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Understanding Diabetes: Causes, risk factors and what you can do to prevent it
General Wellness

Understanding Diabetes: Causes, risk factors and what you can do to prevent it

By Kristy Merritt, RN CDCES, Certified Diabetes Care and Education Specialist | Methodist Le Bonheur Germantown Hospital
Posted: March 24, 2021

Diabetes affects approximately 12% of people living in Shelby County. That number is higher than the national average of 10.5%.

By the year 2060, the rate of diabetes is projected to increase up to 17% nationwide. It is an issue both locally and around the country.

What is diabetes?

Diabetes is a disease in which the body does not make enough insulin — a hormone made by the pancreas — and/or does not properly use the insulin that the pancreas may still be making. There are two main types of diabetes: Type 1 and Type 2.

What is Type 1 Diabetes?

Type 1, which is COMPLETE insulin deficiency, is often times diagnosed in children. However, it can also occur in young adults.

Type 1 diabetes generally develops as a result of defective gene(s) and often times an environmental “trigger” causes a massive autoimmune response, in which the body attacks its own cells. Type 1 patients have to take lifelong insulin injections either by way of multiple daily injections/shots or by an insulin pump, which administers insulin in a continuous fashion.

What is Type 2 Diabetes?

Having type 2 diabetes means someone has inadequate amounts of insulin and insulin resistant cells. Type 2 commonly occurs in adults, with those ages 45 to 65 years being the most prevalent age range.

Type 2 diabetes is often referred to as “lifestyle diabetes.”

What are risk factors of Type 2 Diabetes?

Many times, we see some family history and genetic relationships among those receiving this diagnosis. Other risk factors — like age and ethnicity — can be strong predictors of who may get Type 2. A person’s diet, along with a lack of healthy food choices, can also be a predicting risk factor.

An individual’s height and weight (BMI), if elevated, can increase their likelihood of developing Type 2 diabetes. That is because extra body weight causes insulin resistance, which can slowly harm pancreatic function and insulin production/release until it is reduced to nothing or nearly nothing.

When food is consumed, the body breaks it down into its essential macronutrients (the good stuff) with glucose being the body’s energy producing nutrient. Like a see-saw, if insulin is too low, the blood sugar rises. Conversely, if insulin is too high, the blood sugar drops. This is essentially what Type 2 diabetes is — an imbalance that eventually leads to chronic metabolic dysfunction, resulting in elevated high blood sugar, which can cause short and long-term problems if left untreated.

An easy way to understand Type 2 diabetes is to say that the pancreas is “lazy” and the muscle and fat cells of the body are “hard-headed.”

How do I know if I have diabetes? What are the symptoms/side effects? 

The following tests are available to diagnose diabetes:

Fasting Glucose Test: Nothing to eat or drink when blood is drawn (or fingerstick sample)

Random Glucose Test: Food or drink is permitted when blood is drawn (or fingerstick sample)

Oral Glucose Tolerance Test: Preferred test to diagnose gestational diabetes (pregnancy-type diabetes)

A1C Test: The A1C test is a blood test that provides your average levels of blood glucose over the past three months. Other names for the A1C test are hemoglobin A1C, HbA1C, glycated hemoglobin, and glycosylated hemoglobin test. You can eat and drink before this test.

Are there any foods that trigger diabetes? Should I change my diet?

Consuming a high fat and/or high sugar diet can promote extra weight, because of the body’s inability to metabolize the extra calories. This causes weight gain, and weight gain can be a strong predictor of Type 2 diabetes development, especially as a person continues to age.

Extra weight acts a pressure or a burden on the pancreas and significantly negatively impacts the pancreas’s ability to make and release insulin in a normal, expected manner.

If someone has pre-diabetes — a condition that comes before Type 2 diabetes diagnosis — the nutrition recommendation and treatment plan is often focused on a low(er) fat meal plan, aiming to promote slow and steady weight loss, which can significantly improve insulin resistance. Often times, this will allow the pancreas to regain some of its insulin producing capabilities.

Once a Type 2 diabetes diagnosis is confirmed, the nutrition treatment plan is generally more focused on carbohydrates (AKA “sugars”). Control of blood sugar, regardless of a person’s weight, becomes the most important goal. This aims to prevent hyperglycemia, which is a term that means constant elevated blood sugar levels.

Is diabetes serious? What impact can it have on my health?

Diabetes can have a serious impact on your well-being if left undiagnosed and/or untreated.

Long term complications, like heart attacks and strokes, are the biggest problems. Other conditions include:

Kidney dysfunction, in which the kidneys aren’t able to effectively filter out toxic chemicals and/or substances that can make one feel “sick."

Poor blood flow, mainly in the legs, which can potentially lead to blood clots and/or nerve damage.

Skin irritations and/or infections are often times common. Wounds that develop on the legs and feet may not quite heal and/or become infected, which may lead to amputation.

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Is there anything I can do to control diabetes?  

Yes! You can monitor your blood sugar levels to make sure they remain within a normal range.

There are two ways you can monitor:

With a fingerstick using a Blood Glucose Meter

With a continuous Glucose Sensor, which is a device that is attached to the body and reads the sugar levels through the fluid that circulates in-between the skin and top layer of the muscle

These methods of monitoring your blood sugar levels are a great way to see what your blood sugar is doing either in a fasting state (no food) or in a state with food.

Many people with diabetes aim to keep their blood glucose at these normal levels:

Before a meal: 80 to 130 mg/dL

About 2 hours after a meal starts: less than 180 mg/dL(80mg/dl – 180 mg/dl)

Other helpful ways to control your diabetes involve eating a consistent carbohydrate meal plan with a variety of food from all of the food groups. Seeing a Certified Diabetes Education and Care Specialist and/or a Registered Dietitian can be a great way to get help with nutrition!

Being physically active at least 10 minutes a day doing something that you enjoy is a great way to promote physical well-being and may help to promote a better overall blood sugar response.

Getting enough sleep is also very important, because the lack of sleep or poor sleep quality is highly associated with a constant stress response. This can result in Chronic Fatigued Syndrome and may make one’s risk of having a heart attack or stroke more likely.

What is the best treatment for diabetes?

Making healthier food choices and being mindful of carbohydrate (sugar) proportions is key to successful blood sugar outcomes. Following a carbohydrate consistent meal plan gives the best assurance that the blood sugar will not have a “yo-yo” effect, which is what skipping meals and overeating tend to do.

You can meet with a Certified Diabetes Care and Education Specialist (CDCES) and a Registered Dietitian (RD). They can help provide education and support needed to make behavioral lifestyle changes. They can also help with personal goals to help ensure your greatest potential for success.

What treatment options does Methodist offer for people with diabetes?

Methodist offers a variety of classes and educational opportunities to help you understand and manage your diabetes.

Methodist Le Bonheur Germantown Hospital has an Outpatient Diabetes Education Clinic that is nationally recognized and accredited by the American Diabetes Association (ADA). The clinic treats adult clients, age 18 and older, with the following types of diabetes conditions: pre-diabetes, gestational diabetes, Type1 and Type 2 diabetes.

Both Methodist North Hospital and Methodist South Hospital offer interactive classes and support groups to help you make lifestyle changes, understand your medications, eat healthier and connect with others living with diabetes.

Le Bonheur Children’s Hospital also has ADA recognition. They treat children who are ages 18 and younger for pre-diabetes, Type 1 and Type 2 diabetes.

I’m afraid to go to the hospital right now. Should I delay my diabetes treatment?

It is highly recommended that those with a pre-existing diabetes condition that is not well controlled seek treatment recommendations from their healthcare provider.

Virtual visits via telehealth and telephone may be options in place of an in-person visit.