Diabetes changes the way your body turns food into energy. But it doesn't have to change your life for the worst.
Understanding diabetes is the first step to optimizing your meal plan, making healthy lifestyle changes, and better managing this condition.
What Is Diabetes?
Diabetes refers to several conditions in which the body cannot use insulin effectively or doesn't produce enough of it. Insulin is a hormone secreted by the pancreas to help glucose fuel the cells in your body. Most of the food you eat ends up in the body as glucose, the primary source of energy for cells.
Diabetes leads to a buildup of glucose or sugar in your blood which has adverse health effects. As diabetes progresses, high blood sugar or hyperglycemia can damage tissues and organs.
Simply put, diabetes is a chronic condition that occurs when your blood sugar levels are too high. Another common diabetes definition refers to it as a condition in which the body cannot process food to use as energy the way it should.
Diabetes has long been considered a metabolic condition. But as we'll see, new research indicates that type 2 diabetes, similar to type 1 diabetes, may be an autoimmune disease.
Diabetes may give rise to many complications including cardiovascular disease, stroke, vision loss, neuropathy, foot damage, skin conditions, depression, and even dementia. Diabetes affecting pregnant women increases the risk for cesarian delivery, premature birth, jaundice, and stillbirth.
Living with diabetes means having to pay attention to the glycemic index of foods, adapt to new meal plans, and exercise more. But it doesn't have to mean giving up favorite dishes or activities you enjoy.
Types of Diabetes
Diabetes is a broad term that refers to several related but distinctive conditions. It's important to make the distinction between type 1 diabetes, type 2 diabetes, gestational diabetes, and prediabetes. Let's take a closer look at each one of them.
Type 1 Diabetes
Type 1 diabetes, formerly called insulin-dependent diabetes or juvenile diabetes, occurs when the pancreas fails to produce sufficient insulin.
Deprived of this hormone, cells cannot absorb blood sugar, which builds up in the bloodstream beyond normal levels. Type 1 diabetes is an autoimmune disease-the immune system wrongly attacks the cells that should produce insulin.
According to the 2020 National Diabetes Statistics Report, 1.4 million adults and 187,000 children and young adults under 20 have type 1 diabetes in the US.
The condition is thought to be caused by genes and environmental factors.
Type 2 Diabetes
The most prevalent form of diabetes, type 2 diabetes causes chronic high blood sugar levels. According to the Centers for Disease Control and Prevention, 30.6 to 32.3 million Americans have type 2 diabetes. That amounts to up to 95% of all total diabetes cases in the country.
The condition typically occurs in people over 45 years of age. But as a review in The Lancet notes, the prevalence of type 2 diabetes in young adults and adolescents is increasing dramatically.
According to the World Health Organization, type 2 diabetes can be prevented or delayed by following a healthy diet, maintaining a normal body weight, being physically active, and avoiding tobacco use.
Recent research indicates that type 2 diabetes is an autoimmune disease in which the immune system attacks cells in the body leading to insulin resistance. However, research in this area is still in its initial stages.
Risk factors for type 2 diabetes include obesity (especially fat in the belly), sedentary lifestyle, ethnicity, and family history. The condition is more likely to affect African Americans, Hispanics, Asians, and American Indians.
Gestational diabetes or pregnancy diabetes refers to high blood sugar that appears during pregnancy, usually in the second or third trimester. The placenta, which provides nutrients and oxygen to the growing baby, produces hormones that reduce the body's sensitivity to insulin, resulting in high blood sugar.
This condition tends to disappear after childbirth. It develops in up to 5% of pregnancies. Women who have gestational diabetes are at a higher risk of developing type 2 diabetes.
A 2020 systematic review and meta-analysis of 28 studies involving 170,139 women found that the estimated risk of developing type 2 diabetes ranges from 19.72% at 10 years to 58.27% at 50 years after childbirth.
Risk factors include obesity, lack of physical activity, family history of diabetes, and polycystic ovary syndrome. Giving birth to a baby over 9 pounds also drives up the risk.
Prediabetes is a condition in which blood sugar levels are higher than normal but below 125 mg/dL according to the fasting blood sugar test or 6.4% according to the A1C test.
In prediabetes, cells in your body stop responding to insulin as they would normally. Meanwhile, the pancreas works harder to make insulin, but may not keep up, leading to a spike in blood sugar levels.
According to the latest National Diabetes Statistics report, around 1 in 3 American adults have prediabetes. This means there are over 80 million prediabetic cases in the United States alone.
Risk factors for prediabetes include being overweight, inactivity, unhealthy diet, family history of diabetes, and having had gestational diabetes.
According to the Center for Disease Control and Prevention, common diabetes symptoms include:
- Frequent need to urinate
- Feeling thirsty
- Feeling hungry despite eating
- Losing weight without explanation
- Feeling tired constantly
- Noticing sudden changes in your vision
- Having sores that don't heal quickly
- Having more infections than usual
- Experiencing numbness or tingling in your feet or hands
In addition to these symptoms, people with type 1 diabetes may also experience stomach pains, nausea, vomiting, and mood changes.
Diabetes symptoms are not always obvious and can be hard to notice. Not everyone with a high blood sugar level experiences them. Many people realize they have diabetes only after routine blood tests rather than as a result of their symptoms.
Diabetes Symptoms in Men
Men with diabetes may also experience one or more of the following symptoms:
- Reduced muscle strength
- Decreased sex drive
- Erectile dysfunction
Diabetes Symptoms in Women
Women with diabetes are more likely to experience a few other symptoms:
- Dry skin
- Itchy skin
- Yeast infections
- Urinary tract infections
However, women who have gestational diabetes may be symptomless.
Key Diabetes Statistics
Diabetes affects millions of people around the world and costs billions of dollars to manage. Here are the key diabetes statistics at a glance.
- 34.2 million Americans or 10.5% of the US population have diabetes.
- An estimated 7.3 million have undiagnosed diabetes.
- 24.2 million people over 65 years have diabetes.
- The estimated cost of diabetes in the US is $327 billion including medical costs and reduced productivity according to this 2017 report.
- Diabetes is the seventh-highest cause of mortality In the United States, causing 26.7 deaths per 100,000 people, according to 2019 data.
- Diabetes incidence has increased by 102.9% from 1990 to 2017 according to the Global Burden of Disease Study 2017.
- Premature mortality from diabetes increased by 5% from 2000 to 2016 according to the World Health Organization.
Managing diabetes requires a personalized approach based on continuous monitoring and testing.
People with type 1 diabetes need to have insulin injected or delivered through a pump to survive. Without insulin, muscles and other cells would be starved of energy.
Insulin delivered in this way may range from rapid-acting, its effects lasting up to 4 hours, to long-acting, which needs a few hours to work but whose effects can last for 24 hours or longer.
Healthy Eating & Physical Activity
By contrast, those with type 2 diabetes may be able to control their blood glucose levels through a healthy meal plan and regular exercise. They have to replace sugary and starchy food with diabetes-friendly alternatives. The aim is to lower their daily carbohydrate intake to maintain their blood sugar levels within a manageable range.
Eating small meals throughout the day can also help manage type 2 diabetes.
Dietary changes and exercise are often used as the first response to managing type 2 diabetes, gestational diabetes, and prediabetes. Medication or insulin may also help if blood sugar levels stay high.
Type 2 diabetes medication can lower blood sugar by stimulating the pancreas to produce more insulin or through some other pathway. Some diabetes medications can be taken orally while others have to be injected. Some type 2 diabetics may also have to take insulin.
Reactions to diabetes medication vary from individual to individual. Side effects can include nausea and vomiting, stomach problems, urinary tract infections, headaches, and weight gain.
Unlike type 1 diabetes which is caused by factors beyond your control, type 2 diabetes is more preventable.
Healthier food choices, losing weight, and becoming more active can help you manage type 2 diabetes, prediabetes, and gestational diabetes while also increasing the quality of your life.
Diabetes is a serious medical condition, but there's a lot you can do to keep it under control and, in some cases, even to revert it. It all starts with healthy eating and healthy lifestyle choices.