Tuesday, February 23, 2016

Living with Diabetes



Diabetes. What is this?

Chances are you have heard of this disease.  Maybe you have an uncle that has diabetes because he let his diet and lifestyle get out of hand. You may have seen a coworker poking his/her finger just to draw blood and test it on a handheld machine before they eat lunch.  Or maybe you heard the Liberty Medical commercial and chuckled every time Wilford Brimley mentioned "Diabeetus."  My experience with diabetes came when I was about 16 years old and my father was diagnosed with type 1 diabetes (unusual but true). So what is diabetes? And how is their life any different from yours?

Simply put, diabetes is a medical condition where the pancreas (as pictured) does not make insulin or the body does not use insulin correctly.  To break the definition down a little further, insulin is a hormone that the body uses to convert the foods you eat into energy.  As you eat, the carbohydrate foods (listed below) are broken down into a single sugar molecule called glucose.  Glucose is absorbed into the bloodstream where it flows freely until insulin “unlocks” an opening in the cell wall, so it can be used as energy your body needs to function correctly.  When insulin is not made by the pancreas or cannot be used correctly, the glucose stays in the bloodstream which not only neglects your cells from energy but can cause damage to your blood vessels, eyes, nerves, or kidneys.  In some instances, it can lead to death.  When there is a large amount of glucose roaming in the blood stream it is known as hyperglycemia.


 
 

Foods that contain carbohydrates:
·         Grains
·         Cereals
·         Pasta
·         Fruits
·         Vegetables
·         Milk/yogurt
·         Beans
·         Sweets/sugar

 

When you have diabetes, the body does not discriminate against carbohydrates.  A carb is a carb no matter if it is a piece of candy or piece of fruit. When someone has diabetes they have to watch how many carbohydrate foods they eat and not just avoid sweets, as many of us assume.  When my father was first diagnosed with type 1 diabetes we, his family, thought “oh he can eat candy as long as it is sugar-free” or “he can eat whatever as long as it is not cake or ice-cream.” But neither of these statements are 100% correct.  The American Diabetes Association explains this into further detail:

*Myth: People with diabetes can't eat sweets or chocolate.

*Fact: There are no “off limits” foods for people with diabetes just like for someone without diabetes.  If eaten with a healthy meal plan and blood sugar is not too high, sweets or chocolate may be included.  The key to sweets or chocolate is portion control. These foods contain higher amounts of carbohydrates so if consumed on special occasions or in a small amounts, these foods are acceptable.

*Myth: People with diabetes should eat special diabetic foods.

*Fact: A suggested meal plan for someone with diabetes is in the same ballpark as a healthy diet suggested to any other individual – lean protein, whole grains, fruits and vegetables (non-starchy), healthy fats while limiting saturated and trans fat, and limit salt and sugar.  Diabetic foods or sugar-free foods usually have no benefit while they may increase blood glucose, cost more, and contain sugar alcohols which may cause a laxative effect.

 
There are many different ways to determine what kind of carbohydrate foods to eat or how many the individual should eat.  This includes carbohydrate counting, glycemic index, exchange list, or just an overall healthy diet based on MyPlate.
 
 

Type I vs. Type II

The two main types of diabetes are type 1 diabetes and type 2.  The biggest difference in the two conditions has to do with the insulin in the body. 

Listed below are the differences between type I and type II diabetes:

Type I
Type II
Previously known as “juvenile diabetes”
 
Only about 5 % of diabetic cases
Most common
The pancreas does not make insulin
The pancreas makes insulin but it is not used correctly in the body – “insulin resistant”
Insulin shots are required
Most cases do not have to take insulin shots --
Cannot be reversed
Can be reversed if caught early and diet/lifestyle is corrected
Usually diagnosed before the age of 40
Usually diagnosed after the age of 45
Symptoms develop rapidly (days/weeks)
Symptoms develop slowly (years)
Risk Factors: disease of Pancreas, infection or illness
Risk Factors: Obesity, insulin resistance, ethnicity, high blood pressure, sedentary lifestyle, age

 

Diabetes Complications
·         Diabetic Ketoacidosis (ketosis): a severe condition where hyperglycemia (high blood glucose/sugar) causes an accumulation of ketones in the blood and urine. – may lead to death
·         Cardiovascular disease
·         Retinopathy (eye damage)
·         Neuropathy (nerve damage) – may lead to amputation
·         Nephropathy (kidney damage)
o   In 2011, 49,677 people of all ages began treatment for kidney failure due to diabetes.
o    In 2011, a total of 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant.
·         Coma

 
Both types of diabetes may lead to these complications, but the most severe form of diabetes is when the pancreas completely stops making insulin – type I and later stages of type II diabetes.  Maintaining a consistent blood glucose level is left up to the individual.  Education on diet, insulin, exercise, hyper and hypoglycemia symptoms, handling emergencies, coping, and even pregnancy are crucial at this point.


With everything mentioned above with diet and complications, one would think managing their diabetes should be a priority.  Well, what if you had a child with type I diabetes and their life depended on insulin shots? Would you do everything in your power to keep them healthy?  A recent study published in the Journal of the Academy of Nutrition & Dietetics brought this idea to reality.


Within this questionnaire, parents not only mentioned how specific foods can affect their child’s blood glucose levels but expressed the “importance of not restricting their child’s diet” (276). These parents found a barrier when it came to other siblings without type I diabetes, school events, parties, or play dates, or when the child refused to eat what was offered at mealtime.  The parents talked about others being allow to eat specific foods (high carbohydrate) and not wanting their child to feel “left out.”  Another parent mentioned they would rather have their child eat a food higher in carbohydrates then not eat at all or fight with them to get them to eat the meal provided.

 
After learning about how important carbohydrates can be to an individual with diabetes or how untreated diabetes can be a risk factor to many other conditions, how strict do you think you would be if you were a parent of a child with diabetes?

 

Main Article

Patton, S.R., Clements, M.A., George, K., Goggin, K. (2016). ”I don’t want them to feel different”: A mixed methods study of parents’ beliefs and dietary management strategies for their young children with type I diabetes mellitus. Journal of the Academy of the Academy of Nutrition and Dietetics, 116(2). 272-281. Doi:10.2016/j.jand.2015.06.377.

 
 
Resources for readers

Guide to Raising a Child with Diabetes
http://www.shopdiabetes.org/548-ADA-Guide-to-Raising-a-Child-with-Diabetes-3rd-Edition.aspx?loc=type1&source=dorg

Sports and Rec

Everyday life Links
http://www.diabetes.org/living-with-diabetes/parents-and-kids/everyday-life/

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