Patient Health Resource: Diabetes

Diabetes is a condition where the body is unable to make sufficient insulin or effectively utilize insulin. When this happens, too much glucose, or sugar, stays in your bloodstream and can contribute to health issues.

Older woman checking her blood sugar levels

Diabetes is caused when the pancreas is unable to produce sufficient insulin – or when the body’s cells cannot effectively use the insulin you are producing. Insulin is a hormone that regulates blood sugar or glucose. Left untreated or poorly managed, diabetes can damage health, contributing to blindness, kidney failure, heart attacks, stroke and even lower limb amputation. Diabetes is considered a chronic condition which means the disease is persistent or recurring.

There are two main forms of diabetes. Type 1 diabetes, formerly called juvenile diabetes, usually develops in children or young adults when the pancreas stops making insulin. Often, Type 2 diabetes develops in adulthood (although it’s becoming more common among children) when the pancreas is producing insufficient insulin or the insulin it does produce is not working the way it should. You may have heard this referred to as “insulin resistance.”

Both types are forms of diabetes mellitus, which mean they lead to high blood sugar (hyperglycemia). High blood sugar that’s left untreated can damage nerves, blood vessels, tissues and organs.

According to the Diabetes Research Institute, approximately 11% of the U.S. population has diabetes. An almost equal subset of the population has prediabetes or has not yet been diagnosed. A family history of diabetes can increase your risk, often in conjunction with a sedentary lifestyle and being overweight. In addition, women who experienced gestational diabetes during pregnancy are at higher risk for developing Type 2 diabetes.

Over time, diabetes can contribute to a range of serious health conditions including:

  • Hardening of the arteries (atherosclerosis) which could contribute to a heart attack or stroke.
  • Permanent vision loss due to damaged blood vessels in the eyes.
  • Circulation and nerve damage, such as diabetic neuropathy, which can include pain or numbness of the legs, feet or hands. Diabetes may also cause digestive system or urinary tract issues. For extreme cases, diabetic neuropathy can be seriously painful and even disabling.
  • Chronic kidney disease or kidney failure.

Risk

It is possible to develop Type 2 diabetes at any age but you are more likely to develop this condition if you:

  • Are age 35 or older
  • Are overweight
  • Have a family history of diabetes
  • Are African American, American Indian, Asian American, Hispanic/Latino or Pacific Islander
  • Are not physically active
  • Have been diagnosed with prediabetes
  • Experienced gestational diabetes

Prevention

If you or someone you love is at risk for diabetes, it’s possible to take steps to help prevent or delay the disease. This requires adopting a healthy lifestyle:

  • Maintain a healthy weight. Weight control is an important element of any diabetes prevention plan. If you’re overweight, losing as little as 5-to-10% of your current weight can make a positive difference.
  • Develop a healthy eating plan you can maintain for a lifetime. SWHR dietitians have put together recommendations for how you can prevent, delay or help manage diabetes with healthy nutrition.
  • Exercise regularly. You’ve may have heard this before but exercise has so many benefits that it’s an essential part of any healthy lifestyle. If you’ve been living a sedentary lifestyle, discuss with your primary care physician how you can introduce more activity into your daily life. You might start by walking more or adding low-impact exercises and stretches into your day then slowly working up to a more vigorous routine.
    • Note: if you take medicine or insulin to lower blood sugar, you may need to check your blood sugar before and after physical activity. Discuss with your physician what would be an optimal blood sugar range to achieve before launching an exercise activity. If your blood sugar falls below this level, your physician may advise consuming a snack first to ensure your safety and performance.
  • Don’t smoke, as tobacco use can contribute to insulin resistance. If you already smoke, try to quit.
    • The CDC offers free support to help you quit smoking, including coaching sessions, a customized “quit plan,” educational materials, plus referrals to local resources. Call 1-800-QUIT-NOW (1-800-784-8669).
  • Talk to your healthcare provider for other recommendations about how you can prevent or delay the onset of Type 2 diabetes. If you are at high risk, your provider may prescribe medication to help you manage your blood sugar.

Symptoms

Even before you’ve been diagnosed, you may notice signs that something’s not quite right. For sufferers of Type 2 diabetes, symptoms may include:

  • Frequent urination, especially at night
  • Feeling thirsty or dehydrated
  • Fatigue
  • Unexplained weight loss
  • Wounds heal more slowly
  • Blurred vision which may be caused by the lens of your eye becoming dry

These symptoms may be mild and develop gradually over time. If you’re worried about developing diabetes, discuss these concerns with your physician. Early diagnosis and treatment can help reduce your risk of developing serious complications later.

Diagnosis

Your primary care physician (PCP) may rely on different blood tests to confirm a diabetes diagnosis:

  • The A1C test -- also known as the hemoglobin A1C or HbA1c test – measures your average blood sugar levels over the past few months. An A1C below 5.7% is normal, between 5.7 and 6.4% indicates prediabetes, and a level of 6.5% or higher indicates you have diabetes.
    • Higher A1C levels are linked to diabetes complications. Managing your individual target will be important for your quality of life if you’re diagnosed with diabetes.
  • A fasting blood sugar test measures your blood sugar after you’ve gone without eating for a period of time. A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates prediabetes, and 126 mg/dL or higher indicates diabetes.

Treatment

Once it’s confirmed you have diabetes, your physician will work with you to devise a care plan. A good patient-provider partnership can help you achieve your goals. Management of Type 2 diabetes often includes:

  • Diet modifications
  • Physical activity
  • Weight loss
  • Monitoring blood sugar levels

If you’re having trouble managing your diabetes with diet and exercise, your primary care provider may prescribe medication to help lower glucose levels. Type 2 diabetes is often a progressive disease. Depending upon how well the disease is being managed, insulin therapy may be recommended as part of your treatment plan.

Sources:
American Academy of Family Physicians
Diabetesresearch.org
Centers for Disease Control and Prevention
National Institutes of Health
World Health Organization
NIH: National Institute of Diabetes and Digestive and Kidney Diseases

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