Diabetes
WHAT IS IT?
Diabetes is the term used to describe the condition where patients display higher than normal blood sugar levels.
Basic Facts
- Diabetes is the term used to describe the condition where patients display higher than normal blood sugar levels.
- Diabetes and pre-diabetes are becoming more common as the population becomes more overweight and sedentary.
- Type 2 diabetes is more common than type 1, and is largely preventable.
- Prior to developing type 2 diabetes, patients first go through the stages of pre-diabetes and insulin resistance.
A More Detailed Explanation
Insulin resistance is thought to be the underlying problem that causes type 2 diabetes. When you are insulin resistant, your body is unable to use insulin efficiently to convert glucose (sugar) into energy to be used by the cells in your body. Initially, your body responds by your pancreas making more insulin. Eventually, however, insulin production is overwhelmed and can no longer compensate. Blood sugar rises, and pre-diabetes and finally, type-2 diabetes results.
Insulin Resistance
Diagnosing insulin resistance. Insulin resistance in and of itself has no symptoms. Tests for insulin resistance are usually only done in a research setting. If diabetes or prediabetes is suspected, your doctor can check a fasting blood glucose test. A glucose tolerance test may be ordered to see how your body responds to a dose of a concentrated sugar solution
Treating insulin resistance. You can reduce insulin resistance by increasing your physical activity level, and reducing calorie intake. This will help you to lose excess weight, and even a small amount of weight loss can prevent diabetes. Quitting smoking can also reduce insulin resistance.
Pre-Diabetes
Pre-diabetes is a condition that precedes diabetes. You can have pre-diabetes for several years. When a person’s fasting blood sugar measures between 100 and 125, this is considered pre-diabetes. If you have pre-diabetes, there are some changes you can make to lower your chance of getting diabetes, or at least postponing it. It is not inevitable. By becoming more physically active, and cutting back on your calories (avoid large portions, fast food, and second helpings), you can reduce your weight and your risk for diabetes. The changes in your lifestyle do not have to be drastic, but you need to continue them over time. A blood sugar reading of 126 or higher meets the definition of diabetes. Healthy diet and regular physical activity continue to be important for people with diabetes, but medications and often insulin are usually required also.
How much exercise and what kind of exercise should I do?
Brisk walking is ideal. Riding a bike or swimming are also good. You should exercise at least 30 minutes every day of the week. If you are overweight, you will need to exercise for a longer period of time - 60 minutes a day. You do not have to do all of this at once. Breaking it into smaller periods is okay too. If you have not been active for a while, you should start out slowly.
How about weight loss?
When you have pre-diabetes, it is key to get your weight to an ideal level and keep it there. In research studies about diabetes prevention, people with pre-diabetes could prevent or at least delay diabetes by losing just a modest amount of weight. You can do this by decreasing your calorie intake, and avoiding high-fat foods. Watch your portion sizes and stay away from extra helpings.
What factors put a person at risk for pre-diabetes or diabetes?
- Being Hispanic, African American, Asian, Pacific Islander, or Native American
- Family history of prediabetes or diabetes
- Being older than 45 and overweight
- Having had diabetes when pregnant, or having given birth to a baby weighing over 9 pounds
- Having high blood pressure
- Carrying your weight around the middle, in an apple-shape rather than a pear shape
Type 2 Diabetes
There are 2 kinds of diabetes, type 1 and type 2. Type 1 involves a disorder of the pancreas (the insulin-producing organ), in which the pancreas does not produce the insulin the body needs to convert sugar to energy. People with type 1 diabetes need to replace the insulin their bodies are missing by giving themselves insulin shots at regular intervals. Type-1 diabetes can occur in children or adults.
Type 2 diabetes is much more common, making up about 90% of cases of diabetes. Type-2 diabetes is becoming more common in developed countries, because of its association with overweight and obesity. When you have type-2 diabetes, your pancreas produces insulin but your body’s cells resist insulin. The pancreas tries to keep up by making more insulin but eventually it is overwhelmed, the blood sugar rises, and type-2 diabetes results.
What happens to a person with type-2 diabetes?
The risks associated with type 2 diabetes include heart disease, stroke, nerve damage, circulation problems in the legs, and kidney or eye problems. By taking very careful care of your blood sugar, your blood pressure, and your cholesterol levels, you can lower your risk of these complications.
How is diabetes managed?
Self management is the key. You need to make careful food choices, incorporate physical activity into your daily life, and take the medicines your healthcare provider recommends.
Blood sugar management.
The blood test that measures how well your blood sugar is controlled is called your A-1-C. This level will be tested about every 6 months at least. Ideally this number should be under 7%. This A-1-C level reflects your blood sugar levels over a period of months. A blood sugar meter at home will be used to measure your blood sugar levels on a day-to-day basis. You should work with a healthcare provider or diabetes educator on a plan for measuring and recording your blood sugar levels.
Blood pressure.
Your blood pressure should be measured at each office visit. The goal for your blood pressure is 130/80 or lower. Often medication is required to maintain good blood pressure levels.
Blood cholesterol levels.
Most people with type 2 diabetes will be advised to take a cholesterol-lowering medication. These medicines, called statins, have important effects on reducing the risk of heart attack and stroke. A person with diabetes has an increased chance of these 2 serious health risks, so these medicines will be important
