Diabetes is a condition that impairs the body’s ability to process blood glucose, otherwise known as blood sugar. There are several types of diabetes, which have various treatments.
In the United States, the estimated number of people of all ages living with diagnosed and undiagnosed diabetes is 34.2 million trusted Sources.
Without ongoing, careful management, diabetes can lead to a buildup of sugars in the blood, which can increase the risk of dangerous complications, including stroke and heart disease.
Different kinds of diabetes can occur, and how people manage the condition depends on the type. Not all forms of diabetes stem from a person being overweight or leading an inactive lifestyle. Some are present from childhood.
The most common types of diabetes include type 1, type 2, and gestational diabetes, which we cover in more detail below. Less common types of diabetes include monogenic diabetes and cystic fibrosis-related diabetes.
Type 1 diabetes
Also known as juvenile diabetes, type 1 diabetes occurs when the body does not produce insulin. Insulin is a hormone responsible for breaking down the sugar in the blood for use throughout the body. A person living with type 1 diabetes may receive a diagnosis during childhood.
People living with type 1 diabetes need to administer insulin on a regularTrusted Source basis. Individuals may do this with injections or an insulin pump.
There is no cure for type 1 diabetes. Once a person receives their diagnosis, they will need to regularly monitor their blood sugar levels, administer insulin, and make some lifestyle changes to help manage the condition.
Successfully managing blood sugar levels can help people living with type 1 diabetes avoid serious complications. Some common complications include:
- Ketoacidosis
- nerve damage
- issues with the eyes
- increased risk of skin infection
- issues with the kidneys
- cardiovascular disease
- foot problems, including numbness
- high blood pressure
- stroke
Type 2 diabetes
People with type 2 diabetes do not make or use insulin effectively. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Trusted Source, this is the most common type of diabetes, and it has strong links with obesity.
A person living with type 2 diabetes may or may not need insulin. In many cases, medication along with changes in exercise and diet can help manage the condition.
Anyone, including children and adults, can develop type 2 diabetes. The most common risk factors for type 2 diabetes include:
- age 45 or older
- overweight
- family history
Gestational diabetes
Gestational diabetes occurs during pregnancy when an individual becomes less sensitive to insulin. According to the Centers for Disease Control and Prevention (CDC), between 2–10%Trusted Source of pregnancies each year result in gestational diabetes. Individuals who are overweight going into their pregnancy have an elevated risk of developing the condition.
The CDC adds that around 50% of people with gestational diabetes will later develop type 2 diabetes.
During pregnancy, individuals can take steps to manage the condition. These include:
- staying active
- monitoring the growth and development of the fetus
- adjusting their diet
- monitoring blood sugar levels
Gestational diabetes can increase a person’s risk of developing high blood pressure during pregnancy. It can also cause:
- premature birth
- increased birth weight.
- Blood sugar issues with the newborn, which typically clear up within a few days,
- There is an increased risk of the baby developing type 2 diabetes later in life.
Prediabetes
Prediabetes, or borderline diabetes, occurs when a person’s blood sugar levels are elevated but not enough for a diagnosis of diabetes. For a doctor to diagnose prediabetes, an individual must meet the following trusted source criteria:
- At glucose tolerance levels of 140–199 milligrams per deciliter (mg/dl),
- an A1C test result of 5.7–6.4%.
- Fasting blood sugar levels of between 100 and 125 mg/dl
People living with prediabetes have a higher risk of developing type 2 diabetes, but they do not usually experience the symptoms of full diabetes.
The risk factors for a person developing prediabetes and type 2 diabetes are similar. They include:
- Being overweight
- has a family history of diabetes.
- Having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dl or 50 mg/dl is a sign of
- have a history of high blood pressure.
- having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds.
- I have 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
Prevention
A person cannot prevent type 1 diabetes.
However, people can take some steps to help prevent type 2 diabetes. Some ways to help prevent type 2 diabetes include trusted Source:
- Maintaining a moderate weight
- Eating a balanced diet low in added sugars, saturated fats, and processed foods
- Exercise regularly
To reduce the risk of developing gestational diabetes, a person should maintain a moderate weight before becoming pregnant.
While these steps can help, it is important to note that people may still develop either type 2 or gestational diabetes.
How do insulin problems develop?
Doctors do not know the exact causes of type 1 diabetes. However, insulin resistance, which can lead to type 2 diabetes, 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 trusted source cycle:
- A person’s genes or surroundings make them more likely to be unable to create enough insulin to cover the amount of glucose, or sugar, they consume.
- To digest the elevated blood sugar, the body tries to generate more insulin.
- Because the pancreas can’t keep up with the increased demands, extra blood sugar circulates in the bloodstream, causing harm.
- Insulin becomes less effective at delivering glucose to cells with time, causing blood sugar levels to rise.
With type 2 diabetes, insulin resistance takes place gradually. This is why doctors often recommend making lifestyle changes in an attempt to slow or reverse this cycle.
Exercise and diet tips
If a doctor diagnoses someone with diabetes, they will often recommend lifestyle changes to support weight management and overall health.
A doctor may refer a person living with diabetes or prediabetes to a nutritionist. A specialist can help people living with diabetes lead an active, balanced lifestyle and manage the condition.
Steps a person can take to stay healthy with diabetes include:
- Eating a diet rich in fresh, nutritious foods such as whole grains, fruits, vegetables, lean proteins, low-fat dairy, and healthy fats like nuts.
- Avoiding high-sugar items such sweetened sodas, fried foods, and high-sugar desserts, which provide empty calories or calories with no other nutritional value.
- Avoiding excessive alcohol use or limiting consumption to one or two drinks per day for ladies and two drinks per day for males.
- Walking, aerobics, riding a bike, or swimming for at least 30 minutes each day on at least 5 days per week.
- When exercising, recognise the symptoms of low blood sugar, such as dizziness, confusion, weakness, and excessive sweating.
Some people can also take steps to reduce their body mass index (BMI) if needed, which can help those with type 2 diabetes manage the condition without medication.
Using insulin
Insulin is required for all patients with type 1 diabetes and some people with type 2 diabetes to keep their blood sugar levels from rising too high.
There are many different varieties of insulin, and most of them are classified according to how long they persist. Insulins are classified as rapid-acting, short-acting, intermediate-acting, long-acting, or mixed.
Long-acting insulin is used by some patients to keep their blood sugar levels stable. Others may utilize a combination of insulin types or short-acting insulin. Regardless of the type, a person’s blood sugar levels are routinely checked to determine how much insulin they require.
A person can use a blood glucose monitor, which involves pricking their skin, or a combination of a continuous blood glucose monitor (CGM) and a finger prick test to assess their blood sugar levels.
A CGM takes blood sugar readings regularly throughout the day. They can help a person make any adjustments to their medications. 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 sugar and thinks they need a rapid dose of glucose.
How much is too much?
Insulin helps people living with diabetes live an active lifestyle. However, it can 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, adjust their medications based on their needs, and eat a consistent diet that helps to balance blood sugar levels as much as possible.
Other medications
In addition to insulin, other types of medication are available that can help people manage their condition.
Metformin
A doctor may prescribe metformin in pill form to a person with type 2 diabetes.
It contributes to:
- lowering blood sugar
- making insulin more effective
People living with diabetes may also have other health risks, which they may also need medication to control. A doctor will advise the individual about their needs.
SGLT2 inhibitors and GLP-1 receptor agonists
In 2018, new guidelines also recommended prescribing 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 medication. 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 trusted source of drugs for lowering blood sugar levels. They work separately from insulin and may be useful for people who are not yet 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. helps to regulate meal scheduling, physical activity, and when to take medication, including insulin.
While self-monitoring blood glucose machines vary, they will generally include a meter and test strip for generating readings. It will also involve using a lancing device to prick the skin for obtaining a small quantity of blood.
Precautions
People should 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 devices on the market:
- Before touching the test strips or the metre, make sure both hands are clean and dry.
- To avoid external moisture influencing the outcome, use a test strip only once and store it in its original container.
- After testing, keep the canisters closed.
- Before using it, double-check the expiration date.
- Checking to see if the machine has to be coded before it can be used, which may be the case with older varieties,
- Keeping the metre and strips dry and cold is a good idea.
- Bringing the meter and strips to appointments so that a primary care physician or specialist can evaluate their effectiveness.
Tips
People checking their blood sugar levels with a blood glucose meter will also use a device called a lancet to prick their fingers. While the idea of drawing blood might cause distress for some people, lancing the skin to obtain a blood sample should be a gentle, simple procedure. Many meters require only a teardrop-sized sample of blood.
A person may also find the following tips useful:
- Taking a blood sample with their fingertips. While some metres allow samples from other test sites, such as the thighs and upper arms, the readings from the fingertips or outer palms are more accurate.
- To avoid food residue entering the gadget and altering the reading, they should wash their skin with soapy, warm water.
- For best comfort, choose a small, thin lancet.
- Changing the depth settings on the lancet to make it more comfortable.
- Blood is drawn from the side of their finger, which is less painful. It may be more comfortable to use the middle, ring, and little fingers.
- Using a “milking” motion to draw blood to the surface rather than applying pressure to the lancing spot.
- Following local laws on the disposal of sharp objects, such as lancets.
While remembering to self-monitor involves people making 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 was the seventh leading cause of death in the U.S. in 2017.
While diabetes is manageable, its complications can severely impact 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, lead to ulcers and untreated injuries and cuts.
- Heart disease
- Nerve damage, such as diabetic neuropathy,
- stroke
- Kidney disease
Kidney disease can lead to water retention when the body does not dispose of water correctly, difficulties with bladder control, and kidney failure.
Regularly monitoring blood sugar levels and moderating glucose intake can help people prevent the more damaging complications of diabetes.
For those living with type 1 diabetes, administering insulin is the main way to help them manage the condition.
Summary
Diabetes is a life-changing condition that requires careful blood sugar management and a healthy lifestyle for a person to manage it safely. There are several different types of diabetes.
Type 1 occurs when the body does not produce insulin. Type 2 develops when insulin production or effectiveness can no longer meet the body’s needs.
Depending on the type of diabetes, people may need to administer insulin and take other medications to manage their condition and improve glucose absorption. If a person is living with prediabetes, they can reduce the risk of developing type 2 diabetes through regular exercise and a balanced diet.
The complications of diabetes can be severe, including kidney failure and stroke, so managing the condition is vital.
Anyone who suspects they may be living with diabetes should contact their doctor.