Diabetes: The Basics – General Information

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Updated 2022 by Kim Ladd, RN, BS, CPHQ, CDCES

What Is Diabetes?

Diabetes is an illness that makes it hard for your body to use the food you eat the right way.

Some of the food you eat turns into glucose. Glucose is also called “sugar,” and is your body’s main source of energy. Glucose travels through your body in your blood. Insulin is a substance made in the pancreas, which is a small organ behind your stomach. Insulin helps get the glucose out of the blood and into your cells. Just like a key unlocking a door, insulin is the key that unlocks the door to the cells in your body, and lets the glucose in to be used as energy.

These symptoms may mean that you have diabetes:

  • Being very thirsty
  • Having to urinate a lot
  • Feeling very tired or weak
  • Having wounds or infections that do not heal
  • Having pain, tingling or numbness in your hands or feet
  • Having blurry vision
  • Losing weight without trying

Talk to your doctor if you have any of these signs of diabetes, especially if you have more than one of them.

How do you know if you have diabetes?

A blood test will tell you if you have diabetes. Any one of these three blood tests performed by your doctor can tell you if you have diabetes.

  • The A1C (also called hemoglobin A1C) is a test that measures your average blood sugar for the last 3 months. If it is over 6.5%, you have diabetes.
  • If you are fasting, that is, if you have not had anything to eat or drink for 8 hours before your test, and your blood sugar is 126mg/dl or higher, you have diabetes.
  • If you have had something to eat or drink before the test, and your blood sugar is above 200mg/dl, you have diabetes.

There Are Different Types of Diabetes:

  • Type 1 diabetes (formerly called juvenile-onset, Type I, or insulin dependent) occurs when the body’s immune system destroys its own insulin-producing cells in the pancreas. Possible reasons include genetic factors, viruses, or a defect in the body’s autoimmune system. It usually occurs before age 30 and affects about 5% of individuals with diabetes.
  • Type 2 diabetes (formerly called adult-onset, Type II, or non-insulin dependent) is the most common type of diabetes. It usually occurs after age 30 and affects 90%-95% of individuals with diabetes. It begins with insulin resistance (prediabetes) and can be managed initially with weight loss, physical activity, and effective meal planning and for some individuals this works for a period.  When the disease progresses, however, oral medication, injectable medications or insulin may also be required.
  • Gestational Diabetes develops in the 24th- 26th week of pregnancy. Pregnant women make hormones that can lead to insulin resistance. All women have insulin resistance late in their pregnancy, but if the pancreas doesn’t make enough insulin during pregnancy, a woman develops gestational diabetes. It usually goes away after the birth of the baby but it greatly increases the mother’s chance of developing Type 2 diabetes later in life.
  • Other types of diabetes account for about 1% of diabetes cases. They occur because of specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses and include LADA (Latent Autoimmune Diabetes in Adults), neonatal diabetes, and MODY (Maturity Onset Diabetes in the Young).

Currently, there is no cure for diabetes. Eating the right way, exercising, taking diabetes medicine (if needed), testing your blood sugar, and managing stress can all help control diabetes.

Increased Risk for Diabetes, or Pre-Diabetes

  1. What is increased risk for diabetes, or pre-diabetes?

If you have “increased risk for diabetes,” or pre-diabetes, it means your blood sugar (glucose) levels are higher than normal, but not high enough to have a diabetes diagnosis. This is sometimes called pre-diabetes. Even during this stage of increased risk, long-term damage to your heart and circulatory system can begin to happen. Many people with blood sugar at these in-between levels develop type 2 diabetes within 8 years.

  • What blood sugar levels indicate increased risk for diabetes, or pre-diabetes?

A fasting blood glucose means you have not had anything to eat or drink for 8 hours before your test. If your blood sugar result is between 100-125 mg/dl, you have increased risk for diabetes, or pre-diabetes.

The A1C (also called hemoglobin A1C) is a test that measures your average blood sugar over the last 3 months. If it is between 5.7%- 6.4%, you have increased risk for diabetes, or pre-diabetes.

  • Could I have increased risk for diabetes, or pre-diabetes, and not know it?

Yes. Often, people with increased risk for diabetes, or pre-diabetes, do not have symptoms. If there are symptoms, they usually develop gradually, and the person might not notice them. The symptoms include the same symptoms that can indicate diabetes: unusual thirst, frequent urination, blurred vision or a feeling of tiredness for no apparent reason.

  • Who should be tested for increased risk for diabetes, or pre-diabetes?

You should be tested if you are:

  • Over age 45, especially if overweight  OR
  • Under age 45 and have any of these diabetes risk factors:
    • Have pre-diabetes
    • Overweight
    • Are physically active less than 3 days a week
    • Have a family history of diabetes
    • High blood pressure or high cholesterol
    • Have non-alcoholic fatty liver disease
    • Are African-American, Native-American, Hispanic, or Asian.
    • Have had gestational diabetes or have given birth to a baby weighing 9 pounds or more.
  • What should I do if I have increased risk for diabetes, or pre-diabetes?

The first step is to lose some weight. You do not need to lose all your extra weight right away. Aim for losing 5-10 % of your total body weight, or at least 10 lbs. You should do this by eating a healthy diet and doing regular, moderate exercise. For example, you could try walking for 30 minutes a day, 5 days a week. To help you lose weight, ask your doctor about a referral to a Registered Dietitian, so you can get advice tailored to fit you and your life.

Check with your employer or insurer to see if they offer a Diabetes Prevention Program or weight loss program to support your health goals. The CDC also offers a National Diabetes Prevention Program, and you can learn more about it here: Lifestyle Change Program Details | National Diabetes Prevention Program | CDC

Working With Your Diabetes Team

Managing your diabetes is a team effort. Your diabetes management team should include:

  • doctor
  • nurse diabetes educator
  • dietitian
  • pharmacist
  • dentist

The most important member of your diabetes team is YOU!

Other professionals who often help people manage diabetes are:

  • mental health professional
  • dentist
  • ophthalmologist (eye doctor)
  • podiatrist (foot doctor)
  • exercise physiologist

Each one of these professionals can help you with an important area of diabetes care.

Your doctor is responsible for your routine diabetes care. You should have a routine follow-up visit with your doctor every 3 to 6 months. Visits should be scheduled more frequently if you are having trouble keeping your blood glucose under control, if you have some complications from diabetes, or if you are sick. Your doctor will order your diabetes lab tests, prescribe medications, and watch for signs of diabetes complications. Your doctor can also help you decide when you need to work with any of the other professionals on this list.

A nurse diabetes educator can help you understand diabetes self-management and what you need to do to stay healthy with diabetes. A nurse diabetes educator can also help you solve problems about how to do any parts of your diabetes care that are difficult for you.

A dietitian can help you understand healthy meal planning. You need to know what kinds of food to eat, how much to eat, and when to eat to keep your body healthy. A dietitian can help you design a personal meal plan that meets your medical needs and takes your culture and personal tastes into account.

A pharmacist can help you understand your medications. You need to know how your medications work, how much to take, when to take them, what side effects to watch for, and whether your medications have any special precautions.

A mental health professional can be a psychologist, a psychiatrist, or a social worker. A mental health professional can help you if you are having trouble accepting your diabetes or your diabetes treatment, and if you have depression, anxiety, or high stress.

A dentist can help with care of your teeth and mouth. People who have diabetes often have problems with their teeth and gums.

An ophthalmologist can help with your eye care and provide dilated eye exams to look for early evidence of diabetic retinopathy every year.

A podiatrist can help with your foot care if you have circulatory or nerve damage to your legs and/or feet.

An exercise physiologist can help you develop an exercise plan that works for you.

However, YOU are the most important member of your health care team. The other members of the diabetes care team can only do their jobs if you are actively involved. YOU are the person who actually does the day-to-day diabetes care. YOU are the expert on your own life, and on what can work for you. Only YOU can tell the other team members if something is not working. YOU are the vital link that helps all the different parts of the team work together. When you succeed in working well with your diabetes care team, YOU are the person who will reap the benefits of having a long and healthy life.

Resources

American Diabetes Association: Diabetes Overview

American Diabetes Association: Learn the Genetics of Diabetes

CDC: Diabetes Risk Factors

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