Q & A About Diabetes
Valley physicians, nurses and registered dietitians—all with special training in the treatment of diabetes—prepared this material. The information is intended for your general use and shouldn’t replace consultation with your own healthcare practitioner.
- What is diabetes?
Diabetes is a metabolic disorder where the pancreas produces little or no insulin, causing blood sugar to rise.
- What are the symptoms of diabetes?
The most common symptoms are frequent urination, blurred vision, wounds that don’t heal, frequent infections, increased thirst and chronic fatigue. If you have these symptoms or a family history of diabetes, see your doctor for a blood test.
- What is the difference between Type 1 and Type 2 diabetes?
Type 1 diabetes (about 10 percent of people with diabetes) is an autoimmune disease in which the immune system attacks the cells of the pancreas that produce insulin. Type 2 diabetes (about 80 to 90 percent of persons with diabetes) is a progressive chronic disease that affects insulin production and utilization. Generally, individuals who have Type 2 diabetes still produce insulin, though not as efficiently.
- What is insulin, and how does it affect blood sugar levels?
Insulin is a hormone produced by the pancreas. Insulin allows sugar to move from the blood stream into the cells of the body where glucose is used for energy. Insulin helps to maintain a balance of sugar in the blood. If there is little or no insulin available, as in Type 1 diabetes, or if it does not work normally, as in Type 2 diabetes, blood sugar levels increase. Over time, elevated blood sugar levels can damage different organs in the body, resulting in medical complications.
- What is the treatment for diabetes?
Medical treatment centers on controlling blood sugar as well as preventing and monitoring for complications. Teaching people how to manage their diabetes and regular follow-up with their healthcare provider is essential for long-term wellness. People learn to monitor their blood sugar and are treated medically for blood sugar control. Persons with Type 1 diabetes require insulin injections for blood sugar control and ultimately for their survival. Persons with Type 2 diabetes may be able to control blood sugar by making lifestyle changes and/or through oral medications. Insulin may be required depending on the person’s ability to manage their blood sugar by other means.
- Is it true that only kids get Type 1 diabetes and only adults get Type 2 diabetes?
Commonly Type 1 diabetes manifests in childhood and teenage years, though it can occur at anytime of the life cycle. Type 2 diabetes previously was called adult-onset diabetes. We are now seeing Type 2 manifesting at all ages, even in children.
- I have heard that doctors want to check A1c levels. What is that?
An HbA1c is a measure of the average blood glucose levels during the last 3 months. This value is heavily weighted for the last 30 days before the lab test and is used as a marker for tracking diabetes management.
- What is the Valley Diabetes Network?
The Valley Diabetes Network is a collaborative effort among Valley Medical Center physicians, nurses, and diabetes educators. It was formed for the purpose of monitoring and tracking patient health through the system.
- What are the medical complications associated with diabetes, and how do providers monitor these complications?
Complications associated with diabetes include increased risk for heart disease and stroke, damage to small blood vessels of the eyes and kidneys, and damage to the nervous system. Persons with diabetes should see their healthcare provider regularly, every 3 to 6 months. Patients are monitored for blood sugar and blood pressure control and evaluated and/or treated for underlying cardiovascular disease. Exams or tests done annually include dilated eye exam, foot exam, blood cholesterol, and urinalysis to monitor for kidney changes.
- How do healthcare providers monitor blood sugar control?
A blood test called the hemoglobin A1c is used to determine blood sugar control. This test measures the percentage of hemoglobin (a blood protein) that has sugar or glucose attached. The higher the percentage, the higher the blood sugar has been over the previous 2 to 3 months. The results more closely reflect blood sugar levels occurring within the month prior to the blood draw.
- Why do some people take oral medication and some people have to take insulin to manage their diabetes?
Individuals who have Type 1 diabetes require insulin injections for survival. Patients with Type 2 diabetes may require insulin, depending on how well they are able to control their blood sugar by other means.
- Is my diabetes worse if I have to take insulin?
Elevated blood sugar levels contribute to an increased risk of health complications. Individuals who are unable to control blood sugar levels through lifestyle or oral medications may benefit from insulin injections.
- What is the relationship between sleep apnea and diabetes? What are the symptoms, and am I at risk?
The diagnosis of diabetes means an increased risk for sleep apnea. People with sleep apnea have episodes in their sleep cycle when they do not get enough oxygen. Sleep apnea increases risk for a number of health problems, including high blood pressure, heart disease, and stroke. Symptoms include chronic fatigue and diminished ability to concentrate. Individuals at increased risk include persons who have diabetes, are overweight, or have a family history of sleep apnea. Valley Medical Center has a Sleep Center that specializes in diagnosing and treating individuals with sleep apnea.
- How do I know if I’m at risk for developing diabetes?
The factors that contribute to patients being at risk for diabetes are a family history of diabetes, being overweight or obese, and inactivity or a sedentary lifestyle.
- What is the relationship between diabetes and heart disease or stroke?
Heart attacks and strokes are the leading causes of diabetes-related deaths. Both result from an underlying disease of the arteries. The good news is that by following a heart healthy lifestyle, the risk for heart attack and stroke can be significantly decreased. Not using tobacco, getting regular exercise, maintaining healthy eating habits and a healthy weight, and keeping your blood pressure and blood cholesterol levels within target ranges are all important lifestyle factors that significantly reduce risk of heart disease and stroke.
- How can individuals with diabetes decrease their risk of developing the complications associated with diabetes?
Following a healthy lifestyle will decrease the risk of heart disease and stroke. Blood sugar and blood pressure control play an important role in significantly reducing the risk of complications. One of the most important things individuals with diabetes can do is to become educated about managing their diabetes. The Diabetes Center at Valley Medical Center offers classes that empower individuals to make lifestyle choices that will promote their health and well-being.
- Is it possible to prevent diabetes?
The results of a 3-year national study on diabetes prevention showed a 60 percent reduction in risk among individuals who followed recommended lifestyle practices such as regular exercise (a minimum of 30 minutes, 5 days per week); a “heart healthy” low-fat diet; maintenance of normal body weight and/or moderate weight loss (10–15 pounds).
- Do I have to eliminate sugar from my diet if I have diabetes?
No. Sugar increases blood sugar levels but so do other carbohydrates. Carbohydrates are both sugars and starches, including breads, cereals, grains, fruit, starchy vegetables, milk/yogurts, and of course desserts. A person with diabetes can control blood sugar levels by consuming moderate amounts of carbs with each meal. Small amounts of sugar can be included in meal plans.
- What are the benefits of exercise for a person with diabetes?
Most mortality risk among persons with diabetes is associated with cardiovascular disease. Regular exercise and physical fitness are associated with decreased heart disease risk as well as a decrease in Type 2 diabetes. The best kind of exercise for a diabetic patient is any activity the patient enjoys, such as walking, jogging, or gardening. For the most benefit, it should vary between weight-bearing or resistance activities and cardiovascular activities.
- What is the relationship between obesity and diabetes?
There is a strong relationship between diabetes and obesity. Research shows that overweight or obese individuals are at elevated risk for developing Type 2 diabetes. Obesity causes insulin resistance, which means that the insulin produced in the pancreas is not being used efficiently and the insulin cannot help glucose enter the cells. Blood sugar levels then remain elevated. Moderate weight loss decreases insulin resistance and increases insulin sensitivity.
- Will insurance cover diabetes education classes?
Typically most insurance companies cover diabetes education to some extent if the deductible has been met. We recommend that you check with your insurance company to verify coverage of diabetes education classes. Medicare typically covers 80 percent of the cost of diabetes education classes.
- Are popular diets good for diabetes to control blood sugar levels?
Typically, diets that eliminate certain food groups do not provide people with adequate nutrition. For diabetics, a diet that is moderate in carbohydrates, protein, and fat is the best solution.
- How can I get a test for diabetes?
See your family medicine doctor, who will test your fasting blood sugar or random blood sugar levels.
- If I have diabetes, what should my blood sugars be?
The American Diabetes Association guidelines state that fasting blood sugar levels should be 90–130, and 2 hours post-meal blood sugars should be less than 140.
- In addition to medication, how can I lower my blood sugar levels?
In addition to taking medication, you can lower blood sugar levels by educating yourself, making healthy food choices, increasing activity levels, and decreasing stress levels.
- Should I be concerned about fat in my diet?
Yes, a diet that is moderately low in fat will reduce your risk for cardiovascular disease. Cardiovascular disease is a complication of diabetes.
- If I have high blood pressure, high cholesterol, and high blood sugar levels what is left for me to eat?
All kinds of foods are available as long as you maintain the right balance of carbohydrate, protein, and fat. We recommend that 50 percent of your calories should come from carbohydrates, 20 percent from protein, and 30 percent from fat.