The Trumpet Medical Advisor

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Patricia Naeder, RN, BS.


February, 2010 Edition


Diabetes is a metabolism disorder involving the way the body digests food. Learn how  you can control some of the process:

There are three kinds of Diabetes:

  • Type 1 diabetes, aka juvenile diabetes

  • Type 2 Diabetes, aka Metabolic Syndrome

  • Gestational Diabetes

In Type 1 Diabetes the Pancreas, located behind the stomach, which is usually responsible for producing Insulin through the Beta cells in the Islets of Langerhans, does not produce Insulin, or not enough to handle normal sugar metabolism. These individuals usually take Insulin injections into their subcutaneous, or fatty tissue.   

Monitoring blood sugar levels, while on Insulin therapy, is important to prevent the individual from going into one of two metabolic imbalances, Glucose overload, or Insulin shock.

If there is too much sugar in the blood, it will overflow into the urine. The person will have some or all of the following symptoms of high blood sugar:

  • Flushing and feeling warm all over

  • Increased thirst (polydypsia)

  • Frequent urination (polyurea) and urgency

  • Increased respirations

  • Fatigue which could progress to malaise and loss of energy and possible unconsciousness

If there is too much insulin in the blood the symptoms of shock will ensue:

  • Drop in blood pressure

  • Diaphoresis (profuse sweating)

  • Delerium, Fainging or Loss of consciousness, or coma.

  • Very fast heart rate (tachycardia) to compensate for the drop in blood volume which carries oxygen throughout the body.

In Type 2 Diabetes the Pancreas produces Insulin but the body’s cells are resistant to taking up the Insulin to ensure the metabolism of sugar. This condition has also been referred to as Metabolic Syndrome. It is responsible for about 85% of Diabetes incidence.

Gestational Diabetes is triggered during pregnancy and can recede after giving birth. However these patients are predisposed to recurrence, and should be monitored.


  • Type 1 can be caused by an auto-immune response, genes or virus, which destroy the insulin producing cells in the pancreas’ Islets of Langerhans

  • Type 2 is usually associated with obesity, sedentary lifestyle, and can have a genetic pre-disposition. This syndrome can also be accompanied by high blood pressure, high cholesterol, and atherosclerosis which is the thickening of the walls of the blood vessels with plaque

  • Gestational is triggered by pregnancy


  • Urine can be tested either at the doctor’s office or using an at-home testing kit.

  • Blood sugar can be tested by seeing your physician and going to the lab for a blood test

  • A1C test is a Hemoglobin averaging test which averages the blood sugar levels over the last 2-3 months. Normal is below 7%

  • If diagnosed with diabetes the cardiovascular system should be monitored for narrowing of vessels which causes less blood carrying oxygen, to travel throughout the body

  • Stress testing, which is walking on a treadmill with EKG leads on, should be done to test for ischemia, which is oxygen depletion level

  •  If the vessels of the heart are suspected of being affected, then an echocardiogram should be performed

  • Cholesterol levels should be monitored. The goal is to have low LDL, and Triglycerides, and a high HDL

Complications of Diabetes:

  • Heart attack, (myocardial infarction)

  • Stroke, (cardiovascular accident, aka CVA)

  • Retinopathy, causing damage to the structures of the retina in the eye, causing serious vision disturbances and possible blindness

  • Kidney dysfunction due to the pathology of the circulatory system. The structures in the kidney become narrowed, twisted and possibly obstructed. This slows the glomerular filtration rate, which is the filtering of waste products through the kidney for excretion. This chronic condition can progress to kidney failure which is life threatening. If there is protein in the urine this signals kidney damage

  • Poor peripheral perfusion , again due to the pathological changes in the blood vessels. This can lead to poor healing and gangrene, and the loss of limbs

  • Peripheral neuropathy which is damage to the nerve branches

Treatment and Prevention Options:

  • Insulin subcutaneous injections for Diabetes Type 1

  • Oral meds for Type 2. These meds increase the sensitivity of the cells to be more receptive and responsive to the natural insulin from the pancreas

  •  Lose weight! Losing 5-10 lbs can make a huge difference in your sugar metabolism.

  • Cholesterol lowering agents may be prescribed. If statins are prescribed ask your doctor about taking a daily coq10 supplement, as statins may deplete your normal stores of coq10 which helps with cellular energy

  • Blood pressure meds may be prescribed

  • Eat a no sugar, no carbohydrates,  no alcohol diet. Avoid foods that convert to sugar

  • Increase vegetables by triple

  • Eat a low glycemic diet. Get the list of low glycemic foods and choose them

  • Eat a high fiber diet and complex carbohydratess such as green veggies, fruit (low glycemic) beans, whole grains

  • Exercise is mandatory. It increases circulation from your brain to your feet, and it enhances cellular repair

  • Don’t smoke. Get the “stop smoking” lozenges to melt in your mouth

  • Keep moving! Walk for 30 minutes a day, 5 days a week, or walk for:

10 minutes, 3 times a day if that is easier. The long list of positive results from walking cannot be overestimated. Here are a few benefits to moving:

  • Weight loss

  • Bone strength increased

  • Blood pressure drops

  • HDL, the good “sweeper” cholesterol goes up

  • Stress is reduced as endorphins go up

  • Relaxation occurs due to the feeling of being in control and knowing that you are doing something to make a positive change

  • Psychological improvement because there is hope and optimism in doing something positive for yourself

  • Dancing, Swimming, Biking, Golf, Tennis, are all great. Do what you enjoy! Smile!


  • When you sleep your body repairs itself. Your mind is allowed to be stress free. Blood sugar levels are more balanced in people who have enough sleep

  • Create a peaceful sleep environment. Pamper yourself

Manage Your Stress:

  • Stress causes a physical response in your body. It raises cortisol, a very damaging hormone which rips through your blood vessels and body

  • Refuse to let constant worries and fear dominate your day. Fight it with action

  • Problem-solve instead of worrying

  • Remember that 85% of what you worry about never happens!

  • Use your resources. Get help. There are people who would love to give you a hand. Just ask. Doctors and nurses enjoy helping. Use their education to solve your problems

  • Arm yourself with solid information. It will pave the way to peacefulness

  • Have a massage, or float in a pool at the gym, or take a long bath with your favorite book or music

  • Avoid toxic people. They will make you sick

  • Don’t do difficult frustrating things if you don’t have to

  • Try to spend time with positive people

  • Don’t be too hard on yourself. Give yourself a break

  • Watch TV shows that make you laugh

  • Go on the computer and communicate with people that make you smile!

  • Be good to yourself. You deserve it!

Be the best that you can be using today’s Science!

Good Health to you,

Patricia Naeder, RN, BS

Medical Advisor

This column is for informational purposes only, and represents the opinion, and reporting of the author only. Any discussions with the Author should be presented to your own personal Physician for his/her Professional opinion. It is not meant to substitute for seeing one's own Medical Doctor, Psychiatrist, or Psychologist for Professional care.