Type 2 Diabetes

Dr. Branden Scott, Medical Director at JHH

What is Type 2 diabetes?

Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is when you have glucose, which is known as the energy for the cell, that cannot get into the cell through the Glucose Transport Protein because the insulin, aka the "key," does not open the cell. When it comes to both forms of diabetes, Type 2 diabetes is the most common form of diabetes. - See more at: http://www.diabetes.org/diabetes-basics/type-2/#sthash.ZxfTZ3UU.dpuf


The following segments show how to control Type 2 diabetes with diet recommendations, monitoring blood sugar levels, exercise recommendations, lifestyle choices, and 3 helpful professions to help you...

Recommended Diet

Understand serving size. When you buy food, look at the serving size on the label. Be sure to compare/contrast the serving size to the total servings of the food item. Make sure it is okay for your meal pan.

  • Examine fat content. There are two types of fats, good and bad. Good fats (such as monounsaturated and polyunsaturated fats found in nuts, seeds, olive oil, and fish) can help protect your heart from disease, and lowers cholesterol. Bad fats (like saturated and trans fats found in fast food, butter, and junk foods) raise cholesterol and increase the risk of heart disease. This can lead to a potential stroke.
  • Look for healthier foods. Try choosing foods that have less sugar and contain simple carbs. If you need help, dieticians can help create a personalized meal plan that's healthy for your body type.
  • Control portions. Check food labels to see the portion size. Try and maintain a portion that is within a balanced amount, though this could be more or less than you usually eat.
  • Balance carbohydrate intake with insulin needs. Your health care provider can help you understand how a food’s carbohydrate count can increase your blood sugar, and how much insulin you will need to balance that increase. Ideally you should keep carbs and insulin levels similar.
  • Keep track of meal and snack times. Your blood sugar may rise and fall throughout the day. The food you eat and the times that you eat your food will work with your insulin treatment to keep your blood sugar balanced and appropriate. Make a planned snack time that's right for your intake so you can manage your blood sugar.
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    Monitoring Blood Sugar

    Monitoring your blood sugar at home- Monitoring your blood sugar at home can be a positive and important long-term factor in controlling Type 2 diabetes. You can test your blood sugar at home with an electronic device called the "glucose meter" that measures sugar levels within a small drop of your blood. After consulting with your doctor for treatments, he or she may recommend several times a day, depending on your insulin levels. As a medical director I agree with the number of times that your should treat yourself daily. Testing your blood sugar levels should usually happen before meals and then right before bedtime.


    What Is My Target Range?

    Your personal doctor will set target blood sugar test results based on several components, including:

    • Severity of Type 2 diabetes
    • Your age
    • How long you've had Type 2 diabetes
    • If you are pregnant
    • Overall health and other medical conditions

    For many people who have Type 2, we at Johns Hopkins Hospital generally recommend targeting blood sugar levels that are:

    • Between 80 and 120 millgrams per deciliter (mg/dL) for people age 59 and younger with no other medical concerns
    • Between 100 and 140 mg/dL for people age 60 and older, or those who have other medical conditions, such as heart, lung or kidney disease


    How to increase your levels- You should bring up your glucose levels if you have hypoglycemia. Hypoglycemia is when you have abnormally low blood glucose levels, normally around 70 mg/dl. It is important to speak with your general doctor or Certified Diabetes Educator (CDE) to determine a glucose level that is considered "low" for you. You can treat hypoglycemia by consuming 15-20 grams of glucose or simple carbohydrates. Recheck your blood glucose after 15 minutes. Once your blood glucose returns to normal, eat a small snack if your next planned meal or snack is more than an hour or two away.


    Symptoms of Hypoglycemia-

    Shakiness

    Nervousness or anxiety

    Sweating, chills and clamminess

    Irritability or impatience

    Confusion, including delirium

    Rapid/fast heartbeat

    Lightheadedness or dizziness

    Hunger and nausea

    Sleepiness

    Blurred/impaired vision

    Tingling or numbness in the lips or tongue

    Headaches

    Weakness or fatigue

    Anger, stubbornness, or sadness

    Lack of coordination

    Nightmares or crying out during sleep

    Seizures

    Unconsciousness


    How to reduce your levels- If you need to reduce glucose levels this is because you have hyperglycemia. Try to not get this confused with hypoglycemia. Signs of high blood sugar start when your levels reach more than 200 mg/dL. Again, consult with your personal doctor or nutritionist to determine the exact level that is considered high for you. The best way to reduce levels is by exercising and eating healthy because you cannot easily remove glucose.


    Regular levels- The American Heart Association (AHA) recommends a range of 70 to 130 mg/dL before meals, and blood glucose less than 180 mg/dL after eating. This is a normal range for type 2 diabetics.



    PICTURE BELOW SHOWS EXAMPLE OF TESTING BLOOD SUGAR LEVELS

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    Exercise lifestyle

    How It Helps- Type 2 diabetes is when you have too much glucose in your blood because your insulin cannot process it. Exercising helps by reducing the amount of glucose in the blood stream. When you exercise, your muscles get the glucose they need, causing a reduction in your blood glucose level.


    The Beginning- The first thing to keep in mind is that you must set REALISTIC goals, as most people with Type 2 diabetes are overweight. After further communication with your general doctor or a CDE, he/she will check your heart health, which is important if you have blocked arteries or high blood pressure. Allow yourself to build a steady, challenging exercise routine. It is okay with going slow at first because, again, this is your personal workout. It’s better for your body in the long-term. Finally, always remember to stay hydrated. This is an important factor in your health in many ways.


    What Kinds of Exercise to Do-

    There are three main, important kinds of exercise: aerobic, strengthening, and flexibility. Try to incorporate all three, if possible.

    1. Aerobic

    Aerobic exercises include:

    -Walking

  • -Jogging/Running
  • -Tennis
  • -Basketball
  • -Swimming
  • -Biking
  • 2. Strengthening

    Strengthening exercises include:

    -Pushups

    -Weight Lifting

    -Sit ups

    3. Flexibility

    Flexibility exercises include:

    -Stretching

    -Basic workouts :)


    Additional Benefits of Regular Exercise-

    • Lower blood pressure
    • Better control of weight
    • Increased level of good cholesterol (HDL)
    • Leaner, stronger muscles
    • Stronger bones
    • More energy
    • Improved mood
    • Better sleep
    • Stress management

    Additional Professions

    Certified Diabetic Educator- A CDE is a health professional who educates patients about diabetes management, prediabetes, and diabetes prevention. Your certified diabetic educator will describe exactly what is going on inside your body. He or she will help you with the best day-to-day decisions and lead you on a healthy path to controlling Type 2 diabetes to the best of your ability.


    Nutritionist- Dietitians and nutritionists at the JHH provide advice on good eating habits. They also help you with your diet and detail how your diet affects your health. They assist with nutrition needs and food plans, a diet that's appropriate for your physical and dietary needs, and provide food counseling.


    Psychologist- Trained in the medical and psychological fields, a psychologist diagnosis the mental, emotional, and behavioral health of a patient. Our psychologists can support your mental status while dealing with life changing conditions, such as Type 2 diabetes. Dr. Unterberg is a state-of-the-art psychologist and loves to interact with you and other patients to help you not to stress about this medical condition.


    LISTED BELOW IS INFO OF DR. Unterberg, OUR PSYCHOLOGIST

    Randy Jackson talks a little about life with Type 2 diabetes.

    Randy Jackson Talks Type 2 Diabetes -- The Doctors

    Additional info and health risks

    If you have diabetes you may have some or all of these symptoms:

    • Increased thirst and hunger
    • Frequent urination
    • Weight loss
    • Blurry vision
    • Feeling very tired


    You may also have problems with:

    • Scrapes or bruises healing slower than usual
    • Tingling or numbness in the limbs

    Helping Sources

    1. Type 2 Diabetes and Exercise - Exercise Makes It Easier to Control Your Diabetes. (n.d.). Retrieved from http://www.endocrineweb.com/conditions/type-2-diabetes/type-2-diabetes-exercise


    2. Type 2 Diabetes Research Joslin Diabetes Center. (n.d.). Retrieved from http://www.joslin.org/diabetes-research/type_2_diabetes_research.html


    3. Checking Your Blood Glucose (Blood Sugar): American Diabetes Association. (n.d.). Retrieved from http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html


    4. Type 2 Diabetes. (n.d.). Retrieved from http://www.diabetes.org/diabetes-basics/type-2/#sthash.ZxfTZ3UU.dpuf