Diabetes Overview (Living with Diabetes)

Getting the diagnosis

Being diagnosed with diabetes can be frightening or depressing news for many people. If you are familiar with diabetes, you may have heard about the possible severe complications, such as eye problems, kidney failure, heart disease, and amputations. You may not have heard the good news: the complications of diabetes can be delayed or even prevented by taking good care of yourself. Here are some things you should know.

Basic facts

Having diabetes means that there is too much sugar (glucose) in your blood. Your blood always has some sugar in it because your body needs it for energy. But too much glucose in the blood is not good for your health.

When you digest food, your body breaks down much of the food into glucose. Your blood carries the sugar to the cells of your body for energy. Your body uses a chemical (hormone) called insulin to help move the sugar from the bloodstream into the cells. Insulin is made by the pancreas. When your body does not have enough insulin, or has trouble using insulin, sugar cannot get into your cells. Sugar builds up in your blood. Too much sugar in your blood can cause many problems.

There are 4 common types of diabetes: type 1, type 2, gestational, and prediabetes.

Type 1 diabetes happens when you have little or no insulin. Your pancreas just stops making it. This usually happens in childhood or young adulthood. The cause is not yet understood. It may be due to an injury or viral illness affecting the pancreas. It might also be caused by an autoimmune disease (where your body attacks part of itself). Type 1 diabetes requires taking insulin the rest of your life.

Type 2 diabetes happens when you become unable to use your own insulin. There are many factors that put people at higher risk of developing type 2 diabetes. They include race (it's more prevalent among brown-skinned people), family history, too little physical activity, overweight, and a high-calorie diet.

A woman who starts having high blood sugar during pregnancy has gestational diabetes. Diagnosis and treatment of this type of diabetes is very important. Not only can the mother have problems from high blood sugar, but the baby can have problems, such as being born too early.

Prediabetes is a new term used for people whose blood sugar is above normal but not yet high enough to be called diabetes. People who have prediabetes are at very high risk of developing diabetes unless they do things to lower their risk, such as learn how to eat healthy and increase their activity.

All of these types of diabetes have one thing in common: blood sugar that is too high if not treated.

Effects of high blood sugar

Having high blood sugar running through your blood vessels over time damages the blood vessels. This damage occurs throughout the body, but some organs are more sensitive to the changes in the blood vessels. The organs most often affected are the eyes, the heart, the kidneys, and the blood vessels to the feet and legs. The blood vessels to the brain are also damaged, which makes it more likely that people with diabetes will have a stroke.

Staying well

The most important part of staying well with diabetes is controlling your blood sugar. People who keep their blood sugar in the range recommended by their healthcare providers (usually close to or at a normal level) can delay or prevent the complications of diabetes.

The steps to controlling your blood sugar are:

• Learn how to eat healthy.
• Get enough exercise.
• Keep track of your blood sugar - at home and at your healthcare facility
• Take your medicine, if prescribed, every day.
• Keep all appointments with your healthcare provider.

The second most important part of staying well is keeping your blood pressure normal. Like high blood sugar, high blood pressure damages blood vessels. When these two work together, damage to your organs can happen much faster. A person with diabetes and high blood pressure is at high risk for heart attack, stroke, eye damage, and kidney failure. The best ways to control your blood pressure are like the ways for controlling your blood sugar:

• Keep track of your blood pressure--at home and at your healthcare facility.
• Follow your provider's recommendation for limiting the salt in your diet.
• Exercise according to your provider's exercise plan for you.
• Keep a healthy weight. (Ask your provider to help you determine a healthy weight for you.)
• Do not drink a lot of alcohol (no more than 1 drink a day for women and no more than 2 for men).
• Take your blood pressure medicine, if prescribed, every day.
• Keep your blood pressure checkups with your provider.

The third part to staying well is to try to prevent infection. People who have diabetes are more susceptible to infection. Do these things to stay healthy:

• Check your skin, especially your feet (top and bottom) every day for sores, blisters, or other injuries. Report any problems to your provider for prompt treatment.
• Keep your blood sugar normal (bacteria and fungus, which can cause infections, thrive on high sugars).
• Stay up to date on all of your shots, especially tetanus, pneumonia , and your annual flu shots
• Get a tuberculosis (TB) test every year.

Finally, an important part of staying well is avoiding as much stress as possible. Stressful events or situations affect the body's hormones. One hormone in particular, cortisol, increases blood sugar. Stress also makes your blood pressure rise. If stress is a part of your life, find ways to lower your stress level. Reducing your stress can take many forms, such as exercise, counseling, better money management, and family meetings. Reducing your stress will help you control your blood sugar and stay healthy.

For more information, see the Web site for the American Diabetes Association at http://www.diabetes.org/home.jsp and the National Diabetes Information Clearinghouse Web site at http://diabetes.niddk.nih.gov/index.htm.

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