How do people know if they have diabetes?
In many cases of Type II diabetes, there are no symptoms in the early stages of the disease. People can live for months, even years without knowing they have the disease. This form of diabetes comes on so gradually that symptoms may not even be recognized. This is why it is so important to have your blood glucose tested.
A general tiredness and lack of energy are the most common symptoms for pre-diabetics.
You are at risk if you:
- Drink more than 2 sodas a day.
- Eat large meals (over 1500 calories)
- Eat more starchy or sugary foods on a regular basis (Bread, Pasta, rice, tortias, potatoes) (Snack foods, candy, sweetned fruit juices, etc)
- Get little exercise
This is why it is so important to have your blood glucose levels tested when you see your doctor.
People with advanced type II or type I diabetes where the body is producing little or no insulin people experience certain symptoms. These include:
- being very thirsty
- frequent urination
- weight loss
- increased hunger
- blurry vision
- tingling or numbness in the hands or feet
- frequent skin, bladder or gum infections
- wounds that don''t heal
- extreme unexplained fatigue
Again a simple blood glucose meter will be able to tell you if your glucose levels are in a healthy range.
What is diabetes?
Diabetes is a disease in which the body is unable to properly use and store glucose (a form of sugar). Glucose backs up in the bloodstream — causing one’s blood glucose (sometimes referred to as blood sugar) to rise too high. This elevated glucose level is harmful to the body.
There are two major types of diabetes.
Type 1 (formerly called juvenile-onset or insulin-dependent) diabetes, the body completely stops producing any insulin, a hormone that enables the body to use glucose found in foods for energy. People with type 1 diabetes must take daily insulin injections to survive. This form of diabetes usually develops in children or young adults, but can occur at any age.
Type 2 (formerly called adult-onset or non insulin-dependent) diabetes results when the body doesn’t produce enough insulin and/or is unable to use insulin properly (insulin resistance). This form of diabetes usually occurs in people who are over 40, overweight, and have a family history of diabetes, although today it is increasingly occurring in younger people, particularly adolescents.
What is pre-diabetes and how is it different from diabetes?
Pre-diabetes is the state that occurs when a person''s blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.
A person with pre-diabetes has a fasting blood glucose level between 100 and 125 mg/dl.
If the blood glucose level rises to 126 mg/dl or above, a person has diabetes.In the American Diabetes association testing About 11 percent of people with pre-diabetes in the Diabetes Prevention Program standard or control group developed type 2 diabetes each year during the average 3 years of follow-up. Other studies show that many people with pre-diabetes develop type 2 diabetes in 10 years.
Pre-diabetes should be taken seriously, and is an indication of the body functioning in a reduced capacity.
According to the National Diabetes Information Clearing House (NDIC)
Pre-diabetes among People Ages 20 Years or Older, United States, 2010
Pre-diabetes is a condition in which individuals have blood glucose, also called blood sugar, or A1C levels higher than normal but not high enough to be classified as diabetes. People with pre-diabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke.
Studies have shown that people with pre-diabetes who lose weight and increase their physical activity can prevent or delay type 2 diabetes and in some cases return their blood glucose levels to normal.
In 2005–2008, based on fasting glucose or A1C levels, 35 percent of U.S. adults ages 20 years or older had pre-diabetes—50 percent of those ages 65 years or older. Applying this percentage to the entire U.S. population in 2010 yields an estimated 79 million Americans ages 20 years or older with pre-diabetes.
On the basis of fasting glucose or A1C levels, and after adjusting for population age differences, the percentage of U.S. adults ages 20 years or older with pre-diabetes in 2005–2008 was similar for non-Hispanic whites, 35 percent; non-Hispanic blacks,35 percent; and Mexican Americans, 36 percent.
Using a different data source than for other race/ethnicity groups, a different age group, and a different definition on the basis of fasting glucose levels only, and after adjusting for population age differences, 20 percent of American Indians ages 15 years or older had pre-diabetes in 2001–2004.
Diagnosed and Undiagnosed Diabetes among People Ages 20 Years or Older, United States, 2010
Number or percentage who have diabetes
Ages 20 years or older
25.6 million, or 11.3 percent, of all people in this age group
Ages 65 years or older
10.9 million, or 26.9 percent, of all people in this age group
13.0 million, or 11.8 percent, of all men ages 20 years or older
12.6 million, or 10.8 percent, of all women ages 20 years or older
15.7 million, or 10.2 percent, of all non-Hispanic whites ages 20 years or older
4.9 million, or 18.7 percent, of all non-Hispanic blacks ages 20 years or older
New Cases of Diagnosed Diabetes
What are safe Glucose Levels?
A blood glucose test measures the amount of a type of sugar, called glucose, in your blood.
Results are often ready in 1 to 2 hours. Glucose levels in a blood sample taken from your vein (called a blood plasma value) may differ a little than glucose levels checked with a finger stick.
Fasting blood glucose:
70-99 milligrams per deciliter (3.9-5.5mmol/L)
2 hours after eating (postprandial):
70-145 mg/dL (3.9-8.1 mmol/L)
70-125 mg/dL (3.9-6.9 mmol/L)
Normal results may vary from lab to lab. Many conditions can change your blood glucose levels. Your doctor will discuss any significant abnormal results with you in relation to your symptoms and past health.
You may have diabetes. But your doctor will not use just one test result to diagnose you with the condition.
The American Diabetes Association (ADA) criteria for diagnosing diabetes are met when any of the following results have been repeated on at least two different days:
- A fasting blood glucose level is 126 mg/dL (7.0 mmol/L) or higher.
- A 2-hour oral glucose tolerance test result is 200 mg/dL (11.1 mmol/L) or higher. For more information, see the medical test Oral Glucose Tolerance Test.
- Symptoms of diabetes are present and a random blood glucose test is 200 mg/dL (11.1 mmol/L) or higher. Symptoms of diabetes include increased thirst and frequent urination (especially at night), unexplained increase in appetite, unexplained weight loss, fatigue, erection problems, blurred vision, and tingling or numbness in the hands or feet.
- If your fasting blood glucose level measures in the range of 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L), you are considered to have prediabetes(impaired fasting glucose), and you have an increased chance of getting diabetes.
- Other conditions that can cause high blood glucose levels include severe stress,heart attack, stroke, Cushing''s syndrome, medicines such as corticosteroids, or excess production of growth hormone (acromegaly).
A fasting glucose level below 40 mg/dL (2.2 mmol/L) in women or below 50 mg/dL (2.8 mmol/L) in men that is accompanied by symptoms of hypoglycemia may mean you have an insulinoma, a tumor that produces abnormally high amounts of insulin.
Low glucose levels also may be caused by:
- Addison''s disease.
- Decreased thyroid hormone levels (hypothyroidism).
- A tumor in the pituitary gland.
- Liver disease, such as cirrhosis.
- Kidney failure.
- Malnutrition or an eating disorder, such as anorexia.
- Medicines used to treat diabetes.
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
- Eating or drinking less than 8 hours before a fasting blood test or less than 2 hours before a 2-hour postprandial test.
- Drinking alcohol.
- Illness or emotional stress, smoking, and caffeine.
Taking a medicine, such as birth control pills, medicines used to treat high blood pressure, phenytoin (Dilantin), furosemide (Lasix), triamterene (Dyrenium, Dyazide),hydrochlorothiazide (Esidrix, Oretic), niacin, propranolol (Inderal), or corticosteroids (prednisone), can cause changes in your test results. Make sure that your doctor knows about any medicines you take and how often you take them.
What is insulin Resistance?
Insulin is a hormone produced by the pancreas that helps unlock the body''s cells so that sugar (glucose) from the food we eat can be used by the cells for energy. In people with type 2 diabetes, a combination of problems occurs, and scientists aren''t really sure which is the chicken and which is the egg.
The person''s body may not be producing enough insulin to meet their needs, so some glucose can''t get into the cells. Glucose remains in the bloodstream, causing high blood glucose levels. In many cases, the person may actually be producing more insulin than one might reasonably expect that person to need to convert the amount of food they''ve eaten at a meal into energy. Their pancreas is actually working overtime to produce more insulin because the body''s cells are resistant to the effects of insulin. Basically the cells, despite the presence of insulin in the bloodstream, don''t become unlocked and don''t let enough of the glucose in the blood into the cells.
Scientists don''t know exactly what causes this insulin resistance, and many expect that there are several different defects in the process of unlocking cells that cause insulin resistance. Medications for type 2 diabetes focus on different parts of this insulin-cell interaction to help improve blood glucose control. Some medications stimulate the pancreas to produce more insulin. Others improve how the body uses insulin by working on this insulin resistance. Physical activity also seems to improve the body''s ability to use insulin by decreasing insulin resistance, which is why activity is so important in diabetes management.
Can I Exercise with Diabetes? (the Mayo Clinic advises)
Exercise can be very helpful for diabetics, however there are some conditions that should be checked before during and after you exercise.
Before jumping into a fitness program, get your doctor''s OK to exercise — especially if you''ve been inactive. Discuss with your doctor which activities you''re contemplating and the best time to exercise, as well as the potential impact of medications on your blood sugar as you become more active.
For the best health benefits, experts recommend 150 minutes a week of moderately intense physical activities such as:
If you''re taking insulin or medications that can cause low blood sugar (hypoglycemia), test your blood sugar 30 minutes before exercising and again immediately before exercising. This will help you determine if your blood sugar level is stable, rising or falling and if it''s safe to exercise.
Consider these general guidelines relative to your blood sugar level — measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).
Lower than 100 mg/dL (5.6 mmol/L). Your blood sugar may be too low to exercise safely. Eat a small carbohydrate-containing snack, such as fruit or crackers, before you begin your workout.
100 to 250 mg/dL (5.6 to 13.9 mmol/L). You''re good to go. For most people, this is a safe pre-exercise blood sugar range.
250 mg/dL (13.9 mmol/L) or higher. This is a caution zone. Before exercising, test your urine for ketones — substances made when your body breaks down fat for energy. Excess ketones indicate that your body doesn''t have enough insulin to control your blood sugar. If you exercise when you have a high level of ketones, you risk ketoacidosis — a serious complication of diabetes that needs immediate treatment. Instead, wait to exercise until your test kit indicates a low level of ketones in your urine.
300 mg/dL (16.7 mmol/L) or higher. Your blood sugar may be too high to exercise safely, putting you at risk of ketoacidosis. Postpone your workout until your blood sugar drops to a safe pre-exercise range.
During exercise, low blood sugar is sometimes a concern. If you''re planning a long workout, check your blood sugar every 30 minutes — especially if you''re trying a new activity or increasing the intensity or duration of your workout.
This may be difficult if you''re participating in outdoor activities or sports. However, this precaution is necessary until you know how your blood sugar responds to changes in your exercise habits.
Stop exercising if:
Your blood sugar is 70 mg/dL (3.9 mmol/L) or lower
You feel shaky, nervous or confused
Eat or drink something to raise your blood sugar level, such as:
Two to five glucose tablets
1/2 cup (118 milliliters) of fruit juice
1/2 cup (118 milliliters) of regular (not diet) soda
Five or six pieces of hard candy
Recheck your blood sugar 15 minutes later. If it''s still too low, have another serving and test again 15 minutes later. Repeat as needed until your blood sugar reaches at least 70 mg/dL (3.9 mmol/L). If you haven''t finished your workout, continue once your blood sugar returns to a safe range.
After exercise, check your blood sugar right away after exercise and again several times during the next few hours. Exercise draws on reserve sugar stored in your muscles and liver. As your body rebuilds these stores, it takes sugar from your blood. The more strenuous your workout, the longer your blood sugar will be affected. Low blood sugar is possible even hours after exercise.
If you do have low blood sugar after exercise, eat a small carbohydrate-containing snack, such as fruit or crackers, or drink a small glass of fruit juice.
Exercise can be beneficial to your health in many ways, but if you have diabetes, testing your blood sugar before, during and after exercise may be just as important as the exercise itself.
How often should I be tested?A: If are under the age of 40 and your blood glucose levels are in the normal range, it is reasonable to be checked every 3 years. If you have prediabetes, you should be checked for type 2 diabetes every year after your diagnosis.
If you are over 40 years old we recommend testing your blood glucose levels every year I your glucose levels are normal If you are pre-diabetic and over 50 you should be testing monthly.
Is being Pre-Diabetic serious?
Studies have shown that blood glucose levels over 140 for any period of time actually damage the body and specifically the pancreas. Being pre-diabetic is not just a warning sign, it is an indication that your body is functioning in a compromised manner and that if not addressed may lead to a serious health condition with many negative health effects. Addressing this condition with your doctor at the early stages making nutritional and exercise changes may reduce the development of diabetes. People that do not address the pre-diabetic condition have been shown to develop diabetes in some cases over a period of 3 to 10 years.
Should children be screened for pre-diabetes?
Yes, pre-diabetes in children is the fastest growing segment of the diabetic population.
Diabetes is one of the most common chronic diseases in children and adolescents; About 215,000 people younger than 20 years had diabetes—type 1 or type 2—in the United States in 2010 this is over a 25% increase in the last 3 years. According to the National Diabetes Information Clearing House (NDIC)
- Each year, more than 13,000 young people are diagnosed with type 1 diabetes.
- Type 2 diabetes begins when the body develops a resistance to insulin and no longer uses the insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce sufficient amounts of insulin to regulate blood sugar.
- Health care providers are finding more and more children with type 2 diabetes, a disease usually diagnosed in adults aged 40 years or older.
- A statistically significant increase in the prevalence of type 2 diabetes among children and adolescents was found only for American Indians.
- The epidemics of obesity and the low level of physical activity among young people, as well as exposure to diabetes in utero, may be major contributors to the increase in type 2 diabetes during childhood and adolescence.
- Type 2 diabetes in children and adolescents already appears to be a sizable and growing problem among U.S. children and adolescents. Better physician awareness and monitoring of the disease’s magnitude will be necessary.
- Standard case definition(s), guidelines for treatment, and approval of oral hypoglycemic agents (to lower blood sugar) are urgently required for children and adolescents.
Children and adolescents diagnosed with type 2 diabetes are generally between 10 and 19 years old, obese, have a strong family history for type 2 diabetes, and have insulin resistance. Generally, children and adolescents with type 2 diabetes have poor glycemic control (A1C = 10% - 12%).
Preventing Diabetes Complications
According to the National Diabetes Information Clearing House (NDIC)
- Studies in the United States and abroad have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, every percentage point drop in A1C blood test results, for example, from 8.0 to 7.0 percent, can reduce the risk of microvascular complications—eye, kidney, and nerve diseases—by 40 percent. The absolute difference in risk may vary for certain subgroups of people.
- In patients with type 1 diabetes, intensive insulin therapy has long-term beneficial effects on the risk of cardiovascular disease.
Blood Pressure Control
- Blood pressure control reduces the risk of cardiovascular disease—heart disease or stroke—among people with diabetes by 33 to 50 percent and the risk of microvascular complications—eye, kidney, and nerve diseases—by about 33 percent.
- In general, for every 10 mmHg reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12 percent.
- No benefit of reducing systolic blood pressure below 140 mmHg has been demonstrated in randomized clinical trials.
- Reducing diastolic blood pressure from 90 mmHg to 80 mmHg in people with diabetes reduces the risk of major cardiovascular events by 50 percent.
[Control of Blood Lipids
- Improved control of LDL, or bad, cholesterol can reduce cardiovascular complications by 20 to 50 percent.
Preventive Care Practices for Eyes, Feet, and Kidneys
- Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50 to 60 percent.
- About 65 percent of adults with diabetes and poor vision can be helped by appropriate eyeglasses.
- Comprehensive foot care programs—ones that include risk assessment, foot-care education and preventive therapy, treatment of foot problems, and referral to specialists—can reduce amputation rates by 45 to 85 percent.
- Detecting and treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30 to 70 percent. Treatment with particular medications for hypertension called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) is more effective in reducing the decline in kidney function than is treatment with other blood pressure lowering drugs.
- In addition to lowering blood pressure, ARBs and ACE inhibitors reduce proteinuria, a risk factor for developing kidney disease, by about 35 percent.
Can and should I test my blood glucose levels at home?
Yes, however we do not recommend self-treatment for any disease. Testing is a critical part of a diabetic management plan and can be done at home in conjunction with your regular doctor visits. With any dietary exercise, and nutritional supplement plan testing is critical part to be able to measure progress and monitor your health condition effectively.
Glucose meters are available from many sources. They vary in price, accuracy and features. It is critical to find a meter with the highest accuracy, that compensates for maltose error, and requires no coding where possible errors can occur leading to false readings.
For diabetics with blood sugar levels over 180, measurement of ketone levels is is also recommended to avoid a serious health condition of ketosis.