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Diabetes Care

Diabetes is a disease in which the body does not produce, or properly use, insulin. Insulin is a hormone needed to convert sugar, starches and other food into the energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 18.2 million people in the United States, or 6.3% of the population, who with diabetes. While an estimated 13 million have been diagnosed with diabetes, unfortunately, 5.2 million people (or nearly one-third) are unaware they have the disease.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it’s easier, faster and less expensive. With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast — and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

Major Types of Diabetes

Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It’s estimated that 5-10% of Americans diagnosed with diabetes have Type 1 diabetes.

Type 2 Diabetes

Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have Type 2 diabetes.

Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

Some diabetes symptoms include:

  • Frequent urination
  • Excessive thirst
  • Extreme hunger
  • Unusual weight loss
  • Increased fatigue
  • Irritability
  • Blurry vision

If you have one or more of these diabetes symptoms, see your doctor right away.

Weight Loss

Losing weight, and keeping it off, is a real challenge for most people. That's why it's important to begin a weight loss program with the help of your health care team, including, if possible, a dietitian. They can help you find ways to decrease calories but still consume the foods you enjoy. And they can suggest strategies to help you change old habits for new ones. It's important to remember that losing even a relatively small amount of weight can make a real improvement in reducing your risk for diabetes and other serious conditions.


Exercise, also known as physical activity, includes anything that gets you moving: walking, dancing, working in the yard, etc. You can earn the benefits of being physically active without going to a gym, playing sports, or using fancy equipment. When you're physically fit, you have the strength, flexibility and endurance needed for your daily activities. Being physically active helps you feel better physically and mentally.

How can food choices help keep my heart and blood vessels healthy?

Diabetes increases your chances of having a heart attack or a stroke. But you can protect your heart and blood vessels by:

  • eating less of the foods that raise your blood cholesterol and your chances of heart disease
  • eating more of the foods that lower your cholesterol and your chances of heart disease

Choosing foods wisely can also help you lose weight and keep your blood glucose (sugar) levels on target.

How can I make wise food choices?

Try these steps to help protect your heart and blood vessels:

  • Eat less fat, especially saturated fat and trans fats, and fewer high-cholesterol foods. Saturated fat is found in meat, poultry skin, butter, 2% or whole milk, ice cream, cheese, lard and shortening. You'll also want to cut back on foods that contain palm oil or coconut oil.
  • Avoid trans fats. Trans fats are produced when liquid oils are turned into solids. This process is called hydrogenation. Cut back on foods that list hydrogenated or partially hydrogenated oils on the labels. This type o f fat is found in crackers and snack foods, baked goods like cookies and donuts, french fries, and stick margarine. Use a soft margarine in place of butter or stick margarine. Look for soft margarine in a tub that lists a liquid oil such as corn, safflower, soybean, or canola oil as the first ingredient.
  • Watch your cholesterol. Egg yolks and organ meats such as liver are high in cholesterol. Check the Nutrition Facts and the list of ingredients on food labels.
  • Choose fats that can help lower your cholesterol. If you use cooking oil, choose olive oil or canola oil. Nuts have a healthy type of fat as well. Corn oil, sunflower oil and safflower oil also protect your heart. However, all oils, nuts, and fats are high in calories. If you're trying to lose weight, you'll want to keep servings small.
  • Have fish two or three times a week. Albacore tuna, herring, mackerel, rainbow trout, sardines and salmon are high in omega-3 fatty acids, a type of fat that may help lower blood fat levels and prevent clogging of the arteries.
  • Use special cholesterol-lowering margarine. Having two to three tablespoons of a cholesterol- lowering margarine every day can lower your cholesterol. These margarines contain plant stanols or plant sterols, ingredients that keep cholesterol from being absorbed. You'll find several types at the grocery store in the margarine section.
  • Cook with less fat. You can cut down on total fat by broiling, microwaving, baking, roasting, steaming or grilling foods. Using nonstick pans and cooking sprays instead of cooking with fat also helps.
  • Eat more foods high in fiber. Foods high in fiber may help lower blood cholesterol. Fiber also can prevent problems with the digestive system such as constipation. Oatmeal, oat bran, dried beans and peas (such as kidney beans, pinto beans and black-eyed peas), fruits and vegetables are good sources of fiber.
  • Include more soy protein in your meals and snacks. Replacing foods high in saturated fat with soy-containing foods may help lower your cholesterol. Foods with soy protein includez; soybeans, tofu, miso, tempeh, soy nuts, soy milk, textured soy protein, soy protein powder, and items that are made from soybeans, such as burgers.
  • Limit your alcoholic beverage consumption. Drinking light to moderate amounts of alcohol is associated with a low risk of heart disease, perhaps by raising HDL (good) cholesterol levels. There isn't enough information to recommend that people who don't drink should start drinking alcohol to reduce heart risk. But, for those who do drink alcohol, one serving daily for women and up to two servings daily for men have been associated with good health. Drinking more than one or two drinks a day isn't helpful; it contributes unnecessary calories and may actually raise your blood pressure and triglycerides. In addition, it can cause other health problems. It's best to discuss drinking alcohol with your health care provider to find out if it might be helpful.