Diabetes For Dummies, 3rd Edition by Alan L. Rubin, MD Table of Contents
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Diabetes For Dummies, 3rd Edition by Alan L. Rubin, MD Table of Contents

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Diabetes For Dummies, 3rd Edition by Alan L. Rubin MD Table of Contents
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  • 1. Contents at a Glance Introduction .................................................................1 Part I: Dealing with the Onset of Diabetes......................7 AL Chapter 1: Dealing with Diabetes .....................................................................................9 Chapter 2: It’s the Glucose ..............................................................................................19 RI Chapter 3: What Type of Diabetes Do You Have?.........................................................29 TE Part II: How Diabetes Affects Your Body ......................51 Chapter 4: Battling Short-Term Complications ............................................................53 MA Chapter 5: Preventing Long-Term Complications ........................................................69 Chapter 6: Diabetes, Sexual Function, and Pregnancy ..............................................101 Part III: Managing Diabetes: The “Thriving with D Diabetes” Lifestyle Plan............................................119 TE Chapter 7: Glucose Monitoring and Other Tests........................................................121 Chapter 8: Diabetes Diet Plan .......................................................................................151 Chapter 9: Keeping It Moving: Exercise Plan ..............................................................175 GH Chapter 10: Medications: What You Should Know.....................................................195 Chapter 11: Diabetes Is Your Show ..............................................................................227 RI Chapter 12: Putting Your Knowledge to Work for You...............................................237 Part IV: Special Considerations PY for Living with Diabetes ............................................243 Chapter 13: Your Child Has Diabetes...........................................................................245 CO Chapter 14: Diabetes and the Elderly ..........................................................................261 Chapter 15: Occupational and Insurance Problems ..................................................269 Chapter 16: What’s New in Diabetes Care ...................................................................279 Chapter 17: What Doesn’t Work When You Treat Diabetes ......................................287 Part V: The Part of Tens ............................................297 Chapter 18: Ten Ways to Prevent or Reverse the Effects of Diabetes .....................299 Chapter 19: Ten Myths about Diabetes That You Can Forget...................................305 Chapter 20: Ten Ways to Get Others to Help You.......................................................311
  • 2. Part VI: Appendixes ..................................................317 Appendix A: Mini-Cookbook .........................................................................................319 Appendix B: Dr. W.W. Web .............................................................................................349 Appendix C: Glossary ....................................................................................................359 Index .......................................................................367
  • 3. Table of Contents Introduction ..................................................................1 About This Book...............................................................................................2 Conventions Used in This Book .....................................................................3 What You’re Not to Read.................................................................................3 Foolish Assumptions .......................................................................................4 How This Book Is Organized...........................................................................4 Part I: Dealing with the Onset of Diabetes ..........................................4 Part II: How Diabetes Affects Your Body .............................................4 Part III: Managing Diabetes: The “Thriving with Diabetes” Lifestyle Plan .....................................................................4 Part IV: Special Considerations for Living with Diabetes..................5 Part V: The Part of Tens.........................................................................5 Part VI: Appendixes................................................................................5 Icons Used in This Book..................................................................................6 Where to Go from Here....................................................................................6 Part I: Dealing with the Onset of Diabetes ......................7 Chapter 1: Dealing with Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Achieving Anything . . . Or Everything! .........................................................9 Keeping good company .......................................................................10 Realizing your potential.......................................................................11 Reacting to Your Diagnosis ...........................................................................11 Experiencing denial..............................................................................12 Feeling anger .........................................................................................12 Bargaining for more time.....................................................................13 Moving on..............................................................................................14 Maintaining a High Quality of Life................................................................15 The importance of regular exercise ...................................................15 The (minimal) impact of insulin treatments .....................................16 Other key quality of life factors..........................................................17 The bottom line ....................................................................................18 Chapter 2: It’s the Glucose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 Detecting Prediabetes ...................................................................................19 Knowing whether you should get tested...........................................20 Testing for prediabetes........................................................................20
  • 4. x Diabetes For Dummies, 3rd Edition Understanding What Diabetes Does ............................................................21 Realizing the role of glucose ...............................................................21 Testing for diabetes..............................................................................22 Controlling glucose ..............................................................................23 Losing control of glucose ....................................................................24 Tracing the History of Diabetes Treatment ................................................25 Sharing Some Real Patient Stories ...............................................................27 Chapter 3: What Type of Diabetes Do You Have? . . . . . . . . . . . . . . . . . .29 Getting to Know Your Pancreas....................................................................30 Examining your pancreas ....................................................................30 Understanding insulin..........................................................................30 Type 1 Diabetes and You...............................................................................32 Identifying symptoms of type 1 diabetes ..........................................32 Investigating the causes of type 1 diabetes ......................................34 Getting type 1 diabetes........................................................................34 Preventing type 1 diabetes..................................................................36 Having Type 2 Diabetes .................................................................................38 Identifying symptoms of type 2 diabetes ..........................................39 Investigating the causes of type 2 diabetes ......................................40 Getting type 2 diabetes........................................................................42 Preventing type 2 diabetes..................................................................43 Recognizing a variant of type 2 diabetes...........................................45 Having Gestational Diabetes.........................................................................47 Recognizing Other Types of Diabetes .........................................................47 Part II: How Diabetes Affects Your Body.......................51 Chapter 4: Battling Short-Term Complications . . . . . . . . . . . . . . . . . . .53 Solving Short-Term Complications ..............................................................53 Understanding Hypoglycemia ......................................................................54 The seriousness of hypoglycemia......................................................55 Symptoms of hypoglycemia................................................................55 Causes of hypoglycemia ......................................................................57 Prevention of hypoglycemia ...............................................................60 Levels of hypoglycemia .......................................................................60 Treatment of hypoglycemia ................................................................60 Combating Ketoacidosis ...............................................................................62 Can ketoacidosis affect you?...............................................................62 Symptoms of ketoacidosis ..................................................................63 Causes of ketoacidosis ........................................................................64 Treatment of ketoacidosis...................................................................64
  • 5. Table of Contents xi Managing the Hyperosmolar Syndrome......................................................65 Symptoms of the hyperosmolar syndrome.......................................66 Causes of the hyperosmolar syndrome.............................................66 Treatment of the hyperosmolar syndrome.......................................67 Chapter 5: Preventing Long-Term Complications . . . . . . . . . . . . . . . . .69 How Long-Term Complications Develop.....................................................70 Kidney Disease ...............................................................................................70 The impact of diabetes on your kidneys...........................................72 Early indications of kidney disease....................................................73 Progressive changes ............................................................................75 Treatment for diabetic nephropathy .................................................76 Eye Disease .....................................................................................................79 Understanding how the eye works ....................................................79 Retinopathy...........................................................................................80 Resources for the blind and visually impaired.................................82 Nerve Disease, or Neuropathy .....................................................................83 Basics of neuropathy ...........................................................................84 Disorders of sensation .........................................................................85 Disorders of movement (mononeuropathy).....................................88 Disorders of automatic (autonomic) nerves ...................................88 Entrapment neuropathies ...................................................................89 Heart Disease..................................................................................................91 Risks of heart disease to diabetic patients .......................................91 Metabolic syndrome ............................................................................92 Cardiac autonomic neuropathy..........................................................94 Cardiomyopathy ...................................................................................94 Diabetic Blood Vessel Disease Away from the Heart.................................95 Peripheral vascular disease ................................................................95 Cerebrovascular disease .....................................................................96 Diabetic Foot Disease ....................................................................................97 Skin Disease in Diabetes................................................................................98 Gum Disease in Diabetes ..............................................................................99 Chapter 6: Diabetes, Sexual Function, and Pregnancy . . . . . . . . . . .101 Examining Erection Problems ....................................................................101 The erection process .........................................................................102 Discussing ED with your doctor .......................................................103 Treatment for erectile dysfunction ..................................................103 Facing Female Sexual Problems .................................................................105 Striving for a Healthy Pregnancy................................................................107 Realizing the body’s reaction to pregnancy....................................107 Being proactive before and during pregnancy ...............................108 Diagnosing gestational diabetes.......................................................108
  • 6. xii Diabetes For Dummies, 3rd Edition Realizing risks to mother and baby .................................................110 Treating diabetes during pregnancy................................................112 Maintaining your health after pregnancy........................................115 Focusing on your baby’s health .......................................................116 Identifying Polycystic Ovarian Syndrome.................................................117 Part III: Managing Diabetes: The “Thriving with Diabetes” Lifestyle Plan .....................................119 Chapter 7: Glucose Monitoring and Other Tests . . . . . . . . . . . . . . . . .121 Testing, Testing: Tests You Need to Stay Healthy ....................................122 Monitoring Blood Glucose: It’s a Must ......................................................124 How often should you test? ..............................................................125 Using a lancet......................................................................................126 How do you perform the test? ..........................................................127 Choosing a Blood Glucose Meter ...............................................................128 Factors that may influence your purchase .....................................128 Profiles of different meters................................................................129 Tracking Your Glucose over Time: Hemoglobin A1c ...............................137 GlycoMark Test.............................................................................................140 Testing for Kidney Damage: Microalbuminuria........................................141 Checking for Eye Problems .........................................................................142 Examining Your Feet ....................................................................................142 Tracking Cholesterol and Other Fats.........................................................143 Measuring Blood Pressure ..........................................................................146 Checking Your Weight and BMI ..................................................................147 Testing for Ketones ......................................................................................149 Testing the C-reactive Protein ....................................................................149 Checking the TSH .........................................................................................149 Chapter 8: Diabetes Diet Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151 Considering Total Calories First.................................................................152 Carbohydrates ....................................................................................155 Proteins................................................................................................159 Fats .......................................................................................................160 Getting Enough Vitamins, Minerals, and Water........................................162 Counting Alcohol as Part of Your Diet.......................................................164 Using Sugar Substitutes...............................................................................165 Eating Well for Type 1 Diabetes..................................................................166 Eating Well for Type 2 Diabetes..................................................................167 Reducing Your Weight .................................................................................168 Types of diets......................................................................................168 Surgery for weight loss ......................................................................170 Behavior modification .......................................................................171
  • 7. Table of Contents xiii Coping with Eating Disorders .....................................................................172 Signs of anorexia or bulimia..............................................................172 Sources of help ...................................................................................174 Chapter 9: Keeping It Moving: Exercise Plan . . . . . . . . . . . . . . . . . . . .175 Getting Off the Couch: Why Exercise Is Essential....................................176 Preventing macrovascular disease ..................................................176 Taking charge of your health ............................................................176 Understanding your body mechanics during exercise..................177 Reaping the benefits ..........................................................................178 Exercising When You Have Diabetes .........................................................178 Working out with type 1 diabetes.....................................................179 Working out with type 2 diabetes.....................................................180 Determining How Much Exercise to Do.....................................................180 Exerting enough effort .......................................................................181 Devoting an hour a day......................................................................182 Making moderate exercise your goal...............................................182 Is Golf a Sport? Choosing Your Activity ....................................................183 Walking 10K a Day ........................................................................................186 Lifting Weights ..............................................................................................188 Chapter 10: Medications: What You Should Know . . . . . . . . . . . . . . .195 Taking Drugs by Mouth: Oral Agents.........................................................196 Sulfonylureas.......................................................................................196 Metformin ............................................................................................198 Alpha-glucosidase inhibitors ............................................................201 Thiazolidinediones (the glitazones) ................................................202 Meglitinides.........................................................................................204 DPP-4 inhibitors..................................................................................205 Combining oral agents.......................................................................206 New injectable drugs .........................................................................207 Insulin ............................................................................................................209 Shooting yourself ...............................................................................212 Conducting intensive insulin treatment ..........................................214 Adjusting insulin when you travel....................................................215 Delivering insulin with a pen ............................................................216 Delivering insulin with a jet injection device..................................217 Delivering insulin with an external pump .......................................218 Utilizing aids to insulin delivery.......................................................221 Using Other Medications.............................................................................222 Avoiding Drug Interactions .........................................................................223 Finding Assistance Obtaining Drugs..........................................................224
  • 8. xiv Diabetes For Dummies, 3rd Edition Chapter 11: Diabetes Is Your Show . . . . . . . . . . . . . . . . . . . . . . . . . . . .227 Your Role as Author, Producer, Director, and Star...................................227 The Primary Physician — Your Assistant Director .................................228 The Diabetologist or Endocrinologist — Your Technical Consultant ...229 The Eye Doctor — Your Lighting Designer ...............................................230 The Foot Doctor — Your Dance Instructor...............................................230 The Dietitian — Your Food Services Provider..........................................231 The Diabetes Educator — Your Researcher .............................................232 The Pharmacist — Your Usher...................................................................232 The Mental Health Worker — Your Supporting Actor.............................233 Your Family and Friends — Your Captivated and Caring Audience ......233 The Internet: Your Potential Partner in Lifestyle Change .......................234 Sites for diet and weight loss............................................................234 Sites for exercise programs ..............................................................235 Finding reputable Web sites..............................................................235 Chapter 12: Putting Your Knowledge to Work for You . . . . . . . . . . . .237 Delaying or Preventing Diabetes ................................................................237 Developing Positive Thinking .....................................................................238 Monitoring and Testing ...............................................................................238 Using Medications........................................................................................239 Following a Diet ............................................................................................240 Exercising Regularly ....................................................................................241 Using Expertise Available to You ...............................................................242 Part IV: Special Considerations for Living with Diabetes.............................................243 Chapter 13: Your Child Has Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . .245 Your Baby or Preschooler Has Diabetes ...................................................246 Nurturing a diabetic infant................................................................246 Taking care of a toddler with diabetes ............................................246 Becoming an educated caregiver .....................................................247 Your Primary School Child Has Diabetes..................................................248 Coping with type 1 diabetes .............................................................248 Recognizing and treating type 2 diabetes .......................................251 Your Adolescent Has Diabetes ...................................................................253 Your Young Adult Child Has Diabetes .......................................................254 Off to College ................................................................................................254 Obesity and Type 2 Diabetes in Children..................................................255 Defining obesity in children ..............................................................255 Preventing obesity in children..........................................................256 Dealing with type 2 diabetes.............................................................256
  • 9. Table of Contents xv Sick Day Solutions........................................................................................257 Thyroid Disease in Type 1 Children...........................................................258 The Extra Value of Team Care.....................................................................259 Chapter 14: Diabetes and the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . .261 Diagnosing Diabetes in the Elderly ............................................................261 Evaluating Intellectual Functioning ...........................................................262 Considering Heart Disease..........................................................................262 Preparing a Proper Diet...............................................................................263 Avoiding Hypoglycemia...............................................................................264 Using Medications........................................................................................264 Dealing with Eye Problems .........................................................................266 Coping with Urinary and Sexual Problems ...............................................266 Considering Treatment Approaches..........................................................267 Understanding the Medicare Law ..............................................................268 Chapter 15: Occupational and Insurance Problems . . . . . . . . . . . . . .269 Traveling with Diabetes...............................................................................269 Knowing Where You Can’t Work.................................................................271 Becoming Familiar with Workplace Law ...................................................272 Navigating the Health Insurance System ..................................................273 Private insurance ...............................................................................273 Insurance for low income patients...................................................275 High-risk pools....................................................................................276 Changing or Losing a Job ............................................................................276 Considering Long-Term Care Insurance....................................................277 Shopping for Life Insurance........................................................................278 Chapter 16: What’s New in Diabetes Care . . . . . . . . . . . . . . . . . . . . . .279 Protecting Yourself from the Dangers of New Drugs ...............................279 Red Wine to Defy Aging ...............................................................................281 Taking a Statin for All People With Diabetes ............................................282 Correcting the Cause of Complications.....................................................283 Getting Cells to Make Insulin ......................................................................284 Understanding the Importance of the ACCORD Study............................285 Chapter 17: What Doesn’t Work When You Treat Diabetes . . . . . . . .287 Developing a Critical Eye ............................................................................287 Identifying Drugs That Don’t Work ............................................................288 Chromium............................................................................................289 Aspirin..................................................................................................290 Cinnamon ............................................................................................290 Pancreas formula................................................................................290 Fat Burner............................................................................................291 Ki-Sweet ...............................................................................................291 Gymnema silvestre.............................................................................291
  • 10. xvi Diabetes For Dummies, 3rd Edition Avoiding Illegal Drugs ..................................................................................292 Knowing the Dangers of Some Legal Drugs ..............................................292 Antipsychotics....................................................................................293 AIDS medications ...............................................................................293 Recognizing Diets That Don’t Work ...........................................................294 Part V: The Part of Tens .............................................297 Chapter 18: Ten Ways to Prevent or Reverse the Effects of Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299 Major Monitoring .........................................................................................299 Devout Dieting ..............................................................................................300 Tenacious Testing ........................................................................................300 Enthusiastic Exercising ...............................................................................301 Lifelong Learning..........................................................................................301 Meticulous Medicating ................................................................................302 Appropriate Attitude ...................................................................................302 Preventive Planning .....................................................................................303 Fastidious Foot Care ....................................................................................303 Essential Eye Care ........................................................................................304 Chapter 19: Ten Myths about Diabetes That You Can Forget . . . . . . .305 Perfect Treatment Yields Perfect Glucoses ..............................................305 You Can Have Borderline Diabetes for Years............................................306 Unorthodox Methods Can Cure Diabetes .................................................306 You Can Tell the Level of Your Blood Glucose by How You Feel ...........307 Hypoglycemia Kills Brain Cells...................................................................307 If You Need Insulin, You’re Doomed...........................................................307 People with Diabetes Shouldn’t Exercise..................................................308 You Can’t Get Life and Health Insurance...................................................309 Most Diabetes Is Inherited ..........................................................................309 Diabetes Wrecks Your Sense of Humor .....................................................310 Soak Your Feet Daily if You Have Diabetes ...............................................310 Chapter 20: Ten Ways to Get Others to Help You . . . . . . . . . . . . . . . . .311 Explain Hypoglycemia .................................................................................311 Follow the Standards of Care with Your Doctor.......................................312 Find an Exercise Partner .............................................................................312 Use Your Foot Doctor ..................................................................................313 Enlist Help to Fight Food Temptation........................................................313 Expand Your Education with Diabetes Educators ...................................314 Fit Your Favorite Foods into Your Diet with a Dietitian ..........................315 Seek Out Appropriate Specialists...............................................................315
  • 11. Table of Contents xvii Discuss Your Medications with the Pharmacist.......................................316 Share This Book with Everyone .................................................................316 Part VI: Appendixes...................................................317 Appendix A: Mini-Cookbook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .319 Aqua...............................................................................................................319 Border Grill ...................................................................................................324 Charlie Trotter’s ...........................................................................................327 Fringale ..........................................................................................................330 Gaylord India Restaurant ............................................................................334 Greens............................................................................................................336 Harbor Village...............................................................................................341 Il Fornaio .......................................................................................................344 Appendix B: Dr. W.W. Web . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .349 My Web Site...................................................................................................349 General Sites .................................................................................................349 The American Diabetes Association ................................................350 Online Diabetes Resources by Rick Mendosa ................................350 National Diabetes Education Program.............................................350 National Diabetes Education Initiative ............................................350 Medscape Diabetes and Endocrinology Home Page......................351 The Diabetes Monitor ........................................................................351 Juvenile Diabetes Research Foundation..........................................351 Children with Diabetes ......................................................................351 Joslin Diabetes Center .......................................................................351 Canadian Diabetes Association ........................................................352 The International Diabetes Federation............................................352 Ask NOAH About Diabetes ................................................................352 Companies That Make Diabetes Products ................................................352 Glucose meters ...................................................................................352 Lancing devices ..................................................................................353 Insulin pumps .....................................................................................353 Insulin ..................................................................................................353 Insulin syringes...................................................................................354 Insulin jet injection devices ..............................................................354 Oral medications ................................................................................354 Diabetic Exercise and Sports Association ................................................354 Government Web Sites ................................................................................355 National Institute of Diabetes and Digestive and Kidney Disease ........................................................................355 Centers for Disease Control ..............................................................355 Healthfinder Web site ........................................................................355
  • 12. xviii Diabetes For Dummies, 3rd Edition PubMed Search Service of the National Library of Medicine.......355 Nongovernment Web site for searching the National Library......356 Diabetes Information in Other Languages ................................................356 Sites for the Visually Impaired ...................................................................356 American Foundation for the Blind..................................................356 Blindness Resource Center ...............................................................356 The Diabetes Action Network (National Federation of the Blind).....................................................................................357 Animals with Diabetes .................................................................................357 Dogs and other pets...........................................................................357 Cats.......................................................................................................357 Recipes for People with Diabetes ..............................................................357 Appendix C: Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359 Index........................................................................367