These are the thoughts of a cantankerous ol' gynecologist who remembers when things were a little different. I try to find a little humor in my life and the people I meet along the way. Come meet the characters in my world.

Monday, August 29, 2011

A Little Too Sweet

What Happens if You Don’t Control Your Blood Sugar

I have a lot of patients who have “adult onset diabetes”, now known as Diabetes Mellitus II (DMII) or “sugar diabetes” (in the south).  Many do not know what a “normal” blood sugar should be.  I cringe inside when I hear “but my sugar is only 350”. 

Some of my patients are first introduced to diabetes when they are pregnant.  This is called gestational diabetes.  We test ALL pregnant women for this.  Elevated glucose during pregnancy can cause very large babies, birth defects, stillborn babies, difficult labors, increased cesareans, and newborns with many different problems.  Women with gestational diabetes often have DMII later in life. 

DMII is a relative insulin resistance.  This is often related to excess weight, sedentary lifestyle and aging.  You can also have a family tendency towards diabetes. 

Diabetes out of control increases the risk of problems in the small vessels.  This includes heart disease, kidney disease and disease of the small vessels in your eyes.  We also see problems with the nerves in your hands and feet.  Diabetics don’t heal well after injury or surgery. 

Also note that smoking and blood pressure problems make all of this worse.

Depending on your lab, your fasting blood sugar should be 110 or less.  Your two hour after eating should be about 140 or less.  There is a test called Hemoglobin A1C (HgbA1C) that checks how much sugar is stuck to your red blood cells.  It is a measure of your sugar over the last three months.  It should be less than 6.5 or so.  Remember that these results vary some from lab to lab. 

How can you get “a little less sweet”?  Not by being grumpy.  You need to listen to your doctor.  You may get sent to the nutritionist.  Diet is the first challenge.  Some people can manage to change things by losing weight and getting rid of the high cholesterol, high sugar foods that we Americans like to eat.  {Guilty!}  Frequent small meals with higher protein and complex carbohydrates will help keep your blood sugar stable. 

Exercise helps, too.  It burns that sugar, burns fat and increases muscle mass.  Muscles use up more energy even in the resting phase. 

Some of us need medicine.  It is not a failure.  It is a way of protecting your body from itself.  Most doctors will start with pills.  There are several different kinds.  If you have problems with one, don’t give up.  There’s usually something else to try.  Giving Insulin and checking your blood sugar have become much easier in the last few years. 

Let’s have the sweetness in your disposition, not your blood sugar!

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