Diabetes
November is National Diabetes Month. This is a time when communities across the country team up to bring attention to diabetes.
So, why November? Glad you asked.
The main reason is because November 14th is the birthday of Frederick Banting. This Canadian doctor and his team of scientists did an amazing thing back in 1923. He saw from other’s work that dogs who had their pancreas removed quickly developed diabetes and died. So, he and others knew there was something made in the pancreas which helped the body manage sugar (glucose). He and his team were able to extract a chemical from “islands” of cells (called Langerhans) and give it to the dogs without a pancreas, and they survived. The Latin word for island is “insula.” Sounding familiar? It should, this is the origin for the name of the hormone we know as insulin.
Banting and another scientist, James Collip, then tried their extract on a 14-year-old named Leonard Thompson. Back then, a child or adolescent who got diabetes lived an average of one year. Leonard lived until the age of 27 and died of pneumonia.
Banting received the Nobel Prize for Medicine and Physiology and promptly shared it with his entire team. He believed this lifesaving hormone should be made available to all diabetics, everywhere.
This was literally only 100 years ago. Prior to then, diabetes was recognized to probably be two different kinds. It seemed that some died very quickly and other might take months or years. Even about a thousand years ago, doctors were in to examining a patient’s urine to try to understand what was going on with them. This included looking at the color, the sediment, how did it smell, and yes, sometimes even tasting. The term “mellitus” (as in diabetes mellitus) meant honey in Latin. The urine was sweet in diabetics. We’ve come a long way in a century.
What we know now
Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. It affects about 37 million Americans, including adults and youth. Diabetes occurs when your body doesn’t make enough of a hormone called insulin, or if your body doesn’t use insulin the right way. If left untreated, it may result in blindness, heart attacks, strokes, kidney failure and amputations. Only half of the people who have diabetes are diagnosed because in the early stages of diabetes, there are few symptoms, or the symptoms may be the same as in other health conditions.
What are early symptoms of diabetes?
In fact, the Greek origin of the word diabetes meant “siphon.” Literally, fluids were being siphoned out of the body. Symptoms would include extreme thirst, frequent urination, unexplained weight loss, blurry vision that changes from day to day, unusual tiredness, or drowsiness, tingling or numbness in the hands or feet, frequent or recurring skin, gum or bladder infections.
If you have any of these symptoms, call your family doctor right away.
Damage may already be happening to your eyes, kidneys, and cardiovascular system before you notice symptoms. Because of this, health care providers like to screen for possible diabetes in people that are considered higher risk. Who does that include?
- You’re older than 45.
- You’re overweight.
- You don’t exercise regularly.
- Your parent, brother or sister has diabetes.
- You had a baby that weighed more than 9 pounds, or you had gestational diabetes while you were pregnant.
- You are Black, Hispanic, Native American, Asian or a Pacific Islander.
Testing, which is also called “screening,” is usually done with a fasting blood test. You will be tested in the morning, so you shouldn’t eat anything after dinner the night before. A normal blood sugar test result is lower than 110 mg per dL. A test result higher than 125 mg per dL suggests diabetes.
Many people have diabetes for about five years before they show the symptoms of diabetes. By that time, some people already have eye, kidney, gum, or nerve damage. There is no cure for diabetes, but there are ways to stay healthy and reduce the risk of complications.
If you get more exercise, watch your diet, control your weight, and take any medicine your doctor prescribes, you can make a big difference in reducing or preventing the damage that diabetes can do. The earlier you know you have diabetes, the sooner you can make these important lifestyle changes.
Two (or more) types of diabetes?
Type 1 diabetes is defined as a state of high blood sugar due to insulin deficiency because of an autoimmune process. This means the body is attacking and destroying the cells in the pancreas which make insulin. Medical nutrition therapy and multiple daily injections of insulin (or through a pump) are mainstays of treatment. If you have Type 1 diabetes, you should be screened regularly for high blood pressure and other associated conditions.
Prediabetes? Type 2 diabetes?
Unlike Type 1 diabetes, which must be treated with insulin, Type 2 diabetes may or may not need insulin. Prediabetes is not diabetes, yet. But doctors and other providers can tell from your blood test if you are moving in the direction of diabetes. From 2013 to 2016, 34.5% of US adults had prediabetes. Your provider knows if you are at risk and may want to test or screen you. Why? Because it has been shown that physical activity and healthy eating patterns continue to be the cornerstones of diabetes prevention. Although no drugs are approved by the Food and Drug Administration (FDA) for diabetes prevention, strong evidence supports the use of metformin in adults with prediabetes. Delaying the onset of diabetes is huge because 463 million people across the world have diabetes. Fifty percent of them were undiagnosed.
Risk factors for prediabetes or Type 2 diabetes?
Since early stages of diabetes have few symptoms, there are risk factors which increase your chances of getting diabetes.
- Regular consumption of sugar-sweetened beverages as well as consumption of artificially sweetened beverages and fruit juice.
- In children, obesity is a significant risk factor.
- Diets high in fat and sugar.
- Sedentary behavior.
- Exposure to maternal diabetes and maternal obesity in utero.
The good news? Breastfeeding is protective. Further, physical activity and healthy eating patterns have been shown to be the cornerstones of diabetes prevention.
A variety of healthy eating patterns are acceptable for patients with prediabetes. Eat non-starchy vegetables; reduce your intake of added sugars and refined grains; choose whole foods over processed foods; and eliminate intake of artificially or sugar-sweetened beverages and fruit juices.
For children and adolescents with diabetes, the ADA recommends 60 minutes per day or more of moderate- or vigorous-intensity aerobic activity and vigorous muscle-and bone-strengthening activities at least three days per week.
Your doctor may want you to self-monitor your blood glucose. It helps you better understand the ups and downs of your blood sugar throughout the day, to see how your medicines are working, and assess the impact of lifestyle changes you are making. Your doctor may talk to you about goals, which include something called your A1c. This gives you and your doctor feedback on how your diabetes is doing over time, like three months. This is different than the day-to-day monitoring of your blood glucose.
If you have Type 2 diabetes and are unable to control with lifestyle changes, your doctor may start you on a medicine called metformin. This has revolutionized the care of diabetes by making the cells in your body more sensitive to the insulin in your system. If you still are not meeting your goals, your provider may add a second medicine, or even recommend you start insulin. The choice often depends on other medical conditions you might have.
Bottom line, diabetes comes down to you. You are in control, and you can do this.
- Learn as much as you can about your disease and talk with your provider about how you can get the support you need to meet your goals.
- Manage diabetes as early as possible.
- Create a diabetes care plan. Acting soon after being diagnosed can help prevent diabetes-problems such as kidney disease, vision loss, heart disease, and stroke. If your child has diabetes, be supportive and positive. Work with your child’s primary care provider to set specific goals to improve their overall health and well-being.
- Build your diabetes care team. This may include a nutritionist or a certified diabetes educator.
- Prepare for visits with your providers. Write down your question, review your plan, record your blood sugar results.
- Take notes at your appointment, ask for a summary of your visit, or check your online patient portal.
- Have a blood pressure check, foot check, and weight check. Talk with your team about medications and new treatment options, as well as the vaccines you should get to reduce your risk of getting sick.
- Start with small changes to create healthy habits.
- Make physical activity and healthy eating part of your daily routine
- Set a goal and try to be active most days of the week
- Follow a diabetes meal plan. Choose fruits and vegetables, whole grains, lean meats, tofu, beans, seeds, and non-fat or low-fat milk and cheese.
- Consider joining a support group that teaches techniques for managing stress and ask for help if you feel down, sad, or overwhelmed.
- Sleeping for seven to eight hours each night can help improve your mood and energy level.
You are not a diabetic. You may be a person who has diabetes, along with many other traits. There are others ready to come alongside you in meeting your goals. You can do this.
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