Introduction 1
About This Book 2
Foolish Assumptions 3
Icons Used in This Book 4
Beyond This Book 4
Where to Go from Here 5
Part I: Getting Started with Diabetes 7
Chapter 1: Dealing with Diabetes 9
Achieving Anything Or Everything! 10
Keeping good company 10
Realizing your potential 11
Reacting to Your Diagnosis 11
Experiencing denial 11
Feeling anger 12
Bargaining for more time and feeling depressed 12
Moving on 13
Maintaining a High Quality of Life 14
Exercising regularly 15
Factoring in the (minimal) impact of insulin treatments 15
Managing stress 16
Considering other key quality-of-life factors 17
Chapter 2: Making the Diagnosis with Glucose and Hemoglobin A1c 19
Realizing the Role of Glucose 19
Understanding the Hemoglobin A1c 21
Getting a Wake-Up Call from Prediabetes 22
Knowing whether you should get tested 22
Testing for prediabetes 23
Detecting Diabetes 24
Diagnosing diabetes through testing 24
Examining the symptoms of diabetes 26
Tracing the History of Diabetes Treatment 27
Explaining the Obesity (and Diabetes) Epidemic 29
Putting Faces to the Numbers: Sharing Some Real Patient Stories 30
Chapter 3: Recognizing the Various Types of Diabetes 33
Getting to Know Your Pancreas and Its Role in Diabetes 34
Examining your pancreas 34
Understanding insulin 35
Understanding Type 1 Diabetes and You 36
Identifying symptoms of type 1 diabetes 36
Investigating the causes of type 1 diabetes 37
Getting type 1 diabetes 38
Preventing type 1 diabetes 39
Having Type 2 Diabetes 39
Identifying symptoms of type 2 diabetes 40
Investigating what causes (and what doesn't cause) type 2 diabetes 42
Getting type 2 diabetes 43
Preventing the causes of type 2 diabetes 44
Recognizing variants of type 1 and 2 diabetes 46
Dealing with Gestational Diabetes 48
Recognizing Other Types of Diabetes 48
Part II: Knowing How Uncontrolled Diabetes Affects Your Body 51
Chapter 4: Avoiding Short-Term Complications 53
Solving (and Steering Clear of) Short-Term Complications 53
Dropping Too Low: Hypoglycemia 54
Identifying the signs of hypoglycemia 55
Categorizing levels of hypoglycemia 57
Managing the causes of hypoglycemia 57
Understanding the risks of hypoglycemia in special situations 60
Treating hypoglycemia 61
Combating Ketoacidosis 62
Managing Hyperosmolar Syndrome 63
Heeding the symptoms of hyperosmolar syndrome 64
Finding the cause 64
Treating hyperosmolar syndrome 65
Chapter 5: Warding Off Long-Term Complications 67
Knowing How Long-Term Complications Develop and How to Avoid Them 68
Kidney Disease 68
The impact of diabetes on your kidneys 70
Early indications of kidney disease 70
Progressive changes in the kidneys 71
Treatment for diabetic nephropathy 73
Eye Disease 76
Noting common eye problems in diabetics 76
Eyeing the risks of retinopathy 78
Resources for the blind and visually impaired 80
Nerve Disease, Also Known as Neuropathy 80
Examining the basics of neuropathy 81
Recognizing disorders of sensation 82
Comprehending disorders of movement 84
Recognizing disorders of automatic (autonomic) nerves 85
Entrapment neuropathies 86
Heart Disease 87
Identifying risks of heart disease to diabetic patients 88
Metabolic syndrome 90
Cardiac autonomic neuropathy 92
Cardiomyopathy 92
Diabetic Blood Vessel Disease Away from the Heart 93
Peripheral vascular disease 93
Cerebrovascular disease 95
Diabetic Foot Disease 95
Skin Disease in Diabetes 97
Gum Disease in Diabetes 98
Sleep Apnea 98
Other Conditions Associated with Diabetes That You Should Know 99
Chapter 6: Preserving Sexual Function and Protecting Pregnancy 101
Examining Erection Problems 101
Reviewing the erection process 102
Discussing ED with your doctor 103
Treating for ED 103
Facing Female Sexual Problems 106
Striving for a Healthy Pregnancy 107
Realizing the body's reaction to pregnancy 107
Being proactive before and during pregnancy 108
Diagnosing gestational diabetes 109
Recognizing risks to mother and baby 110
Treating diabetes during pregnancy 112
Maintaining your health after pregnancy 115
Focusing on your baby's health 117
Dealing with Polycystic Ovarian Syndrome 118
Part III: Managing Diabetes: The Thriving with Diabetes Lifestyle Plan 121
Chapter 7: Self-Testing for Glucose and Other Key Tests 123
Testing, Testing: Tests You Need to Stay Healthy 124
Monitoring Blood Glucose: It's a Must 126
How often should you test? 127
How do you use a lancet? 128
How do you perform the test? 129
Choosing a Blood Glucose Meter 130
Factors that may influence your purchase 130
Profiles of different meters 131
Tracking Your Glucose over Time: Hemoglobin A1c 141
Testing for Kidney Damage: Moderately Increased Albumin (MIA) 143
Checking for Eye Problems 144
Examining Your Feet 144
Tracking Cholesterol and Other Fats 146
Measuring Blood Pressure 149
Checking Your Weight and BMI 151
Testing for Ketones 152
Testing the C-Reactive Protein 152
Checking the TSH 153
Evaluating Testosterone in Men with Type 2 Diabetes 153
Checking Vitamin D 154
Chapter 8: Tackling What You Eat: Healthful Nutrition 155
Considering Total Calories First 156
Consuming the right amount of carbohydrates 159
Portioning proteins 163
Filling the fat requirement 164
Getting Enough Vitamins, Minerals, and Water 166
Counting Alcohol as Part of Your Diet 168
Using Sugar Substitutes 169
Eating Well for Type 1 Diabetes 171
Reducing Your Weight 171
Types of nutritional plans (NP) 172
Vegetarian plans 174
Mediterranean NP 174
Metabolic surgery for diabetes 175
Behavior modification 176
Coping with Eating Disorders 177
The dangers of anorexia and bulimia 178
Sources of help 179
Chapter 9: Metabolic Surgery: A Possible Cure for Type 2 Diabetes 181
Realizing the Benefits of Metabolic Surgery 182
Comparing surgery versus medical weight loss 183
Considering costs 183
Contemplating the other benefits 184
Considering Surgery over Traditional Diabetes Care 185
Realizing that surgery is a safe option 185
Comparing metabolic surgery and usual care 185
Focusing on metabolic surgery and intensive care 186
Getting Familiar with Guidelines for Surgical Candidates 187
Eyeing medical determinants 188
Noting psychological determinants 188
Knowing who shouldn't have surgery 189
Choosing the Operation 189
Adjustable gastric banding (AGB) 190
Roux-en-Y gastric bypass (RYGB) 191
Vertical sleeve gastrectomy (VSG) 192
How the surgery works 193
Preparing for Surgery 193
Finding the right surgeon 193
Getting ready for surgery 194
Identifying Short-Term and Long-Term Complications of Surgery 195
Managing your medications after surgery 195
Listing short-term problems 196
Noting long-term problems 196
Eating Properly and Exercising after Surgery 198
Focusing on nutrition after surgery 198
Comprehending why you may gain weight 198
Exercising before and after surgery 199
Hearing from Real Patients 202
Patient GM 202
Patient MS 203
Patient MP 205
Considering New Guidelines for Surgery 206
Chapter 10: Creating Your Exercise Plan 209
Getting Off the Couch: Why Exercise Is Essential 210
Preventing macrovascular disease 211
Providing other benefits 211
Taking charge of your health 212
Understanding your body mechanics during exercise 212
Reaping the benefits 213
Exercising When You Have Diabetes 214
Working out with type 1 diabetes 215
Working out with type 2 diabetes 215
Determining How Much Exercise to Do 216
Exerting enough effort 216
Devoting an hour a day 217
Making moderate exercise your goal 218
Is Golf a Sport? Choosing Your Activity 218
Walking 10K Steps a Day 222
Lifting Weights 224
Chapter 11: Medications: What You Should Know 231
Taking Drugs by Mouth: Oral Agents 232
Sulfonylureas 232
Metformin 234
Alpha-glucosidase inhibitors 237
Thiazolidinediones (The glitazones) 238
Meglitinides 240
DPP-4 inhibitors 241
Bile acid sequestrants 243
Bromocriptine 243
SGLT2 inhibitors 243
Combining oral agents 244
New injectable drugs 245
Taking Insulin 248
Considering insulin options 249
Shooting yourself 251
Conducting intensive insulin treatment 253
Adjusting insulin when you travel 255
Delivering insulin with a pen 256
Delivering insulin with a jet-injection device 257
Delivering insulin with an external pump 258
Utilizing aids to insulin delivery 261
Using Other Medications 262
Avoiding Drug Interactions 263
Finding Assistance Obtaining Drugs 264
Chapter 12: Assembling Your Diabetes Team 267
Your Role as Author, Producer, Director, and Star 267
The Primary Physician: Your Assistant Director 268
The Diabetologist or Endocrinologist: Your Technical Consultant 269
The Eye Doctor: Your Lighting Designer 270
The Foot Doctor: Your Dance Instructor 270
The Dietitian: Your Food-Services Provider 271
The Diabetes Educator: Your Researcher 272
The Pharmacist: Your Usher 272
The Mental-Health Worker: Your Supporting Actor 273
Your Family and Friends: Your Captivated and Caring Audience 273
The Internet: Your Potential Partner in Lifestyle Change 274
Sites for diet and weight loss 274
Sites for exercise programs 275
Finding reputable websites 275
Part IV: Special Considerations for Living with Diabetes 277
Chapter 13: Managing Diabetes in Children 279
Dealing with Diabetes in Your Baby or Preschooler 280
Nurturing a diabetic infant 280
Taking care of a toddler with diabetes 281
Becoming an educated caregiver 281
Helping Your Primary-School Child with Diabetes 282
Coping with type 1 diabetes 283
Recognizing and treating type 2 diabetes 285
Managing Your Adolescent's Diabetes 287
Handing Over the Reins to Your Young Adult Child with Diabetes 288
Preventing and Treating Obesity and Type 2 Diabetes in Children 289
Defining obesity in children 290
Preventing obesity in children 291
Dealing with type 2 diabetes 291
Taking Special Care of Sick Children 293
Checking for Thyroid Disease in Type 1 Children 293
Appreciating the Value of Team Care 294
Chapter 14: Diabetes and the Elderly 295
Diagnosing Diabetes in the Elderly 295
Evaluating Intellectual Functioning 296
Considering Heart Disease 297
Preparing a Proper Diet 297
Avoiding Hypoglycemia 298
Using Medications 299
Dealing with Eye Problems 300
Coping with Urinary and Sexual Problems 301
Monitoring Foot Problems 301
Considering Treatment Approaches 302
Understanding the Medicare Law 303
Chapter 15: Dealing With Occupational and Insurance Problems 305
Traveling with Diabetes 305
Knowing Where You Can't Work 307
Becoming Familiar with Workplace Law 309
Navigating the Health-Insurance System 310
Employer insurance 311
Government insurance 311
Private insurance 311
No insurance 313
Changing or Losing a Job 313
Considering Long-Term Care Insurance 314
Shopping for Life Insurance 315
Chapter 16: Eyeing What's New in Diabetes Care 317
Protecting Yourself from the Dangers of New Drugs 317
Checking the Role of Intestinal Organisms in Type 2 Diabetes 319
Eating One Meal a Day to Control Diabetes 319
Losing Weight with Gastric Artery Embolization 320
Blocking the Vagus Nerve for Weight Loss 320
Lowering Blood Glucose in Pregnancy 321
Using an Endoscopic Duodenal-Jejunal Bypass Liner for Weight Loss 321
Placing a Gastric Balloon 322
Understanding the Importance of the ACCORD Trial 323
Taking Advantage of Metabolic Memory 324
Chapter 17: Discovering What Doesn't Work When You Treat Diabetes 325
Developing a Critical Eye 325
Identifying Drugs and Supplements That Don't Work 326
Chromium 328
Aspirin 328
Cinnamon 329
Pancreas formula 329
Fat Burner 329
Ki-Sweet 329
Gymnema sylvestre 330
Avoiding Illegal Drugs 330
Knowing the Dangers of Some Legal Drugs for Other Purposes 331
Antipsychotics 331
AIDS medications 332
Recognizing Diets That Don't Work 332
Part V: The Part of Tens 335
Chapter 18: Ten Commandments for Excellent Diabetes Care 337
Major Monitoring 337
Devout Dieting 338
Tenacious Testing 338
Enthusiastic Exercising 339
Lifelong Learning 339
Meticulous Medicating 340
Appropriate Attitude 340
Preventive Planning 341
Fastidious Foot Care 341
Essential Eye Care 342
Chapter 19: Ten Myths about Diabetes That You Can Forget 343
Perfect Treatment Yields Perfect Glucoses 343
Type 2 Diabetes Occurs in All Overweight People and Not in Normal Weight People 344
You Can't Enjoy Your Food 344
You Can Tell the Level of Your Blood Glucose by How You Feel 345
People With Diabetes Get More Colds and Other Illnesses 345
If You Need Insulin, You're Doomed 345
People with Diabetes Shouldn't Exercise 346
You Can't Give Blood Because You Have Diabetes 347
If You're Sick and Can't Eat, You Can Skip Your Diabetes Medications 347
Diabetes Wrecks Your Sense of Humor 348
Soak Your Feet Daily if You Have Diabetes 348
Chapter 20: Ten Ways to Get Others to Help You 349
Explain Hypoglycemia 349
Follow the Standards of Care 350
Find an Exercise Partner 350
Use Your Foot Doctor 351
Enlist Help to Fight Food Temptation 351
Expand Your Diabetes Knowledge 352
Fit Your Favorite Foods into Your Diet with a Dietitian 353
Seek Out Appropriate Specialists 353
Discuss Your Meds with the Pharmacist 354
Share This Book with Everyone 354
Appendix: Mini-Cookbook 355
Getting to Know the Contributing Restaurants and Chefs 355
Avra Estiatorio 355
Border Grill 356
Greens 356
Gerald Hirigoyen 357
Luna Blu 357
Paulette Mitchell 357
Cooking Some Healthful Recipes 358
Index 391
