What is Diabetes?
Diabetes is a serious disease in which the body does not properly breakdown food for energy. Most of the food that we eat is broken down into sugar/glucose, for the body to use as energy. When a person has diabetes, the body either doesn't make insulin or cannot use insulin as well as it should. Since insulin is produced in the pancreas and helps get sugar/glucose into the cells of the body, when it is not working properly a buildup of sugar/glucose occurs in the blood, causing high blood glucose.
When diabetes is not managed properly, it can cause complications such as blindness, kidney failure, heart disease, nerve damage, and loss of toes, feet and even legs. Diabetes can be controlled by working with a physician to keep blood sugar/glucose levels within a normal range, eating well and being physically active. It is when steps are taken to control diabetes that the risk of developing complications may become lower.
Use the tabs below to learn more about diabetes and what you can do to prevent it.
Type 1 Diabetes
Previously known as juvenile-onset diabetes, type 1 diabetes is a chronic disease in which the pancreas does not produce insulin. The disease usually develops in children and young adults but can occur at any age, when the body’s immune system attacks and destroys the insulin producing cells in the pancreas. The cause of developing type 1 diabetes is unknown, however it is believed that there are both genetic and environmental factors that may trigger the onset (Source: JDRF). There is no known way to prevent type 1 diabetes, but the disease can be managed through daily insulin injections, blood glucose monitoring, eating healthfully and adequate exercise.
What Causes Type 1 Diabetes?
According to the Centers for Disease Control and Prevention (CDC) the causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for developing both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.
Prediabetes
Prediabetes is a condition in which individuals have blood sugar/glucose levels higher than normal but not high enough to be diagnosed with type 2 diabetes. Individuals that are diagnosed with prediabetes are at an increased risk of developing type 2 diabetes within 10 years along with other health problems such as heart disease and stroke.
The CDC estimates that about 84 million Americans now have prediabetes - That is 1 out of 3 adults. Of those 84 million, 9 out of 10 of them don’t even know that they have it.
Am I At Risk for Prediabetes?
According to CDC, individuals who have the following risk factors may be at higher risk for prediabetes and type 2 diabetes.
- Overweight
- 45 years of age or older
- Family history of type 2 diabetes
- Physically inactive (less than 3 times per week)
- Gave birth to a baby that weighed more than 9 pounds
- Gestational diabetes
- High blood pressure
- Abnormal cholesterol
Race, ethnicity, and age also affect your risk. Blacks, Hispanics/Latinos, American Indians, Pacific Islanders, and some Asian Americans, as well as the aging population, are at particularly high risk for prediabetes and type 2 diabetes.
Do I Have Prediabetes?
According to the American Diabetes Association (ADA), prediabetes can be diagnosed through one of the following tests:
- A hemoglobin A1c (A1c) – Measures average blood glucose for the past 3 months. Prediabetes is diagnosed at an A1c between 5.7% – 6.4%.
- Fasting plasma glucose (FPG) – Measures fasting blood sugar/glucose levels after not having anything to eat or drink for at least 8 hours. Prediabetes is diagnosed at a FPG level of 100 – 125 mg/dl.
- An oral glucose tolerance test (OGTT) – Measures blood glucose levels before and 2-hours after the consumption of glucose drink. Prediabetes is diagnosed at a 2 hour blood glucose level of 140 mg/dl – 199mg/dl.
Can I Prevent Prediabetes/Type 2 Diabetes?
Prediabetes is a serious medical condition. Taking action right away by moderately losing weight and increasing physical activity can help prevent prediabetes from becoming type 2 diabetes. Early prediabetes diagnosis can prevent or minimize some of the complications and outcomes of type 2 diabetes, like:
- Heart attack
- Stroke
- Blindness
- Kidney failure
- Loss of toes, feet or legs
Also, according to CDC, if you do have prediabetes, research shows that lifestyle changes of losing 5% - 7% of body weight, and getting at least 150 minutes each week of physical activity can help prevent or delay type 2 diabetes. The CDC National Diabetes Prevention Program can assist with the 5% - 7% body weight loss goal along with getting the required amount of daily physical activity.
What is the National Diabetes Prevention Program?
The CDC's National Diabetes Prevention Program (N-DPP) is a lifestyle change program delivered in-person or online, developed specifically to prevent type 2 diabetes. The structure of the class is based on research led by the National Institutes of Health (NIH), which showed that individuals can decrease their risk of developing type 2 diabetes by 58% when they lose a small amount of weight (5% - 7% percent of total body weight) through healthful eating and being physically active for 150 minutes per week.
The N-DPP is not a quick fix. It is a yearlong program that focuses on making lasting lifestyle changes. Classes are delivered by professionally trained lifestyle change coaches, in a group setting, over a 12-month period. Sessions take place weekly for six months, followed by a second six months of maintenance.
According to CDC, during the first six months of the program, participants will learn how to:
- Eat healthy
- Add or increase physical activity
- Deal with stress
- Cope with difficult challenges, like dining out
The following second six months enhance skills learned to help maintain changes. Sessions will review key ideas such as tracking food and physical activity, goal setting, staying motivated and overcoming barriers.
The cost of the N-DPP varies depending on the location, organization offering the program, as well as the type of program (online or in-person). For details on the cost, contact the program directly. Also, some employers and insurance companies cover the program, so check with an employer or insurance company to see if the program is covered.
Type 2 Diabetes
Previously known as non-insulin-dependent diabetes mellitus (NIDDM) or adult onset, type 2 diabetes is the most common form of diabetes accounting for 90 to 95% of all diagnosed cases of diabetes. With type 2 diabetes, the body either is not able to use insulin correctly (a hormone that regulates sugar/glucose), or doesn’t produce enough insulin to maintain a normal glucose level.
Am I at Risk for Type 2 Diabetes?
Certain risk factors increase the risk of developing type 2 diabetes. They include:
- Weight – Being overweight is a primary risk factor for type 2 diabetes
- Age – Typically those individuals over 45 are at higher risk
- Family History – Increased risk if any parents or siblings have type 2 diabetes
- Physical Inactivity – The less active one is (less than 3 times per week) the greater the risk.
- Gestational Diabetes – If while pregnant there was a diagnosis of gestational diabetes or if a baby was birthed weighing more than 9 pounds.
- Race – Individuals of certain races including blacks, Hispanics/Latinos, American Indian, Pacific Islanders and Asian Americans are more likely to develop type 2 diabetes.
- Blood Pressure - Having high blood pressure measuring 140/90 mmHg or higher.
- Cholesterol – Having a high total cholesterol (above 200 mg/dL), or a high triglyceride level (above 250 mg/dL) or higher, makes individuals at an increased risk of developing type 2 diabetes.
- Tobacco – Tobacco users place themselves at an increased risk of developing type 2 diabetes.
Do I Have Type 2 Diabetes?
The following symptoms of type 2 diabetes are typical. However, some individuals with type 2 diabetes have symptoms so mild that they go unnoticed, so it is best to get tested.
Look for these common symptoms of type 2 diabetes:
- Increased thirst
- Frequent urination
- Increased hunger
- Weight loss
- Fatigue
- Blurry vision
- Cuts/bruises that are slow to heal
- Tingling, pain, or numbness in the hands/feet
If any of the above symptoms are occurring, is it best to follow up with a primary care physician to confirm a diagnosis. According to the American Diabetes Association (ADA), type 2 diabetes can be diagnosed through one of the following tests:
- A hemoglobin A1c (A1c) – Measures average blood glucose for the past 3 months. Diabetes is diagnosed at an A1c of greater than or equal to 6.5%
- Fasting plasma glucose (FPG) – Measures fasting blood sugar/glucose levels after not having anything to eat or drink for at least 8 hours. Diabetes is diagnosed at a FPG level of greater than or equal to 126 mg/dl.
- An oral glucose tolerance test (OGTT) – Measures blood glucose levels before and 2 hours after the consumption of a glucose drink. Diabetes is diagnosed at a 2-hour blood glucose level of greater than or equal to 200 mg/dl – 199mg/dl.
Early detection and treatment of diabetes can decrease the risk of developing complications. Take the Risk Test to find out if you are at increased risk for having type 2 diabetes.
What are the Complications of Undiagnosed Type 2 Diabetes?
Type 2 diabetes can be easily ignored as there are limited effects on an individual’s outward appearance. However, type 2 diabetes does affect many major organs. If neglected, type 2 diabetes can impact the heart, blood vessels, nerves, eyes and kidneys. Getting diagnosed if you think you have diabetes and controlling your blood sugar levels if you already have diabetes can help prevent these potential complications:
- Eye/retina damage
- Foot/nerve damage
- Hearing impairment
- Kidney damage (nephropathy)
- Nerve damage (neuropathy)
- Cardiovascular diseases (heart attack, stroke, atherosclerosis, high blood pressure, angina)
How Can I Manage My Type 2 Diabetes?
The management of type 2 diabetes takes a team-based approach between the physician, dietitian, nurse, and other medical staff, with the patient serving as the team coach. While the team is there to help, the day-to-day management is up to the patient.
According to the Mayo Clinic, care/management includes:
- Healthy Eating - It is important to center eating around wholesome fruits, vegetables, lean meats, and whole grains, while limiting refined carbohydrates (white rice, white bread, rice cereals, etc.), and sweets.
- Schedule a visit with a registered dietitian for additional help on meal planning
- Physical Activity - Everyone needs regular aerobic exercise, and individuals with type 2 diabetes are not an exception. Patients should check with their primary care physician before starting an exercise program, then choose an activity that they enjoy and try to aim for at least 30 minutes of exercise for at least 5 days of the week. If physical activity is not something that a patient is accustomed to, start slow and gradually build up.
- Also remember that physical activity lowers blood glucose/sugar, so make sure to check blood glucose/sugar level before any activity.
- Monitoring Blood Glucose/Sugar - Depending on the management plan, checking and recording blood glucose/sugar may be necessary to determine glucose/sugar levels, keeping in mind that blood glucose/sugar levels can be unpredictable. A physician will recommend the frequency of monitoring, as glucose/sugar levels change in response to food, exercise, alcohol, illness and medication.
- Medication Management - Some individuals who have type 2 diabetes can achieve their target blood sugar levels with healthy eating and exercise, but many may also need diabetes medications or insulin. The decision about a patient’s medication depends on many factors but it is best to consult with a physician and then continue to stick to the determined medication plan, until otherwise determined.
- Diabetes Education - Living with a type 2 diabetes diagnosis is not easy, but becoming educated on the disease does help with overall disease management. Around Ohio there are many community resources to help educate individuals on type 2 diabetes. For information on those program, check out:
Gestational Diabetes
Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women develop gestational diabetes in the middle of pregnancy. Doctors usually test for it between 24 and 28 weeks of pregnancy.
Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within five to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes. About 3 to 8 percent of pregnant women in the United States develop gestational diabetes.
As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.
For more information on Gestational Diabetes please check out the Gestational Diabetes Collaborative.