A: More recently there has been a lot of media coverage around the possibility for a "cure" for type1 diabetes (insulin-dependent). A Canadian study was performed with patients who had longstanding type 1 diabetes, where they received injections of isolated beta cells (insulin-producing cells obtained from recently deceased persons). These patients received special experimental medicines to prevent rejection of these "foreign cells," and after about a year were able to control their blood sugars without insulin injections. A larger study is now in progress. As it stands there are several challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. Studies continue and progress is being made in all these areas.

There are no promising long-term scientific studies for a cure of type 2 diabetes. However, these individuals can help prevent future complications by controlling their diabetes with diet, exercise, weight control, and regular monitoring of blood sugar levels. Your treatment plan should meet your individual medical, social, and life-style needs. There are more recent studies indicating that people with impaired glucose tolerance can prevent type 2 diabetes from occurring. For more information on this topic, link here: Preventing type 2 diabetes.

[Information adapted from CDC's Division of Diabetes Translation (DDT) office & article by CDC's Frank Vinicor, MD, Director of DDT appearing in: inMotion, Volume 11 (2), March/April 2001].

Q: "I have diabetes, what is a healthy blood sugar level for me?"

A: If you have diabetes it is important to test your blood sugar at home as well as having regular lab tests at your doctor’s or other health care provider's office. Talk with your doctor or Diabetes Outpatient Educator (DOE) to find out how often you should do this and when, since each person’s need to test is different. Testing regularly will help you and your doctor figure out what your pattern is, and learn how your diabetes treatment plan works for you. The American Diabetes Association (ADA) recommends that most people with diabetes try to keep their blood sugar levels close to the blood sugars of a person without diabetes. That means having blood sugars* as follows:

Between 80 and 120 before meals (before breakfast, lunch, or dinner)100 - 140 at bedtime
120 - 160 on average

* The above are current national ADA guidelines. Work with your doctor to help you set your blood sugar goals and make any necessary changes to your treatment plan.

Q: "What exactly is the hemoglobin (HbA1c or "A1c") test and what does it mean for my diabetes care?"

A: The A1c test gives you and your health care provider a picture of what your average blood sugar level has been over the past two to three months. The blood sugar test you do at home measures your blood sugar at that exact time. Use the chart below to figure out what your A1c means.

NOTE: Most people with diabetes should aim for an A1c test of 7% or less (check with your doctor). If your A1c is 7% or more, you increase the risk of developing diabetes complications like eye, kidney, heart and nerve problems.

If your A1c result is (%):	Then your average blood sugar (in mg/dL) has been about:
13	330
12	300
11	270
10	240
9	210
8	180
7	150
6	120
5	90
4	60
Remember to talk about your results with your doctor -- use your "My Diabetes Record" to keep track!

Q: "There are so many things to remember around my diabetes care, how do I keep track?"

A: Every person has their own system of tracking their results. For help with diabetes control, try the following tips:

Test your blood sugar at least once every day or more often if your doctor recommends it. Keep track of your blood sugar before each meal and at bedtime, writing results in calendar or notebook (check with your doctor or Diabetes Outpatient Educator [DOE] since there is no standard format).
Use the "My Diabetes Record" or other similar tools, to track the following:

Check-up visits with your doctor or health care team (see "Check-up Visits" section below)
Lab test resultsYour own management (blood glucose testing, etc.)
Medications Medication name, date started, dose, times to take
Equipment for self-testing blood sugar è Brand of meter, test strips, and lancets
Healthy Changes Goals more exercise, check your feet daily, less or no alcohol use, stop smoking, etc.
Resources Pages find local and national diabetes related information.

CHECK-UP VISITS

Every 3 months for Type 1, twice a year for Type2, or as recommended by health care professional or team:

A1c (blood test - Hemoglobin A1c) – doctor’s office
Foot check – self-test daily AND have doctor examine your feet . For more information on foot care or locating a Podiatrist in your area, go to the following website:

American Podiatric Medical Association

Skin -- have your doctor check your insulin injection sites or finger-stick sites for signs of infection
Blood pressure – doctor’s office -- for more information on your heart and stroke please go to the following websites:

American Heart Association
Diabetes & Your Heart (DCP Website)

Weight (your ideal weight)
Height -- You or your physician can calculate your Body Mass Index (BMI) using height & weight. The calculated BMI may be helpful if you
don't know your percent body fat.
BMI results should be interpreted
with caution since persons with
extensive muscle mass (athletes and
body builders for example) also
have increased BMIs. To calculate your BMI go to the following website: Body Mass Index Info

Yearly Tests & Vaccines (or as recommended by your doctor):

Dilated Eye exam

Urine test (to check kidneys for protein)

A1c test

Total cholesterol (including LDL, HDL and triglycerides)

Flu vaccinePneumococcal vaccine (ask your doctor if this is necessary for you)

Dental exam

Ask your doctor, pharmacist, or Diabetes Outpatient Educator for any other helpful tools for you to use in tracking your results, goals, and progress.

Q: I am having problems with circulation, my legs and eyes. How is diabetes affecting my body?

A: Diabetes can affect many organs in your body. This includes your eyes, teeth and gums, heart, kidneys, and feet. For more information please go to the following pages:

Q: I am often overwhelmed and feel depressed while trying to control my diabetes. Is this a common feeling?

A: Most people feel depressed from time to time. However, if depression symptoms last two weeks or more, this may be an indication of a more serious condition such as clinical/major depression. Major depression is more common in patients with diabetes than in the general population. Approximately 15% - 20% of adults with diabetes, both type 1 and 2, suffer from depression.

For more information and references see our Depression & Diabetes pages

Q: How else does diabetes affect my brain?

A: Diabetes affects the blood stream (or circulation) which in turn affects the brain. People with diabetes are twice as likely to become depressed. Depression can be short-term (situational) or long-term (clinical) and affects the brain hormone levels of serotonin in the brain. Research also indicates that people with diabetes may also be at a higher risk of developing Alzheimer’s disease or may affect the brain systems that control memory for words and events, the speed of processing information, and the ability to recognize spatial patterns. (May 2004, Vol 61(5) Archives of Neurology)

Q: "Does exercise help my diabetes? How much exercise do experts recommend?"

A: Exercise is beneficial to both controlling diabetes (Type 1 or Type 2) and preventing people from developing Type 2 diabetes. Type 2 diabetes is linked to obesity and physical inactivity. By improving your diet, increasing physical activity, and losing weight you can delay the progression of diabetes. You can also control your diabetes by monitoring your blood glucose levels and accessing proper medical treatment. Always check with your physician before starting a new exercise program.

For more information and references see our
Exercise & Diabetes pages

Q: "How do I get more information on diet and nutrition as it relates to my diabetes?"

A: Choosing the right food and the right portions to eat can be a challenge for someone with diabetes in a world of fast food, high fat, and high sugar options. Working with your doctor or with a Diabetes Outpatient Educator is a good place to start.There is a well-established association between poor dietary habits and lack of exercise contributing to five of the ten leading causes of death in the United States. Diets that are high in total fat, saturated fat, cholesterol, and sodium, and low in fiber and calcium are associated with a variety of chronic diseases and conditions. These diseases include coronary heart disease, some types of cancer, type 2 diabetes, stroke, high blood pressure, high blood cholesterol, obesity, and osteoporosis. These diseases and conditions contribute to death and disability as well as reduce the quality of life. Useful Links:

Highlights

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