Introduction
Diabetes is a serious, potentially life-threatening condition that affects over 400 million people around the globe today. However, this silent disease doesn’t have to be as scary as you might think. There are plenty of ways to prevent diabetes, treat it and even reverse its effects if you’ve already been diagnosed! This ultimate guide will give you all the information you need to beat diabetes once and for all.
What is diabetes?
Diabetes is a chronic condition that leads to high blood sugar levels over time. It’s the most common metabolic disorder in the United States.
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 build up 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.
Symptoms of diabetes include:
- Increased thirst.
- Weak, tired feeling.
- Blurred vision.
- Numbness or tingling in the hands or feet.
- Slow-healing sores or cuts.
- Unplanned weight loss.
- Frequent urination.
- Frequent unexplained infections.
- Dry mouth.
Diagnosis of diabetes
- A fasting plasma glucose test measures your blood glucose after you have gone at least 8 hours without eating. This test is used to detect diabetes or prediabetes.
- An oral glucose tolerance test measures your blood sugar after you have gone at least eight hours without eating and two hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes or prediabetes.
- In a random plasma glucose test, your doctor checks your blood sugar without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes, but not prediabetes.
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A hemoglobin A1c (HbA1c) test can be done without fasting, and can be used to diagnose or confirm either prediabetes or diabetes.
Positive test results should be confirmed by repeating the fasting plasma glucose test or the oral glucose tolerance test on a different day. When first diagnosed with diabetes, your doctor may suggest a zinc transporter 8 autoantibody (ZnT8Ab) test. This blood test — along with other information and test results — can help determine if a person has type 1 diabetes and not another type. The goal of having the ZnT8Ab test is a prompt and accurate diagnosis and that can lead to timely treatment.
Fasting Plasma Glucose (FPG) Test
The FPG is most reliable when done in the morning. Results and their meaning are shown in table 1. If your fasting glucose level is 100 to 125 mg/dL, you have a form of prediabetes called impaired fasting glucose (IFG), meaning that you are more likely to develop type 2 diabetes but do not have it yet. A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes.
Treatment of diabetes
An important part of managing diabetes — as well as your overall health — is keeping a healthy weight through a healthy diet and exercise plan:
- Healthy eating. There’s no specific diabetes diet. You’ll need to focus your diet on more fruits, vegetables, lean proteins and whole grains. These are foods that are high in nutrition and fiber and low in fat and calories. You’ll also cut down on saturated fats, refined carbohydrates and sweets. In fact, it’s the best eating plan for the entire family. Sugary foods are OK once in a while. They must be counted as part of your meal plan.
Understanding what and how much to eat can be a challenge. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle. This will likely include carbohydrate counting, especially if you have type 1 diabetes or use insulin as part of your treatment.
- Physical activity. Everyone needs regular aerobic activity. This includes people who have diabetes. Physical activity lowers your blood sugar level by moving sugar into your cells, where it’s used for energy. Physical activity also makes your body more sensitive to insulin. That means your body needs less insulin to transport sugar to your cells.
Get your provider’s OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What’s most important is making physical activity part of your daily routine.
Aim for at least 30 minutes or more of moderate physical activity most days of the week, or at least 150 minutes of moderate physical activity a week. Bouts of activity can be a few minutes during the day. If you haven’t been active for a while, start slowly and build up slowly. Also avoid sitting for too long. Try to get up and move if you’ve been sitting for more than 30 minutes.
Prevention of diabetes
Diet and exercise
Weight loss resulting from healthy eating and increased physical activity enables muscle cells to use insulin and glucose more efficiently, thus lowering diabetes risk. Lack of exercise can cause muscle cells to lose their sensitivity to insulin, which controls levels of sugar in the blood.
“Even if you don’t lose weight, exercise will make you stronger and healthier,” says endocrinologist Douglas Zlock, MD, medical director of the diabetes center at John Muir Health. “Healthy habits can definitely postpone the onset of diabetes even if they don’t prevent it.”
The certified diabetes educators at John Muir Health are firm believers that those at risk for diabetes can develop a flexible care program with the help of a diabetes team. Important clinical trials have shown that exercise, healthy eating, and modest weight reduction can prevent diabetes. It takes time and effort to reduce your risk of diabetes; however this investment in your health is a valuable one!
Avoid complications
Although cutting out fatty foods and sweets and motivating oneself to maintain a daily exercise program can take some discipline, the payoff is tremendous because people at risk for diabetes are much more prone to developing cardiovascular disease.
Heart disease is two to four times more prevalent in those with diabetes and the risk of stroke is two to four times higher; high blood pressure manifests itself in the majority of adults with the disease; and diabetes is the leading cause of kidney disease.
“Controlling blood glucose, blood pressure, and blood cholesterol, along with regular preventive care can greatly reduce your risk of developing cardiovascular disease,” says endocrinologist Douglas Zlock, MD. medical director of the Diabetes Center at John Muir Health.
Early detection
“Detecting diabetes early by screening those at high risk, especially because many people do not exhibit symptoms, is vital to preventing complications,” Dr. Zlock says.
Those more predisposed to diabetes are Hispanic Americans, African-Americans, Native Americans, Asian Americans, Pacific Islanders, older adults, women who have had gestational diabetes, people who are overweight or inactive, and people with a family history of diabetes.
If you fall into one of these groups, you should be especially careful to monitor your lifestyle and follow the suggestions below. If you are at very high risk, obese, and under 60 years of age, your doctor may also recommend medication.
Tips
Experts recommend incorporating the following suggestions into a health care regimen:
- Exercise at least 30 minutes a day
- Eat a low-fat, low-sugar diet rich in vegetables, fruits, and whole grains
- Maintain your ideal weight through sufficient exercise and well-balanced meals
- Check your blood cholesterol at least once a year. Total cholesterol should be below 200, with LDL under 100, HDL (good cholesterol) above 60, and triglycerides below 150
- Keep blood pressure under control at 130/80 or lower
- Avoid smoking
- Drink in moderation
- Regular follow up with your doctor
