Diabetes

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.

Does eating red meat increase the risk of diabetes?

DEAR DOCTOR K: My wife has read that eating red meat increases the risk of diabetes. Is this true?

DEAR READER: You've heard for a long time that limiting the amount of red meat -- especially processed foods with red meat, such as salami -- reduces your risk of heart disease. The evidence for that is very strong.

Does intensive diet and exercise decrease heart disease risk in diabetics?

DEAR DOCTOR K: I just heard on the radio that some study says that intensive diet and exercise don't decrease heart disease risk in diabetics. Is this true? If so, I've made a lot of hard changes in my life for nothing.

DEAR READER: I assume you're referring to results from the recently publicized Look AHEAD (Action for Health in Diabetes) trial. The results of this study were reported in June of this year. Several of my patients have already asked me about it, and what I've told them is: Take these results with several grains of salt.

Can you explain how diabetes affects vision?

DEAR DOCTOR K: Could you explain how diabetes affects vision?

DEAR READER: The high blood sugar levels that occur in people with diabetes can have serious consequences throughout the body, including the eyes. Many of my patients with diabetes are most concerned that diabetes will rob them of the precious gift of sight.