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What is Diabetes?

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Diabetes Background


Diabetes is a chronic medical disease that impacts how your body turns food into energy. A person's blood sugar, also known as blood glucose levels, is impacted by the foods they eat. Those with Diabetes have blood sugar levels that are too high.


There are three main types of Diabetes which include Type 1 Diabetes, Type 2 Diabetes, and Gestational Diabetes. Each of these three types of Diabetes affects an individual’s blood sugar levels, although their cause and mechanisms differ. 


In general, all forms of Diabetes are medically known as Diabetes Mellitus. 


What is the difference between type 1 and type 2 diabetes?


Type 1 Diabetes


Type 1 Diabetes is the most severe form of Diabetes, where the immune system attacks and destroys the cells of the pancreas. The pancreas is an essential organ where humans make the hormone insulin. To learn more about insulin, see below in the Insulin section of this guide.


The root cause of Type 1 Diabetes is not fully known, though it is thought to be caused by an autoimmune reaction. An autoimmune reaction occurs when the body attacks itself. People with Type 1 Diabetes do not have sufficient insulin production from their pancreas. 


Type 1 Diabetes is sometimes referred to as juvenile Diabetes or insulin-dependent diabetes. Although Type 1 Diabetes can present in patients of any age, it is most often seen in children or teenagers.


Type 2 Diabetes


Unlike Type 1 Diabetes, Type 2 Diabetes does not involve the pancreas’ ability to create insulin. Rather, Type 2 Diabetes occurs when a person’s body becomes resistant to insulin. This insulin resistance causes their blood sugar to spike too high, as insulin’s main role is to help lower blood sugars.


People with Type 2 Diabetes struggle to keep their blood sugar levels within range.


Though it was once called “adult-onset diabetes" and thought to be more common in adults or older adults, Type 2 Diabetes can occur in people of any age. In fact, diagnosis in younger children and young adults is rising.


Gestational Diabetes


Gestational Diabetes is a specific type of Diabetes that only presents in pregnant women who did not have diabetes pre-pregnancy. This type of Diabetes often only affects a woman while pregnant and may go away after birth. According to the CDC, 2 to 10% of United States pregnancies experience gestational Diabetes.


Other Types of Diabetes


The three main types of Diabetes, as expressed above, are the most common. However, some other types of Diabetes may exist. A condition known as pre-diabetes refers to patients with rising blood glucose levels, which may turn into Diabetes over time. Pre-diabetes patients may have above-range blood sugar levels but are not quite at a level for diagnosing Type 2 Diabetes.


Other types of rare Diabetes do exist. These may include neonatal diabetes mellitus (NDM), maturity-onset Diabetes of the young (MODY), Diabetes Insipidus, or other rare forms of the disease.


Diagnosing and Recognizing Diabetes


What are the early signs of having Diabetes? 


Patients with Type 1 Diabetes often notice symptoms quickly, while Type 2 Diabetes occurs slowly over many years. Many people live with Type 2 Diabetes for several years without knowing about it, as symptoms can often be mild. Over time, this chronic progressive disease worsens. Some common symptoms of Diabetes include:

  • Excessive thirst
  • Excessive urination
  • Enhanced hunger
  • Tiredness or fatigue
  • Numbness in extremities (fingers or toes)
  • Blurred vision
  • Slow-healing wounds


Diagnosing Diabetes


Doctors can diagnose Diabetes using a variety of medical testing options. One option, known as the fasting plasma glucose test, is often used. This involves testing a patient’s blood sugar levels through a simple blood test. This is done fasting, which allows doctors to see a patient's blood sugar levels without being impacted by their food.


Another method of diagnosis is known as an A1C test. This blood test provides an average of a patient's blood sugar levels over two to three months.


What to Expect if a Loved One Has Been diagnosed


A Diabetes diagnosis can become overwhelming quickly. However, family members can provide support in a variety of ways. Start by finding a diabetes educator, and learning about proper Diabetes care so you can help support your loved one. Further, encourage healthy lifestyle choices and aid when needed. Offering verbal and emotional support for a loved one can help a loved one manage their Diabetes, no matter which type they have.


Reversal or Cure of Diabetes


There is no known cure for Type 1 Diabetes, and patients with this condition must manage their disease throughout their lifetime. While Type 2 Diabetes was often thought to be incurable, newer research suggests patients with Type 2 Diabetes who make serious lifestyle changes may return to the non-diabetes range or stages of partial or full remission.


What causes Diabetes?


The cause of Diabetes may differ depending on which type of Diabetes a person has. Determining the cause of Diabetes is not always a clear answer, as several factors can contribute to a person developing this medical condition.


Type 1 Diabetes Causes


The root cause of Type 1 Diabetes starts with the pancreas, as the pancreas cannot make insulin like it does in a person without Type 1 Diabetes. Researchers do not know entirely what causes this disease, however, it is thought to be some autoimmune response or genetic. This means a person's lifestyle factors are not a cause for developing Type 1 Diabetes.


Type 2 Diabetes Causes


In contrast, Type 2 Diabetes involves the failure of insulin to work properly. Several factors may cause type 2 Diabetes; however, lifestyle factors play a big role. Overweight or obese individuals with poor lifestyle choices are at higher risk for developing Type 2 Diabetes. 


Other risk factors include genetics or past family history of Type 2 Diabetes. In addition, certain racial or ethnic groups may be at higher risk of developing Type 2 Diabetes.


Gestational Diabetes 


Gestational Diabetes is caused by changing hormone levels through a woman’s pregnancy. However, genetic and lifestyle factors may also cause an increased risk of developing this condition and genetics and family history.


Sugary Foods and Diabetes


Eating a sugar-heavy diet may increase your risk of developing Diabetes. However, Diabetes is linked to several poor lifestyle choices beyond excess sugar, and sugar intake is just one piece of the puzzle. Eating a healthy diabetes diet made up of real foods without processed food can help you manage your weight, and this can help reduce your risk of developing Diabetes or help manage your Diabetes.


Preventing Diabetes


Preventing Type 1 Diabetes is not possible, however, Type 2 Diabetes can be prevented through a healthy diet and lifestyle. Maintaining normal body weight, (and weight loss where necessary), participating in physical exercise, and making healthy choices can help you prevent Diabetes.


Caring for Someone with Diabetes


Insulin and Glucose


Insulin is an important part of diabetes treatment. Insulin helps your body keep its blood sugar within range by taking glucose out of the bloodstream and moving it around the body for energy. Blood glucose can then do its job of providing cells with energy.


Glycemic Index


The Glycemic Index or GI helps measure how much a given food impacts blood sugar levels. Foods are ranked on a scale from 0 to 100, helping Diabetes to determine which foods are best to eat. The GI is helpful to help find low or medium GI foods that will not spike a Diabetics blood sugar level.


Managing Blood Sugar and Insulin Doses


Each person's insulin doses will vary. Your doctor will help you find the correct dose for your loved one’s insulin injections. Insulin dosage levels are impacted by several factors, including blood sugar levels, activity levels, and carbohydrate content of meals. Too much insulin or an insulin overdose is possible, which may cause your blood sugars to fall too low, causing hypoglycemia.


Your doctor will help you put a plan in place to check your blood glucose level; this may be done through a blood sugar meter or continuous glucose monitoring system. Knowing your blood sugar levels and determining the correct insulin dosage for your body is an important part of diabetes management.


You may notice an increased blood sugar level after eating a carb-heavy or sugar-heavy meal.


Insulin Resistance


Insulin resistance occurs when your body no longer responds well to insulin. As a result, your pancreas must make more insulin to combat this issue. This causes a person's blood sugar levels to increase, causing insulin resistance.


Best Diet for Diabetes 


The best diet for someone with Diabetes is low in carbohydrates and refined sugars. Focus on eating lean protein and high fiber, and limiting sugary and starchy items, which will elevate your blood glucose levels. Controlling your diet is one of the most important components to managing Diabetes. Choose drinks and cocktails that are lower in sugar and carb content, such as light beer or red wine. 


Best Exercises for patients with Diabetes


Exercise is important for patients with Diabetes to manage their body weight and control blood glucose levels. The best type of exercise includes cardiovascular exercises, such as walking, cycling, or swimming. Weight training may also help target insulin resistance.


What are the Risk Factors of Diabetes?


Type 1 Diabetes Risk Factors


Certain viral infections can trigger Type 1 Diabetes, such as measles or mumps. In addition, people of Caucasian race may be more likely to develop Type 1 Diabetes. Family history also plays a role in a person's likelihood to develop Type 1 Diabetes.


Type 2 Diabetes/Pre-diabetes Risk Factors


Risk factors for Type 2 Diabetes or Pre-diabetes include:

  • Being overweight or obese
  • Age (Older individuals  over the age of 45 have an increased likelihood)
  • Race/Ethnicity: Black, Hispanic, and Asian American individuals may be at a higher risk
  • Activity and Exercise levels
  • High blood pressure or High Cholesterol 


Gestational Diabetes Risk Factors


Women with certain risk factors may be at high risk of experiencing Gestational Diabetes in their pregnancy. These risk factors are like those of Type 2 Diabetes, which include: overweight or obesity, lack of physical activity, Polycystic Ovary Syndrome (PCOS), race/ethnicity, or past family history.


Other Health Problems Linked to Diabetes


Diabetes can result in long-term diabetes complications, including heart disease/cardiovascular disease, nerve damage, kidney disease/kidney failure, eye damage, and cognitive conditions.


Complications of Gestational and Prediabetes


Untreated Gestational Diabetes can result in complications with the baby, including excess growth, low blood sugar, or increased risk to develop Type 2 Diabetes later in life. Complications for the mother include preeclampsia or subsequent Gestational Diabetes in future pregnancies. Patients with pre-diabetes may develop Type 2 Diabetes without intervention.


What are the effects of Diabetes?


Diabetes causes several complications over time. Due to poorly controlled blood sugar levels, Diabetes can cause damage to your blood vessels. In turn, this can affect your heart and kidneys. Diabetic neuropathy, or nerve damage, often occurs, causing damage to the nerves in the legs or feet. In addition, Diabetes can cause nerve damage in your ears which contributes to potential hearing loss.


High blood sugar levels may also have other effects, including long-lasting eye damage. One condition, known as Diabetic Retinopathy, can cause vision loss and blindness.


Other effects of Diabetes may include headaches, dizziness, or hair loss. These symptoms may result from too high or low blood sugar levels.


Diabetic Ketoacidosis


One complication of Diabetes, known as Diabetic Ketoacidosis, occurs when the body does not have enough insulin to use for energy. The liver breaks down fat, leading to an overproduction of ketones in the body. DKA can be prevented by effectively managing your Diabetes.


How Common is Diabetes?


Diabetes is one of the most commonly occurring medical conditions in the United States healthcare system, and the 7th leading cause of death in the country. According to the Centers for Disease Control and Prevention (CDC) and American Diabetes Association, about 1 in 10 Americans have Diabetes (37.3 million Americans.) In addition, more than 1 in 3 Americans have pre-diabetes, meaning they have an impaired glucose tolerance and are at risk for developing Diabetes.



Robert C. Fisher

Robert C. Fisher is a Nurse Director at a large medical center with over a decade of experience.

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