Managing diabetes and keeping it under control

Although diabetes can't be cured, it can be managed and kept under control. Anyone diagnosed with diabetes should seek treatment immediately to prevent associated illnesses. The type of treatment depends on the type of diabetes.

Treating type 1 diabetes

Type 1 is treated with insulin and by eating a healthy diet. Insulin can't be taken by mouth because the digestive juices in the stomach destroy it. This means that for most people it has to be given by injections. Most people find giving the injections simple and relatively painless, since the needle is so fine.

How often someone needs to inject depends on what their diabetes specialist has recommended, and which type of insulin they're using. Insulin is given at regular intervals throughout the day, usually two to four times. 

Each injection may contain one, or a combination of different types of insulin, which act for a short, intermediate or longer period of time.

Injections can be given using either a traditional needle and plastic syringe, or with an injection pen device, which many people find more convenient.

An automatic insulin pump is available, which means that fewer injections are needed. The needle is sited under the skin, and connected to a small electrical pump that attaches to a belt or waistband and is about the size of a pager. Inside is a reservoir of fast-acting insulin which is delivered continuously at an adjustable rate.

Inhaled insulin has recently become available for treating people with a proven needle phobia or people who have severe trouble injecting.

What is insulin?

Insulin was first used to treat diabetes in 1921. Under normal circumstances, it's made by beta cells that are part of a cluster of hormone-producing cells in the pancreas. 

The hormone regulates the level of glucose in the blood, preventing the level from going too high. Insulin enables cells to take up the amount of glucose they need to provide themselves with enough energy to function properly. It also allows any glucose left over to be stored in the liver.

Most insulin used today is 'human insulin', although some people still use insulin from cows and pigs. 'Human insulin' is a product of genetic engineering, where bacteria bred in a laboratory are given a gene that allows them to produce insulin.

Treating type 2 diabetes

Type 2 may have been considered the 'milder' form of diabetes in the past, but this is no longer the case. For many people, type 2 diabetes can be controlled by diet alone. Medication in tablet form is used when diet doesn't provide adequate control. 

The different types of tablets work by one of these methods:

• helping the pancreas to make more insulin
• increasing the use of glucose and decreasing glucose production slowing down the absorption of glucose from the intestine
  
• stimulating insulin release from the pancreas
• enabling the body to use its natural insulin more effectively
  

Over time, a careful diet combined with oral medication may not be sufficient to keep the diabetes under control. If this is the case then insulin injections may be recommended.

BBC Health. This article was last medically reviewed by Dr Rob Hicks in September 2006. First published in April 2001.

The Best Herbs and Supplements for Diabetes

These 10 have shown promise in lowering blood sugar, boosting insulin sensitivity and reducing high blood pressure and cholesterol.

Can herbs or supplements help you control your diabetes? These 10 have shown some promise in lowering blood sugar, boosting insulin sensitivity, reducing high blood pressure and cholesterol, and more. Talk to you doctor before adding any new pill to your regimen, especially if it has the potential to lower your blood sugar. You may need to check your blood sugar more often and possibly have your doctor adjust your medication dosage. If you don’t see results after a month or two, stop wasting your money.

1. Gymnema Sylvestre

Main use: Lowering blood sugar

Typical dosage: 200 to 250 milligrams twice daily.

This plant's Hindi name translates as "sugar destroyer," and the plant is said to reduce the ability to detect sweetness. It’s regarded as one of the most powerful herbs for blood-sugar control. It may work by boosting the activity of enzymes that help cells use glucose or by stimulating the production of insulin. Though it hasn’t been studied extensively, it's not known to cause serious side effects.

2. Bitter Melon

Main use: Lowering blood sugar

Typical dosage: 50 to 100 milliliters (approximately 3 to 6 tablespoons) of the juice daily.

The aptly named bitter melon is thought to help cells use glucose more effectively and block sugar absorption in the intestine. When Philippine researchers had men and women take bitter melon in capsule form for three months, they had slight, but consistently, lower blood sugar than those taking a placebo. Gastrointestinal problems are possible side effects.

3. Magnesium

Main use: Lowering blood sugar

Typical dosage: 250 to 350 milligrams once a day.

Magnesium deficiency is not uncommon in people with diabetes, and it can worsen high blood sugar and insulin resistance. Some studies suggest that supplementing with magnesium may improve insulin function and lower blood sugar levels, but other studies have shown no benefit. Have your doctor check you for deficiency before supplementing with magnesium.

4. Prickly Pear Cactus

Main use: Lowering blood sugar

Typical dosage: If you eat it as a food, aim for 1⁄2 cup of cooked cactus fruit a day. Otherwise, follow label directions.

The ripe fruit of this cactus has been shown in some small studies to lower blood sugar levels. You may be able to find the fruit in your grocery store, but if not, look for it as a juice or powder at health food stores. Researchers speculate that the fruit may possibly lower blood sugar because it contains components that work similarly to insulin. The fruit is also high in fiber.

5. Gamma-Linolenic Acid

Main use: Easing nerve pain

Typical dosage: 270 to 540 milligrams once a day.

Gamma-linolenic acid, or GLA, is a fatty acid found in evening primrose oil. Some research suggests that people with diabetes have lower than optimal levels of GLA, and studies have found that the supplement can reduce and prevent nerve pain associated with diabetes.

6. Chromium

Main use: Lowering blood sugar

Typical dosage: 200 micrograms once daily.

This trace mineral is thought to enhance the action of insulin as well as being involved in carbohydrate, fat, and protein metabolism. Some research shows that it helps normalize blood sugar -- but only in people who are deficient in chromium.

7. Bilberry

Main use: Protecting the eyes and nerves

Typical dosage: 80 to 120 milligrams two times per day of standardized bilberry extract.

This relative of the blueberry contains powerful antioxidants in its fruit and leaves. These antioxidants, called anthocyanidins, seem to help prevent damage to tiny blood vessels that can result in nerve pain and retinopathy (damage to the eye’s retina). Animal studies have also suggested that bilberry may lower blood sugar.

8. Alpha-Lipoic Acid

Main uses: Easing nerve pain, lowering blood sugar

Typical dosage: 600 to 800 milligrams a day.

Called ALA for short, this vitamin-like substance neutralizes many types of free radicals. A build-up of free radicals, caused in part by high blood sugar, can lead to nerve damage and other problems. ALA may also help muscle cells take up blood sugar. In a German study, a team of scientists had 40 adults take either an ALA supplement or a placebo. At the end of the four-week study, the ALA group had improved their insulin sensitivity 27 percent. The placebo group showed no improvement. Other studies have shown a decrease in nerve pain, numbness, and burning.

9. Fenugreek

Main use: Lowering blood sugar

Typical dosage: 5 to 30 grams with each meal or 15 to 90 grams with one meal per day.

These seeds, used in Indian cooking, have been found to lower blood sugar, increase insulin sensitivity, and reduce high cholesterol, according to several animal and human studies. The effect may be partly due to the seeds' high fiber content. The seeds also contain an amino acid that appears to boost the release of insulin. In one of the largest studies on fenugreek, 60 people who took 25 grams daily showed significant improvements in blood sugar control and post-meal spikes.

10. Ginseng

Main use: Lowering blood sugar

Typical dosage: 1 to 3 grams a day in capsule or tablet form, or 3 to 5 milliliters of tincture three times a day.

Known for its immune-boosting and disease-fighting benefits, this Chinese herb has several positive diabetes studies behind it. Re­searchers have found that ginseng slows carbohydrate absorption; increases cells' ability to use glucose; and increases insulin secretion from the pancreas. A team from the University of Toronto has repeatedly demonstrated that ginseng capsules lower blood glucose 15 to 20 percent compared to placebo pills.

From 759 Secrets for Beating Diabetes

Natural Sunlight and Vitamin D: Fifteen facts you probably never knew about

Vitamin D prevents osteoporosis, depression, prostate cancer, breast cancer, and even effects diabetes and obesity. Vitamin D is perhaps the single most underrated nutrient in the world of nutrition. That’s probably because it’s free: your body makes it when sunlight touches your skin.

Drug companies can’t sell you sunlight, so there’s no promotion of its health benefits. Truth is, most people don’t know the real story on vitamin D and health. So here’s an overview taken from an interview between Mike Adams and Dr. Michael Holick.

1. Vitamin D is produced by your skin in response to exposure to ultraviolet radiation from natural sunlight.

2. The healing rays of natural sunlight (that generate vitamin D in your skin) cannot penetrate glass. So you don’t generate vitamin D when sitting in your car or home.

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3. It is nearly impossible to get adequate amounts of vitamin D from your diet. Sunlight exposure is the only reliable way to generate vitamin D in your own body.

4. A person would have to drink ten tall glasses of vitamin D fortified milk each day just to get minimum levels of vitamin D into their diet.

5. The further you live from the equator, the longer exposure you need to the sun in order to generate vitamin D. Canada, the UK and most U.S. states are far from the equator.

6. People with dark skin pigmentation may need 20 - 30 times as much exposure to sunlight as fairskinned people to generate the same amount of vitamin D. That’s why prostate cancer is epidemic among black men — it’s a simple, but widespread, sunlight deficiency.

7. Sufficient levels of vitamin D are crucial for calcium absorption in your intestines. Without sufficient vitamin D, your body cannot absorb calcium, rendering calcium supplements useless.

8. Chronic vitamin D deficiency cannot be reversed overnight: it takes months of vitamin D supplementation and sunlight exposure to rebuild the body’s bones and nervous system.

9. Even weak sunscreens (SPF=8) block your body’s ability to generate vitamin D by 95%. This is how sunscreen products actually cause disease — by creating a critical vitamin deficiency in the body.

10. It is impossible to generate too much vitamin D in your body from sunlight exposure: your body will self-regulate and only generate what it needs.

11. If it hurts to press firmly on your sternum, you may be suffering from chronic vitamin D deficiency right now.

12. Vitamin D is “activated” in your body by your kidneys and liver before it can be used.

13. Having kidney disease or liver damage can greatly impair your body’s ability to activate circulating vitamin D.

14. The sunscreen industry doesn’t want you to know that your body actually needs sunlight exposure because that realization would mean lower sales of sunscreen products.

15. Even though vitamin D is one of the most powerful healing chemicals in your body, your body makes it absolutely free. No prescription required.

On the issue of sunlight exposure, by the way, it turns out that super antioxidants greatly boost your body’s ability to handle sunlight without burning.

Astaxanthin is one of the most powerful “internal sunscreens” and can allow you to stay under the sun twice as long without burning. Other powerful antioxidants with this ability include the superfruits like Acai, Pomegranates (POM Wonderful juice), blueberries, etc.

Diseases and Conditions Caused by Vitamin D Deficiency:

• Osteoporosis is commonly caused by a lack of vitamin D, which greatly impairs calcium absorption.
  

• Sufficient vitamin D prevents prostate cancer, breast cancer, ovarian cancer, depression, colon cancer and schizophrenia.
  

• “Rickets” is the name of a bone-wasting disease caused by vitamin D deficiency.
  

• Vitamin D deficiency may exacerbate type 2 diabetes and impair insulin production in the pancreas.

Continue reading - http://natural-health-care.co.cc/natural-sunlight-and-vitamin-d-fifteen-facts-you-probably-never-knew-about/

Control and Exercise Therapy for Diabetic Patient

Diabetes is a disease that can happen to people of any age (not only elders suffer). There are several myths regarding this disease. People think that if you east sweet foods you will have diabetes. It is not like that. It can happen for a number of reasons and the disease can affect many parts of your body such as your heart, eyes, teeth, kidney etc. When you are diagnosed with this disease, you must take proper steps to keep it in control. So check out the following tips and check your diabetes and liver longer with a healthy body.

• First you have to have a clear idea about the disease. When you are suffering from diabetes that means the glucose level in your blood is a high. When there is a malfunction of the usage of insulin in your body, it is called diabetes.
  

• A diabetic patient should follow a strict and healthy diet always. You have to eat healthy to remain fir and feel good. Add lots of fresh fruits and green vegetables in your diet. Fish, chicken and meat are also good for such patients. Avoid spicy and oily food as they contain high percentage of fat.
  

• Exercise is very good for you if you have diabetes. If you are overweight, you must take immediate steps. Shed those extra fats from your body by doing regular exercise. Take out a little time (10-15 minutes) everyday and go out for a brisk walk. It will help you keep fit and also shed some pounds. Exercise helps you to keep your diabetes in control.
  

• You should take care of your eyes and teeth when you are a diabetic patient. These parts of your body get affected by the disease. Bush your teeth every day (twice if possible). Wash you eyes whenever possible. Regular eye check up is also needed.
  

• You must keep yourself away from any kind of stress and tension in everyday life. Stress can have negative effects on diabetes. So try to relax and let go.

Exercise Therapy for Older Adults

Exercise promotes good health, improves functional status, and, along with a healthy diet, may even reverse existing disease and increase life expectancy . One study examining the effects of group exercise found it significantly decreased the risk of falls in frail elderly adults and another that progressive resistance muscle strength training increased muscle mass and strength in frail older people. An exercise programme for older adults that involved brisk walking and moderate resistance training found that exercise can also be used as a treatment for sleep problems, which can be a common issue in the elderly population.

Physicians need to ensure they counsel their older patients regarding exercise as this has been found to be highly influential. A doctor based in a retirement community would need to be particularly aware of this, especially as studies have found that physician counselling relating to exercise is low for all age groups but can be especially helpful for older people and result in significantly increased activity for up to a year after counselling.

The types of exercise recommended for older adults should involve strength, flexibility, endurance, and balance activities. While various land-based exercise programmes have been found to have many benefits for older people, water exercise programmes may be better for those with limited mobility and arthritis.

Images including older people that promote physical activity are important as they are rarely seen and older adults may be getting the message that exercise can be harmful for them. It would therefore be useful for a retirement community to prominently display positive images of older adults participating in exercise.

Diagnosis and Screening Test Diabetes

Testing for Glucose Abnormalities

Fasting Plasma Glucose. The fasting plasma glucose (FPG) test is the standard test for diagnosing diabetes. It is a simple blood test taken after 8 hours of fasting. In general, results indicate the following: 

• FPG levels are considered normal up to 100 mg/dL (or 5.5 mmol/L). 
• Levels between 100 and 125 mg/dL (5.5 to 7.0 mmol/L) are referred to as impaired fasting glucose or pre-diabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
• Diabetes is diagnosed when FPG levels are 126 mg/dL (7.0 mmol/L) or higher.

The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes, or if the tests are normal in people who have symptoms or risk factors for diabetes. For example, people who take the test in the afternoon and show normal results may actually have abnormal levels that would be revealed if they are tested in the morning. 

Glucose Tolerance Test. The oral glucose tolerance test (OGTT) is more complex than the FPG and may overdiagnose diabetes in people who do not have it. Some experts recommend it as a follow-up after FPG, if the latter test results are normal but the patient has symptoms or risk factors of diabetes. The test uses the following procedures: 

• It first uses an FPG test
• A blood test is then taken 2 hours later after drinking a special glucose solution

The following results suggest different conditions: 

• OGTT levels are normal up to 140 mg/dL
• Levels between 140 mg/dL and 199 mg/dL are referred to as impaired glucose tolerance or pre-diabetes
• Diabetes is diagnosed when OGTT levels are 200 mg/dL or higher

Both the FPG and OGTT tests require that the patient not eat for at least 8 hours prior to the test.

The oral glucose tolerance test is used to diagnose diabetes. The first portion of the test involves drinking a special glucose solution. Blood is then taken several hours later to test for the level of glucose in the blood. Patients who have diabetes will have higher than normal levels of glucose in their blood.

Test for Glycated Hemoglobin. Another test examines blood levels glycated hemoglobin, also known as hemoglobin A1c (HbA1c). Measuring glycated hemoglobin is not currently used for an initial diagnosis, but it may be useful for determining the severity of diabetes. 

The basis for its use as a diagnostic measurement in diabetes is as follows: 

• Hemoglobin is a protein molecule found in red blood cells. When glucose binds to it, the hemoglobin becomes modified, a process called glycation.
• Glycation affects a number of proteins, and elevated levels of glycolated hemoglobin is strongly associated with complications of diabetes.
• A glycated hemoglobin level of 1% above normal range identifies diabetes in 98% of patients. Normal HbA1c levels do not necessarily rule out diabetes, but if diabetes is present and levels are normal, the risk for complications is low.

The test is not affected by food intake so it can be taken at any time. A home test has been developed that might make it easier to measure HbA1c. In general, measurements suggest the following: 

• Normal HbA1c levels should be below 7%.
• Levels of 11 - 12% glycolated hemoglobin indicate poor control of carbohydrates. High levels are also markers for kidney trouble.

Testing for Insulin Resistance. Investigators hope that some day a simple test for insulin resistance will be available that will be able to identify people at risk for diabetes. Some research suggests that measuring insulin and triglyceride levels during a fasting period may predict a person's sensitivity to insulin. 

Autoantibody Tests

Type 1 diabetes is characterized by the presence of a variety of antibodies called autoantibodies that attack the islet cells. These antibodies are referred to as autoantibodies, because they attack the body's own cells -- not a foreign invader. Blood tests that test for these autoantibodies can help differentiate between type 1 and type 2 diabetes. 

Screening Tests for Complications

Screening for Heart Disease. All patients with diabetes should be tested for high blood pressure (hypertension) and unhealthy cholesterol and lipid levels and given an electrocardiogram. For cholesterol, people with diabetes should aim for LDL levels below 100 mg/dL, HDL levels over 50 mg/dL, and triglyceride levels below 150 mg/dL. Blood pressure goals should be 130/80 mmHg or lower. Other tests may be needed in patients with signs of heart disease. 

High blood pressure is strongly associated with diabetic nephropathy (kidney disease). In fact, patients with type 2 diabetes who show signs of microalbuminuria typically already have hypertension. Type 1 diabetes patients with microalbuminuria, on the other hand, usually have normal blood pressure readings in the doctor's office. A 2002 study using home monitors, however, found that in type 1 patients, high systolic blood pressure during sleep often occurs before development of nephropathy. (Systolic pressure is the first and higher number in a blood pressure reading.) Home blood pressure monitoring, may help identify type 1 patients at risk for kidney damage.

Screening for Kidney Damage. The earliest manifestation of kidney disease is microalbuminuria, in which tiny amounts (30 to 300 mg per day) of protein called albumin are found in the urine. Microalbuminuria is also a marker for other complications involving blood vessel abnormalities, including heart attack and stroke. 

The American Diabetes Association recommends that people with diabetes receive an annual microalbuminuria urine test. Patients should also have their blood creatinine tested at least once a year. Creatinine is a waste product that is removed from the blood by the kidneys. High levels of creatinine may indicate kidney damage. A doctor uses the results from a creatinine blood test to calculate the glomerular filtration rate (GFR). The GFR is an indicator of kidney function; it estimates how well the kidneys are cleaning the blood. 

Screening for Thyroid Abnormalities. Thyroid function tests should be administered.

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The New York Times | Health Guide

Review Date: 6/17/2008

Reviewed By: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. 

Diabetes Overview And Managed

What is diabetes?

Diabetes mellitus is a disease that prevents your body from properly using the energy from the food you eat. Diabetes occurs when either:

• The pancreas (an organ behind your stomach) produces little insulin or no insulin at all, or,
  

• The pancreas makes insulin, but the insulin made does not work as it should. This condition is called insulin resistance. 

What is insulin?

Insulin is a naturally-occurring hormone, produced by the beta cells of the pancreas, that helps the body use glucose for energy.

Understanding metabolism

To understand diabetes better, it helps to know more about how the body uses food for energy (a process called metabolism). Your body is made up of millions of cells. To make energy, the cells need food in a very simple form. When you eat or drink, much of your food is broken down into a simple sugar called glucose. Glucose (sugar) provides the energy your body needs for daily activities.

The blood and blood vessels are the highways that transport glucose from where it is either taken in (the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is stored (fat). Glucose cannot go into the cells by itself. The pancreas releases a substance called insulin into the blood which serves as the helper, or the "key" that lets glucose into the cells for use as energy. When glucose leaves the bloodstream and enters the cells, the blood glucose level is lowered. 

Compare the human body to a car. To start a car, you must turn the key to move the gas to the engine. Without insulin, or the "key," glucose cannot get into the body's cells for use as energy. This causes glucose to rise. Too much glucose in the blood is called "high blood sugar" or diabetes.

Types of diabetes

Type 1 diabetes

Type 1 diabetes occurs because the insulin-producing cells (called beta cells) of the pancreas are damaged. People with type 1 diabetes produce little or no insulin, so glucose cannot get into the body's cells for use as energy. This causes blood glucose to rise. People with type 1 diabetes MUST use insulin injections to control their blood glucose.

The damage to insulin-producing cells in type 1 diabetes occurs over a period of years. However, the symptoms of type 1 diabetes may occur over a period of days to weeks. Type 1 is the most common form of diabetes in people under age 20, but it can occur at any age.

Type 2 diabetes

Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin. However, the insulin produced is either not enough or doesn't work properly in the body. When there is not enough insulin or the insulin is not used as it should be, glucose cannot get into the body's cells for use as energy. This causes blood glucose to rise.

Type 2 diabetes is most common in people who are over age 40 and who are overweight. Some people with type 2 diabetes can manage it by controlling their weight, watching their diet, and exercising regularly. Others may also need to take an oral glucose-lowering medication or insulin injections.

Gestational diabetes

Gestational diabetes is a high blood glucose level that occurs during pregnancy. As pregnancy progresses, the developing baby has an increased need for glucose. Hormone changes during pregnancy also affect the action of insulin, resulting in high blood glucose levels.

Pregnant women who have an increased risk of developing gestational diabetes include those who:

• are over 25 years old
• are above their normal body weight
• have a family history of diabetes, and
• are Hispanic, African-American, Native American, or Asian.

Usually, blood glucose levels return to normal after childbirth. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.

What are the symptoms of diabetes?

The symptoms of type 1 diabetes are often sudden and severe. These symptoms include:

• Increased thirst
• Increased hunger (especially after eating)
• Dry mouth
• Frequent urination
• Unexplained weight loss (even though you are eating and feel hungry)
• Fatigue (weak, tired feeling)
• Blurred vision
• Numbness or tingling of the hands or feet
• Loss of consciousness (rare)

The symptoms of type 2 diabetes may be the same as those listed above. Most often, there are no symptoms or a very gradual development of the symptoms of type 1 diabetes.

Other symptoms include:

• Slow healing sores or cuts
• Itching of the skin (usually in the vaginal or groin area)
• Yeast infections
• Recent weight gain
  

Diabetes risk factors

Although the causes of diabetes are unknown, the following risk factors may increase your chance of developing diabetes: 

• A family history of diabetes (if a parent or sibling in your family has diabetes)
• Race or ethnic background (the risk of diabetes is greater in Hispanics, African-Americans, Native Americans, and Asians)
• Being overweight (20 percent or more over your desired body weight)
• Hypertension (high blood pressure)
• Abnormal blood cholesterol or triglyceride levels: HDL or "good" cholesterol level under 45 mg/dl for men and 55 mg/dl for women, and/or a triglyceride level over 150 mg/dl.
• Age: Your risk of developing diabetes rises progressively as you get older.

• Use of certain drugs: Blood pressure medications (such as thiazides), Steroid medications (such as prednisone or Decadron [dexamethasone]), Hydantoin medications (such as Dilantin [phenytoin]), Medications for transplant recipients (such as cyclosporine) 

• Alcohol, especially if you have been a heavy drinker for years
• Smoking
• History of gestational diabetes (developing diabetes during pregnancy) or delivery of babies who weigh more than 9 pounds
• Autoimmune disease: Your body's defense system (immune system) attacks certain healthy cells in your pancreas that produce insulin (beta cells).
• Other factors, such as viruses, which may play a part in diabetes development

It is important to note that sugar itself does not cause diabetes. Eating a lot of sugar can lead to tooth decay, but it does not cause diabetes.

How is diabetes diagnosed?

If you suddenly experience symptoms of increased thirst, frequent urination, or unexplained weight loss, diabetes may be the cause. To confirm the diagnosis, a fasting plasma glucose test or a casual plasma glucose test will be performed.

The preferred method of diagnosing diabetes is the fasting plasma glucose (FPG) test because it is easy to administer, convenient for patients, and less expensive than other tests (according to the American Diabetes Association). The FPG measures your blood glucose level after you have fasted or not eaten for 10 to 12 hours. Normal fasting blood glucose is between 70 and 100 mg/dl for people who do not have diabetes. The standard diagnosis of diabetes is made when two blood tests show that your fasting blood glucose level is greater than or equal to 126 mg/dl.

Some people have a normal fasting blood glucose reading, but their blood glucose rises rapidly as they eat. These people may have glucose intolerance. If their blood glucose levels are high enough, they may be considered to have diabetes.

In a casual plasma glucose test, blood glucose is tested without regard to the time since the person's last meal. A glucose level greater than 200 mg/dl may indicate diabetes, especially if the test is repeated at a later time and indicates similar results. 

The oral glucose tolerance test is another method used to detect diabetes, but is not routinely performed except during pregnancy.

How is diabetes managed?

There is no cure for diabetes, but it can be treated and controlled. The goals of managing diabetes are to:

1. Keep your blood glucose levels as near to normal as possible by balancing food intake with medication and activity.
2. Maintain your blood cholesterol and triglyceride (lipid) levels as near the normal ranges as possible by decreasing the total amount of fat to 30% or less of your total daily calories and by reducing saturated fat and cholesterol.
3. Control your blood pressure. (Your blood pressure should not go over 130/80.)
4. Decrease or possibly prevent the development of diabetes-related health problems.

You hold the keys to managing your diabetes by:

• Planning what you eat and following a balanced meal plan
• Exercising regularly
• Taking medication, if prescribed, and closely following the guidelines on how and when to take it
• Monitoring your blood glucose and blood pressure levels at home
• Keeping your appointments with your health care providers and having laboratory tests completed as ordered by your doctor.

What you do at home every day affects your blood glucose more than what your doctor can do every few months during your check-ups.

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