Sulfonylureas
Scientists discovered sulfonylureas accidentally when they noticed that soldiers who were given certain sulfur-containing antibiotics developed symptoms of low blood glucose. When scientists began to search for the most potent examples of this effect, they came up with several different versions of this drug. Sulfonylureas all have the following characteristics i They work by making the pancreas release more insulin. i They are not effective in type 1 diabetes where the pancreas is not capable...
Realizing risks to mother and baby
Whether you have diabetes before pregnancy or develop gestational diabetes, you face many considerations regarding your own health and the health of your baby. Persistently high blood glucose left untreated has major consequences for both mother and fetus. If high glucose is present early in the pregnancy, the result may be congenital malformations physical abnormalities that may be life threatening in the fetus. In the third trimester, the growing fetus may exhibit macrosomia abnormal...
Developing Positive Thinking
Studies have shown fairly conclusively that if you start with a positive frame of mind, your body can work with you and not against you. Even when things go wrong, if you're optimistic, you can pick yourself up and move forward. If you're pessimistic, you can become depressed and believe that nothing will help you. That kind of attitude is not conducive to good control of your blood glucose and avoidance of complications. I have a patient who came to me to improve his glucose control just after...
Hypoglycemia Kills Brain Cells
Hypoglycemia see Chapter 4 often comes on fast and leaves you with a headache or a general feeling of weakness and sometimes confusion. Because of this, people have believed that low blood glucose, especially if it occurs repeatedly, may destroy mental functioning. People who have had repeated episodes of hypoglycemia have shown no loss of mental functioning. Children may have different results because their brains are still developing. Fortunately, your body is supplied with hormones to...
Aqua
Situated in a grand post-1906 earthquake building on California Street, Aqua is located in the heart of San Francisco's bustling Financial District. At Aqua, owner Charles Condy and Executive Chef Michael Mina have joined forces to redefine dining and to pay elegant tribute to the flavors of the sea. The contemporary American design, combining a relaxed yet elegant ambiance, has set the stage for Chef Mina's imaginative menu. Since becoming the Executive Chef of Aqua, Michael Mina's intensely...
Unorthodox Methods Can Cure Diabetes
In Chapter 17, I talk about some treatments that don't work. Those treatments are just the tip of the iceberg. Many treatments do not help you and may hurt you. Whenever a problem affects a huge number of people, others are eager to exploit this potential gold mine. How can you know if what you read in your favorite magazine or see on the j Z Internet is actually useful Check it out with your physician, your diabetes FrAll educator, or other members of your team see Chapter 11 . They will know...
Considering Heart Disease
The major cause of death in the elderly person with diabetes is a heart attack. Strokes and loss of blood flow in the feet are also much more common in diabetics than nondiabetics. Usually, elderly diabetics suffer not only from diabetes but also have high blood pressure and high cholesterol, are overweight or obese, and do little exercise. Although many of these patients have had a diagnosis of diabetes for a relatively short time, they have actually suffered from the metabolic syndrome for...
Obesity and Type Diabetes in Children
The epidemic of obesity, which has spread to children in the United States in the past few decades, has led to a much higher prevalence of type 2 diabetes in children than was ever seen before. Overweight or obesity is present in as many as 25 percent of all children. Only a fraction of these children go on to develop diabetes. There are a number of conditions that can cause obesity in children but they represent probably 1 percent of the causes. Most of them can be diagnosed during the course...
Knowing Where You Cant Work
You may have grown up watching Eliot Ness on television and had your heart set on being a member of the Federal Bureau of Investigation. If you require insulin, forget it. The FBI has a policy called a blanket ban on hiring certain groups of people, including people with diabetes who take insulin. A blanket ban does not take into account the condition of the individual, the past employment history, the way the person manages his or her diabetes, or the responsibilities of the position. It...
Checking the TSH
Because there is a higher incidence of thyroid disease among people with diabetes and because thyroid disease is often confused with other conditions, a screening test called the thyroid stimulating hormone level is done at the time that diabetes is diagnosed and every five years thereafter if it is normal. TSH is produced by the pituitary gland in the brain. When the thyroid gland makes the right amount of thyroid hormone, the pituitary produces the right amount of TSH to keep it working...
The Part of Tens
I'il have ko lettuce iilled, tkree carroi gla ed, tve celery rosied, gt gt 7 he part of tens puts it all together and gives the most valuable techniques for thriving with diabetes. With just a little background from the other parts, you can use this section to really fine-tune your diabetes care. You find the ten commandments of excellent care, along with ten major myths about diabetes that you can discard. Finally, you find out how to utilize the skills and knowledge of the people around you,...
Basics of neuropathy
How high glucose levels damage nerves remains uncertain. Doctors do know that the part of the nerve, called the axon, that connects to other nerves or to muscle becomes degenerated. The damage may be vascular in some cases, resulting from a cut-off of blood to the nerve, and metabolic in others, resulting from chemical toxins produced by the metabolism of too much glucose. Diabetic neuropathy occurs in any situation where the blood glucose is abnormally elevated for ten years or more. It is...
Il Fornaio
Il Fornaio eel for-NIGH-oh means the baker in Italian. The company began as a baking school outside Milan, Italy, in 1972, created in response to the disappearing art of centuries-old Italian baking. In 1981, Il Fornaio came to the United States and has since grown to include some of the most successful restaurants and bakeries in America. Today, you can enjoy Il Fornaio's authen tic Italian food and baked goods at any of 21 locations in California, Portland, Seattle, Las Vegas, Denver, and...
GlycoMark Test
This test is relatively new in the United States but has been used in Japan for several years. It differs from the hemoglobin A1c test in two important ways 1 Results take two weeks rather than three months to change. 1 Better control is marked by a higher rather than a lower number for the GlycoMark test. The test is based on the normal presence of 1.5 anhydroglucitol 1,5 AG in the blood. As blood glucose rises and more of it gets into the kidneys, it blocks the return of 1,5 AG to the blood...
Explain Hypoglycemia
,f you take either insulin or one of the sulfonylurea medications see Chapter 10 , you may become hypoglycemic. Occasionally, hypoglycemia can be so severe that you're unaware of the problem. At that point, someone in your environment needs to know the symptoms of hypoglycemia and how to treat it. Chapter 4 contains all that information. You may want to make a list of the signs and symptoms of hypoglycemia and pass it around to your family and friends. You should keep that list and an emergency...
Your Baby or Preschooler Has Diabetes
If your infant or preschooler is diagnosed with diabetes, you may feel overwhelmed. The information in this section can help you understand that this diagnosis isn't the end of the world it's the beginning of many years of special care for your child. Although type 1 diabetes does not usually show up in babies, it can, and you should know what to expect when it does. Obviously, your baby is not verbal and cannot tell you what is bothering him or her. For this reason, you may miss the fact that...