Volume 6, Number 3: Fall Equinox, 2004 - Special Issue - Live Well With Diabetes

Diabetes — Frequently Asked Questions - BC Endocrine Research Foundation

Is There a Cure? At this point in time there is no cure for diabetes. What we can do is manage diabetes effectively and there has never been better tools available for this purpose than there is today. There is excellent guidance for diet and physical activity as well a wide range of medications, when needed, that help to manage the risk factors that must be treated with diabetes; high blood sugars, high blood pressure and high blood fats.

What have I done to cause diabetes? You might ask yourself why do I have diabetes. Have I done something wrong? Well almost always the answer is no. We know that the vast majority of the tendency to diabetes is genetically transmitted. If you are obese, your chances of developing diabetes are much higher than if you are not obese. But by the same token we know that obesity has many genetic causes as well. So, rather than blame yourself for where you are at, I think it is better to think of what I can do about it, to control your diabetes and to make your health better.

Why do I have to test my blood sugars? Testing blood sugars provides you with valuable information that lets you know whether the diet, exercise and possibly medical therapy are working for you. Ask your diabetes doctor what your blood sugar targets are and do your best to achieve those targets. If changes in diet and physical activity for a period of 8 to 12 weeks doesn’t help then it may be time to start some form of medical therapy. Good blood sugar control is essential to good diabetes management and therefore you need to test your blood sugars and take medications as prescribed by your doctor.

I feel okay so why should I bother with medications and making changes in my diet and exercise? Diabetes is a very deceptive disease because most people diagnosed with diabetes have probably had it for a number of years but didn’t know it. The symptoms are not always obvious. The average blood sugar tends to rise gradually and as it rises there is damage occurring throughout the body; to the heart, the eyes, the kidneys, the nerves. This can occur even though you feel okay. That is why it is so important to take action as soon as you are diagnosed with diabetes. Make the changes suggested by your doctor and see a dietician immediately. Take the medications if needed and focus on taking care of yourself. Managing your diabetes is like managing a long-term investment. You must be thinking years ahead and the quality of your future life depends on decisions and actions in the present.

Once I start taking these medications will I have to take them for the rest of my life? It is very possible that you may be taking many of these medications for the rest of your life but this should not be your focus. These medications are helping you to manage your diabetes and the associated risk factors. Think of these medications as a way to help you manage your wellness and avoid the long-term complications associated with diabetes. What really matters is the quality of life and these medications are often essential to helping you manage your blood sugars, blood pressure and blood fats, the risk factors associated with diabetes.

Once I start insulin am I going to gain weight like friends say? When diabetes is poorly controlled there is a large amount of glucose being excreted in the urine. When insulin is started and blood sugar control improves much of the blood sugar (calories) that was previously being excreted in the urine is now being effectively absorbed into the body tissues and as a result some people may gain weight. This only happens when excess calories are consumed so when taking insulin you should pay very close attention to your food intake, carbohydrates in particular, as well physical activity.

I’m getting plenty of physical activity but I can’t seem lose any weight and don’t know what to do? Weight loss can be very difficult and is a complex issue. Sometimes the best efforts at balancing energy output with caloric intake result in little or no success with respect to weight loss. Please keep these two important messages in mind. First of all increased muscle tone and mass can mask a reduction in fat tissue and the focus should be on how you feel with respect to energy levels. Always remember that the physical activity is helping you to lower your insulin resistance and improve blood sugar management. Secondly, there are numerous research studies that indicate ‘fat and fit’ represents a far lower risk for heart disease and stroke than someone who is thinner but is less fit. Although some weight loss is desirable and beneficial the primary emphasis of a physical activity program should be on improved fitness and a sense of well-being.

My vision is fine so I don’t understand why I need to keep going to an eye doctor? The problems that occur with the eyes associated with diabetes don’t always appear as an immediate impairment of vision. With diabetes the small blood vessels in the back of the eye can become damaged, especially when blood sugars and blood pressure are poorly controlled. This can occur before you notice any change in vision. Therefore it is important to have regular eye check-ups. If there is evidence of eye damage, laser therapy can be used to halt the progression of the damage and preserve your vision.

My cholesterol lab results are in the normal range so I don’t understand why I should take a cholesterol lowering medication? There is strong evidence that lowering the bad cholesterol, the LDL cholesterol, to levels well below the normal range can reduce heart attacks and strokes in people who have a high risk for these events, and that includes people with diabetes. In other words the LDL target is lower for people with diabetes. The family of medications that is used to lower cholesterol most effectively is the statins, and along with a heart-healthy diet and exercise, you should take your cholesterol-lowering medication if your doctor prescribes it.

My blood pressure is the same as my wife’s but she isn’t being told to take blood pressure medication? One of the reasons for this would be that blood pressure needs to be managed more aggressively in people with diabetes. There is clear evidence that lowering blood pressure below normal targets helps to reduce damage to the eyes and the kidneys, two major long-term complications associated with diabetes. Lower blood pressure can also reduce heart attacks and strokes in people with diabetes so blood pressure lowering medications are often essential as part of the treatment of diabetes.

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B.C. Endocrine Research Foundation

#4116 - 2775 Laurel Street
Vancouver, B.C.
V5Z 1M9

Email: aleta.allen@vch.ca
Tel: (604) 875-5929

Board of Directors

President: Dr. Marshall Dahl
Vice-President: Dr. David M. Thompson

Board Members: Dr. Keith Dawson, Dr. Jason Kong, Dr. Ehud Ur, Dr. Jerilynn Prior, Dr. Tom Elliott, Dr. Breay Paty, Dr. Sandra Sirrs

Bookkeeper: Nancy Walker

Administrator: Aleta Allen