Health Care Thought Leadership

Understanding Diabetes

A Woman Tests Her Glucose Levels with a Finger Medical Device

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What is Diabetes?

Diabetes is defined as a chronic disease that occurs when your blood sugar is too high and impacts how your body turns glucose from food into energy. When left untreated, it can lead to complications like heart disease, nerve damage, eye problems, and kidney disease.

There are three main types of diabetes: type 1, type 2, and gestational diabetes. There’s also a condition that precedes type 2 diabetes called prediabetes.

How Diabetes Works

Sugar and carbohydrates that we eat are converted into glucose during digestion. Glucose enters the bloodstream and signals the pancreas to release insulin, which is necessary for allowing sugar (glucose) into cells. Insulin acts as a key that unlocks the cells’ ability to use the glucose for energy. Without it, blood sugar levels become higher than they should be and can cause diabetes.

Type 1 Diabetes is prevalent in about 5-10% of diabetics and occurs when not enough insulin is produced by the pancreas. The insulin-producing cells in the pancreas have become destroyed due to an autoimmune response (when the body attacks its own cells by mistake). Blood sugar levels rise as glucose is unable to enter cells without insulin. Type 1 diabetes requires regular monitoring of blood glucose levels and administering multiple daily insulin injections with a pen, syringe, or a pump.

Type 2 Diabetes occurs when the body is less efficient at using insulin well enough to maintain normal blood sugar levels due to the cells becoming insulin resistant. It is prevalent in 90-95% of people with diabetes. It takes many years to develop type 2 diabetes and is typically preceded by a period of prediabetes. Type 2 diabetes can largely be prevented or delayed by making healthy lifestyle choices such as losing weight if overweight or obese, eating healthy, and being active.

In the United States, 1 in 3 people have prediabetes and more than 8 in 10 of them don’t know they have it yet. With prediabetes, blood sugar levels have begun to creep up and are higher than normal, but not yet high enough for a diagnosis of type 2 diabetes. Prediabetes can occur because your pancreas may not make enough insulin, or your cells become resistant to insulin and don’t allow as much sugar in resulting in the buildup of sugar in your bloodstream. The exact cause of prediabetes is not determined, but over time can lead to type 2 diabetes. The good news is that you can take healthy diet and lifestyle steps to reverse prediabetes and ultimately prevent developing type 2 diabetes.

Gestational diabetes is diagnosed during pregnancy when a women who has never had diabetes now has uncontrolled, elevated blood sugar levels. It often resolves after pregnancy but can increase the risk of pregnancy complications if left unmanaged. It may also increase the mother’s risk of developing Type 2 diabetes later in life and increases the risk of obesity and type 2 diabetes in the child.

Symptoms and Risk Factors of Diabetes

Symptoms of diabetes include increased hunger and thirst, fatigue, blurred vision, numbness or tingling in hands and feet, slow healing sores, and unexplained weight loss.

There are not usually signs or symptoms of prediabetes. One potential sign of prediabetes is darkened skin on certain parts of the body. This would include the neck, armpits, and groin.

Factors that increase the risk of prediabetes include weight, waist size, diet, inactivity, age, family history, genetics, race or ethnicity, gestational diabetes, polycystic ovary syndrome, sleep, tobacco smoke, high blood pressure, low levels of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol, and high levels of triglycerides – a type of fat in your blood.

Diagnosing Diabetes

Healthcare professionals diagnose diabetes using several different types of blood tests. Providers commonly use the Fasting Blood Glucose Test, the Oral Glucose Tolerance Test, and the Hemoglobin A1C Test. It is important to understand what each of these tests involves and what the results mean.

The Fasting Blood Glucose (FBG) Test is a simple blood test that checks your blood glucose levels after an overnight fast (not eating for at least 8 hours). If your fasting blood glucose level is 126 milligrams per deciliter (mg/dL) or higher on two separate tests, you will be diagnosed with diabetes.

The Oral Glucose Tolerance Test (OGTT) begins with a fasting blood glucose test. You are then given a sweet liquid that contains a known amount of glucose. Your blood glucose levels are then checked several times over the next 2-3 hours. A blood sugar level less than 140 mg/dL is normal. A reading between 140 and 199 mg/dL indicates prediabetes. A reading of 200 mg/dL or higher after two hours indicates diabetes.

The Hemoglobin A1C (HbA1c) Test is the most effective way to monitor longer-term blood sugar control. This blood test reflects your average blood sugar level for the past 2 to 3 months. When blood sugars run high, sugar sticks to hemoglobin, the protein found in red blood cells. The sugar will remain attached for the life of the cell, which is about 2-3 months. The HbA1c test represents the percentage of red blood cells with glucose attached. An HbA1c level of 5.6% or below is normal. An HbA1c level between 5.7% and 6.4% indicates prediabetes. An HbA1c level of 6.5% or higher on two separate tests indicates diabetes.

Prevention

Healthy lifestyle choices can help prevent prediabetes and stop the progression of prediabetes into type 2 diabetes. These choices would include controlling your blood pressure and cholesterol, not smoking, eating healthy foods, losing excessive weight, and getting active.

Ask your provider about blood sugar screening to test for potential risk factors. See your health care provider if you’re concerned about diabetes or if you notice any signs or symptoms diabetes.

What to do

The biggest thing you can do to improve your glucose control is to be consistent. Eating healthy, being more active, and losing weight can decrease your risk of diabetes by 58%, and if you are over 50 by 71%.

Eating healthy means to set consistent mealtimes and to consume balanced meals. Widely varying mealtimes can put you on a glucose roller coaster, so it’s recommended to eat meals and snacks at about the same time each day, to not let more than 4 hours pass between meals, and to avoid skipping meals. Try to eat 3 balanced meals and 2-3 nutritious snacks each day to prevent overeating and to control glucose. Work with a registered dietitian or certified diabetes educator to determine your carbohydrate needs.

Consistent exercise and activity can have a big impact on helping you achieve healthy blood sugar levels. When you exercise, your cells become more sensitive to insulin so they can work more efficiently and remove glucose from the blood. Exercise can lower blood glucose and improve your A1C, cholesterol, and blood pressure. Aim to exercise most days (5-7 days per week) and set a goal of 30 minutes of exercise per day. After getting your doctor’s OK, start out with 5-10 minutes per day and gradually work towards 30 minutes.

Maintaining a healthy weight is another way to control your blood glucose levels. If you are overweight or obese, it may be beneficial to lose 5-7% of your body weight. An example would be losing 10-15 pounds if you weigh 200 pounds.

Nutrition Therapy is another option to improve your glucose control. It involves choosing a variety of fruits, vegetables, whole grains, heart-healthy fats, and lean proteins, while limiting fried foods, foods high in sodium, desserts, and sugar-sweetened beverages. It can be helpful to work with a registered dietitian as they can personalize a nutrition plan just for you.

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Would you like to learn more about identifying your risk for diabetes? Our team of experts at the Whole Health Institute are here to help you start your healing journey. Visit us on the web or call us at 913-632-3550


Sources:

The Mayo Clinic.

American Diabetes Association. (n.d.). Retrieved from http://www.diabetes.org/

Mahan, L.K., MS, RD, CDE, & Raymond, J. L., MS, RD, CD. (n.d.). Krause’s Food & the Nutrition Care Process (13th ed.). Saunders.

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