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Questions About Diabetes? Here’s a Quick Guide

Newly diagnosed with diabetes? Caring for a loved one with the disease? Or just looking to learn a little more about the seventh-leading cause of death in the U.S.?

Diabetes is a complex disease to understand and treat. The facts below will get you started on your journey.

What Is Diabetes?

Diabetes is a disease in which the body cannot properly turn food into glucose (sugar) to use as energy.

The pancreas makes insulin, a hormone, to help the glucose get into the cells of the body. With diabetes, your body either cannot produce enough insulin to accomplish that task, or does not use insulin correctly. This causes glucose to build up in your blood, which can be dangerous.

“Diabetes is actually a very sneaky disease,” says family physician Irina Gendler, MD. She goes on to explain that diabetes is not only about high sugar levels, “but it’s also about low blood sugar as well, because we have to keep our sugar in a very narrow therapeutic window, and whenever the sugar is too high or too low it is dangerous for the body and for our well-being.”

Dr. Gendler explains what diabetes is.

Click play to watch the video or read video transcript.

What Are the Different Types?

Type 1 diabetes, previously known as juvenile diabetes, is usually diagnosed in children and young adults. Only five percent of people with diabetes have this form of the disease. Type 1 is an auto-immune disorder, which means that the body’s immune system attacks and destroys the cells that produce insulin.

Type 2 diabetes is the most common form of the disease. It can affect people at any age, even children, but occurs most often in people who are middle-aged and older. People who are overweight and inactive are also more likely to develop type 2 diabetes.

Type 2 usually begins with insulin resistance — a condition that occurs when your body stops using insulin properly. At first, the pancreas just makes more insulin to keep your blood glucose levels normal. But over time, the pancreas can’t keep up with the demand for insulin, and glucose starts to build up in your blood.

The difference between type 2 diabetes and type 1 diabetes is that in type 2 diabetes, insulin is available for storing calories. But, over time the supply of insulin depletes, the causing blood sugar to rise. This requires you to add medications or insulin to control your blood sugars. In type 1 diabetes, the insulin supply in your pancreas degraded, or broken down or destroyed, by our immune systems.

Gestational diabetes occurs in some pregnant women. It most often goes away after the baby is born. Women with gestational diabetes often show no symptoms, which is why it is so important to have glucose levels tested when pregnant.

What Is Prediabetes?

Prediabetes means you have blood glucose levels that are higher than normal, but not high enough to be considered diabetes.

What Are the Warning Signs?

You may have no symptoms, or one or more of the following

• Frequent urination
• Excessive thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in hands or feet
• Excessive fatigue
• Very dry skin
• Sores that are slow to heal
• More infections than usual

Nausea, vomiting, or stomach pains may accompany some of these symptoms with an abrupt onset of type 1.

What Are the Risk Factors?

According to the National Institutes of Health, scientists don’t yet know what causes the body’s cells to attack insulin in patients with type 1 diabetes.

“Diabetes is actually a very sneaky disease.”

You may be at risk for type 2 if you:

• Are over 45
• Are overweight or obese
• Have a first-degree relative (parent, brother, or sister) with diabetes
• Are African American, American Indian, Alaska Native, Asian American, or Pacific Islander, or Hispanic American/Latino
• Have gestational diabetes, or have given birth to at least one baby weighing more than nine pounds
• Have blood pressure of 130/80 or higher
• Have abnormal cholesterol levels (HDL level of 35 or lower, or a triglyceride level of 250 or higher)
• Exercise less than three times a week
• Have polycystic ovary syndrome (PCOS)
• Had prediabetes on previous testing (an A1c level of 5.7 to 6.4 percent)
• Have a history of cardiovascular disease

What Are the Treatments?

Treatments vary according to the type of diabetes and how far the disease has progressed. Changes in lifestyle (like adopting a healthier diet and more exercise) are crucial, and sometimes oral medication is prescribed. Insulin may or may not be required, depending on the type of diabetes you have and how far it’s progressed.

What Happens If It Goes Untreated?

If diabetes goes untreated, your body’s cells become starved for energy. In addition, glucose builds up in your blood. This can result in all kinds of complications, and eventually damage to the eyes, kidneys, and liver. It can also cause heart disease and stroke, and may require amputations as a result of damaged nerve endings (neuropathy) in the feet and other limbs.

Is There a Cure?

To date, there are only treatments to slow down the progression of diabetes and address the symptoms. There is no cure, but research toward one is actively underway.

Source: American Diabetes Association; National Institutes for Health; Centers for Disease Control and Prevention; Irina Gendler, MD, Troy Primary Care Physicians

Irina A. Gendler, MD

Upper Valley Family Medicine

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