Health and Wellness

Diabetes: An Overview

Diabetes is when your body isn’t able to take up sugar (glucose) into its cells and use it for energy. This results in a build up of extra sugar in your bloodstream. Poorly controlled diabetes can lead to serious consequences, causing damage to a wide range of your body’s organs and tissues.

Complications of diabetes

Cardiovascular issues including coronary artery disease, chest pain, heart attack, stroke, high blood pressure, high cholesterol, atherosclerosis

Nerve damage (neuropathy) that causes numbing and tingling that starts at toes or fingers then spreads
Kidney damage (nephropathy) that can lead to kidney failure or the need for dialysis or transplant
Eye damage (retinopathy)
Foot damage
Skin infections
Dental problems

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, which make your blood acidic.

Does eating sugary foods cause diabetes?

While 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, however, leads to all kinds of health harms, including increased risk of cardiovascular disease, high blood pressure, cholesterol, triglyceride, fat buildup, and tooth decay.

When should I call my doctor?

See your healthcare provider if you have any symptoms of diabetes.

What happens if my blood glucose level is low?

Hypoglycemia

What causes diabetes?

The cause of diabetes, regardless of the type, is having too much glucose circulating in your bloodstream.

Causes of Type 1 diabetes: Immune system disease
Type 2 diabetes and prediabetes: Your body’s cells don’t allow insulin to work as it should to let glucose into its cells
Gestational diabetes: Hormones produced by the placenta during your pregnancy make your body’s cells more resistant to insulin

How often do you need to see your primary diabetes healthcare professional?

Generally, if you are being treated with insulin shots, 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 leastevery four to six months.

What does it mean if test results show protein in my urine?

Proteinuria is a sign of kidney damage.

The earlier diabetes is diagnosed, the sooner steps can be taken to treat and control it. The better you are able to control your blood sugar level, the more likely you are to live a long, healthy life.

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 do have some control over.

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
Get physically active
Aim for 30 minutes a day at least five days a week, and lose weight if you are overweight
Lower your stress
Learn relaxation techniques, deep breathing exercises, mindful meditation, yoga and other helpful strategies
Limit alcohol intake
Have an adequate amount of sleep
Take medications – to manage existing risk factors for heart disease, cholesterol, or to reduce the risk of developing diabetes

How is diabetes treated?

Treatments for diabetes depend on your type of diabetes, how well controlled 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. Type 2 diabetes: 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: The goal is to keep you from progressing to diabetes. Treatments are focused on treatable risk factors, including losing weight by eating a healthy diet, exercising, and controlling your blood sugar.

What insulin medications are approved to treat diabetes?

Rapid-acting insulins: These are taken 15 minutes before meals, 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 insulin: These 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.
Intermediate-acting, long-acting and combination insulin types: These last for about 18 hours.

How does diabetes affect your heart, eyes, feet, nerves and kidneys?

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.

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.

How do I check my blood glucose level?

Most common way is with a blood glucose meter

Test by prick prick on the side of finger, apply a drop of blood to test strip, insert the strip into the meter and the meter will show your glucose level at that moment in time

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).

Although the complications can be wide ranging and affect many organ systems, there are many basic principles of prevention shared in common.

Other treatment options for diabetes

Pancreas transplant is possible, but requires taking immune-suppressing drugs for the rest of your life and dealing with side effects of these drugs.

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.

What is continuous glucose monitoring?

Continuous glucose monitoring uses a tiny sensor inserted under your skin.

You don’t need to prick your finger and the sensor measures your glucose and can display results anytime during the day or night (up to 24 hours a day, 6 days a week).

How common is diabetes?

34.2 million people of all ages – about 1 in 10 – have diabetes in the U.S.

Can you be born with diabetes?

Type 1 diabetes usually appears in childhood

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 it
Prediabetes and diabetes develop slowly
Gestational diabetes occurs during pregnancy

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.

These include: sulfonylureas, glinides, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, glucagon-like peptide-1 receptor agonists, GLP-1 analogs, sGLT2 inhibitors, and dPP-4 inhibitors.

What types of diabetes require insulin?

Type 1 diabetes: Your body has attacked your pancreas, destroying the cells that make insulin – insulin is needed to live

2 diabetes: Insulin may be needed to help glucose move from your bloodstream to your body’s cells where it’s needed for energy
Gestational diabetes: check your blood glucose level, assess other risk factors and determine a treatment approach

Can diabetes cause hearing loss?

There appears to be a correlation between hearing loss and diabetes

How is insulin taken?

Needle and syringe: With this method, you insert a needle into a vial of insulin, pull back the syringe and fill the needle with the proper dose of insulin.

Insulin pen: This device looks like a pen with a cap. You 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.
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.

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)

HHNS develops more slowly than diabetes-related ketoacidosis. It occurs in patients with Type 2 diabetes, especially the elderly.

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).

How is diabetes diagnosed?

Diabetes is diagnosed and managed by checking your glucose level in a blood test.

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 glycerol test: Can be done any time without the need to fast and provides your average blood glucose over the past two to three months
Oral glucose tolerance test: Blood glucose level is first measured after an overnight fast and then checked one hour later
Gestational diabetes tests: Two blood glucose tests if you are pregnant

How does diabetes lead to amputation?

Poor circulation

Without oxygen and nutrients, 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 farthest away from your heart (the blood pump) are more likely to experience the effects of poor blood flow, so are areas of your feet, legs and fingers.

Can diabetes cause hair loss?

Uncontrolled diabetes can lead to persistently high blood glucose levels, which can damage blood vessel damage and restricted flow, and oxygen and nutrients can’t get to the cells that need it, including hair follicles.

What types of healthcare professionals might be part of my diabetes treatment team?

Most people with diabetes see their primary healthcare provider first.

What should I expect if I have been diagnosed with 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 meal: less than 180 mg /dL
You will need to 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.

How does COVID-19 affect a person with diabetes?

Having diabetes does not increase your risk of contracting the virus, if you do get it, you are more likely to have more severe complications including bleeding, blindness, and kidney damage.

Who gets diabetes?

Risk factors for Type 1 diabetes include: Having a family history (parent or sibling) of type 1 diabetes, injury to the pancreas, presence of autoantibodies, physical stress, exposure to illnesses caused by viruses, being overweight, being physically inactive, being age 45 or older, smoking, and having a history of heart disease or stroke

Types of diabetes

Type 1 diabetes: This type is an autoimmune disease, meaning your body attacks itself

It’s usually diagnosed in children and young adults, and it is also called insulin-dependent diabetes. Up to 10% of people who have diabetes have Type 1. Diabetes insipidus is a distinct rare condition that causes your kidneys to produce a large amount of urine.
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 and occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes.

Why is my blood glucose level high?

Glucose provides the “fuel” or energy tissues and organs need to properly function

If you have diabetes, your pancreas does not make enough insulin, or your body does not respond to it as it normally should, your blood glucose levels will rise

How is diabetes managed?

To best manage diabetes, you’ll need to take steps to keep your risk factors under control and within the normal range

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), triglyceride levels, and blood pressure as near the normal ranges as possible.

Who should be tested for diabetes?

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 to prevent or delay developing Type 2 diabetes.

What are the symptoms of diabetes?

Increased thirst

Blurred vision
Numbness or tingling in the hands or feet
Slow-healing sores or cuts
Unplanned weight loss
Frequent urination
Dry mouth
Other symptoms
Decreased sex drive, erectile dysfunction, decreased muscle strength

Can diabetes kill you?

Yes, it’s possible that if diabetes remains undiagnosed and uncontrolled (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.

What should my blood glucose level be?

Most people try to keep their blood glucose levels at these targets

Can diabetes be cured or reversed?

Successfully reversing diabetes is more commonly called achieving “remission.”

It’s possible to reverse prediabetes and Type 2 diabetes with a lot of effort and motivation.
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.

Can diabetes cause headaches or dizziness?