Understanding diabetes and how to manage it
Diabetes is an all too common and serious condition. Diabetes is a group of diseases that cause the level of blood sugar (glucose) to rise. The body needs glucose for energy. But too much sugar in the blood can lead to many serious health problems.
In the United States, 37 million people have diabetes. That is the estimate by the Centers for Disease Control and Prevention (CDC). The CDC also reports another 96 million Americans may have “prediabetes.” Prediabetes means the glucose level is high, but not enough to be diagnosed with diabetes.
The most common types of diabetes are type 1 and type 2.
- Type 1 diabetes can start at any age and is a risk factor for people of every race, shape, or size. It is caused by the body’s inability to produce insulin. That is the hormone that controls blood sugar. Only about five percent of individuals with diabetes have type 1.
- Type 2 diabetes usually develops later in life. It can be genetic, meaning it can be passed from one generation to another. It can also develop if the body becomes resistant to insulin. There are many causes for type 2 diabetes. While genetics plays a part, other factors such as weight and diet can also cause diabetes.
Signs and symptoms of diabetes
Type 1 diabetes: Type 1 diabetes can occur at any age and can develop in a few weeks or months and can be severe. Individuals with type 1 diabetes may experience nausea, vomiting, or stomach pain.
Type 2 diabetes: Type 2 diabetes symptoms can take several years to develop and can occur at any age. Some people don’t notice any symptoms at all. Symptoms include:
- increased thirst
- losing weight without trying
- increased appetite or feeling hungrier than usual
- blurry vision
- tingling or numbness in hands
- feeling more tired than usual
- skin changes such as very dry skin or sores that heal slowly
Risk factors of diabetes
There are many factors associated with an increased risk of diabetes. These are some of the most common ones:
- Family history: If a parent or a sibling has diabetes, you are at a higher risk of developing diabetes.
- Ethnicity: African American, Hispanic, Indian American, and Asian American individuals are at higher risk.
- Obesity/fat distribution in the body: Increased fat is linked to insulin resistance.
- Alcohol consumption: Heavy drinking increases risk for diabetes.
- Exercise: The less active you are, the more likely you are to have elevated blood sugar levels. Also, weight gain from lack of exercise can also lead to insulin resistance.
- Smoking: Smoking causes increased blood sugar levels and insulin resistance. Smokers are much more likely to develop diabetes than nonsmokers. Also, smoking with diabetes makes it harder to control your glucose level.
- High blood pressure and cholesterol: High blood pressure and high cholesterol are linked to an increased risk of type 2 diabetes.
Prediabetes occurs when blood sugar levels are higher than they should be, but not high enough to be diagnosed with type 2 diabetes. Unfortunately, there are no symptoms associated with prediabetes. It’s important to have your blood sugar levels tested regularly, especially if you have any of the following risk factors for prediabetes:
- Age 45 or older
- Being overweight
- Having a parent, brother, or sister with type 2 diabetes
- Exercising less than three times per week
- Having gestational diabetes (diabetes that develops during pregnancy)
- Having polycystic ovary syndrome
Prediabetes can be reversed. Eating right and exercise can help you lower your blood sugar levels and reduce your chance of developing type 2 diabetes.
The first step in treating type 2 diabetes focuses on lifestyle change. Often, individuals with type 2 diabetes can manage blood sugar levels by:
- eating a healthier diet
- losing extra weight
- quitting smoking
- reducing alcohol intake
Sometimes lifestyle changes are not enough. Then your doctor may prescribe medication to help manage your diabetes. Insulin hormone replacement is used for type 1 and some advanced cases of type 2 diabetes.
The dangers of diabetes
Diabetes is a very serious condition with lifelong health consequences, especially if not managed well. It is a leading cause of death and can have significant complications that affect all organs. It is associated with an increased risk of heart attacks, strokes, and kidney disease.
It can also affect the:
- nerves, often causing a condition known as neuropathy
- skin, increasing your risk of skin infections, poor healing, and other skin disorders
- eyes, increasing the chance of retinopathy, cataract, glaucoma and blindness
- blood vessels, increasing your risk of peripheral vascular disease
If left untreated, diabetes can cause a metabolic disturbance such as diabetic ketoacidosis. That is a serious condition that requires a hospital admission. Other severe, long-term consequences include:
- limb amputation
- cerebrovascular disease
- kidney impairment
- heart disease
Important Screenings for People with Diabetes
- What it is: A blood test that measures your average blood glucose level over the past two to three months. Target goal is less than 7% for many adults. But A1C is individualized. Your doctor may give you a higher or lower A1C goal, depending on your needs.
- How often to be tested: Every six months if your last A1C was in goal range. Every three months if your medications have changed or your last A1C was not in your target range.
Dilated Eye Exam
- What it is: An eye doctor (optometrist or ophthalmologist) performs this exam to check for signs of eye disease caused by diabetes. One such disease is diabetic retinopathy.
- How often to be tested: It depends on your type of diabetes and how long you’ve had it. At least 1 to 2 years based on doctor’s recommendation.
- What it is: A measurement of the force of blood flow inside your blood vessels.
- Why you need it: Diabetes raises the risk for high blood pressure, which increases your chances of heart disease, stroke, vision loss, and kidney disease. Target Number: Less than 130/80 mmHg. But everyone is different. Your doctor will use different aspects of your health to recommend the right blood pressure target for you.
- How often to be tested: Get checked at every visit with a healthcare provider.
Kidney Function Estimated Glomerular Filtration Rate (eGFR)
- What it is: An estimate of how well your kidney’s function. Your eGFR is based on the level of creatinine in your blood and other factors, such as your age and gender.
- Why it’s important: People with diabetes have an increased risk for kidney disease. Target Number: An eGFR higher than 80 ml/min/1.73 m2. Normal is around 100 to 120 ml/min/173 m2.
- How often to be tested: Once a year, if you have type 2 diabetes or have had type 1 diabetes for at least five years. At least twice a year if your previous test showed signs of kidney disease.
To manage diabetes, diet and exercise are key. That’s because they both help you maintain a target range for your blood sugar or reverse a spike in your glucose level. These tips can help those with diabetes control their condition:
Limit the following foods:
- Starchy vegetables such as potatoes, corn, and green peas. These are high in carbohydrates and can cause spikes in your blood sugar.
- Fried foods and foods with high levels of saturated fat or trans fats (read your food labels!).
- High-sodium foods, such as pizza, potato chips, deli meats, canned soups and more. You can learn more here. Diabetes & Sodium: How Much Salt Should You Eat? – Diabetes Strong
- Sweets and sweet drinks such as desserts, cookies, soda, and energy drinks.
- Processed foods that are pre-packaged such as cookies, bacon or ham, and cereals.
Include the following foods:
- “Healthy fats” such as olive oil, avocado, and salmon
- “Whole foods” such as fresh fruits and vegetables, whole grains, and legumes
- Vegetables should be “low starch” such as broccoli, spinach, peppers, and mushrooms.
- “Protein-rich” foods such as black beans, chicken, or turkey (without the skin), and tuna.
Be sure you are eating regular, balanced meals. That will help to keep your blood sugar levels steady.
Exercise is vital:
Adding exercise into your daily routine can lower your blood sugar levels. It can also help lower blood pressure and weight loss. If you’re new to exercise, be sure to start slowly and build up. Walking is a great way to start, and you can gradually increase your speed and distance. It’s also helpful for those with diabetes to include some strength training too. The American Diabetes Association offers more tips on how to exercise safely with diabetes.
Check out this post for more information on how to manage diabetes. https://www.commonwealthcarealliance.org/living-well-at-home/how-to-manage-diabetes-with-diet-and-exercise/
If you have any risk factors or are experiencing signs or symptoms, talk to your doctor.
8:00 am to 8:00 pm ET, Monday through Friday, and 8:00 am to 6:00 pm ET, Saturday and Sunday