Our bodies need energy in order to work properly, and we get that energy from the food we eat. Once eaten, the carbohydrates in food are converted into sugar, called glucose, which is carried by our blood to every cell in the body. For glucose to provide energy to our cells two things must happen; first there have to be enough receptors in the cells or "doors" to allow glucose to enter in, and secondly, the hormone insulin, which is made in the pancreas, must be present to unlock the doors. Diabetes is a disease that makes it difficult for the body to get and use glucose, causing it to build up in the bloodstream and making blood sugar levels rise.
There are two main Types of Diabetes; Type 1 and Type 2. If a person is diagnosed with Type 1 Diabetes their pancreas produces little to no insulin so the receptors in the cells cannot be unlocked to allow the glucose to enter and be used for energy. Those diagnosed with Type 1 Diabetes must take insulin every day as well as manage their diet and exercise habits. Approximately 5% of all diagnosed cases of Diabetes in the United States are Type 1.
Type 2 Diabetes is the most common form. If a person is diagnosed with Type 2, their pancreas still produces insulin, but not enough to be used effectively by the body. There are not enough receptors in the cells to allow the glucose to enter, so even though insulin is present, it cannot be properly used by the cells. Those diagnosed with Type 2 Diabetes manage their disease through a combination of diet, exercise, self‐monitoring of blood glucose levels, and in some cases, oral medication or injectable insulin. Type 2 Diabetes accounts for about 90% to 95% of all cases in the United States.
Diabetes is a common and costly disease in the United States with an estimated 8.1 million adults being affected. The cost of Diabetes is high for those who have the disease and for the health care system. Diabetes and its complications cost $245 billion dollars annually, with the average patient spending $13,700 a year on health care and supplies to manage their disease.
The signs and symptoms of Diabetes vary. Some are more common than others. These include excessive thirst, frequent urination, excessive hunger, weight loss, fatigue, changes in vision, cuts or infections that are slow to heal, and excessive itching on the skin. The risk of developing Type 2 Diabetes increases when a person is older, physically inactive, has a family history of Diabetes, high blood pressure or high cholesterol, pre‐Diabetes, or from African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American descent.
Complications of Diabetes, if uncontrolled, can be life threatening. People with Diabetes are at an increased risk of heart attack, stroke, vision loss, and amputation. They can also develop nerve damage called Diabetic Neuropathy which can lead to infection and serious complications. The feet of people with Diabetes are particularly susceptible to this, making it very important for them to check their feet regularly. Kidney disease is also a complication, so it is important to have urine, blood, and blood pressure monitored, and to keep both blood sugar and blood pressure under control. Eye problems can develop with uncontrolled Diabetes, leading to glaucoma and cataracts. It is critical to have yearly eye exams to screen for these complications. The key to preventing many of the complications of Diabetes is to keep blood sugar at a healthy level.
It takes monitoring to keep glucose in a healthy range. One very important screening is the A1c test. The results of this test show average blood sugar levels over time, and are reported as a percentage. The American Diabetes Association (ADA) recommends trying to keep A1c numbers at less than 7%. Studies suggest that A1c levels in the healthy range lower the incidence of diabetic complications. It is also important for people with Diabetes to monitor and control their blood pressure. High blood pressure can worsen complications of Diabetes such as eye and kidney disease. When it comes to preventing Diabetes complications, normal blood pressure is as important as controlling blood sugar levels.
Diabetes is a manageable disease, but that management can sometimes seem overwhelming. Learning how to take the proper steps to control Diabetes can lead to a longer healthier life. Remember that everyone with Diabetes is different. What works for one person may not work for another. Talk with your doctor and develop a plan that works for you.
Centers for Disease Control and Prevention (2014). National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States. Atlanta, GA: U.S. Department of Health and Human Services.
Joslin Diabetes Center (2014). General Diabetes Facts and Information. Boston, MA.
National Institute of Health (2012). Type 2 Diabetes: What you need to know. Bethesda, MD.