Don’t become a statistic…

Diabetes means you have too much glucose in your blood. Glucose is a form of sugar your body uses for energy. Your blood always has some glucose in it, but too much glucose in your blood can damage your body over time.

Your body needs the hormone insulin to use glucose for energy. If your body doesn’t make enough insulin or doesn’t use insulin properly, you may develop diabetes. The main types include type 1 diabetes, type 2 diabetes and gestational diabetes.

Diabetes symptoms may include increased thirst and urination, blurred vision and fatigue.

If gone untreated, diabetes can cause heart attacks, strokes, blindness, kidney failure and other serious health problems.

Finding out you have high blood sugar or the onset of diabetes can be emotional. Although it is serious, the good news is that it is manageableif you start to make some basic changes in your lifestyle. In fact, research shows that type 2 diabetes and much of the illness and premature death caused by diabetes can be prevented or delayed. By taking control of your blood-sugar levels NOW, you can reduce the chance of developing complications or diabetes down the road. And you may look forward to living a long, healthy and fulfilling life with your family.

It is important to learn about your blood sugar to help prevent diabetes. And, if you have diabetes, you can live a healthier, more active life by learning about your disease and treatments and by becoming an active participant in your care.

Why care about high blood sugar levels?

When you eat, your body breaks food down into glucose (sugar) and sends it into the  bloodstream. Insulin, a hormone made by the pancreas, helps move the sugar from the blood into the cells to be used for energy. Insulin is like the key that unlocks the door to the cell so the sugar can get inside. Your body usually makes just the right amount of insulin to match the food you eat.

If the cells no longer respond well to insulin, they are considered “insulin resistant” and sugar can’t get into the cells. So the cells don’t get the fuel they need and sugar builds up in the blood stream. This is called “high blood glucose” or “high blood sugar.”

Having too much sugar in your blood for long periods of time can cause serious health problems if not treated. Some of the problems can include:

• Nerve damage. Over time, high blood sugar damages nerves and may cause loss of feeling or pain in the hands, feet, legs, or other parts of the body. Simple problems can become life threatening— because the nerves aren’t working as an early warning system.
• Blindness. High blood sugar keeps your eyes from getting the oxygen they need. Blurred vision and blindness can follow.
• Heart and blood-vessel damage. High blood sugar damages arteries. Damaged arteries aren’t able to keep blood pressure normal. Cholesterol builds up.
• Kidney failure. Diabetes damages kidneys. It’s the leading cause of kidney failure.
• Erectile dysfunction. Impotence is common in people with high blood sugar.
• Moodiness. Blood sugar has a big impact on mood. You may feel irritable, depressed, confused, anxious, shaky—just because your blood sugar is off.
• Extra weight. Too much blood sugar can cause the body to make excess insulin. This can result in blood sugar dropping below normal, making you feel tired and hungry for sugary or starchy foods —starting the cycle over again.  As a result, you overeat and gain weight.

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What is type 2 diabetes?

Type 2 diabetes is the most common type of diabetes. It occurs because the body doesn’t use insulin properly, a condition called insulin resistance. Over time, the cells that produce insulin cannot keep up with the body’s needs and diabetes develops.

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What are the causes of diabetes?

Diabetes is a chronic disease that is caused by the body’s inability to use glucose (blood sugar) properly due to a lack of or defects in insulin production. The precise cause of this insulin malfunction isn’t entirely understood, but genetic and environmental factors come into play. Additional contributing factors include lifestyle choices, such as diet and exercise.

Am I at risk?

As yourself these questions:

• Am I age 45 or older?
• Am I overweight?
• Am I lacking physical activity (less than 30 minute /day, five days/week)
• Do I have a family history of diabetes?
• Do I have high blood pressure or high cholesterol?
• Did I have gestational diabetes—diabetes during pregnancy—or gave birth to a baby weighing more than 9 pounds?
• Do I have blood glucose levels that are higher than normal, but not high enough to be called diabetes
• Am I African American, American Indian, Asian American, Pacific Islander or Hispanic/Latino?
• Do I have polycystic ovary syndrome?
• Do I have blood vessel problems affecting my heart, brain or legs?

The more frequently you answer “yes” to these questions, the greater your odds of developing diabetes.  Discuss these answers with your doctor or a RedBrick Health Coach.

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What are the symptoms?

Some people have signs of diabetes, but others have no signs at all. Look for these tell tale signs:

1. Going to the bathroom a lot: The kidneys respond to high levels of sugar in the blood by flushing out the extra sugar in urine. People with diabetes need to urinate more often and in larger amounts.
2. Drinking a lot: Because a person is losing so much fluid from urinating so much, he or she can get very thirsty.
3. Losing weight even though your appetite has stayed the same: If there isn’t enough insulin to help the body use the sugar, the body breaks down muscle and stored fat instead in an attempt to provide fuel to hungry cells. This means you start to lose weight.
4. Feeling tired often: Because the body can’t use sugar for energy properly, a person may feel unusually tired.
5. Blurry vision: High blood sugar causes the lens of the eye to swell.

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How is type 2 diabetes diagnosed?

Your doctor can test your blood to measure the blood glucose (blood sugar) level. The blood-glucose level is the amount of sugar in the blood. Tests can include:

• Fasting blood glucose test
• Random (non-fasting) glucose test
• Oral glucose tolerance test
• Glycated hemoglobin (A1C) test
• Urine test

It is critical to keep your blood sugar in a certain range to be healthy. Blood-sugar levels over 99 mg/dL (mg/dL = milligrams of glucose per deciliter of blood) or under 60 mg/dL are considered unhealthy.

High blood sugar (above 99 mg/dL) may be a sign of inadequate levels of insulin, caused by overeating, lack of exercise, diabetes medication or other factors.

Low blood sugar (below 60 mg/dL) may be a caused by skipping or postponing a meal, over-exercising, excessive alcohol consumption, taking too much insulin or other factors.

Blood Sugar Level (assumes no food for previous eight hours) 

In addition, your doctor may review your medical history and your family’s medical history, document your diabetes symptoms or lack of symptoms and conduct a full physical exam before making a diagnosis.

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How is it treated?

Many people with type 2 diabetes can control their blood sugar by following a healthy meal plan and exercise program, losing excess weight and taking oral medication. Some people with type 2 diabetes may also need insulin to control their blood glucose.  Many people with diabetes also need to take medications to control their cholesterol and blood pressure.

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What can I do to prevent or manage my diabetes?

Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your doctor or a RedBrick Health Coach to set up a game plan to keep your diabetes under control.  Here are some steps that should be included in your plan:  

• Establish and use your diabetes meal plan.
  • Make healthy food choices such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains and low-fat or skim milk and cheese.
  • Keep fish and lean meat and poultry portion to about 3 ounces (or the size of a deck of cards). Bake, broil, or grill it.
  • Eat foods that have less fat and salt.
  • Eat foods with more fiber such as whole grains cereals, breads, crackers, rice, or pasta.
  • Get 30 to 60 minutes of physical activity on most days of the week. Brisk walking is a great way to move more.
    
• Stay at a healthy weight by using your meal plan and moving more.
• Ask for help if you feel down. An Employee Assistance Program (EAP) representative, support group, member of the clergy, friend or family member who will listen to your concerns may help you feel better.
• Learn to cope with stress. Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it.
• Stop smoking. Ask a RedBrick Health Coach for help to quit.
• Take medicines even when you feel good. Ask your doctor if you need aspirinto prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects.
• Check your feet every day for cuts, blisters, red spots and swelling. Call your doctor right away about any sores that do not go away.
• Brush your teeth and floss every day to avoid problems with your mouth, teeth or gums.
• Monitor your blood glucose (blood sugar). You may want to test it one or more times a day. Use the card at the back of this booklet to keep a record of your blood glucose numbers. Be sure to take this record to your doctor visits. (See below for details.)
• Check your blood pressure if your doctor advises.
• Report any changes in your eyesight to your doctor.

Monitoring your blood sugar

If you’ve been diagnosed as pre-diabetic or diabetic, your doctor can provide you with a monitor to help you stay on top of your blood-sugar levels. Blood-sugar monitoring is the main tool you have to check your diabetes control. This quick check is done by sticking your finger with a special needle, called a lancet, to get a drop of blood which is then read by the monitor and tells you your blood-sugar level at any one time.

Keeping a log of your results is vital. When you bring this record to your doctor, you both will have a good picture of your body’s response to your game plan for managing your levels and let’s you see what works and what doesn’t. You and your doctor can then decided if any changes in treatment need to change. In addition to these self-checks, your doctor may take blood samples on a regular basis for more detailed information to monitor the disease.

Keep in mind that blood-sugar results often trigger strong feelings. The numbers can leave you upset, confused, frustrated, angry or down. It’s easy to use the numbers to judge yourself. Remind yourself that your blood-sugar level is simply a way to track how well your

diabetes game plan is working—it may show you need a change in your plan.

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Resources and tools

Contact a RedBrick Health Coach to participate in the diabetes online and/or telephone-based health coaching program. Call 866.261.7144 or visit www.redbrickhealth.com/login.

If your diabetes is affecting your mood and you feel you need someone to talk with, contact an EAP representative confidentially at 888.327.4347 (DTE Energy Affiliate Company employees call 800.969.6162.

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Where to turn

Diabetes is a challenging condition to manage, but these resources provide the latest strategies for making diabetes management easier and more effective.

American Association of Clinical Endocrinologists

This professional organization represents the nation’s endocrinologists (the medical specialists whose work focuses on diabetes management and treatment, as well as on other endocrine disorders). The website features a search function to help you locate a clinical endocrinologist in your area and up-to-date news on diabetes research.

American Diabetes Association

This comprehensive website has just about everything you need to know about diabetes.

Diabetes Exercise and Sports Association

Find out about many different kinds of exercises, how much you can do, and whether there are limitations because of diabetes. You also can find others who share your interests.

Centers for Disease Control and Prevention (CDC)

In response to the diabetes epidemic, the CDC has created an online Diabetes Public Health Resource that makes available patient information about diabetes, as well as links to a variety of state diabetes control programs and other special projects and initiatives aimed at controlling and reducing diabetes cases. The website offers a simple test that can help you determine whether you are at risk for developing diabetes. You also can access fact sheets, statistical reports and brochures regarding diabetes trends and research.

National Diabetes Education Program
Sponsored by the federal government, this site provides information aimed at improving treatments and outcomes for people with diabetes.

National Diabetes Information Clearinghouse
NDIC was established in 1978 to increase knowledge and understanding about diabetes among patients, health care professionals and the general public.  It includes easy-to-read publications about diabetes and other useful tools.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

This federal agency, a part of the National Institutes of Health, makes available a wide variety of resources regarding diabetes treatment and diabetes management.

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