A Comprehensive Guide to Diabetes

Diabetes is one of the most common chronic conditions affecting individuals today and it is imperative that we remain aware of what the disease is and how to cope with it. Here we will describe diabetes, discuss the different types, how it presents itself in different age groups and provide recommendations on how to adapt to living with diabetes. Let's get started!

What is Diabetes?

As mentioned before, diabetes is a chronic (lifelong) disease that affects the body’s ability to to produce or use insulin. For people without diabetes, once their body breaks down food insulin is released to bring glucose to the cells to allow them to use it for energy. For people with diabetes, the glucose is not transported to the cells and remains in the bloodstream and this results in high glucose levels. This is the underlying concept behind diabetes; ultimately, it is insulin that is key to allowing the human body to use glucose from the food we consume for energy or store it for later use in the form of glycogen.

The Three Common Types of Diabetes

There are three main types of diabetes found in individuals.

1. Type 1 Diabetes

Type 1 diabetes, also known as juvenile diabetes, is a type of diabetes that results when the body produces little to no insulin; therefore, there is no transport of glucose to the cells at all and this results in a high concentration of sugar in the bloodstream. Unfortunately, Type 1 diabetes is not something that can be prevented and individuals tend to get diagnosed early on. Diabetics with Type 1 diabetes are put on insulin therapy that replaces the missing insulin in their body and allows for effective use of the glucose from the food they digest.

2. Type 2 Diabetes

This type, is the most common. People with this type do make insulin, but their bodies don’t make enough or don’t respond well to it. Type 2 is most often managed through lifestyle changes and oral medication. Insulin therapy may be added after the pancreas gradually loses the ability to produce insulin.

3. Pre-diabetes

The 57 million Americans who have pre diabetes have higher than normal blood glucose, but not high enough to be diagnosed with diabetes. Within 10 years, many of these individuals with prediabetes will develop Type 2 Diabetes. But there is good news, a healthy lifestyle can help the body better use glucose so it doesn’t build up in the blood. Research shows that people with prediabetes can lower their risk for Type 2 Diabetes by more than half when they lose 5 to 10 percent of their body weight by exercising and eating right. Check out the At-Risk Weight Chart – if you weigh the same as or more than the weight listed across from your height, you may be at risk for diabetes.

Diabetes and Pregnancy

Gestational diabetes is the form of diabetes that develops during pregnancy. It can cause many problems, from high blood pressure to delivery complications. Without treatment, gestational diabetes carries some serious risks that includes sudden high blood pressure (pre-eclampsia) in the mother. Additionally, mothers with gestational diabetes tend to give birth to larger babies, causing them to require cesarean section. The infant is also at an increased risk for breathing issues and blood glucose problems after birth. The good news is that both mother and baby can often be healthy by having the mother follow a special meal plan and be physically active. Many women with gestational diabetes can keep their blood glucose under control by adopting healthy eating and exercise patterns. Some also need testing and insulin injections to control their blood glucose. Work with your health care practitioner to design a plan to keep your blood glucose levels in the target range. Many plans recommend, but are not limited to,the following.

1. Eat three small meals and one to three snacks a day.
2. Count your carbohydrates. Your meal plan should tell you when and how many to have at meals and snacks.
3. Limit sweets.
4. Try to be active for 30 minutes or more, at least five days a week. Walking and swimming are good activities for pregnant women.

Although gestational diabetes often disappears after delivery, those with the condition have an increased risk of developing it again in a future pregnancy and Type 2 Diabetes later in life. It is crucial to maintain a healthy weight, eat right, and stay active 30 minutes a day on most days of the week to prevent the repercussions of gestational diabetes.

Childhood Obesity and Diabetes

These days, lots of kids – many who are overweight and inactive – are developing Type 2 Diabetes, putting them at risk for complications like early heart disease. Here are some simple lifestyle changes that can help prevent childhood obesity, diabetes as well as many other health problems:

1. Parents should lead by example

Parents need to set an example for their children to follow. They should always eat healthy and adopt an active and healthy lifestyle for children to follow. Developing a routine and including your child in the decision making process allows them to develop healthy skills that they can carry with them throughout their lives.

2. Dine together

Regular family meals can foster healthy eating habits. Research shows that kids whose families eat together consume more fruits and vegetables, have improved self-esteem, better grades, and are less likely to smoke, drink, or use drugs by keeping a healthy lifestyle.

3. Encourage exercise

Kids need at least one hour of physical activity every day. Finding an activity that your child enjoys may be difficult at first but not only is it an excellent way to remain healthy, they can also use this activity to build teamwork skills, interact with their peers and even develop strong friendships.

4. Ask for help

If you think your child is overweight, talk with his or her doctor. Your physician can help point out things you are doing incorrectly and how to fix them. Many of the times, simple adjustments can solve the issue your child is facing. Talking to your physician can also help rule out any thyroid or metabolic conditions that could be contributing to your child’s health issues and allowing you to start treatment as soon as possible, if needed.

5. Know the symptoms

People with Type 2 Diabetes often don’t have specific symptoms, but you should see the doctor right away if your child shows signs of frequent urination, unexplained weight loss/weight gain, blurred vision, fatigue, nausea, excessive thirst, or cuts and bruises that are slow to heal.

Special Care

Kids who’ve been diagnosed with diabetes may feel emotional, stressed, or left out. A little parental support can go a long way and here is how you can help.

• Cook the same healthy foods for the whole family.
• Plan family walks to help kids get 60 minutes of exercise a day.
• Give teens some space once they’ve shown they can keep their glucose under control.

Small Changes, Big Differences — Adopt a Healthy Lifestyle

Small steps do add up. You don’t need special foods or a Pro-Athlete-like regimen to make a difference. You can lower your risk for Type 2 Diabetes or delay its onset by making some sensible adjustments.

First, Eat Better

Fine-tuning your eating habits helps cut calories and fat. Use some of the following strategies for a healthier meal.

1. Replace some of the red meat in your diet with a variety of vegetables and whole grains.
2. Replace desserts and snacks with fresh fruit.
3. Compare food labels and choose alternatives that are lower in calories, fat, and sugar, such as nonfat milk instead of 2 percent.
4. Use smaller plates to help shrink your portion sizes.
5. Split large restaurant portions with a friend or take half home.

Get Fit, and Pump up your Activity Levels

Follow these simple tips and keep the diabetic risks low.

1. Walk every chance you get – to work or on errands, with co-workers during a break, and before or after dinner.
2. Socialize with family and friends by being active together. Ride bikes, play soccer or basketball, etc.
3. Do housework and yard work with vigor.
4. Break exercise into 10 minute segments to fit into your schedule.
5. If you’ve been inactive, begin by getting your doctor’s advice about what and how much to do.

Choose one action you can take today to start reducing your risk. Setting daily, weekly, and monthly goals can help you move gradually toward a healthier lifestyle.

Recommendations And Suggestions

Following are a few expert recommendations and suggestions that will help you keep yourself in good shape and health.

Keep your Diabetes in Check

If you have diabetes, you need to keep up with several tests during the year to find out how your glucose levels are affecting your overall health. The American Diabetes Association has created a Checkup Checklist to keep track of all the tests you need and how often you need them. It recommends the following for adults with diabetes. A1C Test (estimated average blood glucose): This should be taken at least twice a year. If your treatment has changed or you’re not achieving your blood glucose goals, up to four times a year. Dental Visits Pay your dentist a visit twice a year. Annual Tests, Shots, and Visits

• Flu vaccine
• Fasting lipid Profile (cholesterol and triglycerides)
• Urine Albumin Excretion (kidney function)
• Serum Creatinine (kidney function)
• Dilated Eye Exam
• Food exam including neuropathy testing with monofilament

Other Screenings and Vaccinations:

• PAD (peripheral arterial disease) screening for those at risk
• PPV (pneumococcal polysaccharide vaccine) - A one-time vaccine for most, but people over 65 will need to get it again.

Immunization is crucial for diabetic patients. Catching the flu is never fun, but people with diabetes have a higher risk for serious complications, such as pneumonia and even death. Help protect yourself by getting a yearly flu shot. And get a pneumonia shot if you haven’t already – one shot usually protects you for life!

Know your Diabetes ABC’s

Keeping your ABC’s on target helps lower your risk of heart disease. A: A1C level – your average blood glucose for the past two to three months – should be less than 6.5 * B: Blood pressure is best below 130/80* C: Cholesterol level – the bad type, LDL – should be no higher than 100* (individual targets may vary). For people with diabetes, food, activity, and stress can cause glucose levels to change throughout the day. Watching your glucose level closely can help you avoid hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose). Additionally, you should perform daily self checks to see if there are any cuts or bruises you did not notice, especially on your feet. This will allow you to keep these wounds clean and take care that they do not get infected. When your glucose level is too high too often, it can lead to problems with your kidneys, heart, eyes, and nerves. Frequent checks can help prevent damage to these parts of the body. Many people do daily glucose checks before and after meals and at bedtime. Your doctor will help you find the best routine for you.

Blood Glucose Targets

The American Diabetes Association has recommended the following blood glucose targets.

• Before meals: 70-130 mg/dL
• Two hours after meals: below 180 mg/dL

If you have diabetes, you need an A1C test at least twice a year to give you a picture of your average blood glucose control for the past two to three months. This helps you see how well your treatment plan is working. Using the chart below, see how your A1C compares with your estimated average glucose (eAG), a new format for giving A1C results in milligrams per deciliter (mg/dL). This is the same format you see when you check your glucose level with a meter.

Parting Advice

Maintain a healthy lifestyle including a healthy diet and a robust exercise regime even before you discover any health complications. Follow up with your physician for proper management if needed.