Diabetes Management & Treatment

What is Diabetes?

Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders that affect how your body uses glucose, or blood sugar, over a prolonged period. This chronic health condition affects how your body turns food into energy. Glucose is vital to health because it’s an important energy source for muscles and other tissues. It’s also your brain’s primary source of fuel.

In normal metabolic function, when your blood glucose is high, your body signals your pancreas to release insulin, which moves the sugar into your cells for energy. But when you have diabetes, your pancreas doesn’t make enough insulin, or your body doesn’t use insulin properly, so the sugar stays in your blood. Other cells don’t get enough sugar for fuel, leaving the body without enough energy to function. Too much sugar in your blood over time can lead to serious health problems. Causes of diabetes vary by type. No matter your type, it leads to excess sugar in your blood. Managing this condition under the guidance of a knowledgeable doctor in the Seattle area can help you maintain your health.

Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include heart disease, stroke, chronic kidney disease, foot ulcers, damage to the eyes, nerve damage and other diabetes complications.

WHAT ARE THE EARLY SYMPTOMS OF DIABETES

Diabetes symptoms vary on how much your blood sugar is elevated. Some individuals may not experience symptoms initially, especially if they have pre-diabetes or Type 2 diabetes. Pre-diabetes is a condition where blood sugar is higher than normal but not high enough to be classified as diabetes. Symptoms tend to come on quickly and be more severe with the onset of Type 1 diabetes.

Symptoms of high blood sugar include:

• Frequent urination, especially at night
• Increased thirst and hunger
• Unexplained weight loss
• Weakness and fatigue
• Presence of ketones, a byproduct of muscle and fat breakdown, in urine
• Irritability
• Blurred vision
• Slow-healing sores
• Frequent urinary tract or yeast infections
• Pins and needles, or tingling in your hands and feet

TYPES OF DIABETES

Many different types of diabetes exist, but the three most common are Type 1, Type 2 and gestational diabetes. About 37.3 million Americans have diabetes, with over 90% having Type 2 diabetes. Another 84.1 million may have prediabetes, but most people in this category do not know they are at a higher risk for developing the condition.

Type 1 can develop at any age, but most often during childhood or adolescence, and results from the pancreas’s failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes.” Researchers believe that Type 1 is an autoimmune condition where the immune system mistakenly attacks and destroys the beta cells in the pancreas that produce insulin. This damage is permanent. The cause of these attacks is unclear, but genetic and environmental factors may be involved.

Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond properly to insulin. As the disease progresses, a lack of insulin may also develop. This form was previously referred to as "non-insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes.” The most common causes are excessive body weight and insufficient exercise. Genetics may also play a role.

Gestational diabetes is the third main form, occurring when pregnant women without a previous history of diabetes develop high blood glucose levels. Due to hormonal changes, the pancreas does not make sufficient insulin. Untreated gestational diabetes puts women at an increased risk for pregnancy complications. After pregnancy, gestational diabetes usually goes away, yet about half of those with gestational diabetes develop Type 2 diabetes later in life. Women who have had gestational diabetes or have borne children weighing more than nine pounds should have their blood sugar levels checked often.

Secondary diabetes occurs when blood glucose levels are elevated from treatments for other diseases. Blood glucose can rise due to certain medications, such as chemotherapy drugs or steroids. Some anti-rejection drugs used following organ transplantation can also affect blood glucose. Secondary diabetes is usually treated with insulin, a sound nutrition plan and monitoring. It’s often temporary; once you reduce or stop taking the medications, blood glucose may return to normal.

WHAT IS GLUCOSE INTOLERANCE?

Often, as people age, they develop glucose intolerance. It is a metabolic condition in which the body cannot effectively process glucose. People with this condition have blood glucose levels too high to be considered normal but do not meet the threshold to be considered diabetic. While some use glucose intolerance interchangeably with prediabetes, it is a separate condition that can develop outside of a diabetic state. Glucose intolerance and insulin resistance can develop simultaneously. The good news is that glucose intolerance can be reversed. One of the most common and effective ways to reverse these conditions is through weight loss. We can help you manage diabetes, glucose intolerance and other health conditions through our medically supervised weight loss program.

DIABETIC RISK FACTORS

Individuals who are overweight and physically inactive are more likely to develop Type 2 diabetes. Additional weight can cause insulin resistance in those with Type 2 diabetes. Extra belly fat is linked to insulin resistance, along with heart and blood vessel disease.

Genes and family history are also factors. Some ethnic groups are more prone to Type 1 and Type 2 diabetes, including:

• African Americans
• Native Americans
• Asians
• Hispanics
• Pacific Islanders

Genetic tendencies that increase an individual’s tendency toward obesity are also a risk factor for Type 2 diabetes.

HOW DIABETES IS DIAGNOSED

Blood glucose tests are the primary way to learn if you have diabetes. These tests measure the number of milligrams (mg) of glucose in a deciliter of blood. When a person fasts, the normal glucose level is 70 to 99 mg/dl. After a person eats, normal blood glucose may rise, but rarely exceeds 200. The American Diabetes Association lists these factors to determine whether someone has diabetes:

• Symptoms of diabetes and a blood glucose level of 200 or higher on a blood glucose test
• A fasting blood glucose level of 126 or higher
• A blood glucose level of 200 or higher after drinking a special sugar solution, called a glucose tolerance test
• An HbA1c (A-one C) level of 6.5% or higher

HOW DR. KAUR MANAGES DIABETES AT VIVAA

People with diabetes should try to keep their blood glucose levels as close to normal as possible. During the day before eating (fasting), good levels should be between 80 and 120. Postprandial (2 hours after a meal), the goal is <180. The goal for HbA1c is less than 7% for most patients.  Proper nutrition and knowing how certain foods can affect blood sugar are essential. Foods that are rich in vitamins, minerals, antioxidants, and fiber are good for overall health and may also help prevent diabetes.

Maintaining a healthy lifestyle is essential to managing diabetes. In addition to eating a healthy diet, patients should engage in regular physical activity, maintain a normal body weight and avoid tobacco use.  Control of blood pressure and proper foot care are essential for people with diabetes. We also recommend annual screening for eye complications.

Those with Type 1 diabetes must manage their blood glucose levels with daily insulin injections. Type 2 patients can manage diabetes through medications and insulin treatment if needed. Weight loss and medical or surgical interventions in those with obesity are sometimes effective measures in those with Type 2 diabetes. Gestational diabetes usually resolves after the birth of the baby.

SCHEDULE YOUR DIABETES MANAGEMENT CONSULTATION TODAY

Take control of your diabetes with Dr. Kaur. She combines years of expertise in prescribing advanced diabetes medications with a strong commitment to lifestyle and weight management counseling. Schedule a consultation today. We provide the personalized care and tools you need to effectively manage your health and avoid long-term complications.