Frequently Asked Questions 

About Diabetes

Dr. Tina Marcantel is a naturopathic doctor practicing in Mesa, Arizona. Other East Valley cities she serves are Gilbert, Chandler, Tempe, Scottsdale, Queen Creek, Apache Junction, and the greater Phoenix area.

What is causing the current "diabetes epidemic" I keep hearing about?

A big part of the problem is refined carbohydrates and refined sugars combined with decreased activity. This means more people in our population are overweight and obese, putting them at a higher risk for developing the disease.

How do people develop diabetes?

Obesity is a risk factor for type 2 diabetes and certain racial and cultural groups are at increased risk, as well. The chances of developing diabetes increase with age.*

What is the difference in being "overweight" or being "obese"?

Overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems.

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index” (BMI).

• An adult who has a BMI between 25 and 29.9 is considered overweight.
• An adult who has a BMI of 30 or higher is considered obese.

To calculate your own BMI, try the easy-to-use calculator at this link:

http://www.cdc.gov/nccdphp/dnpa/bmi/index.htm

What are the symptoms of type 2 diabetes?

Polyuria (urinating large volumes frequently) and polydipsia (abnormal thirst) are mild at first and gradually worsen over weeks or months. The type 2 diabetic usually presents with fatigue (not enough glucose in the cell to produce energy). Headaches, blurred vision, recurrent yeast infections or slow healing of a cut or wound, low libido, and urinary tract infections can all be possible symptoms of diabetes.

How do I know if I'm a diabetic?

Your doctor can diagnose diabetes by your clinical signs and symptoms and diabetic lab screenings and diagnostic tests.

What is the difference between type 1 and type 2 diabetes?

Type I diabetes patients produce little or no insulin at all; a person with type I diabetes must regularly inject insulin. The cause of DM 1 may be from a viral infection or nutritional factors in childhood or early adulthood, which causes the immune system to destroy the insulin producing cells in the pancreas.

In type 2 diabetes the pancreas continues to manufacture insulin--sometimes even at higher than normal levels. However, the body develops resistance to its effects, resulting in a relative insulin deficiency.* In essence there is too much sugar (glucose) in the blood and not enough in the cell.

Is there a cure for diabetes?

There is no cure for type 1 diabetes because the pancreatic cells stop producing insulin, leading to insulin dependence. The symptoms of type 2 diabetes can be controlled and some effects of diabetes reversed with medicine, diet, and exercise. How effectively all this works depends on the individual.

How does diabetes affect the body?

Too much sugar in the body can lead to complications such as neuropathy, vision loss, kidney failure, cardiovascular disease, stroke, and diabetes foot ulcers from poor circulation.

Why do diabetics have to examine their feet daily?

Because of decreased circulation to the extremities, diabetics can lose sensation in their feet, especially on the soles. They need to examine their feet for cuts, blisters, sores, etc. daily. See tips from podiatrist Dr. Kimberly Leach from the Arizona Institute of Footcare Physicians in the article Diabetes and your feet: Tips for proper care.

What is considered a "normal" blood sugar range?

Blood sugar levels are normally between 70-100 mg/dl in the morning after an overnight fast. They are usually lower than 120-140 mg/dl two hours after eating foods or drinking liquids containing sugar or other carbohydrates.* American Diabetic Association (ADA) guidelines recommend diabetics on treatment to have a fasting blood sugar of 90-130 mg/dl and a peak postprandial of less than 180 mg/dl.

What is Hemoglobin A_1c?

This is a blood test used to monitor diabetes treatment. This test provides an accurate long-term index of the patient's average blood glucose level over three months. Hemoglobin in the RBC combines combines strongly with glucose in a process called glycossylation.

Are there certain foods that diabetics should avoid?

Diabetics should avoid refined sugars and processed carbohydrates. They should also avoid foods high in animal fats.

What, specifically, is Dr. Marcantel's diabetes management program?

The program consists of patient education, testing, a personalized diet plan, and ongoing monitoring and support. Please click here for a more detailed explanation.

What is insulin and why is it often prescribed for diabetics?

Insulin is a hormone produced by the pancreatic cells that opens the cell door to allow glucose into the cell, which then produces energy.

Are there any harmful side effects to insulin use?

Insulin in excess can cause low blood sugars (hypoglycemia) and abnormal weight gain after  using it for a long period of time.

Why did I start to gain weight after my doctor put me on insulin?

Insulin is a fat storing hormone.

If I am on insulin now does it mean I'll have to take it all my life?

Not necessarily. It depends on the individual. I have seen some patients reduce their insulin and even get off insulin gradually when on a diabetic meal plan combined with exercise. This, of course, needs to be closely monitored by a physician.

*Definitions marked with an asterisk are taken from the Merck Manual of Medical Information, 1997.