Diabetes is a state that impairs the
body's ability to process blood glucose, otherwise known as blood sugar. According to a report, in the United States, the estimated
number of people over 18 years of age with diagnosed and undiagnosed diabetes is 30.2
million. This figure represents between 27.9 and 32.7 percent of the
population.
Without ongoing, careful management,
diabetes can lead to a buildup of sugars in the blood, which can raise the risk
of dangerous complications, including stroke and heart disease.
Different kinds of
diabetes can happen, and managing the condition depends on its type. Not all
forms of diabetes stem from a person being overweight or leading an inactive
lifestyle. In fact, some are present from childhood or are genetically
activated.
Types of Diabetes
Three major diabetes types can
develop; Type 1, type 2, and gestational diabetes.
Type I diabetes: Also
known as juvenile diabetes, this type occurs when the body fails to
produce insulin. People with type I diabetes are
insulin-dependent, which means they must take artificial insulin daily to stay
alive.
Type 2 diabetes: Type
2 diabetes marks the way the body uses insulin. While the body still makes
insulin, unlike in type I, the cells in the body do not retort to it as
effectively as they once did.
Gestational diabetes: This
type befalls in women during pregnancy when the body can become less sensitive
to insulin. Gestational diabetes does not occur in all women and usually
resolves after giving birth.
Pre-diabetes
Doctors refer to some people as
having pre-diabetic or borderline diabetes when blood sugar is usually in the
range of 100 to 125 milligrams per deciliter (mg/dL).
Normal blood sugar levels sit
between 70 and 99 mg/dL, whereas a person with diabetes will have a fasting
blood sugar higher than 126 mg/dL.
The pre-diabetes level means
that blood glucose is higher than usual but not so high as to constitute
diabetes.
People with pre-diabetes are,
however, at risk of developing type 2 diabetes, although they do not usually
experience the symptoms of full diabetes.
The risk factors for pre-diabetes
and type 2 diabetes is similar. They include:
- being overweight
- a family history of diabetes
- having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL
- a history of high blood pressure
- having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds
- a history of polycystic ovary syndrome (PCOS)
- being of African-American, Native American, Latin American, or Asian-Pacific Islander descent
- being more than 45 years of age
- having a sedentary lifestyle
If
a doctor identifies that a person has pre-diabetes, they will recommend that an individual makes healthful changes that can ideally stop the progression to
type 2 diabetes. Losing weight and having a more healthful diet can often help
prevent the disease.
How insulin problems
develop
Many doctors do not know the exact
causes of type I diabetes. Type 2 diabetes, also known as insulin resistance, has
clearer causes. Insulin allows the glucose from
a person's food to access the cells in their body to supply energy. Insulin resistance
is usually a result of the following cycle:
1.
A person has genes or an
environment that make it more likely that they are unable to make enough
insulin to cover how much glucose they eat.
2.
The body tries to make
extra insulin to process excess blood glucose.
3.
The pancreas cannot keep
up with the increased demands, and the excess blood sugar starts to circulate
in the blood, causing damage.
4.
Over time, insulin
becomes less effective at introducing glucose to cells, and blood sugar levels
continue to rise.
In the case of type 2 diabetes,
insulin resistance takes place gradually. That is why doctors often recommend
making lifestyle changes in an attempt to slow or reverse this cycle.
Exercise and Diet Tips
If a person is diagnosed with type 2 diabetes, they will often get the recommendation of making lifestyle changes to
support weight loss and overall health.
Doctors may refer a person
with diabetes or pre-diabetes to a Nutritionist. A specialist can help a person
with diabetes lead an active, balanced lifestyle and manage the condition.
Following are a few steps that a person can take to
embrace a lifestyle with diabetes include:
·
Eating a diet high in
fresh, nutritious foods, including whole grains, fruits, vegetables, lean
proteins, low-fat dairy, and healthy fat sources, such as nuts.
·
Avoiding high-sugar
foods that provide empty calories,
or calories that do not have other nutritional benefits, such as sweetened
sodas, fried foods, and high-sugar desserts.
·
Refraining from drinking
excessive amounts of alcohol or keeping intake to less than one drink a day for
women or two drinks a day for men.
·
Engaging in at least 30
minutes exercise a day on at least 5 days of the week, such as of walking,
aerobics, riding a bike or swimming.
·
Recognizing signs of low
blood sugar when exercising, including dizziness, confusion, weakness, and
profuse sweating. Slow, steady weight loss goals
are more likely to help a person retain long-term benefits.
Using Insulin
People with type I diabetes and
some people with type 2 diabetes may need to inject or inhale insulin to keep
their blood sugar levels from becoming too high.
Various types of insulin are
available, and most are grouped by how long their effect lasts. There are
rapid, regular, intermediate, and long-acting insulins.
Some people will use a
long-acting insulin injection to maintain consistently low blood sugar levels.
Some people may use short-acting insulin or a combination of insulin types.
Whatever the type, a person will usually check their blood glucose levels using
a fingerstick.
This method of checking blood
sugar levels involves using a special, portable machine called a glucometer. A
person with type I diabetes will then use the reading of their blood sugar
level to determine how much insulin they need.
Self-monitoring is the only way
a person can find out their blood sugar levels. Assuming the level from any
physical symptoms that occur may be dangerous unless a person suspects
extremely low glucose and thinks they need a rapid dose of glucose.
How much is too much?
Insulin helps people with
diabetes live an active lifestyle. However, it can also lead to serious side
effects, especially if a person administers too much.
Excessive insulin can
cause hypoglycemia,
or extremely low blood sugar, and lead to nausea, sweating, and shaking.
It is essential that people
measure insulin carefully and eat a consistent diet that balances blood sugar
levels as much as possible.
Other Medications
In addition to insulin, other
types of medication are available that can help a person to manage their
condition.
Metformin
For Type II diabetes, a doctor
may prescribe metformin in pill or liquid form. It contributes to:
·
lowering blood sugar
·
making insulin more
effective
It can also help with weight
loss. Having a healthy weight can reduce the impact of diabetes. As well as diabetes, a person
may also have other health risks, and they may need medication to control
these. A doctor will advise the individual about their needs.
SGLT2 inhibitors and GLP-1
receptor agonists
In 2018, doctors also
prescribes additional drugs for people with:
·
atherosclerotic
cardiovascular disease
·
chronic kidney disease
These are sodium-glucose
cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide-1 (GLP-1) receptor
agonists.
For those with atherosclerotic
cardiovascular disease and a high risk of heart failure, the guidelines advise doctors to prescribe
an SGLT2 inhibitor.
GLP-1 receptor agonists work
by increasing the amount of insulin the body produces and decreasing the amount
of glucose that enters the bloodstream. It is an injectable drug. People may
use it with metformin or alone. Side effects include gastrointestinal problems,
such as nausea and a loss of appetite.
SLGT2 inhibitors are
a new type of drug
for lowering blood glucose levels. They work separately from insulin, and they
may be useful for people who are not ready to start using insulin. People can
take it by mouth. Side effects include a higher risk of urinary and genital
infections and ketoacidosis.
Self-monitoring tips
Self-monitoring blood sugar
levels are vital for effective diabetes management, helping to
regulate meal scheduling, physical activity, and when to take medication,
including insulin.
While self-monitoring blood
glucose (SMBG) machines vary, they will generally include a meter and test
strip for generating readings and a lancing device to prick the skin for
obtaining a small quantity of blood.
Refer to the specific
instructions of a meter in every case, as machines, will differ. However, the following
precautions and steps will apply to many of the machines on the market:
·
Make sure both hands are
clean and dry before touching the test strips or meter
·
Do not use a test strip
more than once and keep them in their original canister to avoid any external
moisture changing the result.
·
Keep canisters closed
after testing.
·
Always check the
expiration date.
·
Older meters might
require coding prior to use. Check to see if the machine currently in use needs
this.
·
Store the meter and
strips in a dry, cool area.
·
Take the meter and
strips into consultations, so that a primary care physician or specialist can
check their effectiveness.
A person who is self-monitoring
diabetes uses a device called a lancet to prick the skin. While the idea of
drawing blood might cause distress for some people, the lancing of the finger
to obtain a blood sample should be a gentle, simple procedure.
Take the following precautions:
·
Clean the area from
which the sample will come with soapy, warm water to avoid food residue
entering the device and distorting the reading.
·
Choose a small, thin
lancet for maximum comfort.
·
The lancet should have
depth settings that control the depth of the prick. Adjust this for comfort.
·
Many meters require only
a teardrop-sized sample of blood.
·
Take blood from the side
of the finger, as this causes less pain. Using the middle finger, ring finger,
and little finger may be more comfortable
·
While some meters allow
samples from other test sites, such as the thighs and upper arms, the
fingertips or outer palms produce more accurate results.
·
Tease blood to the
surface in a "milking" motion rather than placing pressure at the
lancing site.
·
Dispose of lances in
line with local regulations for getting rid of sharp objects.
While remembering to
self-monitor involves lifestyle adjustments, it need not be an uncomfortable
process.
Outlook
Diabetes is a serious, chronic
condition. According to the American Diabetes Association (ADA), the condition
is the seventh leading cause of death in the U.S.
While diabetes itself is
manageable, its complications can severely impact on daily living, and some can
be fatal if not treated immediately.
Complications of diabetes
include:
·
dental and gum diseases
·
eye problems and sight
loss
·
foot problems, including
numbness, leading to ulcers and untreated injuries and cuts
·
heart disease
·
nerve damage, such
as diabetic
neuropathy
·
stroke
·
kidney disease
In the case of kidney disease, this the complication can lead to kidney failure, water
retention when the body does not dispose of water correctly,
and a person experiencing difficulties with bladder control.
Regularly monitoring blood
glucose levels and moderating glucose intake can help people prevent more
damaging complications of type 2 diabetes.
For those with types 1
diabetes, taking insulin is the only way to moderate and control the effects of
the condition.
Takeaway
Diabetes is a life-changing condition that requires careful blood sugar management and a healthy lifestyle
for a person to be able to manage it correctly. There are several different
types of diseases.
Type I occurs when the body
does not produce insulin. Type 2 happens when excess consumption of high-sugar
foods flood the blood supply with glucose and reduce the production and
effectiveness of insulin.
People can take supplementary
insulin to manage the condition and improve glucose absorption. If a person has
prediabetes, they can reduce the risk of full diabetes through regular exercise
and a balanced, low-sugar diet.
The complications of diabetes
can be severe, including kidney failure and stroke, so managing the condition
is vital.
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