Shutterstock: pp. 2 , 5 , 7 , 15 , 19 , 27 , 30 , 32 , 35 , 36 , 38 , 41 , 42 , 47 , 52 , 57 , 60 , 63 , 64 , 69 , 74 , 77 , 78 , 91 , 94 , 95 , 97 , 99 , 101 , 103 , 105 , 109 , 112 , 114 , 116 , 117 , 121 , 123 , 125 , 128 , 130 , 132 , 134 , 137 , 139 , 141 , 143 , 144 , 149 , 153 , 154 , 160 , 163 , 165 , 166 , 168 , 169 , 171 , 176 , 180 , 182 , 183 , 187 , 190 , 193 , 197 , 202 , 205 , 209 , 211 , 214 , 219 , 220 , 223 , 225 , 228 , 230 , 236 , 237 , 240 , 241 , 243 , 248 , 254 , 257 , 260 , 263 , 264 , 269 , 271 , 275 , 277 , 280 , 282 , 284 , 287 , 289 , 292 , 295 , 297 , 299 , 302 , 304 , 306 , 307 , 309 , 315 , 318 , 321 , 346 , 352 .
U.S. Department of Health and Human Services: p. 67 .
Public domain: pp. 9 , 13 , 330 .
The Handy Diabetes Answer Book
Disclaimer
Information in this book is not meant as a replacement for the medical treatment of diabetes or other aliments, nor is it intended to substitute for the advice of your physician. It is meant for educational and information purposes only. If you have any questions about diabetes or any other medical problem, please seek help from a health care professional.
( Note : Because some people are sensitive to the term “diabetic,” the word will be used sparingly in this text.
The preferred phrase is “people with diabetes” (and we will refrain from using the annoying acronym “PWDs” or “People with Diabetes”).
Also note, type 1 and type 2 diabetes are written as such throughout this text, although they are often written in the media as “Type 1,” “Type I,” or “T1D,” and “Type 2,” “Type II,” or “T2D,” respectively.
Also, some health care professionals prefer to call diabetes a “syndrome,” not a “disease.” Because most references refer to diabetes as a “disease,” this text will also use that term.)
The Handy Diabetes Answer Book
Acknowledgments
We, the authors, would like to thank everyone who “wages the war on diabetes”, from the doctors, nurses, and dieticians who help people cope with diabetes to the researchers and scientists who are constantly trying to mitigate the many forms of this disease.
Thanks to Roger Jänecke, our publisher, who asked us to write this book and let us take it in a more scientific direction.
Thanks to Kevin Hile, our fabulous editor, for all his help and suggestions, not to mention realizing that Patricia writes best with plenty of chocolate.
We’d also like to thank typesetter Marco Divita, page and cover designer Mary Claire Krzewinski, indexer Larry Baker, and proofreaders Shoshana Hurwitz and Brian Buchanan.
And, as always, thanks to Agnes Birnbaum, our good friend and agent who puts up with our many questions, and always has the answers.
You’re the best, and always will be, Agnes.
A special (and huge) thanks goes to Gail Bykonich (who has had type 1 diabetes since she was ten) for all her help with this book. She is also one of the bravest people we’ve ever known, along with being a good friend. And, of course, thanks to brother James Barnes, sister Karen Barnes, and aunt and uncle Janet and John Barnes.
Finally, thanks to all the wonderful people who told us their (good and bad) experiences with diabetes. You all give people who cope with diabetes something special: hope.
The Handy Diabetes Answer Book
Introduction
Both of us have known many people, friends, family, and acquaintances, who have had (or currently have) some form of diabetes.
Patricia’s paternal grandmother died after 72 hours with uremia-acidosis (kidney problems exacerbated by her type 2 diabetes) and other complications of the disease at the tender age of 66.
Her mother was diagnosed with type 2 diabetes at 68, and three years later she experienced her first heart attack.
Her mother’s attending physician nodded and stated, “Diabetes and heart problems.
No surprise there.”
And after writing this book, and knowing people who have the disease, we can both say, “No surprise there.”
There are other stories.
One night in June, there was the gentleman who rammed his truck into the front of a nearby house, the vehicle’s nose landing right in the front part of the kitchen.
He had no idea what was going on, including that he had also rammed a car down the street on his way up the hill, causing the car to flip over into a ditch (with no injuries).
The EMTs were finally able to take his blood glucose (sugar) levels.
The meter revealed a reading of 29 (normal hovers around 100), which is a dangerously low blood sugar level.
Amazingly, no one was hurt and there was only house and car damage. The sheriff told us the gentleman in the truck was lucky. He also mentioned how hard it was for a policeman or emergency personnel to determine if a person was drunk or had low blood sugar, a condition called hypoglycemia. Apparently and tragically, he also mentioned that this happens quite frequently.
One of the reasons for so many such stories is that diabetes (especially type 2) has almost become an epidemic. It is extremely pervasive not only in the United States but in other countries around the world. In 2016, it was no surprise when the World Health Organization announced that 422 million adults had diabetes, with 3.7 million deaths per year due to diabetes and its complications.
And there are reasons.
First and foremost, medical research has greatly advanced in the past fifty years, and more is known about the causes and effects of the disease.
Thus, it is studied and mentioned more in the medical literature and media.
Second, more people are going to their doctors for checkups, and being tested for diabetes, than five decades ago.
When Patricia’s grandmother was diagnosed, there were no diabetic centers to go to for information, no Internet to check for information from the National Institutes of Health, the American Diabetes Association, and other diabetes interest groups.
And above all, there was no “fit the treatment to the individual” attitude that is prevalent in many health care facilities today.
There are more devices and medications than ever before to help those with type 1 and 2 diabetes, and even more treatments for the lesser-known forms of the disease.
And of course, another reason for the seeming epidemic of diabetes is that many more people are truly developing the disease.
Presented in this book is the latest about diabetes, from what causes the disease and why people develop it to how to best cope with diabetes at this time (we have no doubt treatment of diabetes will continue to metamorphose and improve).
We present much of the science behind the disease, along with the details of how diabetes affects the various systems of the human body.
We offer the history of diabetes research, who gets diabetes (including some animal research), and statistics surrounding diabetes.
We even mention some celebrities who have diabetes, people who have bravely stepped forward (some after many years of hiding the disease) to help and educate others about how to cope and understand it.
There are suggestions for readers as to why exercise, along with better, healthier eating habits, can actually help people with the disease. And for those with prediabetes, we offer ways to help possibly stave off, or at least slow down, the disease. There are also book, Internet, and app resources to assist the reader (and, hopefully, to help them seek out more information), as well as a glossary of terms.
We also mention the promise of help in the future.
For example, there is the current testing of an artificial pancreas for people with type 1 diabetes, along with monitors that don’t require stabbing a person’s finger over and over to test blood glucose levels.
For people with type 2 diabetes, there are many studies that propose various ways to reverse the disease, along with possible ways never to contract type 2 diabetes (much if it in obesity research).
And, of course, along with all the changes, research, and inventions, there are plenty of discussions (many of them heated) of the best ways to treat the disease.
This book is especially for those who have just learned they have diabetes. It is also for those who have a family member or friend with the disease. We discovered it is truly important for those who live, work, or play with a person with diabetes to know not only the signs of a diabetic emergency, but also when to contact emergency medical help. It can often save a family member or good friend. We know because we’ve been there many times.
One of the most difficult parts of having diabetes is coping.
It’s not easy when a person gets their first diagnosis of having diabetes.
It’s not easy for a person with diabetes to constantly be aware of their blood glucose (sugar) levels.
It’s not easy trying to watch what they consume, while others consume “forbidden” foods around them, and to understand how foods and beverages affect the person with diabetes.
And it’s especially difficult to watch a young child, or anyone, especially those close to us, cope with the disease.
We hope this book helps you to understand diabetes and lets you know how much of an effort is now placed in finding ways to help those with the disease, or at least ways to slow down the progression of diabetes. (We hesitate to say “cure,” as not everyone can be helped with newer treatments, although one day, there may be a “cure” to mitigate the disease for many in the future.) We also hope you walk away knowing there are people who care, who can help you, and who are truly trying to understand this disease.
We found that many times it’s not easy for a person to admit to others they have diabetes. But having diabetes is nothing to be “ashamed” of or to fear. Maybe this book will help a person with diabetes explain to others what it’s like to cope with diabetes, to get over the fear of being (what some of our friends with diabetes say) “different.” And we hope this book answers many of your questions about diabetes and helps you find the assistance you need.
To the brave people who have to deal with diabetes every day, we salute you.
The Handy Diabetes Answer Book
INTRODUCTION TO DIABETES
What is a general definition of diabetes?
Diabetes is considered a complex group of diseases with a variety of causes.
It is also often called a syndrome, or a combination of associated conditions.
In most cases, people with diabetes have a high amount of glucose (a sugar) in their blood, also referred to as high blood glucose (or sugar) levels or, in the case of extremely high glucose levels, hyperglycemia.
It is a disease that occurs when for various reasons the body’s cells are unable to absorb excess glucose from the blood, which causes an overabundance of the sugar in the body.
This is a very basic definition, as there are several types of diabetes, including type 1, type 2, and gestational diabetes.
For simplicity, and because most media mentions that diabetes is a disease (after all, it does include a collection of diseases with various causes), the remainder of this text will mention diabetes as a “disease” not a “syndrome.”
What is the medical term for the condition caused by the body’s inability to produce or use insulin?