What is Diabetes?

What is Diabetes? 
By Prem Sahasranam MD and Theresa Garnero, APRN, BC-ADM, MSN, CDCES  

Diagnosing diabetes is based on blood sugar or A1C values.

Diabetes is when your body is not able to process the foods you eat resulting in high blood sugar (blood glucose). That’s a simple definition.   Ready for a more detailed explanation?   When we eat, food eventually turns into glucose, the main source of energy for our body. Our body is made up of millions of cells. These cells need insulin in order to get glucose. Insulin is made by specialized beta-cells from within a gland called the pancreas. The pancreas is located behind the stomach. It releases insulin into the bloodstream in response to the rise in blood glucose after consuming food or calorie-containing drinks. Glad we got that out of the way. 
What’s important to know is that with the right care, education, and support, you can live a healthy life with diabetes.   So, let’s review common types of diabetes and their treatments.   

Prediabetes: a condition where blood sugar is rising but not high enough to be classified as type 2 diabetes. Research has shown that one can prevent and delay its progression to type 2 diabetes by learning how to eat in a carb-balanced way, by getting 150 minutes of physical activity a week, and for those who are overweight, by losing 5-7% of weight. If you have prediabetes, be sure to get your A1C done once a year. And if you have a strong family history of type 2 diabetes, your healthcare provider might want to consider a medication called metformin (although that is “off-label”, research is promising in how it can prevent type 2 in combination with proper nutrition and intentional exercise).   

Type 2 diabetes: is the most common type of diabetes caused by the body not making enough of the hormone insulin and not using it well. This resistance” that the body has to its own insulin can be reduced through exercise and by reducing weight for those who need to. The main ways to manage type 2 is through learning about how to use food as medicine (help balance blood sugar by food choices), by getting regular physical activity, by taking medication to address the body’s deficits specific to type 2 (including pills, injectable medication and/or insulin), by checking glucose, and by learning how to live with the emotional aspects of this ongoing condition. Type 2 is diagnosed primarily in mid- to late life but is also seen in youth.   

Type 1 diabetes: is an autoimmune disorder in which the body mistakenly attacks itself by destroying the insulin-producing beta cells. This means taking insulin is required in order to live. Type 1 diabetes often is diagnosed in youth but it’s also seen in young adults and occasionally into late adulthood. Managing type 1 diabetes is a challenging effort to keep blood sugars from going too low or too high. Treatment of type 1 includes being on an optimized insulin by using advanced technology that works for the individual, monitoring glucose, anticipating situations that can cause glucose variability, having regular checkups to prevent problems, and getting ongoing support to ease the burden of this condition.   

Latent Autoimmune Diabetes in Adults (LADA): is a condition that has parts of both type 1 and type 2 diabetes. The antibodies that destroy the beta cells are present, as they are with type 1 diabetes, however the process is slow. Individuals with LADA are often misdiagnosed with type 2 and only start on insulin years later, after diabetes pills are ineffective. Typically, this happens to people under the age of 50 who are thin (a BMI less than 25), who aren’t responding to diabetes pills. If this sounds like it could be true for you, or you have a personal or family history of autoimmune disease, you can ask your doctor to check your islet cell antibodies.   

Gestational diabetes: is a condition where high blood sugar levels start or are detected during pregnancy. Screening for gestational diabetes usually occurs at 24-28 weeks into the pregnancy. The risk is that the high sugar from the mother gets passed to the fetus, which can then grow too large, causing possible issues with delivery, or later, a risk for childhood obesity and type 2 diabetes. Treatment includes learning how to count carbohydrates, monitoring glucose, being physically active, and taking insulin or medication. Women with gestational diabetes have a high risk for type 2 diabetes and need to be screens 6 – 12 weeks after delivery, and at least every 3 years thereafter.    
Regardless of your diabetes type, our care team can do a check-up on your self-care areas [TG1] to see if there are any opportunities that will help, and create the best individualized plan given your situation.  [TG1]Link to the other article about diabetes education.  

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