I enjoy reading and writing about healthy living. I also enjoy a Mediterranean-style diet. My blog offers practical tips to help you lose weight, lower cholesterol, and reduce your risk of cardiovascular disease and other chronic diseases.
Cholesterol plaque in artery with Human heart anatomy. 3d illustration
Hyperlipidemia (high cholesterol) is an excess of lipids or fats in your blood. This can increase your risk of heart attack and stroke because blood can’t flow through your arteries easily. Adding exercise and healthy foods can lower your cholesterol. Some people need medication as well. Managing your cholesterol is a long-term effort.
What is hyperlipidemia?
Hyperlipidemia, also known as dyslipidemia or high cholesterol, means you have too many lipids (fats) in your blood. Your liver creates cholesterol to help you digest food and make things like hormones. But you also eat cholesterol in foods from the meat and dairy aisles. As your liver can make as much cholesterol as you need, the cholesterol in foods you eat is extra.
Too much cholesterol (200 mg/dL to 239 mg/dL is borderline high and 240 mg/dL is high) isn’t healthy because it can create roadblocks in your artery highways where blood travels around to your body. This damages your organs that don’t receive enough blood from your arteries.
Bad cholesterol (LDL) is the most dangerous type because it causes hardened cholesterol deposits (plaque) to collect inside of your blood vessels. This makes it harder for your blood to get through, which puts you at risk for a stroke or heart attack. The plaque itself can be irritated or inflamed, which can cause a clot to form around it. This can cause a stroke or heart attack depending on where the blockage is.
Think of cholesterol, a kind of fat, as traveling in lipoprotein cars through your blood.
Low-density lipoprotein (LDL) is known as bad cholesterol because it can clog your arteries like a large truck that broke down and is blocking a traffic lane. (Borderline high number: 130 mg/dL to 159 mg/dL. High: 160 mg/dL to 189 mg/dL.)
Very low-density lipoprotein (VLDL) is also called bad because it carries triglycerides that add to artery plaque. This is another type of traffic blocker.
High-density lipoprotein (HDL) is known as good cholesterol because it brings cholesterol to your liver, which gets rid of it. This is like the tow truck that removes the broken down vehicles from the traffic lanes so vehicles can move. In this case, it’s clearing the way for your blood to get through your blood vessels. For your HDL, you don’t want to have a number lower than 40 mg/dL.
It’s important to know that providers consider other factors in addition to your cholesterol numbers when they make treatment decisions.
What is dyslipidemia vs. hyperlipidemia?
They’re mostly interchangeable terms for abnormalities in cholesterol. Your cholesterol can be “dysfunctional” (cholesterol particles that are very inflammatory or an abnormal balance between bad and good cholesterol levels) without being high.
Both a high level of cholesterol and increased inflammation in “normal” cholesterol levels put you at increased risk for heart disease. Your providers may use both terms to refer to a problem with your cholesterol levels, and both mean that you should do something to bring the levels down.
How common is hyperlipidemia?
Hyperlipidemia is very common. Ninety-three million American adults (age 20 and older) have a total cholesterol count above the recommended limit of 200 mg/dL.
How serious is high cholesterol?
Hyperlipidemia can be very serious if it’s not managed. As long as high cholesterol is untreated, you’re letting plaque accumulate inside of your blood vessels. This can lead to a heart attack or stroke because your blood has a hard time getting through your blood vessels. This deprives your brain and heart of the nutrients and oxygen they need to function.
Cardiovascular disease is the leading cause of death in Americans.
How does hyperlipidemia (high cholesterol) affect my body?
Hyperlipidemia (high cholesterol) that’s not treated can allow plaque to collect inside of your body’s blood vessels (atherosclerosis). This can bring on hyperlipidemia complications that include:
Early on, you feel normal when you have high cholesterol. It doesn’t give you symptoms. However, after a while, plaque buildup (made of cholesterol and fats) can slow down or stop blood flow to your heart or brain. The symptoms of coronary artery disease can include chest pain with exertion, jaw pain and shortness of breath.
When a plaque of cholesterol ruptures and a clot covers it, it closes off an entire artery. This is a heart attack, and the symptoms include severe chest pain, flushing, nausea and difficulty breathing. This is a medical emergency.
Are there any warning signs of high cholesterol?
Most people don’t have symptoms when their cholesterol is high. People who have a genetic problem with cholesterol clearance that causes very high cholesterol levels may get xanthomas (waxy, fatty plaques on their skin) or corneal arcus (cholesterol rings around the iris of their eye). Conditions such as obesity have a link to high cholesterol, and this may prompt a provider to evaluate your cholesterol level.
What causes cholesterol to get high?
Various hyperlipidemia causes include:
Smoking.
Drinking a lot of alcohol.
Eating foods that have a lot of saturated fats or trans fats.
Sitting too much instead of being active.
Being stressed.
Inheriting genes that make your cholesterol levels unhealthy.
Being overweight.
Medications that are helpful for some problems can make your cholesterol levels fluctuate, such as:
People who need medicine to treat their high cholesterol usually take statins. Statins are a type of medication that decreases how much bad cholesterol is circulating in your blood. Your provider may order a different type of medicine if:
You can’t take a statin.
You need another medicine in addition to a statin.
You have familial hypercholesterolemia, a genetic problem that makes your bad (LDL) cholesterol number extremely high.
Are there side effects of hyperlipidemia (high cholesterol) treatment?
Any medication can have side effects, but the benefits of statins far outweigh the risks of minor side effects. Let your provider know if you aren’t doing well on your medicine so they can develop a plan to manage your symptoms.
How soon will the hyperlipidemia (high cholesterol) treatment start working?
Your provider will order another blood test about two or three months after you start taking hyperlipidemia medication. The test results will show if your cholesterol levels have improved, which means the medicine and/or lifestyle changes are working. The risk of cholesterol causing damage to your body is a long-term risk, and people usually take cholesterol-lowering treatments for a long time.
How can I reduce my risk of hyperlipidemia?
Even children can get their blood checked for high cholesterol, especially if someone in the child’s family had a heart attack, stroke or high cholesterol. Children and young adults can get checked every five years.
Once you reach middle age, you should have your cholesterol checked every year or two. Your healthcare provider can help you decide how often you should have a hyperlipidemia screening.
How can I prevent hyperlipidemia (high cholesterol)?
Changes you make in your life can keep you from getting hyperlipidemia. Things you can do include:
Don’t buy snacks that have “trans fat” on the label.
Stay at a healthy weight.
What can I expect if I have hyperlipidemia?
If you have hyperlipidemia, you’ll need to keep using healthy lifestyle habits for years to come. You’ll also need to keep follow-up appointments with your provider and continue to take your medicine. If you and your provider are able to manage your cholesterol level, you may not have serious health problems as a result of it.
How long will you have hyperlipidemia?
Hyperlipidemia is a condition you’ll need to manage for the rest of your life.
What is the outlook for hyperlipidemia (high cholesterol)?
Although high cholesterol puts you at risk for heart attacks and stroke, you can protect yourself by living a healthier lifestyle and taking medicine if needed.
How do I take care of myself with hyperlipidemia?
Be sure to follow your provider’s instructions for making your lifestyle healthier.
Here are things you can do yourself:
Exercise.
Stop smoking.
Sleep at least seven hours each night.
Manage your stress level.
Eat healthier foods.
Limit how much alcohol you drink.
Stay at a healthy weight.
Other things you can do:
If your provider ordered medicine for you, be sure to keep taking it as the label tells you to do.
Talk to your provider about estimating your risk of heart disease and stroke so they can manage your risk effectively.
Call 911 if you think you’re having a heart attack or stroke.
What questions should I ask my doctor?
Do I need to make lifestyle changes, take medication or both?
If I do what you tell me to do, how quickly can my numbers improve?
How often do I need to check in with you?
A note from QBan Health Services
Hyperlipidemia, or high cholesterol, can let plaque collect inside of your blood vessels and put you at risk of a heart attack or stroke. The good news is that you have the power to reduce your risk of heart attack and stroke. Exercising more and eating healthier are just two of the ways you can improve your cholesterol numbers. Taking medicine your provider orders makes a difference, too.
If you have diabetes, your body isn’t able to properly process and use glucose from the food you eat. There are different types of diabetes, each with different causes, but they all share the common problem of having too much glucose in your bloodstream. Treatments include medications and/or insulins. Some types of diabetes can be prevented by adopting a healthy lifestyle.
What is diabetes?
Diabetes happens when your body isn’t able to take up sugar (glucose) into its cells and use it for energy. This results in a buildup of extra sugar in your bloodstream.
Mismanagement of diabetes can lead to serious consequences, causing damage to a wide range of your body’s organs and tissues — including your heart, kidneys, eyes and nerves.
Why is my blood glucose level high? How does this happen?
The process of digestion includes breaking down the food you eat into various different nutrient sources. When you eat carbohydrates (for example, bread, rice, pasta), your body breaks this down into sugar (glucose). When glucose is in your bloodstream, it needs help – a “key” – to get into its final destination where it’s used, which is inside your body’s cells (cells make up your body’s tissues and organs). This help or “key” is insulin.
Insulin is a hormone made by your pancreas, an organ located behind your stomach. Your pancreas releases insulin into your bloodstream. Insulin acts as the “key” that unlocks the cell wall “door,” which allows glucose to enter your body’s cells. Glucose provides the “fuel” or energy tissues and organs need to properly function.
If you have diabetes:
Your pancreas doesn’t make any insulin or enough insulin.
Or
Your pancreas makes insulin but your body’s cells don’t respond to it and can’t use it as it normally should.
If glucose can’t get into your body’s cells, it stays in your bloodstream and your blood glucose level rises.
What are the different types of diabetes?
The types of diabetes are:
Type 1 diabetes: This type is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed. Up to 10% of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults (but can develop at any age). It was once better known as “juvenile” diabetes. People with Type 1 diabetes need to take insulin every day. This is why it is also called insulin-dependent diabetes.
Type 2 diabetes: With this type, your body either doesn’t make enough insulin or your body’s cells don’t respond normally to the insulin. This is the most common type of diabetes. Up to 95% of people with diabetes have Type 2. It usually occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes. Your parents or grandparents may have called it “having a touch of sugar.”
Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
Gestational diabetes: This type develops in some women during their pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes you’re at higher risk of developing Type 2 diabetes later on in life.
Less common types of diabetes include:
Monogenic diabetes syndromes: These are rare inherited forms of diabetes accounting for up to 4% of all cases. Examples are neonatal diabetes and maturity-onset diabetes of the young.
Cystic fibrosis-related diabetes: This is a form of diabetes specific to people with this disease.
Drug or chemical-induced diabetes: Examples of this type happen after organ transplant, following HIV/AIDS treatment or are associated with glucocorticoid steroid use.
Diabetes insipidus is a distinct rare condition that causes your kidneys to produce a large amount of urine.
How common is diabetes?
Some 34.2 million people of all ages – about 1 in 10 – have diabetes in the U.S. Some 7.3 million adults aged 18 and older (about 1 in 5) are unaware that they have diabetes (just under 3% of all U.S. adults). The number of people who are diagnosed with diabetes increases with age. More than 26% of adults age 65 and older (about 1 in 4) have diabetes.
Who gets diabetes? What are the risk factors?
Factors that increase your risk differ depending on the type of diabetes you ultimately develop.
Risk factors for Type 1 diabetes include:
Having a family history (parent or sibling) of Type 1 diabetes.
Injury to the pancreas (such as by infection, tumor, surgery or accident).
Presence of autoantibodies (antibodies that mistakenly attack your own body’s tissues or organs).
Physical stress (such as surgery or illness).
Exposure to illnesses caused by viruses.
Risk factors for prediabetes and Type 2 diabetes include:
Family history (parent or sibling) of prediabetes or Type 2 diabetes.
Being Black, Hispanic, Native American, Asian-American race or Pacific Islander.
Family history (parent or sibling) of prediabetes or Type 2 diabetes.
Being African-American, Hispanic, Native American or Asian-American.
Having overweight/obesity before your pregnancy.
Being over 25 years of age.
What causes diabetes?
The cause of diabetes, regardless of the type, is having too much glucose circulating in your bloodstream. However, the reason why your blood glucose levels are high differs depending on the type of diabetes.
Causes of Type 1 diabetes: This is an immune system disease. Your body attacks and destroys insulin-producing cells in your pancreas. Without insulin to allow glucose to enter your cells, glucose builds up in your bloodstream. Genes may also play a role in some patients. Also, a virus may trigger the immune system attack.
Cause of Type 2 diabetes and prediabetes: Your body’s cells don’t allow insulin to work as it should to let glucose into its cells. Your body’s cells have become resistant to insulin. Your pancreas can’t keep up and make enough insulin to overcome this resistance. Glucose levels rise in your bloodstream.
Gestational diabetes: Hormones produced by the placenta during your pregnancy make your body’s cells more resistant to insulin. Your pancreas can’t make enough insulin to overcome this resistance. Too much glucose remains in your bloodstream.
In men: Decreased sex drive, erectile dysfunction, decreased muscle strength.
Type 1 diabetes symptoms: Symptoms can develop quickly – over a few weeks or months. Symptoms begin when you’re young – as a child, teen or young adult. Additional symptoms include nausea, vomiting or stomach pains and yeast infections or urinary tract infections.
Type 2 diabetes and prediabetes symptoms: You may not have any symptoms at all or may not notice them since they develop slowly over several years. Symptoms usually begin to develop when you’re an adult, but prediabetes and Type 2 diabetes is on the rise in all age groups.
Gestational diabetes: You typically will not notice symptoms. Your obstetrician will test you for gestational diabetes between 24 and 28 weeks of your pregnancy.
What are the complications of diabetes?
If your blood glucose level remains high over a long period of time, your body’s tissues and organs can be seriously damaged. Some complications can be life-threatening over time.
In the mother:Preeclampsia (high blood pressure, excess protein in urine, leg/feet swelling), risk of gestational diabetes during future pregnancies and risk of diabetes later in life.
In the newborn: Higher-than-normal birth weight, low blood sugar (hypoglycemia), higher risk of developing Type 2 diabetes over time and death shortly after birth.
How is diabetes diagnosed?
Diabetes is diagnosed and managed by checking your glucose level in a blood test. There are three tests that can measure your blood glucose level: fasting glucose test, random glucose test and A1c test.
Fasting plasma glucose test: This test is best done in the morning after an eight hour fast (nothing to eat or drink except sips of water).
Random plasma glucose test: This test can be done any time without the need to fast.
A1c test: This test, also called HbA1C or glycated hemoglobin test, provides your average blood glucose level over the past two to three months. This test measures the amount of glucose attached to hemoglobin, the protein in your red blood cells that carries oxygen. You don’t need to fast before this test.
Oral glucose tolerance test: In this test, blood glucose level is first measured after an overnight fast. Then you drink a sugary drink. Your blood glucose level is then checked at hours one, two and three.
Type of test
Normal (mg/dL)
Prediabetes (mg/dL)
Diabetes (mg/dL)
Fasting glucose test
Less than 100
100-125
126 or higher
Random (anytime) glucose test
Less than 140
140-199
200 or higher
A1c test
Less than 5.7%
5.7 – 6.4%
6.5% or higher
Oral glucose tolerance test
Less than 140
140-199
200 or higher
Gestational diabetes tests: There are two blood glucose tests if you are pregnant. With a glucose challenge test, you drink a sugary liquid and your glucose level is checked one hour later. You don’t need to fast before this test. If this test shows a higher than normal level of glucose (over 140 ml/dL), an oral glucose tolerance test will follow (as described above).
Type 1 diabetes: If your healthcare provider suspects Type 1 diabetes, blood and urine samples will be collected and tested. The blood is checked for autoantibodies (an autoimmune sign that your body is attacking itself). The urine is checked for the presence of ketones (a sign your body is burning fat as its energy supply). These signs indicate Type 1 diabetes.
Who should be tested for diabetes?
If you have symptoms or risk factors for diabetes, you should get tested. The earlier diabetes is found, the earlier management can begin and complications can be lessened or prevented. If a blood test determines you have prediabetes, you and your healthcare professional can work together to make lifestyle changes (e.g. weight loss, exercise, healthy diet) to prevent or delay developing Type 2 diabetes.
Additional specific testing advice based on risk factors:
Testing for Type 1 diabetes: Test in children and young adults who have a family history of diabetes. Less commonly, older adults may also develop Type 1 diabetes. Therefore, testing in adults who come to the hospital and are found to be in diabetes-related ketoacidosis is important. Ketoacidosis a dangerous complication that can occur in people with Type 1 diabetes.
Testing for type 2 diabetes: Test adults age 45 or older, those between 19 and 44 who have overweight/obesity and have one or more risk factors, women who have had gestational diabetes, children between 10 and 18 who overweight/obesity and have at least two risk factors for type 2 diabetes.
Gestational diabetes: Test all pregnant women who have had a diagnosis of diabetes. Test all pregnant women between weeks 24 and 28 of their pregnancy. If you have other risk factors for gestational diabetes, your obstetrician may test you earlier.
How is diabetes managed?
Diabetes affects your whole body. To best manage diabetes, you’ll need to take steps to manage your risk factors, including:
Keep your blood glucose levels as near to normal as possible by following a diet plan, taking prescribed medication and increasing your activity level.
Maintain your blood cholesterol (HDL and LDL levels) and triglyceride levels as near the normal ranges as possible.
Manage your blood pressure. Your blood pressure should not be over 140/90 mmHg.
You hold the keys to managing your diabetes by:
Planning what you eat and following a healthy meal plan. Follow a Mediterranean diet (vegetables, whole grains, beans, fruits, healthy fats, low sugar) or Dash diet. These diets are high in nutrition and fiber and low in fats and calories. See a registered dietitian for help understanding nutrition and meal planning.
Exercising regularly. Try to exercise at least 30 minutes most days of the week. Walk, swim or find some activity you enjoy.
How do I check my blood glucose level? Why is this important?
Checking your blood glucose level is important because the results help guide decisions about what to eat, your physical activity and any needed medication and insulin adjustments or additions.
The most common way to check your blood glucose level is with a blood glucose meter. With this test, you prick the side of your finger, apply the drop of blood to a test strip, insert the strip into the meter and the meter will show your glucose level at that moment in time. Your healthcare provider will tell you how often you’ll need to check your glucose level.
What is continuous glucose monitoring?
Advancements in technology have given us another way to monitor glucose levels. Continuous glucose monitoring uses a tiny sensor inserted under your skin. You don’t need to prick your finger. Instead, the sensor measures your glucose and can display results anytime during the day or night. Ask your healthcare provider about continuous glucose monitors to see if this is an option for you.
What should my blood glucose level be?
Ask your healthcare team what your blood glucose level should be. They may have a specific target range for you. In general, though, most people try to keep their blood glucose levels at these targets:
Before a meal: between 80 and 130 mg/dL.
About two hours after the start of a meal: less than 180 mg/dL.
What happens if my blood glucose level is low?
Having a blood glucose level that is lower than the normal range (usually below 70 mg/dL) is called hypoglycemia. This is a sign that your body gives out that you need sugar.
Symptoms you might experience if you have hypoglycemia include:
Weakness or shaking.
Moist skin, sweating.
Fast heartbeat.
Dizziness.
Sudden hunger.
Confusion.
Pale skin.
Numbness in mouth or tongue.
Irritability, nervousness.
Unsteadiness.
Nightmares, bad dreams, restless sleep.
Blurred vision.
Headaches, seizures.
You might pass out if your hypoglycemia is not managed.
What happens if my blood glucose level is high?
If you have too much glucose in your blood, you have a condition called hyperglycemia. Hyperglycemia is defined as:
A blood glucose level greater than 125 mg/dL while in the fasting state (nothing to eat or drink for at least eight hours).
or
A blood glucose level greater than 180 mg/dL one to two hours after eating.
How is diabetes treated?
Treatments for diabetes depend on your type of diabetes, how well managed your blood glucose level is and your other existing health conditions.
Type 1 diabetes: If you have this type, you must take insulin every day. Your pancreas no longer makes insulin.
Type 2 diabetes: If you have this type, your treatments can include medications (both for diabetes and for conditions that are risk factors for diabetes), insulin and lifestyle changes such as losing weight, making healthy food choices and being more physically active.
Prediabetes: If you have prediabetes, the goal is to keep you from progressing to diabetes. Treatments are focused on treatable risk factors, such as losing weight by eating a healthy diet (like the Mediterranean diet) and exercising (at least five days a week for 30 minutes). Many of the strategies used to prevent diabetes are the same as those recommended to treat diabetes (see prevention section of this article).
Gestational diabetes: If you have this type and your glucose level is not too high, your initial treatment might be modifying your diet and getting regular exercise. If the target goal is still not met or your glucose level is very high, your healthcare team may start medication or insulin.
Oral medications and insulin work in one of these ways to treat your diabetes:
Stimulates your pancreas to make and release more insulin.
Slows down the release of glucose from your liver (extra glucose is stored in your liver).
Blocks the breakdown of carbohydrates in your stomach or intestines so that your tissues are more sensitive to (better react to) insulin.
Helps rid your body of glucose through increased urination.
What oral medications are approved to treat diabetes?
Over 40 medications have been approved by the Food and Drug Administration for the treatment of diabetes. It’s beyond the scope of this article to review all of these drugs. Instead, we’ll briefly review the main drug classes available, how they work and present the names of a few drugs in each class. Your healthcare team will decide if medication is right for you. If so, they’ll decide which specific drug(s) are best to treat your diabetes.
Diabetes medication drug classes include:
Sulfonylureas: These drugs lower blood glucose by causing the pancreas to release more insulin. Examples include glimepiride (Amaryl®), glipizide (Glucotrol®) and glyburide (Micronase®, DiaBeta®).
Glinides (also called meglitinides): These drugs lower blood glucose by getting the pancreas to release more insulin. Examples include repaglinide (Prandin®) and nateglinide (Starlix®).
Biguanides: These drugs reduce how much glucose the liver produces. It also improves how insulin works in the body, and slows down the conversion of carbohydrates into sugar. Metformin (Glucophage®) is the example.
Alpha-glucosidase inhibitors: These drugs lower blood glucose by delaying the breakdown of carbohydrates and reducing glucose absorption in the small intestine. An example is acarbose (Precose®).
Thiazolidinediones: These drugs improve the way insulin works in the body by allowing more glucose to enter into muscles, fat and the liver. Examples include pioglitazone (Actos®) and rosiglitazone (Avandia®).
GLP-1 analogs (also called incretin mimetics or glucagon-like peptide-1 receptor agonists): These drugs increase the release of insulin, reduce glucose release from the liver after meals and delay food emptying from the stomach. Examples include exenatide (Byetta®), liraglutide (Victoza®), albiglutide (Tanzeum®), semaglutide (Rybelsus®) and dulaglutide (Trulicity®).
DPP-4 inhibitors (also called dipeptidyl peptidase-4 inhibitors): These drugs help your pancreas release more insulin after meals. They also lower the amount of glucose released by the liver. Examples include alogliptin (Nesina®), sitagliptin (Januvia®), saxagliptin (Onglyza®) and linagliptin (Tradjenta®).
SGLT2 inhibitors (also called sodium-glucose cotransporter 2 inhibitors): These drugs work on your kidneys to remove glucose in your body through your urine. Examples include canagliflozin (Invokana®), dapagliflozin (Farxiga®) and empagliflozin (Jardiance®).
Bile acid sequestrants: These drugs lower cholesterol and blood sugar levels. Examples include colestipol (Colestid®), cholestyramine (Questran®) and colesevelam (Welchol®).
Dopamine agonist: This medication lowers the amount of glucose released by the liver. An example is bromocriptine (Cyclocet®).
Many oral diabetes medications may be used in combination or with insulin to achieve the best blood glucose management. Some of the above medications are available as a combination of two medicines in a single pill. Others are available as injectable medications, for example, the GLP-1 agonist semaglutide (Ozempic®) and lixisenatide (Adlyxin®).
Always take your medicine exactly as your healthcare prescribes it. Discuss your specific questions and concerns with them.
What insulin medications are approved to treat diabetes?
There are many types of insulins for diabetes. If you need insulin, you healthcare team will discuss the different types and if they are to be combined with oral medications. To follow is a brief review of insulin types.
Rapid-acting insulins: These insulins are taken 15 minutes before meals, they peak (when it best lowers blood glucose) at one hour and work for another two to four hours. Examples include insulin glulisine (Apidra®), insulin lispro (Humalog®) and insulin aspart (NovoLog®).
Short-acting insulins: These insulins take about 30 minutes to reach your bloodstream, reach their peak effects in two to three hours and last for three to six hours. An example is insulin regular (Humulin R®).
Intermediate-acting insulins: These insulins reach your bloodstream in two to four hours, peak in four to 12 hours and work for up to 18 hours. An example in NPH.
Long-acting insulins: These insulins work to keep your blood sugar stable all day. Usually, these insulins last for about 18 hours. Examples include insulin glargine (Basaglar®, Lantus®, Toujeo®), insulin detemir (Levemir®) and insulin degludec (Tresiba®).
There are insulins that are a combination of different insulins. There are also insulins that are combined with a GLP-1 receptor agonist medication (e.g. Xultophy®, Soliqua®).
How is insulin taken? How many different ways are there to take insulin?
Insulin is available in several different formats. You and your healthcare provider will decide which delivery method is right for you based on your preference, lifestyle, insulin needs and insurance plan. Here’s a quick review of available types.
Needle and syringe: With this method, you’ll insert a needle into a vial of insulin, pull back the syringe and fill the needle with the proper dose of insulin. You’ll inject the insulin into your belly or thigh, buttocks or upper arm – rotating the injection spots. You may need to give yourself one or more shots a day to maintain your target blood glucose level.
Insulin pen: This device looks like a pen with a cap. They come prefilled with insulin or with insulin cartridges that are inserted and replaced after use.
Insulin pump: Insulin pumps are small, computerized devices, about the size of a small cell phone that you wear on your belt, in your pocket, or under your clothes. They deliver rapid-acting insulin 24 hours a day through a small flexible tube called a cannula. The cannula is inserted under the skin using a needle. The needle is then removed leaving only the flexible tube under the skin. You replaces the cannula every two to three days. Another type of insulin pump is attached directly to your skin and does not use tubes.
Artificial pancreas (also called a closed loop insulin delivery system): This system uses an insulin pump linked to a continuous glucose monitor. The monitor checks your blood glucose levels every five minutes and then the pump delivers the needed dose of insulin.
Insulin inhaler: Inhalers allow you to breath in powdered inhaler through an inhaler device that you insert into your mouth. The insulin is inhaled into your lungs, then absorbed into your bloodstream. Inhalers are only approved for use by adults with Type 1 or Type 2 diabetes.
Insulin injection port: This delivery method involves the placement of a short tube into tissue beneath your skin. The port is held in place with an adhesive patch. You use a needle and syringe or insulin pen and inject the insulin through this port. The port is changed every few days. The port provides a single site for injection instead of having to rotate injection sites.
Jet injector: This is a needleless delivery method that uses high pressure to send a fine spray of insulin through your skin.
Are there other treatment options for diabetes?
Yes. There are two types of transplantations that might be an option for a select number of patients who have Type 1 diabetes. A pancreas transplant is possible. However, getting an organ transplant requires taking immune-suppressing drugs for the rest of your life and dealing with the side effects of these drugs. However, if the transplant is successful, you’ll likely be able to stop taking insulin.
Another type of transplant is a pancreatic islet transplant. In this transplant, clusters of islet cells (the cells that make insulin) are transplanted from an organ donor into your pancreas to replace those that have been destroyed.
Another treatment under research for Type 1 diabetes is immunotherapy. Since Type 1 is an immune system disease, immunotherapy holds promise as a way to use medication to turn off the parts of the immune system that cause Type 1 disease.
Bariatric surgery is another treatment option that’s an indirect treatment for diabetes. Bariatric surgery is an option if you have Type 2 diabetes, have obesity (body mass index over 35) and considered a good candidate for this type of surgery. Much improved blood glucose levels are seen in people who have lost a significant amount of weight.
Of course other medications are prescribed to treat any existing health problems that contribute to increasing your risk of developing diabetes. These conditions include high blood pressure, high cholesterol and other heart-related diseases.
Can prediabetes, Type 2 diabetes and gestational diabetes be prevented?
Although diabetes risk factors like family history and race can’t be changed, there are other risk factors that you can manage, to an extent. Adopting some of the healthy lifestyle habits listed below can improve these modifiable risk factors and help to decrease your chances of getting diabetes:
Eat a healthy diet, such as the Mediterranean or Dash diet. Keep a food diary and calorie count of everything you eat. Cutting 250 calories per day can help you lose ½ pound per week.
Get physically active. Aim for 30 minutes a day at least five days a week. Start slow and work up to this amount or break up these minutes into more doable 10-minute segments. Walking is great exercise.
Work to achieve a weight that’s healthy for you. Don’t lose weight if you are pregnant, but check with your obstetrician about healthy weight gain during your pregnancy.
Lower your stress. Learn relaxation techniques, deep breathing exercises, mindful meditation, yoga and other helpful strategies.
Limit alcohol intake. Men should drink no more than two beverages containing alcohol a day; women should drink no more than one.
Get an adequate amount of sleep (typically 7 to 9 hours).
Take medications as directed by your healthcare provider to manage existing risk factors for heart disease (like high blood pressure, cholesterol) or to reduce the risk of developing Type 2 diabetes.
If you think you have symptoms of prediabetes, see your provider.
Can Type 1 diabetes be prevented?
No. Type 1 diabetes is an autoimmune disease, meaning your body attacks itself. Scientists aren’t sure why someone’s body would attack itself. Other factors may be involved too, such as genetic changes.
Can the long-term complications of diabetes be prevented?
Chronic complications are responsible for most illness and death associated with diabetes. Chronic complications usually appear after several years of elevated blood sugars (hyperglycemia). Since patients with Type 2 diabetes may have elevated blood sugars for several years before being diagnosed, these patients may have signs of complications at the time of diagnosis.
The complications of diabetes have been described earlier in this article. Although the complications can be wide ranging and affect many organ systems, there are many basic principles of prevention that are shared in common. These include:
Take your diabetes medications (pills and/or insulin) as prescribed by your doctor.
Take all of your other medications to treat any risk factors (high blood pressure, high cholesterol, other heart-related problems and other health conditions) as directed by your doctor.
Monitor your blood sugars closely.
Follow a healthy diet, such as the Mediterranean or Dash diet. Do not skip meals.
Exercise regularly, at least 30 minutes five days a week.
Maintain a weight that’s healthy for you.
Keep yourself well-hydrated (water is your best choice).
Quit smoking, if you smoke.
See your doctor regularly to monitor your diabetes and to watch for complications.
What should I expect if I have been diagnosed with diabetes?
If you have diabetes, the most important thing you can do is keep your blood glucose level within the target range recommended by your healthcare provider. In general, these targets are:
Before a meal: between 80 and 130 mg/dL.
About two hours after the start of a meal: less than 180 mg/dL.
You will need to closely follow a treatment plan, which will likely include following a customized diet plan, exercising 30 minutes five times a week, quitting smoking, limiting alcohol and getting seven to nine hours of sleep a night. Always take your medications and insulin as instructed by your provider.
When should I call my doctor?
If you haven’t been diagnosed with diabetes, you should see your healthcare provider if you have any symptoms of diabetes. If you already have been diagnosed with diabetes, you should contact your provider if your blood glucose levels are outside of your target range, if current symptoms worsen or if you develop any new symptoms.
Does eating sugary foods cause diabetes?
Sugar itself doesn’t directly cause diabetes. Eating foods high in sugar content can lead to weight gain, which is a risk factor for developing diabetes. Eating more sugar than recommended — American Heart Association recommends no more than six teaspoons a day (25 grams) for women and nine teaspoons (36 grams) for men — leads to all kinds of health harms in addition to weight gain.
These health harms are all risk factors for the development of diabetes or can worsen complications. Weight gain can:
Raise blood pressure, cholesterol and triglyceride levels.
Increase your risk of cardiovascular disease.
Cause fat buildup in your liver.
Cause tooth decay.
What types of healthcare professionals might be part of my diabetes treatment team?
Most people with diabetes see their primary healthcare provider first. Your provider might refer you to an endocrinologist/pediatric endocrinologist, a physician who specializes in diabetes care. Other members of your healthcare team may include an ophthalmologist (eye doctor), nephrologist (kidney doctor), cardiologist (heart doctor), podiatrist (foot doctor), neurologist (nerve and brain doctor), gastroenterologist (digestive tract doctor), registered dietician, nurse practitioners/physician assistants, diabetes educator, pharmacist, personal trainer, social worker, mental health professional, transplant team and others.
How often do I need to see my primary diabetes healthcare professional?
In general, if you are being treated with insulin shots, you should see your doctor at least every three to four months. If you are treated with pills or are managing diabetes through diet, you should be seen at least every four to six months. More frequent visits may be needed if your blood sugar isn’t managed or if complications of diabetes are worsening.
Can diabetes be cured or reversed?
Although these seem like simple questions, the answers are not so simple. Depending on the type of your diabetes and its specific cause, it may or may not be possible to reverse your diabetes. Successfully reversing diabetes is more commonly called achieving “remission.”
Type 1 diabetes is an immune system disease with some genetic component. This type of diabetes can’t be reversed with traditional treatments. You need lifelong insulin to survive. Providing insulin through an artificial pancreas (insulin pump plus continuous glucose monitor and computer program) is the most advanced way of keeping glucose within a tight range at all times – most closely mimicking the body. The closest thing toward a cure for Type 1 is a pancreas transplant or a pancreas islet transplant. Transplant candidates must meet strict criteria to be eligible. It’s not an option for everyone and it requires taking immunosuppressant medications for life and dealing with the side effects of these drugs.
It’s possible to reverse prediabetes and Type 2 diabetes with a lot of effort and motivation. You’d have to reverse all your risk factors for disease. To do this means a combination of losing weight, exercising regularly and eating healthy (for example, a plant-based, low carb, low sugar, healthy fat diet). These efforts should also lower your cholesterol numbers and blood pressure to within their normal range. Bariatric surgery (surgery that makes your stomach smaller) has been shown to achieve remission in some people with Type 2 diabetes. This is a significant surgery that has its own risks and complications.
If you have gestational diabetes, this type of diabetes ends with the birth of your child. However, having gestational diabetes is a risk factor for developing Type 2 diabetes.
The good news is that diabetes can be effectively managed. The extent to which your Type 1 or Type 2 diabetes can be managed is a discussion to have with your healthcare provider.
Can diabetes kill you?
Yes, it’s possible that if diabetes remains undiagnosed and unmanaged (severely high or severely low glucose levels) it can cause devastating harm to your body. Diabetes can cause heart attack, heart failure, stroke, kidney failure and coma. These complications can lead to your death. Cardiovascular disease in particular is the leading cause of death in adults with diabetes.
How does COVID-19 affect a person with diabetes?
Although having diabetes may not necessarily increase your risk of contracting COVID-19, if you do get the virus, you are more likely to have more severe complications. If you contract COVID-19, your blood sugars are likely to increase as your body is working to clear the infection. If you contract COVID-19, contact your healthcare team early to let them know.
How does diabetes affect your heart, eyes, feet, nerves and kidneys?
Blood vessels are located throughout our body’s tissues and organs. They surround our body’s cells, providing a transfer of oxygen, nutrients and other substances, using blood as the exchange vehicle. In simple terms, diabetes doesn’t allow glucose (the body’s fuel) to get into cells and it damages blood vessels in/near these organs and those that nourish nerves. If organs, nerves and tissues can’t get the essentials they need to properly function, they can begin to fail. “Proper function” means that your heart’s blood vessels, including arteries, are not damaged (narrowed or blocked). In your kidneys, this means that waste products can be filtered out of your blood. In your eyes, this means that the blood vessels in your retina (area of your eye that provides your vision) remain intact. In your feet and nerves, this means that nerves are nourished and that there’s blood flow to your feet. Diabetes causes damage that prevents proper function.
How does diabetes lead to amputation?
Unmanaged diabetes can lead to poor blood flow (poor circulation). Without oxygen and nutrients (delivered in blood), you are more prone to the development of cuts and sores that can lead to infections that can’t fully heal. Areas of your body that are farthest away from your heart (the blood pump) are more likely to experience the effects of poor blood flow. So areas of your body like your toes, feet, legs and fingers are more likely to be amputated if an infection develops and healing is poor.
Can diabetes cause blindness?
Yes. Because unmanaged diabetes can damage the blood vessels of the retina, blindness is possible. If you haven’t been diagnosed with diabetes yet but are experiencing a change in your vision, see primary healthcare provider or ophthalmologist as soon as you can.
Can diabetes cause hearing loss?
Scientists don’t have firm answers yet but there appears to be a correlation between hearing loss and diabetes. According to the American Diabetes Association, a recent study found that hearing loss was twice as common in people with diabetes versus those who didn’t have diabetes. Also, the rate of hearing loss in people with prediabetes was 30% higher compared with those who had normal blood glucose levels. Scientists think diabetes damages the blood vessels in the inner ear, but more research is needed.
Can diabetes cause headaches or dizziness?
Yes, it’s possible to develop headaches or dizziness if your blood glucose level is too low – usually below 70 mg/dL. This condition is called hypoglycemia. You can read about the other symptoms hypoglycemia causes in this article. Hypoglycemia is common in people with Type 1 diabetes and can happen in some people with Type 2 diabetes who take insulin (insulin helps glucose move out of the blood and into your body’s cells) or medications such as sulfonylureas.
Can diabetes cause hair loss?
Yes, it’s possible for diabetes to cause hair loss. Unmanaged diabetes can lead to persistently high blood glucose levels. This, in turn, leads to blood vessel damage and restricted flow, and oxygen and nutrients can’t get to the cells that need it — including hair follicles. Stress can cause hormone level changes that affect hair growth. If you have Type 1 diabetes, your immune system attacks itself and can also cause a hair loss condition called alopecia areata.
What types of diabetes require insulin?
People with Type 1 diabetes need insulin to live. If you have Type 1 diabetes, your body has attacked your pancreas, destroying the cells that make insulin. If you have Type 2 diabetes, your pancreas makes insulin, but it doesn’t work as it should. In some people with Type 2 diabetes, insulin may be needed to help glucose move from your bloodstream to your body’s cells where it’s needed for energy. You may or may not need insulin if you have gestational diabetes. If you are pregnant or have Type 2 diabetes, your healthcare provider will check your blood glucose level, assess other risk factors and determine a treatment approach — which may include a combination of lifestyle changes, oral medications and insulin. Each person is unique and so is your treatment plan.
Can you be born with diabetes? Is it genetic?
You aren’t born with diabetes, but Type 1 diabetes usually appears in childhood. Prediabetes and diabetes develop slowly over time. Gestational diabetes occurs during pregnancy. Scientists do believe that genetics may play a role or contribute to the development of Type 1 diabetes. Something in the environment or a virus may trigger its development. If you have a family history of Type 1 diabetes, you are at higher risk of developing Type 1 diabetes. If you have a family history of prediabetes, Type 2 diabetes or gestational diabetes, you’re at increased risk of developing prediabetes, Type 2 diabetes or gestational diabetes.
What is diabetes-related ketoacidosis?
Diabetes-related ketoacidosis is a life-threatening condition. It happens when your liver breaks down fat to use as energy because there’s not enough insulin and therefore glucose isn’t being used as an energy source. Fat is broken down by the liver into a fuel called ketones. The formation and use of ketones is a normal process if it has been a long time since your last meal and your body needs fuel. Ketones are a problem when your fat is broken down too fast for your body to process and they build up in your blood. This makes your blood acidic, which is a condition called ketoacidosis. Diabetes-related ketoacidosis can be the result of unmanaged Type 1 diabetes and less commonly, Type 2 diabetes. Diabetes-related ketoacidosis is diagnosed by the presence of ketones in your urine or blood and a basic metabolic panel. The condition develops over several hours and can cause coma and possibly even death.
What is hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?
Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) develops more slowly (over days to weeks) than diabetes-related ketoacidosis. It occurs in patients with Type 2 diabetes, especially the elderly and usually occurs when patients are ill or stressed. If you have HHNS, you blood glucose level is typically greater than 600 mg/dL. Symptoms include frequent urination, drowsiness, lack of energy and dehydration. HHNS is not associated with ketones in the blood. It can cause coma or death. You’ll need to be treated in the hospital.
What does it mean if test results show I have protein in my urine?
This means your kidneys are allowing protein to be filtered through and now appear in your urine. This condition is called proteinuria. The continued presence of protein in your urine is a sign of kidney damage.
A note from QBan Health Services
There’s much you can do to prevent the development of diabetes (except Type 1 diabetes). However, if you or your child or adolescent develop symptoms of diabetes, see your healthcare provider. The earlier diabetes is diagnosed, the sooner steps can be taken to treat and manage it. The better you are able to manage your blood sugar level, the more likely you are to live a long, healthy life.
A stroke is your brain’s equivalent of a heart attack, happening when there’s an issue with blood flow to part of your brain. This can happen when blood vessels are blocked or because of bleeding in your brain. Strokes are a life-threatening emergency, and immediate medical attention is critical to prevent permanent damage or death.
What is a stroke?
A stroke is a life-threatening condition that happens when part of your brain doesn’t have enough blood flow. This most commonly happens because of a blocked artery or bleeding in your brain. Without a steady supply of blood, the brain cells in that area start to die from a lack of oxygen.
IMPORTANT: A stroke is a life-threatening emergency condition where every second counts. If you or someone with you has symptoms of a stroke, IMMEDIATELY call 911 (or your local emergency services number). The quicker stroke is treated, the more likely you’ll recover without disability.
To recognize the warning signs of a stroke, remember to think FAST:
F. Ask the person to smile. Look for a droop on one or both sides of their face, which is a sign of muscle weakness or paralysis.
A. A person having a stroke often has muscle weakness on one side. Ask them to raise their arms. If they have one-sided weakness (and didn’t have it before), one arm will stay higher while the other will sag and drop downward.
S. Strokes often cause a person to lose their ability to speak. They might slur their speech or have trouble choosing the right words.
T. Time is critical, so don’t wait to get help! If possible, look at your watch or a clock and remember when symptoms start. Telling a healthcare provider when symptoms started can help the provider know what treatment options are best for you.
Who does it affect?
Anybody can have a stroke, from children to adults, but there are some people who have a greater risk than others. Strokes are more common later in life (about two-thirds of strokes happen in people over age 65).
There are also certain medical conditions that increase the risk of stroke, including high blood pressure (hypertension), high cholesterol (hyperlipidemia), Type 2 diabetes, and people who have a history of stroke, heart attack or irregular heart rhythms like atrial fibrillation.
How common is a stroke?
Strokes are very common. Worldwide, strokes rank second among the top causes of death. In the United States, stroke is the fifth cause of death. Strokes are also a leading cause of disability worldwide.
How does a stroke affect my body?
Strokes are to your brain what a heart attack is to your heart. When you have a stroke, part of your brain loses its blood supply, which keeps that brain area from getting oxygen. Without oxygen, the affected brain cells become oxygen-starved and stop working properly.
If your brain cells go too long without oxygen, they’ll die. If enough brain cells in an area die, the damage becomes permanent, and you may lose the abilities that area once controlled. However, restoring blood flow may prevent that kind of damage or at least limit how severe it is. That’s why time is critical in treating a stroke.
What are the types of stroke?
There are two main ways that strokes can happen: ischemia and hemorrhage.
Ischemic stroke
Ischemia (pronounced “iss-key-me-uh”) is when cells don’t get enough blood flow to supply them with oxygen. This usually happens because something blocks blood vessels in your brain, cutting off blood flow. Ischemic strokes are the most common and account for about 80% of all strokes.
Ischemic strokes usually happen in one of the following ways:
Formation of a clot in your brain (thrombosis).
A fragment of a clot that formed elsewhere in your body that breaks free and travels through your blood vessels until it gets stuck in your brain (embolism).
Small vessel blockage (lacunar stroke), which can happen when you have long-term, untreated high blood pressure (hypertension), high cholesterol (hyperlipidemia) or high blood sugar (Type 2 diabetes).
Unknown reasons (these are cryptogenic strokes; the word “cryptogenic” means “hidden origin”).
Hemorrhagic stroke
Hemorrhagic (pronounced “hem-or-aj-ick”) strokes cause bleeding in or around your brain. This happens in one of two ways:
Bleeding inside of your brain (intracerebral). This happens when a blood vessel inside of your brain tears or breaks open, causing bleeding that puts pressure on the surrounding brain tissue.
Bleeding into the subarachnoid space (the space between your brain and its outer covering). The arachnoid membrane, a thin layer of tissue with a spiderweb-like pattern on it, surrounds your brain. The space between it and your brain is the subarachnoid space (“sub” means “under”). Damage to blood vessels that pass through the arachnoid membrane can cause a subarachnoid hemorrhage, which is bleeding into the subarachnoid space, putting pressure on the brain tissue underneath.
What are the symptoms of a stroke?
Different areas of your brain control different abilities, so stroke symptoms depend on the affected area. An example of this is a stroke that affects Broca’s area, a part of your brain that controls how you use muscles in your face and mouth to speak. That’s why some people slur their words or have trouble speaking when they have a stroke.
The symptoms of stroke can involve one or more of the following:
A transient ischemic attack (TIA) — sometimes called a “mini-stroke” — is like a stroke, but the effects are temporary. These are often warning signs that a person has a very high risk of having a true stroke in the near future. Because of that, a person who has a TIA needs emergency medical care as soon as possible.
What causes a stroke?
Ischemic strokes and hemorrhagic strokes can happen for many reasons. Ischemic strokes usually happen because of blood clots. These can happen for various reasons, such as:
High blood pressure (this can play a role in all types of strokes, not just hemorrhagic ones because it can contribute to blood vessel damage that makes a stroke more likely).
Migraine headaches (they can have symptoms similar to a stroke, and people with migraines — especially migraines with auras — also have a higher risk of stroke at some point in their life).
Smoking and other forms of tobacco use (including vaping and smokeless tobacco).
Drug misuse (including prescription and non-prescription drugs).
Is it contagious?
Strokes aren’t contagious and you can’t pass them to or get them from other people.
How are strokes diagnosed?
A healthcare provider can diagnose a stroke using a combination of a neurological examination, diagnostic imaging and other tests. During a neurological examination, a provider will have you do certain tasks or answer questions. As you perform these tasks or answer these questions, the provider will look for telltale signs that show a problem with how part of your brain works.
What tests will be done to diagnose this condition?
The most common tests that happen when a healthcare provider suspects a stroke include:
Lab blood tests (looking for signs of infections or heart damage, checking clotting ability and blood sugar levels, testing how well kidneys and liver function, etc.).
Treating a stroke depends on many different factors. The most important factor in determining treatment is what kind of stroke a person has.
Ischemic: With ischemic strokes, the top priority is restoring circulation to affected brain areas. If this happens fast enough, it’s sometimes possible to prevent permanent damage or at least limit a stroke’s severity. Restoring circulation usually involves a certain medication type called thrombolytics, but may also involve a catheterization procedure.
Hemorrhagic: With hemorrhagic strokes, treatment depends on the location and severity of the bleeding. Reducing blood pressure is often the top priority because this will reduce the amount of bleeding and keep it from getting worse. Another treatment option is to improve clotting so the bleeding will stop. Surgery is sometimes necessary to relieve pressure on your brain from accumulated blood.
What medications or treatments are used?
The medications and treatments used vary depending on the type of stroke and how soon a person receives treatment after the stroke. There are also long-term treatments for stroke. These happen in the days and months after emergency treatment deals with a stroke’s immediate threat.
Overall, your healthcare provider is the best person to tell you what kind of treatment(s) they recommend. They can tailor the information they provide to your specific case, including your medical history, personal circumstances and more.
Some examples of treatments for stroke are as follows:
Ischemic stroke
Hemorrhagic stroke
Thrombolytic drugs (within three to four and a half hours).
Blood pressure management.
Thrombectomy (within 24 hours if there’s no significant brain damage).
Reversal of any medication that might increase bleeding.
Blood pressure management.
Use of medications or surgery to reduce pressure inside your skull.
Thrombolytic drugs
Thrombolytic drugs (their name is a combination of the Greek words “thrombus,” which means “clot,” and “lysis,” which means “loosening/dissolving”) are an option within the first three hours after stroke symptoms start. These medications dissolve existing clots. But they’re only an option within that three- to four-and-a-half hour time frame because after that, they increase the risk of dangerous bleeding complications.
Mechanical thrombectomy
In some cases, especially ones where thrombolytic drugs aren’t an option, a catheterization procedure known as mechanical thrombectomy is an option. Thrombectomy procedures are also time-sensitive, and the best window for these procedures is within 24 hours after symptoms start. This procedure involves inserting a catheter (tube-like) device into a major blood vessel and steering it up to the clot in your brain. Once there, the catheter has a tool at its tip that can remove the clot.
Blood pressure management
Because high blood pressure is usually why hemorrhagic strokes happen, lowering blood pressure is a key part of treating them. Lowering blood pressure limits bleeding and makes it easier for clotting to seal the damaged blood vessel.
Clotting support
Your body’s clotting ability relies on a process called hemostasis to stop bleeding and repair injuries. Supporting hemostasis involves infusion of medications or blood factors that make it easier for clotting to happen. Examples include vitamin K therapy, prothrombin or clotting factor infusions, and more. This treatment is most common with hemorrhagic strokes, and can help control bleeding (especially for people who take blood-thinning medications).
Surgery
In some cases, surgery is necessary to relieve the pressure on your brain. This is especially true with subarachnoid hemorrhages, which are easier to reach because they’re on the outer surface of your brain.
Supportive treatments and other methods
There are several other ways that stroke treatment can happen. Some of these treatments are supportive directly, while others help avoid complications. Your healthcare provider can tell you more about these other treatments and which ones they recommend and why.
Stroke rehabilitation
One of the most important ways to treat stroke is to help a person recover or adapt to the changes in their brain. That’s especially true when it comes to helping them regain abilities they had before the stroke. Stroke rehabilitation is a major part of recovery for most people who have a stroke. That rehabilitation can take many forms, including:
Speech therapy: This can help you regain language and speaking abilities and improve your ability to control muscles that help you breathe, eat, drink and swallow.
Physical therapy: This can help you improve or regain the ability to use your hands, arms, feet and legs. This can also help with balance issues, muscle weakness and more.
Occupational therapy: This can help retrain your brain so you can go about your activities of daily life. This therapy is especially helpful with improving precise hand movements and muscle control.
Cognitive therapy: This can be helpful if you’re having memory problems. It can also help if you have difficulty with activities that require focus or concentration that you could do before.
Other therapies are possible, depending on your case and circumstances. Your healthcare provider is the best person to tell you what kind of treatments can benefit you.
Complications/side effects of the treatment
The side effects of stroke treatments depend greatly on the type of stroke, the treatments used, your medical history and more. Your healthcare provider can tell you more about the side effects you can or should expect and what you can do to manage or even prevent them.
How can I take care of myself or manage the symptoms?
A stroke is a life-threatening medical emergency, and you shouldn’t try to self-diagnose or self-treat it. If you have — or someone with you has — stroke symptoms, you should immediately call 911 (or your local emergency services number). The longer it takes for stroke treatment to begin, the greater the risk of permanent brain damage or death.
How soon after treatment will I feel better?
The recovery time and how long it takes to feel better after treatment both depend on many factors. Your healthcare provider is the best person to tell you what you can expect and the likely timeline for your recovery.
How can I reduce my risk of having a stroke or prevent them entirely?
There are many things you can do to reduce your risk of having a stroke. While this doesn’t mean you can prevent a stroke, it can lower your risk. Actions you can take include:
Improve your lifestyle. Eating a healthy diet and adding exercise to your daily routine can improve your health. You should also make sure to get enough sleep (the recommended amount is seven to eight hours).
Avoid risky lifestyle choices or make changes to your behaviors. Smoking and tobacco use, including vaping, recreational drug use or prescription drug misuse, and alcohol misuse can all increase your risk of having a stroke. It’s important to stop these or never start them. If you struggle with any of these, talking to your healthcare provider is important. Your provider can offer you guidance and resources that can help you change your lifestyle to avoid these behaviors.
Manage your health conditions and risk factors. There are several conditions, such as obesity, abnormal heart rhythms, sleep apnea, high blood pressure, Type 2 diabetes or high cholesterol, which can increase your risk of having an ischemic stroke. If you have one or more of these conditions, it’s very important that you do what you can to manage them, especially by taking medications — such as blood thinners — as prescribed by your provider. Doing that earlier in life can you avoid severe stroke-related problems later in life.
See your primary care provider for a checkup or wellness visit annually. Yearly wellness visits can detect health problems — especially ones that contribute to having a stroke — long before you feel any symptoms.
Is there anything I shouldn’t eat or drink with this condition?
Beverages that contain caffeine, such as coffee, tea, soft drinks, etc.
Foods that contain a lot of salt or sodium, which can increase blood pressure.
Foods that are high in saturated fats, such as fried foods, etc.
Alcohol or recreational stimulant drugs (cocaine, amphetamines/methamphetamine, etc.).
What can I expect if I have this condition?
If you have a stroke, many factors affect what you can expect, such as how big it is and where it is in your brain. There are also some key differences between ischemic and hemorrhagic strokes.
Ischemic strokes
In general, the more severe an ischemic stroke is, the worse the damage. When brain damage is more severe, it’s more likely that you’ll lose certain abilities, at least temporarily. The faster you get medical attention for stroke symptoms, the better your chances that these effects are temporary or less severe.
Hemorrhagic stroke
These strokes usually cause much worse symptoms, especially when bleeding is more severe. The symptoms of hemorrhagic stroke tend to get worse quickly. People with hemorrhagic strokes tend to cause severe headaches, seizures and coma.
How long does a stroke last?
A stroke lasts as long as there’s a lack of blood flow to part of your brain. Without treatment, a stroke will continue until the brain cells in the affected areas of your brain die, causing permanent damage.
Even after you receive treatment for a stroke, it’s common for the effects to linger. Most people will take weeks or even months to recover. Most of the progress in recovery happens within the first six months to 18 months (approximately) after a stroke. Further progress is possible after that, but can be harder to achieve or take longer.
When can I go back to work or school?
Your healthcare provider is the best person to tell you when you can return to your usual routine and activities. But it’s important not to push yourself too hard. Without enough time to recover, you could cause another stroke or other complications.
What’s the outlook for this condition?
Strokes have the potential to cause death when they’re severe or if they go too long without treatment. However, the outlook can still vary widely depending on many factors. Those factors include where in your brain a stroke happens, how severe it is, your health history and more.
Your healthcare provider is the best person to tell you more about the outlook for your situation. The information they provide will be the most accurate and most relevant information that you can get.
How do I take care of myself?
If you have a stroke, your healthcare provider will talk with you about a plan for treatment and the timeline for your recovery. They may also prescribe medications, recommend therapy options and more. It’s important to talk with your healthcare provider about why they recommend these and what they can do for you.
Once you and your provider finalize the treatment plan, it’s very important that you follow it as closely as possible. Doing that will give you the best chance to maximize how much you recover. Other things you can do include:
Take your medication. Medications that you take after a stroke can prevent having another.
Go to rehabilitation/therapy appointments. These appointments are critical to your recovery. Going to these appointments and putting in your best effort can make a big difference in how much you recover from a stroke.
Take care of your mental health. Depression and anxiety are extremely common after having a stroke. Experiencing these doesn’t mean you’re weak or hopeless, but letting them go untreated can make it harder for you to recover. Talk to your healthcare provider about these feelings if you have them. They can recommend care that can help keep mental health concerns from standing in the way of your recovery.
Make recommended lifestyle changes as best you can. Health concerns like your blood pressure, blood sugar and cholesterol can all play a role in your recovery from a stroke. Managing these can also help you avoid another stroke in the future. If you use tobacco products (including vaping products) of any kind, quitting them can also help greatly.
When should I see my healthcare provider?
You should see your healthcare provider as recommended. You should also see them if you notice any new symptoms affecting you, especially symptoms that might have a connection to your previous stroke. Even symptoms that don’t seem connected might be important, so don’t wait to discuss them with your healthcare provider.
When should I go to the ER?
You should call 911 (or your local emergency services number) and go to the nearest ER if you experience any symptoms of another stroke (see the FAST criteria at the top of this article to know the symptoms for which you should watch).
You should also go to the hospital if you experience any of the symptoms of dangerous complications that are common after a stroke. The most common complicating conditions include:
A stroke is your brain’s version of a heart attack, making it a critical, life-threatening medical emergency. Strokes are also time-sensitive, and delays in care can lead to permanent brain damage and death. Strokes can be frightening for those who experience them or people nearby.
But the treatment options for stroke are expanding everyday thanks to advances in our understanding of the brain, technological leaps in imaging and new medications. If you notice the symptoms of a stroke in yourself or someone you’re with, immediate medical attention is critical. The faster a person having a stroke gets medical care, the more likely the effects of the stroke will be limited or even reversible.
High blood pressure (hypertension) can be dangerous if it’s not treated. It can put you at risk for stroke, heart failure, kidney failure and other medical problems. Changing what you eat, exercising more and taking your medicine can help you keep your blood pressure where it should be.
What is high blood pressure (hypertension)?
Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls. When you have hypertension (high blood pressure), it means the pressure against the blood vessel walls in your body is consistently too high. High blood pressure is often called the “silent killer” because you may not be aware that anything is wrong, but the damage is still occurring within your body.
Your blood pressure reading has two numbers. The top number is the systolic blood pressure, which measures the pressure on the blood vessel walls when your heart beats or contracts. The bottom number is the diastolic blood pressure, which measures the pressure on your blood vessels between beats when your heart is relaxing.
Normal blood pressure is under 130/80 mmHg
Stage 1 hypertension (mild) is 130-139/or diastolic between 80-89 mmHg
Stage 2 hypertension (moderate) is 140/90 mmHg or higher
Hypertensive crisis (get emergency care) is 180/120 mmHg or higher
What are the types of high blood pressure?
Your healthcare provider will diagnose you with one of two types of high blood pressure:
Primary (also called essential) high blood pressure. Causes of this most common type of high blood pressure include aging and unhealthy habits like not getting enough exercise.
Secondary high blood pressure. Causes of this type of high blood pressure include different medical problems (for example kidney or hormonal problems) or sometimes a medication you’re taking.
What can happen if high blood pressure is not treated?
Untreated hypertension may lead to serious health problems including:
Stroke
Heart attack
Kidney disease/failure
Complications during pregnancy
Eye damage
Can high blood pressure affect pregnancy?
High blood pressure complicates about 10% of all pregnancies. There are several different types of high blood pressure during pregnancy and they range from mild to serious. The forms of high blood pressure during pregnancy include:
Chronic hypertension: High blood pressure which is present before pregnancy.
Gestational hypertension: High blood pressure in the latter part of pregnancy.
Preeclampsia: This is a dangerous condition that typically develops in the latter half of pregnancy and results in hypertension, protein in the urine and generalized swelling in the pregnant person. It can affect other organs in the body and cause seizures (eclampsia).
Chronic hypertension with superimposed preeclampsia: Pregnant people who have chronic hypertension are at increased risk for developing preeclampsia.
Your healthcare provider will check your blood pressure regularly during prenatal appointments, but if you have concerns about your blood pressure, be sure to talk with your healthcare provider.
How do I know if I have high blood pressure?
High blood pressure usually doesn’t cause symptoms. The only way to know if you have high blood pressure is to have your healthcare provider measure it. Know your numbers so you can make the changes that help prevent or limit damage.
What are the risk factors for high blood pressure?
You are more likely to have high blood pressure if you:
Have family members who have high blood pressure, cardiovascular disease or diabetes.
Are of African descent.
Are older than 55.
Are overweight.
Don’t get enough exercise.
Eat foods high in sodium (salt).
Smoke or use tobacco products.
Are a heavy drinker (more than two drinks a day in men and more than one drink a day in women).
How is high blood pressure diagnosed?
Since high blood pressure doesn’t have symptoms, your healthcare provider will need to check your blood pressure with a blood pressure cuff. Providers usually check your blood pressure at every annual checkup or appointment. If you have high blood pressure readings at two appointments or more, your provider may tell you that you have high blood pressure.
What should I do if I have high blood pressure?
If your healthcare provider has diagnosed you with high blood pressure, they will talk with you about your recommended blood pressure target or goal. They may suggest that you:
Check your blood pressure regularly with a home blood pressure monitor. These are automated electronic monitors and are available at most pharmacies or online.
Eat healthy foods that are low in salt and fat.
Reach and maintain your best body weight.
Limit alcohol to no more than two drinks each day for men and less than one drink each day for women. One drink is defined as 1 ounce of alcohol, 5 ounces of wine, or 12 ounces of beer.
Be more physically active.
Quit smoking and/or using tobacco products.
Work on managing anger and managing stress.
What diet helps manage high blood pressure?
Eat foods that are lower in fat, salt and calories, such as skim or 1% milk, fresh vegetables and fruits, and whole-grain rice and pasta. (Ask your healthcare provider for a more detailed list of low sodium foods to eat.)
Use flavorings, spices and herbs to make foods tasty without using salt. The optimal recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day. Don’t forget that most restaurant foods (especially fast foods) and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food. Don’t add salt at the table. (Salt substitutes usually have some salt in them.)
Avoid or cut down on foods high in fat or salt, such as butter and margarine, regular salad dressings, fatty meats, whole milk dairy products, fried foods, processed foods or fast foods and salted snacks.
Ask your provider if you should increase potassium in your diet. Discuss the Dietary Approaches to Stop Hypertension (DASH) diet with your provider. The DASH diet emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since it’s rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.
Can I prevent high blood pressure?
There are certain things you can do to help reduce your risk of developing high blood pressure. These include eating right, getting the right amount of exercise and managing salt intake.
How can you reduce your risk of high blood pressure?
Fortunately, there are certain things you can do to help reduce your risk of developing high blood pressure. These include the following:
Eat right: A healthy diet is an important step in keeping your blood pressure normal. The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since it’s rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.
Keep a healthy weight: Going hand-in-hand with a proper diet is keeping a healthy weight. Since being overweight increases your blood pressure, losing excess weight with diet and exercise will help lower your blood pressure to healthier levels.
Cut down on salt: The recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day (equal to about one teaspoon). To prevent hypertension, you should keep your salt intake below this level. Don’t forget that most restaurant foods (especially fast foods) and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food; do not add salt at the table. (Salt substitutes usually have some salt in them.)
Keep active: Even simple physical activities, such as walking, can lower your blood pressure (and your weight).
Drink alcohol in moderation: Having more than one drink a day (for women) and two drinks a day (for men) can raise blood pressure.
What can I expect if I have this condition?
Since high blood pressure doesn’t cause many symptoms at first, you probably won’t feel any different with a high blood pressure diagnosis. But it’s important to follow your provider’s instructions to bring your blood pressure down so it doesn’t cause serious illnesses later in life.
How long does high blood pressure last?
If you have primary high blood pressure, you’ll need to manage it for the rest of your life.
If you have secondary high blood pressure, your blood pressure will most likely come down after you receive treatment for the medical problem that caused it. If a medication caused your high blood pressure, switching to a different medicine may lower your blood pressure.
What is the outlook for high blood pressure?
You can get seriously ill if you don’t treat your high blood pressure. However, if you take the medicines your provider ordered, you can manage your blood pressure. Exercising and eating healthy foods also helps lower your blood pressure.
How can I be more active?
Check first with your healthcare provider before increasing your physical activity. Ask your provider what type and amount of exercise is right for you.
Choose aerobic activities such as walking, biking or swimming.
Start slowly and increase activity gradually. Aim for a regular routine of activity five times a week for 30 to 45 minutes each session.
What if lifestyle changes don’t help lower my blood pressure?
If diet, exercise and other lifestyle changes don’t work to lower your blood pressure, your healthcare provider will prescribe medications to help lower your blood pressure. Your provider will take into account other conditions you may have, such as heart or kidney disease and other drugs you’re taking when prescribing medications to treat your high blood pressure. Be sure to follow your provider’s dosing directions exactly.
What questions should I ask my provider?
Are there supplements or non-prescription medicines that I shouldn’t take?
Can I keep taking these medicines if I get pregnant?
What kinds of exercise should I do?
A note from Qban Healthcare Services
If you don’t treat high blood pressure, it can put you at risk for developing serious illnesses later in life such as heart attack, kidney failure and stroke. But if you follow your provider’s instructions, you can manage your blood pressure. Be sure to take any medicines your provider ordered as instructed. Keep taking them even if your blood pressure numbers begin to fall into the normal range. Living a healthy lifestyle by eating healthy foods, watching your weight and getting regular exercise is also a great way to help manage your blood pressure.
Qban Health Care - Dominica 