What is Diabetes?

Diabetes

Diabetes is a disease that results when there is too much of a sugar called glucose in the blood. The most common types of diabetes are Type 1 Diabetes, Type 2 Diabetes and Gestational Diabetes. Currently, close to 10% of the world’s population suffers from diabetes. Given its prevalence, diabetes and diabetes related complications are the 6th most common cause of death worldwide.

Type 1 Diabetes

Type 1 diabetes is also known by the names Juvenile Diabetes and Insulin Dependent Diabetes. Type 1 diabetes is caused when a person’s immune system damages to portions of their pancreas that are responsible for Insulin production. Insulin is a hormone that helps to move sugar from the blood stream into the body’s tissues. When Insulin levels are low, sugar cannot be effectively moved from the blood stream into the body’s tissues. Sugar then builds up in the blood stream causing “high blood sugar” levels. Type 1 diabetes is a chronic condition. There is currently no cure for type 1 diabetes currently.

Type 2 Diabetes

Type 2 diabetes is also known by the names Adult Onset Diabetes and Non-Insulin Dependent Diabetes. Unlike type 1 diabetes, in type 2 diabetes the pancreas is typically able to make sufficient amounts of Insulin. However, in type 2 diabetes, the body is not able to properly utilize the Insulin that is produced by the pancreas. When the body is not able to properly utilize Insulin to move sugar from the blood stream into the body’s tissues, high blood sugar levels result. Type 2 diabetes is a chronic condition for most people. Some people are however able to reverse type 2 diabetes with healthy lifestyle changes.

Normal blood sugar (left) and high blood sugar (right)

Gestational Diabetes

Gestational Diabetes is a form of diabetes seen only in pregnant women. In all pregnant women, the placenta produces a number of hormones that are critical to maintaining a healthy pregnancy. It is thought that some of these hormones affect the way that some women’s bodies processes Insulin. In these women, Insulin is not able to effectively do its job of moving sugar from the blood stream into the body’s tissues. High blood sugar levels then result. Gestational diabetes resolves when a pregnancy is finished. However, close to 50% of women who suffer gestational diabetes during a pregnancy will develop type 1 or type 2 diabetes later in life.

Gestational Diabetes

Why Is Diabetes Dangerous?

Heart Attack

Diabetes is dangerous because high blood sugar levels damage blood vessels. When blood vessels are damaged, blood does not flow through them optimally. When blood flow through damaged blood vessels is compromised, the organs that the damaged vessels provide blood to can also become damaged.  In uncontrolled diabetes, the blood vessels supplying blood to the brain, heart, kidneys, nerves and eyes are all frequently damaged. Damage to the blood vessels supplying the brain can cause strokes. Damage to the blood vessels supplying the heart can cause heart attacks. So, it is not surprising that adults with diabetes are at a 200%-400% increased risk for heart attack and stroke.

when the blood vessels supplying the kidneys are damaged by high blood sugar levels, kidney damage and ultimately kidney failure can result. When the blood vessels supplying nerves are damaged, diabetes sufferers can experience the loss of sensation in their fingers and toes. When the blood vessels supplying the eyes are damaged, vision loss and blindness can result.

What Are Symptoms of Diabetes?

Common symptoms of diabetes include increased thirst, frequent urination, frequent hunger, fatigue, blurry vision, weight gain or weight loss and poor wound healing.

How Is Diabetes Diagnosed?

Type 1 Diabetes and Type 2 Diabetes

Both type 1 and type 2 diabetes can be diagnosed using a variety of different blood tests.

• Glycosylated Hemoglobin (A1C) Test: The A1C test is a blood test that calculates what a person’s average blood sugar has been for the 2-3 months leading up to the blood test. An A1C value of 6.5 or higher on two separate tests indicates that a person has diabetes.
• Random Blood Sugar: A random blood sugar of greater than 200 indicates that a person has diabetes.
• Fasting Blood Sugar: When a person who has not eaten has a blood sugar level of 126 or higher on two separate occasions, this indicates that they have diabetes.

Gestational Diabetes

Gestational diabetes can be diagnosed using either a glucose challenge test or a glucose tolerance tests.

Sugar (Glucose) Drinks

• Glucose Challenge Test: For the Glucose Challenge Test, a pregnant woman must drink a syrupy sugar solution. One hour after drinking this solution her blood sugar will be drawn. A blood sugar of 200 or greater indicates a diagnosis of gestational diabetes. A blood sugar of 140-199 indicates that a pregnant woman is at higher risk for gestational diabetes. To ultimately determine whether or not she actually has gestational diabetes, a glucose tolerance test must then be done.
• Glucose Tolerance Test: For the Glucose Tolerance Test, a pregnant woman must be fasting. She will then have her fasting blood sugar level drawn. This blood sugar value should be 95 or less. After the fasting blood sugar has been drawn, the patient will then drink a syrupy sugar solution. Her blood sugar levels will then be drawn three more times. One, two and three hours after the syrupy sugar solution has been completed. The blood sugar drawn one hour after completing the sugar solution should be less than 180. The blood sugar drawn two hours after completing the sugar solution should be less than 155. The blood sugar drawn three hours after completing the sugar solution should be less than 140. When looking at all four of the blood sugar levels drawn (i.e. the fasting blood sugar and the blood sugars drawn 1, 2 and 3 hours after completing the sugar solution), if 2 or more values are high, a diagnosis of gestational diabetes is made.

How Can Diabetes Be Prevented?

Type 1 Diabetes

Regular exercise can both prevent and treat certain forms of diabetes.

There is no known way to prevent type 1 diabetes. Type 1 diabetes is an autoimmune disease that results from the immune system attacking the pancreas. Complications from type 1 diabetes can however be delayed or prevented by adequately controlling blood sugar levels.

Type 2 Diabetes

There are a number of things that can be done to prevent type 2 diabetes. They include;

Ideal Diabetic Diet

• Maintaining a healthy weight with a Body Mass Index (BMI) of 18.5-24.9.
• Exercising regularly. This means getting at least 150 minutes of moderate aerobic activity every week, 75 minutes of vigorous aerobic activity every week or a combination of the two.
• Eating healthy. A good rule of thumb when trying to eat healthy is to properly portion your meals. 50% of your plate should have non-starchy vegetable. These vegetables include things like asparagus, Brussel Sprouts, carrots, mushrooms, beans and baby corn. 25% of your plate should have starchy vegetable like potatoes or peas. The remaining 25% of your plate should have proteins like fish and poultry.
• Getting 7-8 hours of sleep a night.
• Avoiding tobacco use.

Gestational Diabetes

There are a number of things that can be done to prevent gestational diabetes. They include;

• Avoiding excessive weight gain during pregnancy. Women with a healthy pre-pregnancy BMI of 18.5-24.9 should gain 25-35 pounds during pregnancy. Women who are overweight with pre-pregnancy BMI’s of greater than 25 should only gain 15-25 pounds during pregnancy. Women who are underweight with pre-pregnancy BMI’s of 18.4 or less should gain between 28-40 pounds during pregnancy.
• Exercising regularly. This means getting at least 30 minutes of moderate aerobic exercise each day. Moderate aerobic exercise can include walking, swimming and yoga.
• Eating healthy. A good rule of thumb when trying to eat healthy is to properly portion your meals. 50% of your plate should have non-starchy vegetable. These vegetables include things like asparagus, Brussel Sprouts, carrots, mushrooms, beans and baby corn. 25% of your plate should have starchy vegetable like potatoes or peas. The remaining 25% of your plate should have proteins like fish and poultry. Additionally during pregnancy, increasing fiber in-take reduces the risk of gestational diabetes. For every additional 10 grams of fiber eaten each day, a woman’s risk of gestational diabetes drops by 26%.
• Getting 7-8 hours of sleep a night.
• Avoiding tobacco use.

How Is Diabetes Treated

Just like maintaining a heathy weight, exercising regularly, eating a healthy diet, avoiding tobacco and getting enough sleep can help to prevent type 2 and gestational diabetes, so too can these healthy lifestyle modifications help to treat type 2 and gestational diabetes. When these lifestyle modifications are not able to bring blood sugar down adequately however, medications may be needed.

Type 1 Diabetes

Insulin Injection

Type 1 diabetes results from a decreased production of Insulin by the pancreas. The treatment for type 1 diabetes therefore largely involves replacing the Insulin not being produced by the pancreas. Insulin is frequently replaced by injecting a synthetic form of it beneath the skin one or more times a day.

Type 2 Diabetes

Type 2 diabetes primarily results when the body can not properly utilize the Insulin that the pancreas is producing. So, the treatment of type 2 diabetes typically involves taking oral medications that help the body to better utilize Insulin. When Insulin is better utilized, it is then able to do it’s job of helping to move sugar from the blood stream into the body’s tissues. Medications frequently used to treat type 2 diabetes include, Metformin, Sulfonylureas, Meglitinides, Thiazolidinediones, DPP-4 Inhibitors, SGLT2 Inhibitors and GLP-1 Receptor Agonists. Insulin can also be used sometimes to treat type 2 diabetes.

Gestational Diabetes

Gestational diabetes is frequently treated using Insulin, Metformin or the Sulfonylurea medication Glyburide.

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