Real-Talk Answers to Your Adult Diabetes Questions
Diabetes can affect anyone, but it is often preventable with a few lifestyle changes. Learn about the different types of diabetes, plus get tips for managing the disease.
Diabetes mellitus, or diabetes, is a disease that refers to the body's problems with insulin, a hormone produced in the pancreas. Insulin plays a vital role in metabolism–in helping glucose (sugar) to move out of the blood into cells, which use the glucose for fuel. In type 1 and type 2 diabetes, there's a need to control glucose levels in the blood.
How Can I Prevent Diabetes Naturally?
More than 100 million Americans have diabetes or prediabetes. New research shows these moves can help prevent it.
- Hit the weights. Strength training plus cardio can lower your type 2 diabetes risk 59 percent. Aim for two sessions per week.
- Nix nighttime noshing. Regular nighttime snackers don't sleep as soundly and are more likely to develop type 2 diabetes.
- Go easy on the bacon. A diet high in processed meat raised type 2 diabetes risk 19 percent. Limit your intake to once a week or less.
What's the Difference Between Type 1 and Type 2 Diabetes?
Type 1 Diabetes
Type 1 used to be called juvenile diabetes because most people with type 1 diabetes were diagnosed before age 30. In this form of the disease, the insulin-producing beta cells in the pancreas have been destroyed.
- Symptoms may include high levels of blood sugar, high levels of sugar in the urine, frequent urination, extreme hunger, extreme thirst, extreme weight loss, weakness and fatigue, moodiness and irritability, or nausea and vomiting.
- Treatment: Insulin is received via injections or insulin pumps.
- Possible complications of poorly controlled diabetes include kidney disease; eye damage; heart problems; compromised nerve function in the arms, hands, legs, and feet that can set the stage for ulcers and amputations; coma and death.
Type 2 Diabetes
According to the CDC, 90 to 95 percent of all people with diabetes have type 2. Until several years ago, type 2 diabetes mostly occurred in overweight adults older than 45. Today, however, women and men in all races and ethnic groups, along with children and adolescents, are developing it.
In type 2 diabetes, the pancreas may be producing insulin; however, there are insulin-resistance problems in the body that interfere with insulin's ability to do its job.
- Symptoms may include increased thirst; frequent urination; increased appetite accompanied by weight loss; edginess; fatigue; nausea; repeated hard-to-heal infections; tingling or numbness in the hands or feet; high levels of sugar in the urine; or dry, itchy skin.
- Treatment: Ten percent of type 2 patients rely on diet and exercise to manage their disease. Fifty percent are treated with oral medications; 30 percent with a combination of insulin and oral medications; and 10 percent with insulin alone.
- Possible complications are the same as for type 1 diabetes.
What Are the Risk Factors Associated with Diabetes?
Hereditary Risk Factors
Some diabetes risk factors cannot be controlled, especially those that are hereditary, points out David S.H. Bell, M.D., of the University of Alabama at Birmingham. Hereditary factors that increase your risk include:
- Having a close relative, such as a father, mother, sister, or brother, who has diabetes;
- Being of African-American, Latino, Native American, or Asian descent.
Health-Related Risk Factors
Type 2 diabetes is preventable, and certainly treatable, especially when you exercise and stick to a low-fat diet. The following health-related risk factors often can be controlled, though your susceptibility to them may be inherited:
- Having high blood pressure
- Having "good" (HDL) cholesterol that is too low (generally, less than 40 mg/dl);
- Having levels of triglycerides (another type of fat in the blood) that are high (generally, more than 259 mg/dl).
Heart Disease Risk
Women with diabetes, especially type 2, are at risk for heart problems. "Women who are not diabetic typically do not get heart disease until they're in their 60s," explains Dr. Bell. "However, with diabetic women, this can occur a lot earlier." That's why it's essential that your doctor apply what Dr. Bell calls the Big Three: 1. Treat the blood sugar problems associated with diabetes; 2. treat lipids–the cholesterol and triglycerides; and 3. work with you to keep your blood pressure under control.
How Does Diabetes Affect Pregnant Women?
Some women develop gestational diabetes, which occurs in up to 6 to 8 percent of all pregnancies. Women with gestational diabetes may avoid having to take insulin injections if they do not eat certain foods, such as table sugar, honey, brown sugar, corn syrup, maple syrup, molasses, soft drinks, fruit drinks, fruit packed in syrup, cake, cookies, ice cream, candy, jams, and doughnuts. It is also recommended that fruit juices be limited to 6 ounces and taken with meals. If you are diagnosed with gestational diabetes, you'll likely be referred to a registered dietitian. Working with your obstetrician, the dietitian can plan a diet that provides your baby with adequate nutrition while omitting foods that increase your blood sugar levels.
Gestational diabetes disappears when a pregnancy is over. However, about one-third of women with gestational diabetes will develop type 2 diabetes later on, says Dr. Bell. Many of these women can prevent this from happening if they keep their weight down after pregnancy by following a diet low in fat and calories, and exercising.
Moms who have given birth to a large baby–one weighing more than 10 pounds–are at increased risk for developing diabetes later in life.
If you are a diabetic woman who wants to bear children, seek expert medical advice before getting pregnant. "Generally, it's better for pregnancy to occur when you're younger and in the early, controlled stages of diabetes," says Dr. Bell. "However, at any age you'll need high-risk pregnancy management, which might include an endocrinologist working with your obstetrician."
Can Diabetes in Children Be Prevented?
Traditionally, pediatricians have seen type 1 diabetes in children, not type 2. In fact, type 2 used to be referred to as "adult-onset diabetes." But the lines are blurring because of an increase of type 2 diabetes in children and adolescents. Why? Too much junk food and television and too little exercise, says James R. Gavin III, M.D., of the Howard Hughes Medical Institute in Chevy Chase, Maryland, and a former president of the American Diabetes Association.
You can fight this epidemic by exercising with your children and minimizing fast food dinners and snacks. Stock the fridge with fruits and vegetables, and put beans, grains, cereals, low-fat dairy foods, lean meats, chicken, and fish on the healthy family dinner menu.
If your children have diabetes, ensure they get cholesterol and other blood fat tests, a yearly dilated eye exam, a foot exam to check circulation and nerves, a urine test to check kidney function, and regular dental checkups. They need to have their blood pressure checked regularly; if elevated, it should be treated.
What Are the Best Treatments for Diabetes?
Testing and Medication
Researchers are developing innovative treatments that make diabetes easier to manage. Drugs such as Actos (pioglitazone) and Avandia (rosiglitazone) lower insulin resistance. Drugs like Starlix (nateglinide) and Prandin (repaglinide) help the pancreas make more insulin. "These are tremendous aids in treating type 2 diabetes," says Dr. Bell.
The hemoglobin A1c test also makes a big difference in treatment. The test can tell the doctor how high the patient's blood sugar has been, on average, over the last two to three months. This provides a better picture of the degree to which the kidneys, heart, nerves, and eyes have been exposed to high blood sugar. Surprisingly, only 40 percent of patients with diabetes get the hemoglobin A1c test once a year, says Bell. If you are diabetic, talk to your doctor about taking the test.
Most people with diabetes measure blood glucose daily or even continuously so they know how food, exercise, and medication affect their blood sugar. Insulin injection has gotten easier with inventive gadgets, like disposable, pocket-sized pen-like injectors that contain insulin and small needles. Another popular option to manage blood sugar for patients with type 1 diabetes is the insulin pump, a small, computerized device that can inject insulin multiple times a day.
For now, medications, regular checkups, nutrition, and exercise are the best ways to manage diabetes, and live a full life.