What is Diabetes?
- A long-lasting health condition that affects how your body turns food into energy
- Your body breaks down food into sugar and releases it into your bloodstream. When your blood sugar goes up, your pancreas releases insulin, which allows the blood sugar to go into your body’s cells to use as energy.
- Diabetes prevents your body from making enough insulin or from using it as well as it should. When there isn’t enough insulin or cells aren’t responding to insulin, too much blood sugar stays in your bloodstream which can cause serious health problems.
Main Types of Diabetes
Type 1 diabetes is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed, which prevents your body from making insulin. Up to 10% of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults but can develop at any age, and symptoms can develop quickly. People with Type 1 diabetes need to take insulin every day.
With Type 2 diabetes, your body doesn’t make enough insulin or your body’s cells don’t respond normally to the insulin. This is the most common type of diabetes, and up to 95% of people with diabetes have Type 2. It develops over many years and is usually diagnosed in adults, but it is becoming more common for children, teens, and young adults to be diagnosed. Because it is easy to not notice any symptoms, it’s important to get your blood sugar tested if you’re at risk.
Gestational diabetes develops in pregnant women who have never had diabetes, and it usually goes away after your baby is born. It does however increase your risk for type 2 diabetes later in life and causes your baby to be at a higher risk for health problems. Your baby is more likely to have obesity as a child or teen and develop type 2 diabetes later in life.
Type 1 Diabetes
Risk factors for Type 1 diabetes include:
- Having a family history (parent or sibling) of Type I diabetes.
- You can get type 1 diabetes at any age, but it usually develops in children, teens, or young adults.
Type 2 Diabetes
Risk factors for Type 2 diabetes include:
- Having prediabetes
- Being overweight
- Being 45 or older
- Having a family history (parent or sibling) with Type 2 diabetes
- Being physically active less than 3 times a week
- Previously having gestational diabetes
- Giving birth to a baby weighing over 9 lbs
- Being African American, Hispanic or Latino, American Indian, or Alaska Native person Some Pacific Islanders and Asian American people are also at higher risk
- Having non-alcoholic fatty liver disease
Risk factors for gestational diabetes include:
- Previously having gestational diabetes
- Giving birth to a baby weighing over 9 lbs
- Being overweight.
- Being older than 25
- Having a family history of type 2 diabetes
- Having polycystic ovary syndrome, a hormone disorder
- Being African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander person.
How to Manage Diabetes
Carbohydrates often have the biggest impact on your blood sugar levels. For people taking mealtime insulin, it’s important to know the amount of carbohydrates in your food, so you get the proper insulin dose.
- Learn what portion size is appropriate for each food type.
- Make every meal well balanced. Plan for every meal to have a good mix of starches, fruits and vegetables, proteins, and fats. Pay attention to the types of carbohydrates you choose.
- Talk to your doctor, nurse or dietitian about the best food choices and the appropriate balance of food types.
- Coordinate your meals and medications. The amount of food in proportion to your diabetes medications, especially insulin, may result in dangerously low blood sugar (hypoglycemia) or dangerously high blood sugar (hyperglycemia).
- Avoid sugar-sweetened beverages. These tend to be high in calories and cause blood sugar to rise quickly.
Regular physical activity helps your body use insulin more efficiently. The more strenuous your workout, the longer the effect lasts.
- Talk to your doctor about an exercise plan. Ask your doctor about what type of exercise is appropriate for you. Most adults should get at least 150 minutes a week of moderate aerobic activity.
- Keep an exercise schedule. Talk to your doctor about the best time of day to exercise so your workout routine is coordinated with your meal and medications.
- Know your numbers. Talk to your doctor about what blood sugar levels are appropriate for you before you begin exercise.
- Check your blood sugar level. Check your blood sugar level before, during and after exercise. Exercise can lower your blood sugar levels even up to a day later. Be aware of warning signs of low blood sugar.
- Stay hydrated. Drink plenty of water or other fluids while exercising because dehydration can affect blood sugar levels.
- Be prepared. Always have a small snack or glucose tablets with you during exercise in case your blood sugar level drops too low. Wear a medical identification bracelet.
- Adjust your diabetes treatment plan as needed. Your doctor can advise you on appropriate changes in your medication.
Insulin and other diabetes medications are designed to lower your blood sugar levels, but the effectiveness of these medications depends on the timing and dosage.
- Store insulin properly. Insulin that’s improperly stored or past its expiration date may not be effective. Insulin is especially sensitive to extremes in temperature.
- Report problems to your doctor. If your diabetes medications cause your blood sugar level to drop too low or if it’s consistently too high, the dosage or timing may need to be adjusted.
- Be cautious with new medications. If you’re considering an over-the-counter medication or your doctor prescribes a new drug to treat another condition — such as high blood pressure or high cholesterol — ask your doctor or pharmacist if the medication may affect your blood sugar levels.
Always check with your doctor before taking any new over-the-counter medication, so you know how it may impact your blood sugar level.
When you’re sick, your body produces stress-related hormones that help your body fight the illness, but they also can raise your blood sugar level. Changes in your appetite and normal activity also may complicate diabetes management.
- Plan ahead. Work with your doctors to create a sick-day plan. Know what medications to take, how often to measure your blood sugar and urine ketone levels, how to adjust your medication dosages, and when to call your doctor.
- Continue to take your diabetes medication. However, if you’re unable to eat because of nausea or vomiting, contact your doctor. You may need to adjust your insulin dose. It is important to monitor your blood sugars frequently when you are sick, and your doctor may instruct you also to check your urine for the presence of ketones.
- Stick to your diabetes meal plan. Eating as usual will help you control your blood sugar level and always keep a supply of foods that are easy on your stomach.
- Stay hydrated. Drink lots of water or other fluids that don’t add calories to make sure you stay hydrated. If you’re taking insulin, you may need to sip sugar-sweetened beverages to keep your blood sugar level from dropping too low.
The liver normally releases stored sugar to counteract falling blood sugar levels. But if your liver is busy metabolizing alcohol, your blood sugar level may not get the boost it needs from your liver resulting in low blood sugar.
- Get your doctor’s OK to drink alcohol. Alcohol can aggravate diabetes complications, such as nerve damage and eye disease. But if your diabetes is under control and your doctor agrees, an occasional alcoholic drink is fine.
- Don’t drink alcoholic beverages on an empty stomach. If you take insulin or other diabetes medications, be sure to eat before you drink, or drink with a meal to prevent low blood sugar.
- Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates than do other alcoholic drinks. If you prefer mixed drinks, sugar-free mixers won’t raise your blood sugar.
- Tally your calories. Remember to include the calories from any alcohol you drink in your daily calorie count.
- Check your blood sugar level before bed. Because alcohol can lower blood sugar levels long after you’ve had your last drink, check your blood sugar level before you go to sleep.
Menstruation and menopause
Changes in hormone levels the week before and during menstruation can result in significant fluctuations in blood sugar levels.
- Look for patterns. Keep careful track of your blood sugar readings from month to month.
- Adjust your diabetes treatment plan as needed. Your doctor may recommend changes in your meal plan, activity level or diabetes medications to make up for blood sugar variation.
- Check blood sugar more frequently. If you’re likely approaching menopause or experiencing menopause, talk to your doctor about whether you need to monitor your blood sugar level more often. Symptoms of menopause are sometimes confused with symptoms of low blood sugar.
- Most forms of birth control can be used by women with diabetes without a problem. However, oral contraceptives may raise blood sugar levels in some women.
If you’re stressed, the hormones your body produces in response to prolonged stress may cause a rise in your blood sugar level.
- Look for patterns. Log your stress level on a scale of 1 to 10 each time you log your blood sugar level. A pattern may soon emerge.
- Take control. Once you know how stress affects your blood sugar level, fight back. Learn relaxation techniques, prioritize your tasks and set limits. Exercise can often help relieve stress and lower your blood sugar level.
- Get help. Learn new strategies for coping with stress. Working with a psychologist or clinical social worker can help you identify stressors, solve stressful problems or learn new coping skills.
Diabetes by the Numbers
The Big Picture
- 96 million US adults—over a third—have prediabetes.
- Diabetes is the 7th leading cause of death in the United States
- Type 2 diabetes accounts for approximately 90% to 95% of all diagnosed cases while Type 1 diabetes accounts for approximately 5-10%.
- In the last 20 years, the number of adults diagnosed with diabetes has more than doubled as the American population has aged and become more overweight.
- 37.3 million people have diabetes.
- 28.7 million people have been diagnosed with diabetes while 8.5 million people are undiagnosed.
Type 1 Diabetes
- 64,000 people are diagnosed each year in the U.S.
- 2.1 million people in the U.S. are expected to have Type 1 diabetes by 2040.
- Between 2001 and 2009, there was a 21% increase in the prevalence of Type 1 diabetes in people under age 20.
- In the United States, there is $16 billion in Type 1 diabetes-associated healthcare expenditures and lost income annually.
- Less than one-third of people with Type 1 diabetes in the U.S. are consistently achieving target blood-glucose control levels.
Type 2 Diabetes
- most common form of diabetes.
- affecting more than 34 million Americans, or just over 10% of the U.S. population.
- an estimated 6.28% of the world’s population is impacted by type 2 diabetes.
- That number is expected to rise to 7,079 individuals per 100,000 people by 2030.
- over one million people die every year from type 2 diabetes, making it the ninth leading cause of death worldwide.
- Nearly 10 percent of pregnancies in the U.S. are affected by gestational diabetes every year.
- About 50% of women with gestational diabetes go on to develop type 2 diabetes
- Every year, 2% to 10% of pregnancies in the United States are affected by gestational diabetes.
- 96 million people aged 18 years or older have prediabetes (38.0% of the adult US population)
- 26.4 million people aged 65 years or older (48.8%) have prediabetes
Updates in Diabetes
- After almost 2 decades of continual increases, the incidence of newly diagnosed cases of diabetes in the United States decreased from 9.3 per 1,000 adults in 2009 to 5.9 per 1,000 adults in 2019.
- Prevalence of prediabetes among US adults remained steady from 2005–2008 to 2017–2020. However, notification of prediabetes status nearly tripled (from 6.5% to 17.4%).
- American Indian or Alaska Native, non-Hispanic Black, Hispanic, and non-Hispanic Asian people are more likely to be diagnosed with diabetes than non-Hispanic White people (14.5%, 12.1%, 11.8%, 9.5%, and 7.4%, respectively).
- During the COVID-19 pandemic, diabetes emerged as an underlying condition that increases the chance of severe illness. Nearly 4 in 10 adults who died from COVID-19 in the United States also had diabetes.
The above information was compiled from the following resources: