According to the Centers for Disease Control and Prevention (CDC), about 30 million Americans have diabetes. About 84 million others have prediabetes, a condition that can develop into type 2 diabetes within five years if it isn’t treated.

 

What is diabetes?

 

Diabetes is a disease where the body does not make or use insulin, a hormone made by the pancreas, properly. Without it, your body is unable to use the food as energy. 

 

In normal food metabolism, most of the food that you eat is broken down into glucose, a type of sugar.  As your food is digested, the glucose passes into your bloodstream.  Before it can be used as your body’s main source of energy, the glucose must first get into your body’s cells.  Insulin is what helps the glucose enter those cells. 

 

Usually, a small steady stream of insulin is released into the body.  When you eat a meal, the pancreas releases a burst of insulin.

 

Not eating causes blood glucose levels to drop.  If your level drops to below 70 mg/dL, your liver will release stored glucose into the blood.  The body will try to maintain a normal balance and between 70 to 99 mg/dl..

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What are the types of diabetes?

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Type I

 

Formerly known as juvenile-onset diabetes, this type is when the body makes little to no insulin and typically occurs in children and young adults, but can occur in older adults.  People with this form of diabetes must take insulin every day.  Type I accounts for 5-10% of all diabetes cases.

 

Type II

 

Formerly known as adult-onset diabetes, there are two different things that can occur with Type II diabetes.  The first thing that can happen is the body might be able to produce insulin, but isn’t using it properly.  The second instance could be that the body just isn’t making enough insulin.  This form of diabetes typically occurs in people who are older or those who are overweight.  Type II diabetics make up 90-95% of the diabetic population. 

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Genetics play a role in type 2 diabetes, but your lifestyle is also an important factor.

 

The Good News – you can make lifestyle changes to prevent your prediabetes from developing into diabetes:

• Lose weight

• Get 30 minutes of aerobic exercise every day

• Eat more vegetables and whole grains

• Quit smoking

 

Prediabetes

 

This is when a person’s blood glucose is higher than normal, but nor high enough to be diagnosed with diabetes. 

 

Gestational diabetes

 

This occurs in the last trimester of pregnancy for some women and typically resolves after the baby is born.  The mother is at a high risk for developing Type II diabetes later in life. 

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What are Complications from Diabetes?

 

Over time, high blood glucose levels can cause damage to virtually every organ system of the body including:

• Central nervous system

• Vision

• Cardiovascular

• Kidney

• Skin teeth and gums

• Musculoskeletal

• Sexual

• Cognitive

• Digestion

 

To lower your risk of diabetic complications, know your ABC’s.

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A stands for A1C.  The American Diabetes Association recommends 7% or less.

B stands for blood pressure.  For diabetic people, normal blood pressure is <130/80 mmHg.

C is for cholesterol. It is recommended that diabetic patients maintain cholesterol levels of <100mg/dL of LDL cholesterol and >40 mg/dL for men and >50 mg/dL for women of HDL cholesterol.

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Is it important to stay active?

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Exercising 30 minutes a day most days of the week will help keep your glucose in a healthy range and will also help you reach your goal weight and improve your blood fats.  Check with your doctor to see if you can begin an exercise program.

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What Does Glucose Monitoring Mean?

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Improved glucose control will help you prevent the long-term complications from diabetes.  It is recommended that diabetics check their glucose levels one or more times a day and you should consult with your doctor to determine what your blood glucose goals are.  Every time you check your glucose levels it is important to write it in a log because this can help you and your doctor determine how different factors affect your glucose, including:

• What your blood sugar is at that point in time

• How food, medicine, and exercise are helping

• How stress affects your blood sugar

• How illness affects your blood sugar

• If your blood sugar is too high or too low

 

Self Blood glucose monitoring is done at home by pricking your finger and placing a drop of blood on a test strip that is placed in a meter.  The meter then reads your blood glucose levels.  You should check your blood sugar:

• One to two times a day (Type II)

• Four or more times a day (Type I)

• Any time you feel that your blood sugar is too high or too low

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What are my Target Blood Glucose Levels?

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Your blood glucose targets should be determined by you and your physician, but the following are recommended ranges for diabetics. 

Before meals:                    80-130 mg/dL

1-2 hrs after meal:             Less than 180 mg/dL

Bedtime:                             Between 90-150 mg/dL

 

Research shows that keeping blood glucose as close to normal as possible, without hypoglycemia, helps prevent complications of the disease. 

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What is the difference between hypoglycemia and hyperglycemia?

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Hypoglycemia is low blood sugar caused by too much insulin, not enough food, too much exercise, or drinking alcohol without food.  Some signs are cold sweat, dizziness, headache, pounding heart, blurred vision, irritability, personality change, hunger, or inability to awaken.  To treat it, follow the Rule of 15.  This means eating 15 grams of sugar, wait 15 minutes and test blood sugar again.  If it is still below 60 mg/dL treat with 15 grams of sugar again and eat a meal or snack.  Train friends and family on how to help you if you become unconscious.

 

Hyperglycemia is high blood sugar caused by not enough insulin, too much food, illness, or emotional stress.  Some signs are increased thirst and urination, large amounts of sugar in the blood, ketones in urine, weakness, stomach pain, general aches, heavy breathings, loss of appetite, vomiting, or fatigue.  A doctor should be called immediately and the patient should drink fluids without sugar.  Blood sugar should be tested frequently and urine should be tested for ketones if blood sugar is over 240 mg/dL.  If using an insulin pump, change the set.  If not, give insulin via syringe. 

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What does A1C Mean?

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A1C is your average blood glucose number and provides you and your doctor with an average of what your blood glucose has been over the past two to three months.  The American Diabetes Association recommends and A1C of less than 7% or as close to normal as possible without hypoglycemia.   

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(excerpts from UPMC: My Health Insight: Issue Two – 2018)