Discussing Diabetes

Discussing Diabetes

By Catherine Smith

Over 37 million adults in the United States have diabetes, but the CDC reports that 1 in 5 are not aware of it. Unfortunately, diabetes can cause significant health complications when left untreated – it is the No. 1 cause of kidney failure, lower-limb amputations, and blindness in the United States, as well as the eighth leading cause of death. In order to better protect yourself and your loved ones, it is important to understand the symptoms, treatments, and preventative or proactive measures associated with different types of diabetes. Read on to learn more from local healthcare professionals.

What is Diabetes?

Diabetes is a chronic condition that inhibits the body’s ability to either produce or properly use insulin, the hormone responsible for regulating blood sugar levels and converting sugars from our food into energy. As a result, elevated blood sugar, or hyperglycemia, is a hallmark of diabetes.

Our blood sugar fluctuates naturally throughout the day as we eat and are active, but prolonged or highly elevated hyperglycemia is a cause for concern. “All types of diabetes lead to impaired glucose movement into muscle cells, which creates a ‘starvation’ environment despite the ample amounts of glucose around. This makes glucose levels increase even when a diabetic hasn’t eaten that much,” explains Dr. Stephanie Hinds of CHI Memorial Primary Care Associates. “This happens because the liver is stimulated to make more glucose, so fat and protein are broken down.”

Type 1 Diabetes

Roughly 5-10% of diabetes cases are type 1. Type 1, also known as juvenile diabetes, is believed to be an autoimmune condition in which the body attacks its own pancreas and damages the cells needed to create insulin. “Type 1 diabetes is a result of pancreatic beta cell failure. Hence, the pancreas does not make sufficient insulin anymore,” explains Tiffany Potter, a nurse practitioner with CHI Memorial Endocrinology Associates. As a result, type 1 diabetics must closely monitor their blood sugar throughout the day. When blood sugar is elevated, the proper amount of insulin must be administered via injection or an insulin pump.

Type 1 diabetes can develop at any age. Risk factors for type 1 include having a first degree relative with the condition or having another autoimmune disorder. There is currently no way to prevent the onset of type 1 diabetes, and it is very dangerous if left untreated. Therefore, it is critical that people with a family history of the condition inform their medical providers and follow screening guidelines.

Type 2 Diabetes

Type 2 diabetes is far more common than type 1, accounting for 90-95% of cases. With type 2, the pancreas is still capable of producing insulin, but the body has developed insulin resistance which makes it harder for the hormone to properly regulate blood sugar. As a result, blood sugar becomes elevated and can do significant damage over time.

Unlike type 1, type 2 diabetes can be prevented – typically by making lifestyle changes. “For type 2 diabetes, family history may not be that significant. Diet, exercise, and lifestyle habits are the most important,” explains Dr. Asma Khan of Galen Center for Diabetes and Endocrinology. “Type 2 may not cause any symptoms, so any person who is overweight should be tested.”

Gestational Diabetes

Gestational diabetes occurs when hormone changes and weight gain during pregnancy lead to insulin resistance. This usually does not cause noticeable symptoms for the mother, but it can lead to high blood pressure, increased birth weight, and premature birth. Though gestational diabetes resolves after giving birth, it increases the risk of both mother and baby developing type 2 diabetes later on.

“Diabetes causes high blood sugars which can damage the blood vessels to many organs of the body,” says Potter. “Good glucose control greatly reduces the risk of long-term complications, which include heart disease, heart attacks, strokes, peripheral artery disease that can lead to poor wound healing and loss of limbs, eye disease that can lead to blindness, kidney disease, and peripheral neuropathic pain.” For this reason, keeping blood sugar within the normal range is the most important factor in treating diabetes. “It might be hard to imagine how glucose or blood sugar can create so much damage in the body,” Dr. Hinds shares. “Glucose itself is not dangerous; it is a vital nutrient for every cell in our body. As with anything in life, the ‘dose makes the poison,’ and glucose in excess can wreak havoc if left unchecked.”

Standard Adult Blood Sugar Levels

Normal

• Fasting: 80-100

• Just After Eating: 170-200

• 3 Hours After Eating: 120-140

Prediabetic

• Fasting: 101-125

• Just After Eating: 190-230

• 3 Hours After Eating: 140-160

Diabetic

• Normal: 126+

• Just After Eating: 220-300

• 3 Hours After Eating: 200+

When blood sugar is higher than average but not yet at diabetic levels, this is known as prediabetes. This indicates a strong risk of developing type 2 diabetes. The good news is that prediabetes can be reversed with lifestyle changes and guidance from your physician.

Diabetes Symptoms

• Increased urination, especially at night

• Increased appetite

• Increased thirst

• Unexplained weight loss

• Blurry vision

• Numbness or tingling in hands or feet

• Fatigue

• Dry skin

• Slow-healing wounds

• More infections than normal

• Nausea, vomiting, or stomach pain (for type 1)

Both type 1 and type 2 diabetes can develop at any age, and some people may have no noticeable symptoms. If you or a family member are experiencing any of these symptoms, it is important to get tested – particularly for those who are at increased risk of diabetes. If you are pregnant, your doctor should test for gestational diabetes between 24 and 28 weeks.

Managing Diabetes – Tips From Professionals

For parents of kids with type 1, Dr. Khan says, “Have a good relationship with the school nurse. Give them detailed information about your child and explore new technologies.” New developments like round-the-clock glucose monitors have helped put parents’ minds at ease.

In addition to medications and insulin injections, lifestyle changes can make it easier to control blood sugar levels. “Many other factors, aside from foods, can affect glucose levels in either type 1 or type 2 diabetic patients including pain, stress, sleep habits, smoking, alcohol, acute illness, and medications such as steroids and some vitamins,” Potter shares.

When it comes to preventing type 2 diabetes, Dr. Hinds has some advice. “For those with a family history of type 2 diabetes, a weekly exercise program is vital. Exercise has been shown to improve what is called insulin sensitivity and glucose uptake into muscle cells. Even those who cannot do traditional exercise can be taught certain techniques to increase their muscle strength and muscle mass,” she says.

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Asma Khan, MD
Endocrinologist, Galen Center for Diabetes and Endocrinology

Tiffany Potter, MSN, APRN-BC, FNP-C
Nurse Practitioner, CHI Memorial Endocrinology Associates

Stephanie Hinds, MD
Internal Medicine Specialist, CHI Memorial Primary Care Associates – Atrium