Diabetes and Insulin
To fully understand diabetes risk factors and treatment options, it is important to first understand what the pancreas is and how it is related to diabetes.
The pancreas is a flattened gland located deep in the abdominal cavity. It is a vital part of the digestive system and plays an important role in regulating the blood sugar level. It is made up of tens of thousands of different types of cells. One type of cells, B cells, is responsible for the secretion of insulin; a protein hormone which regulates blood sugar levels by playing an important role of promoting carbohydrate (starch) metabolism Normal insulin secretion is continuous, and its secretion is closely related to meal time. Blood sugar increases significantly 2 hours after meals, insulin secretion also increases to prevent excessive blood sugar. About 2 hours after a meal, blood sugar will slowly drop to the level before the meal and insulin will also slowly start to decline. If this regulatory mechanism is disrupted or not working properly, diabetes will appear.
Both my mother and eldest brother have type II diabetes. I am currently 37 year old, love exercise, and am healthy. What are the chances that I will develop type II diabetes as well?
Enjoying exercise will be your advantage, however due to genetics, your chances of developing type II diabetes will still be higher. Please watch your diet and visit your family doctor for blood sugar test annually
I am a diabetic patient and am about to have inguinal hernia surgery. My doctor told me to fast for 12 hours prior to surgery. Would I still be required to take my diabetic medications?
Check with your surgeon in advance.
I am 75 years old and have been diagnosed with diabetes for 30+ years now. My vision is deteriorating and I have been having trouble with cutting my toe nails. I heard there are professionals that would provide toe nails cutting service. Would the cost be paid by the government?
Diabetic patients who are 65 years old or older should not cut their own toe nails. There are professionals who can do it for you with the expense paid for by the government.
I am a diabetic patient. I recently started suffering from a cold and loss of appetite. During the cold, should I continue to take my diabetic medication with the usual dose like normal?
Yes, please take the same dose as usual.
I am 47 years old with diabetes. Recently I experienced blurry vision, should I be seeing an eye doctor?
Yes. Diabetic patient should have annual eye checkup because retinopathy and cataracts are common complication of diabetes.
Why do diabetic patients need to pay special attention to kidney function? How do we check for kidney function? Are bubbles in my urine a sign of kidney deterioration?
Renal(kidney) function deterioration is one of the diabetic complications. Blood tests will reveal your renal function. Your kidney is in charge of excreting waste. The bubbles in your urine may be caused by waste, so it may not necessarily be caused by renal deterioration.
Are diabetes and heart attack associated?
Yes, the following 5 condition will increase your risk of developing heart attacks: diabetes, high cholesterol, smoking, high blood pressure, and lack of exercise. Diabetes is one of the cause for heart attack.
Once I have been diagnosed with diabetes, will I always have diabetes?
If you have mild type II diabetes (non-insulin dependent), your condition could be improved by a healthy lifestyle (e.g. improve diet, exercise, and body weight) to control your blood sugar level instead of insulin treatment. Gestational diabetes are often temporary since it is caused by changes in hormones, which suppresses insulin function.
If the paternal family has a history of diabetes, can the children avoid diabetes through healthy lifestyle?
If the father or immediate family members have had diabetes, the chances of the children developing diabetes will be higher. The children of type II diabetic patient can lower their risk of developing diabetes through healthy lifestyle, such as, healthy diet, adequate exercise, and control body weight. Type I diabetes on the other hand have yet to be verified.
Usually people who develop diabetes are overweight, but are there people who are skinnier and develop diabetes? Why aren’t they fat?
Usually middle-aged adults or older people who are overweight, or have a lot of fat accumulated around the waist have a higher chance of developing diabetes. Often the patients become resistant to insulin or their liver releases sugar. Skinnier people also have a chance of developing diabetes, especially type I (insulin dependent), or type II when they grow older due to insufficient insulin supply. One of the symptoms of diabetes is decrease in body weight because glucose cannot effectively enter human cells to be used.
Are there any mental conditions that cause diabetes? Such as an unexpected sudden mental shock.
Up until now there has been no evidence showing mental state can directly lead to diabetes but it can indirectly affect diabetes. For example, people with depression experience changes in their diet or daily activity that could cause their blood sugar levels to increase. On the other hand, diabetic patients often suffer from mental illness such as, depression, anxiety disorders, and poor diet.
Can type II diabetes be cured? The Spirit Happy Company published their “Reverse Diabetes Cure” report online. Can change in diet cure diabetes? Are they trustworthy and what is the attitude of the medical profession towards such reports?
In the cases of mild type II diabetes, pancreatic cells are still functioning and so a change in diet will effectively control your blood sugar level and your diabetes. At the later stages or more severe type II diabetes, pancreatic cells have lost their ability to function and a simple diet change will not be sufficient to control your blood sugar level. You will require medication or insulin injections as treatment. Western medicine uses evidence-based medicine to evaluate the credibility of each piece of medical advice. Nowadays there have been studies on Islet cell transplantation as one form of diabetes treatment.
Will taking cortisone affect blood sugar level?
Cortisone is a type of steroid. It will increase the blood sugar level of diabetic patients. If a diabetic patient needs to take such a drug, then the patient should test their blood sugar level regularly to ensure the sugar level stays within standard. It is not impossible for diabetic patients to take such a drug but it must be administered according to a physician’s evaluation and recommendation in the case where Cortisone is the only available treatment.
Will taking diabetic medication long-term be harmful to the stomach or kidney?
Many varieties of diabetes drug are currently available in the market and have different side effects. Under normal circumstances, drugs administered within the normal range should have no significant effect on the stomach or kidney (except for patients with kidney failure). Therefore, do not reduce the dose of medicines. If blood sugar level is out of control, other organs may be affected in a negative way.
Does the BC medical insurance subsidize the purchasing of insulin pumps?
BC medical insurance (PharmaCare) will subsidize insulin pumps and other related products. However, PharmaCare does not subsidize the battery of insulin pumps. For more information, check out the following link: PharmaCare-Insulin Pumps & Insulin Pump Supplies
I want to know if I have diabetes; can I go directly to a clinic to check?
No, because doctors will need to do a blood test on you to determine if you have the condition.
If my blood sugar level is borderline diabetic, how do I prevent myself from developing diabetes?
People with high blood sugar, yet below the range for type II diabetes, are considered “pre-diabetic”. Research has shown acting in controlling your blood sugar level can delay or avoid your condition developing into type II diabetes. Some actions you can take are to increase the amount of exercise you do and/or enjoy a healthy balanced diet.
If I am testing my blood sugar level once a day or minimizing the amount of testing, what time of the day would be the best to test for blood sugar level?
Blood sugar level testing is not like submitting an assignment. The test result is useless if you do not interpret the result and use it to improve your lifestyle. If you don’t know how to do the prick test, find it troublesome or is afraid to do it yourself you can ask medical professionals for advice on the appropriate instrument, needle, etc. Testing blood sugar level can:
- Let you know your blood sugar level instantaneously
- Reveal how your activity, diet, and drugs affect your blood sugar level
- Help you adjust your diet, such as carbohydrate portion or types
- Familiarize yourself with the effect of exercising and then allow you to adjust the intensity, timing, and repetition of exercise in order to achieve the desired blood sugar level
- Prevent and control low blood sugar
- Help your health care provider in understanding your blood sugar level control and your lifestyle in order to effectively adjust your medication and give you suggestion for lifestyle improvements
Ask your health care provider how to test and how frequency to test your blood sugar levels
Where can I find family physician specializing in diabetes in Victoria?
Any family doctors can provide diabetes care. Your family doctor will give you a referral if you require a specialist. Please call the College of Physician to inquire for the family physicians in your area if you do not already have one.
With type II diabetes, do I need to control my body weight?
Obesity increases insulin resistance and so affects blood sugar level control. Research has shown that if a person who is overweight loses 5-10% of that weight it will help with controlling blood sugar levels.
What should a healthy non-diabetic person be aware of to prevent or avoid the risk of developing diabetes?
Please refer to the risks factors for developing Diabetes section to determine if you are at risk of developing diabetes. Healthy lifestyles such as having a healthy balanced diet, doing regular exercise and maintaining a healthy weight will all lower the risks of developing diabetes.
Why does accumulation of fat around the waist increases the risks of developing diabetes?
Being overweight is one of the diabetic risk factors. Body mass index (BMI) and waist circumference are the two most common ways to determine if your weight falls under the healthy range. BMI reflects overall body fat content, and waist circumference reflects the fat around the waist. The fat accumulated around the waist is associated with insulin resistance and so indicates an increased risk of developing diabetes. In addition, excess amount of fat around the waist may increase the risk of high blood pressure, high cholesterol levels, high triglyceride level and heart attack. The waist circumference of Asian male and female should be smaller than or equal to 90 cm (36 inches) and 80 cm (32 inches) respectively.
Why does alcohol trigger low blood sugar rather than high blood sugar?
Alcohol alone does not increase blood sugar levels. However, the sugar content in alcoholic beverages and mixed drinks may increase your blood sugar level. Since alcohol does not need to be digested our body will quickly absorb it, especially with an empty stomach. Under normal circumstance, to prevent low blood sugar level, our liver will release glycogen into our blood stream after a long period of time without intake of food or after intense exercise. However when we drink alcohol on an empty stomach, our liver will first process the alcohol and not release glycogen. This causes our blood sugar level to remain low. So if you use medication and/or insulin to control blood sugar level, please remember to eat at the same time as drinking alcoholic beverages to avoid low blood sugar levels. The influence of alcohol can last up to 24 hours. Click here to learn more about the relationship between alcohol and diabetes.
Will drinking beer increase the chance of developing diabetes?
Drinking beer itself will not increase the risk of developing diabetes but beer contains alcohol, fat, protein and carbohydrates. Every gram of alcohol contains 7 calories, every gram of fat contains 9 calories, and every gram of protein and carbohydrate contains 4 calories. If you are overweight and drink excessive amounts of beer the calories in beer will increase your risk of developing diabetes.
How do I know how much to eat per meal?
The amount you need to eat per meal depends on your age, gender, height, body weight and amount of activity. People should eat a minimum of three meals a day and with a wide variety of food. If you are diabetic or wish to prevent the risk of developing diabetes the Canadian Diabetes Association provides some resources on meal planning called “healthy diet, tips on prevention and controlling diabetes”, which you can access here: http://www.diabetes.ca/CDA/media/documents/diabetes-and-you/healthy-living-resources/chinese-just-the-basics.pdf (Chinese) or go to our healthy eating section. If you are currently on any medication and/or insulin and need a meal plan, please discuss your need with your diabetic dietician.
What is the maximum daily intake of salt for a diabetic person?
The daily salt (sodium) intake for diabetic and non-diabetic patients is the same. Adults require 1,500 mg daily. Health Canada suggests a maximum of 2300 mg daily salt intake for adults. Our body requires salt(sodium) to regulate the body fluids and blood pressure and to maintain the proper functioning of muscle and the central nervous system. Eating too much salt can increase your blood pressure which can increase your risk of suffering from stroke, heart attack and liver disease. The majority of Canadians have a daily salt intake of 3000 mg. Please note that 1 teaspoon of table salt has 2400 mg of sodium which is more than the recommended daily limit.
Honey versus artificial sweeteners, which one is more suitable for diabetics?
Honey and other sugars (e.g. sugar/cane sugar, rock sugar/brown sugar) are the same as they are high in sugar content and will increase your blood sugar level. On the other hand, artificial sweeteners do not affect your blood sugar level. Diabetic patients can use appropriate amounts of artificial sweetener. If you would like to understand more about artificial sweetener, follow this link http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/sugar-sweeteners to the Canadian diabetes Association for resources on sugar and artificial sweetener.