Dealing with diabetes

  • Mehmet Marangoz (left) and Della Flanagan Courtesy of Concord Hospital

Published: 1/8/2021 12:14:10 PM
Modified: 1/8/2021 12:13:56 PM

What is diabetes? 

Diabetes is a condition that causes blood glucose levels to rise higher than normal. People with type 1 diabetes don’t produce insulin, whereas people with type 2 diabetes don’t produce enough insulin, or their cells don’t use insulin as they should. Insulin is a hormone/protein that carries blood glucose into body cells. About 90 percent of people with diabetes have type 2. 

We are in the midst of a pandemic. What are the risks for people who have contracted COVID-19 and who are diabetic?

According to the Centers for Disease Control, people with type 2 diabetes are at higher risk for severe illness if they contract this virus. Severe illness from COVID-19 is defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death. Taking your medication as prescribed, keeping a 30-day supply of insulin on hand, and following the advice of your healthcare provider if you feel ill will help to avoid severe illness. However, if you do feel severely ill, contact your healthcare provider immediately for instructions.

Given that it is cold and flu season and COVID-19 remains ever-present and people with diabetes have poorer outcomes to both the flu and COVID-19, how can you boost the immune system?

Consider six lifestyle choices to boost immunity:

1. Reduce stress: pause, take some time to consider your breathing, listen to a favorite song or watch a funny video. Be mindful as this reduces stress which decreases stress hormones known to elevate blood glucose.

2. Stop smoking.

3. Make healthy food choices.

4. Be active for 30 minutes, five days a week or as little as 20 minutes, five days a week can help decrease inflammation and support immunity.

5. Get adequate sleep – aim for seven to nine hours a night. Sleeping fewer than six hours a night makes your body more vulnerable to illness.

6. Connect with family and friends. There is an increased incidence for type 2 diabetes in those who are socially isolated.

What is the microbiome?

The microbiome has become known as the most important organ of the body where an estimated 100 trillion organisms (bacteria, viruses and fungi and other living things referred to as microorganisms or microbes for short). Research suggests that these beneficial microbes may have more widespread effects such as improving heart health, body weight, blood glucose, mood, and more. Just like we all have a distinct set of fingerprints, we also have a unique gut microbiota. Studies have shown, however, that people with type 2 diabetes tend to have greater numbers of bacteria shown to promote inflammation than people who do not have diabetes.

How can you improve your gut microbiome?

Include a diverse range of high fiber foods, prebiotics, and foods rich in polyphenols such as artichokes, asparagus, broccoli, carrots, endive, potatoes, spinach, shallots, apples, apricots, berries, grapes, cherries, grapefruit, lemon, nectarine and peaches. Prebiotic foods include garlic, onions, beans, chickpeas, lentils, whole grains and some fruits and vegetables. Include probiotic foods that contain live active cultures of bacteria such as yogurt and kefir. For women aged 21 to 49, aim for 25 grams of fiber daily and for 50 and older, 21 grams daily. For men age 21 to 49 years, aim for 38 grams daily and for 50 and older, 30 grams daily.   

What does making healthy food choices mean?

In addition to how to improve your gut microbiome, above, the World Health Organization advises people to limit alcohol consumption, particularly during the current pandemic, noting that alcohol compromises immunity and carries other health risks. Alcohol also harms the liver which helps to fight infection. Limit sugar, as high sugar diets contributes to chronic conditions like obesity that may lead to type 2 diabetes and heart disease. High sodium diets have been shown to show a weakened immunity after just one week. Only one in ten adults get enough fruits of vegetables daily according to the CDC. The goal is a minimum of five servings of fruits and vegetables combined daily in order to meet your vitamin and mineral dietary recommended allowances.

What are the latest innovations in reading blood glucose levels, and do they eliminate the need for finger pricks? What are the benefits and limitations of these innovations?

Because of diabetes research, many advances producing higher accuracy and less invasiveness for patients are being seen every day. Many people with diabetes have access to continuous glucose monitoring systems that provide real-time and detailed information 24/7. The benefits to these innovations are better treatment and quality of life for diabetes patients.

Insulin pumps have changed a great deal over the years. What’s new with pumps and how are they making living with diabetes easier?

There’s a good deal of excitement around automatic insulin pumps. These devices allow insulin to be delivered into the body throughout the day, resulting in more effective distribution of insulin when needed. When combined with continuous glucose monitoring, they are very effective and have been clinically proven to reduce the risk hypoglycemia. 

What do you see in the future for treating diabetes?

Diabetes research gives us glimpses into the future of treatments every day. The goal of any innovation, however, is to extend the life and improve the quality of life for people who have diabetes. The future looks for faster insulin, better glucose sensors and insulin pump algorithms, improved infusion sets, electronic medical record integration and a true artificial pancreas.

Dr. Mehmet Marangoz is board-certified in internal medicine and Della Flanagan RDN, CDCES, MEd, BC-ADM, LD is a certified diabetes educator. They recently presented on diabetes management at Concord Hospital Trust “What’s Up Doc?” Donor Lecture Series. The monthly series features members of Concord Hospital’s medical staff speaking to Concord Hospital Trust donors about new and innovative medical treatments and services. You can watch their presentation on Concord Hospital’s YouTube channel at

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