Diabetes Mellitus
For most persons with type 2 diabetes, every time you eat your body converts the foods you consume into glucose. Insulin is a hormone the body makes that enables the glucose to get into cells for use as energy. Someone with diabetes either lacks sufficient amounts of insulin or is unable to use the insulin they make. When insulin is absent or ineffective, the body is unable to get energy into cells and the level of glucose in the blood increases. Genetics, obesity, and lack of exercise appear to be causal factors in most cases of diabetes.
Type 1 Diabetes
Approximately 5–10 percent of known cases of diabetes are classified as type 1 diabetes. Type 1 diabetes was formerly referred to as juvenile-onset diabetes because the onset typically occurs before the age of thirty. Type 1 diabetes is an autoimmune disorder that is thought to develop when stress factors (such as a viral infection) damage or destroy the beta cells of the pancreas. The person with type 1 diabetes is always dependent upon insulin because their pancreas no longer produces insulin. Type 1 diabetes is usually not associated with obesity or lack of exercise.
Type 2 Diabetes
Type 2 diabetes affects the vast majority of individuals who have diabetes. For most type 2 diabetics, the pancreas still produces insulin, but it is being produced in insufficient amounts or the body is unable to use the insulin in an efficient way.
Type 2 diabetes is generally diagnosed in mid to late adulthood. Unfortunately, with the increase and prevalence of obesity among children, practitioners are now seeing children with type 2 diabetes as well.
Type 2 diabetes is usually related to a sedentary lifestyle and an over-weight or obese status. If diagnosed early enough, this form of diabetes can often be controlled with weight loss, proper eating habits, and exercise. It is important to understand that diabetes is a disease that progresses, and while it can be controlled, it cannot be cured. Over time, many persons with type 2 diabetes may require oral medications and/or insulin to effectively treat and manage the disease.
Gestational Diabetes
Gestational diabetes is similar to type 2 diabetes because the body still makes insulin; however, a hormone secreted by the placenta interferes with the action of insulin. The result is elevated blood glucose levels, usually starting around the twenty-fourth to twenty-eighth week of the pregnancy. In most cases, the pregnant woman's blood glucose returns to normal after the delivery of the baby and the diabetes is gone. A woman who has had gestational diabetes in the past has an increased risk of developing type 2 diabetes later in her life.
Gestational diabetes is usually treated in a similar way to type 2 diabetes, through proper eating habits, weight control, and exercise. If blood glucose does not normalize with these measures, it may become necessary to use insulin to control the diabetes for the duration of the pregnancy. Oral diabetic medications cannot be used during pregnancy.
The major health concerns with gestational diabetes are macrosomia (a fetus that has grown too large for normal delivery) and hypoglycemia (low blood sugar) in the infant after delivery.
Summary
Careful and routine monitoring of blood glucose is extremely important for all diabetics. Activity and timing of insulin, medications, and meals must be taken into consideration to prevent highs and lows.
When blood glucose is very low (hypoglycemia), the individual may exhibit symptoms of disorientation, sweating, hunger, shakiness, pale skin color, or dizziness. If hypoglycemia occurs, the blood glucose should be tested immediately to verify a low. Hypoglycemia needs to be treated by consuming a form of carbohydrate that can get into the bloodstream quickly. All persons with diabetes and particularly those with type 1 diabetes, should understand and know how to treat hypoglycemia. One procedure for treating hypoglycemia is known as the “Rule of 15”:
- Take 15 grams of carbohydrate (4 ounces of juice or soda, 4 glucose tablets, or 5–6 Life Savers).
- Test blood glucose in 15 minutes.
- Treat with another 15 grams of carbohydrate if blood glucose is still low.
As you read this book, you will see the common theme of having a plan mentioned throughout. It is through planning and know-how that you will achieve optimal management of your diabetes.
