In western societies, and in some rapidly industrializing nations such as India, diabetes is one of the most prolific public health problems we face. But what exactly is this disease that is running rampant through the population, and what do you do if you are diagnosed with diabetes?
What is Diabetes?
Diabetes mellitus, almost universally referred to simply as diabetes, is a metabolic anomaly in which the body fails to process sugar out of the bloodstream, resulting in higher than normal blood sugar levels. This imbalance in blood sugar results in a laundry list of negative effects on the body from infections, inability to heal from wounds and even nerve damage.
Diabetes is the body’s resistance to or inability to produce insulin, the naturally-occurring protein responsible for transferring sugar from your bloodstream into your cells. There are cases where damage to the pancreas, which produces insulin, can hinder the body’s ability to produce enough insulin. In the majority of cases, though, diet, lifestyle choices or a host of other factors produce resistance to insulin, meaning your body no longer properly uses the insulin it is making naturally.
There are two main types of diabetes. Type 1 diabetes, which is the less common type and makes up only 10% of cases, has no known cause but the autoimmune disease is suspected. As an autoimmune disease, Type 1 diabetes is characterized by your immune system attacking the pancreas, destroying the body’s natural ability to produce insulin. There may be a genetic predisposition to this form of diabetes, as having family members who have also been diagnosed with Type I diabetes is a risk factor associated with developing the disease. It is possible that environmental factors such as exposure to viruses may contribute to disease formation, but more study is needed to confirm this.
Type 2 Diabetes is the form of the disease most commonly known. Unlike Type 1 diabetes where the body fails to produce insulin, Type 2 diabetes is characterized by the body developing a resistance to insulin. Type 2 diabetes gets far more press than Type 1 diabetes, not just because it is more common. In many cases, Type 2 diabetes is preventable through lifestyle and diet changes.
Symptoms of Type II diabetes typically come on slowly over time as your body’s level of resistance to insulin grows. For this reason, many people may not notice the symptoms of the disease until they become fairly advanced.
There are two more types of diabetes, though they are less common than those already mentioned. Prediabetes is sometimes separated out as a distinct diagnosis. As the name suggests, it is a condition in which your blood sugar is elevated, but you do not yet meet the requirements of an official diagnosis for Type II diabetes.
The last form of diabetes is what is referred to as gestational diabetes. This form of insulin resistance occurs in women during pregnancy. The placenta contains hormones that block insulin, producing a form of diabetes where it may not otherwise be produced by lifestyle and diet. Though gestational diabetes usually does not outlast the pregnancy, if poorly managed it can increase your chances of Type II diabetes later in life, and could raise your child’s risk of developing diabetes.
What are the Symptoms of Diabetes?
The various types of diabetes all share common symptoms, as the underlying effect is the same regardless of the cause. As your blood sugar levels elevate, you will likely experience the following symptoms to one degree or another:
- blurred vision
- increased hunger
- increased thirst and urination
- sores that do not heal
- numbness or tingling in the feet or hands
- slow-healing wounds
- yeast infections
- increased urine output
These are not the only symptoms of diabetes, and it is possible you may be diabetic or have prediabetes without showing symptoms. If you do not treat your symptoms, it is possible for serious nerve damage (diabetic neuropathy) to occur in your legs and feet. In severe cases, this damage can be so extreme that amputating the affected foot or lower leg may be necessary.
While the direct symptoms of diabetes can be very damaging, other complications of diabetes can be lethal. High blood pressure is often linked with the progression of diabetes symptoms. A rise in blood pressure is closely related to high blood sugar. As your body continues to develop insulin resistance, high blood pressure (or hypertension) is more and more common. This is widely noted, and common no matter what type of diabetes you have.
Cardiovascular disease is not the only worry. Diabetes is the leading cause of some forms of kidney disease in America. In addition to changes in blood chemistry, tissue damage from inflammation and fibrosis can eventually result in kidney failure. As with diabetes itself, women and ethnic minorities such as African Americans and Latinos are more susceptible to the effects of kidney disease resulting from diabetes.
How Insulin Problems Develop
If you have Type 1 diabetes, the development of insulin problems is fairly straightforward. As your autoimmune system attacks your pancreas, its ability to produce insulin is reduced. The consequent drop in insulin production causes a series of knock-on effects that will eventually lead to life-impacting problems if they are not addressed.
Genetic mutations can also cause diabetes. In a form called monogenic diabetes, a single gene is altered. This genetic mutation can be inherited, but it can also occur on its own. This form of diabetes typically manifests either in the first 6 months of life or during your early teenage years.
Diabetes can also occur as a result of other health conditions. Cystic fibrosis in particular, which causes scarring of the pancreas, can produce diabetes by reducing the body’s ability to create the insulin it needs. Hemochromatosis, in which the body stores too much iron, can also result in pancreatic damage, once again depriving the body of the insulin it requires to maintain normal glucose levels in your blood.
There are also several types of medication that can disrupt or change the way your body produces insulin. Unfortunately, these include many different drugs that are very important for the role they play in managing other health conditions. In many of these cases, the potential for diabetes occurring is seen as a risk worth taking to ensure more serious damage is not done by other illnesses. The following is a sample of the types of medications that can interfere with the body’s natural production and processing of insulin:
- anti-rejection medicines, which are vital after an organ transplant
- certain types of diuretics, or water pills, taken for some cardiac conditions
- psychiatric drugs
- anti-seizure drugs
- glucocorticoids—which are used to treat illnesses like rheumatoid arthritis, asthma, lupus, and ulcerative colitis
- drugs to treat human immunodeficiency virus (HIV )
For Type 2 diabetes, the story is very different. Here, lifestyle and diet factors play the largest role. Being overweight or obese is associated with a drop in the ability for your muscles, liver and fat cells to properly use insulin, resulting in high blood glucose levels. To allow glucose to move from your bloodstream into your cells, your pancreas initially increases its output of insulin. Eventually, the pancreas is unable to keep up with the rising demand for insulin, and your blood sugar levels begin to rise.
A lack of physical activity is also seen as a high-risk factor for diabetes, as is smoking and the excess consumption of alcohol. Unfortunately, these risk factors are often found together, so the effect any of them may have on your likelihood of developing diabetes is compounded.
If you are in one or more of these lifestyle risk groups because of your diet or another habit like smoking, There is good news. If you can change your diet and lifestyle, you can greatly lower your risk of developing diabetes in the future or help your body regulate itself as much as possible if you have already been diagnosed as diabetic.
Family history is also a major risk factor in developing diabetes. Many people groups are at higher risk of diabetes globally. In the United States, rates of type 2 diabetes are measurably higher among African Americans, Asian Americans, Latinos and Native Americans.
What Causes Gestational Diabetes?
Gestational diabetes is a different matter than other forms of diabetes. Unlike type 2 diabetes, the placenta is the cause of diabetic symptoms rather than your body becoming resistant on its own. During pregnancy, the placenta produces a hormone called human chorionic somatomammotropin or human placental lactogen (HPL). This powerful hormone can modify the mother’s metabolism and affects many things related to processing carbohydrates and even insulin. HPL is capable of raising your overall blood sugar level and lowering your insulin sensitivity.
Close to a fifth of pregnant women in the United States may experience gestational diabetes, though not all of these cases result in complications. There are definitely risks to your baby if gestational diabetes is left untreated, though, so doctors will closely monitor your blood sugar levels during pregnancy. Your TWC physician will test you for this condition and walk you through the best ways to manage the issue.
Exercise and Diet Tips
Since excess weight is a major problem in regular type 2 diabetes and gestational diabetes, improving your diet and getting more exercise are two of the best things you can do to help your body use insulin as well as possible.
One of the first things to remember when starting any weight loss or exercise plan, especially if you have gained weight as a result of pregnancy or other causes, is to talk to your health care provider first. This is particularly important if you have been diagnosed with any form of heart disease. Once you have been cleared by your doctor, it is important to begin slowly. It may be tempting for some people to begin a program of physical activity looking for quick results, but when you are living with diabetes, starting slow is a better plan.
The good news is, even light walking is a great place to start, and one that can begin bringing real health benefits. Small steps in beginning an exercise regimen can help you incorporate new habits into your life rather than a rapid wholesale change.
The same goes for diet. Slowing removing sugary treats, greasy or fried foods, regulating your intake of carbohydrates and increasing the number of vegetables in your diet will take some time, but building a diet you can sustain is often more important than making a quick change you may not be able to stick with. Thankfully, a diet for diabetes may still include tasty items such as nuts, avocados, olive oil, and fish.
When Should I Talk to My Doctor About Diabetes?
If you are pregnant, you will hopefully be talking to your doctor quite often, though not all women get access to constant medical care during pregnancy. You should pay particular attention to your blood sugar levels beginning after the 24th week of pregnancy.
If you are not pregnant, it is a different story. If you have been living with obesity for a long period of time, or if you are in a people group or family that has a history of diabetes, you should talk to your doctor about your risks for diabetes. This is particularly true if you have not been maintaining a regular exercise regimen. Certainly you should talk to your doctor if you have been experiencing the symptoms listed above such as blurred vision, increased urination or urinary tract infections, or increased thirst and appetite. It is important to know you do not have to face diabetes alone. At The Woman’s Clinic, we are ready to help you understand your risk factors and help walk you through the steps you will take to regain control of your life.
If you are ready to make a change, or just to find out more about diabetes, make an appointment at The Woman’s Clinic today. We have the experience and knowledge necessary to help you make the best decisions you can about your health.