Diabetes: Symptoms, treatment, prevention, and early diagnosis (original) (raw)

Diabetes is a chronic condition that impairs the body’s ability to process blood glucose, or blood sugar. There are several types, including type 1, type 2, and gestational diabetes, which have various treatments.

Without ongoing, careful management, diabetes can lead to glucose buildup in the blood, which can increase the risk of dangerous complications, including stroke and heart disease.

Different kinds of diabetes can occur. How people manage the condition depends on the type. Not all forms of diabetes stem from diet or inactivity. Some are present from childhood.

The most common types of diabetes include type 1, type 2, and gestational diabetes, which we cover in more detail below.

Also known as juvenile diabetes, type 1 diabetes occurs when the body does not produce insulin.

Insulin is a hormone responsible for breaking down the sugar in the blood for use throughout the body. A person living with type 1 diabetes may receive a diagnosis during childhood.

People living with type 1 diabetes need to regularly administer insulin. Individuals may do this with injections or an insulin pump.

There is no cure for type 1 diabetes. Once a person receives their diagnosis, they need to regularly monitor their blood sugar levels, administer insulin, and follow some lifestyle strategies to help manage the condition.

Successfully managing blood sugar levels can help people living with type 1 diabetes avoid serious complications.

With type 2 diabetes, the body does not make or use insulin effectively.

A person living with type 2 diabetes may or may not need insulin. In many cases, medication, along with exercise and diet strategies, can help manage the condition.

Anyone, including children and adults, can develop type 2 diabetes.

Gestational diabetes occurs during pregnancy when a person becomes less sensitive to insulin.

According to the Centers for Disease Control and Prevention (CDC), 2–10% of pregnancies each year result in gestational diabetes. Individuals with overweight or obesity going into pregnancy have an elevated risk of developing the condition.

The CDC adds that around 50% of people with gestational diabetes will later develop type 2 diabetes.

During pregnancy, people can take steps to manage gestational diabetes. These include:

• staying active

• monitoring the growth and development of the fetus

• adjusting their diet

• monitoring blood sugar levels

• premature birth

• increased birth weight

• blood sugar issues with the newborn, which typically clear up within a few days

• increased risk of the baby developing type 2 diabetes later in life

In addition to type 1, type 2, and gestational diabetes, there are less common forms of the condition. Some examples include:

• Monogenic diabetes: In this form, a single gene change causes the condition to develop. There are two main types of monogenic diabetes: neonatal diabetes mellitus and maturity onset diabetes of the young.
• Type 3c diabetes: This type of diabetes, which people may also call pancreatogenic diabetes, can result from damage to the pancreas following surgery to remove the organ, injury, or illnesses, like pancreatitis.
• Cystic fibrosis-related diabetes: People living with cystic fibrosis may develop this type of diabetes as a complication of the condition.

Prediabetes, or borderline diabetes, occurs when a person’s blood sugar levels are elevated but not enough for a diagnosis of diabetes.

For a doctor to diagnose prediabetes, an individual must meet the following criteria:

• glucose tolerance levels of 140–199 milligrams per deciliter (mg/dL)
• an A1C test result of 5.7–6.4%
• fasting blood sugar levels of 100–125 mg/dL

People living with prediabetes have a higher risk of developing type 2 diabetes, but they do not usually experience the symptoms of full diabetes.

The risk factors for prediabetes and type 2 diabetes are similar. They include:

• obesity or overweight
• a family history of diabetes
• HDL cholesterol lower than 40–50 mg/dL
• a history of high blood pressure
• gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds
• a history of polycystic ovary syndrome (PCOS)
• being African American, Native American, Latin American, or Asian Pacific Islander
• being older than age 45 years
• not getting enough physical activity

A person cannot prevent type 1 diabetes.

However, people can take some steps to help prevent type 2 diabetes. Some ways to help prevent type 2 diabetes include:

• maintaining a moderate weight
• eating a balanced diet that limits added sugars, saturated fats, and processed foods
• getting regular physical activity

To reduce the risk of developing gestational diabetes, a person can maintain a moderate weight before becoming pregnant.

While these steps can help, it is important to note that people may still develop either type 2 or gestational diabetes.

Doctors do not know the exact causes of type 1 diabetes. However, insulin resistance, which can lead to type 2 diabetes, has clearer causes.

Insulin allows the glucose from food to access the cells in the body to supply energy. Insulin resistance is usually a result of the following cycle:

1. A person has genes or an environment that make it more likely for their body to be unable to produce enough insulin to cover how much glucose, or sugar, they eat.
2. The body tries to make extra insulin to process the excess blood sugar.
3. The pancreas cannot keep up with the increased demands, and the excess blood sugar starts to circulate in the blood, causing damage.
4. Over time, insulin becomes less effective at introducing glucose to cells, and blood sugar levels continue to rise.

With type 2 diabetes, insulin resistance takes place gradually. This is why doctors often recommend making lifestyle changes in an attempt to slow or reverse this cycle.

If a doctor diagnoses someone with diabetes, they often recommend making lifestyle changes to support weight management and overall health.

For example, a doctor may refer a person living with diabetes or prediabetes to a nutritionist. A specialist can help people living with diabetes lead an active, balanced lifestyle and manage the condition.

Steps a person can take to manage their diabetes and well-being include:

• eating a diet high in fresh, nutritious foods, including whole grains, fruits, vegetables, lean proteins, low fat dairy, and healthy fat sources, such as nuts
• avoiding high sugar foods, such as sweetened sodas, fried foods, and high sugar desserts
• refraining from drinking heavy amounts of alcohol or keeping intake to fewer than one drink per day for females or two drinks per day for males
• getting at least 30 minutes of physical activity per day on at least 5 days of the week, such as walking, aerobics, riding a bike, or swimming
• recognizing signs of low blood sugar, including dizziness, confusion, weakness, and profuse sweating

Some people can speak with their doctor about how to maintain a moderate weight if needed. This may help those with type 2 diabetes manage the condition without medication.

All people living with type 1 diabetes and some people living with type 2 diabetes need to administer insulin to keep their blood sugar levels from becoming too high.

Various types of insulin are available. Most are grouped by how long their effect lasts. There are rapid-acting, short-acting, intermediate-acting, long-acting, and mixed insulins.

Some people use long-acting insulin to maintain consistently low blood sugar levels. Others may use short-acting insulin or a combination of insulin types. Whatever the type, a person usually checks their blood sugar levels to determine how much insulin they need.

To check blood sugar levels, a person can use a blood glucose monitor, which involves pricking their skin, or a combination of a continuous blood glucose monitor (CGM) and skin pricks.

A CGM takes blood sugar readings regularly throughout the day. It can help a person make any adjustments to their medications.

Self-monitoring is the only way a person can find out their blood sugar levels. Assuming the level from any physical symptoms that occur may be dangerous unless a person suspects extremely low sugar and thinks they need a rapid dose of glucose.

How much is too much?

Insulin helps people living with diabetes live an active lifestyle. However, it can lead to serious side effects, especially if a person administers too much.

Too much insulin can cause hypoglycemia, or extremely low blood sugar, and lead to nausea, sweating, and shaking.

It is essential that people measure insulin carefully, adjust their medications based on their needs, and eat a consistent diet that helps balance blood sugar levels as much as possible.

In addition to insulin, other types of medication are available that can help people manage their condition.

Metformin

RECALL OF METFORMIN EXTENDED RELEASE

In May 2020, the

Food and Drug Administration (FDA)

recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets.

If you currently take this drug, call your healthcare professional. They will advise whether you should continue to take your medication or if you need a new prescription.

A doctor may prescribe metformin in pill form to a person with type 2 diabetes.

It helps lower blood sugar and makes insulin more effective.

People living with diabetes may also have other health risks, which they may also need medication to manage. A doctor can advise the individual about their needs.

SGLT2 inhibitors and GLP-1 receptor agonists

Guidelines from the American College of Cardiology recommend doctors prescribe additional drugs to people with atherosclerotic cardiovascular disease and type 2 diabetes.

For people with atherosclerotic cardiovascular disease and a high risk of heart failure, the guidelines advise doctors to prescribe an SGLT2 inhibitor.

SLGT2 inhibitors are a new type of drug for lowering blood sugar levels. They work by causing the kidneys to get rid of glucose in the urine. People can take it by mouth. Side effects include a higher risk of urinary and genital infections and ketoacidosis.

GLP-1 receptor agonists work by increasing the amount of insulin the body produces and decreasing the amount of glucose that enters the bloodstream. It is an injectable medication. People may use it with metformin or alone. Side effects include gastrointestinal problems, such as nausea and loss of appetite.

Self-monitoring blood sugar levels is vital for effectively managing diabetes. It helps regulate meal schedules, physical activity, and when to take medication, including insulin.

While self-monitoring blood glucose machines vary, they generally include a meter and test strip for generating readings. Self-monitoring also involves using a lancing device to prick the skin to obtain a small quantity of blood.

Precautions

People should refer to the specific instructions of a meter in every case, as machines will differ. However, the following precautions and steps generally apply to many devices on the market:

• Make sure both hands are clean and dry before touching the test strips or meter.
• Use a test strip only once. Keep strips in their original canister to avoid any external moisture changing the result.
• Keep canisters closed after testing.
• Check the expiration date before use.
• Check whether the machine requires coding before use, which may apply to older varieties.
• Store the meter and strips in a dry, cool area.
• Take the meter and strips to doctors’ appointments so healthcare professionals can check their effectiveness.

Tips

People checking their blood sugar levels with a blood glucose meter also use a device called a lancet to prick their finger.

While the idea of drawing blood might cause distress for some people, lancing the skin to obtain a blood sample should be a gentle, simple procedure. Many meters require only a teardrop-sized sample of blood.

• Use fingertips to obtain a blood sample. While some meters allow samples from other test sites, such as the thighs and upper arms, the fingertips or outer palms produce more accurate results.
• Clean the skin with soapy, warm water to avoid food residue entering the device and distorting the reading.
• Choose a small, thin lancet for maximum comfort.
• Adjust the lancet’s depth settings for comfort.
• Take blood from the side of their finger, as this typically causes less pain. Using the middle finger, ring finger, and little finger may be more comfortable.
• Tease blood to the surface in a “milking” motion rather than placing pressure at the lancing site.
• Follow local regulations for disposing of sharp objects, including lancets.

While remembering to self-monitor involves people making lifestyle adjustments, it does not need to be an uncomfortable process.

Diabetes is a serious, chronic condition. According to the American Diabetes Association, diabetes was the eighth leading cause of death in the United States in 2021.

While diabetes is manageable, its complications can severely affect daily living. Some complications can be fatal if not treated immediately.

Complications of diabetes include:

• ketoacidosis
• nerve damage
• eye issues
• kidney disease
• cardiovascular disease
• foot problems, including numbness
• high blood pressure
• stroke
• issues with the gums and teeth
• heart attack

Regularly monitoring blood sugar levels and moderating glucose intake can help people prevent the more damaging complications of diabetes.

For those living with type 1 diabetes, administering insulin is the main way to help them manage the condition.

The following are some frequently asked questions about diabetes treatment.

What is the best treatment for type 2 diabetes?

A person can speak with a doctor to discuss the best treatment options for type 2 diabetes. However, common treatment options include the following types of medication:

• metformin
• DPP-4 inhibitors
• SGLT2 inhibitors
• sulfonylureas
• GLP-1 and GIP receptor agonists
• thiazolidinediones

What is the most common medication for type 2 diabetes?

The most common type of medication for type 2 diabetes is metformin. Metformin decreases the amount of glucose the liver produces, which lowers blood glucose levels.

What drink lowers blood sugar?

To help manage blood sugar levels, a person can drink water, including flavored, sugar-free water, and herbal teas.

Does type 2 diabetes require insulin?

Some people with type 2 diabetes may need to take insulin pills or shots.

This is because the body can make insulin but does not respond well to it. In type 2 diabetes, insulin can help the body use glucose for energy.

Diabetes is a life changing condition that requires careful blood sugar management and healthy lifestyle strategies for a person to manage it safely.

There are several types of diabetes. Type 1 occurs when the body does not produce insulin. Type 2 develops when insulin production or effectiveness can no longer meet the body’s needs.

Depending on the type of diabetes, people may need to administer insulin and take other medications to manage their condition and improve glucose absorption. If a person is living with prediabetes, they can reduce the risk of developing type 2 diabetes through regular exercise and a balanced diet.

The complications of diabetes can be severe, including kidney failure and stroke, so managing the condition is vital.

Anyone who suspects they may be living with diabetes should contact a doctor.