1. Gattullo, Barbara Ann RN, ANP-BC, CDE, MS
  2. Edelman, Maryann RN, CNS, MS

Article Content

What is diabetes?

Diabetes is a disease that affects the way your body uses food. Most of the food you eat changes into glucose, or sugar, for your body to use as energy. The pancreas, an organ near the stomach, makes a hormone called insulin, which helps sugar get into the body's cells. The cells use sugar for energy.


When you have diabetes, your body either doesn't make enough insulin or it can't use the insulin that it makes. This causes you to have high blood sugar.


There are two types of diabetes-type 1 and type 2. In type 1 diabetes, the body doesn't make insulin. This type of diabetes often develops before age 30.


Most people with diabetes have type 2, which usually develops in adults over age 40. With type 2 diabetes, the body still makes insulin but the cells can't use it.


The cause of diabetes isn't known, but you may be more likely to have it if someone else in your family does.


How will I know if I have diabetes?

Your healthcare provider will look for certain well-known symptoms known as the "diabetes alert." These include the need to urinate often, extreme thirst or hunger, blurry vision, sores that won't heal, weakness and fatigue.


He'll also order one or more tests, which may include:


* Urinalysis. This looks for sugar in your urine.


* Fasting plasma glucose test. This test measures the sugar level in your blood. You'll have to stop eating and drinking for at least 8 hours before this test.


* Random (nonfasting) plasma glucose test. This test also measures the amount of sugar in your blood, but you don't have to stop eating or drinking before the test.


* Oral glucose tolerance test. For this test, you'll fast for at least 8 hours, then drink a sugary beverage.



How will my diabetes be treated?

Diet and lifestyle changes can help keep your blood sugar at a normal level and prevent other problems, such as blindness and kidney damage. Your healthcare provider may also prescribe medicine (see How does my diabetes medicine help me?). Some people with type 2 diabetes need to inject insulin if these changes don't control their blood sugar level.


Your healthcare provider may tell you to check your blood sugar level at home using a blood sugar meter. He'll tell you when and how often to check and what your level should be. Keep a daily record of your levels. If they're too high or too low, let your healthcare provider know.

Table. How does my d... - Click to enlarge in new windowTable. How does my diabetes medicine help me?

What are the possible complications?

Low blood sugar, or hypoglycemia, can occur in people taking medications for diabetes. Severe hypoglycemia can be dangerous because you may pass out. Signs to watch out for are feeling dizzy, nervous, weak, and shaky. You may also sweat, feel sleepy, confused, or hungry, or have trouble speaking. If your blood sugar level is 70 mg/dL or lower, eating or drinking any of these foods can help:


* one-half cup (4 ounces) of any fruit juice


* one-half cup (4 ounces) of a regular (not diet) soft drink


* one cup (8 ounces) of milk


* one or two crackers


* five or six pieces of hard candy


* one or two teaspoons of sugar or honey.



You can check your blood sugar level again after about 15 minutes, and if it's still too low, have another serving. You should always carry one of these foods with you.


Another possible complication of diabetes is hyperglycemia, or high blood sugar. It can cause poor vision, slow-healing cuts and sores, vaginal and skin infections, and nerve damage. Early signs include increased thirst, headaches, trouble concentrating, blurred vision, frequent urination, weight loss, and feeling weak and tired.


To keep your diabetes under control:


* Change your diet. Your healthcare provider and a nutritionist can help you plan meals that are low in fat, salt, sugar, and cholesterol. Cut calories if you're overweight. Limit your alcohol intake.


* Stop smoking. Besides raising your blood sugar level, smoking also damages your heart and kidneys.


* Exercise regularly. A balanced program of exercise and rest can help keep your blood sugar level stable. Check your blood sugar level before and after exercise. Always carry a carbohydrate snack (like crackers) to eat if you feel weak.



How can I prevent health problems?

Untreated or poorly controlled diabetes can damage your eyes, nerves, kidneys, heart, and cause erectile dysfunction in men. To avoid these complications:


* Take your medicine as prescribed. If you have unpleasant side effects, contact your healthcare provider.


* Have a complete eye exam once a year. Controlling your blood sugar level can prevent damage to your eyes.


* Take care of your teeth. People with diabetes have a higher risk of cavities and gum disease. Have regular checkups, brush after every meal, and floss daily.


* Protect your skin. Inspect your skin daily for dryness, cuts, redness, or any changes. Drink plenty of water (unless your healthcare provider wants you to limit fluids).


* Check your feet. Because diabetes may damage nerves in your feet, you may not feel small cuts and bruises. Check your feet every day for sores. If you feel any numbness, tingling, or burning in your feet, contact your healthcare provider immediately. Wear comfortable shoes that fit properly and never go barefoot.


* Keep an eye on your blood pressure and weight. Your healthcare provider will check your blood pressure at each visit; 130/80 or less is best.


* Watch your blood cholesterol level. Have it checked once a year. Your total cholesterol should be below 200 mg/dL.


* Find support. Your healthcare provider can tell you about diabetes support groups in your area so you can get tips for living with diabetes.