Written by: Chris Veenendall, RN, CDCES
Do you have diabetes or worry about getting diabetes? If so, here is some valuable information you should know.
In 1975 the American Diabetes Association joined the International Diabetes Federation and the World Health Organization in recognizing November as National Diabetes Month. This partnership was formed to raise diabetes awareness, encourage screening for diabetes, and increase diabetes research.
There are two main types of diabetes, type 2, and type 1 diabetes. Type 2 diabetes is a condition that happens because of a problem in the way the body regulates and uses sugar as a fuel. Type 2 diabetes is the result of two problems. One, cells in muscle, fat and the liver become resistant to insulin, as a result the cells do not take in enough sugar. Two, the pancreas cannot make enough insulin to keep blood sugar levels within a healthy range. If you have type 1 diabetes, your pancreas does not make insulin or makes little insulin. Type 1 diabetes was once called insulin-dependent or juvenile diabetes, but it can develop at any age. Type 1 diabetes is less common than type 2, about 5-10% of people with diabetes have type 1.
In my experience I will tell you that Type 2 diabetes is darn sneaky! No one thinks about feeling tired, easily getting grouchy, or always feeling hungry as a sign of Type 2 diabetes! When drinking fluids by the gallon with the following urination-especially at night, is increased to six times or more per night, it is a clear indication that you should be screened for diabetes.
Screening is especially important if Mom, Dad, or grandparents on one or both sides had Type 2, or if there is history of gestational diabetes. Type 2 is the most inherited form of diabetes, yet people are often surprised when coming face to face with it. It is always best for a concerned person to see their primary provider and a simple blood sugar test can find a diagnosis – or not. The earlier diabetes is diagnosed; the sooner treatment can begin. Early detection increases the chances of managing with pills, and controlling sugar levels that can permanently damage other organs.
Patients are considered in a pre-diabetes state when their fasting blood sugar reading (or morning before food) is over 100 and below 125. A normal blood sugar reading is below 100. Patients are pre-diabetic when they eat a meal, and their blood sugar rises over 140. The Pre-diabetes range for after eating is 140-199.
Another important test used to measure the health of a diabetic is through an A1c test also known as the hemoglobin A1c test. An A1c test is a simple blood test that measures your average blood sugar levels over the past three months. It is commonly used to diagnose prediabetes and diabetes and is also the main test to help health care teams assist patients in managing their diabetes. The A1c (3month test) range for Pre-diabetes is 5.7-6.4%
There are new medications that can be offered that protect the heart, kidneys and offer lower glucose. Up to this point we only thought diabetes could be controlled by effectively managing blood glucose levels. Currently the most exciting medications are effective in protection and weight loss which makes them much more attractive. This treatment is life changing in type 2 diabetes, especially if found early and treated aggressively.
In Type 1, the biggest advancements are a Federal Drug Administration (FDA) approval of a medication that stalls type 1. If found early, this treatment is the closest we have been to a true cure. The treatment involves medication known as teplizumab or TZield. Through Trial Net TZield is not costly and protection can last for two years. Antibody testing is needed to determine if this medication is effective. In Stage 1 when there are two or more autoantibodies present, but blood sugars are normal. Stage 2 is when two or more autoantibodies are present and blood sugar is abnormal, but no other symptoms. Knowing this progression is on the horizon for people with Type 1 is wonderful news. With a connection like Trial Net, it will be possible for patients to receive treatment with TZield when it can do the most. By stage 3, the blood sugar levels are persistently high and insulin therapy is immediately needed. Some may test for the autoantibodies and others do not so the lab checks are needed plus the provider to keep an eye on it. The stages may take months or years.
Insulin actions are much better than they used to be, are more predictable, and come in larger quantity pens for times of travel. Additional resources for tracking and thus, help with ensuring effective treatment, include sensors. The benefit of sensors are that they follow glucose in real time for those using insulin. Medicare, now, only requires a person to use insulin to qualify for continuous sensors. They do need a doctor’s prescription. This will expand to those using pills or with pre-diabetes someday. Amazing changes can happen when we can see the effects of our actions in real time for 24 hours a day.
To the 37 million people with diabetes and the 96 million with pre-diabetes, partnering with a great provider to work with you to protect yourself from the damage of uncontrolled diabetes is an immediate next step.
Western Wisconsin Health offers many diabetic resources including:
- A diabetes prevention community education class, at no charge!
- -A lifestyle medicine program, known as Simple Health, aimed at helping with weight loss, food education, exercise, health coaching and providing ways to live a healthy and happy life.
- Care from a certified diabetic educator.
- Care from a Board-Certified Endocrinologist.
Type 2 diabetes – Symptoms and causes – Mayo Clinic