Diabetes

Diabetes Mellitus (DM)

Diabetes mellitus is something almost everyone has been affected by in one form or another. It is estimated that 11% of the population in the United States has diabetes. That is almost 40 million people, of which 8 million are not yet diagnosed or know that they have diabetes!

We all know diabetes is related to sugar. Our bodies turn the food we eat into sugar in our bloodstream. This sugar is called glucose. When the glucose goes up in our blood our pancreas, an organ in between our liver and stomach, starts to produce insulin. Insulin in turn tells the cells of your body to take in the glucose, or sugar, for food. If the cells don’t respond properly to insulin or no insulin is produced then glucose/sugar builds up in the blood. This is why diabetics have “high” blood sugar. 

When someone has diabetes the insulin part of the cycle is affected. This happens in two different ways depending on the type of diabetes. 

There are 3 main types of Diabetes:

Type 1 Diabetes Mellitus (DM)

• 5-10% of diabetics have type 1 DM

• Most commonly diagnosed in children and young adults

• The body doesn’t make insulin and these patients must take insulin for the rest of their lives

• Thought to be due to an autoimmune reaction, meaning the body attacks itself and in this case attacks the pancreas preventing it from producing insulin properly. 

• There is no cure for Type 1 DM

Type 2 Diabetes Mellitus (DM)

• Type 2 DM is the most common form of diabetes affecting 90-95% of all diabetics

• Most commonly diagnosed in adults, though due to lifestyle habits and obesity more children are developing Type 2 Diabetes than in the past

• The body often still makes insulin, but it doesn’t use it properly and the sugar accumulates in the blood

• Sometimes lifestyle changes may be able to stave off Type 2 Diabetes such as diet and exercise

Gestational Diabetes (GD)

• This is diabetes of a pregnant person without a history of diabetes

• Usually goes away once the baby is born

• If you had GD you are at an increased risk of diabetes in the future

• Children of birth moms with gestational diabetes are at an increased risk of obesity and diabetes

What is Diabetes Insipidus (DI)?

Diabetes insipidus is a different chronic health condition not related to what we think of as diabetes. There isn’t a cure for DI. It is a rare disease that causes a problem with body fluids and is not related to blood sugar issues. It has some similar symptoms as DM such as increased thirst and urination but it is not related to DM. Treatment for DI consists of preventing dehydration and controlling thirst. 

What does extra sugar/glucose in the blood cause?

Extra sugar in the blood clogs up the blood vessels and accumulates in body parts causing serious diseases such as in the eyes leading to blindness. It gets in the ends of the small capillaries at the ends of our fingers and toes leading to a lack of blood flow to them, gangrene and amputation. 

Symptoms of Diabetes Mellitus:

• Increased thirst

• Increased urination

• Weight loss or gain

• Mood changes/irritability

• Changes in vision/blurry vision

• Increased infections and body sores

• Increased fatigue

• Feeling physically weak

How is Diabetes Mellitus diagnosed?

• 2 fasting blood sugar levels (nothing to eat or drink other than water for at least 8 hours) equal to or greater than 126 mg/dl is diagnostic for diabetes

• Glucose tolerance test-you are given a sugary liquid to drink after fasting overnight and your blood sugar is checked after 2 hours. If the blood sugar is equal to or greater than 200 mg/dl you have diabetes. 

• Random (not fasting) blood sugar of 200 mg/dl or higher suggests you have diabetes. 

• A random HgA1C blood test that shows 6.5% or higher on two separate tests means you have diabetes. You do not have to be fasting for this test. HgA1C tests the average of your blood sugar for the previous 3 months. 

What are normal blood sugar numbers?

Blood sugar-Fasting (nothing to eat and only water for at least 8 hours)

Normal              99 mg/dl or lower

Prediabetes     100-125 mg/dl

High                   126 mg/dl or higher

Blood sugar-Random (last meal doesn’t matter)

Normal             140 mg/dl or less

High                  200 mg/dl or more

HgA1C-you can be fasting or not it doesn’t matter

Normal             5.6% or less

Prediabetes     5.7%-6.4%

High                   6.5% or higher

When checking your blood sugar with a home monitor make sure to record your last meal or drink and what type. Also makes sure to wash your hands, or the site you will be getting the drop of blood from, and use a new needle each time. It is common to get abnormal blood sugar readings due to dirt or dried sugar on your hands or device. 

How is diabetes treated?

Work with your healthcare provider on a treatment plan. Depending on your diagnosis and current health your doctor may prescribe lifestyle changes such as diet, exercise, and stopping alcohol and tobacco. 

Oral medications can be very effective. There are also insulin injections your doctor may discuss with you depending on your health and the type of diabetes you have. 

If you have Type 1 Diabetes your doctor may discuss a pancreatic transplant with you. 

Bariatric surgery may be helpful for Type 2 Diabetics. 

What are some of the complications of DM?

• Obesity

• Death

• Stroke

• Heart attack

• Impotence

• Vascular disease

• Kidney disease

• Neuropathy

• Eye diseases such as blindness

• Chronic infections

• Coma

If you have diabetes, or think you may have diabetes, and notice any concerning signs such as increased thirst/urination, fruity odor to your breath, increasing fatigue, very high blood sugars, nausea, vomiting, confusion, blindness or stomach pain seek immediate in-person local medical care. These can indicate something serious and you need to be seen right away.