Mayo Clinic: The Essential Diabetes Book 3rd Edition

How to prevent, manage and live well with diabetes

M. Regina Castro

• Publisher: Mayo Clinic Press
• Year: 2022
• Print ISBN: 9781893005792
• eBook ISBN: 9780795353291
• Topic: Medicine
• Subtopic: Nutrition, Dietics & Bariatrics

From the diabetes experts at Mayo Clinic comes a new 3rd edition of this practical, comprehensive guide to understanding and managing your diabetes. Whether you or a loved one are living with type 1 or type 2 diabetes, Mayo Clinic The Essential Diabetes Book is a practical manual for learning the ins and outs of the disease—why it develops, how it affects your body, how it’s treated, and what you can do to live well in spite of it. Each chapter delves into specific topics like how to monitor your blood sugar, how to incorporate healthy eating and exercise to lose weight, how to stay active and maintain a healthy weight, and how to get the most from your medications and treatment program. The newly revised third edition also outlines the most up-to-date information on new medications, advances in insulin delivery, and the latest diabetes technology being used by medical experts. You’ll learn about different diabetes technology options and how they may benefit your diabetes management routine, as well as how to avoid the distress and burnout many diabetics face. If you have a child with diabetes, there’s help for you too. You’ll learn how to recognize the key signs and symptoms of childhood diabetes, set your child up for a healthy future, implement new diabetes technology that works for you and your child, and support your child’s emotional well-being. Diabetes is a serious illness—and it’s becoming increasingly common. But with the collective knowledge and wisdom of a team of Mayo Clinic experts provided in Mayo Clinic The Essential Diabetes Book, you can be on your way to not just managing your illness, but thriving.

Chapter 1Understanding diabetes

A visit with M. Regina Castro, M.D.

“The threat of diabetes to our general health is significant enough that for the first time in history, younger generations may not enjoy the long lives that we have come to expect.”

We seem to be involved in an uphill battle. The number of individuals diagnosed with diabetes, particularly type 2 diabetes mellitus, continues to rise.

In addition, we’re seeing more young people with type 2 diabetes — many children and adolescents — as well as people of varied ethnic backgrounds and all levels of economic status.

What’s driving this epidemic? Have our genes changed dramatically? No. What has changed is the way we lead our lives. Meals are often eaten on the run, high in fat and calories and low in fruits and vegetables. We’ve become less physically active. As a result, many of us weigh too much. This increases the risk of diabetes and predisposes us to many other serious health problems.

It’s clear that we can’t solve this problem in doctors’ offices, clinics or hospitals — we’ve tried and failed. We need instead to focus on the daily decisions we make that affect our health. This requires change, and change is often hard.

When you face a big challenge, you want the best people on your side. In this book, we’ve recruited the help of experts who play important roles in caring for people who live with diabetes. Their advice will help you understand how small, everyday decisions can help you manage your disease and protect your health, as well as promote the health of those close to you.

As much as I believe in the importance of these changes, I know how challenging making them can be. By reading this book, you’re taking a first step in empowering yourself to live a healthier life. The information here will arm you with knowledge that’s easy to understand and put into action.

Identifying the obstacles that keep you from taking better care of yourself is the first step. Then recruit individuals who can help you overcome those obstacles, such as your family, friends, co-workers, and yes, your doctor. And don’t forget about the people on your diabetes care team, who are there to help you succeed.

In our ever changing environment, your role in protecting your health is more important than ever. We hope you find the information available here to be a helpful tool in fulfilling that role.

Perhaps your primary care provider recently broke the news that you have diabetes or that you’re very close to getting the disease. You’re worried. Will you never be able to eat desserts and sweets again? Will you have to give yourself daily shots of insulin? Will you eventually face an amputation? Will diabetes kill you?

For most people with diabetes, the answer to these questions is no. Researchers have learned a great deal about how to diagnose diabetes early and how to manage it. Because of these advances, you can live well and avoid serious complications if you follow the advice of your diabetes care team regarding eating, exercise, blood sugar (glucose) monitoring and, when necessary, use of medications. You can enjoy an active and healthy life despite having diabetes, but you have to be willing to do your part.

• • • • •

Typical metabolism

1. Glucose is broken down from the sugar in food and enters the bloodstream.
2. Insulin leaves the pancreas and enters the bloodstream.
3. Insulin “unlocks” the cell, letting glucose in to provide the cell with energy. Without insulin, glucose remains locked outside of the cells.
4. Extra glucose is stored in the liver.

• • • • •

What is diabetes?

The term diabetes refers to a group of diseases that affect the way your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it’s the main source of energy for the cells that make up your muscles and tissues. It’s your body’s main source of fuel.

If you have diabetes — no matter which type — it means you have too much glucose in your blood, although the reasons why may differ. And too much glucose can lead to serious problems.

To understand diabetes, it helps to understand how the body typically processes blood glucose.

• • • • •

A national epidemic

Due largely to the growing number of Americans who are overweight and the aging of the population, diabetes has become a major health problem in the United States. As your age and weight increase, so does your risk of the most common form of diabetes — type 2.

The latest figures from the Centers for Disease Control and Prevention show that 34 million American adults and children — or just over 10% of the population — have diabetes. Estimates also show that 88 million Americans — about 1 in 3 U.S. adults — have prediabetes, which increases the risk of diabetes. Type 2 diabetes accounts for 90% to 95% of all diabetes cases. Diabetes is the seventh-leading cause of death and contributes to more than 270,000 deaths in the United States each year. That’s why it’s important to treat the disease as soon as you discover you have it.

• • • • •

Processing of blood glucose

Blood glucose comes from two major sources: the food you eat and your liver. During digestion, glucose is absorbed by your bloodstream so that it can be circulated to your cells.

Your pancreas, which is sensitive to blood glucose levels, secretes a hormone called insulin into your bloodstream. This is essential because insulin gives your cells access to the glucose in your bloodstream. As insulin circulates with glucose, it acts like a key, unlocking microscopic access points that allow glucose to enter your cells. In this way, insulin helps fuel your cells and lowers the amount of glucose in your bloodstream, preventing it from reaching high levels. As your blood glucose level drops, so does the secretion of insulin from your pancreas.

Your liver acts as a glucose storage and manufacturing center. When the level of glucose in your blood is high, such as after a meal, your liver stores extra glucose as glycogen in case your cells need it later. When your glucose levels are low — for example, when you haven’t eaten in a while — your liver releases stored glucose into your bloodstream to keep your blood glucose level within a standard range.

When you have diabetes

If you have diabetes, the interplay between glucose and insulin doesn’t work like it should. Instead of being transported into your cells, glucose builds up in your bloodstream and eventually some of it is excreted in your urine.

Too much glucose in your bloodstream usually occurs when your pancreas produces little or...

Table of contents

• Your diabetes care team
• Preface
• Chapter 1: Understanding diabetes
• Chapter 2: Developing a healthy-eating plan
• Chapter 3: Achieving a healthy weight
• Chapter 4: Getting more active
• Chapter 5: Monitoring your blood sugar
• Chapter 6: Medical treatment
• Chapter 7: Using technology to manage diabetes
• Chapter 8: If your child has diabetes
• Chapter 9: Living well with diabetes
• Chapter 10: Staying healthy
• Chapter 11: Traveling with diabetes
• Appendix