The Complete Idiot's Guide to Type 2 Diabetes

by Davidson, M.D., Mayer B.; Gordon, Debra L.

• ISBN13: 9781592574094
• ISBN10: 1592574092
• Format: Paperback
• Copyright: 2005-11-01
• Publisher: DK Publishing, Inc.

Summary

You're no idiot, of course. You know that type 2 diabetes has reached epidemic proportions world-wide due to the nature of our modern sedentary lifestyles. And although this condition puts diabetics at greater risk of acquiring life-threatening illnesses, it is manageable once you're willing to break old habits and develop healthier ones.

Author Biography

Mayer Davidson, M.D., is a professor of medicine at the UCLA School of Medicine and director of the Clinical Trials Unit at Charles R. Drew University of Medicine & Science in Los Angeles. Debra L. Gordon is an award-winning journalist who has been writing about health and health care for more than 15 years.

Table of Contents

Part 1: Type 2 Diabetes Uncovered	1	(40)
An Emerging Epidemic	3	(14)
Who Has It?	4	(1)
Just What Is Diabetes Anyway?	4	(1)
Why Do So Many People Have Diabetes?	5	(3)
Pima Indians: The Canary in the Mine	6	(1)
From Thrifty Gene to Obesity	6	(1)
But I'm Not a Pima Indian; Why Do I Have Diabetes?	7	(1)
Why Are Americans So Fat?	8	(1)
Deconstructing Type 2 Diabetes	9	(1)
Who Gets It?	9	(1)
Slowly Developing Symptoms	10	(1)
Don't Forget These Other Types	10	(4)
Type 1 Diabetes: Sudden and Dramatic	11	(1)
Gestational Diabetes: Only During Pregnancy	11	(1)
Testing for Gestational Diabetes	12	(1)
Treating Gestational Diabetes	12	(1)
Other Specific Types of Diabetes	13	(1)
Gender Differences: Diabetes in Women	14	(3)
Coping With the Diagnosis	17	(14)
Take a Deep Breath	17	(2)
This Isn't Happening to Me	18	(1)
Strangely Enough, I Feel Relieved	18	(1)
But I'm So Darn Mad!	19	(1)
Let's Make a Deal	20	(1)
But I'm So Sad	20	(2)
Tipping the Balance into Depression	21	(1)
On Your Way to Feeling Better	21	(1)
Accepting the Reality	22	(1)
Time to Tell	22	(3)
How to Tell	22	(1)
Telling the Kids	23	(1)
Telling Mom and Dad	24	(1)
Telling Other Relatives	24	(1)
Telling Your Friends	25	(1)
Is It My Fault?	25	(1)
Living With a Chronic Disease	26	(1)
Time to Surf the Diabetes Web	26	(3)
Sorting the Wheat from the Chaff	27	(2)
Practice Safe Surfing	29	(1)
Prepare for Bumps in the Road	29	(2)
Diabetes and Your Body	31	(10)
It's a System, Silly	31	(1)
Hormones, Hormones, Everywhere	32	(1)
Peering at the Pancreas	33	(1)
You Say Organ; I Say Gland	33	(1)
A Million Strong: The Islets of Langerhans	34	(1)
A Sugar by Any Other Name: Glucose	34	(1)
The Unbroken Circle: Regulating Blood Sugar	34	(2)
After Eating	35	(1)
Getting Glucose into Cells	35	(1)
Insulin to the Rescue!	35	(1)
What to Do with the Extra	36	(1)
What About Between Meals?	36	(1)
So What's Going On in Fat Tissue?	37	(1)
Falling Out of Normal Balance: Diabetes	37	(1)
Behind the Symptoms of Diabetes	38	(3)
Part 2: Traveling the Treatment Trail	41	(126)
Assembling Your Treatment Team	43	(20)
What's Up, Doc? Finding the Right Doctor	44	(1)
Fun with Your Family Practitioner	45	(1)
Of Internists, Family Practitioners, and Diabetes	45	(1)
Was It Something I Said?	45	(3)
Finding the Right Doc: Asking Around	46	(1)
Interviewing Your Doctor	46	(1)
What About the Office?	47	(1)
The Real Question: Primary Care Doctor or Endocrinologist?	48	(1)
Why Do I Need a Diabetes Educator?	48	(2)
What Do They Do?	49	(1)
Do I Need a Dietitian (Nutritionist)?	50	(1)
The Team Approach	50	(4)
Looking Out for Number One	51	(3)
Paying for It All: Navigating the Labyrinth of Insurance	54	(3)
The Alphabet Soup of Managed Care	54	(1)
Harkening Back to the Past: The Return of the Indemnity Plan	55	(1)
Aaack! I Lost My Job!	56	(1)
I Can't Find (or Can't Afford) Health Insurance	57	(3)
Medicare: A Good Idea Gone Bad	59	(1)
Medicaid: Pinched from All Ends	60	(1)
It's Up to You: Your Role in Disease Management	60	(3)
Exercise Is Everything	63	(16)
Exercise: Everything for Everyone	64	(2)
What Happens When You Exercise	64	(2)
A Different Picture: Exercising When You Have Diabetes	66	(1)
Before You Start	66	(1)
Starting Slowly	67	(1)
How Much Is Enough?	68	(1)
Hitting Your Heart Rate Target	69	(1)
Exercise, Smexercise; We're Talking Movement!	70	(2)
Why Walking Is Best	72	(1)
Revving Up Your Walking	73	(1)
Watching TV While You Work Out	73	(1)
When You Simply Can't Get Motivated	74	(1)
Why the Weight You Lift Can Be the Weight You Lose	74	(2)
The Low-Tech Weightlifting Approach	75	(1)
Resistance Beyond Weights	76	(1)
Exercising with Diabetes-Related Complications	76	(3)
The Food Issue	79	(22)
Coming to Terms with Carbohydrates	80	(4)
Carbs: Not So Simple	80	(1)
An Apple a Day	81	(1)
A Carb Is a Carb Is a Carb	81	(1)
The Glycemic Index: What It All Means	82	(1)
What About Low-Carb Diets?	83	(1)
Picking Out the Protein	84	(1)
Figuring Out Fats	85	(2)
Staying Away from Saturated	85	(1)
Unsaturated Fats: The Good and the Bad	86	(1)
Omega-3 Fatty Acids	86	(1)
Trans Fats	87	(1)
Fabulous Fiber	87	(1)
Exchange Food Programs and Beyond!	88	(2)
Exchange Diets	88	(1)
Constant Carbohydrate	89	(1)
Counting Carbohydrates	89	(1)
So What Should I Eat?	90	(2)
Timing Is Everything (in Some People)	92	(1)
Playing the Weight-Loss Card	92	(1)
Follow the Three Commandments	93	(1)
Losing Weight: It Doesn't Take Much	93	(4)
The Weight-Loss Equation	94	(1)
Getting Your Pound of Fat	95	(1)
How Much Is Enough?	96	(1)
Cheers to You, Too!	97	(1)
Dining Out with Diabetes	98	(3)
Finding Hidden Gems in Fast Food	98	(1)
Hitting the Sit-Down Chains	99	(2)
Time to Pop a Pill	101	(18)
Remembering the Basics of Type 2 Diabetes	102	(1)
Medication? Me? Fuggedaboudit!	103	(1)
Welcome to the Wonderful World of Drugs	103	(2)
Don't Forget to Take Your Medicine	103	(2)
There's No Magic Bullet	105	(1)
Your Pharmacist: Your New Best Friend	105	(1)
Online Drugs---Not a Good Idea	106	(1)
Buying Online Safely	106	(1)
What's Your Problem?	107	(1)
Sing a Song of Sulfonylureas	108	(2)
The Downside	109	(1)
When and How to Take	109	(1)
The Big Deal About Biguanides	110	(2)
How Good Is It?	110	(1)
The Downside	111	(1)
Which One and How to Take	112	(1)
Going with the Alpha-Glucosidase Inhibitors (AGI)	112	(1)
How Good Are They?	112	(1)
The Downside	112	(1)
Which One and How to Take	113	(1)
Bouncing Back from Adversity: Thiazolidinediones (TZD)	113	(2)
An Added Bonus	114	(1)
The Downside	114	(1)
Which One and How to Take	115	(1)
Messing with Meglitinides	115	(1)
How Good Are They?	115	(1)
Choosing the Right Drug	116	(3)
Combining Pills	116	(1)
Two Pills in One	117	(2)
Beyond the Pills: Insulin	119	(20)
Just What the Heck Is Insulin (and Why Doesn't It Come in a Pill?)	120	(1)
A Bit of Chemistry	120	(1)
Why the Needles?	121	(1)
So How Much Do I Need?	121	(2)
What's My Dose?	122	(1)
Getting Over Needle Phobia	123	(1)
Preparing to Stick	124	(1)
Avoiding That ``Pin Cushion'' Feeling	125	(2)
Choosing the Right Injection Site	125	(1)
Making the Stick	126	(1)
Long, Short, Medium, Tall ... Picking the Right Insulin	127	(5)
Rapid-Acting Insulin: Get Me My Insulin and Get It to Me Now!	129	(1)
Short-Acting or Regular Insulin: Predictable and Boring, but Effective	129	(1)
Intermediate Acting Insulin: Not Too Hot, Not Too Cold	130	(1)
Long-Acting Insulin: In for the Long Haul	130	(1)
Premixed Insulins: A Little of This; a Little of That	131	(1)
The Insulin Bartender: Mixing Insulins	132	(1)
Understanding the Relationship Between Type and Timing of Insulin and Blood Sugar Levels	133	(1)
Hold Me Tight! Intensive Insulin Therapy	134	(1)
How Low Can You Go? Avoiding and Coping with Hypoglycemia	135	(4)
Carbs Are Your Friends	136	(3)
All Insulin, All the Time: External Insulin Pumps	139	(12)
The History of Insulin Pumps	140	(1)
Get Out Your Pocketbook	140	(1)
Pump Basics	141	(2)
Navigating Your Way Around a Pump	141	(1)
Linking Monitoring and Infusion	142	(1)
What's the Best Insulin?	143	(1)
Supplying Your Pump	143	(1)
Puncturing the Pump Myths	144	(2)
So Why Bother?	145	(1)
Living Life with a Pump	146	(1)
Is a Pump Right for Me?	147	(1)
The Fine Art of Carbohydrate Counting	148	(3)
Alternative Approaches	151	(16)
Welcome to the World of CAM	152	(1)
What You Need to Know About CAM	153	(1)
Finding a Complementary or Alternative Provider	154	(1)
Nutrition in a Pill	154	(6)
Free Radicals and Other Nasty Things	155	(1)
Vitamin E	156	(1)
Magnesium	157	(1)
Chromium	157	(1)
The Nutrient You Never Heard Of: Vanadium	158	(1)
L-carnitine	158	(1)
Alpha-Lipoic Acid	159	(1)
Fish Oil	160	(1)
A Hankering for Herbs	160	(1)
Herbal Remedies and Diabetes	161	(2)
On Pins and Needles: Acupuncture	163	(1)
Focusing With Biofeedback	164	(1)
Relaxing with a Massage	165	(2)
Part 3: Daily Living with Diabetes	167	(72)
Monitoring Your Levels	169	(16)
Before There Were Meters	170	(1)
Just a Bit of History	170	(3)
It Works, It Really Works!	171	(1)
Join the (Still-Small) Crowd	171	(2)
Meters, Meters; Who's Got the Meters?	173	(1)
Testing Without Needles	174	(1)
Where Do You Want to Test Today?	175	(1)
Getting It Right	176	(1)
When to Test	177	(1)
How to Test	178	(1)
Aiming for the Right Level	179	(1)
Tracking the Results	179	(1)
The Care and Feeding of Your Glucose Meter	180	(1)
Testing at Your Doctor's Office	180	(3)
No Place to Hide: Glycated Hemoglobin Testing	181	(1)
Fructosamine Test	182	(1)
Ketone Tests	183	(1)
Identifying Kidney Disease Early: Microalbumin Test	183	(2)
The Three S's: Stress, Sleep, and Sickness	185	(16)
Stress: The Good, the Bad, and the Ugly	185	(2)
Your Body on Stress	187	(1)
Diabetes and Stress: The Connection	188	(1)
Tackling the Stress	188	(6)
Learning How to Breathe Again	189	(1)
Meditating Your Stress Levels Away	190	(1)
Picturing Yourself on a Beach	191	(1)
Progressive Muscle Relaxation	191	(1)
Yoga and Diabetes	192	(1)
Changing Your Attitude	193	(1)
Getting Your Zzzzzzzssss	194	(3)
Getting Evaluated for Sleep Disorders	196	(1)
Getting a Good Night's Sleep	196	(1)
When You're Not Feeling Well	197	(4)
Caring for Yourself When You're Sick	198	(3)
What About Sex?	201	(14)
Starting with the Men	202	(2)
Anatomy of an Erection	202	(2)
It Might Not Be Your Diabetes' Fault	204	(1)
Testing, Testing, Testing	204	(1)
The Little Blue Pill and Beyond	205	(2)
Viagra: The Pill That Started It All	206	(1)
Loving with Levitra	207	(1)
Cialis: Last out of the Gate but Gaining Fast	207	(1)
Beyond the Pills	207	(1)
Sexual Dysfunction: Women Get It, Too	208	(1)
Numbers Vary	209	(2)
So What's Going On?	210	(1)
Treating the Problem: Few Options	211	(1)
Beyond Medical Treatment	212	(3)
And Baby Makes Two	215	(14)
Behind the Blue and Pink: Facts About Pregnancy and Diabetes	216	(1)
Preventing Unplanned Pregnancies	216	(1)
Understanding the Risks	217	(1)
Insulin Resistance	218	(1)
Planning for Your Pregnancy	219	(2)
Centralizing Your Care	219	(1)
The Goals of Preconception Care	220	(1)
Getting Started	221	(1)
When the Stick Turns Blue	221	(4)
Your First Visit	222	(1)
Eating for Two	223	(1)
The Rest of Your Pregnancy Diet	224	(1)
Exercising for Two	225	(1)
When It's Time: Delivering the Baby	225	(2)
Timing the Delivery	226	(1)
After the Birth	227	(2)
On the Job	229	(10)
Diabetes on the Job: Knowing Your Rights	230	(1)
The American with Disabilities Act: What It Means for You	231	(3)
Who's Covered	233	(1)
Is Your Diabetes a Disability?	233	(1)
If You Suspect Discrimination	234	(1)
Other on-the-Job Protections	234	(1)
To Tell or Not to Tell	235	(1)
Diabetes on the Job	236	(1)
On-the-Job Tips	237	(2)
Part 4: Avoiding Complications	239	(64)
Your Heart on Diabetes	241	(16)
Many Unaware of Higher Risks for Heart Disease	242	(1)
Starting with the Basics	242	(1)
Getting to Cardiovascular Specifics	243	(1)
Diabetes and CVD: What's the Connection?	244	(1)
How Low Can You Go: Reducing Blood Pressure	245	(1)
Getting the Numbers Down	246	(2)
Drugs to Drop Blood Pressure	248	(1)
Of Cholesterol and Other Blood Lipids	249	(1)
Insulin Resistance at Work Again	250	(1)
So What's It All Mean?	250	(1)
Cholesterol by the Numbers	250	(1)
Getting to Goal	251	(3)
Sussing Out the Statins	253	(1)
Beyond Statins	253	(1)
Take One Aspirin and Call Me in the Morning	254	(3)
Take Good Care of Your Eyes	257	(12)
R is for Retinopathy	258	(3)
Three Types of Retinopathy	259	(2)
An Ounce of Prevention	261	(1)
The Screening Exam	261	(1)
Treating Diabetic Retinopathy	262	(1)
Laser Surgery	263	(2)
Focal Surgery	264	(1)
Hundreds of Laser Burns	264	(1)
Vitrectomy: Serious Surgery	265	(1)
Other Eye Conditions	266	(3)
Your Kidneys: Hidden Gems Worth Keeping Healthy	269	(12)
Your Kidneys: Without Diabetes	270	(1)
Your Kidneys: With Diabetes	271	(1)
Recognizing Kidney Disease	272	(2)
Managing Diabetic Nephropathy	274	(1)
Controlling High Blood Pressure	274	(1)
Controlling Blood Sugar	275	(1)
Following Your Diet	275	(1)
When Your Kidneys Fail	275	(2)
Hemodialysis: An Artificial Kidney	276	(1)
Getting Started with Hemodialysis	276	(1)
Peritoneal Dialysis: Mobile Dialysis	277	(1)
Time for a New Kidney	277	(1)
Urinary Tract Infections	278	(3)
Navigating Your Way Through the Diabetic Neuropathies	281	(12)
Diabetic Neuropathy Unplugged	282	(1)
Understanding the Nervous System	283	(1)
Neuropathy by Any Other Name	283	(4)
Specific Forms of Neuropathy	285	(2)
What's Going On?	287	(1)
Easy-to-Miss Early Warning Signs	287	(1)
Diagnosing Diabetic Neuropathy	288	(1)
But It Hurts!	289	(2)
Treating the Problem	291	(2)
Focusing on the Externals	293	(10)
Focusing on the Feet	294	(1)
Keeping Your Tootsies Healthy	294	(2)
Detecting Foot Problems Early	296	(2)
Medicare and Foot Care	297	(1)
Treating Foot Ulcers	298	(1)
Taking Care of Your Teeth	299	(1)
Beyond Brushing	299	(1)
Maintaining Beautiful (and Healthy) Skin	300	(3)
Part 5: A Glimpse into the Future	303	(44)
Moving Research Forward: Clinical Trials	305	(8)
Clinical Trials: How Research Gets Done Today	306	(1)
You and Clinical Trials	306	(1)
The Downside to Clinical Trials	307	(1)
Behind the Rhetoric of Clinical Trials	307	(2)
The Vocabulary of Clinical Trials	308	(1)
Getting into a Clinical Trial	309	(4)
You Are Not a Guinea Pig	310	(1)
Finding a Clinical Trial	311	(2)
What Does the Future Hold?	313	(34)
Starting at the Top: New Insulins	313	(2)
Beyond Insulin: Hitting the Hormones	315	(1)
Imitating Incretin	315	(1)
All About Amylin Analogs	316	(1)
Nonhormonal Medications on the Horizon	316	(1)
``P'' is for Permanent: Implantable Insulin Pumps	317	(1)
The Possibility of a Cure	318	(3)
Of Pancreases: Mine, Yours, Ours	318	(1)
Islet Transplantation	319	(1)
Engineered Beta Cells	320	(1)
Virtual Pancreas	320	(1)
Stem Cells	320	(1)
Treating Complications	321	(2)
Appendixes
A. Glossary	323	(18)
B. Resources	341	(6)
Index	347