What is diabetes?

Diabetes is a chronic disease resulting in the body being unable to properly regulate the amount of glucose (sugar) in the blood. Glucose is an important source of energy for the brain and body, but it can only enter your cells with insulin, a hormone that controls blood sugar levels and is produced by the pancreas. Bodies with diabetes cannot produce enough insulin, or the insulin doesn’t work properly, and this can lead to long term issues like heart disease, nerve damage, kidney disease, and strokes.

Diabetes is rising worldwide, and particularly in the United States. The CDC estimates that 37.3 million people have diabetes (11.3% of the US population), including 8.5 million people who are undiagnosed.

Types of diabetes

While type 1 and type 2 diabetes are most commonly known, there are basically four major types of diabetes:

  1. Prediabetes

  2. Type 1 diabetes

  3. Type 2 diabetes

  4. Gestational diabetes

Each type has notably high blood glucose levels, but have different specific causes, risk factors, and considerations.

Prediabetes

Prediabetes is the condition in which blood glucose levels are higher than normal, but not yet high enough to qualify as diabetes. While some cases of prediabetes progress to diabetes, there are some steps that may reduce the risk of progression for up to 10 years. Lifestyle changes like diet, exercise, and medication can help treat prediabetes.

Type 1 diabetes

In type 1 diabetes, the pancreas produces no or too little insulin to control blood sugar. Usually children, teens, and young adults are diagnosed, but it can appear at any age. Type 1 diabetes can be managed with monitoring, daily insulin therapy, and diet and exercise routines.

Type 2 diabetes

Type 2 diabetes, or non-insulin dependent diabetes mellitus, is the most common type of diabetes today. In this condition, the pancreas doesn’t produce enough insulin, or the body doesn’t use it effectively (known as insulin resistance). While type 2 diabetes is linked with obesity and lifestyle, you can still be genetically predisposed to it. Diet and exercise are essential in managing type 2 diabetes, as well as monitoring your blood glucose levels and possibly medication.

Gestational diabetes

Gestational diabetes develops during pregnancy. High blood sugar appears in a body that has not had diabetes previously, but usually returns to normal after the birth. However, it can leave you with a higher risk of developing type 2 diabetes in the next 10 years, so pay attention. Gestational diabetes can cause other complications during pregnancy and delivery and in some cases cause complications for the infant.

Causes of diabetes

While genetics, certain viruses, and lifestyle choices can heighten the risk for diabetes, the exact cause is still unknown. Each type of diabetes also has its own prevalent causes: type 1 diabetes is typically genetic and is diagnosed in childhood, and type 2 is more commonly linked to lifestyle and diet. The risk of developing type 2 diabetes also increases with age, and if you’ve had gestational or prediabetes.

Some common risk factors of diabetes are:

  • Genetics

  • Over 45 years of age

  • Having gestational or prediabetes

  • Being overweight or obese

  • Diets high in sugar and processed foods

  • Little or no regular exercise

Still, having no family history of diabetes and a fairly healthy lifestyle does not completely eliminate the risk of developing diabetes. Many people with diabetes have no close relative with it, and many overweight or obese people never develop diabetes.

With no exact causes known, it can be difficult to completely prevent diabetes. However, there are some ways to lower your risk of developing diabetes:

  • Remain at a healthy weight

  • Exercise frequently

  • Eat healthy: lots of vegetables and whole grains, and try to limit excess sugar, fat, and sodium

  • No smoking

If you are at high risk or suspected of having diabetes, your doctor may order a hemoglobin A1C test, which tracks your average blood sugar levels over 2-3 months. If your A1C is 5.7% to 6.4%, you have prediabetes. 6.5% or higher is considered diabetes. Different diseases, conditions, and medications can cause an A1C to become falsely elevated or decreased. A physician can help determine if that is the case.

Living with diabetes

If you or a loved one have been diagnosed with diabetes, it is important to follow your doctor’s guidance on medication, monitoring, and lifestyle. Millions of people worldwide live with this chronic condition, and still have happy, full lives.

Treatments can vary by type of diabetes, but all have to do with assisting your body in managing blood glucose levels. Generally, diabetes treatments include:

  • Taking insulin

  • Monitoring carbohydrate, fat, and protein in your diet

  • Monitoring blood sugar frequently

  • Healthy diet including vegetables, fruits, and whole grains

  • Regular exercise and maintaining a healthy weight

Prediabetes treatment is primarily self-care. Progression to diabetes is avoidable with a health-conscious lifestyle and anti-diabetic medication. Regular physical exercise, a low carb and low fat diet, and weight loss can prevent diabetes and even reverse prediabetes.

Type 1 diabetes must be treated with lifelong insulin therapy, which involves injecting or pumping insulin into the body regularly. This table shows the types of insulin used to treat type 1 diabetes, and how fast they work:

Type

Enters the bloodstream

Peaks

Effective for

Rapid-acting

15 minutes after injection

1-2 hours after injection

2-4 hours

Short-acting (regular)

30 minutes after injection

2-3 hours after injection

3-6 hours

Intermediate-acting (NPH)

2-4 hours after injection

4-12 hours after injection

12-18 hours

Long-acting

3-5 hours after injection

No peak

Up to 24 hours

Ultra long-lasting

6 hours after injection

No peak

36 hours or longer

Type 2 diabetes can be treated with a mix of self care, anti-diabetic medication, and potentially insulin therapy. Making more significant diet and exercise changes include quitting smoking, exercising 5 days a week, eating lots of dietary fiber, and potentially starting nutrition counseling. There are a variety of medications to manage type 2 diabetes; many of them help the body properly respond to insulin, stimulate the pancreas to produce more insulin, and help reduce blood glucose levels.

Gestational diabetes treatments work to keep blood glucose levels normal despite pregnancy, including meal plans, physical activity, and potentially blood sugar testing and insulin. Monitoring and medication is always necessary. However, like the other types of diabetes, a healthy diet and regular physical activity will help manage gestational diabetes.