Here’s a little tutorial we’ll call Diabetes 101.
First, some basic definitions, provided by the Centers for Disease Control and Prevention (CDC):
• Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should.
• Insulin is a hormone produced in the pancreas that regulates the amount of glucose in the blood. When there isn’t enough insulin, or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems such as heart disease, vision loss, and kidney disease.
• Glucose is the main type of sugar in the blood and is the major source of energy for the body's cells. Glucose comes from the foods we eat, or the body can make it from other substances. Glucose is carried to the cells through the bloodstream. Several hormones, including insulin, control glucose levels in the blood.
There are two primary types of diabetes:
• Type 1 is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin. Five to ten percent of people who have diabetes have type 1. It’s usually diagnosed in children, teens, and young adults because its symptoms often develop quickly. If you have type 1 diabetes, you’ll need to take insulin every day to survive. Currently, no one knows how to prevent this type of diabetes. The primary risk factor for type 1 is family history—having a parent, brother, or sister with type 1 diabetes.
• Type 2 occurs when your body doesn’t use insulin well and can’t keep blood sugar at normal levels. Between 90-95% of people with diabetes have type 2. It develops over many years and is usually diagnosed in adults. You might not notice any symptoms, so it’s important to get your blood sugar tested if you’re at risk. Type 2 can be prevented or delayed with healthy lifestyle changes such as losing weight, eating healthy foods, and being active. You are at risk for type 2 diabetes if you:
• have prediabetes.
• are overweight.
• are 45 years or older.
• have a parent, brother, or sister with type 2 diabetes.
• are physically active fewer than 3 times a week.
• have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 9 pounds.
• are an African American, Hispanic or Latino, American Indian, or Alaska Native. Some Pacific Islanders and Asian American people are also at higher risk.
Prediabetes is when your blood sugars are higher than normal but not high enough yet to be diagnosed as type 2 diabetes. In the U.S., 96 million adults (more than 1 in 3) have prediabetes, and 80% of them don’t know they have it. Prediabetes raises your risk of type 2 diabetes, heart disease, and stroke. The good news is if you have prediabetes, lifestyle changes can help you take healthy steps to reverse it.
According to the CDC:
• 37.5 million adults in the U.S. have diabetes, and 20% of them don’t know they have it.
• Diabetes is the seventh leading cause of death in the U.S.
• Diabetes is the number one cause of kidney failure, lower-limb amputations, and adult blindness.
• In the last 20 years, the number of adults diagnosed with diabetes has more than doubled.
Now that you have successfully completed Diabetes 101 and you understand what diabetes is, how can you manage it if you have it? Better yet, how can it be avoided?
Do your research. There are lots of sources on education, support, and resources to improve quality of life with diabetes. You can learn how to manage diabetes to prevent or delay health complications by eating well, being physically active, managing diabetes sick days, reaching and maintaining a healthy weight, managing stress, and ensuring you sustain good mental health. Just be careful to use reputable sources, such as the CDC and Mayo Clinic.
A good place to start if you want to manage your diabetes is the CDC’s Diabetes Self-Management Education and Support (DSMES) services: https://www.cdc.gov/diabetes/dsmes-toolkit/index.html This program helps diabetics learn how to take the best care of themselves. Endocrinology Associates can provide a referral to DSMES services.
To avoid getting diabetes, you should embrace many of the strategies diabetics use to manage their illness. Following are some strategy recommendations for both managing and avoiding diabetes.
Eat Well; Eat Healthy
Eat foods in the right amounts at the right times so your blood sugar stays in your target range as much as possible. Fiber-rich foods promote weight loss and lower the risk of diabetes. They include fruits (tomatoes, peppers, fruit from trees), non-starchy vegetables (leafy greens, broccoli, cauliflower), legumes (beans, chickpeas, lentils), and whole grains (whole-wheat pasta and bread, whole-grain rice, whole oats, and quinoa). Avoid foods with “bad carbohydrates” that are high in sugar with little fiber or nutrients such as white bread, pastries, pasta made from white flour, fruit juices, and processed foods with sugar or high-fructose corn syrup. Your diet should include a variety of foods with unsaturated fats, sometimes called “good fats”: olive, sunflower, and canola oils; nuts and seeds such as almonds, peanuts, flaxseed, and pumpkin seeds; fatty fish such as salmon, mackerel, tuna, and cod. (Think Mediterranean diet.)
Your dietary goal should be to lose weight, if you’re overweight, and then maintain a healthier weight moving forward. Work with a dietician, a diabetes educator, or the staff at Endocrinology Associates to create a healthy eating plan.
Maintain a Healthy Weight
Two measurements to get a ballpark idea if your weight is healthy or not are your body mass index (BMI, which measures your height compared to your weight) and your waist circumference. Consult your doctor on what your stats should be.
You don’t have to lose a lot of weight at one time. Take it in small, achievable steps. Taking off just 5% to 10% (that’s 10-20 pounds for a 200-pound person) can improve your health and well-being. If you have diabetes, you might find your blood sugar levels are easier to manage and that you need less diabetes medicine after you lose weight. Many people who lose weight have more energy and sleep better.
A healthy weight goal is one thing; dropping the pounds is quite another. Create an eating plan for life. It just needs two components: it should be based on healthy food, and it should be one you can keep doing long-term. Let Endocrinology Associates’ diabetes specialists guide you in developing a sensible weight loss plan.
Be Physically Active
If you have diabetes, being active makes your body more sensitive to insulin, which helps manage your diabetes. Physical activity also helps control blood sugar levels and lowers your risk of heart disease and nerve damage.
The goal is to get at least 150 minutes per week of moderate-intensity physical activity. One way to do this is to try to fit in at least 20 to 25 minutes of activity every day. Also, on two or more days a week, include activities that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms). Examples of moderate-intensity physical activities include walking briskly, doing housework, mowing the lawn, dancing, swimming, bicycling, and playing sports. These activities work your large muscles, increase your heart rate, and make you breathe harder, which are important goals for improved fitness. Stretching helps to make you flexible and prevents soreness after being physically active. Aim for 30 minutes or more of moderate to vigorous aerobic exercise on most days to get to your 150-minute/week goal, include resistance exercises at least two to three times a week, and break up long bouts of inactivity—move and walk around every 30 minutes.
To get started, find an activity you like, begin slowly and work up to your desired level, participate with a partner (it’s more fun and it should be someone who can help you stay on track), set realistic and achievable goals, and schedule your activities. Put them on your calendar or write them in your daily plan.
Remember—it’s never too late to start on any of these strategies. Give them time, and stick with them long enough to develop into positive, healthy habits that lead you to accomplish your goals.
Endocrinology Associates can help you care for your diabetes. We can work with prediabetics to avoid this condition by providing screening with diagnostic tests for type 2 diabetes and offering recommendations for a healthier life.