What is diabetes?

Diabetes is a severe condition. It occurs when the body fails to produce enough insulin or cannot utilise it effectively. This leads to elevated glucose (blood sugar) accumulation in the bloodstream. Consequently, the body does not function as it should. Diabetes is a condition that causes blood sugar levels to rise to perilous heights. Blood sugar, also referred to as glucose, is regulated by insulin. Your primary energy source is blood sugar, mainly from your food. Insulin is a hormone that assists your body's cells absorb glucose from your bloodstream for energy usage or storage. When you have diabetes, your body either produces insufficient insulin, does not utilise its insulin efficiently, or both. This results in sugar accumulation in your blood.  You can read more about the importance of understanding your diabetes tests here.
 

What types of diabetes exist?

There are two principal types of diabetes

Type 1 and Type 2

• Type 1 diabetes typically manifests in children and young adults. It occurs when the body ceases insulin production. Individuals with Type 1 diabetes need to administer insulin or other medications daily. 
• Type 2 diabetes is the most prevalent form of diabetes. It primarily develops in adults and arises when the body does not effectively use the insulin it produces, a condition known as insulin resistance. Additionally, the pancreas may fail to produce sufficient insulin to meet the body’s demands. Prediabetes indicates that the body struggles to lower blood sugar levels to a healthy range, but it has not yet reached the status of Type 2 diabetes.  Managing type 2 diabetes effectively is crucial, and you can learn more about managing diabetes in 2024 here.
   

In people diagnosed with diabetes:

• The pancreas produces little or no insulin, or
• The body does not react to and utilise insulin as it should. This issue is termed insulin resistance.
   

Monitoring your blood glucose (blood sugar)

Regularly checking your blood glucose—or blood sugar—levels independently can be crucial to diabetes management. Frequent monitoring will indicate:

• Whether your insulin or other diabetes medications are effective
• How physical activity, dietary choices, and stress influence your blood glucose
• Maintaining blood glucose close to your target will improve your mood and provide more energy. Properly managing your blood glucose levels can also lower the likelihood of developing diabetes-related complications.

 You can explore the importance of regular monitoring and understanding tests further by reading here.
 

Understanding your A1C

The A1C test assesses your estimated average blood glucose level over roughly three months. It serves as a “memory” of your blood glucose readings. It reflects how well you’re managing your levels over time. Two additional blood glucose assessments factor into your A1C:

• FPG is your fasting plasma glucose, which is your blood glucose measurement after fasting (not eating) for at least eight hours.

• PPG refers to your postprandial plasma glucose, which is your blood glucose level checked about one to two hours after you start eating. This measures the blood glucose spikes that occur post-meal. 

Your FPG and PPG should meet their target goals for your A1C to reach the desired level. Your A1C and blood glucose readings fluctuate together. Below is how A1C levels relate to estimated average blood glucose levels:

Recommended A1C testing frequency

• At least twice annually if your blood glucose levels are within your target range

• Four times a year if you are not achieving your goals or if there have been changes in your treatment 

According to the American Diabetes Association, lowering your A1C to below 7% may decrease the risk of certain complications associated with diabetes, such as issues with your nerves, eyes, and kidneys. Your healthcare provider will inform you of your specific A1C target.
 

When to monitor your blood glucose

You and your diabetes care team will determine the timing and frequency of your blood glucose checks. Here are specific times when you might consider testing:

• At night, before bed and upon waking up, monitor whether your blood glucose remains controlled while you sleep.

• Before meals or large snacks, assess your blood glucose level before eating.

• One to two hours after starting a meal, evaluate how your food impacts your blood glucose.

• Before engaging in physical activity, and shortly after, observe how exercise influences your blood glucose levels.

• Whenever you suspect your blood glucose may be low

Your healthcare professional may recommend checking your blood glucose more or less frequently, depending on your medication. Discuss the appropriate timing and frequency of your checks with them.
 

How to monitor your blood glucose and keep a record of your results

Numerous types of blood glucose meters are available today. Your diabetes care team can assist you in selecting a suitable meter and instruct you on its use. It’s essential to document your blood glucose readings so you can track the factors that cause them to rise or fall. Some meters also maintain a record of your previous blood glucose levels.
 

Managing type 2 diabetes

Your care team may suggest various diabetes medications, such as pills or alternative non-insulin treatments, as part of your diabetes management plan. They will also help you create a management plan tailored to your needs. In addition to taking medication, you should strive for a nutritious and balanced eating plan, incorporate physical activity into your daily routine, achieve and maintain your target weight, and monitor your blood glucose levels.
 

Progression of type 2 diabetes

• The beta cells may become dysfunctional.

• As the number or effectiveness of beta cells diminishes, the pancreas may produce less insulin

• The beta cells might produce insulin, but the body may not respond to or utilise it effectively. The beta cells may then compensate by generating extra insulin. However, over time, the pancreas may not be able to produce sufficient insulin.

• As your diabetes progresses, modifications to your treatment may also be necessary

Keeping blood glucose levels as close to the target is crucial to preventing diabetes-related complications.
 

Are you at risk for type 2 diabetes?

You have a higher likelihood of developing type 2 diabetes

• If you are overweight, mainly if you carry extra weight around your abdomen.
• Having a parent, sibling, or child with diabetes increases your risk.
• Belonging to an African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander community may make you more susceptible.
• A history of gestational diabetes during pregnancy raises your chances.
• Giving birth to a baby weighing 9 pounds or more can be a risk factor.
• Elevated blood pressure, reading 140/90 mmHg or higher or being diagnosed by a healthcare professional, increases the risk.
• Abnormal cholesterol levels, such as HDL cholesterol of 40 mg/dL or lower or triglycerides equal to or exceeding 150 mg/dL, can contribute to the risk.
• Engaging in minimal physical activity, such as less than 2 hours and 30 minutes of moderate exercise and fewer than 2 days of strength training per week, can also increase the likelihood of developing type 2 diabetes.
   

Do you have diabetes?

Below 100 mg/dL: Normal – Keep up your healthy habits.

100 to 125 mg/dL: Prediabetes – You're at risk for type 2 diabetes. Focus on weight management and aim for at least 2 hours and 30 minutes of physical activity each week.

126 mg/dL or higher: Diabetes – Work with your healthcare provider to manage the condition. Focus on the ABCs of diabetes management:

• A1C: Regular blood tests to monitor your average blood sugar levels over time.
• Blood Pressure: Keep your blood pressure in a healthy range.
• Cholesterol: Maintain healthy cholesterol levels to avoid complications.
   

Insulin Therapy

There are myths and fears associated with insulin in patients' minds and sometimes even healthcare providers. Being prescribed insulin does not imply that your disease is severe. Type 2 Diabetes Mellitus is a serious condition that requires treatment by any available means. The apprehension towards insulin often stems from its delivery method, injection. However, with the latest injection syringes and proper technique, one can experience minimal discomfort when taking the injection.

Insulin may be necessary for:

1. Young individuals with diabetes

2. Extremely high blood sugar levels

3. Pregnant women with diabetes

4. Diabetics needing surgical procedures and/or dealing with other serious health issues.

5. Diabetics with additional complications like heart or kidney disease may also require insulin in addition to oral medications.

6. Infections such as tuberculosis or hepatitis in the presence of diabetes.
 

Hypoglycemia (Low Blood Sugar)

Hypoglycemia refers to a rapid decrease in blood sugar levels. When undergoing diabetes treatment, a reduction in blood sugar is the anticipated effect of the medication. This is not considered a side effect of the treatment, but blood glucose can drop to dangerously low levels under certain circumstances.  
 

How can you identify hypoglycemia?  

The following signs can be associated with hypoglycemia:  

- A sudden onset of hunger and stomach cramps  

- Unexplained feelings of anxiety  

- Perspiration  

- Headaches  

- Vision disturbances  

- Shakiness  

- Heart palpitations  

- Unusual behaviour  

- Rapid mood shifts  

If not addressed promptly, it can lead to a decline in consciousness, seizures, paralysis, and loss of consciousness. All of these hypoglycemic symptoms can be prevented with immediate treatment.  
 

What causes hypoglycemia?

- Skipping meals  

- Overdose of diabetes medication  

- Unexpected intense physical activity  

- Drinking alcohol  
 

Managing hypoglycemia 

At the first sign of symptoms, consume sugar, fruit juice, chocolate, or candy immediately. If left untreated, the patient may require glucose or glucagon injections. It’s essential to inform your doctor about this incident so that necessary adjustments can be made to medication dosages.  

Using a glucometer is very useful for tracking glucose levels, which can assist in monitoring hypoglycemic episodes.  
 

Can diabetes be prevented?

This is a complex question. While it is theoretically feasible, it is challenging. This is due to the lack of a singular cause that can be quickly addressed. Preventive measures can be instituted at various phases.  
 

Primary prevention:  

• This involves preventing the onset of Diabetes Mellitus from the beginning. Genetic counselling could be beneficial at this stage. 
• Two diabetic individuals shouldn't marry as a more substantial family history increases the likelihood of diabetes in their children. Similarly, unions between two genetically predisposed individuals should be avoided. 
• Gene therapy and targeted prevention against the disease represent significant challenges of the new millennium. Individuals with a strong family history of diabetes should take some precautions. 
• Healthy eating habits and an active lifestyle can help fend off the disease. Alterable risk factors such as obesity, smoking, and tobacco use should be managed. What it requires is increased self-discipline and confidence. Remember, “It’s not hard; I can accomplish it.”  
   

Secondary prevention:  

• This aims to ensure the early detection of the disease and proper management to reduce the risk of long-term complications. 
• This can be achieved by keeping blood glucose levels as close to normal as possible. Various tests for monitoring target organs are readily accessible. Comprehensive medical check-ups and tests such as microalbumin excretion, treadmill testing, and eye examinations help identify early organ involvement.
•  Timely medical intervention and the start of treatment can significantly delay or prevent complications from developing.  
   

Tertiary prevention:  

• At the tertiary prevention level, actions can be taken to slow the progression of complications that have already arisen. 
• Management of target organ issues such as heart disease or kidney problems can be effectively addressed. 
• New cardiology advancements and developments in dialysis and renal replacement therapies have improved the lives of people with diabetes. Modern healthcare practices have increased longevity and enhanced the quality of life for those living with diabetes.
   

Conclusion

Being diagnosed with diabetes is a life-changing event, but it does not preclude you from living a happy and healthy lifestyle. Diabetes management requires continual care and diligence. While it may be daunting at first, you will gradually better understand how to manage the illness and be in sync with your own body. TruePal empowers individuals with diabetes through education, monitoring, and personalised care. 

FAQs

1. How can I manage diabetes to lower my risk of heart disease and stroke?

Making changes to your lifestyle is essential for managing diabetes and preventing heart disease and strokes. Although medication might still be necessary, implementing these measures can help reduce your risk.  

A diet that promotes heart health can assist in managing diabetes and decreasing risk factors.  

1. Control your diabetes effectively.  

2. Stop smoking and steer clear of secondhand smoke.  

3. Keep track of your blood pressure.  

4. Enhance your cholesterol levels.  

5. Adhere to a diet that supports heart health.  

6. Achieve and maintain a healthy weight.  

7. Stay active with regular physical exercise.  

8. Ensure you get adequate sleep.  

9. Address stress and focus on your overall well-being.  

10. Schedule regular medical checkups.  

2. What forms of diabetes exist?

There are two forms of diabetes: type 1 and type 2.

• Type 1 diabetes generally affects children and young adults.
• It occurs when the body stops manufacturing insulin. Type 1 diabetes requires daily medication, such as insulin.
• Type 2 diabetes is the most prevalent type and typically affects adults. Insulin resistance occurs when the body fails to use its insulin efficiently. Additionally, the pancreas may not produce enough insulin to meet the body's needs.
• Prediabetes is characterised by difficulty lowering blood sugar levels to a healthy range but not yet progressing to type 2 diabetes. 
   

3. What is diabetes?

Diabetes raises blood sugar levels to hazardous levels. Insulin controls blood sugar (glucose), your primary energy source, primarily derived from your diet. Insulin is a hormone that helps cells absorb and store glucose for energy. 

4. Why is diabetes so dangerous?

Diabetes significantly increases the risk of heart attack and stroke. High blood glucose levels can cause damage to the body over time. Diabetes can cause blindness, amputation, kidney issues, and death.