LADA is neither classified as type 2 diabetes or type 1 diabetes but considered somewhere in between. It is a form of type 1 diabetes that has similarities and differences to both type 1 and type 2 diabetes.
1.Onset: Type 1 diabetes onsets rapidly and at a younger age than does LADA. Both LADA and type 2 onset is slow, over many months or years.
2.Family history: There is often an absence of family history of type 2 diabetes in a LADA patient’s family, but a genetic marker of HLA genes found in type 1 and LADA, but not in type 2 diabetes. LADA does not usually affect children and is uncommon in young adults (age 25–30). It is most often diagnosed after age 35.
3.Antibodies: Persons with type 1 diabetes and LADA usually test positive for certain (same) antibodies that are not present in type 2 diabetes.
4.GAD antibodies: Persons with LADA usually test positive for GAD antibodies, whereas in type 1 diabetes these antibodies are more commonly seen in adults rather than in children.
5.Insulin sensitivity: Persons with LADA are not insulin resistant (and may be insulin sensitive) as in the case of type 2 diabetes and prediabetes.
6.Lifestyle and excess weight: Type 2 diabetes may onset as a result of a sedentary lifestyle and excess body weight (especially when excess weight is carried about the center, or in those with an “apple” shaped body).
These factors are not thought of as contributing factors to the onset of type 1 diabetes or LADA.
Persons with LADA are often normal body weight or thin and are not insulin resistant.
Persons with type 2 diabetes are often insulin resistant and overweight.
7.Prognosis: About 80% of all persons initially diagnosed with type 2, who also have GAD antibodies, will become insulin dependent within six years.
LADA occurs slowly, but progresses towards insulin dependency.
8.Treatment: Although LADA may appear to initially respond to similar treatment (lifestyle and medications) as type 2 diabetes, it will not halt or slow the progression of beta cell destruction.
People with LADA will eventually become insulin dependent.
Because your baby may be larger than normal, he or she is at higher risk for some complications. Remember, these are just possible complications. Your baby might have none of them. They include:
1.Injuries during delivery because of the baby’s size
The greatest impact of gestational diabetes on delivery is related to fetal size. When gestational diabetes is undiagnosed or poorly managed during pregnancy the fetus responds to the high maternal glucose levels by secreting insulin.
These high levels of fetal insulin result in excessive fetal growth. At term these infant may weigh in the range of 9 to 12 pounds.
These macrosomic infants are more likely to become wedged in the birth canal, to cause laterations of the maternal perineal tissue, to sustain birth injuries and to necessitate a cesaream delivery.
2.Low blood sugar and mineral levels at birth
Low blood glucose (hypoglycemia): Right after the baby is born, the blood glucose level may drop very low (hypoglycemia) because they have so much insulin in their bodies. The extra glucose in your body actually stimulates the baby’s body to make more insulin, so when the baby is out the womb, the extra insulin can cause problems. Hypoglycemia in babies is easily treated by giving the baby a glucose solution to quickly raise the blood glucose level. Feeding the baby should also raise the blood glucose level.
3.Jaundice, a treatable condition that makes the skin yellowish
Most parents panic when they hear their baby has jaundice as they think it’s the same ailment which affects adults. Jaundice in healthy infants, unlike in adults, is not due to problems in the liver.
Jaundice develops in a healthy baby when her blood contains an excess of bilirubin – a chemical produced during the normal breakdown of old red blood cells.
Newborns tend to have higher levels because they have extra oxygen-carrying red blood cells and their young livers can’t metabolise the excess bilirubin.
As the baby’s bilirubin level rises above normal, the yellowness spreads downwards from the head to the neck, to the chest, and in severe cases, to the toes. Unless it’s a serious case, your baby’s jaundice will usually not cause any damage.
In severe but rare cases of jaundice caused by liver disease or maternal blood incompatibility, newborns may suffer damage to the nervous system.
How common is jaundice in newborns?
60 per cent of full-term infants develop jaundice on the second or third day after birth. It usually peaks by around the fifth or sixth day and then starts to decrease. In most babies it disappears after one week, though some babies may take about a fortnight to recover completely.
80 per cent of premature babies develop it between the fifth and seventh days after delivery. It usually disappears within a month of birth.
Some studies suggest that mothers with gestational diabetes may have a higher risk of giving birth to babies with jaundice.
Some studies also suggest that the male child is more likely to have jaundice than a female.
Babies of mothers with blood group O have a higher chance of developing jaundice.
How can jaundice in my baby be treated?
If your baby looks jaundiced, your doctor may suggest tests to measure the bilirubin level in her blood. If your baby was born at term and is otherwise healthy, most doctors will not begin treatment, unless the bilirubin level is over 16 milligrams per decilitre of blood but it also depends on the age of the baby.
Since the early 1970s, jaundice has been treated with phototherapy, a process in which infants are exposed to fluorescent-type lights which break down excess bilirubin. The baby usually lies naked under the lights for a day or two, with her eyes covered by a protective mask.
If the level of bilirubin doesn’t require phototherapy, you can still help your baby by taking her out into the sunlight in the early morning or late afternoon. Take care not to expose your baby for too long since her delicate skin is prone to sunburns.
In the rare case of blood-type incompatibility where the bilirubin level can rise to dangerously high levels, your baby may need a blood transfusion. The Rh blood test you have when you are pregnant should alert you in advance about any incompatibility with your baby, and you will be given anti-D injections to avoid this problem.
4.Pre-term birth
If your baby is born early – also called ‘premature’ or ‘preterm’ – he may need special care.
The definition of a ‘premature’ or ‘preterm’ baby is one that is born before 37 weeks. There are different levels of prematurity and these carry their own risks. Very premature babies, born before week 26, are at most risk and are sometimes known as micro preemies. A baby born at 37 weeks or more is known as a ‘term’ baby. Generally the earlier your baby is born the higher the risk of health problems.
5.Temporary breathing problems
Sometimes, babies have trouble breathing on their own right after they’re born, and this breathing difficulty is more likely in babies whose mother has gestational diabetes. This should go away after the lungs become stronger.
6.Development problems
Researchers have noticed that children whose mothers had gestational diabetes are at a higher risk for developmental problems, such as language development and motor skill development.
Later in life, your baby might have higher risks of obesity and diabetes. So help your child live a healthy lifestyle — it can lower his/her chances of developing obesity and diabetes.
How Will Gestational Diabetes Affect Me?
Gestational diabetes increases the chances of certain pregnancy complications. Your doctor or midwife will want to watch your health and your baby’s health closely for the rest of your pregnancy.
Possible risks include:
1.Higher chance of needing a C-section
Gestational diabetes can sometimes affect whether you are able to deliver your baby vaginally or by cesearean delivery.
Your healthcare provider, once you have been diagnosed with gestational diabetes, will follow you closely, and monitor your baby. In monitoring you and your baby closely, your healthcare provider will monitor the baby’s growth.
Babies born to mothers with gestational diabetes are often large for their gestational age — meaning that they are bigger than most babies at the same time in their mother’s pregnancy. Large babies, sometimes referred to as macrosomic infants, are at risk for not fitting through the mother’s boney pelvis.
This may lead to a failure to dilate in labor, or an ability to dilate in labor to 10 centimeters, but an innability to push the baby out safely.
As your healthcare provider measures your baby’s growth in the last weeks of your pregnancy, he/she will be able to determine the safest route of delivery for you and your baby.
2.Miscarriage
Women with pre-existing diabetes have a higher risk of miscarrying. Those with type 2 often need to adjust their medication early in pregnancy; many switch from tablets to insulin injections.
Women with type 1 diabetes are risk having severe ‘hypos’ (episodes of low blood glucose). Often, the usual warning signs, such as feeling sweaty or shaking, change or disappear during pregnancy. To avoid unexpected hypos, you should be careful not to skip meals. You should also always carry foods to quickly treat hypos, such as jelly beans, carbohydrate snacks and glucose tablets.
3.High blood pressure or preeclampsia
Like gestational diabetes, preeclampsia is a condition that only appears during pregnancy. Gestational diabetes causes elevated blood sugar levels and can result in preeclampsia which involves type of high blood pressure.
Sometimes pregnancy hormones can disrupt your body’s ability to use insulin. Insulin is the hormone that converts blood sugar into usable energy. When it can’t perform effectively, blood glucose (sugar) levels rise.
Insulin resistance can cause high blood glucose levels and can eventually lead to gestational diabetes.
Gestational diabetes is a risk factor for preeclampsia. Your risk for gestational diabetes is highest if you already have preeclampsia.
Preeclampsia results in an escalation in blood pressure, as well as high levels of protein in the urine or blood, as well as swelling in the face, feet and hands. Preeclampsia is more prevalent among women with gestational diabetes, and among overweight women.
There are many factors that can increase the risk for preeclampsia.
Periodontal disease or urinary tract infections may leave a woman more vulnerable to preeclampsia. If you have been subject to chronic high blood pressure, kidney disease, lupus, migraines or rheumatoid arthritis or other chronic conditions you are at high risk for preeclampsia.
Women at risk for preeclampsia may have a family history of preeclampsia, or may have had it in an earlier pregnancy. Women pregnant for the first time are at highest risk for preeclampsia.
Women who have become pregnant by a new partner will be at higher risk for preeclampsia than women who are pregnant a second time by the same partner. A multiple pregnancy (carrying twins, triplets or more) brings with it a higher risk for preeclampsia than a single pregnancy.
Women between the ages of 20 and 40 years of age are at lower risk for preeclampsia than women who are younger or older.
Preeclampsia must be carefully monitored to prevent serious complications such as seizures. Once preeclampsia is on the scene, the only way to end it is by delivering the baby.
If the pregnancy is at less than approximately 37 weeks, and if the preeclampsia is mild, you may be able to buy some time by resting in bed at home. You can help things by drinking more water and eating less salt. Your doctor will want frequent appointments with you to monitor the situation.
At or beyond 37 weeks, your doctor may recommend induction of labor or a cesarean section.
Generally delivering the baby begins the resolution of preeclampsia. In most cases within six weeks of delivering the baby will see the disappearance of high blood pressure, protein in the urine and all other symptoms of preeclampsia.
4.Pre-term birth
Mothers with pre-existing or gestational diabetes are more likely to have a pre-term (prior to 37 weeks), or very pre-term (before 32 weeks) birth. On average, one-in-five women with type 1 or 2 diabetes and almost one-in-ten mothers with gestational diabetes give birth at 32-36 weeks. Women with diabetes are more likely to have an induced labour, an instrumental birth (delivery with forceps or ventouse) or a caesarean section.
After birth, you will have a higher risk of developing type 2 diabetes. Lifestyle changes can lower the odds of that happening. Just as you can help your child, you can lower your own risk of developing obesity and diabetes.
How can I protect myself and my baby?
Women with diabetes can have healthy pregnancies and babies. It is important to try to establish healthy blood glucose levels before pregnancy. If you have an unplanned pregnancy, stabilising your blood glucose as soon as you find out you’re pregnant is critical because your baby’s major organs develop during the first eight weeks. Paying careful attention to nutrition and maintaining general fitness can help you control your blood glucose levels.
Before you conceive, or as soon as possible afterwards, your doctor will want to test you for diabetes-related complications. You may undergo a physical exam to check for nerve damage; you will be asked to provide a urine sample so your kidney function can be assessed and your doctor will recommend that you visit an ophthalmologist to have your eyes assessed.
During pregnancy, your diabetes medication will need to be carefully monitored. If you have type 2 diabetes and are taking tablets prior to pregnancy, your doctor may advise that you convert to insulin in order to better control your glucose levels. During labour and delivery, your endocrinologist will keep an eye on your levels. They will adjust your insulin dosage directly after your baby is born to safeguard you against hypoglycaemia.
If your baby is producing high levels of insulin during your pregnancy in response to your high glucose levels, their blood sugars could be low following birth. If left untreated, this could lead to seizures. Your baby’s blood glucose levels will be tested (by heel prick) every four hours for the first 24 hours of their life. If their glucose levels are very low, they may need to have supplementary feeds. Insulin does not pass into your breastmilk, so it is safe for mothers to breastfeed their babies. Breastfeeding within 30 to 60 minutes of birth can reduce the risk of your baby having low blood sugar. Regular feeds (every three to four hours) can help them to maintain blood glucose levels.
Mothers with gestational diabetes are at risk of developing type 2 diabetes later in life. You will typically be offered an oral glucose tolerance test about 6-8 weeks after giving birth. This test assesses whether your blood glucose levels are within the normal range. The test should be repeated every three years.
It’s a man-made version of a hormone called GLP-1 (glucagon-like peptide-1). Your intestines normally release this substance when you eat. It helps control your blood sugar.
Who can take it: Adults who have type 2 diabetes and haven’t had success with other treatment. If you’re planning to get pregnant, talk with your doctor, since researchers haven’t studied albiglutide in pregnant women.
What it does: After you eat, albiglutide helps your pancreas release insulin, which moves blood sugar (glucose) into your cells. It also limits how much of the hormone glucagon your body makes. This substance spurs your liver to release stored sugar. The drug also slows down digestion.
Side effects: The most common ones are upper respiratory tract infection, diarrhea, nausea, and skin reactions where you give yourself the shot. All GLP-1 drugs, including albiglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people, though. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect.
What it is: Exenatide was the first GLP-1 drug approved by the FDA. Byetta came first. You take it as a shot twice daily. Bydureon is the newer, extended-release version, which you inject once a week. You can’t take both drugs.
Who can take it: Adults with type 2 diabetes for whom other treatment hasn’t worked. If you think you might get pregnant, talk to your doctor. Researchers haven’t studied this drug in pregnant women.
What it does: Like other GLP-1 drugs, exenatide tells your pancreas to release insulin, which moves glucose out of your bloodstream and into your cells. It also limits how much glucagon your body makes. This hormone prompts your liver to release stored sugar. The drug slows digestion, too.
Side effects: The most common ones include nausea, vomiting, diarrhea, feeling jittery, dizziness, headache, acid stomach, constipation, and weakness. These usually go away after the first month of treatment. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect.
The FDA has also received reports of kidney failure in people taking this drug. All GLP-1 drugs, including both types of exenatide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people. It’s possible you could get low blood sugar or have an allergic reaction to the drug.
What it is: This is another GLP-1 drug. You inject it once a day. It helps your body release more insulin. This helps move glucose from your bloodstream into your cells.
Who can take it: Adults who have type 2 diabetes but haven’t had results with other treatment. You take it in combination with metformin or a sulfonylurea drug. If you’re planning to get pregnant, talk with your doctor. Liraglutide hasn’t been studied in pregnant women.
What it does: Like the other GLP-1 drugs, liraglutide cues your pancreas to release insulin. This moves glucose out of your bloodstream and into your cells. It also limits how much of the hormone glucagon your body makes. This substance prompts your liver to release stored sugar. The drug also slows digestion.
Side effects: The most common ones include nausea, diarrhea, and headache. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect.
All GLP-1 drugs, including liraglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people.
It’s possible to have an allergic reaction to liraglutide, or to get low blood sugar while you’re taking it. If you get dehydrated from nausea, vomiting, or diarrhea, that could lead to kidney failure.
What it is: It’s a man-made version of a hormone called amylin, which your pancreas makes along with insulin when your blood sugar levels rise.
Who can take it: It’s approved for people with type 1 diabetes who are taking insulin. It’s also OK’d for people with type 2 diabetes who are taking insulin, a sulfonylurea drug, or metformin. If you think you could get pregnant, tell your doctor, since researchers haven’t studied this drug in pregnant women.
What it does: You take pramlintide with insulin after a meal. The two drugs work together to lower your blood sugar. Pramlintide also helps you digest food more slowly. This puts less sugar into your bloodstream. In addition to controlling your A1C levels, pramlintide helps lessen your appetite, so you eat less.
Side effects: Nausea is the most common one. Starting this drug at a low dose and increasing it slowly can help fight the nausea. Other side effects include less appetite, vomiting, stomach pain, tiredness, dizziness, or indigestion. The drug can also cause low blood sugar if you don’t adjust the amount of insulin you’re taking.
What it is: This is another GLP-1 drug. Unlike the others, you inject it only once a week. It helps your body release more insulin and move glucose from your bloodstream into your cells.
Who can take it: Adults with type 2 diabetes who have not had success with other diabetes treatment. You can take it alone, or in combination with metformin, pioglitazone, or a sulfonylurea drug. If you’re planning to get pregnant, tell your doctor, since researchers haven’t studied this drug in pregnant women.
What it does: Like other GLP-1 drugs, dulaglutide prompts your pancreas to release insulin, which moves glucose out of your bloodstream and into your cells. It also limits how much of the hormone glucagon your body makes, since glucagon normally spurs your liver to release stored sugar. The drug slows digestion, too.
Side effects:The most common ones include nausea, vomiting, diarrhea, belly pain, and less appetite. All GLP-1 drugs, including dulaglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people.
Some people experience a variety of side effects from different oral diabetes drugs.
Each of the medicines discussed here has side effects and other warnings and precautions. Some diabetes pills have been associated with increased risk of heart disease. It is important to discuss the risks and benefits of a drug with your doctor before starting any therapy.
For these pills to work, your pancreas has to make some insulin.
Generic names for some of the more common sufonylureas are glimepiride, glyburide, chlorpropamide, and glipizide.
Some sulfonylureas work all day, so you take them only once a day – usually before breakfast. Others you take twice a day, typically before breakfast and before supper. Your doctor will tell you how many times a day you should take your diabetes pills.
Some possible side effects include low blood glucose (hypoglycemia), upset stomach, skin rash or itching, and/or weight gain.
Known under the generic name metformin (met-FOR-min), this drug helps lower blood glucose by making sure your liver does not make too much glucose. Metformin also lowers the amount of insulin in your body.
Metformin can improve blood fat and cholesterol levels. Also, metformin does not cause blood glucose to get too low (hypoglycemia) when it is the only diabetes medicine you take.
Regular metformin is taken 2 to 3 times a day, with meals. Your doctor will tell you which meals to take it with. There is an extended release version of metformin which is taken once a day.
Some possible side effects of metformin include nausea, diarrhea and other stomach symptoms, weakness or difficulty breathing, or a metallic taste in the mouth.
People with kidney problems and people who drink more than 2-4 alcoholic drinks per week should not take metformin. If you are having surgery or any medical test involving dye, tell the doctor. You may be asked to stop taking metformin for a while.
C.Alpha-glucosidase inhibitors
Known under the generic names acarbose and miglitol, these medicines block the enzymes that digest the starches you eat. This action causes a slower and lower rise of blood glucose through the day, but mainly right after meals.
Neither acarbose nor miglitol causes hypoglycemia when it is the only diabetes medicine you take.
You take these pills three times a day, with the first bite of each meal. Your doctor might ask you to take the medicine less often at first.
Possible side effects include stomach problems (gas, bloating, and diarrhea). These side effects often go away after you take the medicine for a while.
Sold under the generic names pioglitazone and rosiglitazone, these pills help make your cells more sensitive to insulin. The insulin can then move glucose from your blood into your cells for energy.
Pioglitazone is usually taken once a day, while rosiglitazone is taken either once or twice a day, with or without a meal. If taken as the only diabetes pill, they do not cause blood glucose to drop too low.
Possible side effects of pioglitazone or rosiglitazone include weight gain, anemia, and swelling in the legs or ankles. In addition,
It is important for your doctor to check your liver enzyme levels regularly. Call your doctor right away if you have any signs of liver disease: nausea, vomiting, stomach pain, lack of appetite, tiredness, yellowing of the skin or whites of the eyes, or dark-colored urine.
If you take birth control pills, medicines in this group might make your birth control pills less effective, which increases your chances of getting pregnant.
Known under the generic names repaglinide and nateglinide, this pill helps your pancreas make more insulin right after meals, which lowers blood glucose.
Repaglinide works fast and your body uses it quickly. Repaglinide lowers blood glucose the most one hour after you take it, and it is out of the bloodstream in three to four hours. This fast action means you can vary the times you eat and the number of meals you eat more easily using repaglinide than you can using other diabetes pills.
Repaglinide is taken from thirty minutes before to just before you eat a meal. If you skip a meal, you should not take the dose of repaglinide.
Possible side effects include hypoglycemia and weight gain.
This combination pill may cause your blood glucose to drop too low. Also, your doctor may not want you to take it if you have kidney problems.
If you need medical tests that require using dyes, or if you are having surgery, your doctor will tell you to stop taking this medicine for a short time.
The pills should not be used by people who often drink alcoholic beverages.
Sitagliptin (brand name Januvia) is a once-a-day pill that helps to lower blood sugar in two ways:
Increases insulin when blood sugar is high, especially after you eat. This is when the body needs the most help in lowering blood sugar.
Reduces the amount of sugar made by your liver after you eat, when your body doesn’t need it.
Sitagliptin can be taken alone, or in combination with other diabetes pills such as metformin, or sulfonylureas.
Sitagliptin is also combined with metformin into a single pill, sold under the brand name Janumet.
When Januvia is used with a sulfonylurea, low blood sugar (hypoglycemia) can occur. To avoid this risk, your doctor may prescribe lower doses of the sulfonylurea.
Possible side effects include upper respiratory tract infection, stuffy or runny nose and sore throat, and headache.
The goal of these oral medications is to help the body stimulate and use insulin more effectively and to lower blood sugar. However, different classes of these drugs achieve this goal differently. Exactly which class of drug your health care practitioner prescribes for you will depend on your individual situation, your blood glucose levels and any side effects you may experience.
Eventually most type 2 diabetics who don’t lower their blood sugar levels will stop producing insulin altogether.
At this point, diet and exercise will not be able to reverse the effects of diabetes, and many type 2 diabetics will ultimately need insulin therapy (via injection) in combination with oral antidiabetic medications.
Hypoglycemia is the most common and serious side effect of insulin, occurring in type 1 and type 2 diabetics.
Symptoms of low blood sugar(Hypoglycemia) can be mild, such as a feeling of lightheadedness, but can also be severe. In extreme cases, low blood sugar can even lead to coma and death. Other symptoms of low blood sugar include sweating, confusion and rapid breathing. Loss of consciousness is a less common, but severe symptom of low blood sugar.
Insulin overdose can occur if you use too much insulin or if you use the right amount of insulin but eat less than usual or exercise more than usual. Insulin overdose can cause hypoglycemia. If you have any symptoms of hypoglycemia, follow your doctor’s instructions for what you should do if you develop hypoglycemia. Other symptoms of overdose are loss of consciousness and seizures.
Hyperglycemia is the result of your body receiving too little insulin. You may feel confused or drowsy. Other effects include rapid breathing, breath that smells fruity, increased urination or extreme thirst. if you experience these symptoms you may need to speak with your doctor in order to adjust your insulin dosage.
Some other side effects of insulin. If you experience any of the following symptoms, call your doctor immediately:
1.rash and/or itching over the whole body
2.shortness of breath
3.wheezing
4.dizziness
5.blurred vision
6.fast heartbeat
7.sweating
8.difficulty breathing or swallowing
9.weakness
10.muscle cramps
11.abnormal heartbeat
12.large weight gain in a short period of time
13.swelling of the arms, hands, feet, ankles, or lower legs
Because the insulin is administered by the use of a needle, people can develop side effects to the injection site. As the medicine enters the tissues under the skin, it can cause local inflammation and irritation. Diabetics can develop pain, itching or redness at the site of the insulin injection.
Medication Errors: Accidental mix-ups between insulin products can occur. Diabetics must check insulin labels before injection.
Strategies To Handle the Potential Side Effects of Insulin
Many people assume insulin injections will hurt. Often this is just a fear of needles dating back to childhood. But sometimes the fear goes much deeper: Some are concerned that injecting insulin means their disease is getting worse. But that notion is outdated. The important thing is not to avoid needles but to do everything that’s in your power to control your diabetes and prevent damage to your nerves, eyes and other organs.
Since insulin can’t be swallowed—digestive enzymes break it down before it can reach the bloodstream—it must be injected, whether you’re afraid of needles or not.
But advances in insulin-delivery devices have made injections practically painless. The needles used today are extremely thin and coated with silicone, so they slide in more easily.
Also, insulin is injected into the fatty tissue of the abdomen, upper arm or hips, where there are few nerve endings.
2.Prevent low blood sugar
Hypoglycemia occurs when blood glucose drops below normal, about 60 mg/dL, which can be triggered by administering too much insulin (the most common cause), delaying or missing a meal or exercising on an empty stomach.
Most FDA-approved insulin formulations are carefully calibrated so as not to cause hypoglycaemia but when blood sugar does drop, there are many strategies for managing it.
Learning the early signs—such as sweating, heart palpitations, hunger and feeling weak or faint—allows you to stop hypoglycemia in its tracks. Treat early signs with four ounces of orange juice, or up to five glucose tablets—and call your doctor.
If you’ve been on insulin therapy for many years and stop experiencing the early warning signs, you may be in danger of serious hypoglycemia (which can cause loss of consciousness). Keeping glucose tablets and pre-filled glucagon syringes on hand—if your doctor agrees—will ensure you’re prepared to keep your blood sugar at a healthy level.
Perhaps you’ve heard that insulin can cause you to pack on pounds? While it does have the potential to cause weight gain, it poses no more of a weight risk than oral blood-glucose-lowering medications.
If you eat the same amount of food as you did before you started taking insulin, you will likely gain weight. The best way to prevent it is to modify your diet and increase physical activity once you start insulin, in order to help you achieve a healthy weight.
Work closely with your doctor and a nutritionist to take the steps necessary to prevent weight gain.
Some doctors will add the injectable medication pramlintide, which makes insulin more effective by blocking glucose release by the liver and slowing the emptying of the stomach, which, in turn, produces a feeling of fullness.
Ask your doctor about these breakthroughs in comfort and convenience. They can make insulin therapy easier and more effective than ever before.
Silicone-coated needles This new breed of smaller, thinner insulin needle coated with silicone can make injections virtually painless.
Pens Pre-filled disposable insulin pens have tiny needles and are easy to use and more discreet than a syringe.
Rapid-acting insulin By beginning to work just five minutes after it is injected, and lasting approximately two to four hours, rapid-acting insulin allows some diabetics more flexibility when timing meals.
Room-temperature insulin This insulin can be safely stored at room temperature and doesn’t require refrigeration, providing diabetics a greater degree of freedom and convenience.
Insulin pumps Delivering rapid-acting insulin throughout the day.
When most people are sick with a cold or the flu, they usually rest, drink tea or eat chicken soup. If they do not start to feel better in a couple of days, they will usually call their doctor.
When you have diabetes, not feeling well affects your eating patterns and how your blood sugar reacts to your usual dose of insulin or diabetes pills.
When you are sick, your body will release hormones that work to help your body fight against your illness, but they will also make your blood sugar levels rise.
This means that your diabetes will be more difficult to control when you are sick. That is why it is so important to plan ahead and be prepared in case of illness.
Sickness can include: a cold, flu-like symptoms such as vomiting, diarrhea, sore throat, and infections such as ear, teeth or bladder, or more serious illnesses like pneumonia or a foot infection.
Maintaining good control of your diabetes is not easy. It requires motivation, discipline, and an understanding of how diabetes affects your body.
Sometimes, however, no matter how hard you try, things go wrong. Infection or an illness such as a cold or the flu, for instance, can cause high blood sugars, loss of diabetes control, and if you have type 1 diabetes may result in a condition known as ketoacidosis.
Infection causes a stress response in the body by increasing the amount of certain hormones such as cortisol and adrenaline.
These hormones work against the action of insulin and, as a result, the body’s production of glucose increases, which results in high blood sugar levels.
When your blood sugar is high, the white cells in your body are unable to “mop up” bacteria because they cannot move around at their normal speed and do not reach the infection site quickly enough to engulf and kill the bacteria.
In people without diabetes, when the liver releases sugar to help the body fight against the illness, the pancreas also makes extra insulin.
This allows the body to use the sugar for energy and the blood sugar remains within a normal range.
However, if you have diabetes, your body cannot make the extra insulin needed and your blood sugar will go up.
The stress hormones also work against insulin.
Together, the sugar produced from your liver and the stress hormones act to make your blood sugar rise .
You can see how illness can cause blood sugar levels to go out of control.
If not treated quickly, high blood sugar levels caused by illness can lead to more serious problems like Diabetes Ketoacidois (DKA) or Hyperosmolar Hyperglycemic Non-ketotic Syndrome (HHNK).
If you have type 2 diabetes, ketoacidosis is rare but you may experience very high blood sugars and you should know how deal with these events.
Ketoacidosis is a condition in which the body breaks down fat for energy rather than using sugar. When you are ill or stressed your blood sugar levels rise.
A person with Type 1 diabetes does not have an insulin supply to deal with this elevation and begins to break down fats for fuel.
When fat is burned for fuel, chemicals called ketones are released. Ketones are poisonous to the body. The kidneys usually remove ketones via the urine.
However, if the blood sugar levels remain too high for a period of time the kidneys are unable to remove the ketone build up and they begin to accumulate in the body. This can become a life-threatening situation, resulting in a diabetic coma or death.
Ketoacidosis is more common in individuals with Type 1 diabetes because of their inability to produce insulin.
Individuals with Type 2 diabetes are less likely to develop ketoacidosis because they do produce some insulin, even though it may not work as well as it should.
High blood sugar levels and ketoacidosis may develop as a result of an illness or omission of insulin.
People with type 2 diabetes are at risk for a problem called hyperosmolar hyperglycemic nonketotic syndrome (HHNS).
It is very rare in people with type 1 diabetes.
Your risk of developing diabetic hyperosmolar syndrome might be higher if you:
1.Have type 2 diabetes. If you don’t monitor your blood sugar or you don’t yet know you have type 2 diabetes, your risk is higher.
2.Are older than age 65.
3.Have another chronic health condition, such as congestive heart failure or kidney disease.
4.Have an infection, such as pneumonia, a urinary tract infection or a virus, which causes your blood sugar levels to rise.
5.Take certain medications. Some drugs — such as corticosteroids (prednisone), diuretics (hydrochlorothiazide and chlorthalidone) and the anti-seizure medication phenytoin (Dilantin).
HHNS is an emergency caused by very high blood sugar, often over 600 mg/dL. Your kidneys try to get rid of the extra blood sugar by putting more sugar into the urine. This makes you urinate more and you lose too much body fluid, causing dehydration.
As you lose fluids, your blood becomes thicker and your blood sugar level gets too high for the kidneys to be able to fix.
With the high blood sugar and dehydration there is also an imbalance of minerals, especially sodium and potassium in the blood.
The imbalance of fluids, glucose, and minerals in the body can lead to severe problems, such as brain swelling, abnormal heart rhythms, seizures, coma, or organ failure. Without rapid treatment, HHNS can cause death.
You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the HHNS.
The key to dealing with your diabetes when you’re sick is preparation. You should have already come up with a plan BEFORE you experience a sick day.
Working with your diabetes educator or doctor, develop a plan that includes how often to measure blood glucose and urine ketones, which over-the-counter medicines to take, what and how often to eat, and when to call your diabetes team.
It’s also helpful to put together a contacts list that includes daytime and evening phone numbers for your doctor, diabetes educator, and dietitian.
It can be difficult to manage your diabetes on your own when you are sick.
Let a family member or friend know that you are sick and ask them to check in on you.
Be sure someone knows how to test your blood sugar and give your insulin if you need help when you are unwell.
1. Continue to take your insulin. Even if you are not eating, it is essential that you continue to take your insulin. As skipping the dose will result in a further elevation of your blood sugar with the resultant production of ketones.
When you’re sick, it is extremely important to continue your diabetes medications. Even if you’re throwing up, don’t stop taking your medicines. You need them because your body makes extra glucose when you’re sick. When taking any over-the-counter medications, read the labels carefully. Cough syrup, for example, often contains alcohol or sugar, which can throw off your glucose levels even more. Key words to look for in the list of ingredients for any over-the-counter medication include: dextrose, glucose, fructose. These are all sugars. If in doubt about whether to take a particular medication, consult your pharmacist.
As a general rule, if you have Type 1 diabetes, you may need to take extra insulin to bring down your higher blood glucose levels while you’re sick.
2. Monitor your blood glucose levels every 2-4 hours.
3. If your blood glucose level is over 250, test your urine for ketones.
4. If your blood glucose levels are high and ketones are present, you will need to increase your insulin. Contact your doctor for advice or follow the guidelines your healthcare provider has given you.
5. If you are unable to eat normally, substitute meals with easily digestible foods or liquids of a similar carbohydrate value. Drink plenty of fluids as you can quickly become dehydrated.
If you’re having a hard time swallowing, eat soft foods with the same amount of carbohydrates as your regular foods. If you’re sick to your stomach or vomiting, drink enough liquids to equal the amount of carbohydrates that you’d normally eat.
Use the list below as a guide:
Food
Normal
Carbo-
hydrate grams
Apple or pineapple juice
1/2 cup
15
Cereal, cooked
1/2 cup
15
Coffee, tea, bouillon, broth
1 cup
0
Cream soup, made with milk
1 cup
27
Cream soup, made with water
1 cup
15
Gelatin, regular
1/2 cup
20
Grape or prune juice
1/3 cup
15
Ice cream, vanilla
1/2 cup
15
Milk
1 cup
12
Non-diet soft drink
1/2 cup
15
Orange juice
1/2 cup
15
Popsicle ®
1
24
Pudding, regular
1/2 cup
30
Pudding, sugar-free
1/2 cup
15
Sherbet
1/2 cup
30
Soup, thick chunky
1 cup
20
Soup, thin creamy
1 cup
15
Sugar
1 tsp
24
Yogurt, fruit flavored
1 cup
40-60
Yogurt, plain or artificially sweetened
1 cup
17
As a rule of thumb, try to take in 50 grams of carbohydrates every four hours.
6. If you feel nauseous, take about 15 gm of carbohydrates hourly in the form of juice or soda (not diet) ,applesauce, fruit juice bar, frozen yogurt , toasted brown bread .
Glucose is absorbed if taken slowly in small amounts.
7. Sickness and diarrhea can cause dehydration. It is very important to prevent this, so replace lost fluids with hourly drinks.
8. If vomiting occurs and is continuous, you must seek medical advice as you can rapidly become dehydrated and very ill.
1. Monitor your blood glucose levels every 4 – 6 hours.
2. Continue taking your medication or insulin and, if your blood glucose levels remain high for more than 48 hours, seek medical advice as you may require an increase in your dose or additional treatment.
3. Continue to eat, but substitute normal food with easily digestible nourishing fluids if necessary. Drink plenty of fluids.
4. If you feel nauseous, take carbohydrates in the form of juice or soda (not diet) ,applesauce, fruit juice bar, frozen yogurt , toasted brown bread.
Glucose is absorbed if taken slowly in small amounts.
5. Sickness and diarrhea can cause dehydration. It is very important to prevent this, so replace lost fluids with hourly drinks.
6. If vomiting occurs and is continuous, you must seek medical advice as you can rapidly become dehydrated and very ill.
When you are sick, you may need to increase your rapid or short acting insulin doses or even take an extra injection to lower high blood sugars and get rid of ketones.
The following section on insulin adjustment is a guideline only. Check with your health care team before using these guidelines.
1. When your blood sugar is higher than 14 mmol/L, you need extra rapid or short acting insulin.
2. Insulin adjustments are based on your total daily dose (TDD) of insulin. To get your TDD, add your usual unit doses of pre meal and basal insulin.
For example, if you usually take 10 units rapid at breakfast, 8 units rapid at lunch, 12 units rapid at supper and 24 units of long acting insulin at 10 pm, your TDD is 10 + 8 + 12 + 24 = 54 units.
3. Your sick day adjustment will then be a percentage of your TDD.
The adjustment could be 10%, 15% or 20% of your TDD, based on your blood sugar and ketone levels.
Blood glucose less than 13 mmol/L – continue with current dosage.
Blood glucose 13-22 mmol/L – patient should increase by two units each injection, even if unable to eat.
Blood glucose greater than 22 mmol/L – patient should increase by four units each injection, even if unable to eat.
Return dose to normal when blood glucose returns to normal.
4..The suggested extra rapid or short acting insulin can be taken either by:
1. Adding the suggested extra units to your usual dose at the usual time or
2. Taking an extra insulin injection
Remember to record all insulin injections, including any extra ones, in your log book.
Rapid acting insulin can be taken every 3 to 4 hours.
Short acting insulin can be taken every 4 to 6 hours.
5.If your blood sugar is:
4 to 13 mmol/L: take your usual basal and rapid or short acting insulin doses and use your usual correction factors.
less than 4 mmol/L: treat as hypoglycemia with fast acting carbohydrate; you may need to reduce your insulin doses slightly.
Coping With Morning Sickness When You Have Diabetes
Nausea and vomiting in pregnancy (also known as morning sickness – although it can occur at any time of day) is very common in early pregnancy. It’s unpleasant, but it doesn’t put your baby at any increased risk, and usually clears up between weeks 12 and 14 of pregnancy. Unfortunately, for some women, it can have a significant adverse effect on their day-to-day activities and quality of life.
Managing your diabetes if you suffer from morning sickness may be especially difficult. You may find that making adjustments to your insulin doses – both in amount and timing – may help you with this.
Often you will need less insulin during this stage. However, it is very important that you discuss this first with your Diabetes Specialist Nurse or Midwife or other healthcare professional.
If you do suffer with morning sickness, your healthcare professional may also recommend that you try a number of changes to your diet and lifestyle to help you cope better.
Check your blood Sugar every 2 to 3 hours when blood sugars are high (above 14 mmol/L) or more often if needed.
Record the blood sugar and ketone results, insulin used, food eaten and fluid intake . Have it handy if calling your health care professional for help.
I = Insulin
Continue to take your Insulin. Often extra rapid acting or short acting insulin is needed especially if glucose levels are elevated or ketones are present.
If you are having low blood sugars you may need to reduce your insulin dose(s). Never omit your basal insulin as it is needed to stop ketones from forming.
C =Carb and Fluid
Try to keep Carb (carbohydrate) intake as normal as possible when you are sick. Your body needs carb for energy and to balance with your insulin. If you can only eat a small amount, focus on eating carb containing foods.
You may need to eat small amounts of lighter foods or sip on carb containing fluids throughout the day to get the carb you need. Also increase your fluid intake to prevent dehydration.
K =Ketone Testing
Check for blood or urine Ketones. Test for ketones every 2 to 3 hours or every time you use the bathroom. Ketones are produced when your body burns fat instead of sugar for energy. This can happen even when blood sugars are not high if your food intake has been poor. Record the results.
Check the expiry date on your strips. Urine ketone strips are only good for six months after opening.
Forgetting to check for ketones when sick is a common and serious mistake. Ketones are a sign your body is lacking insulin and burning too much fat for energy. Having large amounts of ketones and high blood sugar can lead to DKA.
Remember to get a flu shot every year and pneumonia shot every five years.
Everyone gets sick, but if you plan ahead, take proper precautions and stay in touch with your diabetes team, you will get better, just like everyone else.
Obesity is a serious worldwide problem and is associated with the risk of developing Type 2 diabetes.
Obesity combined with a genetic predisposition are high risk factors for type 2 diabetes to develop.
Today, more than 1.1 billion adults worldwide are overweight, and 312 million of them are obese.
In the past 20 years, the rates of obesity have tripled in developing countries that have adopted a Western lifestyle, with the Middle East, Pacific Islands, Southeast Asia, India, and China facing the greatest increase.
Consequently, the number of people with diabetes in these countries is expected to increase from 84 million in 2000 to 228 million by 2030.
Thus, preventing obesity is a high priority for the prevention of diabetes and other chronic diseases.
If you’ve recently been diagnosed with diabetes and you’re overweight, you should get started as soon as possible on a weight loss plan.
It is important to work with a registered dietitian to help you figure out a plan that will work for you—a healthy meal plan, physical activity, and realistic goals will help you reach a healthy weight.
As you may already know, losing weight can be a challenge, but don’t let that stop you. Do whatever you need to in order to stay motivated.
It is the amount of calories we eat that contributes to weight gain.
Make small changes. Learn portion sizes and reduce the amount of snacks in your day to reduce the total amount of calories you consume each day.
It’s no secret that losing weight and keeping it off isn’t easy. But it is possible, and the benefits for those with diabetes are great.
Learning how to regulate your blood sugar is really crucial in losing weight.
So the way your body normally regulates blood sugar, is your body always has to have a certain amount of sugar in your bloodstream at all times to provide energy for your brain and for your muscles and for your liver, and just for basic functioning.
If you have too much sugar in your bloodstream, it’s going to cause problems.
It can cause nerve damage ,eye damage,kidney and heart problems so it is extremely detrimental.
And if you have too little sugar in your blood, it’s going to make you tired and you’re not going to have enough energy for your brain.
So your body always has to keep a certain amount of sugar in your bloodstream at all times, not too much, and not too little.
Your body needs a certain amount of essential vitamins and minerals to function properly.
Taking vitamin and mineral supplements in addition to a balanced daily diet can give your body the nutritional support it needs for optimal metabolism.
There are specific vitamins, minerals, and all-natural supplements that can help you lose weight.
Choosing medications for people with diabetes involves consideration of a number of factors, including effects on weight.
Improvements in glucose control are often linked to weight gain, but this does not have to be the inevitable result of diabetes treatment.
Adding a drug that either promotes weight-loss or is weight neutral to one that promotes weight gain should be considered.
The current approach to the treatment of both type 1 and type 2 diabetes is to achieve the best possible glucose control.
During the past 20 years, a number of new medications to control blood glucose have been introduced, and new approaches to the use of older medications have been developed.
Weight and diabetes, especially type 2 diabetes, are closely related.
Obesity is a major risk factor for the development of type 2 diabetes, and the current increase in obesity in our society has fueled a major increase in this disease.
The choice of treatment for patients depends on the degree of progression of their diabetes.
Insulin is always the first choice for the treatment of type 1 diabetes, but there are multiple treatment choices for patients with type 2 diabetes.
It’s commonly known that people often gain weight when they start insulin .
But the same rules of exercise and good food habits apply to stay at a healthy weight.
It’s dangerous to fall into the temptation to skip insulin doses in order to lose weight.
It’s never the insulin alone that is causing people to gain weight, or prevents them from losing it.
And while taking less than the correct amount of insulin will lead to rapid weight loss, the weight lost will be mostly water and muscle being broken down, and not all fat… And losing weight that quickly is unhealthy not to mention the fact that keeping your blood glucose high makes you increasingly prone to long-term diabetes complications.
Although diabetes medications such as basal insulin, sulfonylurea and thiazolidinedione are associated with variable weight gain in some diabetics.
The newer drugs, such as pramlitide, extenatide, sitaglitin, or inhaled insulin appear to have a neutral effect on weight gain or to actually cause weight loss.
Pramlitide has been studied both in type 1 and type 2 diabetes and has been associated with modest weight loss.
Extenatide has been shown to cause weight loss in patients along with sustained decrease in HbA1C.
Less weight gain has been seen with inhaled insulin in diabetics on basal-bolus therapy, and the DPP-IVs have been associated with weight neutrality.
Exenatide (Byetta, Bydureon) and liraglutide (Victoza) are taken by injection, similar to insulin, but they’re not insulin.
These medications are in a class of drugs called incretin mimetics, which improve blood sugar control by mimicking the action of a hormone called glucagon-like peptide 1 (GLP-1).
Among other things, these drugs stimulate insulin secretion in response to rising blood sugar levels after a meal, which results in lowering of the blood sugar.
Byetta, Bydureon and Victoza not only improve blood sugar control, but may also lead to weight loss.
There are many proposed ways in which these medications cause weight loss.
They appear to help suppress appetite. But the most prominent effect of these drugs is that they delay the movement of food from the stomach into the small intestine.
As a result, you may feel “full” faster and longer, so you eat less.
Byetta is injected twice daily, and Victoza is injected once a day. Bydureon, a newer formulation, is injected once a week.
In some people with type 2 diabetes, bariatric surgery has been found to effectively reverse their diabetes. Their blood sugar levels become normal, and they no longer need to take drugs to lower blood sugar levels.
Also known as weight-loss surgery, bariatric surgery either restricts the amount of food that can be eaten and/or changes the way in which nutrients are absorbed in the digestive tract. The result is usually significant weight loss.
Often, the normalization of blood sugar levels happens before a person has lost much weight.
The diabetes-reversing effects of bariatric surgery can last for many years, but it’s still important for people who once had type 2 diabetes to be monitored for its recurrence.
Regular physical activity is important for good health, and it’s especially important if you’re trying to lose weight or to maintain a healthy weight.
When losing weight, more physical activity increases the number of calories your body uses for energy or “burns off.”
The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a “calorie deficit” that results in weight loss.
Most weight loss occurs because of decreased caloric intake. However, evidence shows the only way to maintain weight loss is to be engaged in regular physical activity.
This can be achieved a number of ways and the way I achieve it is through exercise and diet!
People who love gardening like myself and Brendan are always active that’s because it is a lot of hard work especially in the Summertime!
Gardening really is enjoyable especially when you get to eat some lovely fresh produce like the courgette and beetroot in the picture below!
This is my homegrown produce!
Most importantly, physical activity reduces risks of cardiovascular disease and diabetes beyond that produced by weight reduction alone.
When it comes to weight management, people vary greatly in how much physical activity they need.
To maintain your weight
Work your way up to 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent mix of the two each week.
Strong scientific evidence shows that physical activity can help you maintain your weight over time.
However, the exact amount of physical activity needed to do this is not clear since it varies greatly from person to person.
It’s possible that you may need to do more than the equivalent of 150 minutes of moderate-intensity activity a week to maintain your weight.
To lose weight and keep it off
You will need a high amount of physical activity unless you also adjust your diet and reduce the amount of calories you’re eating and drinking.
INFOGRAPHIC – Calculating Protein Intake for Weight Loss And Reduced Risk of Type 2 Diabetes
While the exact cause of Type 2 diabetes is still not fully understood, it is known that being overweight or obese (having a body mass index – BMI – of 30 or greater) has a significant impact.
In fact, recent research suggests that obese people are up to 80 times more likely to develop type 2 diabetes than those with a BMI of less than 22.
So losing weight and bringing your BMI below this value is one of the most important, and controllable, ways to reduce your risk of Type 2 diabetes. And according to research, simply optimizing your protein intake can help you achieve rapid weight loss results – even with light-to-moderate exercising.
Thanks to Thinner You Centers, the following infographic on protein for weight loss contains science-based information about the effects of protein intake on body composition, and how to calculate your optimal protein intake for maximum weight loss potential!
The term “latent autoimmune diabetes in adults” (LADA) is used more commonly than “slow diabetes” or “diabetes 1.5” and is probably a more accurate description.
LADA is a controversial diagnosis in the diabetes community.
Roughly 10 percent of adults with diabetes actually have LADA, making it even more widespread than Type 1.
However, many of these diabetics were initially diagnosed with Type 2 diabetes.
Latent autoimmune diabetes in adults (LADA) is a term used to describe a form of autoimmune diabetes that resembles Type 1 diabetes, but has a later onset and slower progression toward an absolute insulin requirement.
Adults with LADA may initially be diagnosed as having Type 2 diabetes based on their age, particularly if they have risk factors for Type 2 diabetes such as a strong family history or obesity.
LADA is sometimes referred to as type 1.5 diabetes. This is not an official term but it does illustrate the fact that LADA is a form of Type 1 diabetes that shares some characteristics with Type 2 diabetes.
As a form of Type 1 diabetes, LADA is an autoimmune disease in which the body’s immune system attacks and kills off insulin producing cells.
The reasons why LADA can often be mistaken for Type 2 diabetes is it develops over a longer period of time than Type 1 diabetes in children or younger adults.
Whereas Type 1 diabetes in children tends to develop quickly, sometimes within the space of days,
LADA develops more slowly, sometimes over a period of years.
Autoantibodies and their effect on beta cell health may be the key to defining the relationships among Type 1, Type 2, and LADA.
Scientists have discovered several different types of autoantibodies related to diabetes.
People with Type 1 have higher levels and more types of these proteins than do those with LADA, which may be the reason beta cells are destroyed faster in Type 1 than in LADA.
In Type 2 diabetes, autoantibodies are generally absent and, as a consequence, beta cell decline is the slowest.
Genetically, LADA has features of both Type 1 and Type 2 diabetes.
So, in autoantibodies and genetics, LADA appears to fall somewhere between Types 1 and 2 on the diabetes spectrum, though perhaps closer to Type 1.
People with LADA are often thin, so if you are thin and are told you have Type 2 diabetes, you should demand the antibody tests that are used to diagnose LADA.
The antibodies tested for are: GAD antibodies, Islet cell antibodies, and more rarely, tyrosine phosphatase antibodies.
People with defective autoimmune genes are also prone to get thyroid disease and rheumatoid arthritis both of which can promote obesity, the first because incorrectly treated thyroid disease will make you fat and the latter because it limits mobility and hence the ability to exercise and because it is often treated with steroids that promote weight gain.
At first, LADA can be managed by controlling your blood glucose with diet, weight reduction if appropriate, exercise and, possibly, oral medications.
But as your body gradually loses its ability to produce insulin, insulin shots will eventually be needed.
People with LADA benefit from being put onto full basal/bolus insulin regimens as soon as possible.
The sooner you start insulin the easier it will be to control your blood sugar with insulin for many years to come.
A Japanese study in 2008 concluded that early insulin treatment may keep beta cells in the business of producing insulin for diabetics with LADA.
Also medicines being developed to prevent or cure Type 1 diabetes may also turn out to be effective against LADA.
Insulin shots are painless and if you have been running high blood sugars for a while, you will feel much, much better once you start using insulin to get normal blood sugars.
1. You are diagnosed with Type 2 diabetes while at a normal weight.
2.A family history of Type 1 diabetes.
There is a genetic tendency towards developing autoimmune diabetes, so if you have a close family member who has autoimmune diabetes, it is more likely that you have that same genetic make up and the same tendency towards developing autoimmune diabetes.
3. Whatever your weight, either you or a member of your family has some other autoimmune disease such as thyroid disease, rheumatoid arthritis, lupus, or multiple sclerosis.
4. You lower your carbohydrate intake shortly after diagnosis to no more than 15 grams a meal and still have a fasting blood sugar over 110 mg/dl and blood sugars that rise 40 mg/dl or more after each meal.
5. No matter what your weight, you do not see a dramatic drop in your blood sugar when you take metformin, Avandia, Actos, Januvia or Byetta in combination with a lowered carbohydrate intake.
6. Your blood sugar deteriorates significantly over the period of a year despite treatment with oral drugs and carbohydrate restriction.
Symptoms Of LADA
Symptoms of LADA may occur suddenly and could include:
1.Extreme thirst
2.Frequent urination
3.Drowsiness or lethargy
4.Sugar in urine
5.Sudden vision changes
6.Increased appetite
7.Sudden weight loss
8.Fruity or sweet odor on the breath
9.Heavy, labored breathing
10,Stupor or unconsciousness
If you experience any of these symptoms, contact your health-care provider immediately.
The exact causes of LADA are not known, although researchers have identified certain genes that are associated with a higher diabetes risk.
Comparison between LADA, Type 1 Diabetes and Type 2 Diabetes
LADA is neither classified as type 2 diabetes or type 1 diabetes but considered somewhere in between. It is a form of type 1 diabetes that has similarities and differences to both type 1 and type 2 diabetes.
The most common test for LADA is one that looks for GAD (glutamic acid decarboxylase) antibodies.
Glutamic acid decarboxylase (GAD) is an enzyme which is found in all human cells.
It catalyzes the degradation of glutamic acid, part of the cycle for the disposal of a waste (ammonia) in the body.
The presence in the blood of self-antibodies to GAD is an early marker of the process that leads to the destruction of insulin producing islet cells, and thus of Type 1 diabetes.
However, a small number of people with autoimmune diabetes will not have GAD antibodies, but they will have islet cell antibodies and/or tyrosine phosphatase antibodies.
So a lack of GAD antibodies does not entirely rule out LADA. Another issue is that very early on in the disease process there may be no detectable antibodies, but over time they may emerge.
The other important test for LADA is the fasting C-peptide test.
A very low C-peptide result suggests that the beta cells have stopped making insulin, possibly because they are dead.
People with Type 2 diabetes often test with normal or high levels of C-peptide.
So a low C-peptide level is suggestive of LADA, though it should be confirmed with antibody tests.
LADA does not present like type 1 diabetes with significant weight loss and ketoacidosis from rapidly progressive β-cell failure.
Because of the slow progressive β-cell failure, LADA presents similarly to type 2 diabetes, with elevated blood glucose values and typical symptoms of hyperglycemia, such as polyuria, polydipsia, polyphagia, and visual blurring.
If you have LADA, you’d do best to get treated by an endocrinologist who specializes in treating Type 1 diabetes as you will need an up-to-date insulin regimen and the kind of diabetes education Type 1 diabetics get which will help you learn how to use insulin to get more normal blood sugar numbers.
It is important to note that people with LADA have the same risk of damaging their organs by running higher than normal blood sugar as do people with other forms of diabetes.
This means that it is essential that you learn What Is a Normal Blood Sugar and strive to achieve Healthy Blood Sugar Targets.
The best blood sugar level for a person with insulin-dependent diabetes is the lowest level they can achieve without experiencing hypos–with hypos being defined as blood sugars under 70 mg/dl.
Unlike the case with Type 2 diabetes, it is usually not possible to reverse or control LADA with carbohydrate restriction alone.
That said, it is much easier to make insulin work when you are eating a lower carbohydrate diet than it is with a high carbohydrate diet.
1.Distinguishing LADA diabetics from diabetics with type 2 diabetes is important .
Since insulin resistance is minimal or non-existent in LADA diabetes, medications designed to reduce insulin resistance such as Avandia and Actos are not effective.
Also, several of the oral drugs used to treat Type 2 diabetes stimulate the beta cells to produce insulin, and because LADA involves an autoimmune attack which is stimulated by the production of insulin at the beta cells, stimulating insulin production by the beta cells with drugs may increase the ferocity of the attack, killing more beta cells.
So it is very important to get a correct diagnosis so you can avoid the drugs that stimulate insulin production by the beta cells.
These drugs include the sulfonylureas like Amaryl and Glipizide and may also include the incretin drugs, Byetta and Januvia because they also stimulate insulin production by the beta cells.
Other medications that stimulate the pancreas to produce insulin, slow digestion of carbohydrates, or reduce excess glucose production by the liver are often effective in controlling the blood sugar for a few years.
Because LADA develops slowly, someone with LADA may be able to produce enough of their own insulin to keep sugar levels under control without needing insulin for a number of months or sometimes even years after the initial diagnosis of diabetes.
Insulin will almost certainly be required at some point in the future.
In some cases, insulin therapy may be postponed.
However, there is evidence to suggest that starting insulin treatment soon after a diagnosis of LADA will help to better preserve the pancreas’ ability to produce insulin.
Regular blood glucose testing is advised for people with LADA at a similar number of tests per day that are advised for people with type 1 diabetes.
This means that it is advisable to test your blood sugar levels before each meal and before bed.
One major benefit for patients with Type 1.5 LADA diabetes is that when their blood sugars are controlled they usually do not have the high risk for heart problems more often found with the high cholesterol and blood pressure seen in true Type 2 diabetes.
People with LADA diabetes comprise an important section of the diabetic population.
Although LADA can occur in any age group, including children and adolescents,it is characterized predominantly by adult age at onset (30–40 years),mainly nonobese body type, gradually leading to insulin dependency, characteristically low C-peptide levels, and marked presence of GAD autoantibodies.
Thus determination of C-peptide levels and GAD autoantibodies is strongly recommended for confirmatory diagnosis of LADA.
Appropriate diagnosis of LADA would prevent misdiagnosis as type 2 diabetes and would help in optimum treatment of LADA diabetes so that residual β-cell function is preserved and the further autoimmune destruction of β-cells is delayed.
If you have any information,questions, or feedback you would like to include in this post.
Please email momo19@diabetessupportsite.com or leave your comments below.
Optimism is a wonderful attribute a pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.
Your mental state can help or harm your health. In fact, it may be that happiness breeds health!
The reasons for the health benefits of happiness aren’t hard to find. Emotions strongly affect the immune system.
Positive moods reduce stress-related hormones, increase immune function and promote the speedy recovery of the heart after exertion.
I had a lovely time today walking in the countryside around Mooncoin,I came across a lot of very pretty houses and gardens especially near a lovely nursery called Farrell’s nursery!
I stopped the car at the corner of a very pretty house!
The entrance to the very pretty house!
The pretty house had some lovely pink flowers that I admired!
Then I walked further down the road and I came across a sign for Farrell’s nursery!
I then decided to turn around to look at the other houses in the area before I ventured into Farrell’s nursery!
See below a selection of very attractive houses and gardens situated below Farrell’s nursery!
This is a lovely house up on a hill surrounded by hedges and a small tree!
Then I passed a lovely red berry tree!
I then came across one of the most gorgeous gardens I have ever seen!
See below a selection of photos! What do you think?
After viewing the fabulous garden above I came across another house which was very pretty also!
See below a picture of the pretty house!
I saw a number of houses and gardens below Farrell nursery,see below a selection of these houses and gardens!
After that I was feeling a bit tired as I had walked a lot that day around other areas in Mooncoin taking photos!
So I turned around and went back to Farrell’s nursery ,see below for the sign!
I was welcomed by two black dogs at the entrance to the nursery,initially I was a bit afraid of the bigger one but then I saw they were just like Hachi and Bruno my own two pets and I thought they are just two harmless pets!
See below a picture of the entrance to Farrell’s nursery and the two pets!
After meeting the two dogs a very kind friendly man asked me could he help me,I just said I wanted to promote his nursery on my website!
He then told me he was just starting off and there wasnt much plants in his two polytunnels yet!
I told him I didnt mind that I could take some photos of his lovely garden!
So I hope through this website this article will help him get a lot of visitors to his nursery as I think once the nursery is setup properly it will be great!
I think it could be the kind of nursery where he could sell potted plants,minature trees,small water features,hanging baskets,window boxes and garden features such as garden plaques,keyrings with garden logos and cards with garden designs!
How about you have you any good ideas to help this kind man that would make his start off nursery a success,cheap and cheerful is best!
See below a selection of lovely pictures of his garden!
Farrell’s nursery is going to be a lovely little nursery especially if you all could help him by coming up with some great ideas!
I think that if he put a sign in the village of Mooncoin which is only five minutes walk from his nursery more people would know about it and would go there for a visit!
After leaving Farrell’s nursery I took photos of more houses and gardens in the area!
See below a selection of houses and gardens,what do you think arent they lovely!
How about you I bet you have a lovely house and garden,or maybe you like houses and gardens in your area if so I would love if you would take a photo and put them in the comment section below!
Scientists and psychologists have known for some time that negative emotions harm health.
Negative emotions such as depression, fear, anger, and anxiety lead to a stress response in the body and release of hormones such as adrenaline and cortisol.
Negative emotions can increase cholesterol, inflammation, and the risk of heart disease.
Studies have shown that negativity can weaken the immune system, increase the risk of disease, and shorten your life span.
People who are in a healthier psychological state are more likely to engage in healthy behaviors.
They tend to exercise, eat healthfully, drink less alcohol, and are less likely to smoke.
In our daily life we constantly experience happiness and unhappiness, but we are still quite ignorant as to what happiness really is.
Everywhere there are many who hope to win the lottery some day; they think that this way they will find happiness.
Some in fact do win. However, this does not bring them the happiness for which they yearn so much.
Research suggests, more money doesn’t bring us more happiness,people who prioritize material things over other values are much less happy, and comparing ourselves with people who have more is a particular source of unhappiness.
People value time with family and friends more than money and material things!
I think that people love to learn new things like I loved creating this website!
We went out to lunch on Sunday with my Inlaws for my mother-in-law’s birthday!
We had a lovely time,first we went to Clonmel for a bite to eat and then headed off to Dungarvan for a look around the town!
The lunch was good value,with plenty of food on the plates.
The best thing to remember is that people are very nice when you get to know them!
People are really just looking to be loved!I hope you understand that I would like to help people as much as I can!
People are lovely and kind inside if only they would relax and enjoy themselves!
People dont realise that life is for enjoyment and helping each other not for competing against each other!
People are great at putting each other down but not so good at uplifting each other!
People need to support each other more by being kind to each other,listen to each other,show affection,help out in difficult times!
People also need to love themselves more by being kind to themselves by stopping negative thoughts and by focusing on positive thoughts!
People need to know that this life is wonderful if only we all started to love ourselves and love each other!
When we went to Dungarvan we saw loads of people enjoying themselves on the seafront and that was nice!
Life can be wonderful but without family and friends it can be lonely!So remember it’s really important to love each other especially when times are hard!
Research suggests that happiness is a combination of how satisfied you are with your life (for example, finding meaning in your work) and how good you feel on a day-to-day basis.
Happiness comes when you feel satisfied and fulfilled.
Happiness is a feeling of contentment, that life is just as it should be.
Our individual needs vary based on our genetics, how we were raised, and our life experiences.
That complex combination is what makes each of us unique, both in our exact needs, and in every other aspect of what makes us the person we are.
You have the ability to control how you feel—and with consistent practice, you can form life-long habits for a more satisfying and fulfilling life.
The secret of happiness lies in building a strong inner self that no trial or hardship can ruin.
Happiness for anyone—man or woman—does not come simply from having a formal education, from wealth or from marriage.
It begins with having the strength to confront and conquer one’s own weaknesses.
Only then does it become possible to lead a truly happy life.
Happiness doesn’t exist in the past or in the future. It only exists within our state of life right now, here in the present, as we face the challenges of daily life.
Happiness is not a life without problems, but rather the strength to overcome the problems that come our way.
There is no such thing as a problem-free life; difficulties are unavoidable. But how we experience and react to our problems depends on us.
Absolute happiness is something we must find within. It means establishing a state of life in which we are never defeated by trials, and where just being alive is a source of great joy. This persists no matter what we might be lacking, or what might happen around us.
True happiness is found in a life of constant advancement.
Look at your situation, not with despair, but for opportunity.
We all have our own special skills and talents,share your knowledge and experience the joy of learning and teaching.
A sense of purpose is what drives happy people ,life can either be something you embrace or something you hide from.
Happy people appreciate the life they have and value each minute of every day and live like there’s no tomorrow and make the most out of any situation.
Happy people see each moment as a challenge, where they can learn more about their true selves and continue to grow.
These people dare to dream and work hard to get where they want to be.
They realize life is what you make of it, and although life can throw you some awfully big blows, these types of people do not let bumps in the road deter them from reaching their goals.
They do not look at what they are missing in life, rather, they appreciate the fortunes that they do have.
Happiness is not having what you want; it’s wanting what you have!
“My Wish For You”
I wish for you
Comfort on difficult days,
Smiles when sadness intrudes,
Rainbows to follow the clouds,
Laughter to kiss your lips,
Sunsets to warm you heart,
Gentle hugs when spirits sag,
Friendship to brighten your being,
Beauty for your eyes to see,
Confidence for when you doubt,
Faith so you can believe,
Courage to know yourself,
Patience to accept the truth,
And “LOVE” To complete your life.
Diabetes, like any other disease or health condition, has the potential to make us grow.
That does not mean that it is not sometimes very hard to live with diabetes,however having a lot of negative emotions and thoughts about our diabetes is clearly not going to get us out of this situation.
On the contrary, it would surely worsen it!
Trying to “fight” diabetes is surely not the best way to deal with it,i think the best concept is to believe that whatever you’re doing to treat your illness is helping you overcome it.
We should listen to the advice given to us by our doctor on medication, diet and exercise and educate ourselves on all aspects of diabetes.
No matter how negative you perceive your life right now, there is surely something you can be grateful for.
Start there and see how, little by little, you’ll think of more things to be grateful for.
For a long time I used to think of diabetes as a negative thing in my life but over the years I have come to realise that it has brought me positive things too.
Skin problems may alert your doctor to the fact that you have diabetes before you have any other signs.
And after you’re diagnosed with diabetes, continued skin problems may mean your condition isn’t under control.
Harmful infections receive sustenance from blood sugar.
When you have high levels of blood sugar — or too much glucose in your bloodstream — your body tries to remove the excess by excreting it in your urine.
It takes water to make urine, which leads to a loss of moisture in your body.
With this loss of fluid comes a loss of moisture in your skin, leaving it dry and easily prone to cracking.
Cracks in your skin invite infection because they make it easier for germs to get in.
Diabetics have generally weaker immune systems, making them less able to fight infections.
Also, nerve damage and poor circulation slow tissue healing.
As a result, people with diabetes often have more frequent and serious wounds and skin infections than people without the condition.
While some skin conditions may appear uniquely in people with diabetes, others are simply more common in people with diabetes.
The good news is that a fair number of these conditions are treatable or can be prevented by maintaining blood glucose control and taking good daily care of your skin.
Dry skin can occur as a result of high blood glucose. When the blood glucose level is high, the body attempts to remove excess glucose from the blood by increasing urination.
This loss of fluid from the body causes the skin to become dry.
Dry skin can also be caused by neuropathy (damage to the nerves) by affecting the nerves that control the sweat glands.
In these cases, neuropathy causes a decrease or absence of sweating that may lead to dry, cracked skin. Cold, dry air and bathing in hot water can aggravate dry skin.
Dryness commonly leads to other skin problems such as itching (and often scratching), cracking, and peeling.
Any small breaks in the skin leave it more exposed to injury and infection.
It is therefore important to keep skin well moisturized.
The best way to moisturize is to apply lotion or cream right after showering and patting the skin dry. This will seal in droplets of water that are present on the skin from the shower.
Skin that is severely dry may require application of heavy-duty emollients 2—3 times a day.
Itchy skin is usually related to dryness, but it can also be related to poor circulation, especially in the legs and feet.
This is typically due to atherosclerosis, a disease in which fatty plaques are deposited in the arteries.
Fungal infections, which can be more common when a person has high blood glucose, can also be very itchy.
When blood glucose levels are high, a person with diabetes is more susceptible to infection. This is believed to be why there’s a higher incidence of certain bacterial infections among people with diabetes and why these infections tend to be more serious than in the general population.
There are different kinds of bacterial infections affecting the skin. These include styes, which are infections of the glands of the eyelids; boils, which are infections of the hair follicles; and carbuncles, which are deep infections of the skin and the underlying tissue.
There also are bacterial infections that affect the nails. With a bacterial infection, the areas involved generally are hot, swollen, red, and painful. Most bacterial infections require treatment with antibiotics in the form of pills and/or creams.
High blood glucose levels can also predispose people with diabetes to developing common fungal skin infections from organisms such as Tinea and Candida.
Fungal infections can occur just about anywhere, including the feet (Tinea pedis), the hands (Tinea manuum), the body (Tinea corporis), and the groin (Tinea cruris).
This condition is characterized by the formation of velvety, brownish, thickened areas of skin in the groin, underarms, under the breasts, and in the creases of the neck.
The affected skin may become leathery or warty or develop tiny skin tags.
Acanthosis nigricans is common in people who are obese, but it may also be associated with certain forms of cancer as well as endocrine disorders such as polycystic ovarian syndrome (PCOS), Cushing syndrome, and diabetes.
There is no cure for this condition, but it may improve with weight loss, topical bleaches, or a class of drugs known as keratolytics.
Vitiligo is a skin disorder that causes white spots or large areas of depigmentation to occur on various areas of the body.
About 30% of people with vitiligo have a family history of the condition, and it is more common in people with Type 1 diabetes than Type 2 diabetes.
Vitiligo progresses slowly over the years, commonly affecting the backs of the hands, the face, and body folds such as the underarms and groin.
Treatment of vitiligo is necessary only in people who have severe cases or who are considerably distressed by the condition.
Treatment involves the use of steroids or chemical agents called psoralens that are either placed directly on the skin or taken orally.
The most popular treatment, known as PUVA, uses oral psoralens in combination with phototherapy sessions, in which the person is exposed to ultraviolet light, specifically ultraviolet A.
A common skin disorder of unknown cause, granuloma annulare manifests as skin-colored or pinkish groups of bumps, or papules, that may be arranged in rings.
There are several subtypes of granuloma annulare; the one associated with diabetes is called disseminated, or generalized, granuloma annulare, in which lesions are widespread over the body.
The use of steroid creams or ointments or steroid injections is sometimes used to treat lesions.
Most, however, disappear on their own within two years.
5.Diabetes-Related Skin Conditions
The following skin conditions occur almost exclusively in people who have diabetes.
This common skin condition is characterized by depressed, irregularly round or oval, light brown, shallow lesions.
Lesions may vary in number from few to many and are usually found on both legs but are not symmetrically distributed.
Dermopathy appears as scaly patches that are light brown or red, often on the front of the legs. The patches do not hurt, blister, or itch, and treatment generally is not necessary. The patches are sometimes called skin spots.
Because these lesions do not itch, hurt, or open up, they are often overlooked and not reported to the health-care provider.
Though there is no cure for diabetes,but there are a variety of treatment options that include lifestyle changes, over-the-counter and prescription treatments, and alternative remedies that can help manage skin conditions in diabetics.
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Over-the-counter remedies are available for certain types of skin disorders associated with type 2 diabetes. These remedies include:
1.hydrocortisone
2.nonprescription antifungals, like clotrimazole
3.topical steroid medications (mild hydrocortisone)
4.Daily skincare must be simple and consistent. For cleansing and moisturizing, a gentle skin cleanser is preferable to harsh deodorant or fragranced soaps that strip the skin of moisture and oils.
Lukewarm rather than hot water should be used to reduce irritations and dryness, and diabetics should avoid long soaks in the tub, since this draws moisture out of the skin.
A penetrating body cream can be applied to the skin after showering or bathing to replenish oils and moisture.
6B.Prescription Medications
Some skin conditions are severe enough that medical attention and prescription medications are required. Prescription medications and treatments available include:
1.antibiotics (topical or oral) to treat skin infections
2.stronger antifungal medications
3.insulin therapy to help regulate the origin of skin conditions
For those who aren’t interested or don’t need prescription medications, alternative remedies are available for those with diabetes-related skin problems. These alternative remedies include:
1.talcum powder where skin touches other parts of the skin (armpit, behind the knees)
2.lotion to soothe dry skin can reduce itching
5. Natural ingredients such as olive oil and primrose oil soften and soothe dry skin and replenish essential elements without irritation.
Before using any natural or alternative remedies, consult your doctor. Even all-natural herbal supplements can interfere with medicine you’re currently taking.
Though sometimes genetics and other factors come into play, being overweight and inactive can have an effect on diabetes.
Lifestyle changes that can help manage diabetes include:
1.Following a healthy diet, including eating more fruits, vegetables, and whole grains
2.Maintaining an exercise program, aiming for 30 minutes of cardio, 5 days a week
3.Monitor your blood sugar
By learning how your body reacts to certain foods and medications, you can better learn how to maintain a healthy blood sugar level.
4.Avoid and actively prevent dry skin
5.Avoid scratching dry skin, which can create lesions and allow infections to set in
6.Treat cuts immediately.Wash minor cuts with soap and water and cover with a sterile gauze secured with a hypoallergenic or paper tape.
Only use an antibiotic cream or ointment if your doctor says it’s okay. Change the bandage at least once a day. See a doctor right away if you get a major cut, burn, or infection.
7.Keep your home humid during dry months
8.Avoid hot baths or showers, as they can dry skin out
9.Pat your skin dry after bathing—while rubbing the skin helps slough off dead skin cells, it can also aggravate the skin, reduce moisture and cause breaks, which leaves you more susceptible to infection.
10.Don’t put lotions between toes. The extra moisture there can encourage fungus to grow.
11.Avoid using feminine hygiene sprays or vaginal douches. They can alter the pH balance of the vagina and set the stage for increased fungal growth.
12.Drink plenty of fluids, like water and caffeine-free, sugar-free drinks, to keep your skin hydrated.
13.Eat foods rich in omega-3 fatty acids, which nourish the skin. This includes fish like salmon, sardines, albacore tuna and mackerel, as well as tofu and other forms of soybeans, walnuts, flaxseed and their oils.
14.Take extra good care of your feet. Check them every day for sores and cuts. Wear broad, flat shoes that fit well. Check your shoes for foreign objects before putting them on.
15.See a dermatologist (skin doctor) or consult with your endocrinologist about skin problems if you are not able to solve them yourself.
There are a fair share of skin disorders associated with diabetes, some more serious than others.
While some skin conditions associated with diabetes are mostly harmless and will go away on their own, some can be much more dangerous.
If you have a flare-up of a new skin condition listed above, make an appointment to see your doctor as soon as possible.
Work with your doctor to develop a skin care regimen that wards off these and other skin problems.
Start by regularly washing with a mild soap. Rinse thoroughly and dry carefully. Don’t miss areas such as between your toes and under your breasts.
Keep your skin moist by drinking plenty of water and applying lotion or cream regularly.
Your doctor can suggest an appropriate formula. And wear cotton underwear so that air can move around your body.
Keeping your diabetes under control is the most important factor in preventing the skin-related complications of diabetes.
Follow your health care provider’s advice regarding nutrition, exercise, and medicine.
Maintaining control of blood glucose level within the range recommended by your health care provider is most important.
Proper skin care also can help reduce your risk of skin-related problems.
If you have any information,questions, or feedback you would like to include in this post.
Please email momo19@diabetessupportsite.com or leave your comments below.
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