Select an answer for each question below to see the correct response and some informative facts about diabetes.
1. If I am a diabetic, can I eat foods with sugar in them?
2. What is the difference between Type 1 and Type 2 Diabetes?
A. Type 1 Diabetics are on insulin and Type 2 Diabetics are on pills.
B. Type 1 Diabetes only happens in children and Type 2 Diabetes only happens those over the age of 40.
C. Type 1 Diabetes is an absolute definciency of insulin while Type 2 Diabetes is a relative deficiency of insulin.
A. A child of a Type 1 Diabetic parent developing Type 1 Diabetes
B. A child of a Type 2 Diabetic parent developing Type 2 Diabetes
4. The goal blood pressure for a diabetic is
A. Less than 150/100
B. Less than 140/90
C. Less than 130/80
D. Less than 120/70
5. What is a normal blood glucose level?
A. Fasting <100, after a meal <140
B. Fasting <126, after a meal <200
C. <100 any time
6. The typical symptoms of new onset diabetes are
A. Weight loss
B. Excessive thirst
C. Excessive urination
D. Blurred vision
E. All of the above
7. Overweight is a risk for diabetes and may indicate thyroid problems.
8. Which hurts more (on average)?
A. Checking your sugar with a lancet and glucometer
B. Taking an injection of insulin
9. When should a Type 2 Diabetic go for a dilated eye exam to look for diabetic retinopathy (bleeding blood vessels in the back of the eye)?
A. Only if the vision gets blurred
B. Once a year
C. Every 2 years
10. What can I do if I overeat at the holidays or at a church potluck?
Answers to Diabetes Questions from Dr. Paul Sack:
1. Answer A. For almost every person with diabetes, the answer is yes! Eating a piece of cake with sugar will raise your blood glucose level. So will eating corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar has gotten a bad reputation. People with diabetes can and do eat sugar. In your body it becomes glucose, but so do the other foods mentioned above. With sugary foods, the rule is moderation. Eat too much, and (1) you'll send your blood glucose level higher than you expected, (2) you'll fill up but not with the nutrients that come with vegetables and grains, and (3) you'll gain weight. So don't pass up a slice of birthday cake. Instead, eat a little less bread or potato and replace it with the cake. Taking a brisk walk to burn some calories is also always helpful.
2. Answer C. Type 1 diabetics require insulin for survival, but many Type 2 diabetics need insulin as well. The onset of Type 1 Diabetes is usually in childhood, but can occur any time in life. Type 2 Diabetes is becoming more common in the younger age groups (even in pre-teens!) due to morbid obesity, lack of exercise, and genetics. Therefore, the answer is C, Type 1 diabetics have no insulin production, while Type 2 diabetics have some, but not enough to meet their bodies' demands.
3. Answer B. The chance of a child of a Type 2 Diabetic developing Type 2 Diabetes is quite high - around 40%. If both parents are Type 2, it goes up even higher (around 60%). The chance of a child of a Type 1 Diabetic parent developing Type 1 Diabetes is still around 5-10%, which is still higher than the risk to a person without a Type 1 Diabetic parent (less than 1%).
4. Answer C. The American Diabetes Associaton recommends <130/80, although a lower blood pressure without developing hypotension is even better.
5. Answer A. The definition of a normal blood sugar is less than 100 after a 6-8 hour fast and no more than 140 2 hours after a glucose challenge. The definition of diabetes is a fasting glucose of greater than 125 (126 and above) or any sugar above 200. A glucose tolerance test can be done where the subject is given 100 grams of glucose and the blood glucose level is checked before and 2 hours after that. A sugar over 200 confirms diabetes. There is an in-between diagnosis of "pre-diabetes." This is when the fasting glucose is 100-125 or the after the meal (or glucose challenge) sugar is 140-199. However, there has already been significant damage done to the pancreas when a person reaches this stage and pre-diabetes needs to be taken very seriously.
6. Answer E. The severity of symptoms usually correlates with how high the sugar is. While these are the typical symptoms, diabetes can also be silent and have no symptoms, which is why routine screening is recommended for those at risk.
7. Answer A - True. Weight loss helps people with diabetes in two important ways. First, it lowers insulin resistance. This allows your natural insulin (in people with Type 2 Diabetes) to do a better job lowering blood glucose levels. If you take diabetes medecine, losing weight lowers blood glucose and may allow you to reduce the amount you're taking, or quit taking it altogether. Second, it improves blood fat and blood pressure levels. People with diabetes are about twice as likely to get cardiovascular disease as most people. Lowering blood fats and blood pressure is a way to reduce that risk. While genetics do play a role in obesity, it is not the main determininant. Our behaviors have much more to do with our choices than our genetics. What we eat and what we do are huge factors. Thyroid deficiency can cause unexpected weight gain.
8. Answer A. Unfortunately we have not developed a painless way of checking blood glucose levels, although the technology is improving. There are machines that need less and less blood, and one can also check on the palms and forearms, which tends to hurt less. An injection of insulin with a 30 or 31 gauge needle is virtually painless. So, most people who are scared of insulin injections are surprised when they try their first injection and there is no pain.
9. Answer B. All Type 2 Diabetics should be screened for retinopathy immediately when they are diagnosed. This is because the prediabetic patient has likely had elevated blood sugars for several years prior to diagnosis and damage may have already occurred. Type 1 Diabetics can be screened 5 years after diagnosis and every year after that. There can be significant bleeding and damage to the retina even before there is blurred vision, so it is important to screen for this even if there are no symptoms. The eye doctor may have the patient come back more frequently if there are issues or treat with laser therapy if retinopathy is severe.
10. Put on your walking shoes and head for the pavement. Being more active helps lower your blood sugar, blood pressure, and cholesterol. Physical activity uses up extra sugar in your blood and helps your insulin work better. Use new guidelines for recipes recommended for diabetics or to help lose weight.
American Diabetes Association
(410) 265-0075 (410) 235-4048 fax
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