Poor glycemic control refers to persistently elevated blood glucose and glycosylated hemoglobin levels, which may range from 200–500 mg/dl (11–28 mmol/L) and 9–15% or higher over months and years before severe complications occur. Meta-analysis of large studies done on the effects of tight vs. conventional, or more relaxed, glycemic control in type 2 diabetics have failed to demonstrate a difference in all-cause cardiovascular death, non-fatal stroke, or limb amputation, but decreased the risk of nonfatal heart attack by 15%. Additionally, tight glucose control decreased the risk of progression of retinopathy and nephropathy, and decreased the incidence peripheral neuropathy, but increased the risk of hypoglycemia 2.4 times.
At the start of the study, all of the patients had been taking two oral diabetes drugs for at least six months. But they still had poorly controlled diabetes based on blood tests showing so-called hemoglobin A1c levels, which reflect average blood sugar levels over about three months. Readings above 6.5 signal diabetes, and everyone in the study had readings of at least 7.
If you have gestational diabetes, you should first try to control your blood glucose level by making healthy food choices and getting regular physical activity. If you can’t reach your blood glucose target, your health care team will talk with you about diabetes medicines, such as insulin or the diabetes pill metformin, that may be safe for you to take during pregnancy. Your health care team may start you on diabetes medicines right away if your blood glucose is very high.
“People need to understand the continuum of diabetes,” she says. “If they’re on an upward trajectory of insulin resistance and a downward trajectory of insulin production weight loss, healthful eating and physical activity will slow down the insulin-loss trajectory and improve insulin sensitivity.” But, she says, “If they gain weight back, the diabetes comes back.”
Obesity is a disease, not something created by lack of character. It is a hormonal disease. There are many hormones involved, and one of the main ones is a hormone called insulin. The vast majority of obese individuals are resistant to insulin and that causes a lot of trouble. So, what does being insulin-resistant mean? Insulin resistance is essentially ‘pre-pre-type 2 diabetes.’ Insulin’s job is to drive glucose or blood sugar into cells where it can be used. In a nutshell, when someone has insulin resistance, they are having trouble getting glucose where it needs to go, into the cells. It can’t all hang out in the blood after we eat, or we would all have a diabetic crisis after every meal. When there is resistance to insulin, our bodies will just make more of it. The insulin levels rise and rise and for a while, years usually, this will keep up and blood sugar will stay normal. However, eventually it can’t keep up, and even elevate insulin levels are not enough to keep blood sugar normal, and blood sugar rises. And that is diabetes.
The chart above gives averages. Follow your doctor’s advice on when and how to take your insulin. Your doctor might also recommend premixed insulin, which is a mix of two types of insulin. Some types of insulin cost more than others, so talk with your doctor about your options if you're concerned about cost. Read about financial help for diabetes care.
In medical world, diabetes is known more commonly by the name of diabetes mellitus. In simpler and day-to-day language, it is referred as diabetes. It is a group of metabolic diseases in which a person has high blood sugar, either because cells do not respond to the insulin that is produced, or the body does not produce enough insulin. In both the conditions, the body is not able to get enough amount of insulin to function properly.
Talking to a counselor or therapist may help you cope with the lifestyle changes that come with a type 2 diabetes diagnosis. You may find encouragement and understanding in a type 2 diabetes support group. Although support groups aren't for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences or helpful information, such as where to find carbohydrate counts for your favorite takeout restaurant. If you're interested, your doctor may be able to recommend a group in your area.
Anyone with diagnosed Diabetes should consult a physician before making any changes to a diabetes regimen, and especially before changing medication dosages. That being said, improving your diet and eating the foods to help your body heal is your prerogative and your right. For the 65% of America that is overweight, including the 37% that are clinically obese, there is a good chance that many are operating in a pre-diabetic state, or may even have undiagnosed diabetes. Even those without any signs of disease can figure out their insulin levels by at home glucose testing.
Diabetes is a serious disease that you cannot treat on your own. Your doctor will help you make a diabetes treatment plan that is right for you -- and that you can understand. You may also need other health care professionals on your diabetes treatment team, including a foot doctor, nutritionist, eye doctor, and a diabetes specialist (called an endocrinologist).
For people with either type of diabetes, exercise can lower the chance of having a heart attack or stroke and can improve circulation. It may offer stress relief, as well. People with type 2 diabetes who need to lose weight can benefit from moderate exercise. Most people with diabetes are encouraged to get at least 150 minutes each week of moderate-intensity aerobic physical activity, like walking. Strength training is often recommended at least twice a week. Talk to your doctor about what type of exercise is right for you.
Pramlintide is administered by injection just prior to meals (three times each day) for type 1 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control despite optimal insulin therapy and type 2 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control with optimal insulin therapy.