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<h2>Springtime is the perfect "lower your A1C</h2>

If your healthcare provider has talked to you about reducing your A1C test result, or you want to make some improvements to your diabetes care, this is the ideal time to get started. After all, warmer weather makes it easier to get outside and get active, fresh foods are easier to come by, and the sunshine may help you feel like you can conquer anything. 7% vs. 7.0 mmol/L First, let's be clear on what your A1C result means. It can be a little confusing, as the A1C is a percentage, rather than a direct measurement of the glucose in your blood. Your regular blood sugar checks tell you...

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Understanding Gestational Diabetes

What is it? Gestational diabetes, or “pregnancy diabetes,” affects between 3 and 20% of pregnant women. It generally occurs in the second or third trimester and goes away on its own after childbirth. Any pregnant woman can develop it, but there are a number of risk factors such as age, ethnicity, excess weight, corticosteroid use, family history and some pre-existing conditions. What’s happening? Gestational diabetes occurs late in pregnancy, at the stage where the baby is already formed. Placental hormones, which help the child grow, start blocking the action of the insulin produced by the mother’s pancreas to regulate sugars in the blood (blood sugar or glucose level). This phenomenon is known as insulin resistance. As a result, glucose is not converted into energy, accumulating in the blood instead. What should you watch for? Women with gestational diabetes often have no symptoms. Therefore, it is recommended that all pregnant women undergo screening between the 24th and 28th week of pregnancy, or earlier if they are at risk. How do you manage gestational diabetes? The goal is to reduce blood glucose to the normal levels exhibited by a woman without gestational diabetes. This usually involves eating a healthy and balanced diet, performing moderate physical activity for about 150 minutes per week, reducing stress as much as possible, monitoring weight gain and measuring blood glucose levels using a glucose meter. These measures should be complemented by checkups at the hospital and adjustments along the way based on how the situation evolves. Changes in habits will sometimes not be enough; in such cases, insulin injections should be used during the pregnancy. What are the potential complications? Listed below are the most common complications, which are very often avoidable with prevention and appropriate treatment. In the child: • Macrosomia (above-average weight) • Risk of being born with very low blood sugar levels and respiratory problems • Risk of obesity and type 2 diabetes later in life In the mother: • Risk of a difficult delivery, possibly by C-section, depending on the baby’s weight • Surplus of amniotic fluid, which could trigger premature delivery • Gestational hypertension • Preeclampsia • Risk of developing type 2 diabetes later • Risk of suffering from gestational diabetes again in a future pregnancy In conclusion In the vast majority of cases, gestational diabetes is easy to control and goes away at the end of the pregnancy. However, there is a real risk of recurrence in the next pregnancy, as well as a possibility of developing type 2 diabetes one day. Fortunately, many problems can be avoided through healthy lifestyle habits in both mother and child. Talk to your physician to see how you can put the odds in your favour.  

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Understanding Prediabetes

What is it? Prediabetes is when a person’s blood sugar level (blood glucose) is higher than average, but not enough to diagnose them with diabetes. Almost all type 2 diabetics have had prediabetes, but not all prediabetics develop type 2 diabetes. Of course, it’s not enough to hope you fall into the right category: without any intervention, prediabetes is extremely likely to evolve in the wrong direction. What’s happening? Prediabetes entails abnormal fasting blood glucose—that is, abnormal blood sugar levels eight hours after a meal—or glucose intolerance. When everything is running normally, the pancreas produces insulin, the hormone that synthesizes the sugars you ingest and your body produces. In people with type 1 or type 2 diabetes, the pancreas partly or completely fails to fulfill this function. In prediabetic people, the process is just beginning to show signs of failure, with sugar accumulating in the blood instead of being properly used as a source of energy. Often, though not always, it’s due to lifestyle habits. What should you watch for? Prediabetes will generally show no symptoms, which makes it difficult to detect. However, there are several risk factors: Age (anyone 40 years or older should get tested) Ethnicity (African, Latin American, Asian, Aboriginal, etc.) Family history Excess weight, especially around the waist Lack of physical activity Hypertension Gestational diabetes Polycystic ovary syndrome High cholesterol Don’t hesitate to see your health professional to have your profile assessed and get tested if necessary. The earlier prediabetes is diagnosed, the better your chance of preventing it from evolving. How do you manage prediabetes? Lifestyle plays a key role in both managing prediabetes and preventing type 2 diabetes. Specifically, you should revise your diet to prefer balanced choices, cutting calories and saturated fats and being very careful with carbohydrates. No worries, though: a dietitian or health professional can provide advice on how to keep your meals delicious and satisfying. In addition, physical exercise is just as important as diet, as it helps you maintain a healthy weight, shrink your waist size a bit, regulate blood sugar, manage stress and keep your heart healthy. In some cases, oral medication can be prescribed to combat prediabetes, depending on the initial risk factors. What are the potential complications? The main possible complication of prediabetes is type 2 diabetes, which comes with its own lot of potential problems, including cardiovascular disease, nerve damage and foot disorders. Note that these may occur even before type 2 diabetes develops. In conclusion Prediabetes is a warning signal: you still have a chance to reverse the trend. Rethink your lifestyle one small change at a time, and keep in mind that the diagnosis doesn’t mean that type 2 diabetes is inevitable—it’s mostly an opportunity to take charge of your health.  

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Diabetes And Depression: Warding Off The Sword Of Damocles

Being diagnosed with diabetes means it’s suddenly time to make lifestyle changes, which can feel like a loss. It’s normal to feel destabilized and experience negative feelings at first. But even beyond that initial shock, people living with diabetes are more likely to slip into depression. Greater risk Nearly 10% of people with diabetes will experience major depression; around 30% will experience symptoms. That prevalence of depression is twice that found in populations without a chronic disease. Risk factors for depression include improper blood glucose management and diabetes-related long-term complications. The risk also increases with the number of years spent living with diabetes, since eventually, having to manage every aspect of your life to cope with an incurable condition can start to weigh on you. Note that other mental health problems, such as generalized anxiety disorder, are also highly prevalent among people with diabetes. Recognizing depression Don’t get depression and feeling depressed confused! Everyone has negative thoughts once in a while, but not everyone will experience major depression. In the latter case, symptoms including those listed below persist for more than two weeks and disrupt the normal course of the individual’s life. Despair or persistent feeling of emptiness Loss of interest Concentration or memory problems Sleep disorders (insomnia or, conversely, constant drowsiness) Appetite disorders; sudden weight loss or gain Suicidal ideas Depression doesn’t necessarily express itself as sadness, either. It can appear as a kind of torpor or lethargy, or on the other end of the spectrum, constant agitation. Someone in this situation will not be able to simply “cheer up” or “fix their attitude”—depression doesn’t work that way! Consulting a health care professional who can diagnose depression can help you find the right treatment, which often involves antidepressant drugs and psychotherapy. Conclusion If a loved one is going through an episode of depression, lend them a non-judgmental ear. And if you’re experiencing those symptoms yourself, find a sympathetic ear of your own.

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How and Why to Get a Good Night’s Sleep

When you are getting enough sleep, you may find that you have an easier time controlling your blood sugar. You’ll be more alert during the day, have more energy, less stress, and an overall better mindset for monitoring and managing your diabetes. Consider what happens when you don’t get enough sleep . In addition to other things that may interfere with your sleep like schedule changes or stress, people with diabetes can have potential complications with sleep. Both high and low blood sugar levels can interrupt your sleep. People with type 2 diabetes who don’t get a good night’s sleep may have a harder time controlling blood sugar levels.1 Sleep apnea is also common in people with type 2 diabetes, and neuropathy can cause leg pain that keeps you awake. The good news: it’s entirely possible to control these things and get a long, healthy night of rest. With that in mind, here are some tips for getting to sleep. 8 helpful tips for getting a good night’s sleep Relax before bedtime. Exercise and other moderate to vigorous activities should be done three hours before bedtime. Chores, errands…have it all finished at least an hour before you go to bed. Go to bed at the same time every day, even on the weekends, if you can. Try not to take a nap late in the day. Don’t eat a heavy meal right before bedtime, and don’t drink alcohol or caffeine late at night. In fact, limit all fluids before bedtime to avoid waking up in the middle of the night to go to the bathroom. Use the bathroom right before you go to bed, too.2 If you’re stressed out, try relaxation techniques like meditating, deep breathing, yoga, reading a favorite book, listening to calm music, or writing in a journal. Make your room comfortable: not too cold or hot, quiet, and dark. If you currently use your bedroom as an office or another TV room, rethink this arrangement. Make your bedroom a place to rest, not get distracted. Put all electronics away before bedtime, especially mobile devices like your smartphone or tablet. We know you love your pets, but they can interrupt your sleep so try to keep them off the bed or out of your room altogether if you have allergies (diabetes alert dogs excluded, of course). Checking your blood sugar level at night It is important to check your blood sugar level before bedtime. To avoid going low overnight, experiment with bedtime snacks that will keep your blood sugar normal overnight, like hummus or guacamole with vegetables. Some health care providers recommend a 3:00 a.m. blood sugar test to ensure that your overnight blood glucose is stable. If you’re on an insulin pump, fine-tune your basal levels if your blood sugar level tends to drop overnight. When to talk to your doctor or pharmacist If you are having trouble sleeping, we hope these tips will help. However, if you’re still struggling to get a good nights rest, or if someone tells you that you have a snoring problem, consider talking to your doctor or pharmacist. Snoring is an indicator of apnea, which is associated with high blood pressure, heart disease, acid reflux, and fatigue.  

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Hyperglycemia

When there isn’t enough insulin in your body, or when the hormone becomes ineffective, your cells are unable to use the available glucose, which then builds up in the blood. Hyperglycemia occurs when glucose levels rise above target values, i.e.: Over 7 mmol/L fasting or before a meal Over 10 mmol/L two hours after a meal Chronic hyperglycemia is what causes the long-term complications of diabetes such as blood vessel and nerve damage, blindness and kidney failure. Signs Fatigue or drowsiness Dizziness Irritability Exaggerated hunger Intense thirst Dry mouth Frequent need to urinate or abundant urine Sounds familiar? It should: type 2 diabetes manifests through hyperglycemia. Causes Hyperglycemia occurs when there is an imbalance between diet, physical activity and medication or insulin doses. Maybe you ate more food or carbs than usual, or your workout may have been cut short? You may also have taken too little insulin or, in the case of type 2 diabetes, taken the right dose of insulin, which wasn’t as effective as it should have been. Psychological or physical stress (illness, infection, etc.) or certain medications, such as cortisone, can also affect blood sugar levels. How to prevent it Monitor your blood sugar closely. Follow the diet plan developed by your nutritionist or dietitian. Adjust your insulin dose based on your diet and activities, and recalculate the amount of insulin you need when necessary. Take your medication as prescribed by your physician. The “dawn phenomenon” Everyone experiences a surge of hormones before they wake up. The cocktail of adrenaline, cortisol and growth hormone promotes glucose secretion by the liver. In people living with diabetes, the pancreas doesn’t produce enough insulin to regulate the resulting increase in blood glucose. This “dawn phenomenon” can lead to hyperglycemia, even if blood glucose levels were at target values at bedtime. Eating earlier in the evening or exercising after dinner can help correct the situation. What to do in case of hyperglycemia Drink enough water to avoid dehydration. Measure your blood glucose more frequently to identify the cause of the problem. You can then adjust your diet or physical activity schedule, or consult your physician to have your medication or insulin dose adjusted. It is a medical emergency if the person: - Does not tolerate any fluid or shows signs of dehydration (e.g., if they are nauseous or vomiting) - Displays an altered state of consciousness—is confused or agitated, engages in unusual behaviour, has hallucinations or fails to respond to stimuli - Has a body temperature above 38.5°C for more than 48 hours In the case of type 1 diabetes, if blood glucose levels are above 14 mmol/L, check for the presence of ketones: if a medium to high level of ketone bodies are present (over 4 mmol/L in urine or over 1.5 mmol/L in blood), see a health care professional. It is also worth consulting if someone with type 2 diabetes has a blood glucose level above 25 mmol/L and is excessively drowsy. In conclusion By being vigilant and learning to understand your body’s reactions, you can help prevent problems and manage diabetes more comfortably!  

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Putting your best foot forward!

In the long run, the hyperglycemia that characterizes diabetes ends up affecting the nerves (in what is known as neuropathy) and the blood vessels, especially the capillaries. This results in a loss of sensitivity and a decrease in the natural hydration of the feet, which leads to dry skin, cracks and calluses. This means that not only are you more likely to injure your feet and not realize it right away, but you heal more slowly, and your wounds are more likely to become infected. How do you prevent problems? As with everything related to diabetes—and health in general—adopting a healthy lifestyle can prevent many ailments. Avoid walking barefoot as much as possible, and wear appropriate, low-heeled shoes that have enough space for your toes (so long, Cinderella glass slippers!). Before putting on your shoes, make sure they’re free of foreign objects (such as a pebble). If you’ve been prescribed an orthosis, wear it as often as possible so that the pressure is evenly distributed when you walk or stand up. Avoid off-the-shelf insoles! Badly fitting soles can cause blisters. Similarly, to treat corns and calluses, avoid off-the-shelf medications, which can be dangerous for people with diabetes. Planning to relax in a warm bath? Check the water temperature with your elbow before climbing in. Otherwise, because of the loss of sensitivity in your feet, you risk not realizing that the water is too hot before it’s too late. Inspect your feet every day! Make sure you have sufficient lighting to see the soles of your feet properly. If you’re not flexible enough, use a mirror or ask someone to help you. If you have an injury (a cut, scrape or blister, for example), swelling, numbness or pain, or if your skin changes colour or looks bruised, consult a health care professional as soon as possible. You should also have one examine your feet every year. Pampering your feet Wash your feet daily and dry them well, especially between the toes. Regularly apply a thin layer of perfume-free moisturizing cream or lotion, or petroleum jelly, to your feet. Don’t apply any between your toes: excessive hydration can lead to infection. Soaking your feet is not recommended. Despite what you’d think, it actually dries out your skin. Use an emery file to care for your nails instead of a nail clipper or a sharp instrument. Always file in the same direction—don’t move back and forth. If you have an ingrown toenail, or if your nails are thick or abnormally shaped, consult a health care professional; a nurse specializing in foot care, for example. To remove calluses, gently rub your wet skin with an exfoliating file or a moistened pumice stone. Never try to cut them off yourself! You could end up with ulcers or an infection. Consult your health care professional instead. Conclusion As is often the case with diabetes-related issues, giving your feet a bit of care can save you a lot of trouble.  

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Hypertension 101

Also known as “high blood pressure,” hypertension is one of the leading causes of strokes and heart disease, and the worst part is that it often shows no symptoms. People with diabetes need to be especially watchful, as they are more likely to develop hypertension at some point and suffer its adverse consequences. Blood pressure “Blood pressure” refers to the pressure blood exerts on artery walls. It’s an essential part of the process that carries oxygen and nutrients throughout the body. Hypertension Hypertension occurs when blood pressure is above normal levels and forces the heart to work harder to make blood circulate. Over time, this excess effort can damage arteries and cause a wide range of health problems including stroke, heart disease, eye conditions, erectile dysfunction, atherosclerosis (the buildup of fat plaques in arteries) and kidney disease. Target values For people with diabetes, blood pressure should be below 130/80 mmHg. The first number represents systolic pressure, or blood pressure during a heartbeat, and the second measures diastolic pressure, which is the pressure between heartbeats. It’s important to note, however, that blood pressure can fluctuate for many reasons. If, on one occasion, you get a test result that’s too high, it doesn’t necessarily mean that you suffer from hypertension. Possible causes Hyperglycemia (elevated glucose levels), family history, poor diet (especially one that’s too rich in sodium), tobacco, alcohol, physical inactivity, excess weight, stress, sleep apnea, kidney disease and age are among the main risk factors. Prevention and treatment Whether you’re hypertensive or not, the same recommendations apply to you if you want to ensure your long-term health and prevent problems further down the line. Have your blood pressure checked at every doctor appointment. Adopt healthy eating habits by limiting your intake of sodium, saturated fat and trans fat. Fit some physical activity into your routine—try to do at least 150 minutes of moderate activity per week. If you smoke, quit for good. Find ways to manage your stress: reading, yoga, walking, etc. Limit your alcohol intake. If you are prescribed hypertension medications, take them exactly as directed. In conclusion High blood pressure should not be taken lightly, but the good news is that it can be prevented or brought back down to normal levels simply by adopting better lifestyle habits. You should also know that you can check your blood pressure in many drugstores, and that blood pressure monitors are available in stores if you want to keep an eye on things at home.  

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Protecting Your Smile When You Have Diabetes

Diabetes increases the risk of mouth problems, but this has (almost) nothing to do with your sugar intake. The main culprit is actually hyperglycemia. The effect of blood glucose Your body can react in many different ways to improperly managed blood glucose. You produce less saliva, and what you do produce contains more glucose, which can lead to dry mouth, ulcers, tooth decay or yeast infections. Due to hyperglycemia, there is increase glucose in the saliva which promotes the spread of bacteria, decreases nutrient absorption and slows healing. This partly explains why you’re more likely to develop gum disease and have it progress faster. A vicious cycle The chain doesn’t stop there; gum disease, in turn, makes diabetes management more complicated, since the infection produces toxins that hinder carbohydrate synthesis. Thus, it can increase your insulin resistance, and ultimately your blood glucose and your risk of cardiovascular problems. Aggravating factors Beyond hyperglycemia, sugar intake, smoking and poor oral hygiene are the main causes of mouth problems in people with diabetes. Gingivitis This is the first stage of gum disease. Plaque accumulates on teeth, most often because of lacking oral hygiene. Gums then become red and swollen and can bleed when teeth are brushed and dental floss is used. Gingivitis can be cured with better care, the use of an antiseptic mouthwash and a good, thorough cleaning at the dentist’s. Periodontitis This is the evolved—and much more serious—form of gingivitis. The accumulated plaque solidifies under the gums and causes them to shrink so that pockets of bacteria form and teeth become loose. At an advanced stage, the disease causes tooth mobility and loss due to the destruction of the bone support. There are several treatments for this, from simple curettage to gingival or bone grafts. Since periodontitis can sometimes be asymptomatic, it’s essential to visit a dentist regularly so it can be diagnosed before it wreaks havoc. Prevention is key Brush your teeth twice a day—ideally after each meal. Floss at least once a day. Replace your toothbrush every three months to prevent the proliferation of germs. Visit your dentist at least once every six months, as they recommend. Keep your blood glucose levels within optimal ranges. Stop smoking. The bottom line With a healthy lifestyle, good oral hygiene and properly managed blood glucose, you’ve got every chance of avoiding all such unpleasantness. Start acting preventively today, and keep those pearly whites shining bright!    

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