Diabetes

Written By Adama Diarra, DO, FACP

What is Diabetes?

Diabetes is a chronic condition that affects how your body turns food into energy. When you eat, your body breaks down most of what you consume into glucose (sugar) and releases it into your bloodstream. Insulin, a hormone produced by your pancreas, helps move that glucose from your blood into your cells to be used for energy.

In people with diabetes, either the body doesn’t make enough insulin or it can’t effectively use the insulin it produces. This leads to elevated blood sugar levels, which, over time, can cause serious health problems.

Types of Diabetes

There are three main types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. Each type has different causes and risk factors.

1. Type 1 Diabetes

Type 1 diabetes is an autoimmune condition where the body’s immune system mistakenly attacks and destroys insulin-producing cells in the pancreas. As a result, the body produces little to no insulin, and individuals with type 1 diabetes must take insulin to survive.

What Causes Type 1 Diabetes?

The exact cause of type 1 diabetes is not fully understood, but it’s believed to be a combination of genetic and environmental factors. Certain viruses may trigger the immune response that leads to type 1 diabetes in people who are genetically predisposed.

Type 1 diabetes often develops in childhood or adolescence, but it can also appear in adults.

2. Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes. It occurs when the body becomes resistant to insulin or when the pancreas can’t produce enough insulin to meet the body’s needs.

What Causes Type 2 Diabetes?

Several factors contribute to the development of type 2 diabetes, including:

  • Obesity or being overweight: Excess body fat, particularly around the abdomen, is a major risk factor for insulin resistance.

  • Physical inactivity: A sedentary lifestyle contributes to weight gain and insulin resistance.

  • Genetics: A family history of type 2 diabetes increases your risk.

  • Diet: Diets high in processed foods, sugars, and unhealthy fats are linked to insulin resistance and type 2 diabetes.

  • Age: The risk of developing type 2 diabetes increases after the age of 45, although more young people are developing type 2 diabetes due to lifestyle factors.

3. Gestational Diabetes

Gestational diabetes develops during pregnancy when the body cannot produce enough insulin to meet the increased needs of both mother and baby. Gestational diabetes typically resolves after pregnancy, but women who develop it are at higher risk of developing type 2 diabetes later in life.

What Causes Gestational Diabetes?

Gestational diabetes is caused by the hormonal changes during pregnancy that make the body less sensitive to insulin. Risk factors include being overweight, having a family history of diabetes, or being over the age of 25 at the time of pregnancy.

Health Complications of Untreated Diabetes

If left untreated, diabetes can lead to serious, potentially life-threatening complications. Over time, consistently high blood sugar levels can damage various organs and systems in the body.

1. Heart Disease and Stroke

People with diabetes are at an increased risk for heart disease and stroke. High blood sugar can damage blood vessels, leading to atherosclerosis (hardening of the arteries), which can increase the risk of heart attack and stroke.

2. Nerve Damage (Neuropathy)

High blood sugar can damage the nerves, particularly in the legs and feet, causing pain, tingling, numbness, or weakness. Severe nerve damage can lead to amputations if left untreated.

3. Kidney Damage (Nephropathy)

The kidneys filter waste from the blood, but over time, high blood sugar can damage the kidneys’ filtering system. This can lead to kidney disease and, in severe cases, kidney failure.

4. Eye Damage (Retinopathy)

Diabetes can damage the blood vessels in the eyes, leading to vision problems and, in severe cases, blindness.

5. Foot Problems

Diabetes increases the risk of foot complications due to poor circulation and nerve damage. Even small cuts or blisters can lead to serious infections if not properly treated.

6. Skin Conditions

People with diabetes are more prone to skin infections, fungal infections, and other skin issues due to poor circulation and immune function.

7. Mental Health

Living with diabetes can lead to emotional stress, anxiety, and depression. Managing the mental health aspect of diabetes is just as important as managing physical symptoms.

How to Manage and Treat Diabetes

While diabetes is a lifelong condition, it can be effectively managed with the right treatment plan. The primary goal is to keep blood sugar levels within a healthy range to prevent complications. In my professional opinion, continuous glucose monitors (CGMs) are invaluable tools for managing all types of diabetes. While CGMs are often considered essential for type 1 and more complex cases of type 2 diabetes, knowing the blood sugar patterns of patients with uncomplicated diabetes is equally important. Monitoring these patterns can greatly influence how we tailor each patient's treatment plan.

Regardless of the type of diabetes, every treatment plan should be personalized based on each patient's unique circumstances—including their type of diabetes, lifestyle, and overall health.

 

1. Type 1 Diabetes Management

For people with type 1 diabetes, insulin therapy is essential because their bodies do not produce insulin. They will need to monitor their blood sugar levels regularly and adjust their insulin doses accordingly.

  • Insulin Therapy: People with type 1 diabetes take insulin through injections or an insulin pump. Different types of insulin (rapid-acting, long-acting) may be used to manage blood sugar levels throughout the day.

  • Diet and Exercise: People with type 1 diabetes should follow a balanced diet and get regular physical activity to help manage blood sugar levels. However, because insulin is required, lifestyle changes alone are not sufficient to manage this type of diabetes.

  • Blood Sugar Monitoring: Frequent blood sugar checks are crucial to ensure levels stay within a healthy range.

2. Type 2 Diabetes Management

For individuals with type 2 diabetes, lifestyle changes are often the first step in managing the condition. In some cases, medication may also be necessary.

  • Healthy Diet: A well-balanced diet that includes plenty of vegetables, fruits, lean proteins, and whole grains can help control blood sugar levels. Limiting processed foods, sugary drinks, and refined carbohydrates is key.

  • Regular Physical Activity: Exercise improves insulin sensitivity and helps the body use glucose more efficiently. Aim for at least 150 minutes of moderate exercise per week.

  • Weight Loss: Losing even a small percentage of body weight can significantly improve insulin sensitivity and blood sugar control.

  • Medications: If lifestyle changes aren’t enough, medications such as metformin, sulfonylureas, or GLP-1 receptor agonists may be prescribed to help manage blood sugar levels.

  • Blood Sugar Monitoring: Regular monitoring of blood sugar levels can help track how well treatment is working and alert patients to any dangerous spikes or drops in blood sugar.

3. Gestational Diabetes Management

Gestational diabetes is managed through dietary changes and physical activity during pregnancy. Some women may need insulin therapy or medications if their blood sugar levels remain high despite lifestyle changes.

  • Healthy Diet: Eating a balanced diet and avoiding excessive sugar intake helps control blood sugar levels during pregnancy.

  • Physical Activity: Gentle exercise, like walking, can help manage blood sugar levels during pregnancy.

  • Blood Sugar Monitoring: Regular blood sugar checks are important to ensure both mother and baby remain healthy throughout the pregnancy.

Personalized Treatment Plans for Every Patient

It’s essential to remember that every patient is different, and treatment for diabetes must be personalized to meet each individual’s needs. Some people may manage their condition with lifestyle changes alone, while others may require medications or insulin therapy. Working closely with a healthcare provider is crucial for developing a treatment plan that’s right for you.

Conclusion

Diabetes is a serious condition, but it is manageable with the right combination of lifestyle changes, medications, and monitoring. Early detection and treatment are key to preventing the long-term complications of diabetes. Whether you have type 1, type 2, or gestational diabetes, managing your blood sugar levels and taking proactive steps toward a healthier lifestyle can improve your quality of life and prevent complications.

If you have been diagnosed with diabetes or are at risk, talk to your healthcare provider about creating a personalized plan to help you take control of your health.

References:

  • American Diabetes Association. (2021). Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement 1), S111-S124. https://doi.org/10.2337/dc21-S001

  • Centers for Disease Control and Prevention. (2020). National Diabetes Statistics Report. U.S. Department of Health and Human Services. https://www.cdc.gov/diabetes/data/statistics-report/index.html

  • Nathan, D. M., Genuth, S., Lachin, J., Cleary, P., Crofford, O., Davis, M., ... & Siebert, C. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The New England Journal of Medicine, 329(14), 977-986. https://doi.org/10.1056/NEJM199309303291401