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New to Diabetes
The first things you need to know
The doctor tells you that your blood test results indicate you have diabetes. The two of you discuss what that means and the recommended treatment. One of the staff nurses gives you brochures and sample supplies. Then you go home and must process everything they told you at the doctor’s office and what it means to change your lifestyle to get and remain healthy. Always remember your healthcare professionals are the best resource to answer your questions and give you the best advice for your situation. Here is a summary of the most common questions a newly diagnosed diabetes patient may have.
Diabetes 101: What is diabetes?
Put simply, diabetes is a condition where your body isn’t able to properly use energy (commonly known as glucose or sugar) from digested food. Knowing how diabetes affects your body can help you understand how the body processes the food you eat and turns it into energy.
When you eat, your digestive system breaks down most of the food into fuel. This fuel is a simple sugar called glucose. Glucose travels through your bloodstream and into the cells, providing energy that allows cells to function. But the glucose needs help to get into the cells. So when you eat, the pancreas, an organ near your stomach, produces and secretes insulin. Insulin makes it possible for glucose to move from the bloodstream into the body’s cells. Think of this process as a delivery system: the fuel (glucose) travels through the body via the bloodstream like a truck carrying goods, traveling on highways to make deliveries. But once the truck arrives at its location, it can’t be unloaded unless it’s put onto smaller carts. Insulin is that smaller cart ushering glucose from the bloodstream into the cells.
For people with diabetes, this delivery system doesn’t work correctly. Either the person doesn’t produce enough insulin or any at all. Also, the person’s cells resist the insulin that the body produces. In either case, the glucose or sugar can’t get into the cells and instead build up in the bloodstream. The extra glucose exits the body in the urine, and the cells can’t get the energy they need even though there’s plenty of glucose in the body.
What are the three main types of diabetes?
- Type 1 diabetes
- Type 2 diabetes
- Gestational diabetes
What is type 1 diabetes?
According to the NIH (National Institutes of Health), type 1 diabetes accounts for 5% – 10% of all people diagnosed with diabetes in the U.S. Type 1 diabetes is caused by an autoimmune response in which the body turns against a part of itself, in this case, the pancreas. With type 1, the pancreas makes little or no insulin. This condition was previously called insulin-dependent diabetes. Often, people find out they have type 1 diabetes during their childhood or teenage years. People with type 1 diabetes must rely on insulin by injection or pump infusion to avoid life-threatening consequences.
The following are some type 1 diabetes symptoms. If left untreated, a life-threatening diabetic coma can occur
- Increased urination, thirst, and appetite
- Rapid weight loss
- Exhaustion or fatigue
- Blurred vision
What is type 2 diabetes?
More than 90% of people with diabetes have type 2 diabetes, in which the body can’t use insulin effectively. This type of diabetes is known as insulin resistance. As type 2 progresses, the pancreas may stop producing insulin altogether. Those with an increased risk of developing type 2 diabetes include adults and children who are overweight, have a family history of diabetes, maintain a physically inactive lifestyle, or belong to specific ethnic groups, such as African-American, Hispanic/Latino-American, and Pacific Islander.
The following are some type 2 diabetes symptoms. These symptoms may be slow to occur or may not occur at all:
- Increased urination, thirst, and appetite
- Blurred vision
- Slow-healing wounds
What is gestational diabetes?
According to the HHS (U.S. Department of Health and Human Services), about 3% – 8% percent of pregnant women develop diabetes, known as gestational diabetes. To diagnose gestational diabetes, your doctor may perform an initial glucose test and order follow-up testing depending on the results. If you are diagnosed with gestational diabetes, your doctor will provide information about controlling your blood glucose levels during your pregnancy to prevent the development of certain complications for you and your unborn baby. Typically, gestational diabetes goes away once the baby is born. However, women who develop gestational diabetes have a 40% – 60% chance of developing type 2 diabetes within 5 to 10 years, notes the HHS.
What is the treatment for diabetes?
There is no cure for diabetes. Doctors and health care professionals work closely with people with diabetes to help them manage their daily blood glucose levels through healthy lifestyle changes, including diet and exercise and diabetes medication or insulin therapy. Controlling blood glucose levels may help people with diabetes delay complications associated with the disease.
How do you monitor blood glucose levels?
A variety of blood glucose monitoring devices are available. Many of these devices use a lancet to prick the skin (often the side of a finger). Then, a blood sample is placed on a testing strip for a blood glucose meter to determine your blood sugar.
What is hypoglycemia (low blood sugar)?
The goal of diabetes care is to manage your blood glucose levels so they don’t go too high or too low. A spike in your blood sugar levels in either direction can lead to a severe condition that would require immediate attention. The condition is called hypoglycemia when your blood glucose levels fall too low.
Low blood sugar symptoms may include:
- Hunger
- Pale appearance
- Shakiness, nervousness, dizziness, or weakness
- Sweating
- Sleepiness
- Confusion or irritability
- Headaches, with or without blurred vision
- Nausea
- Fast heart rate
- Seizures
- Loss of consciousness
Your symptoms may be minor or more significant. You may simultaneously experience only one symptom or multiple signs of low blood sugar.
What are some factors that may cause hypoglycemia?
- Diabetes medications like insulin and oral medications can lower blood glucose too low.
- Skipping or delaying meals or snacks.
- Increased physical activity.
- Consuming alcoholic beverages.
How is hypoglycemia treated?
Treating hypoglycemia quickly is essential to keep your condition from becoming worse. Eating sugar is the quickest way to raise your blood sugar level. You may want to consider carrying glucose tablets as a precautionary measure. According to the American Diabetes Association, if you pass out from low blood sugar, you will need immediate treatment, such as an injection of glucagon or emergency treatment in a hospital.
Note: If you experience or have any questions about hypoglycemia, be sure to talk to your doctor.
What is hyperglycemia (high blood sugar)?
The goal of diabetes care is to manage your blood glucose levels so they don’t go too high or too low. A spike in your blood sugar levels in either direction can lead to a severe condition requiring immediate attention. When blood sugar levels get too high, the condition is called hyperglycemia.
High blood sugar symptoms may include:
- Increased thirst
- Headaches
- Frequent urination
- Blurry vision
- Urinary ketones
If prolonged, high blood sugar symptoms may include:
- Nausea
- Vomiting
- Fatigue
- Difficulty concentrating
- Urinary ketones
Symptoms of hyperglycemia may take several days, or even weeks, to develop. Serious complications may result from high blood glucose levels going untreated. Remember, you may simultaneously experience only one symptom or multiple signs of high blood sugar.
What are some of the factors that may cause hyperglycemia?
- Missing insulin or medicine doses
- Diet
- Infection, illness, or stress
- Decrease inactivity
How is hyperglycemia treated?
Talk to your doctor if you have concerns about hyperglycemia. You may need to adjust your lifestyle, such as diet and activity level, to keep your blood glucose levels from going too high.
If left untreated, hyperglycemia can lead to a severe condition called ketoacidosis, which requires immediate medical attention. With ketoacidosis, the body can’t use insulin to tap into the energy it needs from glucose. The body then turns to fat cells to get the energy it needs. The by-product of breaking down fat cells is a type of acid called ketones. A buildup of ketones in your bloodstream leads to ketoacidosis. The high levels of acid in the body can lead to diabetic coma and even death.
What are diabetes complications?
Diabetes affects your entire body, so carefully managing your blood glucose levels every day is vital to your overall health. Keeping your blood sugar levels within your doctor’s prescribed range and following your treatment plan will go a long way in preventing or delaying the onset of certain diseases that are associated with diabetes.
Kidney disease: People with diabetes are at greater risk of developing kidney disease. The kidneys filter blood, removing waste products. But when there’s excess glucose in the bloodstream, the kidneys can lose their ability to filter the blood and begin to leak protein into the urine. Kidney failure can result.
Eye disease: Diabetic retinopathy is when blood vessels in the back of the eye are damaged by too much glucose in the blood. Symptoms include blurred vision, seeing dark spots, or losing vision. Along with diabetic retinopathy, people with diabetes are also at a greater risk of developing other eye disorders, such as glaucoma and cataracts.
Nerve disease: With poorly controlled diabetes, the body’s nerves (the receptors that transmit messages from the brain) can be damaged and cease functioning correctly. This condition, called neuropathy, can affect any part of the body, including internal organs that digest food and pass urine. The most common neuropathy symptoms include pain, tingling, numbness, and loss of feeling, especially in the hands, arms, feet, and legs.
Heart disease – The ADA (American Diabetes Association) reports that two out of three people with diabetes die from heart disease or stroke, also called cardiovascular disease. Part of the reason people with diabetes are at a greater risk for heart problems is that the high glucose levels in the bloodstream over time result in fatty deposits inside the blood vessels, which can clog or harden the arteries.
Diabetic foot disease: Foot care is especially important for people with diabetes. Diabetes complications such as nerve damage, poor blood circulation, and dry skin can lead to injuries on your feet. You may not even feel these injuries since your foot’s nerves may not function normally. Without adequate blood flow (due to diabetes), these injuries can take a long time to heal.
Sleep disorders: For people with diabetes, nighttime urination can interfere with their sleep. They are also at an increased risk for other sleep disorders, such as OSA (obstructive sleep apnea).
Gum disease: Excess sugar in the body makes it easier for germs to grow and form plaque on your gums. Good dental care, including regular brushing, flossing, and regular dentist visits for cleaning and checkups, can help keep your mouth and gums healthy.
Urinary incontinence: Excess weight, loss of nerve control, and increased frequency of urination are all conditions associated with diabetes that may contribute to incontinence.
Emergency Resources and Precautions for Diabetics
Natural disasters and emergencies are a concern for everyone. But those with diabetes need to take extra precautions to prepare for the possibility of a dangerous situation. Don’t wait until an emergency strikes. Here are some tips for putting together your emergency plan as a person with diabetes.
An Emergency Kit – Assemble a clearly labeled container stored in an easily accessible place. This kit should have a three-day supply of medication, insulin, delivery supplies, lancets, and glucose. Extra batteries for meters and pumps are a good idea. Include a list of emergency contacts, including healthcare providers and family members. If you have school-age children, include information so your children can be cared for properly.
Informing Those Around You – One of the most important things to do is to wear medical identification. An ID is vitally essential if you are injured and cannot communicate. Consider informing your colleagues about your diabetes if they are called to assist you. Let friends and family members know where to find your emergency kit. If you have a child with diabetes, make sure the school has a physician’s order on file and an identified staff member to assist your child.
Avoid Dehydration and Hypoglycemia – High blood sugar can lead to dehydration. In an emergency, be sure to drink safe water or non-carbohydrate fluids. You should also keep something containing sugar with them to treat hypoglycemia.
Know the symptoms of hypoglycemia, and inform the people around you to look for these signs:
- Shakiness
- Nervousness
- Sweating
- Irritability, sadness, or anger
- Impatience
- Chills and cold sweats
- Fast heartbeat
- Light-headedness or dizziness
- Drowsiness
- Stubbornness or combativeness
- Lack of coordination
- Blurred vision
- Nausea
- Tingling or numbness of lips or tongue
- Headaches
- Strange behavior
- Confusion
- Personality change
- Passing out
Prevent Infections – People with diabetes are at higher risk of developing foot infections due to nerve and blood vessel problems. Avoid walking through contaminated water or injuring your feet. If signs of infection, including swelling, redness, or discharge from a wound, are seen, seek immediate medical help.
Sources
http://www.diabetes.niddk.nih.gov/dm/pubs/overview/index.aspx#what
http://www.jdrf.org/life-with-t1d/type-1-diabetes-information/what-is-diabetes/
http://www.mayoclinic.com/health/type-1-diabetes/DS00329/DSECTION=treatments-and-drugs
http://www.mayoclinic.com/health/blood-sugar/DA00007
http://www.diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/
http://www.mayoclinic.com/health/diabetes/DS01121/DSECTION=complications
http://www.mayoclinic.com/health/hyperglycemia/DS01168/DSECTION=symptoms http://www.diabetes.org/living-with-diabetes/complications/k
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