Diabetes

Diabetes
Glucose is the main sugar found in the blood and it is the body's main source of energy. However, too much sugar in the blood can cause many health problems, including diabetes, heart disease, kidney injury, nerve damage, and eye problems. It may also be related to rejection or the use of steroids.

Insulin, which is produced by the pancreas, enables glucose to move from your blood into cells so it can be used as energy. In patients with diabetes, the pancreas does not produce enough insulin or the body does not respond to insulin. Glucose is not absorbed and blood levels become high.

Diabetes after a transplant is more common in transplant recipients who have a family history of diabetes as well as those who are overweight, are taking steroids, or have hepatitis C. Diabetes after a transplant is also more common among African Americans and other ethnic groups. For all transplant recipients, it is best to eat a healthy diet and exercise regularly to avoid weight gain and reduce the risk of developing high blood glucose or diabetes.

Signs and Symptoms of Diabetes

For most people, the normal range of blood sugar before eating is less than 126 mg/dL. Your blood glucose will go up after you eat. You may need your transplant team's supervision for controlling your blood sugar.

The signs of high blood sugar include:
Frequent urination
Extreme thirst and hunger
Sudden weight loss
Blurred vision
Repeated infections
Fatigue
Headache

Controlling Blood Sugar Levels

A healthy diet is needed to prevent diabetes or to help control your glucose if diabetes does occur. Be sure to choose foods from the 5 main food groups: grains, vegetables, fruits, milk, and meat and beans. The American Diabetes Association recommends eating:



Eat whole grains, breads, and cereals such as barley, bran, oats, wheat, and brown rice (1 ounce is about 1 slice of bread, 1 cup of breakfast cereal, or _ cup of rice)
Eat dark-green vegetables such as broccoli, spinach, and green beans
Eat a variety of fruits such as berries, apples, pears, and peaches
Choose low-fat dairy products such as skim or low-fat milk, yogurt, and cheese
Choose high-protein foods such as fish, poultry, lean meat, eggs, nuts, and beans

The main nutrients that are found in the foods we eat include carbohydrates, proteins, fats, vitamins, and minerals. Carbohydrates provide energy. Healthy carbohydrates include whole grain breads, whole grain cereals, peas, beans, lentils, fruits, and vegetables. Proteins are also important for increasing energy and strength. Choose low-fat dairy products, fish, chicken, and lean meat for a good source of protein. In addition, high-fiber foods such as beans, peas, whole grains, bran cereals, vegetables, and some fruits, such as apples, pears, peaches, and oranges, are healthy for people with diabetes because they can help lower blood sugar and fat.

How much you need to eat each day depends on how many calories your body burns. Maintaining your body weight requires a balance between calorie intake and the number of calories you use each day through regular daily activities and exercise. Many transplant recipients are surprised at how few calories are needed to maintain a healthy body weight. Your transplant coordinator or dietician can help determine your recommended daily calorie intake. Limiting the amount of fats and sugar in your diet can also help to maintain a healthy level of blood sugar.


Treatment Options for Controlling Diabetes

There are several types of medications that are currently available for patients with diabetes. The table below lists some of the medications that are used to treat diabetes. They are grouped by how they work to control blood sugar.

For many transplant recipients, insulin injections 2 to 4 times a day or an insulin pump is the best option for controlling blood sugar. Or, you may be given an oral medication to control blood sugar levels. Your transplant team will determine which medication is right for you.