United States—8.3% of the population—have diabetes. 18.8 million have been diagnosed, but 7.0 million people do not know they have it. It is estimated that more than 79 million people have prediabetes.

How do I know if I have diabetes?

Make an appointment with us for a simple blood test to find out the status of your glucose levels. Regardless of the results, we will work together to achieve ensure that your blood sugar is kept under control.

Risk factors for diabetes

Everyone is at risk for diabetes, but many risk factors significantly increase the chances for having the disease. Family history is a common risk factor for diabetes. If someone in your family has already been diagnosed with diabetes, it is even more important to find out your blood sugar status. Being overweight or having high blood pressure also increases your risk. If any of these factors applies to you, it becomes especially important to make an appointment with us as soon as possible to find out your blood sugar levels. If your blood sugar is elevated, then we can discuss diabetes management.

What if I have diabetes?

Regardless of whether you were recently diagnosed with diabetes, or you have been living with diabetes for years, I can help you with diabetes management. Obviously, if we find out together that your blood sugar is elevated, we will need to determine the best approach to managing your care. Diabetes medications are not one-size-fits-all. And even if “one size” fit you in the past, that doesn’t mean it still fits you now. In other words, even if you are already taking medications, it is important for us to make sure your regimen is still working. It is natural for our bodies to change as we grow older and as our lifestyle changes. Even seemingly minor modifications in diet or physical activity can have a huge impact on the way our bodies metabolize glucose. This is a good thing because it means we can make changes in lifestyle that can sometimes reduce the need for medication. Many factors can influence the way your body processes glucose so it is important to reevaluate medications to make sure they are still meeting your needs.

Other health concerns

Having diabetes makes it even more important to be vigilant about other potential health issues. We are all at risk for these health problems, but diabetes greatly increases vulnerability to many of them– especially infection, cardiovascular issues, kidney disease, and nerve damage. In addition to your blood sugar levels, I screen for other problems associated with diabetes, including those noted by the American Diabetes Association as being especially important. Together we will monitor the following health concerns for which you are at increased risk:

• Eye, foot, and skin complications, including
  • glaucoma, cataracts and other eye problems
  • neuropathy (numbness in the feet) as well as other complications
  • skin infections, including foot ulcers and other skin disorders
• Heart Disease
• High Blood Pressure (Hypertension)
  • Diabetes increases risk for hypertension, and hypertension increases risk for heart attack, stroke, eye problems, and kidney disease!
• Mental Health (especially vulnerability to depression)
• Hearing Loss
• Oral Health Problems (particularly gum disease)
• Gastroparesis
• Ketoacidosis (DKA)
  • We will make sure you understand the warning signs of DKA and monitor your urine for ketones.
• Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
  • We will discuss the warning signs for this rare and serious condition in which blood sugar levels rise dangerously high.
• Nerve Damage (Neuropathy)
  • Nerve damage from diabetes called diabetic neuropathy can lead to many kinds of problems.
• Kidney Disease (Nephropathy)
  • Keeping your diabetes and blood pressure under control lowers the chance of kidney disease.
• Peripheral Arterial Disease (PAD)
  • Symptoms include leg pain, troubling walking, tingling in the legs.
• Stroke
  • Controlling blood glucose, blood pressure, and cholesterol reduce your risk of stroke.
• Stress
  • Physical and mental stress affects blood sugar!

Yes, managing diabetes can be challenging. I know!

We all know that diabetes presents unique challenges, but I have plenty of experience working with patients, and I am here to help. By working together to keep your blood sugar levels under control, we can increase your quality of life. Keeping you well is my primary concern. The sooner you call for an appointment, the sooner we can get started planning the best strategy for controlling your blood sugar and maintaining your health.

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