October 10, 2016
Identifying and preventing diabetes
About one out of eleven people in the United States has diabetes. Even though the disease is manageable, it puts you at risk for other complications such as blindness, kidney failure, heart disease, stroke and loss of appendages, so it’s important to know if you have or are at risk for diabetes.
Diabetes affects how our bodies process glucose, the primary source of sugar in the blood. Glucose is the main source of energy we need to fuel our bodily functions. When we eat, our bodies break food down into glucose, which then helps trigger our pancreas to make insulin. Insulin is the hormone that helps glucose get into cells so that it can be used by the body.
Types of diabetes
There are two types of diabetes, Type 1 and Type 2. Five percent of the people who have diabetes have Type 1, also known as juvenile diabetes. This form of the disease isn’t preventable or curable, and it’s currently believed that both genetic and environmental factors play a part. Type 1 is diagnosed when the body doesn’t create enough insulin.
Type 2 is much more prevalent, even though in most cases it can be prevented. When you have Type 2 diabetes, your body makes enough insulin, but can’t use it properly. You’re at risk for Type 2 diabetes if you’re overweight, have a family history of the disease or have diabetes while pregnant.
"One out of three adults has prediabetes. Within five years, 15-30 percent of those cases will develop into Type 2 diabetes."
One out of three adults has prediabetes. Within five years, 15-30 percent of those cases will develop into Type 2 diabetes. People who have high blood glucose levels that don’t yet fall into the diabetic category are considered to have “prediabetes.” Prediabetes usually has no symptoms, but puts you at a higher risk for developing Type 2 diabetes. This is why it’s important to receive regular medical screenings; if you find you have prediabetes, you can take steps to reduce your risk.
Symptoms of diabetes
Type 1 and Type 2 diabetes have a number of common symptoms. They include:
- Feeling hungry and tired — If your body doesn’t make enough insulin or can’t use it well, the glucose your body uses for energy can’t get to your cells, making you lethargic and hungrier than normal.
- Using the bathroom more often — The average person has to urinate between four and seven times in 24 hours, but when you have diabetes, your body tries to get rid of extra blood sugar by making more urine.
- Ongoing thirst — Since you’re urinating more often, you’ll drink more — and when you drink more, you’ll expel more.
- Dry skin — Because you’re losing more fluids, there’s less for the rest of your body, including your skin.
- Blurred vision — The changing fluid levels can make your eyes swell up so they lose their ability to focus.
Type 1 diabetes has type-specific symptoms, including:
- Weight loss due to your body being unable to get energy from food.
- Nausea and vomiting from the extra ketones created by your body burning your excess fat.
Type 2 diabetes has type-specific symptoms that tend to show up when your glucose has been high for a long time, including:
- Yeast infections, in both men and women. Since yeast feeds on glucose and those affected by diabetes have excess, yeast thrives in any fold of the skin, including between fingers and toes, under breasts and in or around sex organs.
- Slow-healing cuts. High blood sugar affects your blood flow and causes damage that make it hard for your body to heal.
- Pain and numbness in your feet, due to nerve damage.
Type 1 diabetes can’t be prevented and can only be managed by taking insulin through injections or a pump. However, the easiest way to decrease your risk for Type 2 diabetes is maintaining an appropriate weight through eating healthy and exercising regularly. Studies have even shown that losing weight, even 5 percent of your body weight, decreases your risk significantly.
Who should get tested?
Normally, screening for Type 2 diabetes is recommended at age 45 when there are no risk factors present. However, if you’re obese or have a family history of diabetes, you should be tested regardless of your age.
The best way to find out if you have diabetes is to visit your doctor or clinic for a simple blood test. The earlier you know about having the disease, the better — so if you have concerns, speak with a physician today.
Q&A with Dr. Mini Abraham
Dr. Mini Abraham is an HCA Midwest Health endocrinologist specializing in diabetes management. She is board-certified with the American Board of Internal Medicine and the American Board of Endocrinology and Metabolism. She attended medical school at the Medical College of Kottayam, University of Kerala, India. She completed her residency in internal medicine and her fellowship in endocrinology at SIU School of Medicine, Springfield, Illinois.
In the last 15 years we have added several oral and injectable medications and newer insulins to treat diabetes. We have several medications that can offer the additional benefit of weight loss, which is always a struggle for patients, especially those with Type 2 diabetes. Patients with Type 1 diabetes always will need insulin. The technology has come a long way with the insulin pump and continuous glucose monitoring system. With the latest advance in technology, a person wearing a glucose sensor and insulin pump will get the benefit of the glucose sensor monitoring the sugar and sending the message to the insulin pump and the pump will deliver the insulin as needed. Definitely the future is full of hope in improving the care and management of patients with Type 1 and Type 2 diabetes.
- Eating sugar causes diabetes.
Fact: Eating sugar does not cause diabetes, but consuming more calories of any kind could cause weight gain and weight gain is a significant risk factor for Type 2 diabetes. But recent research suggests that sugary drinks can increase diabetes risk, even after accounting for weight.
- Thin people don’t get Type 2 diabetes.
Fact: About 80-85 percent of people with Type 2 diabetes are overweight or obese, but the rest are people with normal weight.
- Patients with diabetes have to follow a “strict diet.”
Fact: Making healthy choices most of the time and portion control are the keys. Food rich in simple sugars will raise blood sugars quickly, so this should be consumed in smaller portions and the rest of the diet should be fiber-packed whole grains, veggies and lean protein. The good news is, what one should do in terms of dietary modification after getting diagnosed with diabetes is not any different than what anyone has to do as part of a healthy lifestyle.
- Starting insulin is the worst thing to happen in a patient with Type 2 diabetes.
Fact: Diabetes is a progressive disease. The pancreas continues to lose its ability to produce insulin every year and most patients with Type 2 diabetes will eventually need help with insulin injections. Insulin is a hormone produced by the pancreas and as humans we need that hormone for normal survival. With technology, insulin administration is much easier now using insulin pens and insulin pumps. Insulin can give excellent diabetes control when used appropriately.
- “I can always tell when my blood sugar is high or low.”
Fact: The symptoms of high blood sugar at least initially are mild, so it could be easily missed. The symptoms of low blood sugar include sweating or shakiness. But some patients may not feel those symptoms and they could put themselves and others in danger, depending on the place and the kind of activity they are involved in at the time. So it is important to follow the recommendations made by your physician in terms of monitoring your blood sugars.
Type 2 diabetes is a serious medical condition, but it is possible to have a healthy and happy life by taking care of diabetes and making reasonable lifestyle changes. It is important that the person with diabetes gathers all the information available to them to help manage their disease. This is a unique medical condition — I would typically say it is the patients who are “managing their diabetes” under the guidance of a care provider.
It is extremely important to have a health care provider who has enough training, experience and dedication to work with a patient with diabetes and guide them to better control and improve their overall health and well-being. The patient has to partner with this health care provider and follow the recommendations and get close monitoring in the office setting to ensure good diabetes control. I would also recommend a dedicated diabetes follow-up visit every three to four months, even if you are seeing your provider for other reasons in between visits.
The rise in diabetes in our country is strictly related to our current lifestyle. There is increased incidence of Type 2 diabetes even in young children. Excess consumption of calories, weight gain and lack of physical activity are the modifiable risk factors in addition to genetic risk factors. Adopting a healthy lifestyle for the family and for the community is the best option to prevent diabetes and also to prevent complications of diabetes.
I will use the term “reverse” cautiously. Reversing diabetes means going back to having normal blood sugars without the help of any medications. This is possible especially in some individuals in the early stage of Type 2 diabetes, given they continue a healthy lifestyle. I would prefer the term “diabetes in remission” for those individuals. They still need to get checked periodically to make sure they stay in remission. For patients with the diagnosis of diabetes that they have had for several years, lifestyle changes will improve their control with the need for fewer medications. At any level in the management of diabetes and also in the prevention of diabetes, lifestyle change is the foundation. Patients who are in the prediabetes range can prevent or delay the onset of diabetes, even if they have strong family history for it, by making good lifestyle changes and maintaining them.