iabetes is such a broad topic! I have personally noticed that the general public doesn’t know much about it, other than “you have to be on insulin.” Or, “you got it because you’re fat.” Both are incorrect.
So, I have chosen to write this post to give you all the ‘sweet tea.’ We will go over what it is, some of the risk factors, symptoms of diabetes, and things you can do to prevent it.
I would add that even if it is a disease, it does not mean that you have no control. There are ways you can help manage your diabetes aside from any medications.
Like many others, including high blood pressure or high cholesterol, the beauty of this chronic illness is that your lifestyle and daily habits play a massive role in its progression and control.
Even if you’ve been diagnosed with a chronic disease, there IS something YOU can do about it. So don’t let that keep you down! With the combination of your effort and your physician’s help, you can lead a very healthy life without complications of the disease. It takes a partnership for anything to work, and this includes your health.✓
Types Of Diabetes:
Listed below are the two types of diabetes, but I will be focusing on the signs and symptoms of type 2 diabetes.
Type I Diabetes Mellitus
Insulin-dependent diabetes mellitus
Previously: Juvenile-onset diabetes.
Type 2 Diabetes Mellitus
Insulin-resistant diabetes mellitus
Previously: Adult-onset diabetes.
Both types of Diabetes are issues with insulin. Insulin regulates the amount of sugar level in your bloodstream. Having too much sugar in your blood for too long can lead to specific health issues, which I will discuss in a different post.✓
The most notable difference is that – in type 1 diabetes, your pancreas makes little to no insulin. In contrast, in type 2 diabetes, your pancreas makes plenty of it, but your body is just not responding to it, AKA resistant to it.✓
The treatment of these two types is, therefore, quite different. If your body isn’t making it such as in diabetes mellitus type 1, treatment would be to give yourself insulin. It is the reason why it’s called insulin-dependent diabetes mellitus
But in type 2, your body does make it; it’s just not sensitive enough to it to respond, so it’s treated with different medications. Eventually, if still not controlled, insulin may be necessary, BUT not always.✓
DEFINITION OF RISK FACTORS
Before I discuss specific risk factors for diabetes, I just want to make you guys aware that there are different “classes” of risk factors.
In medicine, risk factors are divided into – those you can change, and those you cannot change. We refer to them as modifiable vs. non-modifiable risk factors, respectively.✓
Things you can change include – your diet, your sleeping patterns, your level of physical activity, whether or not you smoke, or drink alcohol. These are the things you can change.
Things you cannot change include – your family history (genetics), age, height, race, and ethnicity.
Further still, some can be a combination of the two: it can include your social economic status, which can affect your access to health care or even healthier food options. It affects your neighborhood, which can affect how safe it is for you to exercise outside. Some of these you can change with time, but sometimes it will take longer than expected, or they may always be that way. We call these determinants of health. These things can get in the way of you achieving your healthier lifestyle goals; they have nothing to do with your motivation or will to do something.✓
So let’s get started on this sweet topic! Pun intended.
Family history of type 2 diabetes
If your family members have diabetes type 2, it increases your risk of developing it in the future as well.
Even though type 1 diabetes can be caused by autoimmune disease, which can run in families, type 2 diabetes has a more robust “hereditary” pattern than type 1.✓
Past medical history of gestational diabetes (GDM)
Did you know that being diagnosed with diabetes during pregnancy increases your chances of retaining it or developing it later even after delivery? Gestational diabetes is a whole other topic for another day, but for it to be called Gestational Diabetes Mellitus (GDM), you must develop it after 20 weeks of pregnancy. Sugar issues during pregnancy are due to glucose intolerance, and most resolve after delivery.
But did you know that your risk of developing diabetes is about a 3-7x higher than the average person, even 5-10 years after delivery and resolution of gestational diabetes?
Also, infants born to mothers who had GDM are at higher risk of obesity and diabetes throughout their lives. So there is a higher risk of diabetes in both mother and child later in life.✓
Obesity, current or in youth
Excess adipose tissue (fat), and in particular visceral (abdominal) fat, increases your risk of insulin resistance and, therefore, diabetes type 2. Why? There are a few theories on that. It’s believed that visceral fat might cause two things. One, the accumulation of fat in the liver and muscle, which causes insulin resistance in both organs; and two, visceral fat causes the release of cytokines, and proteins that help with signaling in the body, which affects your whole body’s response to insulin.
Your liver is responsible for sugar creation (gluconeogenesis) and sugar storage (fatty acids, glycogen, and triglycerides– energy for later use). Insulin stops gluconeogenesis because it is a signal that there is enough sugar in your blood; there’s no need to make more. Insulin also promotes the creation of fatty acids (building blocks of triglycerides). If your liver is resistant to insulin, it won’t be able to stop gluconeogenesis, which contributes to high sugars, while still promoting fatty acid production and deposition as triglycerides. It is the reason why diabetes can also cause high cholesterol and triglycerides.
Your muscles are involved in the use of sugar. Insulin makes your muscles take up sugar from your bloodstream so it can do the work and grow. Insulin resistance causes your muscles to weaken. But there is good news here — The more you move, the more capable your muscles are in pulling sugar into itself for use. That’s why exercise is GOOD if you have diabetes. By exercising and using the tissue, you make it less resistant to insulin and allow the muscle to pull sugar into its cells and out of your bloodstream. It helps you control your blood sugar!
This brings me to the next risk factor.
Sedentary lifestyle – aka inactivity
The less you move, the less your body will respond to insulin. Exercise improves insulin sensitivity. So, being sedentary does the opposite. Inactivity also promotes obesity, which then increases your risk of developing diabetes. It’s a cycle, and each part contributes.✓
Disrupted sleeping behaviors
When your sleep is affected, the way your body responds changes. Hormones in your body change, and so does your response to them. Not sleeping well increases the release of ghrelin (hunger stimulation), and decreases leptin (fullness stimulation). So you will feel hungrier, less full, and you will eat more. It would not be an issue if you’re active, and you burn what you consume. However, if you don’t burn more calories than you consume, it will be deposited as fat. Do you see the cycle yet? Everything contributes!
Race and Ethnicity
The reason is that individual races and ethnicities have a higher prevalence of obesity and diabetes. It is part of your genetic pool. Therefore, being part of these groups also increases your risk of developing diabetes.✓
This does not mean that you WILL get diabetes. It indicates that you need to take extra measures to keep moving, have healthy eating habits, and sleep well to prevent obesity and the development of diabetes.
Races and ethnicities with a high prevalence of diabetes in the USA include:
- Native American
- African American
- Asian American
- Pacific Islander
(Not in order of highest to lowest. Just a general list)
Age and Gender
Females are at about 1.3-1.7 times higher risk of developing diabetes compared to males during adolescence. Many young girls have been diagnosed with diabetes around puberty, which is at about age 13-14. About 40% of cases occur around 10-14, while the other 60% occur at 15-19.
So imagine a Hispanic woman, with a family history of diabetes, who develops gestational diabetes during pregnancy, who was unable to lose all the “baby weight” and is now considered obese from a clinical standpoint.
Her risk of developing diabetes is even higher than if she was just a Hispanic woman or just a woman who had gestational diabetes. The risk of each of these is compounded, making her total risk much, much much higher.
I know, it sounds nearly impossible to avoid developing diabetes. BUT, you’re wrong! That is the fantastic thing about your body! The amounts of physical activity you do and the things you put in it have a huge effect on your body andhealth!
Catching the first signs of diabetes is crucial to prevent any complications of uncontrolled diabetes mellitus. Listed below are some significant symptoms of high blood sugar.
- Urinary frequency
- Increased thirst
- Feeling hungry even though you’re eating well
- Changes in your vision like blurry vision
- Tingling sensation in your hands or feet
- Weight loss or weight gain
- Frequent infections
- Slow healing cuts or ulcers
DIAGNOSIS – Catch early signs of diabetes
As soon as you develop the first signs of diabetes, you should see a physician to evaluate you and develop a plan. There are a few ways to diagnose diabetes.✓
A fasting blood glucose level, a 2-hour oral glucose tolerance test, or Hemoglobin A1c.
Your A1c level is a percentage, which you should commit to memory. Hemoglobin is the protein within your red blood cells that helps carry oxygen throughout your body. This protein can become ‘glycated,’ meaning coated with sugar, in people with diabetes.
Your red blood cells can have a lifespan of 90 days unless you have a medical condition that causes earlier cell death.
The A1c is the AVERAGE, percentage amount of sugar-coating your red blood cells over those 90 days. So it gives you an average sugar level for the last three months.✓
Pre-diabetes has an A1c between 5.7 – 6.4% Diabetes has an A1c ≥ 6.5%
Critical information to grasp here is that as we get older, we are more sensitive to low sugar levels, and low sugar is more dangerous than high sugar. So, your goal A1c will be a bit different depending on your age. Make sure you review this with your doctor to ensure the medical management of your diabetes mellitus is tailored to you.
So how do you prevent the development of diabetes? Notice I didn’t ask, “CAN you prevent it?”. I asked, “How DO you prevent it?”.
Because you can.✓
Workout as much as you can, as often as you can. At least 60min of moderate to vigorous exercise daily in children and at least 30min a day 5x/week for adults.
Check out my other post on exercise to know the difference between moderate and vigorous workout.✓
At least 7-8 hours a night. It will help your body keep your ghrelin and leptin regulated and, therefore, your appetite and food consumption. It also improves your mood, so it doesn’t lead to less healthy food options and snacks. It also decreases your odds of developing diabetes.✓
Healthy Eating Choices
Eat colorful foods like fruits and veggies—Limit fried foods, junk food, sodas, etc.✓
It will help you feel more energy so you can keep moving throughout your day and help you maintain your weight.
Various ‘diets’ like the vegan diet, Mediterranean diet, and DASH diet have shown good efficacy at A1c reduction. But I will leave that to a different blog post too.✓
You should move more, have healthier eating habits, and get a good night’s rest every day. It is the best way to help prevent the development of diabetes. Moreover, it is also how you can reverse pre-diabetes and even control and manage diabetes without medications. Of course, there are times when even these things need an extra boost, and that is where your doctor will come in to help by prescribing blood sugar lowering medication. But a lot of it, in fact, most of it, depends on YOU.