Diabetes For Dummies, 3rd Edition by Alan L. Rubin MD Table of Contents http://www.drrubin.com

1. Contents at a Glance
Introduction .................................................................1
Part I: Dealing with the Onset of Diabetes......................7
AL
Chapter 1: Dealing with Diabetes .....................................................................................9
Chapter 2: It’s the Glucose ..............................................................................................19
RI
Chapter 3: What Type of Diabetes Do You Have?.........................................................29
TE
Part II: How Diabetes Affects Your Body ......................51
Chapter 4: Battling Short-Term Complications ............................................................53
MA
Chapter 5: Preventing Long-Term Complications ........................................................69
Chapter 6: Diabetes, Sexual Function, and Pregnancy ..............................................101
Part III: Managing Diabetes: The “Thriving with
D
Diabetes” Lifestyle Plan............................................119
TE
Chapter 7: Glucose Monitoring and Other Tests........................................................121
Chapter 8: Diabetes Diet Plan .......................................................................................151
Chapter 9: Keeping It Moving: Exercise Plan ..............................................................175
GH
Chapter 10: Medications: What You Should Know.....................................................195
Chapter 11: Diabetes Is Your Show ..............................................................................227
RI
Chapter 12: Putting Your Knowledge to Work for You...............................................237
Part IV: Special Considerations
PY
for Living with Diabetes ............................................243
Chapter 13: Your Child Has Diabetes...........................................................................245
CO
Chapter 14: Diabetes and the Elderly ..........................................................................261
Chapter 15: Occupational and Insurance Problems ..................................................269
Chapter 16: What’s New in Diabetes Care ...................................................................279
Chapter 17: What Doesn’t Work When You Treat Diabetes ......................................287
Part V: The Part of Tens ............................................297
Chapter 18: Ten Ways to Prevent or Reverse the Effects of Diabetes .....................299
Chapter 19: Ten Myths about Diabetes That You Can Forget...................................305
Chapter 20: Ten Ways to Get Others to Help You.......................................................311

2. Part VI: Appendixes ..................................................317
Appendix A: Mini-Cookbook .........................................................................................319
Appendix B: Dr. W.W. Web .............................................................................................349
Appendix C: Glossary ....................................................................................................359
Index .......................................................................367

3. Table of Contents
Introduction ..................................................................1
About This Book...............................................................................................2
Conventions Used in This Book .....................................................................3
What You’re Not to Read.................................................................................3
Foolish Assumptions .......................................................................................4
How This Book Is Organized...........................................................................4
Part I: Dealing with the Onset of Diabetes ..........................................4
Part II: How Diabetes Affects Your Body .............................................4
Part III: Managing Diabetes: The “Thriving with
Diabetes” Lifestyle Plan .....................................................................4
Part IV: Special Considerations for Living with Diabetes..................5
Part V: The Part of Tens.........................................................................5
Part VI: Appendixes................................................................................5
Icons Used in This Book..................................................................................6
Where to Go from Here....................................................................................6
Part I: Dealing with the Onset of Diabetes ......................7
Chapter 1: Dealing with Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Achieving Anything . . . Or Everything! .........................................................9
Keeping good company .......................................................................10
Realizing your potential.......................................................................11
Reacting to Your Diagnosis ...........................................................................11
Experiencing denial..............................................................................12
Feeling anger .........................................................................................12
Bargaining for more time.....................................................................13
Moving on..............................................................................................14
Maintaining a High Quality of Life................................................................15
The importance of regular exercise ...................................................15
The (minimal) impact of insulin treatments .....................................16
Other key quality of life factors..........................................................17
The bottom line ....................................................................................18
Chapter 2: It’s the Glucose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Detecting Prediabetes ...................................................................................19
Knowing whether you should get tested...........................................20
Testing for prediabetes........................................................................20

4. x Diabetes For Dummies, 3rd Edition
Understanding What Diabetes Does ............................................................21
Realizing the role of glucose ...............................................................21
Testing for diabetes..............................................................................22
Controlling glucose ..............................................................................23
Losing control of glucose ....................................................................24
Tracing the History of Diabetes Treatment ................................................25
Sharing Some Real Patient Stories ...............................................................27
Chapter 3: What Type of Diabetes Do You Have? . . . . . . . . . . . . . . . . . .29
Getting to Know Your Pancreas....................................................................30
Examining your pancreas ....................................................................30
Understanding insulin..........................................................................30
Type 1 Diabetes and You...............................................................................32
Identifying symptoms of type 1 diabetes ..........................................32
Investigating the causes of type 1 diabetes ......................................34
Getting type 1 diabetes........................................................................34
Preventing type 1 diabetes..................................................................36
Having Type 2 Diabetes .................................................................................38
Identifying symptoms of type 2 diabetes ..........................................39
Investigating the causes of type 2 diabetes ......................................40
Getting type 2 diabetes........................................................................42
Preventing type 2 diabetes..................................................................43
Recognizing a variant of type 2 diabetes...........................................45
Having Gestational Diabetes.........................................................................47
Recognizing Other Types of Diabetes .........................................................47
Part II: How Diabetes Affects Your Body.......................51
Chapter 4: Battling Short-Term Complications . . . . . . . . . . . . . . . . . . .53
Solving Short-Term Complications ..............................................................53
Understanding Hypoglycemia ......................................................................54
The seriousness of hypoglycemia......................................................55
Symptoms of hypoglycemia................................................................55
Causes of hypoglycemia ......................................................................57
Prevention of hypoglycemia ...............................................................60
Levels of hypoglycemia .......................................................................60
Treatment of hypoglycemia ................................................................60
Combating Ketoacidosis ...............................................................................62
Can ketoacidosis affect you?...............................................................62
Symptoms of ketoacidosis ..................................................................63
Causes of ketoacidosis ........................................................................64
Treatment of ketoacidosis...................................................................64

5. Table of Contents xi
Managing the Hyperosmolar Syndrome......................................................65
Symptoms of the hyperosmolar syndrome.......................................66
Causes of the hyperosmolar syndrome.............................................66
Treatment of the hyperosmolar syndrome.......................................67
Chapter 5: Preventing Long-Term Complications . . . . . . . . . . . . . . . . .69
How Long-Term Complications Develop.....................................................70
Kidney Disease ...............................................................................................70
The impact of diabetes on your kidneys...........................................72
Early indications of kidney disease....................................................73
Progressive changes ............................................................................75
Treatment for diabetic nephropathy .................................................76
Eye Disease .....................................................................................................79
Understanding how the eye works ....................................................79
Retinopathy...........................................................................................80
Resources for the blind and visually impaired.................................82
Nerve Disease, or Neuropathy .....................................................................83
Basics of neuropathy ...........................................................................84
Disorders of sensation .........................................................................85
Disorders of movement (mononeuropathy).....................................88
Disorders of automatic (autonomic) nerves ...................................88
Entrapment neuropathies ...................................................................89
Heart Disease..................................................................................................91
Risks of heart disease to diabetic patients .......................................91
Metabolic syndrome ............................................................................92
Cardiac autonomic neuropathy..........................................................94
Cardiomyopathy ...................................................................................94
Diabetic Blood Vessel Disease Away from the Heart.................................95
Peripheral vascular disease ................................................................95
Cerebrovascular disease .....................................................................96
Diabetic Foot Disease ....................................................................................97
Skin Disease in Diabetes................................................................................98
Gum Disease in Diabetes ..............................................................................99
Chapter 6: Diabetes, Sexual Function, and Pregnancy . . . . . . . . . . .101
Examining Erection Problems ....................................................................101
The erection process .........................................................................102
Discussing ED with your doctor .......................................................103
Treatment for erectile dysfunction ..................................................103
Facing Female Sexual Problems .................................................................105
Striving for a Healthy Pregnancy................................................................107
Realizing the body’s reaction to pregnancy....................................107
Being proactive before and during pregnancy ...............................108
Diagnosing gestational diabetes.......................................................108

6. xii Diabetes For Dummies, 3rd Edition
Realizing risks to mother and baby .................................................110
Treating diabetes during pregnancy................................................112
Maintaining your health after pregnancy........................................115
Focusing on your baby’s health .......................................................116
Identifying Polycystic Ovarian Syndrome.................................................117
Part III: Managing Diabetes: The “Thriving
with Diabetes” Lifestyle Plan .....................................119
Chapter 7: Glucose Monitoring and Other Tests . . . . . . . . . . . . . . . . .121
Testing, Testing: Tests You Need to Stay Healthy ....................................122
Monitoring Blood Glucose: It’s a Must ......................................................124
How often should you test? ..............................................................125
Using a lancet......................................................................................126
How do you perform the test? ..........................................................127
Choosing a Blood Glucose Meter ...............................................................128
Factors that may influence your purchase .....................................128
Profiles of different meters................................................................129
Tracking Your Glucose over Time: Hemoglobin A1c ...............................137
GlycoMark Test.............................................................................................140
Testing for Kidney Damage: Microalbuminuria........................................141
Checking for Eye Problems .........................................................................142
Examining Your Feet ....................................................................................142
Tracking Cholesterol and Other Fats.........................................................143
Measuring Blood Pressure ..........................................................................146
Checking Your Weight and BMI ..................................................................147
Testing for Ketones ......................................................................................149
Testing the C-reactive Protein ....................................................................149
Checking the TSH .........................................................................................149
Chapter 8: Diabetes Diet Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Considering Total Calories First.................................................................152
Carbohydrates ....................................................................................155
Proteins................................................................................................159
Fats .......................................................................................................160
Getting Enough Vitamins, Minerals, and Water........................................162
Counting Alcohol as Part of Your Diet.......................................................164
Using Sugar Substitutes...............................................................................165
Eating Well for Type 1 Diabetes..................................................................166
Eating Well for Type 2 Diabetes..................................................................167
Reducing Your Weight .................................................................................168
Types of diets......................................................................................168
Surgery for weight loss ......................................................................170
Behavior modification .......................................................................171

7. Table of Contents xiii
Coping with Eating Disorders .....................................................................172
Signs of anorexia or bulimia..............................................................172
Sources of help ...................................................................................174
Chapter 9: Keeping It Moving: Exercise Plan . . . . . . . . . . . . . . . . . . . .175
Getting Off the Couch: Why Exercise Is Essential....................................176
Preventing macrovascular disease ..................................................176
Taking charge of your health ............................................................176
Understanding your body mechanics during exercise..................177
Reaping the benefits ..........................................................................178
Exercising When You Have Diabetes .........................................................178
Working out with type 1 diabetes.....................................................179
Working out with type 2 diabetes.....................................................180
Determining How Much Exercise to Do.....................................................180
Exerting enough effort .......................................................................181
Devoting an hour a day......................................................................182
Making moderate exercise your goal...............................................182
Is Golf a Sport? Choosing Your Activity ....................................................183
Walking 10K a Day ........................................................................................186
Lifting Weights ..............................................................................................188
Chapter 10: Medications: What You Should Know . . . . . . . . . . . . . . .195
Taking Drugs by Mouth: Oral Agents.........................................................196
Sulfonylureas.......................................................................................196
Metformin ............................................................................................198
Alpha-glucosidase inhibitors ............................................................201
Thiazolidinediones (the glitazones) ................................................202
Meglitinides.........................................................................................204
DPP-4 inhibitors..................................................................................205
Combining oral agents.......................................................................206
New injectable drugs .........................................................................207
Insulin ............................................................................................................209
Shooting yourself ...............................................................................212
Conducting intensive insulin treatment ..........................................214
Adjusting insulin when you travel....................................................215
Delivering insulin with a pen ............................................................216
Delivering insulin with a jet injection device..................................217
Delivering insulin with an external pump .......................................218
Utilizing aids to insulin delivery.......................................................221
Using Other Medications.............................................................................222
Avoiding Drug Interactions .........................................................................223
Finding Assistance Obtaining Drugs..........................................................224

8. xiv Diabetes For Dummies, 3rd Edition
Chapter 11: Diabetes Is Your Show . . . . . . . . . . . . . . . . . . . . . . . . . . . .227
Your Role as Author, Producer, Director, and Star...................................227
The Primary Physician — Your Assistant Director .................................228
The Diabetologist or Endocrinologist — Your Technical Consultant ...229
The Eye Doctor — Your Lighting Designer ...............................................230
The Foot Doctor — Your Dance Instructor...............................................230
The Dietitian — Your Food Services Provider..........................................231
The Diabetes Educator — Your Researcher .............................................232
The Pharmacist — Your Usher...................................................................232
The Mental Health Worker — Your Supporting Actor.............................233
Your Family and Friends — Your Captivated and Caring Audience ......233
The Internet: Your Potential Partner in Lifestyle Change .......................234
Sites for diet and weight loss............................................................234
Sites for exercise programs ..............................................................235
Finding reputable Web sites..............................................................235
Chapter 12: Putting Your Knowledge to Work for You . . . . . . . . . . . .237
Delaying or Preventing Diabetes ................................................................237
Developing Positive Thinking .....................................................................238
Monitoring and Testing ...............................................................................238
Using Medications........................................................................................239
Following a Diet ............................................................................................240
Exercising Regularly ....................................................................................241
Using Expertise Available to You ...............................................................242
Part IV: Special Considerations
for Living with Diabetes.............................................243
Chapter 13: Your Child Has Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . .245
Your Baby or Preschooler Has Diabetes ...................................................246
Nurturing a diabetic infant................................................................246
Taking care of a toddler with diabetes ............................................246
Becoming an educated caregiver .....................................................247
Your Primary School Child Has Diabetes..................................................248
Coping with type 1 diabetes .............................................................248
Recognizing and treating type 2 diabetes .......................................251
Your Adolescent Has Diabetes ...................................................................253
Your Young Adult Child Has Diabetes .......................................................254
Off to College ................................................................................................254
Obesity and Type 2 Diabetes in Children..................................................255
Defining obesity in children ..............................................................255
Preventing obesity in children..........................................................256
Dealing with type 2 diabetes.............................................................256

9. Table of Contents xv
Sick Day Solutions........................................................................................257
Thyroid Disease in Type 1 Children...........................................................258
The Extra Value of Team Care.....................................................................259
Chapter 14: Diabetes and the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . .261
Diagnosing Diabetes in the Elderly ............................................................261
Evaluating Intellectual Functioning ...........................................................262
Considering Heart Disease..........................................................................262
Preparing a Proper Diet...............................................................................263
Avoiding Hypoglycemia...............................................................................264
Using Medications........................................................................................264
Dealing with Eye Problems .........................................................................266
Coping with Urinary and Sexual Problems ...............................................266
Considering Treatment Approaches..........................................................267
Understanding the Medicare Law ..............................................................268
Chapter 15: Occupational and Insurance Problems . . . . . . . . . . . . . .269
Traveling with Diabetes...............................................................................269
Knowing Where You Can’t Work.................................................................271
Becoming Familiar with Workplace Law ...................................................272
Navigating the Health Insurance System ..................................................273
Private insurance ...............................................................................273
Insurance for low income patients...................................................275
High-risk pools....................................................................................276
Changing or Losing a Job ............................................................................276
Considering Long-Term Care Insurance....................................................277
Shopping for Life Insurance........................................................................278
Chapter 16: What’s New in Diabetes Care . . . . . . . . . . . . . . . . . . . . . .279
Protecting Yourself from the Dangers of New Drugs ...............................279
Red Wine to Defy Aging ...............................................................................281
Taking a Statin for All People With Diabetes ............................................282
Correcting the Cause of Complications.....................................................283
Getting Cells to Make Insulin ......................................................................284
Understanding the Importance of the ACCORD Study............................285
Chapter 17: What Doesn’t Work When You Treat Diabetes . . . . . . . .287
Developing a Critical Eye ............................................................................287
Identifying Drugs That Don’t Work ............................................................288
Chromium............................................................................................289
Aspirin..................................................................................................290
Cinnamon ............................................................................................290
Pancreas formula................................................................................290
Fat Burner............................................................................................291
Ki-Sweet ...............................................................................................291
Gymnema silvestre.............................................................................291

10. xvi Diabetes For Dummies, 3rd Edition
Avoiding Illegal Drugs ..................................................................................292
Knowing the Dangers of Some Legal Drugs ..............................................292
Antipsychotics....................................................................................293
AIDS medications ...............................................................................293
Recognizing Diets That Don’t Work ...........................................................294
Part V: The Part of Tens .............................................297
Chapter 18: Ten Ways to Prevent or Reverse
the Effects of Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299
Major Monitoring .........................................................................................299
Devout Dieting ..............................................................................................300
Tenacious Testing ........................................................................................300
Enthusiastic Exercising ...............................................................................301
Lifelong Learning..........................................................................................301
Meticulous Medicating ................................................................................302
Appropriate Attitude ...................................................................................302
Preventive Planning .....................................................................................303
Fastidious Foot Care ....................................................................................303
Essential Eye Care ........................................................................................304
Chapter 19: Ten Myths about Diabetes That You Can Forget . . . . . . .305
Perfect Treatment Yields Perfect Glucoses ..............................................305
You Can Have Borderline Diabetes for Years............................................306
Unorthodox Methods Can Cure Diabetes .................................................306
You Can Tell the Level of Your Blood Glucose by How You Feel ...........307
Hypoglycemia Kills Brain Cells...................................................................307
If You Need Insulin, You’re Doomed...........................................................307
People with Diabetes Shouldn’t Exercise..................................................308
You Can’t Get Life and Health Insurance...................................................309
Most Diabetes Is Inherited ..........................................................................309
Diabetes Wrecks Your Sense of Humor .....................................................310
Soak Your Feet Daily if You Have Diabetes ...............................................310
Chapter 20: Ten Ways to Get Others to Help You . . . . . . . . . . . . . . . . .311
Explain Hypoglycemia .................................................................................311
Follow the Standards of Care with Your Doctor.......................................312
Find an Exercise Partner .............................................................................312
Use Your Foot Doctor ..................................................................................313
Enlist Help to Fight Food Temptation........................................................313
Expand Your Education with Diabetes Educators ...................................314
Fit Your Favorite Foods into Your Diet with a Dietitian ..........................315
Seek Out Appropriate Specialists...............................................................315

11. Table of Contents xvii
Discuss Your Medications with the Pharmacist.......................................316
Share This Book with Everyone .................................................................316
Part VI: Appendixes...................................................317
Appendix A: Mini-Cookbook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .319
Aqua...............................................................................................................319
Border Grill ...................................................................................................324
Charlie Trotter’s ...........................................................................................327
Fringale ..........................................................................................................330
Gaylord India Restaurant ............................................................................334
Greens............................................................................................................336
Harbor Village...............................................................................................341
Il Fornaio .......................................................................................................344
Appendix B: Dr. W.W. Web . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .349
My Web Site...................................................................................................349
General Sites .................................................................................................349
The American Diabetes Association ................................................350
Online Diabetes Resources by Rick Mendosa ................................350
National Diabetes Education Program.............................................350
National Diabetes Education Initiative ............................................350
Medscape Diabetes and Endocrinology Home Page......................351
The Diabetes Monitor ........................................................................351
Juvenile Diabetes Research Foundation..........................................351
Children with Diabetes ......................................................................351
Joslin Diabetes Center .......................................................................351
Canadian Diabetes Association ........................................................352
The International Diabetes Federation............................................352
Ask NOAH About Diabetes ................................................................352
Companies That Make Diabetes Products ................................................352
Glucose meters ...................................................................................352
Lancing devices ..................................................................................353
Insulin pumps .....................................................................................353
Insulin ..................................................................................................353
Insulin syringes...................................................................................354
Insulin jet injection devices ..............................................................354
Oral medications ................................................................................354
Diabetic Exercise and Sports Association ................................................354
Government Web Sites ................................................................................355
National Institute of Diabetes and Digestive
and Kidney Disease ........................................................................355
Centers for Disease Control ..............................................................355
Healthfinder Web site ........................................................................355

12. xviii Diabetes For Dummies, 3rd Edition
PubMed Search Service of the National Library of Medicine.......355
Nongovernment Web site for searching the National Library......356
Diabetes Information in Other Languages ................................................356
Sites for the Visually Impaired ...................................................................356
American Foundation for the Blind..................................................356
Blindness Resource Center ...............................................................356
The Diabetes Action Network (National Federation
of the Blind).....................................................................................357
Animals with Diabetes .................................................................................357
Dogs and other pets...........................................................................357
Cats.......................................................................................................357
Recipes for People with Diabetes ..............................................................357
Appendix C: Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359
Index........................................................................367