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Diabetes is caused by damaged or disrupted carbohydrate metabolism.
There are four common types of diabetes:
Pre-diabetes is when a person’s blood sugar is elevated above normal but not high enough to be diagnosed with type 2 diabetes. This can be seen in overweight and obese populations.
Type 1 diabetes is when the pancreas produces little or no insulin at all. This population is 100% reliant on insulin to live.
Type 2 diabetes is when the body has a difficult time processing excessive amounts of sugar for their current body size/weight.
Gestational diabetes is discovered when a woman is pregnant. Woman are checked for elevated sugar levels normally in their second trimester between 24-28 weeks. They are tested by using a glucose tolerance test which can last 1-2 hours. This test evaluates insulin sensitivity and insulin resistance to sugar.
It is estimated that there are approximately 37.3 million people with diabetes in the US (11.3% of the US population). Type I Diabetes represents approximately 10% of patients and type II Diabetes represents approximately 90% of patients. (CDC, June 29, 2022)
Prediabetes is when a person’s blood sugar is starting to increase to higher-than-normal level. This happens over time when people eat foods higher in sugar and fat with no exercise to burn it off. Prediabetes means exactly that, you are moving towards having Type 2 diabetes. Your doctor’s office will check your Hemoglobin A1c (Hgba1c) at your annual checkup. If your result is between 5.7-6.4, you are prediabetic. Once your results are higher then 6.4, you are diagnosed with Type 2 diabetes.
When you are diagnosed as prediabetic, this is a person’s opportunity to adjust their meals, exercise, and overall lifestyle. Meeting with our primary care providers can help you look at your BMI (Body Mass Index) and start a treatment program that can stop or slow the onset of type 2 diabetes. Our patients meet with a PCP, a registered dietitian, and a behavioral health provider while on our weight loss program. We help our patients avoid moving to a diagnosis of Type 2 diabetes.
Type 1 Diabetes
Type 1 diabetes occurs when a person’s body attacks certain cells in the pancreas that make insulin. These cells are needed to capture sugar in the blood stream and turn them into energy. When the body holds sugar outside of the cell this will cause physical symptoms and eventually internal organ damage over time. Some of these symptoms are weight loss, fatigue, increased thirst and hunger, increase urination, yeast infections, blurry vision and slow healing of cuts/bruises.
People can have symptoms for several months to years before diagnosis. When there is little or no insulin produced, a persons body will start to break down its own fat and muscle. This causes significant weight loss. When the body has high levels of sugar in the bloodstream, it can cause a serious short-term condition called diabetic ketoacidosis (DKA). This is when a person’s body develops dangerous levels of ketones, a by-product of the body breaking down fat, in the blood stream causing severe dehydration.
When a person reaches DKA, they are normally hospitalized until their blood sugar levels are under control. Type 1 diabetes can be controlled with multiple dose injections daily of long and short acting insulin. Another option is an insulin pump that dispenses insulin every 5 minutes like a normal pancreas. In addition to the insulin pump, you can use a continuous glucose monitor (CGM) that will tell you what your blood sugar level is every 5 minutes. This will help to decrease finger sticks by 95%. This new technology has made living with Type 1 diabetes more manageable than before.
Type 2 Diabetes
Type 2 diabetes is caused when a person’s body receives excessive amounts of sugar in the bloodstream on a regular basis. Over time, their cells stop working and become resistant to accepting insulin. Cells will stop responding which is when sugar starts to build up in the bloodstream. The pancreas continues to work overtime to make insulin for the cells, but the additional insulin turns into body fat causing weight gain.
This will lead to additional symptoms of increased thirst and hunger, increased urination, feeling tired all the time, dry skin, blurry vision, and increased number of skin infection with slow healing time. Type 2 diabetes can take many years to be diagnosed. Most people do not know they have Type 2 diabetes until they start to feel numbness or tingling in their hands and feet.
Type 2 diabetes can be controlled with diet and exercise for people that are willing to put in the time and effort to eat healthy and exercise every day. Medication is available as well in the form of pills and injectables. Some insurances have allowed people with Type 2 diabetes to use continuous glucose monitoring systems (CGM). Use of the new CGM’s will help keep better control of a persons blood sugar level on a daily basis. When a person’s blood sugar is well controlled, they will remain at a healthy weight and feel good every day.
Gestational diabetes is the one version of diabetes that develops during pregnancy in women that do not already have Type 1 or Type 2 diabetes. Women experience gestational diabetes when their pancreas is unable to make enough insulin for their current body weight during pregnancy. They develop insulin resistance which is when the cells of the body stop working properly and no longer accept insulin and energy to be produced. This is the same response that happens with prediabetes which can eventually lead to Type 2 diabetes in time after pregnancy.
Most women diagnosed with Gestational diabetes do not have symptoms. They find out after their glucose tolerance test (GTT) in the second trimester, generally between 24-28 weeks. Treatment will depend on the severity of blood sugar levels, your HgbA1c results and your provider. Tight blood sugar control is the most important thing during pregnancy when you have Gestational Diabetes. Mothers with high sugar levels during pregnancy are at an increased risk for developing high blood pressure and are at higher risk for delivering babies early. Infants born to mothers with high glucose levels are at risk for having breathing problems since their lungs were not fully developed and they can have low blood sugar levels and can develop type 2 diabetes later in their lives.
Gestational diabetes can be controlled with a healthy minimal carbohydrate, mostly low fat proteins, vegetables, fruits and no processed foods diet along with daily exercise. Medication such as insulin is normally added when a mother is not able to keep her blood sugar under good control. Continuous glucose monitors during pregnancy is a must have in today day and age. It will make all the difference during this stressful 9 months.