When someone is diagnosed with diabetes, many questions and concerns come to mind. But with proper treatment and education, this serious prognosis can be managed and controlled.
Diabetes mellitus is a chronic condition related to insulin production and/or efficiency and blood glucose levels. There are multiple symptoms, both immediate and delayed, that can be signs of diabetes, such as increase in frequency and volume of urination, excessive thirst and hunger, dry mouth, blurred vision and recurring infection. There are two types of diabetes: type 1 diabetes, which is an autoimmune disease, or type 2 diabetes, which is when the body becomes insulin resistant.
“Type 1 diabetes is a shortage of insulin,” said Dr. Fernando Melaragno, an endocrinologist from LECOM Health. “This is caused by something called an autoimmune disease, when a person’s immune system ends up attacking the person’s pancreas and preventing it from making insulin. Most people who have this were diagnosed at an early age, and require insulin (via a syringe, pens or external insulin pump) to survive. Only 5% of diabetics have type 1. It is not entirely clear why people develop type 1 diabetes, but a combination of genetics and things like viral infections are likely triggers. In contrast, the vast majority of diabetics, 95%, are type 2.
“It is due to something called insulin resistance. They make insulin, but their cells do not respond to the insulin as they should. Obesity and a family history are the biggest risk factors for type 2 diabetes. Many diabetics are to use a glucometer to test and monitor their blood glucose with a finger prick. There are also continuous glucose monitors, worn almost like a Band-Aid, which sends the values to a reader or smart phone app.”
There are multiple factors that can cause someone’s blood sugar to go low or high, such as stress, mood, medication, activity level and food, which is the most well-known contributor. How someone’s body reacts to these factors also varies from person to person and can change as they age. Other hormone levels or periods of changing hormone levels such as growth spurts, puberty and menopause can effect blood sugar levels and how it responds to outside factors.
When someone has low or high blood sugars, they can exhibit multiple indicators both physical, such as shakiness or tiredness, and emotional, such as confusion.
“Feeling shakiness, sweating and a fast heartbeat are some signs of a low blood glucose level,” Melaragno said. “Feelings of hunger, dizziness, confusion, irritability and nervousness as well. A patient learns these symptoms and understands how to address them. Low sugars are treated with eating or drinking something, and closely monitoring the glucose levels. If they are unable to safely eat or drink, then an emergency medication can be given, called glucagon, via an injection or nasal spray.
“High sugars are prevented by taking medication properly, or a high can sometimes be lowered by drinking water and by being active to bring sugar levels down. The best way to keep sugars from climbing too much is a good long-term plan, which one would have with their doctor. This is by taking the medications consistently and also by avoiding foods that drive up blood glucose. These include the obvious ones, like sugary foods and drinks, but also food high in carbs (carbohydrates), such as breads and pasta – things mostly made with flour. Very high readings can also be dangerous and may require hospital care.”
If the patient does not take care of themself or mismanages their diabetes for a long period of time, it can lead to severe consequences such as kidney failure, blindness, amputations and heart disease.
There are multiple tools to help those with diabetes and their families manage blood sugar and glucose levels.
“The good thing is that, even though this is a very serious disease with major consequences if not properly treated, it can be controlled,” Melaragno said. “With the right approach, the right education and the right medications, this can be a very manageable disease, reversing the progression and allowing someone to live a fulfilling life. ”
*November is National Diabetes Awareness Month.