What to Expect When You Have Diabetes: 170 Tips for Living Well With Diabetes
By The American Diabetes Association
Copyright © 2008 from The American Diabetes Association
Excerted with permission of the publisher, Good Books.
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NOTE: Excerpts are provided on dLife.com for informational purposes only. The information contained within will not be updated by dLife and may be outdated. Please consult your doctor before acting on anything described here.
Living Well – Diet and Nutrition
Q 33. How do I know when I should see a registered dietitian?
See a registered dietitian (RD) when your diabetes is first diagnosed, when a new doctor changes your treatment plan, or twice a year for a routine review of your meal plan and goals. See the RD more often if:
• You want to improve diabetes control.
• You experience lifestyle or schedule changes, such as a new job, marriage, or pregnancy.
• Your nutritional needs keep changing (this is true for children).
• You've begun an exercise program or had a change in diabetes medication.
• You feel bored, frustrated, or unmotivated to use your meal plan.
• You have unexplained high and low blood-sugar levels.
• You're concerned about weight or blood-fat levels.
• You've developed nutrition-related complications, such as high blood pressure or kidney disease.
We recommend having an RD on your diabetes team. Ask your doctor or hospital for a referral. You can call the American Diabetes Association (800-DIABETES), The American Dietetic Association (800-877-1600), or the American Association of Diabetes Educators (800-TEAM-UP-4) for referrals. Many RDs are certified diabetes educators (CDEs) and have additional training in diabetes care.
Diabetes and Pregnancy
Q 161. What are the risks to my baby during my pregnancy?
Pregnancy in diabetes carries risks for both you and your baby. Babies born to mothers with diabetes have higher rates of birth defects and stillbirth. The babies can also be abnormally large, which complicates the delivery. You can avoid many of these problems by achieving near normal blood-sugar control before and during pregnancy. For example, infants born to mothers with diabetes have about a 10% chance of being born with a birth defect, compared with only 2% of babies born to nondiabetic mothers. These birth defects typically involve the spinal cord, the kidneys, and the heart.
This risk of birth defects can be greatly reduced, however, by achieving normal blood-sugar control before pregnancy even occurs. In fact, blood-sugar control is most important during the first 12 weeks of pregnancy because this is the time when all of the infant's major organs are formed. To be safe, you should plan on achieving an A1C level within 1% of normal before you start trying to get pregnant. If successful, you will give your baby the best chance for a healthy start in life, and you will also decrease the chances of delivering a very large baby. This will improve your chances of staying healthy, too.
Q 105. What is the best medication to treat diabetes?
There are many factors that help you and your doctor decide which is the best medication for you. People with type 2 diabetes who are overweight often release adequate amounts of insulin from their pancreas, but their muscle and fat cells are unable to respond normally, and their liver manufactures large amounts of excess glucose. For these people, metformin may be a good choice for initial therapy because it is very effective and doesn't cause weight gain.
Patients who have insufficient amounts of insulin may respond better to sulfonylureas. Other people may have problems with their blood sugar rising immediately following meals. Alpha-glucosidase inhibitors or meglitinides may be good choices for these people. These factors, along with your current blood-sugar levels and the potency, or strength, of the different medications, help you and your doctor select the most appropriate medication for you. While there may be several possible medications to control your blood sugar, other factors, such as the cost of the medication, the times per day you have to take it, preexisting health problems (called "contraindications"), and possible side effects, also help determine which medication is best for you.
The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.
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