Diabetes

What are “sugar alcohols”?

DEAR DOCTOR K: I have Type 2 diabetes. Many low-carb and sugar-free products contain "sugar alcohols." What are they? Do they count as carbohydrates?

DEAR READER: Type 2 diabetes is marked by elevated levels of blood glucose, or sugar. Untreated or poorly controlled diabetes can lead to serious complications including heart attacks, kidney failure, amputation and blindness. An important part of controlling blood sugar involves making healthy food choices.

Could stem cells be used to treat Type 1 diabetes?

DEAR DOCTOR K: My teenage daughter has had Type 1 diabetes since she was 8 years old. Fortunately, exercise, a good diet and insulin treatments have kept her healthy. I recently heard of a breakthrough at Harvard that might someday cure Type 1 diabetes. Can you explain?

DEAR READER: The research you're referring to was conducted in the Harvard laboratory of Dr. Douglas Melton. Like you, Dr. Melton has a child with Type 1 diabetes. When his child became sick, he redirected his laboratory to the goal of finding a cure.

What is diabetic nephropathy?

DEAR DOCTOR K: I have diabetes. My doctor says I'm at risk for diabetic nephropathy. What is that? What can I do to prevent it?

DEAR READER: Diabetic nephropathy is kidney disease that is a complication of diabetes. Your kidneys are made up of hundreds of thousands of small tubes that filter your blood and help remove waste from your body. In people with poorly controlled diabetes, these structures thicken and become scarred. Over time, the kidneys lose their ability to remove waste products from the blood.

What are signs of hypoglycemia?

DEAR DOCTOR K: I recently started taking medication for Type 2 diabetes. My doctor warned me about hypoglycemia. What signs should I look out for? What should I do if I experience them?

DEAR READER: People with Type 2 diabetes have high levels of sugar, or glucose, in their blood. Diabetes medications work to lower blood sugar to near-normal levels. But sometimes diabetes medications bring blood sugar down too low, a condition called hypoglycemia (hi-po-gly-SEE-me-uh).

What’s the link between diabetes and heart disease?

DEAR DOCTOR K: When I was diagnosed with diabetes, my doctor said I am now also at increased risk for heart disease. What's the connection?

DEAR READER: The link between diabetes and cardiovascular disease is stronger than many people realize: About two-thirds of people with diabetes die of heart disease or stroke. I spoke to my colleague Dr. Benjamin Scirica, a cardiologist at Harvard-affiliated Brigham and Women's Hospital, about the link between the two conditions. He explained that diabetes harms the heart in several ways.

How can I cut down on my type 2 diabetes medications?

DEAR DOCTOR K: I have Type 2 diabetes. Is there anything I can do to cut down on my medications?

DEAR READER: Yes. In fact, some of my patients have entirely eliminated their need for medication with aggressive lifestyle changes. And many more have reduced the number or the dose of the medications they are taking with the same lifestyle changes.

What are the different pills for Type 2 diabetes?

DEAR DOCTOR K: I have Type 2 diabetes and my doctor wants to prescribe medication. Fortunately, he says I don't need shots, just pills. What are the different pills for Type 2 diabetes?

DEAR READER: No one likes needles, but the needles used to give yourself insulin are very small, and the shots are very easy to administer. But for Type 2 diabetes, it is true that pills are often all that are needed. In Type 2 diabetes, like the less common Type 1, blood glucose (sugar) levels are too high.

What is the difference between Type 1 and Type 2 diabetes?

DEAR DOCTOR K: How does Type 1 diabetes differ from Type 2 diabetes?

DEAR READER: Type 1 and Type 2 diabetes are different diseases, but they share many things in common. Both types of diabetes are marked by elevated levels of blood glucose, or sugar. Type 2 diabetes, though, is much more common than Type 1 diabetes.

Why do I need a HbA1c test every few months for my Type 2 diabetes?

DEAR DOCTOR K: I have Type 2 diabetes, and I check my blood sugar levels every day. Why do I need to have my HbA1c levels tested every few months?

DEAR READER: Diabetes is marked by high levels of glucose (sugar) in the blood and urine. Without adequate treatment, diabetes can cause serious long-term complications. The key to preventing them is to control blood sugar -- to keep it close to the normal level.

I have to start taking insulin for my Type 2 diabetes — What do I need to know before I start?

DEAR DOCTOR K: I have to start taking insulin for my Type 2 diabetes. It sounds complicated. What do I need to know before I start?

DEAR READER: The first thing you need to know is that it is simple to learn and do, and the discomfort is minimal. Tens of millions of people all over the world do it every day -- and probably most of them were afraid that it would be complicated and painful before they actually started taking insulin.