Are you having trouble navigating the maze surrounding diabetes? You're not alone! More than 23 million Americans have diabetes, while six million people don't even know they have it. From medications to monitoring, exercise to eye health, and food choices to foot care, our team of diabetes experts at MedStar St. Mary's Hospital is here to help you every step of the way.
Types of Diabetes
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy needed for daily life. The cause of diabetes is unknown, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. The following types of diabetes exist:
Type 1 diabetes is usually diagnosed in children and young adults and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin, the hormone that allows the body to process sugar. The condition can severely damage the kidneys and pancreas. In some cases, diabetes can lead to damage that makes an organ transplant necessary.
Type 2 diabetes is the most common form of diabetes. In type 2 diabetes, either the body does not produce enough insulin, or the cells ignore the insulin. Insulin is the hormone that allows the body to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can cause two problems: Your cells become starved for energy, and over time, high blood glucose levels may adversely affect your eyes, kidneys, nerves, or heart.
Before people develop type 2 diabetes, they almost always have pre-diabetes—blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. Research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes. However, if you take action to control your blood glucose when you have pre-diabetes, you can delay or prevent type 2 diabetes from developing. If you have, or are at risk for pre-diabetes, there are many steps you can take for your health and well-being. People with pre-diabetes can expect to benefit from much of the same advice for good nutrition and physical activity.
Hormonal changes and weight gain are part of a normal pregnancy. But for at least three out of every 100 pregnant women, these changes cause insulin resistance and a rise in blood sugar, resulting in gestational diabetes. With proper treatment, gestational diabetes can be controlled, preventing harm to you and your baby. The key to keeping yourself and your baby healthy is to manage your blood glucose levels by seeking education from a certified diabetes educator. We can translate confusing nutrition restrictions into a customized meal plan for each individual. It is important to know that what you eat, how much you eat and how often you eat each affect your blood sugar levels. Suggested meal plans may include: Eating three small meals and three snacks a day, limiting starches, including cereal, rice, pasta, and potatoes to one cup per meal, and avoiding sweetened beverages such as soda, iced tea, and juice. After giving birth, blood glucose levels in most mothers with gestational diabetes return to normal. However, the risk of developing type 2 diabetes within eight to 10 years is increased. Eating right and staying active—30 minutes of exercise or more for at least five days a week—remain important to prevent this from happening.
Maturity Onset Oiabetes of Youth (MODY)
A mutation in a single gene that limits a person's ability to produce insulin causes MODY. MODY runs in families and is often not diagnosed until adulthood, even though it is always present.
Latent Autoimmune Diabetes (LADA)
This is a type of diabetes that shows signs of both Type I and Type II diabetes. It is often called Type 1.5 diabetes, or double diabetes. In this form of the disease, patients are able to produce their own insulin, but, because of an abnormal autoimmune response, the pancreas cells slowly lose their ability to produce insulin.
Diabetes Risk Factors and Prevention
Certain health problems put you at higher risk for diabetes and heart disease. Understanding and managing your risk factors can help you avoid diabetes. Some risk factors for diabetes can be controlled.
- Excess body weight (especially around the waist)
- HDL cholesterol under 35
- High blood levels of triglycerides, a type of fat molecule (250 mg/dL or more)
- High blood pressure
- Impaired glucose tolerance
- Low activity level
- Poor diet
Those risk factors that cannot be controlled include:
- Age greater than 45 years
- Diabetes during a previous pregnancy
- Giving birth to a baby weighing more than 9 pounds
- Family history
If you already have diabetes, staying healthy and preventing heart disease starts with testing your blood sugar every day to make sure it is within your target range and, if instructed to do so, taking your medicine. Other recommendations include:
- Maintain a healthy weight.
- Follow a diet low in fat, salt, and sugar and high in fiber.
- Exercise on a regular basis. Aerobic activities are good for your heart and help your body work to lower your blood sugar.
- Listen to your doctor about other health problems, such as high blood pressure.
- Try to reduce stress in your life.
- Drink alcohol in moderation – no more than one drink a day for women and two drinks a day for men.
- Regularly test your blood glucose, especially if you are older than 45.
Over time, the high levels of blood glucose found in diabetic patients can lead to damaged nerves. Unable to feel sensations in their feet, diabetic patients can develop cuts, blisters, or sores that, untreated, become ulcers and infections; eventually, amputations may even be necessary. Blood vessels are also frequently damaged from diabetes. Without proper circulation, feet do not get enough blood circulating, which makes it harder for wounds to heal.
All of these complications can lead to what is called the diabetic foot, a complex problem that demands the experience and expertise of the MedStar Health diabetic specialists, wound care physicians, and vascular surgeons.
Diabetic Foot Main Factors:
- Neuropathy - many factors cause neuropathy in diabetes. Numbness in the foot is one of the manifestations of diabetic neuropathy.
- Vascular disease - this is the same as peripheral artery disease (PAD), and is caused by atherosclerosis.
Diabetic Signs and Symptoms:
- An ulcer or sore in the foot
- Redness in the foot
The treatment will be directed toward the causes. Often, this means controlling the infection with antibiotics. If extensive infection is present in the foot, your vascular surgeon will recommend surgery to drain the infection. If vascular disease is present, you may undergo one or more tests, such as Duplex ultrasound or arteriography. This may be followed by either open surgery or endovascular surgery to re-establish normal blood flow to the foot.
Do You Have Diabetes?
Early signs of diabetes may include:
- Low blood sugar
- Fast heartbeat
- Impaired vision
- High blood sugar
- Blurred vision
- Frequent urination
- Dry skin
- Extreme thirst