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Am I a diabetic, or do I have diabetes?
I have many patients who say to me, “I have been a diabetic for fifteen years…” and then go on to ask their question. But when I speak to them or to any audience about diabetes, I never refer to them as being “a diabetic.” I prefer to say “someone with diabetes.” You may think this is a trivial distinction, but I don’t. Many people, including me, are offended when they hear someone in crutches and leg braces being called “a spastic,” and someone who has occasional brain seizures being called “an epileptic.” As far as I am concerned, the diseases and problems that you have to deal with every day do not define who you are as a person. To me, the patients whom I try to help are all interesting and very different people with all sorts of jobs, families, hobbies, and stories to tell. They just happen to have diabetes as well. This is a significant burden to add to their lives, but it does not define who they are. Throughout this book I will try to give useful and practical answers to questions that you might have about having diabetes and living with diabetes, but I will not refer to you or anyone else as being a diabetic.

Should I say blood glucose or blood sugar?
This is a minor thing to make a fuss about. When patients say to me, “Why are my blood sugars so high in the morning, Dr. McCulloch?” they are being quite correct. But since I use the term so often throughout the book, I want to explain why I prefer to talk about blood glucose rather than blood sugar. Sugars are refined (or “simple”) forms of carbohydrate. The basic building block of carbohydrates is a molecule with six carbon atoms joined together in a ring. Glucose is one example of a simple six-carbon sugar molecule. This is the form of sugar that floats around in your blood and gives energy to your muscles and brain and other parts of your body. There are other six-carbon sugar molecules, like fructose and galactose. Table sugar is a larger molecule called sucrose, which is made up of joining a glucose and a fructose molecule together. Starches like bread, rice, potatoes, and pasta are more “complex” kinds of carbohydrate where hundreds of six-carbon sugar building blocks are joined together. Because I will be talking about different kinds of carbohydrates and sugars in answering questions about the food we eat, I am going to refer to the sugar that floats around in your blood (and causes so much frustration and stress to you!) by its proper name—blood glucose.

What is a hormone?
A hormone is a substance that is made in special cells in one part of your body and then gets pushed into the blood, where it travels to other parts of your body to have its effect. For example, special cells in the thyroid gland in your neck make thyroid hormones that get sent all over your body to help all your muscles and bones and nerves and other cells work properly. Groups of cells that make hormones are called endocrine glands, so your thyroid gland is an endocrine gland. Insulin is a hormone, so the pancreas is another endocrine gland. When your body does not make enough insulin or does not respond to it properly, it can lead to diabetes, so I will talk a lot about insulin in this book. I will also mention quite a few other hormones that affect your blood glucose.

 

Acknowledgements Introduction Some Questions Before We Start Part One: The Big Picture Chapter 1: Causes of Diabetes Chapter 2: Types of Diabetes Chapter 3: Diagnosis Chapter 4: Prevention Chapter 5: Cure Part Two: Staying Healthy Longer Chapter 6: Reducing Cardiovascular Risk Chapter 7: Blood Glucose Control Chapter 8: Hypoglycemia Chapter 9: Preventing Eye Damage Chapter 10: Preventing Kidney Damage Chapter 11: Nerve Damage: Feet and Legs Chapter 12: Nerve Damage: Less Common Forms Part Three: Living with Diabetes Chapter 13: Monitoring Blood Glucose Chapter 14: Interpreting Glucose Results Chapter 15: Eating Right Chapter 16: Losing Weight Chapter 17: Carbohydrate Counting Chapter 18: Healthy Exercise Chapter 19: Stress and Diabetes Chapter 20: Drugs for Type 2 Diabetes Chapter 21: Insulin Resistance Drugs Chapter 22: Insulin Production Drugs Chapter 23: Other Drugs Chapter 24: Going on Insulin Chapter 25: Insulin Basics Chapter 26: Insulin Management Chapter 27: Advanced Insulin Management Chapter 28: Traveling and Diabetes Chapter 29: Alternative Therapies Part Four: Staying Positive Chapter 30: Making a Good Plan Chapter 31: Getting Support Glossary Index About the Author

Dr. David K. McCulloch (Seattle) is a clinical professor of medicine at the University of Washington in Seattle. Since 1994, he has been the senior diabetes specialist for a large healthcare organization in Washington. He has also been the diabetes chair in several national efforts to improve diabetes care.

 

Diabetes Answer Book by David McCulloch
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