What we know about diabetes and how to treat it

Created date

August 14th, 2018

If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. Unlike some other medical conditions, it doesn’t occur because of age-related wear and tear on an organ (in this case, the pancreas). Rather, the problem is the trillions of cells throughout your entire body. “Basically, the cells are ‘deaf’ to the insulin signal sent by the pancreas,” says Jacob Teitelbaum, M.D., author of Diabetes Is Optional (2018, To Your Health Books).

At first, your pancreas secretes extra insulin to compensate, but over time it may not be enough to keep your blood glucose normal.

As of 2016 (the most recent data available), the Centers for Disease Control and Prevention reports the rate of newly diagnosed cases of diabetes in the U.S. is trending downward slightly. Still, more than 29 million Americans live with diabetes, and type 2 accounts for roughly 90% to 95% of cases.

Even more Americans (about 86 million) have prediabetes, which may sound like a benign term, but it is a serious medical condition that increases your risk of type 2 diabetes and related diseases.

Causes and effects

“Type 2 diabetes is caused by both genetic and lifestyle factors,” says Matt Narrett, M.D., chief medical officer for Erickson Living. “First-degree relatives of diabetics have five-to-ten times greater risk than individuals with no family history. Lifestyle risk factors include physical inactivity, poor dietary habits, and extra weight.”

Diabetes is the number one cause of kidney failure, blindness, and lower-limb amputations. It can also lead to heart disease, high blood pressure, and nerve problems (neuropathy), and some lesser-known complications. “Older adults with diabetes are at increased risk of memory impairment, depression, and falls,” Narrett adds.

Symptoms can come on slowly and be nonspecific. “You may feel tired, hungry, or thirsty,” Teitelbaum says. “You may lose weight without trying, urinate often, or have trouble with blurred vision. You may also get skin infections or heal slowly from cuts and bruises.”

“If you have one or more of these symptoms, see your doctor right away,” Teitelbaum advises.

Treatment options

“Fortunately, there is much you can do to prevent and manage this disease successfully,” Narrett says. “The first step is education, and there are many resources to choose from. The American Diabetes Association [ADA, diabetes.org] is a great place to start.”

Do-it-yourself treatment modalities include increasing your daily activity. Moving your body helps it stabilize glucose levels, and helps you lose extra pounds. “Weight loss can help reverse diabetes in many cases,” Teitelbaum says.

Learn how different foods affect your glucose. If you need help, ask your doctor for a referral to a dietitian, who can help you develop a meal plan. “Medical nutrition therapy is covered by Medicare and can guide you in the right direction,” Narrett says. “This is a method in which your diet is personally designed for your specific medical conditions, lifestyle, and preferences.”

If do-it-yourself methods fail, or if you have other major health problems, you may also need oral diabetes medication or insulin.

Staying on track

No matter what you are doing to treat diabetes, there is only one way to know if it’s working. “Track your glucose levels,” Teitelbaum says. “Very high glucose levels, called hyperglycemia, or very low glucose levels, called hypoglycemia, can be risky to your health.”

An overall average of your glucose level over time is called an A1C test. It has been found to give an accurate overall picture of how well your treatment is working. Your doctor can determine how often you need this test.

Embrace technology to help you adhere to your schedule. The ADA has several helpful suggestions. You can use smartphones, tablets, or computer apps to document your blood sugar, meals, snacks, activity, and symptoms. You can also set up reminders to check your glucose or take your medicine.

For people who need very close monitoring, there are devices that can measure your glucose every few minutes, and smart pumps that can automatically administer the proper amount of insulin.

Overall health maintenance

Regular health maintenance becomes more important than ever if you have diabetes. See your primary doctor and specialists regularly. Keep your dental appointments every six months and see an eye doctor every year. Check your blood pressure often. Use a home machine or one located in a pharmacy or grocery store.

Seniors should add a podiatrist to their health care team. “Corns and callouses, which are not generally harmful, can cause pain or lead to difficult-to-heal wounds or infections, especially if your lack of sensation is diminished due to neuropathy,” says Jennifer VanDemark, D.P.M., a podiatrist at Maris Grove, an Erickson Living community in Delaware County, Pa.

“Everyone should examine their feet daily,” VanDemark advises. “Look for cuts, bleeding, red areas, blisters, swelling, or any other abnormalities. Use a mirror to examine areas you can’t see well.”

“Yes, you have to make a significant effort to stay well if you have diabetes,” Narrett says. “But by working closely with your doctor, you can turn the challenge of diabetes into an opportunity for better health.”

Did you know? The American Diabetes Association website (diabetes.org) has a one-minute test that can help determine your risk of prediabetes. (source: American Diabetes Association)

Living with diabetes

Sign up for the American Diabetes Association’s free program called Living with Type 2 Diabetes. It includes:

• Six informational packets to help you learn to live well with diabetes

• A monthly e-newsletter with tips, stories, and more resources

• Six free issues of our award-winning Diabetes Forecast magazine

• Access to ADA’s online community and local events