An overview of diabetes types and treatments

Diabetes is a disorder that impairs the capacity of the body to absorb blood glucose, otherwise referred to as blood sugar.

The total number of people over 18 years of age living with diagnosed and undiagnosed diabetes in the United States is 30,2 million. The figure represents a population of between 27.9 and 32.7 per cent.

Without constant careful management, diabetes can lead to a accumulation of blood sugars that can increase the risk of dangerous complications, including stroke and heart disease.

Different types of diabetes will occur, and the form depends on how you treat the disease. Not all types of diabetes stem from an overweight person or living an unhealthy lifestyle. In reality, some are from infancy.

Types

We may develop three major types of diabetes: type 1, type 2, and gestational diabetes.

Type I diabetes: This type also known as juvenile diabetes occurs when insulin is not released by the body. Individuals with type I diabetes are insulin dependent, meaning they have to take artificial insulin daily to stay alive.

Type 2 diabetes: Type 2 diabetes affects how insulin is used in the body. While the body still produces insulin, the cells in the body don’t respond to it as effectively as they once did, unlike in type I. According to the National Institute of Diabetes and Digestive and Kidney Diseases, this is the most common type of diabetes and it has strong ties to obesity.

Gestational diabetes: This type occurs in pregnant women when the body may become less susceptible to insulin. Gestational diabetes is not present in all women, and usually resolves after birth.

The less popular diabetes types include monogenic diabetes and diabetes associated with cystic fibrosis. EOLBREAK

For more information on type I diabetes click here.

Prediabetes

Doctors refer to some people as prediabetes or borderline diabetes when sugar in the blood is typically between 100 and 125 milligrams per deciliter (mg / dL).

Normal blood sugar levels range between 70 and 99 mg / dL, whereas a diabetic individual will have a fasting blood sugar higher than 126 mg / dL.

The amount of prediabetes means blood glucose is higher than usual but not so high as to make up diabetes.

However, people with prediabetes are at risk of developing type 2 diabetes although we usually do not experience complete diabetes symptoms.

The risk factors for prediabetes are close to those for type 2 diabetes. They are:

• being overweight
• a family history of diabetes
• having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL
• a history of high blood pressure
• having 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 of African-American, Native American, Latin American, or Asian-Pacific Islander descent
• being more than 45 years of age
• having a sedentary lifestyle

If a doctor suspects a person with prediabetes, he or she will recommend making healthy changes that can help avoid the progression to type 2 diabetes. Losing weight and getting a healthier diet can often aid in avoiding the disease.

How insulin problems develop

Doctors do not know exactly why type I diabetes is induced. The causes of type 2 diabetes, also known as insulin resistance, are more apparent.

Insulin allows the glucose from a person’s diet to enter energy supplying cells in their body. In general, insulin resistance results from the following cycle:

1. A person has genes or an environment that make it more likely that they are unable to make enough insulin to cover how much glucose they eat.
2. The body tries to make extra insulin to process the excess blood glucose.
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.

In the case of 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.

Learn more about the function of insulin by clicking here.

Exercise and diet tips

When a doctor treats a person with type 2 diabetes, improvements in the lifestyle will often be advised to help weight loss and overall health.

A doctor can refer a nutritionist to a person who has diabetes or prediabetes. A specialist can help a diabetic person lead an active, balanced lifestyle and manage the condition.

Steps a person can take to embrace a lifestyle with diabetes 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 that provide empty calories, or calories that do not have other nutritional benefits, such as sweetened sodas, fried foods, and high-sugar desserts.
• Refraining from drinking excessive amounts of alcohol or keeping intake to less than one drink a day for women or two drinks a day for men.
• Engaging in at least 30 minutes exercise a day on at least 5 days of the week, such as of walking, aerobics, riding a bike, or swimming.
• Recognizing signs of low blood sugar when exercising, including dizziness, confusion, weakness, and profuse sweating.

Individuals may also take steps to decrease their body mass index (BMI), which may help certain individuals with type 2 diabetes control the disease without medication.

Gradual, realistic targets for weight loss are more likely to help a individual maintain long-term benefits.

Using insulin

People with sort I diabetes and some people with type 2 diabetes may need to inject or inhale insulin to avoid becoming too high in their blood sugar levels.

There are different types of insulin and most are categorized by how long their effect lasts. Insulins are strong, regular, moderate, and long-acting.

Most people will use a long-acting insulin injection to maintain the blood sugar levels consistently down. Certain people may use insulin that works fast or a mixture of types of insulins. Whatever the type a person will usually use a fingerstick to test their blood glucose levels.

This method of testing blood sugar levels requires the use of a separate, portable glucometer system. A person with type I diabetes will then use blood sugar amount readings to assess how much insulin they need.

The only way a person can find out their blood sugar levels is by self-monitoring. Taking the level from any physical symptoms that may arise can be dangerous unless a person assumes extremely low glucose and feels they need a fast dose of glucose.

How much is too much?

Insulin helps diabetics lead an active lifestyle. However, it can lead to severe side effects, particularly if a person is taking too much administration.

Excessive insulin can lead to hypoglycemia, or extremely low blood sugar, leading to nausea, sweating and trembling.

It’s important that people carefully monitor insulin and eat a healthy diet that controls as much blood sugar as possible.

Other medications

Certain forms of medication are available, in addition to insulin, which can help a person treat their condition.

Metformin

For type 2 diabetes, a doctor may prescribe metformin in pill or liquid form.

It contributes to:

• lowering blood sugar
• making insulin more effective

It can help with weight loss, as well. Having a healthy weight should reduce the diabetes effects.

A person can also have other health risks, as well as diabetes, and they may need medication to control these. A doctor will inform the patient on his or her needs.

SGLT2 inhibitors and GLP-1 receptor agonists

In 2018, new guidelines also recommended prescribing additional drugs for people with:

• atherosclerotic cardiovascular disease
• chronic kidney disease

These are receptor agonists of the sodium-glucose cotransporter 2 (SGLT2) or glucagon-like peptide-1 (GLP-1).

The guidelines allow doctors to prescribe an SGLT2 inhibitor for those with atherosclerotic cardiovascular disease and a high risk of heart failure.

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 drug. People may use it with metformin or alone. Side effects include gastrointestinal problems, such as nausea and a loss of appetite.

SLGT2 inhibitors are a new type of drug for lowering blood glucose levels. They work separately from insulin, and they may be useful for people who are not ready to start using insulin. People can take it by mouth. Side effects include a higher risk of urinary and genital infections and ketoacidosis.

Self-monitoring tips

Blood sugar levels self-monitoring is vital to effective diabetes management, helping control meal timing, physical activity, and when to take medication, including insulin.

Although blood glucose (SMBG) self-monitoring devices differ, they usually include a meter and test strip to produce readings, and a lancing device to poke the skin to get a small amount of blood.

In each case, refer to a meter’s specific instructions, as machines will vary. But for many of the devices on the market, the following safeguards and steps will apply:

• Make sure both hands are clean and dry before touching the test strips or meter
• Do not use a test strip more than once and keep them in their original canister to avoid any external moisture changing the result.
• Keep canisters closed after testing.
• Always check the expiration date.
• Older meters might require coding prior to use. Check to see if the machine currently in use needs this.
• Store the meter and strips in a dry, cool area.
• Take the meter and strips into consultations, so that a primary care physician or specialist can check their effectiveness.

A person who is diabetes self-monitoring uses a tool to poke the skin, called a lancet. While the concept of drawing blood can cause distress to some people, a gentle, simple procedure should be to lance the finger to obtain a blood sample.

Take the following precautions:

• Clean the area from which the sample will come with soapy, warm water to avoid food residue entering the device and distorting the reading.
• Choose a small, thin lancet for maximum comfort.
• The lancet should have depth settings that control the depth of the prick. Adjust this for comfort.
• Many meters require only a teardrop-sized sample of blood.
• Take blood from the side of the finger, as this causes less pain. Using the middle finger, ring finger, and little finger may be more comfortable
• 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.
• Tease blood to the surface in a “milking” motion rather than placing pressure at the lancing site.
• Dispose of lances in line with local regulations for getting rid of sharp objects.

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

Outlook

Diabetes is a chronic, serious condition. The disease is the seventh leading cause of death in the US, according to the American Diabetes Association (ADA).

While diabetes itself is manageable, its complications can have a severe impact on daily living, and some can be fatal if not promptly treated.

Complications of diabetes include:

• dental and gum diseases
• eye problems and sight loss
• foot problems, including numbness, leading to ulcers and untreated injuries and cuts
• heart disease
• nerve damage, such as diabetic neuropathy
• stroke
• kidney disease

In the case of kidney disease, this condition can lead to kidney failure, water retention when the body does not properly dispose of water, and a person having bladder control difficulties.

Proper control of blood glucose levels and regulation of glucose consumption can help people avoid complications of type 2 diabetes which are more harmful.

For those with type 1 diabetes the only way to mitigate and control the symptoms of the disease is to take insulin.

Takeaway

Diabetes is a life-changing condition that requires careful management of blood sugar, and a healthy lifestyle for a person to manage it properly. The disease has several different types.

Type I occur when insulin isn’t released by the body. Type 2 occurs when excess consumption of high-sugar products fills the blood supply with glucose and reduces insulin production and efficacy.

People may take additional insulin to control the disease, and improve the absorption of glucose. If a person has prediabetes, regular exercise and a healthy, low-sugar diet will reduce the risk of complete diabetes.

Diabetes complications can be serious like kidney failure and stroke, so it’s important to manage the condition.

Someone suspecting having diabetes will contact their doctor.

Q:

If prediabetes causes no symptoms, how do I know I have it and take steps to reverse the condition?

A:

In general people who are at risk for diabetes often get screened at their doctor’s office. The risk factors are listed above, and different groups have slightly different recommendations about when and how often to screen.

Most of the time, we use a test called a hemoglobin A1C that tells us how you have controlled your sugars over the previous 3 months. This test can also tell your doctor how likely it is that you will develop diabetes in the near future — the higher the level, then the more likely this is main steps to reverse prediabetes are the same things we talk about above — losing weight if you are overweight, getting regular exercise, and eating a balanced diet. Suzanne Falck, MD, FACP

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.