Diabetes

Diabetes.  Sugar diabetes.    Blood sugar.  Blood glucose.  We’ve all heard our grandparents, aunts, and/or uncles use these terms, but what exactly do they mean?  Diabetes is a group of diseases that result in excessive blood glucose (blood sugar) in the bloodstream.  Type 1 diabetes, or juvenile diabetes, occurs when the body is unable to produce insulin.  Type 2 diabetes, which is much more common, occurs when the body fails to produce enough insulin or resists the insulin that it does produce.

So what is insulin?  Insulin  is a hormone produced by your pancreas that regulates the movement of glucose (sugar) into your cells.  When our bodies work normally, we obtain glucose from our diet, or as it is released from our liver.  After digesting our food, that glucose is absorbed into our bloodstream.  Normally insulin operates as a key that allows  glucose to enter our cells and be used as  source of energy.  If our key (insulin) does not work, that glucose remains in our bloodstream.  Our key may be faulty because we either don’t make enough insulin, or our cells have become resistant to it.  Over time, persistently having too much glucose in your bloodstream can lead to serious complications such as blood vessel disease, nerve damage, kidney damage, and vision loss.

Risk factors.  Risk factors for diabetes include being overweight, lack of physical activity, family history of diabetes, African American heritage, increased age, and having had gestational diabetes while pregnant.

Symptoms.  While diabetes is associated with certain symptoms, many people are diagnosed without exhibiting any of them.  Common symptoms include increased thirst, frequent urination, increased hunger, weight loss, fatigue, blurred vision, slow-healing sores, frequent infections, and/or areas of darkened skin.

Diagnosis.  The preferred method for diagnosing diabetes is the hemoglobin A1c test.  Think of this test as a “panoramic view” of your blood glucose as it tells your healthcare provider your average reading over the past three months.  An A1c level of >6.5% on two separate occasions indicates you have diabetes.  A result between 5.7-6.5% is considered prediabetes; a normal result is <5.7%.  Fingersticks are not an ideal diagnostic tool because they are more like a “snapshot”.  They tell us what your blood glucose is at that very moment, which can be greatly affected by what your last meal was, and how recently you ate it.

Prevention/Management.  The single most important mechanism for preventing or managing diabetes is to monitor your diet.  Carbohydrates are the food group that most significantly affect our blood glucose.  This is because when our body digests carbohydrates, they turn into glucose.   When selecting your carbohydrates, try to choose complex carbohydrates.  Complex carbohydrates require more energy during the digestive process, and so less glucose is released into your bloodstream.  Complex carbohydrates include wheat, corn, brown rice, oats, barley, quinoa, oatmeal, beans, peas and lentils.

It is also important that you exercise regularly.  As previously discussed, strive for at least 150 minutes of mild/moderate exercise each week.  Exercise requires energy, which uses up the glucose stored in your cells.

If you are a smoker, give serious thought to quitting.  Both smoking and diabetes are damaging to your blood vessels.  Smoking while diabetic further increases your risk of stoke and heart disease.

Alcohol is high in sugar, and therefore can raise your blood glucose.  It is advised that women try not to exceed one drink per day (no more than two drinks a day for men).

If you’ve already been diagnosed with diabetes, be sure to take your medications daily as prescribed by your doctor.  It is also especially important with diabetes medications that you pay close attention to mealtimes.  Taking your medication while skipping meals may lead to low blood sugar, which can quickly become a dangerous situation.

Management of hyper/hypoglycemia.  Hyperglycemia is elevated blood sugar.  In addition to the symptoms listed above, hyperglycemia may be marked by weakness, confusion, dry mouth, and nausea/vomiting.  If you are feeling hyperglycemic, you should check your blood glucose and take your medication if you missed any doses.  On the other end of the spectrum is hypoglycemia.  Hypoglycemia occurs when your blood sugar is too low.  Symptoms of hypoglycemia include fatigue, paleness, shakiness, sweating, hunger, irritability and confusion.  If feeling hypoglycemic, try consuming a fast-acting carbohydrate such as candy, fruit juice, soda, or glucose tablets.

As the saying goes, “an ounce of prevention is worth a pound of cure.”  So what changes can you start making today to reduce your risk of diabetes?  If you’ve already been diagnosed, remember that while sometimes scary, diabetes is a manageable disease.  And if you start making some healthy lifestyle changes today, there’s a possibility the number of medications you need can be reduced (and in the best cases, stopped altogether)!