Monitoring and Regulating Blood Sugar

Monitoring and Regulating Blood Sugar

JOIN FIGHT•LIVE RIGHT•BEAT DIABETES

Quick Facts about Diabetes

-Diabetes develops when your body can not make or properly use the hormone insulin which is normally made in the pancreas.

-The hormone insulin helps the cells in your body take in sugar from your bloodstream.

-Diabetes is diagnosed when a blood sugar know as glucose builds up in your bloodstream.

-High blood sugar levels make you feel tired and dehydrated.

-High blood sugar levels also damages your organs and increases your risk of heart disease.

Keeping blood sugar under control now can help reduce the risk of diabetes-related problems later.

Complications Arising From Diabetes

-Heart Disease: You are 2 to 3 times more likely to have heart disease or a stroke

-Eye Disorders: You are at risk for cataracts, glaucoma, and problems with the retina, which may cause blindness.

-Kidney Damage: About 20% to 40% of people with diabetes develop kidney disease, which could lead to kidney failure.

-Nerve Damage: Major cause for amputations. It may also lead to sexual dysfunction and other problems.

Who Gets Diabetes: Risk Factors You Can Control

- Overweight: If you weigh 20% more than your ideal weight, you are at higher risk.

-Smoking: Causes cells to resist insulin so they cannot get enough blood sugar.

-Being inactive: Leads to excess body fat, high blood pressure and high cholesterol.

-High blood pressure and/or high cholesterol: Raises your risk of developing type 2 diabetes and heart disease.

Who Gets Diabetes: Risk Factors You Cannot Control

-Family History: Your risk is higher if you have a close relative with diabetes.

-Gestational Diabetes: Having a baby weighing over 9 lbs.

-Age: Type 2 diabetes is more common in people age 45 and older, but is rising among young people who are overweight and inactive.

-Ethnic group: African Americans, Hispanics, Native Americans, and Asian Americans are more likely than Caucasians to develop diabetes.

Prevalence of Diagnosed and Undiagnosed Diabetes among People Ages 20 Years or Older, United States, 2007
	Number of People in U.S. (Million)	Percent of People in U.S. (%)
Ages 20 years or older	23.5	10.7
Ages 60 years or older	12.2	23.1
Men*	12	11.2
Women*	11.5	10.2
Non-Hispanic Whites*	14.9	9.8
Non-Hispanic Blacks*	3.7	14.7
Total Population	23.6	7.8

*Ages 20 years or older

Monitoring

Blood sugar

-This is the most important test that you can do yourself. You should take blood sugar readings at least 2-4 times a day. Your healthcare provider will tell you exactly how often you should check your blood sugar. Home tests often show blood sugar levels that are about 10% lower that levels found in laboratory tests. So also have your blood sugar tested by your healthcare provider. Normal blood sugar levels are between 70-120 mg/dL

Hemoglobin A1c

- This blood test shows how well blood sugar levels have been managed during the past 2 to 3 months. A1c tests are usually done in a lab and are recommended to be done at least twice a year. You want to achieve an A1c reading of less than 7% (every 1% increase above 6% increases your risk of developing diabetes complications and heart attacks).

What Alc test results mean:

If your A1c was	Your average blood sugar was
6.3%	129 mg/dL
7%	146 mg/dL
8%	169 mg/dL
9%	192 mg/dL
10%	214 mg/dL
11%	237 mg/dL

Medicine

Four types of Type 2 diabetes medication

-Medicines that improve how your body uses its own natural insulin. They directly target insulin resistance.

-Medicines that reduce blood sugar production. They slow down the liver’s production of blood sugar.

-Medicines that boost insulin production. They cause your pancreas to make more insulin. They, however, may stop working over time.

-Medicines that slow blood sugar absorption. They lessen the amount of blood sugar absorbed in the intestines.

-Sometimes a combination of these medicines is needed.

Insulin

-About 40% of Americans with Type 2 diabetes take insulin.

-Some people take insulin in combination with their diabetes medication.

Remember that medicine should also be combined with regular exercise and healthy eating.

See your doctor and your dietitian/diabetes educator regularly.

For more diabetes support go to the Northeast Missouri Rural Health Network

CareLink Regional Services for Better Self-Management of Diabetes Program

webpage at http://www.mffhdiabetes.org/NEMissouri.html

Sources:

American Diabetes Association. (2009). Type 2 Diabetes. Retrieved September 28, 2009, from the American Diabetes Association webpage at

http://www.diabetes.org/type-2-diabetes.jsp.

National Diabetes Information Clearing House. (2008) National Diabetes Statistics, 2007. Retrieved September 28, 2009, from the NDIC webpage at

http://diabetes.niddk.nih.gov/DM/PUBS/statistics/#people.

The Presence and Effects of Lead in Soil

Lead poisoning is a major health risk, especially for children and infants. Along with water, food, and paint; soil is one of the leading sources of lead exposure. Lawns and gardens should have lead levels tested and taken care of before children are allowed to play or gardens are planted in the area.

Lead poisoning is harmful because the heavy metal affects most of the systems in the body including the cardiovascular, reproductive, nervous, and gastrointestinal systems. Overexposure to lead can cause such symptoms as headaches, irritability, abdominal pain, seizures, and in severe cases, death.

Children and infants are at an elevated risk for several reasons. Because of their developing nervous system, harm that occurs there has much more of an impact on physical and mental development suppressing growth to various degrees based on age and levels of exposure. Children are also more affected by lead in soil because they are at a stage in life where they put many inappropriate things in their mouths. While lead in soil does not typically soak through skin, when children play in the soil and then put their hands in their mouths the lead enters their body through ingestion. Another factor in this is that children’s gastrointestinal systems absorb lead and heavy metals faster and in higher quantities than a developed adults system, so not only do children ingest more lead, but their bodies soak it in more efficiently putting children at a much higher risk of overexposure and poisoning than adults.

Lead is present in soil from multiple environmental sources. There is some lead present in all soil (about 50 micrograms per gram (mg/g)) but not in levels that are harmful or toxic to children. Lead concentration is increased beyond safe levels in areas where there is lead mining, construction, a focus on agriculture, or heavy traffic. Lead mining and smelting releases lead particles into the air which then settles as dust in the soil. Areas of construction are also generally high in lead soil content because of lead released from equipment and during demolition of old houses. Houses before 1978 were painted using mostly lead-based paint which can flake off and get in the soil when they are torn down. Farming acts as a source of lead in soil primarily through fertilizer that contains lead and lime. Waste disposal can also contribute to increased lead levels in these areas. In areas of high traffic lead from gasoline that is pumped into the air settles as dust on soil and pollutes the ground.

In general the most concentrated levels of lead in soil will be in the top 2-5 cm of soil. In areas of farming and construction, the soil is often turned up and pushed around mixing lead much deeper into the soil. Because it is a heavy metal, lead does not biodegrade or decay so once it is deposited in soil it remains there until an outside effort is made to remove it. Lead also presents a danger of leaching into water supplies. Especially in areas where the soil is overturned frequently, or where there is heavy rainfall. Lead can soak deep to water stores or be washed into lakes and creeks and pollute the water source.

Before children are allowed to play in exposed soil, or gardening occurs, lead levels should be tested by a certified specialist. If levels are higher than the safe level, especially if they approach or pass 200 mg/g, measures should be taken to protect people from the heavy metal. Thick grass could be planted to cover the affected area but it would be best to remove the top few inches of soil and replace it with uncontaminated soil.

While lead levels and cases of lead poisoning have been on the decline since the late 1980’s and 1990’s, there is still a danger in areas of construction and farming especially if children are present. Precautions should be taken to avoid exposure to lead in the soil to prevent lead poisoning and the harmful effects of overexposure.

Sources:

Blumenthal H.T. and R. Mayfield An update on blood lead levels in pediatric patients of a neighborhood health center and an analysis of sources of exposure.. Journal of the National Medical Association. 87(2): 99–104. February 1995

Lynch, Robert A., Lorraine Halinka Malcoe, Valerie J. Skaggs, Michelle C. Kegler; The Relationship between Residential Lead Exposures and Elevated Blood Lead Levels in a Rural Mining Community. Journal of Environmental Health, Vol. 63, 2000

Environmental Protection Agency. Lead in paint, dust, and soil. Retrieved from http://www.epa.gov/lead/pubs/leadinfo.htm#where (2009, June 16).

Nutrition for the More Experienced African American Woman

By: Dominique Johnson

Heart Disease
Heart Disease is the #1 killer of women in the United States and African American women are more likely to get this disease than any other race. African American Women are 35% more prone to getting Heart Disease than non-Hispanic white women. This can be due to the fact that African American women have higher rates of obesity and being overweight, high blood pressure, and diabetes. Just by leading a healthier lifestyle, women can lower their rates of getting heart disease by 82%. Women are more likely to get heart disease after menopause because their body no longer produces estrogen. Middle age is the time when most women tend to develop other risk factors related to heart disease.

What is Heart Disease?
Heart disease is a broad term used to describe a range of diseases that affect your heart, and in some cases, your blood vessels. The various diseases that fall under the umbrella of heart disease include diseases of your blood vessels, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you're born with (congenital heart defects).

The term "heart disease" is often used interchangeably with "cardiovascular disease" — a term that generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as infections and conditions that affect your heart's muscle, valves or beating rhythm also are considered forms of heart disease (MayoClinic Definition).

How Your Heart Works

The normal heart is about the size of a person’s fist and it is a pump made of muscle tissue.The heart has four chambers. The upper two chambers are the right atrium and left atrium, and the lower two are the right ventricle and left ventricle (see Figure A in diagram). Blood is pumped through the chambers, aided by four heart valves. The valves open and close to let the blood flow in only one direction.

The four heart valves are:
-the tricuspid valve, located between the right atrium and the right ventricle
-the pulmonary (pulmonic) valve, between the right ventricle and the pulmonary artery
-the mitral valve, between the left atrium and left ventricle
-the aortic valve, between the left ventricle and the aorta.

Each valve has a set of "flaps" (also called leaflets or cusps). The mitral valve normally has two flaps; the others have three flaps.Dark bluish blood, low in oxygen, flows back to the heart after circulating through the body. It returns to the heart through veins and enters the right atrium. This chamber empties blood through the tricuspid valve (B) into the right ventricle.The right ventricle pumps the blood under low pressure through the pulmonary valve into the pulmonary artery. From there the blood goes to the lungs where it gets fresh oxygen (C). After the blood is refreshed with oxygen, it's bright red. Then it returns by the pulmonary veins to the left atrium. From there it passes through the mitral valve (D) and enters the left ventricle.The left ventricle pumps the red oxygen-rich blood out through the aortic valve into the aorta (E). The aorta takes blood to the body's general circulation. The blood pressure in the left ventricle is the same as the pressure measured in the arm.

Obesity and Overweight

About four out of five African American women are overweight or obese. From 2003-2006, African American women were 70% more likely to be obese than Non-Hispanic White women.
In 2007, African Americans were 1.4 times as likely to be obese as Non- Hispanic Whites.
Age-adjusted percentage of persons 20 years of age and over who are overweight or obese, 2003-2006.

Smoking

The smoking rates among African American women usually increases during their 20s and then decreases later on. The fact that African American women smoke a lot during their earlier years is a major contributing factor to them having heart disease later on in life. This also contributes to the fact of black women being continuous smokers at more experienced ages. The following chart shows data of the 2000 National Health Interview Survey (NHIS), it shows that during the ages of 35-47, black women have a higher smoking rate than white women in being current smokers.

Diabetes

Insulin is a hormone that is needed to convert food, sugar, and starches into energy that individuals need daily. Diabetes occurs when the body does not correctly use or make insulin. There are two major types of diabetes: Type 1 and Type 2. Type 1 Diabetes occurs when the body completely does not produce any amount of insulin. Type 2 Diabetes occurs when the body improperly uses the insulin, or does not produce enough of it. African American women age 20 years or older have type 2 diabetes, and about 1 in 4 African American women over the age of 55 has diabetes, which they more than likely experience blindness, amputation, and kidney failure. Twice the rate of white women. There is suggested research that shows that many African Americans carry a gene that predisposes them toward impaired glucose tolerance, one of the risk factors for diabetes.

How do I know if I am experiencing a heart attack?

If you are experiencing a heart attack, you will have the following problems:
pain or discomfort in the center of the chest for more than 20 minutes
pain or discomfort lasting more than 20 minutes in other parts of the upper body, including the arms, back, neck, jaw, or stomach
other symptoms, including shortness of breath (feeling like you can't get enough air), breaking out in a cold sweat, nausea (feeling sick to your stomach), or feeling faint

Other symptoms you may have include:
-unusual tiredness
-trouble sleeping
-problems breathing
-indigestion (upset stomach)
-anxiety (feeling uneasy or worried)

YOU SHOULD IMMEDIATELY CALL 911 IF THESE SYMPTOMS OCCUR!

Prevention

In order for you to help decrease your risk of getting heart disease you should do the following:
1. Exercise: You should try and exercise for at least 30 minutes daily. If not daily, try to exercise most days of the week. Small exercising strategies can make a big improvement as well: taking the stairs and walking to your destinations.
2. Eating Healthy: Eat whole-grain foods, vegetables, and fruit. Choose lean meats and low-fat cheese and dairy products. Limit foods that have lots of saturated fat, like butter, whole milk, baked goods, ice cream, fatty meats, and cheese. Eat fish at least twice a week, particularly fatty fish. Choose fats and oils such as liquid and tub margarines, canola, corn, safflower, soy bean and olive oils.

Transfats

Trans fats are unsaturated, but they can raise total and LDL ("bad") cholesterol and lower HDL ("good") cholesterol. Trans fats result from adding hydrogen to vegetable oils used in commercial baked goods and for cooking in most restaurants and fast-food chains. Examples are cookies, crackers, donuts, French fries, and etc.

Fats That Raise Cholesterol

Examples:

Dietary cholesterol
-foods from animals
-meats, egg yolks, dairy products, organ meats (heart, etc.), fish and poultry

Saturated fats

-foods from animals
-whole milk, cream, ice cream, whole-milk cheeses, butter, lard and meats
-certain plant oils
-palm, palm kernel and coconut oils, cocoa butter

Trans fats

-partially hydrogenated vegetable oils
-cookies, crackers, cakes, French fries, fried onion rings, donuts

Fats That Lower Cholesterol

Examples:

Polyunsaturated fats
-certain plant oils
-safflower, sesame, soy, corn and sunflower-seed oils, nuts and seeds

Monounsaturated fats
-certain plant oils
-olive, canola and peanut oils, avocados

Search Your Heart Program

The American Heart Association’s Search Your Heart program is a community-based educational program/tool to reach high-risk audiences. It was built to encourage people to take action and reduce their risk for heart disease and stroke.
Since its beginnings in 1996, over 15,000 churches across the country have participated in the Search Your Heart program and it has reached over 1.5 million at-risk participants. The program provides people with information about how to go about reducing the risks of heart disease, by talking about nutrition and physical wellness.

Sources:
1. African American Women and Diabetes: “National Organization for women foundation, All information provided by the American Diabetes Association.” Posted Sept. 10, 2002. http://www.nowfoundation.org/issues/health/whp/whp_fact16.html
Data Retrieved: September 22, 2009
2. “Definition of Heart Disease” by Mayo Clinic Staff, Jan. 28, 2009
© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER).
www.mayoc.clinic.com
Data Retrieved: September 23, 2009
3. “Education about heart disease is crucial for African-American women”
www.americanheart.org
Data Retrieved: September 23, 2009
4. Minority Women's Health
www.womenshealth.com
Data Retrieved: September 22, 2009

5. “Obesity and African Americans”
U.S. Department of Health and Human Services: The Office of Minority Health
www.omhrc.gov
Content Last Modified: 7/24/2009 3:22:00 PM
Data Retrieved: September 23, 2009.

6. Smoking
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1447756
Data Retrieved: September 28, 2009.




7. The Heart Truth For Women: “The Heart Truth For African American Women: An Action Plan”. NIH Publication No.07-5066. Originally Printed September 2003,
Revised December 2007.
http://www.nhlbi.nih.gov//educational/hearttruth/downloads/pdf/factsheet-actionplan-aa.pdf
Data Retrieved: September 22, 2009

Further Info Recommendations

1. NHLBI Health Information Center
Phone: 301-592-8573
TTYL: 240-629-3255
www.hearttruth.gov
2. American Heart Association
Phone: 1-888-MY-HEART
www.americanheart.org
3. Women Heart: The National Coalition for Women with Heart Disease
Phone: 202-728-7199
www.womenheart.org
4. Office on Women’s Health
U.S. Department of Health and Senior Services National Women’s Health Information Center
Phone: 1-800-994-WOMAN
TTYL: 1-888-220-5446
www.womenshealth.gov