Diabetes mellitus, or diabetes (as it’s more commonly referred to as), is a metabolic disorder that causes issues with blood glucose levels and insulin, a hormone that’s produced in the pancreas.  It’s a common, yet serious, condition that often requires lifelong management. 

There are different types of diabetes, as well as conditions that are precursors for a diagnosis of diabetes diagnosis, such as insulin resistance and prediabetes.  This article will help break down the facts about diabetes.

Fact 1: Insulin Resistance and Prediabetes Occur When the Body Doesn’t Respond to Insulin Properly

Insulin is a hormone made by the pancreas.  It helps your muscles, fat, and liver use glucose for energy.  We get glucose from the liver and from the foods we eat.

Blood glucose levels rise after eating.  In response to the rise in blood glucose levels, the pancreas releases enough insulin into the blood to help move glucose into our cells.  If muscle, fat, and liver cells don’t respond to insulin, then glucose stays in your blood.  When your cells stop responding to insulin, the body has a tough time using glucose for energy. 

Consistently having high blood glucose levels damages the body.  Insulin resistance can lead to prediabetes and, eventually, type 2 diabetes.

Fact 2: Type 1 and Type 2 Diabetes Are Different Types of Diabetes

Type 1 diabetes is an autoimmune disease.  This means that the body’s immune system mistakenly destroys the pancreatic cells that produce insulin.  There is no cure for type 1 diabetes.  However, since the discovery of insulin, people with type 1 diabetes are able to manage their condition. 

Type 1 diabetes is sometimes called “juvenile diabetes” because children and young adults are more likely to be diagnosed.

Some people have a genetic factor that increases the risk of developing type 1 diabetes.  Research also suggests that being exposed to specific environmental triggers or viral infections can lead to the development of type 1 diabetes.

Type 2 diabetes is characterized by insulin resistance and the progressive failure of pancreatic cells.  This means that the body’s cells may not respond well to insulin and/or the pancreas may stop producing insulin over time.

Many factors impact the risk of developing type 2 diabetes.  Risk factors for type 2 diabetes that we cannot control include:

• Age
• Family history 
• Race 

Risk factors for type 2 diabetes that we can control include:

• Body weight, 
• Level of physical activity
• Lifestyle habits 

These factors influence how adipose tissue (fat tissue), the liver, and the pancreas all react to insulin and blood glucose.

Fact 3:  the Number of People Diagnosed With Diabetes Increases Every Year

Every year, over 1.4 million people living in America are diagnosed with diabetes.

More than 37 million people in America have a form of diabetes.  The majority of those diagnosed with diabetes have type 2 diabetes.  Of those that have a form of diabetes, over 8 million of them do not know they have it.

The age group with the highest prevalence of diabetes is those that are 65 years of age and older.  However, diabetes, especially type 2 diabetes, is increasingly diagnosed in younger populations each year.

Fact 4: The Types of Diabetes May Have Similar or Different Warning Signs

People with insulin resistance, prediabetes, and even type 2 diabetes may not have any symptoms.  These conditions often go undetected until the disease has progressed or until another health issue arises.  Some people may see darkened skin spots or skin tags in their armpits or necks, a condition called acanthosis nigricans.

The symptoms of type 1 and 2 diabetes may appear over time.  General signs of diabetes include:

• Frequent urination
• Frequent thirst
• Frequent hunger
• Unintentional weight loss
• Dry mouth
• Fatigue
• Blurred vision
• Yeast infections 

Other signs that suggest type 1 diabetes include:

• Bedwetting
• Flu-like symptoms that don’t go away
• Breath that smells like fruit

Other signs that suggest type 2 diabetes include:

• Slow-healing wounds
• Numbness or tingling in hands or feet
• Heart problems

Fact 5: There Are Various Tools to Screen for and Diagnose Diabetes

If you notice any of the symptoms of diabetes, contact your primary care physician for an appointment.  Your physician will ask you about your symptoms and will decide which test or tests to perform to determine what’s going on.

The tests that are most often used to evaluate blood sugar levels are the fasting plasma glucose (FPG) test and the Hemoglobin A1c (HbA1c) test.

The FPG test measures blood glucose levels at one moment in time.  Your physician will likely recommend fasting for at least eight hours before this test.  A normal range for the FPG test is considered to be less than 100 mg/dl.  Prediabetes is indicated by an FPG range of 100-125 mg/dl.  An FPG over 126 mg/dl is considered diabetes.

The HbA1c test is a blood test that shows your average blood glucose levels over the past three months.  The test is reported as a percentage – the higher the percentage, the higher your average blood glucose levels.  A normal HbA1c range is below 5.7%.  Prediabetes is indicated by an HbA1c range of 5.7% to 6.4%.  An HbA1c of 6.5% or higher is considered type 2 diabetes.  Along with the results of your HbA1c test, your doctor will also consider factors such as age, health conditions, and race.

Your care team may also use other screening and diagnostic tests, including:

• Oral Glucose Tolerance Test (OGTT) – This test checks blood sugar levels before and two hours after drinking a beverage high in carbohydrates.  High blood sugar levels two hours after drinking the beverage may indicate diabetes.
• Random Plasma Glucose Test – This test checks blood sugar levels randomly when other diabetes symptoms are occurring.
• Insulin in the Blood – This test measures how much insulin is in your blood.  If insulin levels are high, then it may indicate insulin resistance or type 2 diabetes.  If insulin levels are low, then it may indicate type 1 diabetes.
• Ketones in the Blood – This test measures ketone levels in your blood.  Your cells produce ketones if they do not have enough glucose.  High levels of ketones in the blood may indicate diabetes.
• Ketones in Urine – This test measures ketone levels in your urine.  High levels of ketones in urine may indicate diabetes.

Even though these tests can suggest or confirm a diagnosis of diabetes, it is not always clear what type you may have. Along with the test listed above, your healthcare team may use an autoantibodies test, which looks for the autoantibodies that are more common in type 1 diabetes.

Fact 6: Managing Diabetes Requires a Plan

From insulin resistance to type 1 and type 2 diabetes, successfully managing your condition requires a plan.  If you have type 1 diabetes, you will need insulin.  Some people with type 2 diabetes may also require insulin.

The year 2021 marked 100 years since insulin was discovered.  The advancement of technology allows for several ways of getting insulin and managing blood sugar levels, including injections, pens, blood sugar meters, and oral medications.  Review the advantages and disadvantages of each one with your doctor to determine which one works best for you.

Your plan may require that you make some lifestyle changes, such as making healthier food choices and increasing physical activity.  Your doctor may also suggest taking certain medications to help manage your blood sugar levels.

Managing diabetes is easier today than it was in the past.  Today, there are more tools like smart phone apps with many helpful tracking methods.  These apps give you feedback when you log your blood glucose levels, exercise, medications, or other activities.  Using an app as part of a treatment plan from your doctor can help you manage your blood glucose levels.  Research shows that using diabetes management apps may help people improve their HbA1c levels and reduce health complications. 

Fact 7: Food Choices Affect Your Diabetes Health

Eating too much sugar or eating any one food does not directly cause diabetes. 

Instead, it is your overall food choices that have a long-term effect on your health.  The key is to choose a variety of foods from each food group in appropriate portions: lean proteins, vegetables, fruits, whole grains, nuts, seeds, legumes, and healthy fats.

Selecting foods that help keep your blood glucose in target range can help you feel better while decreasing your chances of developing other health complications.  Keep in mind that each person’s body may respond slightly differently to specific foods and various portions.  

Too little or too much food can also change how effective your medications are and may impact blood sugar levels.  It is best to talk with your diabetes healthcare provider about how to coordinate meals with your medications. 

Fact 8: Physical Activity Helps Manage Diabetes

Studies have shown that all forms of exercise help lower HbA1c values, which is often a goal for people with diabetes.  For those who are insulin resistant or have prediabetes, resistance training and aerobic exercise can help lower insulin resistance.

Muscles use glucose for energy.  Also, exercise can help your body use insulin more efficiently.  Together, these two factors help improve your overall health.

If you use insulin, it is important to check your blood glucose levels before, during, and after exercise to evaluate how your body reacts.  Since exercise affects your blood glucose levels, it is important to talk with your healthcare team to figure out an exercise plan.

Final Thoughts on the Facts About Diabetes

The first step to managing your health is seeing your doctor.  Don’t panic if your blood sugar level or HbA1c is high.  However, be ready to take action.  A combination of meal planning, physical activity, and medicine can improve your numbers.  Research shows that following a diabetes management plan developed by you and your healthcare team while consistently practicing healthy lifestyle habits can help you live a healthy, happy life with diabetes.