Diabetes - The Club You Don't Want To Join

It's certain that some people reading this article have diabetes, and it's just as likely that many other readers will develop this disease sometime during 2002. Everyone who is reading this article surely knows someone who struggles with this illness. With these facts, take the information that follows and use it to help yourself and others.

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

There are two major types of diabetes:
Type 1 - A disease in which the body does not produce any insulin, most often occurring in children and young adults. People with Type 1 diabetes must take daily insulin injections to stay alive. Type 1 diabetes accounts for 5 to 10 percent of diabetes.

Type 2 - A metabolic disorder resulting from the body's inability to make enough, or properly use, insulin. It is the most common form of the disease. Type 2 diabetes accounts for 90 to 95 percent of diabetes. Type 2 diabetes is nearing epidemic proportions, due to an increased number of older Americans, and a greater prevalence of obesity and sedentary lifestyles. Type 1diabetes is usually diagnosed in children and young adults and was previously known as juvenile diabetes. In Type 1 diabetes, the body does not produce insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells.

When sugar builds up in the blood instead of going into cells, it can cause two problems:
Right away, your cells may be starved for energy.
Over time, high blood sugar levels may hurt your eyes, kidneys, nerves or heart. Finding out you have diabetes is scary. But don't panic! Sure, diabetes is serious. But people with diabetes can live long, healthy, happy lives. You can too by taking good care of yourself.

The pancreas, an organ near your stomach, produces insulin. The pancreas contains cells called beta cells. Beta cells have a vital job: They make insulin, a hormone that helps cells take in the sugar they need.

Sometimes, the beta cells get wiped out and cannot produce insulin anymore. Many things might have killed your beta cells, but in most people with Type 1 diabetes, the immune system makes a mistake. Cells that normally protect you from germs attack your beta cells instead. The beta cells die. Without beta cells, you make no insulin. Sugar builds up in your blood, and you get diabetes.

Many people with Type 1 diabetes live long, healthy lives. The key is keeping your blood sugar levels within your target range, which can be done with meal planning, exercise and insulin. You will also need to check your blood sugar levels regularly. To check your blood sugar, you need a drop of blood. Place the drop on a special test strip. A device called a glucose meter tells how much glucose the drop of blood contains. Your health care provider will tell you how often to check your blood sugar level.

What Can Go Wrong?High blood sugar (hyperglycemia)What Is Hyperglycemia?
Hyperglycemia is the technical term for high blood sugar. High blood sugar starts when the body has too little, or not enough, insulin or when the body can't use insulin properly. A number of things can cause hyperglycemia. For example, if you have type 1diabetes, you may not have given yourself enough insulin. If you have type 2diabetes, your body may have enough insulin, but it is not as effective as it should be.

The problem could be that you ate more than planned or exercised less than planned. The stress of an illness, such as a cold or flu, could also be the cause. Other stresses, such as family conflicts or school or dating problems, could also cause hyperglycemia.

What Are The Symptoms Of Hyperglycemia? The signs and symptoms include: high blood sugar, high levels of sugar in the urine, frequent urination, and increased thirst.

Part of keeping your diabetes in control is testing your blood sugar often. Ask your doctor how often you should test and what your blood sugar levels should be. Testing your blood and then treating high blood sugar early will help you avoid the other symptoms of hyperglycemia. It's important to treat hyperglycemia as soon as you detect it. If you fail to treat hyperglycemia, a condition called ketoacidosis (diabetic coma) could occur. Ketoacidosis develops when your body doesn't have enough insulin. Without insulin, your body can't use glucose for fuel. So, your body breaks down fats to use for energy.

When your body breaks down fats, waste products called ketones are produced. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Unfortunately, the body cannot release all the ketones and they build up in your blood. This can lead to ketoacidosis.

Ketoacidosis is life-threatening and needs immediate treatment. Symptoms include: shortness of breath, breath that smells fruity, nausea and vomiting, and a very dry mouth. Talk to your doctor about how to handle this condition.

How Do You Treat Hyperglycemia? Often, you can lower your blood sugar level by exercising. However, if your blood sugar is above 240 mg/dl, check your urine for ketones. If you have ketones, do NOT exercise.

Exercising when ketones are present may make your blood-sugar level go even higher. You'll need to work with your doctor to find the safest way for you to lower your blood sugar level. Cutting down on the amount of food you eat might also help. Work with your dietitian to make changes in your meal plan. If exercise and changes in your diet don't work, your doctor may change the amount of your medication or insulin or possibly the timing of when you take it.

How Do You Prevent Hyperglycemia?Your best bet is to practice good diabetes control. The trick is learning to detect and treat hyperglycemia early -- before it can get worse.

Low blood sugar (hypoglycemia)What Are The Symptoms Of Hypoglycemia?
The symptoms include:
Shakiness
Dizziness
Sweating
Hunger
Headache
Pale skin color
Sudden moodiness or behavior changes, such as crying for no apparent reason
Clumsy or jerky movements
Difficulty paying attention, or confusion
Tingling sensations around the mouth

How do you know when your blood sugar is low?
Part of keeping diabetes in control is testing blood sugar often. Ask your doctor how often you should test and what your blood sugar levels should be. The results from testing your blood will tell you when your blood sugar is low and that you need to treat it.

You should test your blood sugar level according to the schedule you work out with your doctor. More importantly, though, you should test your blood whenever you feel an insulin reaction coming on. After you test and see that your blood sugar level is low, you should treat this condition quickly.

If you feel a reaction coming on but cannot test, it's best to treat the reaction rather than wait. Remember this simple rule:
When in doubt, treat.

How Do You Treat Hypoglycemia?
The quickest way to raise your blood sugar is with some form of sugar, such as 3 glucose tablets (you can buy these at the drug store), 1/2 cup of fruit juice, or 5-6 pieces of hard candy. Ask your health care professional or dietitian to list foods that you can use to treat an insulin reaction. And then, be sure you always have at least one type of sugar with you. Once you've tested your blood and treated your reaction, wait 15 or 20 minutes and test your blood again. If your blood sugar is still low and your symptoms don't go away, repeat the treatment. After you feel better, be sure to eat your regular meals and snacks as planned to keep your blood sugar level up.

It's important to treat hypoglycemia quickly because it can get worse and you could pass out. If you pass out, you will need IMMEDIATE treatment, such as an injection of glucagon or emergency treatment in a hospital.

Glucagon raises blood sugar. It is injected like insulin. Ask your doctor to prescribe it for you and tell you how to use it. You need to tell people around you (such as family members and co-workers) how and when to inject glucagon should you ever need it.

If glucagon is not available, you should be taken to the nearest emergency room for treatment. If you need immediate medical assistance or an ambulance, someone should call the emergency number in your area (such as 911) for help. It's a good idea to post emergency numbers by the telephone.

If you pass out, people should:
1. NOT inject insulin
2. NOT give you food or fluids
3. NOT put their hands in your mouth
4. Inject glucagon
5. Call for emergency help

How do you prevent hypoglycemia? Good diabetes control is the best way we know to prevent hypoglycemia. The trick is to learn to recognize the symptoms of an insulin reaction. This way, you can treat low blood sugar before it gets worse.

Type 2 diabetes is the most common form of diabetes. In Type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells.

When glucose builds up in the blood instead of going into cells, it can cause two problems:
Right away, your cells may be starved for energy.
Over time, high blood sugar levels may hurt your eyes, kidneys, nerves or heart. Finding out you have diabetes is scary. But don't panic! Diabetes is serious, but people with diabetes can live long, healthy, happy lives. You can too by taking good care of yourself.

Is It Curable?In people with Type 2 diabetes, glucose (sugar) builds up in the blood. But with treatment, your blood sugar levels may go down to normal again. But this does not mean you are cured. Instead, a blood sugar level in your target range shows that your treatment plan is working and that you are taking care of your diabetes.

Taking Care Of Your DiabetesThe goal of treatment is to lower your blood sugar and improve your body's use of insulin with:
Meal planning - Eat every three to four hours and combine a protein with a carbohydrate at each meal for a more controlled release of energy in your system and a decreased spike in your insulin levels.

Exercise - Moderate and consistent exercise is best for diabetic control. Consult with your physician and a qualified trainer prior to beginning your program.

Weight loss - Countless studies have shown that obesity is a major factor in causing the onset of diabetes, while many other studies have shown that losing extra fat decrease diabetic risk factors.

Meal planning and getting regular exercise can help your body maintain healthy blood sugar levels. If you're overweight, losing weight can be another big part of your diabetes treatment. It will help your body use insulin better. The best way to lose weight is to exercise and follow a meal plan. With a weight loss meal plan, you will eat fewer calories. Decide with your health care provider how much to lose. Sometimes, just 10 or 20 pounds is enough to bring diabetes under control.

Checking Your Blood SugarIn addition to eating healthy, losing weight and keeping fit, check your blood sugar levels at home to keep track of how you're doing. To check your blood sugar, you need a drop of blood. Place the drop on a special test strip. A device called a glucose meter measures sugar in the drop of blood.

Your health care provider will tell you how often to check your blood sugar. Write down each result, along with the time and date. You will soon learn how well your treatment plan is working, and you will learn how exercise and food affects you.

A Back-Up PlanSometimes, using a meal plan, losing weight and being active are not enough. In addition, your doctor may have you take diabetes pills, insulin shots or both. Your doctor will probably try you on diabetes pills first. But sometimes pills don't work. Or they work at first and then stop. When this happens, your doctor may have you take both pills and insulin, or maybe just insulin alone. Your doctor will tell you what kind of insulin to take, how much and when.
Please take of yourself. Be aware of diabetic warning signs, have a moderate and consistent exercise plan, and eat small meals that combine proteins and carbohydrates every three to four hour, and decrease your daily intake of processed sugar.

Fitness Questions and Answers - The Plain Truth

Let's try something different this issue. There are a million questions, rumors, statements, and claims about fitness made to the public each year. It's time to dispel the rumors and become enlightened about the truth behind fitness. Together, let's become savvy about the news clips, high-pressure fitness salesmen, and late night infomercials that prey on our pre-dawn minds.

Q: Do those abdominal "track, slide, dolly" type of exercise devices really work your abs well?
A: Yes they do, but you need to know more. This type of movement certainly will refine your abdominal region, yet you need to do more than just a slide, roll, or glide. Notice that the commercials say that their "Complete System" yields amazing results. The complete system is often a booklet that should you how to cut fat from your diet and reminds you that drinking eight glasses of water is healthy.

These types of abdominal devices can be a strain on the lower back if a weakness or injury is present. Also, the shoulder joint can be stressed. I suggest bending the elbows slightly more than what is shown on TV. The elbows may also need to be turned in or out a bit to decrease stress on the shoulders. There is one last thing to remember. If you only do one of these types of abdominal/upper body exercisers as your fitness regime, your body will become imbalanced over time. Look at the models performing the movements. Everything is done while slightly leaning forward, focusing on specific areas, and strengthening some muscles more than others. If you supplement this exercise with a well-rounded exercise program, then it's no problem. If this is your only form of exercise, you will not be developing core stability (see below).

Q: What do you think about the Total Gym as seen on TV?
A: I personally have never used one. I've been told by a number of individuals that they really enjoy it. As I see it demonstrated, it appears to be well constructed (always considering the price), and it offers a wide range of functional exercises for the entire body. Of all the machines I've seen, it seems to be one of the best for the money.

Q: What's the scoop on the 24-48 hour type of diets?
A: They are great when you want to dehydrate your body and feel sick. When it sounds this good, it's too good to be true. Staying on a diet like this for more than two or three days will also cause you to lose muscle tissue. Fat loss, unfortunately, must be done at a slower and more methodical rate.

Q: How long will it take to reach my goals?
A: This is dependent on a variety of factors, such as your past exercise history, age, coronary risk factors, time spent training and intensity of your training regime. Usually, significant "results" can be seen in a matter of weeks when a properly structured plan is implemented. Please remember that results can mean different things to each person. When a claim is made about quick results, see what is really being said. Will you feel better? Well, if you have not been exercising, it's nearly impossible not to feel better with any exercise. Will you lose four inches in your hips in the first week? This will only be the case if you landed a spot on Survivor or ran a marathon each day for the week. When you see extremely large amounts of weight loss in a very short period of time, the likely reason is dehydration. Only when you are lifting weights, doing cardiovascular exercise three or more times a week, and are on a balanced, yet reduced caloric diet, should you see results appearing half this fast. As the old saying goes, "Anything worth while takes time!"

Q: What happens if I go over my target zone for fat burning? A: According to DietGuru.com, you will burn glycogen (blood glucose), which is fine. The problem, however, is that unless you are a highly trained athlete, you don't have high amounts of glycogen stored in your muscles cells and other storage areas. In this case, cortisol, one of the hormones secreted with exercise begins to break down muscle tissue to transform it into glucose so you can continue to exercise/survive. This process is commonly known as "gluconeogenisis," or the new formation of glucose by breaking down muscle.

Q: My friend said I should do a triathlon to gain focus and lose weight. How should I select my first endurance event?
A: I hope you read this column about a month ago. We discussed this very subject. First, the event should be something that you enjoy. Choose an event that has an attainable distance and one that is logistically practical. Be certain you have prepared yourself properly. Your focus needs to be on the training and learning about your body as you prepare for the race. As you improve your fitness through a well-designed plan, you can't help but lose fat and create a lean, muscular body.

Q: Why should endurance athletes lift weights?
A: When a muscle can generate a greater force (power output), it will better enable the athlete to reach a higher speed. Weight training also keeps the muscles in an endurance athlete from being depleted by the end of a long racing season. In addition, weight training creates muscular balance and stability. This keeps the athlete healthy and helps prevent injuries.

Q: Why are strong abdominal muscles so important?
A: A strong mid-section will help support the lower back (lumbar spine). It also helps transfer strength and power from the upper body to the lower. In general, the abdominal muscles, lower back, and pelvic region is called the "core". What you need to strive for is "core stability". When the hip flexor muscles are too tight, it causes inflexibility and forward pelvic tilt. Weak abdominals and a tight lower back will create an excessive arch in the lower back known as "sway back" or "hyperlordosis". When an imbalance is present in this area, the result can be pain, poor energy transfer in sports, and general body discomfort. Over time, the result can be spinal segments that lip, spur, and even fuse.

Q: How important is massage therapy to an athlete?
A: In one word "VITAL". Massage does the following: reduces stress, decreases recovery time, promotes healing, increases performance, increases speed, releases toxins and it feels oh, so good! Make sure your massage therapist known your tolerance for pain, what type of massage you've experienced, and your intended benefit from the massage.

Q: What is good pain, and what is bad pain?
A: Good pain should feel symmetrical; meaning that both of your arms or legs should feel about the same sensation. Pain shouldn't be deep within a joint. Good pain should go away with a day or so. Only YOU control good pain! Bad pain usually in non-symmetrical. One side or portion of your body will hurt much more than another. Bad pain will last for several days, and may get worse. Often times, it's hard to pinpoint what caused the bad pain. If bad pain persists, seek the advice of a doctor.

Q: Do orthotics (custom shoe inserts) really help an athlete perform better?
A: Many studies show significant improvement in performance in athletes after receiving orthotics. A Personal note: I had extreme foot pain while I was training for the Ironman in 1993. I went to my sports chiropractor and had orthotic molds made. I had a half-marathon course I was practicing on for the race. After one week in the orthotics, my time improved by over five minutes. Absolutely true!!! P.S. I suggest using the soft leather kind, such as those made by the company Foot Levelers, Inc. The harder plastic or carbon fiber types may work well for some individuals as well.

Q: Does chiropractic treatment help sports performance?
A: Every individual is different. In many cases it beneficial. I can tell you of a personal experience. I once dislocated my knee. Let's just say my knee cap was on the side of my leg. I couldn't move. An ambulance had to take me to the hospital. The emergency room doctor said I would most likely need surgery. I didn't want to go that route. The next day I saw my chiropractor for another opinion (to the E.R. doctor's dismay). We began extensive treatment of the knee. This included adjustments, massage and electronic therapy aides. The next week I rode my bike 200 miles. I've competed in over 100 bicycle races since then and have had little or no pain. I also use chiropractic as part of my preventative medicine. As I look back, it would have been much wiser to only ride my bike half that distance, but fortunately it worked out well.
Q: If I'm short on time, what is a good weight training program?
A: This workout should only be done if you have a good fitness base, knowledge of the movements, and no injuries or medical limitations. Bar dips, pull-ups, push-ups, lunges, squats and abs crunches work virtually every muscle in your body. Try 3-4 sets of each. You can probably finish in less than thirty minutes. Complete this training option at an intensity that is appropriate for your fitness level.

Q: Should I stretch before or after I workout with weights?
A: Both. Prior to any stretching, a general warm-up should take place. A bike, rower, treadmill or stepper is fine. This is to heat the body's core temperature. Once the core is warm, perform some moderate intensity stretches. Make certain the entire body is stretched. However, spend a little extra time on the specific area you intend on training first. After you finish your lifting routine, you body will be very warm and better able to stretch more deeply. This is the time to gently increase the intensity of your stretching.

Q: If I'm very over weight, should I still lift weights? I don't want to bulk up any more.
A: You absolutely should lift weights. It doesn't need to be your focus, but it needs to be included in your complete program. In most cases, weight training is not cardiovascular in nature. This means your body will not use fat as a primary source of energy while lifting weights. However, weight training does make your body better at consuming calories throughout the day. Because a muscle requires more energy to maintain its structure as compared to fat, your body must use (burn) more calories to maintain that muscles integrity. Aside from all this, if you don't maintain or build muscle as you lose weight, you will become what is known as a "thin, fat person." This is a slightly built person who has no muscle mass.Some people are worried about the added weight of muscle. It weights about 60% more than fat. So you may not show as many total pounds lost on the scale, but you'll be much healthier. Most people can't tell your muscle density just by looking at you, but they can see if you have large hips!

These are the types of questions that fitness professionals are asked on a daily basis. Keep asking questions and demand the appropriate answer. If the person you ask doesn't know or if you are unsatisfied with the answer you receive, ask someone else who satisfies your thirst for the true information that affects your quality of life.

Be curious about your body and the way it works. Always be learning new ways to improve your health, fitness, and wellness. The reason Olympic records fall every four years is because someone dared to ask how can we make this person better, faster, strong, and more intelligent.