Diabetes

What is diabetes?

Diabetes is a prevalent and serious medical condition that affects approximately 30 million people in the U.S., which is about 10% of the population. It is a chronic condition without a current cure. The term “diabetes mellitus” comes from Greek and means “passing excessive sweet urine,” referring to the buildup of sugar (glucose) in the blood and urine.

To understand how diabetes affects the body, it’s important to consider the relationship between insulin and glucose. Glucose is a form of sugar that serves as the body’s primary energy source, derived from the breakdown of carbohydrates consumed. Insulin, produced by the pancreas, is a hormone responsible for regulating the use and storage of glucose in the body. However, individuals with diabetes either have insufficient insulin production or their body becomes resistant to its effects. As a result, blood glucose levels can rise after a meal and dangerously drop at other times.

Types and causes of diabetes?

Type 1 diabetes

T1D affects less than 5% of individuals with diabetes. It is an autoimmune condition that impacts the pancreas cells responsible for insulin production. People with T1D have insufficient insulin production to meet their body’s requirements. Typically, T1D is diagnosed during childhood or early adulthood.

Type 2 diabetes

T2D is the most prevalent form, accounting for approximately 95% of all diabetes cases. In T2D, the body’s response to insulin is abnormal, and insulin levels may be low. T2D typically develops slowly over months or even years and is often associated with a family history of diabetes. While it primarily occurs in adults, T2D can also affect children.

Gestational diabetes

Gestational diabetes refers to the development of diabetes during pregnancy, which can have implications for the health of both the pregnant individual and the baby. It also indicates a high risk of experiencing gestational diabetes in future pregnancies. Generally, gestational diabetes resolves after childbirth, but it increases the likelihood of developing Type 2 diabetes (T2D) in the future by tenfold. Similar to prediabetes, gestational diabetes presents an opportunity to adopt lifestyle changes that can help prevent the onset of diabetes later in life.

Prediabetes

Prediabetes serves as an early stage of Type 2 diabetes, carrying a heightened risk of various health complications associated with diabetes. However, by implementing healthy lifestyle modifications, it is feasible to stabilize and potentially reverse prediabetes.

There are less common types of diabetes that arise due to various factors. These include diabetes caused by rare genetic mutations, certain medical conditions such as cystic fibrosis and hereditary hemochromatosis, and hormone imbalances like PCOS, hyperthyroidism, acromegaly, and Cushing’s syndrome.

Additionally, certain medications like corticosteroids, certain antipsychotic, HIV, and blood pressure medications, immunosuppressants, gonadotropin-releasing hormone agonists (used for prostate cancer treatment), growth hormones, and sex hormones can also contribute to the development of diabetes.

What are the symptoms of diabetes?

While some individuals with mild or early diabetes may not exhibit any symptoms, others may experience the following:

• Fatigue
• Excessive hunger or thirst
• Frequent urination
• Dry mouth
• Blurry vision
• Headaches
• Numbness or tingling in the hands and feet

These symptoms can manifest gradually and may go unnoticed, or they can abruptly make individuals seriously ill, particularly if they are unaware of their diabetes condition.

How is diabetes diagnosed?

To diagnose any type of diabetes mellitus, blood and urine tests are commonly used. The specific tests required may vary depending on the situation, and additional tests may be needed to determine the exact condition.

If you have symptoms, your healthcare provider will likely conduct a finger-stick glucose test immediately in the office. This test provides quick results by measuring blood glucose levels using a handheld monitor and a small blood sample. A urine test may also be performed to check for the presence of glucose or ketones, which should not normally be found in urine.

In cases where the finger-stick glucose test shows high results, a random plasma glucose test may be ordered for more accuracy. This test involves a blood draw to measure glucose levels.

For individuals without symptoms, healthcare providers typically order one or more of the following blood tests to screen for or diagnose diabetes:

• Fasting blood glucose test: This test requires fasting for at least 8 hours. A normal fasting blood glucose level is below 100 mg/dl.
• Hemoglobin A1C (HbA1C) test: Fasting is not required for this test. It measures the average glucose level over the past 3 months. A normal A1C level is below 5.7%.
• Oral glucose tolerance test: Usually conducted after fasting and staying in the lab for 2 hours. It involves measuring the baseline glucose level, followed by drinking a special sugar drink, and then retesting the glucose level after 2 hours. This test assesses how the body responds to the sugar challenge within the 2-hour timeframe. A normal result is below 140 mg/dl.

See all medications related to Diabetes

What medication can be used for diabetes?

There are three primary categories of medications for individuals with diabetes:

1.  Oral medications: These are taken in pill form and help improve the body’s response to existing insulin. They are specifically used for treating Type 2 diabetes.
2. Injectable insulins: These medications include synthetic insulins or insulin analogues that mimic the function of insulin in the body. They supplement the body’s insufficient insulin levels and can be used to treat both Type 1 and Type 2 diabetes.
3. Injectable non-insulin medications: GLP-1 receptor agonists stimulate the production of insulin in response to meals and are approved for individuals with Type 2 diabetes. Amylin analogues assist insulin in working more effectively and can be used by individuals with both Type 1 and Type 2 diabetes who take insulin with meals.

Finding the right treatment approach for diabetes may require some trial and error, as individual needs and lifestyles vary. Treatment requirements may also change over time as new options become available. It is important to consider insurance coverage and affordability when selecting a long-term treatment plan, as managing diabetes can be costly.

Navigating the evolving landscape of diabetes treatments can be challenging, but a diabetes care team can provide guidance in finding a suitable treatment approach for individual circumstances. Utilizing helpful guides can also be a valuable starting point.

What treatment methods are used for diabetes?

For individuals with Type 1 diabetes, medication, typically insulin, is essential because their bodies do not produce enough insulin. It is necessary to supplement their low insulin levels with medication.

On the other hand, not everyone with diabetes requires medication for treatment. People with Type 2 diabetes and gestational diabetes may begin with lifestyle changes such as diet modifications. These types of diabetes involve the body’s impaired response to insulin. Adopting a diabetes-friendly diet and engaging in regular physical activity can help reverse this condition without the need for medication.

Regardless of the type of diabetes, treatment is most effective when combined with healthy lifestyle adjustments. Although it may be challenging initially, maintaining these changes in the long term can be highly beneficial.

Incorporating regular physical activity and following a diabetes-friendly diet consisting of whole, minimally processed foods, lean proteins, healthy fats, fresh fruits, and vegetables is encouraged. It is important to limit the intake of refined sugars, salt, and highly processed foods.

As part of the treatment process, individuals will learn to regularly monitor their blood sugar levels. They will have a target range and should strive to keep their blood glucose levels within that safe range to prevent complications associated with diabetes.