Frequently Asked Questions About Diabetes

By Staff

Many newly diagnosed diabetic patients have difficulty making the lifestyle changes required to best manage their illness. Common misunderstandings about diabetes often interfere with patient progress. The following are frequently asked questions of patients.

1. What is diabetes?

Diabetes is a progressive disease which causes elevated blood sugars. It is diagnosed by a fasting glucose equal to or greater than 126 mg/dl or a random glucose greater or equal than 200 mg/dl on two separate occasions. It is associated with many annoying symptoms such as excessive hunger, thirst and urination and sexual problems as well as many devastating complications such as heart disease and kidney failure.

2. I don’t want to take medicines. Can I control my blood sugars “naturally”?

If your blood sugars are not terribly high, you can try treating with diet, exercise and weight loss on the advice of your doctor. However, if your sugars remain uncontrolled, despite these lifestyle changes, your doctor will start you on medications.

3. I feel fine. Why do I need to control my diabetes now?

You may feel well now but diabetes is associated with many long-term complications. A diabetic person is twice as likely to have heart disease as someone who does not have diabetes. It is the leading cause of kidney failure in the United States. It is also associated with vision loss, neuropathy (which causes pain and/or numbness of the limbs and feet) and increased rates of infections. It can cause severe dehydration, low blood pressure, and death. The earlier diabetes is treated, the slower the progression of the complications.

4. I hate needles. If I have lab work done at the office to check my diabetes, why do I need to test my blood sugars at home?

The ultimate goal is to normalize your sugars. The glycosylated hemoglobin exam (better known as A1C), which is done at the laboratory, gives us an average of what your blood sugars have been doing over the last 3 months. It doesn’t tell us what your blood sugars are doing throughout the day. The only way we can tell if your sugars are all within the normal range is by checking your home sugars. In this way, we can see if some of your numbers are really low or really high and we can adjust your medicines to avoid these extremes. Some people may need only test once a day but the time should be varied each day so that over a period of weeks we have measurements before each meal and at bedtime. Your sugar should also be checked if you’re feeling poorly to see if this is due to low or high blood sugars.

5. Can diabetes be cured?

No, unfortunately there is no cure for diabetes. However, diabetes in the majority of people can be controlled with lifestyle changes, oral medications, and/or insulin. Unlike treatment for a urinary tract infection in which you take antibiotics for a week or so and you are done, treatment of diabetes requires continued adherence to diet and medications. This means you have to keep taking your medications and follow a diet and exercise program for weight loss. Because diabetes is a progressive disease, even if you do everything “right”, your sugars may slowly get worse over time and the medications must be adjusted accordingly.

6. I know my body. I get shaky and dizzy when my blood sugars go lower than 180. Why do I need to lower my blood sugars more if it makes me feel bad?

Unfortunately this means your body has become accustomed to having a high sugar level. Normal fasting blood sugars should be around 80 to 140. This is a level that you should not have any symptoms. Think of a diabetic with high blood sugars like an alcoholic who drinks. One might feel “fine” while drinking but become shaky, agitated and irritated if one stops drinking. This is due to the declining levels of alcohol in the body. Drinking again will, of course, make the person feel better. However, continued drinking puts one at risk of pancreatitis, gastrointestinal bleeding, and liver failure. In time, with abstinence (total absence of alcohol), the individual will get over the withdrawal symptoms, feel better again and be healthier. So, a diabetic who is slowly lowering their blood sugars may feel “withdrawal” symptoms like an alcoholic getting off alcohol. Part of the symptoms are due to the changing levels of blood sugars in the body not the actual value. Once the blood sugars are normal again and remain steady, one will feel better and healthier.

Patient education is of critical importance for the proper treatment and management of diabetes. Patients need to be aware of how diet and activity affects diabetes. They need to recognize signs and symptoms of worsening diabetes and realize the importance of regular foot checks and eye exams.

There are many resources, classes and even support groups to help individuals understand and live with diabetes. Taking the time to learn is critical to enjoying a healthier life.