Diabetes: An Overview

Getting the diagnosis

Being diagnosed with diabetes can be frightening or depressing news. You may have heard about the possible severe complications, such as eye problems, kidney failure, heart disease, and amputations. You may not have heard the good news: The complications of diabetes can be delayed or even prevented by taking good care of yourself. Here are some things you should know.

Basic facts

Having diabetes means that there is too much sugar (glucose) in your blood. Your blood always has some sugar in it because your body needs it for energy. But too much sugar in the blood is not good for your health.

When you digest food, your body breaks down much of the food into sugar. Your blood carries the sugar to the cells of your body for energy. Your body uses a hormone called insulin to help move the sugar from the bloodstream into the cells. Insulin is made by the pancreas. When your body does not have enough insulin, or has trouble using insulin, sugar cannot get into your cells. Sugar builds up in your blood. Too much sugar in your blood can cause many problems.

There are 4 common types of diabetes: type 1, type 2, gestational, and prediabetes.

• Type 1 diabetes happens when your pancreas stops making insulin. This usually happens before the age of 35. The cause is not yet understood. It can happen because of an injury to your abdomen or a viral illness that affects the pancreas. Or it might be caused by an autoimmune disease (where your body attacks part of itself). If you have type 1 diabetes you will need to take insulin the rest of your life (unless you have a pancreas cell transplant).
• Type 2 diabetes happens when your pancreas doesn’t make enough insulin or you become unable to use the insulin. It usually begins in adulthood but can start in when you are a child. There are many things that can put you at higher risk of having type 2 diabetes. They include race (it's more common among brown-skinned people), family history, too little physical activity, overweight, and a high-calorie diet. Type 2 diabetes can sometimes be controlled with diet and exercise, but often it needs to be treated with medicine to lower the blood sugar.
• Gestational diabetes happens when a woman starts having high blood sugar during pregnancy. Diagnosis and treatment of this type of diabetes is very important. Not only can the mother have problems from high blood sugar, but so can the baby. For example, the baby might be born too early. The baby can grow very large during the pregnancy because of the mother’s high blood sugar. At birth, when the baby is separated from the mother’s ample blood sugar supply, the baby can have problems with low blood sugar until it is nursing well. Gestational diabetes can sometimes be controlled with diet, but often the mother needs to take insulin until the baby is born.
• Prediabetes is a term used if your blood sugar is above normal but not yet high enough to be called diabetes. If you have prediabetes, you are at very high risk of having diabetes unless you do things to lower your risk. You can lower your risk and never develop diabetes by eating healthy and being more active.

All of these types of diabetes have one thing in common: blood sugar that is too high.

Effects of high blood sugar

Over time high blood sugar damages the blood vessels. This damage happens throughout the body, but some organs are more sensitive to the changes in the blood vessels. The organs most often affected are the eyes, the heart, the kidneys, and the blood vessels to the feet and legs. The blood vessels to the brain can also be damaged. This damage makes it more likely that people with diabetes will have a stroke.

Staying well

To stay well when you have diabetes you need to:

• Keep good control of your blood sugar.
• Keep a normal blood pressure.
• Keep your cholesterol levels normal.
• Try to keep from getting infections.
• Get an eye exam every year.
• Quit smoking if you are a smoker.
• Try to avoid stress as much as possible.
• Keep all of your appointments with your healthcare provider.

Controlling your blood sugar: The most important part of staying well with diabetes is controlling your blood sugar. If you keep your blood sugar in the range recommended by your healthcare provider, you can delay or prevent the complications of diabetes. The steps to controlling your blood sugar are:

• Learn how to eat healthy.
• Get enough exercise.
• Keep track of your blood sugar.
• Take your medicine, if prescribed, every day.
• Keep all appointments with your healthcare provider.

Keeping your blood pressure normal: Like high blood sugar, high blood pressure damages blood vessels. When these two work together, damage to your organs can happen much faster. A person with diabetes and high blood pressure is at high risk for heart attack, stroke, eye damage, and kidney failure. The best ways to control your blood pressure are:

• Keep track of your blood pressure.
• Follow your provider's recommendation for limiting the salt in your diet.
• Exercise according to your provider's exercise plan for you.
• Keep a healthy weight. (Ask your provider to help you determine a healthy weight for you.)
• Don’t drink a lot of alcohol. Women should have no more than 1 drink a day. Men should have no more than 2 drinks a day.
• Take your blood pressure medicine, if prescribed, every day.
• Keep your blood pressure checkups with your provider.

Keeping your cholesterol normal: High cholesterol alone can cause heart disease and stroke. Combine it with diabetes or high blood pressure and you have an even higher risk of heart disease. Cholesterol can be controlled with weight, diet, exercise, and, if necessary, medicine. This is a very important part of staying healthy with diabetes.

Preventing infection: People who have diabetes can get infections more easily. Do these things to stay healthy:

• Check your skin, especially your feet (top and bottom), every day for sores, blisters, or other injuries. Report any problems to your healthcare provider right away for prompt treatment.
• Keep your blood sugar normal (bacteria and fungus, which cause infections, thrive on high sugars).
• Stay up to date on all of your shots, especially tetanus, pneumonia, and flu shots.
• Get a tuberculosis (TB) test every year.

Getting your eyes checked every year: Diabetes can cause blindness. This can be prevented if you see your eye doctor as often as recommended by your healthcare provider. Early eye changes that can lead to blindness can be treated to prevent loss of your eyesight.

Quitting smoking: Smoking greatly increases the risk of diabetes complications. One of the best things you can do for yourself is to stop smoking if you are a smoker.

Avoiding stress: Stressful events or situations affect the body's hormones, and some hormones increase blood sugar. Stress also makes your blood pressure go up. Try to find ways to manage the stress in your life. Things that might help are more exercise, counseling, better money management, and family meetings. Reducing your stress will help you control your blood sugar and stay healthy.

Seeing your healthcare provider: Most people with diabetes should see their healthcare provider at least every 3 months. Your provider will check your control of your sugar levels and your blood pressure. He or she will also check your cholesterol level and other test results. Seeing your provider regularly can help you get the most up-to-date care available for diabetes.

For more information, see the Web site for the American Diabetes Association at http://www.diabetes.org/ and the National Diabetes Information Clearinghouse Web site at http://diabetes.niddk.nih.gov.