What is diabetes?
Just as a car needs to burn fuel to run, the body burns energy from food to keep working. Diabetes (die-uh-BEE-teez) affects the body's ability to use energy.
When food is digested, it is broken down into glucose (sugar), protein, and fat. These nutrients then move into the blood. Sugar is the basic source of fuel for many of the body's organs. The body produces a hormone called insulin that "unlocks" the cells of the body and lets sugar move from the blood into the cells, where it can be used for energy. Insulin's job is to tightly control the amount of sugar in the blood and keep it within a narrow range.
In people with diabetes, either the body does not make enough insulin, or it does not respond to the action of the insulin. As a result, the amount of sugar in the blood is not properly controlled by insulin and builds up in the blood, becoming too high. Over time, too much sugar in the blood can cause serious medical problems in the different organs in the body.
There are two main types of diabetes:
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Type 1 diabetes -- People with type 1 diabetes do not make insulin at all. Only about 5% to 10% of all people with diabetes have type 1 diabetes. |
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Type 2 diabetes -- Type 2 diabetes is far more common than type 1 diabetes. People with type 2 diabetes do not make enough insulin or the body cannot respond to the insulin the right way. |
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What causes diabetes?
In type 1 diabetes, the body's immune system (the system for fighting infection) destroys cells in the pancreas (a large gland behind the stomach) that make insulin. Scientists do not know why this happens.
In the early stages of type 2 diabetes, the pancreas makes some insulin, but the body has trouble responding to it. This condition is called insulin resistance. Over time, the pancreas also makes less insulin. This leads to a build-up of glucose (sugar) in the blood. Again, scientists do not know why.
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Who is more likely to have diabetes?
Type 2 diabetes usually occurs in adults. The people who are at the greatest risk for developing diabetes include those who:
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Are 45 years or older |
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Are overweight |
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Have a family member (a parent, brother, or sister) with diabetes |
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Are not physically active |
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Are African-American, Latino, Native American, Asian-American, or Pacific Islander |
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Have had high levels of blood sugar in the past |
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Had a baby weighing more than 4.8 kg |
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Have high blood pressure (greater than 140/90 mmHg in adults) |
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Have low HDL ("good") cholesterol (less than or equal to 0.9 mmol/L) |
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Have a high level of fats (triglycerides) in the blood (greater than or equal to 2.8 mmol/L) |
Diabetes occurs more often in people after age 40. If you are 40 years or older, talk with your healthcare provider about being tested for diabetes, especially if you are overweight. If your results are normal, the Canadian Diabetes Association (CDA) suggests you be retested every 3 years.
Regardless of your age, if you are overweight and have one or more of the risk factors listed above, the CDA suggests that you be tested for diabetes, and then retested more often.
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What are the signs or symptoms of diabetes?
Many people with type 2 diabetes have no symptoms at all. However, others have one or more of the following symptoms:
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Being unusually thirsty |
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Having to urinate a lot |
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Feeling hungry all the time |
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Losing weight (without trying) |
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Having blurry vision |
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Feeling very tired |
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Having frequent infections |
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Having cuts and sores that heal slowly |
Because most of these symptoms seem harmless, many people do not report them to their healthcare provider. This often delays the diagnosis of diabetes. As many as half of all Canadians with diabetes, or about 1 million people, are undiagnosed.
Most people have had diabetes for 10 years before they are diagnosed. During this time, other medical problems caused by high blood sugar may slowly begin to develop, such as eye problems and heart disease. That's why it's important to be aware of the risk factors for diabetes as well as the symptoms. You should be screened early if you have some of these risk factors or symptoms.
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How is diabetes diagnosed?
Your healthcare provider can recommend a blood test to see if you have diabetes. This test measures the level of glucose (sugar) in the blood.
The easiest test to diagnose diabetes is to measure your fasting plasma glucose (FPG). For this test, you fast (do not eat or drink anything except water) for at least 8 hours before having your blood drawn the next morning. If your fasting blood glucose value is 7 mmol/L or more, the test will be repeated on a different day. A fasting blood glucose value of 7 mmol/L or more on 2 different days means that you have diabetes.
Another test that maybe used for diagnosing diabetes is the Oral Glucose Tolerance Test (OGTT). For this test, your blood glucose is measured 2 hours after you drink a glucose (sugar)-containing drink. If your blood glucose value is 11 mmol/L or more on 2 different days that means you have diabetes.
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What are my treatment choices?
The goals in treating diabetes are:
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Lowering blood glucose (sugar) level |
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Keeping it as close to normal as possible |
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Controlling blood pressure and blood cholesterol |
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Preventing serious health problems related to diabetes |
There are several things you can do to try to reach these goals:
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Eat healthy. |
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Get active. |
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Maintain a healthy weight. |
These 3 things can help your body better use insulin.
If your blood sugar still remains high, your healthcare provider may prescribe diabetes pills, insulin shots, or both.
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Some diabetes pills work by helping the body release more insulin from the pancreas. This helps lower blood sugar. |
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Some pills work by helping the body respond better to the insulin it already makes. |
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Some pills work to keep the body from changing certain foods into glucose. |
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Insulin shots can give your body the insulin it needs if your body does not make enough. |
You may have to take one or more of these medicines to control your blood sugar. However, not everyone with type 2 diabetes has to take medicine. Some people with type 2 diabetes can control their blood glucose levels with healthy eating, weight loss, and exercise. Your healthcare provider will work with you to design a treatment plan that is right for you.
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Do I have to treat diabetes?
Yes. Although there is no cure for diabetes, people who have it can lead long, healthy lives. Controlling blood glucose (sugar) levels with meal planning, physical activity, and medicine can help you stay healthy.
If diabetes is not treated, serious health problems can occur, such as:
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Heart disease (heart attack) |
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Stroke |
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Kidney disease or kidney failure |
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Eye problems, such as problems with tiny blood vessels in the back of the eye called retinopathy (reh-tih-NAH-puh-thee), and blindness |
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Nerve damage |
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Skin problems |
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Foot problems |
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Gum disease |
You can help prevent these health problems by carefully following a treatment plan and checking blood sugar levels at home regularly.
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What can I do to help manage my diabetes?
Work closely with your healthcare provider. Together you can set health goals and come up with a plan to care for your diabetes. Here are some tips:
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Follow your meal plan and exercise plan. |
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If you are overweight, lose weight. |
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Check your blood glucose (sugar) levels. Ask your healthcare provider how often you need to check your levels. Recommended goals for blood sugar levels are 6.1 mmol/L or less before breakfast (fasting glucose [FPG]), and 7.7 mmol/L or less 2 hours after meals (post-meal glucose [PPG]). |
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Get regular checkups that include:
- An A1C test. The A1C test measures your average blood glucose over the previous 3 months. The generally recommended goal for A1C is 6.5% or less.
- A blood pressure check. The generally recommended goal for blood pressure is less than 130/80 mmHg.
- A blood lipid test. The generally recommended goals are:
* Less than 2.5 mmol/L for LDL ("bad") cholesterol
* Less than 1.6 mmol/L for triglycerides
* More than 1.0 mmol/L for HDL ("good") cholesterol for men, and more than 1.2 mmol/L for women |
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Have your urine tested every year for protein to check for the early signs of kidney damage. |
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If your test results do not meet your goal numbers, talk with your healthcare provider about what you can do. |
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Ask your healthcare provider to check your feet for scrapes, cuts, ingrown nails, or loss of feeling. |
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Have a dilated eye exam every year by an eye doctor (ophthalmologist or optometrist). |
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Take your diabetes medicines exactly as directed. |
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What questions might I ask my healthcare provider about treating diabetes?
Asking questions can help you learn more about diabetes. You may want to ask some of these questions
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What are my treatment choices? |
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What are the side effects of treatment? |
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What can I do to protect myself from the complications of diabetes? |
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Can you recommend someone to help me set up a meal plan and exercise plan to help control my diabetes? |
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How often and when do I need to check my blood glucose (sugar) levels? Who can teach me how to do this? |
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What are my goal numbers for A1C, blood sugar, blood lipids, and blood pressure? |
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Am I meeting my diabetes goals? If not, what can I do to meet them? |
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How often do I need to have a check-up for my diabetes? |
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