Understanding Diabetes

Reviewed by Taylor Wolfram, MS, RDN, LDN
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A condition that affects how your body uses energy in the form of glucose from food, diabetes can be successfully managed through proper self-monitoring, medication and lifestyle changes. People with diabetes have a high level of glucose in their blood, which can be caused by either too little insulin being produced by the pancreas or the body not accepting or using the insulin it produces, or a combination of both.

People with diabetes need to keep their blood sugar levels within a healthy range. Blood sugar levels are controlled through diet, physical activity and, for some people, a combination of medication and insulin injections.

Understanding Insulin

Insulin is a hormone your cells need to store and use energy from food, and it is responsible for getting glucose into your cells. If you have diabetes, insulin is not able to do its job. Meaning, glucose is unable to get into your cells, which causes it to build up in your blood. High levels of glucose then circulate through your body, damaging cells along the way.

Types of Diabetes

  • Type 1 Diabetes: An autoimmune disease in which the pancreas cannot make insulin or makes very little. Type 1 diabetes often begins in childhood (it was previously known as "juvenile diabetes"), and the onset is sudden. People with Type 1 diabetes need daily insulin injections or an insulin pump. Just 5% of people with diabetes have Type 1 diabetes, which cannot be prevented through diet or lifestyle.
  • Type 2 Diabetes: A chronic disease in which the pancreas makes insulin, but it does not make enough or the body doesn't use the insulin it makes and usually develops slowly. Eight in 10 people with this type of diabetes are overweight. In fact, Type 2 diabetes is becoming more common in children and teenagers because of the increase in obesity within these age groups. Blood sugar levels are controlled through diet and physical activity. Oral medicines may be used to help the body respond to the insulin it makes. Insulin injections or a pump also may be needed.
  • Gestational Diabetes: The cause is unknown but may be the result of hormones during pregnancy blocking the action of insulin. Gestational diabetes often disappears after the baby is born. However, women who experience diabetes while pregnant have a much greater chance of having Type 2 diabetes later in life.

Signs and Symptoms of Diabetes

Common symptoms of diabetes include:

  • Urinating frequently
  • Being unusually thirsty
  • Losing weight
  • Feeling tired
  • Irritability
  • Blurred vision
  • Frequent illness or infection
  • Poor circulation, such as tingling or numbness in the feet or hands

If you think you have diabetes, see a doctor immediately. Only a doctor can confirm a diabetes diagnosis and will most likely recommend one of these blood tests:

  • Fasting Plasma Glucose: The amount of glucose in a sample of blood taken when a person is fasting (not eating anything for eight to 12 hours; usually overnight).
  • HbA1C: This measures a person's average blood glucose range over the past two to three months. This test shows the amount of glucose that sticks to the red blood cell (hemoglobin; Hb).
  • Oral Glucose Tolerance Test: Results of this test are compared with standard non-diabetic results and show how the body uses glucose over time. This test is performed by a health care professional after an overnight fast. A blood sample is taken, the patient drinks a high-glucose beverage and then a blood sample is taken two hours later.

Goals for Managing Diabetes

Whether you have been diagnosed with Type 1, Type 2 or gestational diabetes, your overall goals for managing the disease are similar.

  • Keep blood glucose levels within the target range determined by your doctor. This can prevent or reduce complications.
  • Reduce your risk of heart disease and stroke, since people with diabetes are at risk for both. Keep blood pressure under control and achieve healthy cholesterol levels.
  • Adopt a healthful eating pattern and lifestyle that are enjoyable and doable for you and can help prevent, or at least slow, complications from diabetes.

Managing Blood Glucose Levels

People with diabetes need to keep their blood glucose levels within a healthy range. The American Diabetes Association recommends the following range:

  • 80 to 130 mg/dl (before a meal)
  • <180 mg/dl (1 to 2 hours after beginning a meal)
  • HbA1c 7% (average glucose over 3 months)
For some people, medication or insulin injections are needed to help manage the relationship between glucose and insulin. However, action can be taken to control blood glucose levels including eating right, getting physical activity and weight management.

To successfully manage diabetes, you need to understand how foods and nutrition affect your body. If you have been diagnosed with diabetes, seek the expert advice of a registered dietitian nutritionist to help you manage the disease while ensuring you get the nutrients your body needs.

For more information on diagnosing diabetes, common terms and medical information, visit the American Diabetes Association.

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