Doctors do not know the exact cause of
also known as insulin resistance, is better understood.
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 cycle:
A person has genes of an environment that make it more likely that they are unable to make enough insulin to cover how much glucose they eat.
The body tries to make extra insulin to process the excess blood glucose.
The pancreas cannot keep up with the increased demands, and the excess blood sugar starts to circulate in the blood, causing damage.
All of this makes perfect sense. Disease can be viewed generally as the manifestation of imbalances in the body’s systems.
The three major diabetes types are: Type 1, Type 2 and gestational diabetes.
Type 1 and Type 2 diabetes both occur when the body cannot properly store and use glucose, which is essential for energy. Sugar or glucose collects in the blood and does not reach the cells that need it, which can lead to serious complications.
To maintain the right amount of blood sugar, the body needs insulin to deliver this sugar to the cells. When insulin is lacking, blood sugar builds up.
The symptoms of high blood sugar include, fatigue, weight loss and frequent urination. Type 1 and Type 2 have different causes, but they both involve insulin.
The pancreas produces the insulin to regulate the way blood sugar becomes energy.
In this type, scientists believe that the immune system mistakenly attacks the pancreatic beta cells, which produce insulin. They do not know what causes this to happen, but childhood infections may play a role.
The immune system destroys these cells, which means that the body can no longer make enough insulin to regulate blood glucose levels. A person with type 1 diabetes will need to use supplemental insulin from the time they receive the diagnosis and for the rest of their life.
Type 1 diabetes usually appears first in children and adolescents, but it can occur in older people, too. The immune system attacks the pancreatic beta cells so that they can no longer produce insulin. There is no way to prevent type 1 diabetes, and it is often hereditary. Around 5 percent of people with diabetes have type 1, according to the Centers for Disease Control and Prevention (CDC).
Risk Factors Include:
Type 2 diabetes happens when excess consumption of high sugar foods floods the blood sugar supply with glucose and reduces the production and effectiveness of insulin. According to the National Institute of Diabetes, this is the most common type of diabetes and has strong links with obesity.
Type 2 diabetes is marked by both insulin resistance (the body is resistant to the insulin it produces) and insulin deficiency (the body produces some insulin, but not enough to overcome insulin resistance). Since insulin is unable to transport sugar (glucose) to the body’s cells for use as energy, glucose levels in the blood become elevated. Over time, high blood glucose can lead to serious complications of diabetes like retinopathy, neuropathy, and heart disease.
There is no cure for diabetes, but complications can be prevented or delayed thanks to treatment focused on controlling blood glucose levels with a healthy diet, regular exercise, oral medications, and insulin when required. People with type 2 diabetes are also at an elevated risk for cardiovascular disease. For this reason, adequate treatment for elevated blood pressure and cholesterol levels—both of which increase a person’s risk for heart attack and stroke—is essential.
Cardiovascular disease (CVD) is a disease of the heart and blood vessels. It is the most common cause of death for people with diabetes, both type 1 and type 2. It is sometimes referred to as a macrovascular disease, which refers to large blood vessels, such as those in the heart.
Lipids and cholesterol can build up along the walls of these blood vessels and lead to atherosclerosis, the narrowing, hardening, or clogging of blood vessels. Atherosclerosis is a common cause of CVD in people with diabetes and can lead to a myocardial infarction, which is commonly known as a heart attack.
The risk of CVD can be reduced by careful monitoring and regulation of blood pressure and blood lipids, such as low-density lipoprotein (LDL) cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol. Smoking also increases CVD risk. Lifestyle changes and blood pressure medications can help people with diabetes meet their CVD risk reduction goals.
Unlike type 1 diabetes, type 2 diabetes typically occurs in middle-aged and older adults, although an alarmingly high percentage of new cases are seen in adolescents and young adults.
Many people who develop type 2 diabetes are overweight or obese. A family history, especially in first-degree relatives, also increases the risk for developing type 2 diabetes.
In the United States, it is estimated that 23.6 million people have diabetes, and about 20 percent of those remain undiagnosed. Type 2 diabetes represents about 90 to 95 percent of cases of diagnosed diabetes. People of African American, Hispanic, or Native American origin have a greater risk of developing type 2 diabetes than whites. Some symptoms of type 2 diabetes are excess thirst, frequent urination, blurry vision, fatigue, and recurrent skin and urinary tract infections.
Your doctor may be able to test your blood sugar levels and make the necessary lifestyle changes to help prevent diabetes.
Doctors refer to some people as having prediabetes or borderline diabetes when blood sugar is usually in the range of 100 to 125 milligrams per deciliter (mg/dL).
Normal blood sugar levels sit between 70 and 99 mg/dL, whereas a person with diabetes will have a fasting blood sugar higher than 126 mg/dL.
The prediabetes level means that blood glucose is higher than usual but not so high as to constitute diabetes.
People with prediabetes are, however, at risk of developing type 2 diabetes, although they do not usually experience the symptoms of full diabetes.
The risk factors for prediabetes and type 2 diabetes are similar. They include:
being overweight a family history of diabetes
having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL
a history of high blood pressure
having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds
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
If you suspect that you might be at risk for prediabetes, your Doctor can screen your blood. A commonly used test called “Hemoglobin A1C” will indicate how you have controlled your sugars over the previous three months.
This test can also tell your Doctor how likely it is that you will develop diabetes in the near future – the higher the level, the more likely this will be.
If a doctor identifies that a person has prediabetes, they will recommend that the individual makes healthful changes that can ideally stop the progression to type 2 diabetes. Losing weight and having a more healthful diet can often help prevent the disease.
This occurs in pregnancy and typically resolves after childbirth, but some people then develop type 2 diabetes later in life. Some women become less sensitive to insulin during their pregnancy, but this issue often resolves after giving birth.
When you are not in control of diabetes, you just don’t feel good. Initially when first diagnosed, you may feel a great deal of fear.
Serious diseases are scary and seemingly complicated and difficult to manage, especially if you are a child.
Start being in control by learning the facts about the disease, inside and out. Be more open about the disease, it’s care and your challenges.
Everything you must learn to do will soon become second nature.
Diseases of any kind used to be kept secret as if there was something wrong with you if you had one.
Friends and extended family and people you work with, can’t help if they don’t know what you’ve been going through.
If they don’t know what a “sugar low” looks like and what they can do to help treat it, they won’t be able to help or to understand what is happening to you.
Studies have long shown that people with diabetes are at higher risk for clinical depression than people without the condition.
Recent research, including a study published in 2016 in the journal Diabetic Medicine, suggests that symptoms of depression, anxiety, and burnout can sometimes be attributed to a condition called diabetes distress. Nearly half of all people with diabetes experience diabetes distress, according to a study in a 2012 issue of Diabetes Care.
Diabetes is also linked to eating disorders, including diabulimia (skipping or limiting insulin to lose weight) and, particularly among people with type 2, binge eating disorder and bulimia.
And then there’s the day-to-day emotions that come with managing a chronic illness: stress, guilt, fear, blame, anger—not to mention the mood swings that come with glucose fluctuations. In short: People with diabetes are dealing with extra emotional burdens.
Therapy can help, and the benefits don’t stop at your mental health. Studies have shown that people with diabetes who seek mental health treatment experience A1C improvements, too.
When is the right time to start therapy? Anytime. You can turn to a mental health professional for support when there are changes in your diabetes—a newly diagnosed complication, for instance. If you’re finding management difficult or burdensome, or if your feelings or thoughts about diabetes are getting in the way of your work and relationships, reach out for some professional help.
In a therapy session, you will have a good listener who can help you to shift your perspective and change your behavior.
Making peace with the issues that are bothering you frees you to concentrate on the solutions rather than the problems.
Your therapist can help you to break down big tasks into smaller doable chunks.
You may need help dealing with negative thoughts and how to eliminate them.
Try to find a therapist who has some experience helping people with diabetes. Previous clients would have enabled the therapist to look at diabetes in all of its complexity through a wider lens.
If the cost of a therapist is prohibitive, seek out a group-based therapy.
Many hospitals offer support groups which are free.
Stress influences diabetes in major ways. Low stress resilience (an inability to handle stress effectively) is strongly associated with a high risk of developing type 2 diabetes later in life.
Perhaps a partial explanation for this is that people who are not handling stress well, may in turn to smoking, alcohol and/or unhealthy foods in order to cope.
When we experience stress, a hormone called cortisol is released in the body. Cortisol helps the body access resources such as glucose, that the body then uses to fight off or flee from a predator or other dangers.
When cortisol is released on a regular basis due to chronic stress, it can be harmful. High cortisol levels contribute to depression, insulin resistance, weight gain and type 2 diabetes.
Stress is a reaction to life events. Some events can be avoided or controlled; others are beyond our control.
Practice identifying your stressors as either manageable or out of your control.
Much of our stress originates with negativism. Choose to focus on the positive aspects of your life; seek out the things and people that you love and admire. Be thankful and mindful of the wonderful things in your life and choose to hope over despair.
Walking along the beach or an ocean or lake can awaken a feeling of kinship with something beautiful.
Forests, great architectural masterpieces and symphonic music are all opportunities to associate by participation. Make the choice to disallow negative, low frequency TV shows or other videos from entering your head. You have control over what you allow into your mind.
You don’t enter your name in an Ironman competition right away.
Realistically assess your fitness level and begin to improve it sensibly.
Park a bit further away from the entrance to a shopping mall; in an office building or at work, choose to take the stairwell instead of the elevator.
The sharing you do with your family, friends and your healthcare providers, creates healthy bonding and networking. These relationships assure your connection to the community.
Being a part of the whole is important for a healthy sense of life and your role in it.
Associate with people who are positive, kind and helpful. If some people are negative, angry or destructive, you may wish to re-evaluate their role in your life or eliminate it altogether.
Be alert for ways to be kind to your friends, family or even strangers. When driving, letting someone merge into traffic during busy times, will make someone’s day. Your acts of kindness don’t need to be big to be appreciated.
The American Diabetes Association rates diabetes as the seventh leading cause of death in the U.S.
While diabetes is manageable, it’s complications can severely impact the quality of daily living and if not treated immediately, can be fatal.
In the case of Kidney disease, this complication can lead to kidney failure, water retention when the body does not dispose of water correctly, and to difficulties with bladder control.
In general, men have a higher risk for kidney disease but women with diabetes are just as likely to get kidney disease, regardless of gender or age.
Regularly monitoring blood glucose levels and moderating glucose intake can help people prevent more damaging complications of type 2 diabetes.
For those with type 1 diabetes, taking insulin is the only way to moderate and control the effects of the condition.
While it would seem that diabetes affects men and women differently, is that really true?
The troubling truth is that women with diabetes have it worse, on average, than men with diabetes.
In the general population, women live longer than men, largely because of their lower rates of heart disease. Yet, when women get diabetes, something happens that strips them of this advantage.
“The risk for heart disease is six times higher for women with diabetes than those without,” says Marianne Legato, MD, FACP, director of the Partnership for Gender-Specific Medicine at Columbia University.
With men, diabetes increases the risk for heart disease two- to threefold. Data also show that women with diabetes are more likely than men with the disease to have poor blood glucose control, be obese, and have high blood pressure and unhealthy cholesterol levels.
This shocking inequality was revealed in a 2007 study that found that, between 1971 and 2000, death rates fell for men with diabetes, while rates for women with the disease didn’t budge. Plus, while men with diabetes live 7.5 years less on average than those who don’t have the disease, among women the difference is even greater: 8.2 years.
Warning signs of a Heart Attack It’s important to recognize the warning signs of a heart attack to ensure prompt medical treatment. Women’s symptoms may be different from men.
For example, while chest pain is considered the most common heart attack warning sign, many women have heart attacks without chest pain. Some less familiar symptoms are more common in women than in men. Here is a list of the leading symptoms.
What compounds the female predicament is that heart disease is more deadly in women with diabetes than it is in men with the disease. A 2007 study published in the European Heart Journal found that the association between diabetes and death by heart failure was stronger for women than it was for men.
A Finnish study also found that in people with diabetes, heart attacks are more often fatal for women than they are for men. “For an older woman with diabetes, if she has a heart attack, it’s a big deal,” says Deborah Wexler, MD, MSc, an endocrinologist at Massachusetts General Hospital.
This greater risk, Wexler says, may stem in part from biological differences in how women and men experience heart attacks. For both, the most common warning sign of a heart attack is chest pain or discomfort in the upper body.
However, women are more likely than men to experience only nausea, shortness of breath, and back or jaw pain during a heart attack. If a woman experiences these but doesn’t recognize them as heart attack warning signs, she may not seek treatment, lowering her chances of recovery.
A group of doctors published a list of recommendations in “Gender Medicine” when they encouraged women with diabetes to be tested for heart disease risk factors such as high blood pressure or unbalanced blood fats.
They also recommended that their doctor closely examine their female biological health history. Women with a history that includes gestational diabetes may be at risk for type 2 diabetes and other health problems.
The greater toll that diabetes takes on women is likely to be caused, at least in part, by their blood fat biology.
When women have diabetes, the high triglycerides (blood fats) drive down their HDL levels. The combination of high triglycerides and low HDL adds up to a greater risk of heart disease.
Self-monitoring blood sugar levels is vital for effective diabetes management. Monitoring will assist you to regulate meal scheduling, plan physical activities and decide when medications (including insulin), should be taken.
While self-monitoring blood glucose (SMBG) machines vary, they will generally include a meter and test strip for generating readings and a lancing device to prick the skin for obtaining a small quantity of blood.
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 of the machines on the market:
Make sure both hands are clean and dry before touching the test strips or meter
Do not use a test strip more than once and keep them in their original canister to avoid any external moisture changing the result.
Keep canisters closed after testing.
Always check the expiration date.
Older meters might require coding prior to use. Check to see if the machine currently in use needs this.
Store the meter and strips in a dry, cool area. Take the meter and strips into consultations, so that a primary care physician or specialist can check their effectiveness.
A person who is self-monitoring diabetes uses a device called a lancet to prick the skin. While the idea of drawing blood might cause distress for some people, the lancing of the finger to obtain a blood sample should be a gentle, simple procedure.
Clean the area from which the sample will come with soapy, warm water to avoid food residue entering the device and distorting the reading.
Choose a small, thin lancet for maximum comfort.
The lancet should have depth settings that control the depth of the prick. Adjust this for comfort.
Many meters require only a teardrop-sized sample of blood.
Take blood from the side of the finger, as this causes less pain. Using the middle finger, ring finger, and little finger may be more comfortable
While some meters allow samples from other test sites, such as the thighs and upper arms, the fingertips or outer palms produce more accurate results.
Tease blood to the surface in a “milking” motion rather than placing pressure at the lancing site.
Dispose of lances in line with local regulations for getting rid of sharp objects.
While remembering to self-monitor involves lifestyle adjustments, it need not be an uncomfortable process.
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