The importance of monitoring blood sugar levels and working with a healthcare team for diabetes management
Time to read 6 min
Time to read 6 min
DIABETES MELLITUS |
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| Diabetes is a group of conditions linked by an inability to produce enough insulin and/or to respond to insulin. This causes high blood glucose levels (hyperglycemia) and can lead to a number of acute and chronic health problems, some of them life-threatening. | |||||
| People with diabetes are unable to process glucose, the body's primary energy source, effectively. Normally, after a meal, carbohydrates are broken down into glucose and other simple sugars. This causes blood glucose levels to rise and stimulates the pancreas to release insulin into the bloodstream. Insulin is a hormone produced by the beta cells in the pancreas. It regulates the transport of glucose into most of the body's cells and works with glucagon, another pancreatic hormone, to maintain blood glucose levels within a narrow range. If someone is unable to produce enough insulin, or if the body's cells are resistant to its effects (insulin resistance), then less glucose is transported from the blood into cells. Blood glucose levels remain high but the body's cells "starve." This can cause both short-term and long-term health problems, depending on the severity of the insulin deficiency and/or resistance. Diabetics typically have to control their blood glucose levels on a daily basis and over time to avoid health problems and complications. | |||||
| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention | |
| HbA1c | Glycated / glycosylated hemoglobin | This test evaluates the average amount of glucose in the blood over the last 3 months. | Indicates blood sugar control & how well diet, exercise, medicine, patient compliance etc are helping. | • Small, frequent meals. • Medium to low GI foods. • High fibre intake. • Whole grains should be eaten. • Protein rich meals • Alcohol consumption should be minimal. • Use a diabetic sensor and a food diary to monitor blood sugar levels. |
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| Glutamic acid decarboxylase (GADA) & Insulin autoantibodie s (IAAs) |
Beta cell destruction leads to insulin deficiency in T1diabetes.G ADA is an insulin antibody. | To distinguish between autoimmune Type 1 diabetes and Type 2 diabetes. | Presence of GADA indicates type 1 diabetes. | Nutrition guidelines should be based on classification as Type 1 diabetes or Type 2. | |
| Ketones | To determine the amount of ketones in the blood to help diagnose a life- threatening problem called diabetic ketoacidosis | When your client complaints about symptoms associated with ketoacidosis, such as increased urination, excessive thirst, dehydration, rapid breathing, fruity breath and shortness of breath. This is usually more common in Type 1 diabetics. | Abnormal increase of acid in the blood due to accumulation of substances derived from metabolism of fat (ketone bodies); usually due to severe insulin deficiency in diabetes or to prolonged lack of carbohydrate intake. | • Work in conjunction with the client’s doctor to ensure that medicines and carbs are adjusted. • Ensure adequate carbohydrate intake. • Use a diabetic sensor and food diary to monitor sugar levels. |
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| Insulin / C- peptide | To help evaluate insulin production by the beta cells in the pancreas or to help determine the cause of low blood glucose | • To check if adequate amounts of insulin is being produced or if it is time to supplement oral medication with insulin injections or an insulin pump; • To asses insulin resistance • When you have chronic hypoglycemia |
To adjust Carbohydrate intake and exercise accordingly. | ||
| Kidney function test | Urinary albumin, creatinine, eGRF, BUN, | To evaluate and monitor kidney function | Individual blood tests have different impact on health and diet. | Will be discussed in the Kidney disorders section. | |
| Liver function test | Cholesterol, HDL, LDL, trigylcerides |
To evaluate and monitor liver function | Individual blood tests have different impact on health and diet. | Will be discussed in the Liver disorders section. | |
| Vitamin B 12 Vitamin D Magnesium |
Vitamin important in metabolism especially energy release & healthy nerves. | • Metformin interferes with Vitamin B 12 absorption. • Diabetics with Vitamin B12 deficiency are more likely to suffer from heart disease. • To evaluate the reason behind fatigue, lethargy, poor concentration , poor memory, unhealthy nerves etc |
• Deficiency causes hyperglycaemia easily reduced by improving Vitamin B status. | • Vitamin B rich foods such as milk and milk products, whole grains , meat etc. • Supplementation / injections may be needed in extreme cases. |
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| Vitamin D affects glucose homeostasis | There are two forms: vitamin D2 and D3. Vitamin D2 is a synthetic version called ergocalciferol, which has a shorter shelf life, while vitamin D3 (also known as cholecalciferol) is the same as the vitamin D that is produced by the body following exposure to UVB rays. Studies have shown that vitamin D3 appears to be more than three times as effective as vitamin D2. |
It helps to improve the body’s sensitivity to insulin reducing the risk of insulin resistance. Good vitamin D status helps to reduce parathyroid hormone (PTH) levels, which in the long- term may promote weight loss and reduce risk of obesity, which is a major risk factor for type 2 diabetes. It also helps to increase satiety. | • Supplementation and regular monitoring. • Vitamin D rich food - cod liver oil, fatty fish (salmon , herring, trout, sardines, tuna), egg yolk, milk. • Ensure adequate healthy fat intake to retain Vitamin D. |
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| Magnesium deficiency is associated with insulin resistance. | • Helps anti oxidants work better. • Helps convert excess glucose into glycogen. • Helps prevent nerve damage. |
Mg plays a key role in regulating insulin action, insulin-mediated-glucose- uptake and vascular tone. Deficiency can cause issues in all these. | • Alcoholism causes magnesium deficiency, • Increase consumption of dark green leafy vegetables. • Nuts and seeds are a good source of magnesium. |
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| Chromium ESR CRP / hsCRP Omega 3 Copper |
Mineral which enhances insulin activity | It is a co factor for insulin action. | Deficiency indicates that carbohydrate metabolism is impaired. | • Adequate chromium and biotin levels help reduce HbA1c levels. • Chromium is also found in broccoli, green beans, grape juice, foods made of whole grains, poultry, lean beef and orange juice. |
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| Erythrocyte sedimentation rate. | To detect the presence of inflammation caused by diabetes. | • Its a non specific marker of inflammation and can indicate physical, physiological and psychological stress. • Indicates poor response to therapy. |
• Avoid processed & sugary food. • Anti inflammatory diet - Vitamin C & E rich food. • Consume raw fruits and vegetables. • Drink adequate amounts of water. |
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| C-reactive protein/ high sensitivity CRP | To identify the presence of inflammation and to monitor response to treatment for an inflammatory disorder | • CRP & hsCRP levels are increased during glucose intolerance. • High levels could also indicate risk of heart disease & stroke. |
• Avoid processed & sugary food. • Anti inflammatory diet - Vitamin C & E rich food. • Consume raw fruits and vegetables. • Drink adequate amounts of water. |
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| Fatty acid | It helps to reduce inflammation. | • Healthy Omega 3 levels are responsible for reducing dislipidemia, macular degeneration etc | • Ensure healthy Omega 3: Omega 6 ratios, as Omega 6 is pro inflammatory. • If supplements have to be consumed - ensure that it is Mercury free. |
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| Mineral | Involved in oxidative stress, which is associated with the onset and progression of diabetes mellitus | • Increased plasma copper indicates higher risk of diabetes. | • Copper homeostasis is essential for the treatment of diabetes. • Avoid copper rich foods such as dried mushrooms, spirulina, sesame seeds, cocoa, soya flour, cashew nuts. |
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| Zinc | Mineral | Zinc is also necessary for the formation of insulin in the pancreas's beta cells. | • Zinc supplementation has beneficial effects on glycaemic control and promotes healthy lipid parameters. • Zinc also effects appetite. |
• Phytate, which is present in staple foods like cereals, corn and rice, has a strong negative effect on zinc absorption. • Iron can have a negative effect on zinc absorption, if given together in a supplement (not as food). • Cadmium inhibits zinc absorption. It is present in rice, seaweed, seafood, green leafy vegetables, potatoes and bread. • The amount of protein in a meal has a positive effect on zinc absorption, but individual proteins may act differently; e.g., casein has a modest inhibitory effect of zinc absorption compared with other protein sources. • Amino acids, such as histidine and methionine, and other low-molecular-weight ions, such as EDTA and organic acids (e.g., citrate), are known to have a positive effect on zinc absorption. |
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* Medical Disclaimer - The following information is for educational purposes only. No information provided on this website, including text, graphic, and images, are intended as substitutes for professional medical advice. Please consult with your doctor about specific medical advice pertaining to your condition(s).
