DIABETES AND NUTRITION | Added: 12, August 2017



DIABETES AND NUTRITION

Why is nutrition important?

The nutrients that people take into their body (what they eat) have a major effect on how much they weigh, their health, and their likelihood of developing a chronic disease or not. Overall, there is no one set of nutritional requirements for human health. Such requirements vary from person to person and depend on many factors, including age, size, gender, and health conditions. For example, the nutritional requirements of a person with type 1 diabetes versus a person without diabetes can be very different.

Why are nutrients important to humans?

Nutrients are so important to humans because they are the compounds that help the body to survive and remain healthy. Not all nutrients are the same, either, and they range from vitamins and minerals to non-nutrients, such as water, with each one affecting the body in certain ways. Foods contain these chemical substances that provide the body with heat and energy, help to grow and repair the body’s cells and tissues, and aid in regulating the body’s overall processes.

Does any single food supply all the nutrients humans need?

Although there are claims to the contrary, no single food can supply all the nutrients in the amounts humans need to survive. For example, lemons may supply vitamin C, but they have no calcium. This is why dietitians recommend a balanced diet of foods that contain most of the body’s daily nutrient needs. Or if a person has diabetes, the dieti tian would recommend foods that would help keep the person’s blood glucose levels more stable.

What are the six essential nutrients that cannot be synthesized by the human body?

The six important nutrients are familiar to most people. They are carbohydrates, fats (lipids), proteins, vitamins, minerals, and water. Each has a specific function and relationship to the body, and not one of these nutrients can act independently of the others. In addition, scientists now know that each nutrient is equally valuable for human health. Thus, although factors can alter the amounts of nutrients people ingest (depending on such things as age, body volume, gender, health, and lifestyle), deficiencies in any of these nutrients can lead to an imbalance in the body.

Is there a connection between nutrition and diabetes?

Yes, there is a connection between diabetes and nutrition, especially in that a person should pay close attention to nutrition if he or she has diabetes! Although the tendency to develop diabetes (type 1, but especially type 2) seems to be associated with heredity, pregnancy (gestational diabetes, which often disappears after the baby is born), surgery, or physical and emotional stress, one of the biggest reasons (especially for type 2 diabetes) is obesity. In the majority of cases, prediabetes (and eventually diabetes) occurs when a person is overweight or obese due to bad eating habits, including too many foods rich in fats, salts, and sugars. In fact, many people who are prediabetic-or who are at a higher risk of developing type 2 diabetes-have been known to reverse or slow down the development of the disease by weight control, proper nutrition, and exercise. (For more about connections between obesity and diabetes, see the chapter “Diabetes and Obesity.”)

NUTRITION HELP FOR PEOPLE WITH DIABETES

What is the difference between a dietitian and a nutritionist?

People often mistakenly use the terms dietitian and nutritionist interchangeably, and although they are related in some ways, it is the level of education and qualifications that separate the two professions. Dietitians must have a certain level of education and registration. A nutritionist is free from government regulations, although some states require nutritionists to obtain an occupational license from a Board of Nutrition. Other states require no qualifications, and a person can practice without any previous education, training, or work experience.

What are the qualifications to become a registered dietitian?

In general, a dietitian helps people (including those with diabetes) determine the right number of daily calories and distribution of food throughout the day. This health care professional has to have university qualifications consisting of a four-year college degree (bachelor’s) in nutrition and dietetics or a three-year science degree followed by a master’s degree in nutrition and dietetics. Whichever program the dietitian takes, it must be approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) and include a practical component. This can include a period of practical training in a hospital or community setting (in some areas, it includes about 1,200 hours of supervised practice). Dieticians can also have specialty skills, such as a clinical dietitian.

To become a certified registered dietitian (who most often has “RD” after his or her name, and is usually found in a professional health care facility), the person must: earn a degree from an ACEND program; complete a supervised clinical program; pass the CDR (Commission on Dietetic Registration) examination; and complete continuing professional education credits that are needed to maintain CDR registration.

Dieticians are licensed professionals with bachelor’s or master’s degrees in dietetics. They need some medical background in order to write diets suitable for people suffering from various diseases.

Where do you find a dietitian?

A dietitian can be found in various employment settings, including the following:

Health care, such as in hospitals or other health care facilities, and schools or day-care centers

Business and industry, such as in corporate wellness programs or public relations

Communities and public-health facilities that offer education to the public about better eating habits

Education, at places that teach physician’s assistants, nurses, and dietetics students about the science of food and nutrition

Research groups, such as those found in food and pharmaceutical companies or in university and hospital settings

Government agencies that offer information based on up-to-date research or education to professionals and the public

Private practice groups, such as those working under contract with health care groups or food companies or running their own businesses

How can a dietitian help a person with diabetes?

It is difficult for people with diabetes to balance their blood glucose levels, which is often tied to the foods they eat. Thus, dietitians can help people make better food choices, as they are often involved in the diagnoses and dietary treatment of many diseases, including diabetes.

What recent change occurred concerning registered dietitians?

In 2016, the Academy of Nutrition and Dietetics’ (previously the American Dietetic Association) Board of Directors and the Commission on Dietetic Registration approved an additional credential for registered dietitians: the use of “registered dietitian nutritionist” (RDN). Although several states already use “nutrition” in several of their credentials (for example, CDN, or certified dietitian/nutritionist, or LDN, licensed dietitian/nutritionist), the AND has made the “nutrition” addition official, and a person with such credentials can still use “RD” or the new “RDN” as options. It is thought that this addition will help differentiate the many requirements for a dietitian versus those for a nutritionist-and thus emphasize that all registered dietitians are nutritionists but not all nutritionists are registered dietitians.

What are the qualifications for becoming a nutritionist?

At this writing, there are no true qualifications for becoming a nutritionist, except that in some states, a nutritionist must obtain a license. The term “nutritionist” is not protected by law in almost all countries, so people with varying levels of food expertise can use the term without any degree or license all over the world. Thus, if a person with diabetes is looking for someone to help him or her maneuver through the intricacies of eating with the disease, then it is best to be careful in choosing a qualified nutritional professional.

How can a nutritionist help a person with diabetes?

Although there are people who call themselves “nutritionists” and have no credentials, there are some qualified nutritionists who have completed university degrees in food science, human nutrition, food and nutrition, or food technology (some also call themselves food scientists). In most cases, a nutritionist is concerned with the nutritional value of certain foods, such as the calories, carbohydrates, fiber, protein, total fat, saturated fats, sodium, and cholesterol per serving. Suggestions from a nutritionist can be helpful to people with diabetes who want to limit and improve their food choices in order to control their blood glucose levels. The best way to find a qualified nutritionist (or dietitian) is to ask a health care professional for recommendations. And some hospitals have qualified people to help a person with diabetes eat better.

What is a dietetic technician, registered?

A dietetic technician, registered (DTR) is a person who is educated at the technical level of nutrition and dietetics. According to the Academy of Nutrition and Dietetics, a DTR plays a part in the health care and food-management services and knows about food safety and quality. The DTR works under the supervision of a registered dietitian nutritionist (RDN) in such places as hospitals, clinics, nursing homes, hospices, home health care programs, research institutions, and retirement centers. Or the DTR can work independently, providing general nutrition education in such places as schools, day-care centers, restaurants, health care facilities, corporations, hospitals, programs for the public (such as Meals on Wheels), health clubs, and food companies.

In addition, DTRs are credentialed food and nutrition technical practitioners who have met certain criteria, both educational and professional. One route to this goal includes completing an accredited dietetic-technician program, 450 hours of supervised practice in various community-based programs, health care and food-service facilities, and completing at least a two-year associate’s degree at a regionally accredited college or university. Another route to becoming a DTR involves earning a bachelor’s degree from a regionally accredited college or university or foreign equivalent. The candidate must also complete an Accreditation Council for Education in Nutrition and Dietetics (part of the Academy of Nutrition and Dietetics, with the acronym ACEND) Didactic Program in Dietetics and an ACEND-accredited Dietetic Technician-supervised practice program.

Diabetes educators help those with the disease understand and manage it better by teaching them how diabetes affects their bodies and what they can do about it.

What does being a diabetes educator mean?

A diabetes educator is a health care professional who focuses on all aspects of diabetic care, including knowledge of prediabetes, diabetes prevention, and management of the disease. The educator aids and educates people with diabetes, helping them to understand how blood glucose levels work and how food affects blood sugar. They also give guidance to people with diabetes, such as to how to take medications properly and how to lower the risk of developing complications from the disease.

Does a diabetes educator need to be certified?

Most diabetes educators become certified as certified diabetes educators (CDE) and must go through certain certification examinations to become health professionals. Many are members of the American Association of Diabetes Educators in Chicago.

What was a nurse educator?

“Nurse educator” is an older term used to describe a person who worked in clinical practice and in hospital teams to improve the quality of a patient’s diabetes education. The role was developed mainly because a physician’s contact time with a patient with diabetes was limited. The nurse educator-similar to what is referred to now as a diabetes educator-would be the liaison between the physician and the patient, evaluating and educating the patient and interpreting how the person was managing his or her diabetes.

What is a diabetes health care team?

A diabetes health care team is a group of people whose goal is to help people with diabetes manage and maintain their health with the disease. Although the most important aspect of treating diabetes is self-management, many hospitals and health care facilities offer a team of people to help people with diabetes understand and manage the disease. The team usually includes a person’s primary-care physician or an endocrinologist who specializes in diabetes, a diabetes educator (often a nurse or nurse practitioner), and a dietitian.

For long-term care through the disease, other professionals may be called to help the team, including an ophthalmologist (as the eyes are often affected); a podiatrist (for foot problems, mainly from neuropathy); a wound-care specialist (for foot-related wounds and other wounds that don’t heal as well when the person has diabetes); a nephrologist (kidney specialist); a cardiologist (for heart problems); and/or a nerve specialist (for problems with neuropathy).

DIABETES AND VITAMINS

What are vitamins?

A vitamin is an organic, non-protein substance that is necessary for an organism-plant or animal-to maintain normal metabolic function but that cannot be synthesized by that organism. In other words, vitamins are crucial molecules that must be acquired from outside sources. While most vitamins are present in food, vitamin D is produced as a precursor in our skin and converted to its active form by sunlight.

What is the difference between fat- and water-soluble vitamins?

Vitamins are often classified as fat-soluble or water-soluble. Fat-soluble means the vitamin is stored in the body and can accumulate if too much is ingested (which is why it’s best to use any vitamin supplement under medical supervision). Water-soluble vitamins are not as readily absorbed or stored in the body. For example, vitamins A, D, E, and K are soluble only in fats; vitamins C and the B vitamins are soluble only in water. In addition, if foods that have fat-soluble vitamins are cooled, the vitamins will not be lost. But more often than not, water-soluble vitamins lose their potency from heat when cooked.

What vitamins are essential for human health?

The following lists the fat- and water-soluble vitamins that are essential for human health (the ones associated with glucose and diabetes are italicized):

Essential Vitamins

Vitamin

Essential for Health

Fat-soluble Vitamins

Vitamin A

Beta carotene, retinols: Needed for growth and cell development; prevents night blindness; helps fight some cancers; helps the cardiovascular system; needed to maintain healthy gums, glands, bones, teeth, nails, skin, and hair; beta carotene is also considered to be an antioxidant

Vitamin D

Calciferol: Needed for calcium absorption and helps build strong bones and teeth; helps maintain the brain, pancreas (responsible for insulin balance), and reproductive organs; also targets the kidneys and intestines; some studies show it may help reverse insulin resistance

Vitamin E

Tocopherols: Helps maintain muscles and red blood cells; it’s also a major antioxidant

Vitamin K

Necessary for efficient blood clotting; may help eliminate inflammation and improve insulin sensitivity and blood glucose levels

Water-Soluble Vitamins

Biotin

Needed for energy and metabolism

Folate

Folic acid, folacin (some call this vitamin F; it is more often thought of as B9): Necessary to make DNA, RNA, red blood cells, and to synthesize certain amino acids

Niacin

Vitamin B3, nicotinic acid, nicotinamide: Necessary to metabolize energy and to promote normal growth; for some people, larger doses often help lower cholesterol

Pantothenic acid

Vitamin B5: Helps to metabolize energy; normalizes blood sugar levels, and helps the body to synthesize antibodies, some hormones, cholesterol, and hemoglobin (in the blood)

Riboflavin

Vitamin B2: Necessary to metabolize energy and helps the body’s adrenal function

Thiamine (thiamin)

Vitamin B1: Necessary to metabolize energy; needed for proper nerve function, normal digestion, and appetite

Vitamin B6

Pyridoxine, pyridoxamine, pyridoxal: Helps to metabolize proteins and carbohydrates (for energy) in the body; good for proper nerve function and helps synthesize red blood cells

Vitamin B12

Cyanocobalamin: Necessary to make DNA, RNA, red blood cells, and myelin (for the body’s nerve fibers); may help prevent heart disease in some people

Vitamin C

Ascorbic acid: Helps to build blood vessel walls and promote wound healing; necessary for iron absorption; said to help prevent atherosclerosis; considered to be an antioxidant

What are some health problems caused by vitamin deficiencies, especially for people with type 2 diabetes?

For people with diabetes (especially type 2), certain vitamin deficiencies can cause additional health problems. The following lists a few of the problems with vitamin deficiency:

Vitamin D-According to some studies, people with the lowest levels of vitamin D in their blood seem more likely to have insulin resistance. In some people, adding vitamin D to their diet-or even as supplements (taken under a doctor’s care, of course)-may help reverse insulin resistance. (But there is still a major quandary about vitamin D and diabetes: No one knows whether vitamin D causes lower levels of glucose in the blood or having diabetes lowers vitamin D.) This deficiency also causes muscle weakness and an increase in infections, something that people with diabetes have to watch carefully since higher blood glucose levels can compromise their immune system.

Vitamin E-One study indicated a deficiency in vitamin E, an antioxidant, is often seen in people with type 2 diabetes. It also found that people with diabetes had a lower amount of antioxidants in their systems.

Vitamin A-A study conducted in 2015 indicated that a deficiency in vitamin A-which boosts beta-cell activity-may play a role in the development of type 2 diabetes.

What oral medication for type 2 diabetes increases the risk for vitamin B2 deficiency?

According to several studies, the commonly prescribed oral medication for type 2 diabetes called metformin is thought to increase the risk for vitamin B2 deficiency-but the reason is still unknown. (There are several symptoms, including impaired memory, fatigue, and nerve problems in the hands and feet.) One study found that 10 to 30 percent of the participants who took the drug on a regular basis had problems with vitamin B2 absorption. Another study indicated that the problems with B2 levels increased for those who took a higher dose of the drug and who were on metformin for a long time. Thus, most researchers suggest that people who take metformin have their vitamin B2 levels checked periodically.

What is vitamin K?

N itamin K, discovered in the 1930s, is a fat-soluble vitamin linked to heart, bone, and brain health. It is also thought that vitamin K has a relationship with calcium and vitamin D, all of which are thought to be necessary for maintaining healthy bones. Good food sources are spinach, salad greens, broccoli, Brussels sprouts, and cabbage, along with some vegetable oils, including olive and canola. As supplements, vitamin K, as K1, can be from green plants (called phylioquinone). K2 is a form that is more readily absorbed and lasts longer in the body than K1. It is synthesized from bacteria (for supplements) and is found in some types of cheese. Most important, it is also synthesized in the digestive tract, which is why most people do not have to eat more foods rich in vitamin K or take supplements to get enough of the vitamin.

It is, indeed, possible to take too many vitamins, especially when it comes to fat-soluble ones, which can accumulate in the body over time.

Does vitamin K affect glucose levels in the body?

Although more studies need to be conducted, it is thought that vitamin K may help eliminate inflammation in the body. It may also help to improve insulin sensitivity and thus help to balance blood glucose levels.

Is it possible to take too many vitamins?

Yes, it is very possible to take excessive amounts of vitamins; the practice may cause health complications as serious as vitamin deficiencies. The clinical term for excessive intake of vitamins is hypervitaminosis. It occurs when the dietary intake of a vitamin exceeds the body’s ability to store, use, or excrete the vitamin. Hypervitaminosis is most common among the fat-soluble vitamins (vitamins A, D, E, and K) because the excessive quantities of the vitamins are usually stored in fat (lipid) tissues. In comparison, excessive amounts of water-soluble vitamins do not accumulate in the body since they are most often excreted in urine.

Are vitamin supplements necessary for a person with diabetes?

Vitamin supplements may be useful for individuals who do not receive all of the nutrients they need from their diet. These individuals either cannot or do not eat enough or do not eat enough of a variety of healthful foods; thus, they need extra vitamins and often minerals (see below). But for most people who eat a balanced, healthful diet, vitamin and mineral supplements are not necessary. If a person has-or does not have-diabetes, the best way to determine whether supplements are needed is to ask a health care provider or, in the case of a person with diabetes, a diabetes educator.

What unusual supplement has been suggested to control blood glucose?

The unusual supplement that has been suggested to control blood glucose levels is made from the native northern African plant aloe vera. Researchers gathered several clinical trials on this succulent plant and found that, taken as an oral supplement, it may reduce fasting blood glucose and HbA1c levels. But as with all unregulated supplements, the use of any supplement (or medicine, for that matter) that has not gone through rigorous clinical trials is highly debated. This is because there is no government regulation controlling such items. Even the researchers suggested that many more studies should be conducted to understand just how aloe vera affects the overall control of blood glucose-and even how it compares with treatments already available to people who have diabetes.

DIABETES AND MINERALS

What are macrominerals and microminerals?

The body contains or uses three types of minerals: macrominerals, microminerals, and electrolytes. The following lists the characteristics of each:

Macrominerals-Three to five percent of the average human body is composed of minerals. The macrominerals make up the majority-calcium, magnesium, and phosphorus. Most of the macrominerals are stored in the bones, but they also circulate in the blood. And as with vitamins, the best sources of macrominerals for the human body are natural or, in other words, ingested foods and not supplements, if possible.

Microminerals-Also called trace minerals, microminerals are found in lesser quantities in the human body, but all are necessary for health in varying quantities.

Electrolytes-The minerals dissolved in the body’s fluids are called electrolytes, all of which create electrically charged ions. The most important ones in terms of eating and health include sodium, potassium, and phosphate.

What are the most necessary minerals for our health?

The body needs a good amount of minerals-a combination of macrominerals, trace minerals, and electrolytes. The following lists these major minerals (not all are listed) and their role in human health (those associated with glucose and diabetes are italicized):

Essential Minerals

Mineral

Essential for Health

Macrominerals

Calcium

Best for building bones and teeth and vital to muscle and nerve function; helps in blood clotting; helps to maintain stable blood pressure; helps the body’s cells use insulin

Magnesium

Helps to stimulate bone growth; helps with metabolism and muscle function

Phosphorus

Found in some body enzymes; helps keep bones and teeth strong; necessary for metabolism

Trace Minerals (Microminerals)

Chromium

Helps insulin to metabolize glucose in the body

Copper

Needed for iron absorption in the body; helps with connective tissues, nerve fibers, and red blood cells, along with being a component of several of the body’s enzymes

Fluoride

Helps the body maintain strong bones and teeth

Iodine

Helps the body make thyroid hormones

Iron

Necessary to produce hemoglobin, by which the body transports oxygen

Manganese

Necessary for metabolism since it is a component of many body enzymes; helps in the formation of bones and tendons

Molybdenum

Necessary for the storage of iron in the body; necessary for metabolism since it is a component of many body enzymes

Selenium

Works with vitamin E to protect cell membranes from oxidation

Zinc

Helps certain enzymes in metabolism; necessary for growth and reproduction, along with supporting the body’s immune system

Electrolytes

Chloride

Helps to keep our body’s chemistry stable; used to make our digestive juices; seawater has almost the same concentration of chloride ion as human body fluids

Potassium

Necessary to maintain our body’s fluid balance; helps our metabolism and muscle function

Sodium

Along with potassium, helps to maintain the body’s fluid balance; also helps with muscle function

Bicarbonate

Listed in some research as an electrolyte; acts as a buffer to maintain the body’s normal levels of acidity in the blood and other fluids

Is there a connection between type 2 diabetes and the mineral magnesium?

Yes, in a study conducted in 2013, researchers found that there may be a connection between the amount of magnesium ingested and the risk of developing type 2 diabetes. About half of all Americans get enough magnesium, the mineral that helps bone growth and muscles. In the study of 2,500 adults without diabetes, the researchers found that the highest magnesium intake was associated with a 37 percent lower risk of developing prediabetes. Those with prediabetes and a higher magnesium intake showed a 32 percent lower risk for developing type 2 diabetes. But there is a caution: Diabetics with kidney disease (or anyone with kidney disease) should check with his or her doctor before increasing the intake of magnesium, whether by supplements or with foods.

Why do we need trace minerals for our health?

The trace minerals-chromium, copper, fluoride, iodine, iron, manganese, molybdenum, selenium, and zinc-all have their places in terms of a person’s health (see above for more information). For example, chromium acts like a key to unlock insulin, and without it, insulin would have a difficult time controlling blood sugar. It also helps to build proteins. Copper is needed to make red blood cells, skin pigment, connective tissues, and nerve fibers. It also helps the body to absorb iron. And iron is necessary for the pigment (color) in our blood, specifically the red blood cells that carry oxygen throughout the body.

What are symptoms of deficiencies of certain minerals?

There are several symptoms of macromineral, trace mineral, and electrolyte deficiencies. The following lists minerals (not all are listed) and symptoms if there is a major deficiency (the minerals associated with glucose and diabetes are italicized):

Mineral Deficiency Symptoms

Mineral

Result of Deficiency

Macrominerals

Calcium

In children, rickets; in at-risk adults, it can lead to osteoporosis (brittle, porous bones); may also indicate a lack of vitamin D, which helps the body to absorb calcium

Magnesium

Deficiency is rare but can be depleted by alcoholism, long-term diarrhea, liver or kidney disease, and severe diabetes; a deficiency is also often tied to high insulin levels and glucose intolerance that can lead to type 2 diabetes

Phosphorus

Lack of appetite, weight loss, or even obesity; it may cause irregular breathing, mental and physical fatigue, and nervous disorders

Trace Minerals (Microminerals)

Chromium

Even slight deficiencies can lead to problems with metabolizing glucose and upset the function of insulin levels

Copper

Although rare, deficiencies include low blood levels in children with edema or iron deficiency anemia; in adults, it may lead to general weakness, impaired respiration, and skin sores

Fluoride

Poor tooth development and dental caries (cavities)

Iodine

Enlarged thyroid (goiter) and hypothyroidism (low secretion of thyroid hormones); can lead to hardening of the arteries, obesity, sluggish metabolism, dry hair, slow mental reactions, rapid pulse, heart palpitations, tremors, nervousness, and irritability

Iron

Most common is iron-deficiency anemia; can lead to constipation, brittle nails or ridges in nails, lethargy, apathy, pallor, reduced brain function, headaches, and heart enlargement; can cause unusual food cravings (such as for ice, clay, and other non-food items; see sidebar)

Manganese

Mostly affects glucose tolerance, resulting in the inability to remove excess sugar from the blood by oxidation and/or storage, causing diabetes; can cause atherosclerosis; severe deficiencies can cause paralysis, convulsions, blindness, and deafness in infants; in adults, can cause dizziness, ear noises, and hearing loss

Molybdenum

Excessive deficiencies may cause fast heartbeat, increased rate of breathing, and visual problems

Selenium

May cause premature aging; major deficiencies may cause cataracts, liver necrosis, and growth retardation; low levels have been associated with several types of cancers, including bladder and colon cancers

Zinc

May show up in a diet high in grains and cereals and low in animal protein; it can cause retarded growth, delayed sexual maturity, and cause wounds to take longer to heal; it can cause brittle nails, and white spots on the nail may be a sign; it can also cause irregular menstrual cycles in teenage women and painful knee and hip joints in teens of both genders

Electrolytes

Chloride

A deficiency can cause hair and tooth loss, poor muscular contractions, and impaired digestion; it also usually means there is a deficiency of sodium in the body

Potassium

An abnormal decrease (hypokalemia) or increase (hyperkalemia) affects the nervous system, and both can increase the chance for arrhythmias (irregular heartbeats); both can also affect the kidneys

Sodium

A major deficiency can cause intestinal gas, weight loss, poor memory, short attention span, difficulty in concentrating, muscle weakness, low blood sugar, and heart palpitations

Bicarbonate

Listed in most research as an electrolyte; difficult to determine a deficiency in some cases, and deficiencies are often connected to other conditions, such as kidney disease, respiratory function, and metabolic conditions

What is iron-deficiency anemia?

Iron-deficiency anemia is also called hypochromic anemia. It occurs when the amount of hemoglobin in the red blood cells is reduced and, as a result, the cells become smaller. Because of this, the oxygen-carrying capacity of the blood is reduced. Those at risk are usually women of child-bearing years (especially pregnant or lactating), older infants, children, and people with certain dietary restrictions, such as those with diabetes, the elderly, low-income people, and minorities. It is also estimated that one in four college women is deficient in iron, most often from menstruation and not eating as healthfully while in school.

Can a person with diabetes become anemic?

Yes, just as with non-diabetics, the lack of iron in people with diabetes can lead to anemia. In fact, it is estimated that 25 percent of people with diabetes are anemic. It is thought that anemia occurs in people with diabetes because the erythropoietin, the hormone that controls the production of red blood cells, is produced in the kidneys. Since one complication of diabetes is kidney damage, the two conditions are often found together. In addition, if a person with diabetes has anemia, his or her blood glucose levels can be affected, with some reports of blood glucose test results being 20 percent too high. This is why it is important-especially for people with type 1 diabetes and their health care providers-to be aware of this combination.

Anemia occurs when one’s blood is deficient in red cells. Since diabetics often have damaged kidneys, leading to lower amounts of erythropoietin, they may produce fewer red blood cells and become anemic.

What is potassium and its connection to glucose in the body?

Potassium, along with sodium, is a very necessary mineral that helps to regulate the body’s balance of fluids. It is also necessary for our metabolism, helps in the transmission of nerve impulses, and is needed for muscle function. Further, it regulates the transfer of nutrients to the cells and functions in the chemical reactions within the cells. It is important to our bodies’ sugar levels, helping to convert glucose into glycogen so it can be stored in the liver. Potassium also helps stimulate the kidneys to eliminate our toxic body wastes and acts with sodium to help normalize our heartbeats.

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