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Diabetes
Overview

Diabetes or the body’s inability to maintain blood sugar levels is one of the leading causes of death in the United States. High blood sugar levels over time reduce energy and nutrients into your body’s cells and damage delicate organ tissue. It can lead to severe complications to the eyes, heart, and kidneys. It can also damage blood vessels in the limbs and lead to possible amputation. Heart attacks and stroke are other common complications.
There are two different types of diabetes; Type 1 Diabetes where the body does not produce insulin, and Type 2 Diabetes where the body does not produce enough insulin or respond to insulin that the body produces. Both types need to be closely monitored and treated on a daily basis.
There are over 29.1 million people in the United States that are living with diabetes. Only 21 million of these people actually know they have diabetes. Around 8.1 million people do not know they have diabetes. Early diagnosis and treatment are very important to prevent long-term complications. This article will help you understand this disease and how to manage it.

What Is Diabetes?

Diabetes is when your body cannot process the glucose from the food you eat and use it for energy. In healthy people, the body uses insulin that is made by the pancreas to convert any carbohydrates or sugars into glucose. Insulin also makes the glucose enter your cells to give you energy. With diabetes, there is either no or not enough insulin to do this job and the blood sugar level raises too high. You may have heard this condition called, “sugar diabetes” by some sufferers.
Blood sugar levels that stay too high for too long can cause damage to the body. High blood sugar damages the blood vessels and prevents blood flow to organs and tissues.

Types of Diabetes

There are two forms of diabetes. Type 1 is an auto-immune type and Type 2 is acquired, but both have a genetic link. Here is the description of the two types:
Type 1 Diabetes. This is also called “Juvenile Diabetes” and usually comes on in childhood, but can appear anytime into early adulthood. For some unknown reason, the pancreas no longer produces insulin and the body is unable to process any glucose without taking daily insulin injections. This is thought to be an auto-immune disorder that is triggered by either a virus or environmental factors. There is no cure and this type is not reversible, but it is manageable. It requires lifelong treatment with insulin injections.
Type 2 Diabetes. Type 2 diabetes comes on in the adult years. The pancreas decreases or stops production of insulin and the body has reduced sensitivity to any insulin present. There is usually a cause linked to the following; obesity, family history, history of gestational diabetes, and ethnic background (Native American, African American, Latino). The good news is this type is highly treatable and even reversible if the pancreas is still functioning. You may or may not require insulin injections and often manageable with diet and/or oral medications.
Gestational Diabetes. This sub-type of type 2 diabetes only occurs during pregnancy. It is more common in women who are obese and have a history of Polycystic Ovarian Syndrome (PCOS). Babies born to mothers with GD have a risk of being higher birthweight and low blood sugar at birth. This condition is easily managed during pregnancy with good medical care and diet.

Causes of Diabetes

The causes for each type of diabetes are different. These are:
Type 1 Diabetes
Something triggers the body’s own immune system to attack the pancreas destroying the cells that produce insulin. There is a possible genetic factor that raises the risk of Type 1 diabetes and/or autoimmune disorders.
When enough of the islet cells in the pancreas cease function, insulin is no longer produced. Insulin works by:
Insulin is secreted into the blood from the pancreas

The insulin allows the sugar to get into your cells

Insulin helps keep the blood sugar levels in check

If your blood sugar is in normal range, your pancreas lowers the insulin levels

Blood sugar is important to help your muscles and body with energy needs. Sugar is converted to glucose by the body and its primary role is:
Your body gets glucose from the food you eat and your liver produces a glucose like substance known as, glycogen

You absorb sugar from food and insulin helps it get into the cells

Your liver stores glycogen for times when you don’t have enough blood sugar

When you have Type 1 Diabetes, the pancreas no longer produces insulin and the blood sugar stays in the blood and does not get into the cells.
Type 2 Diabetes
A combination of lifestyle factors (obesity, poor diet, and lack of exercise) and family history all contribute to the development of Type 2 diabetes. The insulin producing cells in the pancreas still work, but produce less insulin than the body requires. The body also does not respond as well to the insulin.

Symptoms of Diabetes

The symptoms for both Type 1 and Type 2 diabetes are pretty much the same. Type 2 diabetes and gestational diabetes symptoms may tend to be mild or not even appear until the disease has progressed. They include:
Urinary frequency

Excessive thirst

Excessive hunger

Severe fatigue

Blurred Vision

Slow healing

Loss of weight (Type 1)

Pins and needles or pain in the legs, hands, and feet

Diagnosing Diabetes

Diabetes can be very silent. If you do not have symptoms, the disease is often found during a routine physical. It is highly recommended that anyone age 45 and older be screened routinely for diabetes every three years. If you do have any of the above symptoms, see your doctor as soon as possible. The following tests are used to diagnose diabetes:
Random Blood Sugar Test. During a routine office visit your doctor can just take a small sample of blood from your finger and test it for blood sugar. Whether you have eaten or not, if your blood sugar is 200 mg/dL or higher you may have diabetes.
Fasting Blood Sugar Test. You will fast after bedtime the night before and nothing to eat or drink the morning before your test. They will take a blood sample and test it for blood sugar. It should be lower than 100 mg/dL and if it is between 100 mg/dL and 125 mg/dL you may have prediabetes. Over 125 mg/dL two times means you have diabetes.
Glucose Tolerance Test. This blood test requires fasting the night before the test and the morning of the test. When you first get to the lab they will draw a blood sample and then have you drink a very sweet glucose drink. After drinking the solution, they will draw your blood every two hours to see how your body processes glucose.
If your blood sugar drops to 140 mg/dL or less after two hours, your body handles glucose normally. If your blood sugar stays above 200 mg/dL then you may have diabetes. If your blood sugar stays between 140 mg/dL and 100 mg/dL then you may have prediabetes.
The A1C Test. The “Glycated Hemoglobin A1C Test” checks the average of your blood sugar levels over a three month period. When your blood sugar rises, it sticks to the hemoglobin in your blood and stays there. Even if you have normal blood sugar levels during random testing, this test will pick up that you may have had high blood sugars over the three month period. The test levels that indicate your blood sugars work like this:
A1C 5.7 or lower – Normal
A1C 5.7 to 6.4 – Prediabetes
A1C 6.5 or higher – Diabetes if this number comes up on two different occasions
If you are diagnosed with diabetes, it is recommended that you have the A1C test done 2 to 4 times yearly. It is recommended that you try to keep your A1C less than 7, but your doctor will tell you the best numbers for your age and other health conditions you may have.
You will also keep track of your daily blood sugar levels either twice daily or before each meal if you take insulin.
Other Tests
To check for any complications your doctor may test:
Liver Function Tests

Thyroid Function Tests

Kidney Function Tests

Cholesterol Testing

Blood Pressure

Eye Examinations

Foot Examinations

Treatments for Diabetes

The treatments for diabetes include:
Eating a healthy balanced diet

Exercise

Diabetic medications (oral antidiabetics and/or insulin injections)

Daily blood sugar monitoring

Eating a Healthy Balanced Diet
A diabetic diet consists of balanced low-calorie, low-fat, and healthy carb foods. It is also important to eat foods that are high in fiber such as; fresh vegetables, fresh fruits, and whole grains. Try to avoid processed foods, high fat foods, and desserts.
The good news is that diabetics can have carbohydrates if they are low on the “glycemic index.” Recent studies have shown that certain carbohydrates break down slower than refined carbohydrates and actually benefit a diabetic diet. Adding protein foods to carbohydrates also slows down blood sugar spikes. A diabetic educator can help you with your meal plans that will keep your blood sugar in a good range.
Exercise
Diabetics need to get 30 minutes of exercise at least 5 days a week. This includes; swimming, walking quickly, and riding a bike. Aerobic exercise at least 3 days a week can help lower blood sugar levels and improve circulation.
Exercise brings down the blood sugar levels so it is important to check your blood sugar before and after exercise, eat a light carb snack before you start and after you finish and stop physical activity if you have symptoms of low blood sugar including; dizziness, sweating, confusion, or shakiness.
Diabetic Medications
If you have Type 1 diabetes you will need insulin injections since your pancreas no longer makes insulin. You may also need other medications to prevent complications.
If you have Type 2 diabetes, you may be able to control your blood sugar levels with dietary management alone. You may also need oral antidiabetics to help your body process glucose and increase insulin production from the pancreas. In more advanced Type 2 diabetes, some people need to also take insulin injections.
Blood Sugar Monitoring
Diabetes means pricking your finger and checking your blood sugar at least twice a day. Type 1 diabetics need to check before each meal to know how much insulin to take. No one likes to think about this, but you need to see how well your medication and treatment plan is working. It is also important so you know when your blood sugar is either too low or too high. Symptoms of these include:
Low Blood Sugar
Fatigue

Weakness

Shakiness

Sweating

Confusion

Hunger

Headache

Irritability

Anxiety

Blurred vision

Fast heartbeat

Fainting

Seizures

High Blood Sugar
Excessive urination

Excessive thirst

Blurred vision

Dry skin

Weakness

Fatigue

Complications of Diabetes

If your blood sugar stays too high for too long, you may develop complications. Some may be very severe and can result in death. These complications include:
Heart Disease. People with diabetes have an increased risk of heart disease. High blood sugar narrows the arteries and can result in a heart attack or stroke.
Nerve Damage. High blood sugar damages the blood vessels that feed your nerves. This is most common in the feet and legs. If you lose these nerves, you may not feel an injury or infection and can lead to amputation. The nerves in your stomach can also be damaged and cause digestion problems.
Kidney Disease. The sugar in your blood may damage the filters in your kidneys and they can begin to fail. If they fail completely, you may need to go on dialysis and/or need a kidney transplant.
Eye Disease. High blood sugar affects the tiny blood vessels that supply your retina with blood. Diabetes can lead to a disease known as “diabetic retinopathy” and can cause blindness, cataracts or glaucoma.
Other conditions stemming from diabetes include:
Fungal infections

Hearing loss

Increased risk of Alzheimer’s Disease

Lifestyle Changes for Diabetes

Learn The Glycemic Index. The glycemic index is based on how high carbohydrates will raise your blood sugar. There are low glycemic carbs, moderate glycemic carbs, and high glycemic carbs. This will help you include healthy carbs in your diet.
Increase Fluid Intake. Increased sugar-free fluids can help flush excess sugar from your body and protect your health.
Check Restaurant Menu Options. Before you go out to eat, check ahead to make sure there are menu options that are “diabetic friendly.” If you are in a pinch and don’t have time, opt for the “heart healthy” choices.
Let People Know About Your Condition. People you are around need to know that you are diabetic. Teach them about symptoms of low or high blood sugar and how to help you if you become unconscious or unable to care for yourself.
Keep Blood Sugar Rescue On Hand. If you do have a drop in blood sugar, you will need to have some kind of blood sugar rescue available. If you are able to manage yourself, keep things like; orange juice, hard candies, or glucose rescue tablets. You will also need a glucose pen injection and the people around you will need to know how to use it.

Diabetes Prevention

Type 1 diabetes may not be preventable because it is a genetic and autoimmune condition. Type 2 diabetes is preventable and reversible in the early stages of the disease. Prevention tips include:
Keep your weight in a healthy range

Get plenty of exercise

Eat healthy

Get your blood sugar checked at your yearly physical

Avoid stress

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