Diabetes 101: The Basics

By Kendra Butner, BC-FNP, MBA, CDCES 

Over the past several years, I’ve seen an increase in patient demand for diabetes management support more than any other time in my 30-year healthcare tenure. More and more of the population struggle with diabetes, not only from a health perspective but also from a cost and time-management perspective.

In fact, it’s been estimated that about 1 in 3 will be diagnosed with diabetes by 2025. In addition to affecting more patients, this will significantly impact our healthcare system and patients’ loved ones. As a provider, I believe preventative education is crucial to help minimize this impact we’re trending toward.

In this article, I break down the basics of diabetes, what are some common signs, and how diabetes can be prevented.

What is diabetes?

Diabetes is a chronic disease in which the body is not producing enough insulin to convert blood sugar to energy for the body’s use. This can potentially keep too much blood sugar in the body’s circulation and cause harmful effects to the body, such as kidney failure and heart disease.

What causes diabetes?

Type 1 diabetes is caused by an assault on the pancreas that causes it to not work anymore. This dysfunction may be due to a person’s own body attacking itself or a virus that attacked it, causing the pancreas to no longer produce insulin. Patients managing type 1 diabetes usually are still sensitive to insulin and, in most cases, use small amounts of insulin to control their diabetes. They also must monitor their blood sugars closely to control them and to be safe.

Type 2 diabetes results from insulin resistance, or when a patient’s body just “wears out” sooner than it should from overworking. Insulin resistance can be caused by genetics (passed down through the family), obesity (fat cells are very insulin resistant), eating a lot of very foods containing a high carbohydrate amount (soda or sweets), or certain medications (like long-term use of steroids). Usually, someone will be in a pre-diabetic or borderline-diabetic state for about 6-10 years before they are diagnosed with type 2 diabetes. By the time of diagnosis, the ability of the pancreas to produce insulin is mostly gone and blood sugars start to increase.

What is the difference between Type 1 and Type 2 Diabetes?

Believe it or not, there is a difference between type 1 and type 2 diabetes. Many people think that just because someone is using insulin to treat their diabetes that they must be a type 1 diabetic. But, that’s not the case.

  • Patients with type 1 must use insulin at all times. This is because their pancreas has stopped producing insulin. Patients must obtain insulin either through injections or through an insulin pump. This helps ensure that the patients are receiving the appropriate dosage amount.
  • Patients with type 2 diabetes still have some insulin being produced by the pancreas. They also may be able to use some oral medications or injections (that are not insulin) to help manage their blood sugars. However, some of these medications used to manage type 2 diabetes cannot be used for type 1 diabetes management. It is important that your doctor discuss your options to have a safe treatment plan. Medications for diabetes can be very patient-specific for certain safety concerns.

What are some of the signs that a person may have diabetes, and how can I prevent it?

I recommend that patients receive a fasting glucose screening with their yearly exam to ensure diabetic signs are not present. Having at least three of the following metabolic issues are signs that a patient might have diabetes:

  • Family history of diabetes
  • High triglycerides
  • Fasting blood sugar of 100 or more
  • Waistline greater than 35 inches (obesity)
  • Hypertension
  • An A1c of 5.7-6.4

Other signs of diabetes include:

  • Unexplained weight loss – This is a sign that nutrients are not getting into the cells from the aid of insulin.
  • Being thirstier – This implies that a patient’s cells are getting dehydrated and the body will start breaking down other components to give the body its energy.
  • Being tired – Without energy, a person will be tired and may feel irritable.
  • Nerve pain – If a patient has had diabetes for a while, nerve pain or tingling in their feet may become an issue.

Smoking and stress can also contribute to the early onset of diabetes. Be mindful if either of these impacts your life. Preventing obesity is a major factor in helping prevent diabetes. Limiting grams of carbohydrates to no more than 30-35 per meal for a woman and 40-45 for a male is a good start. Limit snacks to 15-20 gm. Limit to 90 gm carbohydrates a day if you need to lose weight. Avoiding starches like potatoes, pasta, rice, bread, and bananas is also very helpful. These starches provide a lot of sugar to the system, which will turn into fat if you don’t burn it off. Also, exercise!