Understanding Diabetes

Having diabetes means you have too much sugar—called glucose—in your blood. If untreated, diabetes can harm the body, particularly the heart and vascular system. In fact, people with diabetes are two-to-four times more likely to have heart disease or suffer a stroke than those who don’t have the disease. Experts say this risk is even greater for women with diabetes. 

Diabetes can lead to heart attacks, strokes, kidney disease, blindness, dental disease, amputations, and other serious health problems. And the longer you have high levels of blood glucose traveling around your body, the more likely you are to have problems. 

If you have diabetes, the best thing you can do is learn about how to manage your condition and prevent problems. 

About diabetes 

Diabetes develops when the body either:

• Does not make enough insulin or
• Is unable to use insulin properly (called insulin resistance, generally the result of being overweight, not exercising and eating a poor diet, which can lead to metabolic syndrome) or
• Both 

Insulin is a hormone that is usually made in the pancreas. It helps your body use the sugars that are in the foods we eat. Glucose gives your body energy, and insulin helps carry glucose to your cells. 

If the body doesn’t make or use insulin well, glucose builds up in the blood instead of being absorbed by cells in the body. The body’s cells are then starved of energy, despite high blood glucose levels.

There are three types of diabetes:

• Type 1 diabetes, also known as juvenile diabetes, is usually found in childhood, though not always.
• Type 2 diabetes is the most common form of diabetes—accounting for up to 95% of all cases. It most often occurs in adults; however, more and more children are being diagnosed. This may be because more youth are overweight or less physically active.
• Gestational diabetes occurs during pregnancy. 

There is also growing concern over prediabetes. People with prediabetes are more likely to develop type 2 diabetes, as well as heart disease and stroke. The good news is that you can take steps to prevent or delay the onset of full-blown diabetes. Some studies find that losing weight—just 5-to-10% of your starting weight—can delay or even reverse prediabetes.

Diabetes is a lifelong condition that needs to be managed to stay healthy. Over time, too much glucose in the blood can cause serious problems including:

• heart disease
• stroke
• damage to the blood vessels in your eyes, kidneys and nerves
• damage to the arteries of the legs that, in some cases, can lead to loss of a limb
• ulcers on the feet or legs that don’t heal well
• gum disease 

Am I at risk?

There are a number of things that can make someone more likely to develop type 2 diabetes. For example: 

• Being overweight/obese—the more weight you carry, especially around your midsection, typically the more resistant your body is to insulin
• Having high blood pressure generally or during pregnancy (called preeclampsia)
• Eating an unhealthy diet that is high in fat, calories, cholesterol and processed food
• Not exercising regularly
• Being older than 45, although it can occur in younger people
• Having a parent, brother or sister who has diabetes
• Being diagnosed with gestational diabetes
  • Up to 3 out of 5 women who had this during pregnancy will go on to develop diabetes within 15 years
• Giving birth to a baby that weighed more than 9 pounds
• Having polycystic ovarian syndrome (PCOS)

Type 2 diabetes is also more common among certain ethnic/racial groups including African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders. 

It’s important to talk with your doctor about all of your personal risk factors.

What are the signs and symptoms?

According to the American Diabetes Association, about 7 million people in the U.S. have undiagnosed diabetes; but symptoms are often present. Still, some people have no signs. 

Common signs and symptoms include:

• extreme thirst
• urinating more than usual
• unexplained weight loss/losing weight without trying
• blurry vision
• wounds or blisters that don’t heal well
• tingling or numbness in your hands and/or feet
• feeling very tired
• dry, itchy skin
• red, swollen, tender gums
• frequent infections

How it’s diagnosed 

Diabetes is diagnosed by taking a detailed medical history, including a report of symptoms, and blood tests that measure the amount of glucose in the blood or how your body handles it.

There are several types of blood tests to check your sugar level:

• Hemoglobin A1c (HbA1c or A1c), or simple A1c gives an overall picture of your blood sugar level over the last 2-3 months
• Fasting glucose test measures the amount of glucose in your blood after you haven’t had anything to eat or drink for 8 hours
• Oral glucose tolerance test checks your blood glucose levels before and 2 hours after you drink a special sweet drink and shows how well your body processes glucose

Managing Diabetes 

There are a number of things you can do to help manage your diabetes and live a healthier life. It’s very important to take steps that will help you to keep your blood sugar level low. This is most often achieved through a combination of:

• healthy eating
• exercise
• insulin therapy and/or diabetes medication, and
• routine blood sugar monitoring

The American Diabetes Association has set the following blood glucose targets for people with diabetes. Your health care team will work with you to set your personal blood glucose goals and map out a course of treatment that’s best for you.

Target Blood Glucose Levels for Most People with Diabetes
Before Meals:	70 to 130 mg/dL
1 to 2 Hours After the Start of a Meal:	Less than 180 mg/dL

HbA1c/A1c is also used to give an average blood glucose level over the past three months. Target A1c for people with diabetes should be less than 7%.

American Diabetes Association Guidelines
RESULT	A1c
Normal