Diabetes is one of the most common chronic diseases in the U.S. More than 37 million people — or one in 10 — have diabetes.
“Diabetes causes high levels of sugar in your blood,” says Loyola Medicine endocrinologist Madalina Ionescu, MD.
“Our goal with treatment is to control your blood sugar. That requires attention every day and is a challenge for many people.”
How does diabetes affect your body?
Diabetes affects how your body uses sugar (glucose). Sugar is the main form of energy your cells need to function.
Food breaks down into sugar in your digestive tract and enters your bloodstream. The increase in blood sugar triggers the release of a hormone called insulin from your pancreas. Insulin helps your cells take in sugar for energy or storage.
In diabetes, your body doesn’t make enough insulin or respond to insulin the way it should, says Dr. Ionescu. As a result, your blood sugar levels rise.
Over time, high blood sugar can damage your blood vessels and lead to:
- Amputation of your toes, feet or legs
- Blindness
- Heart disease
- Kidney failure
- Stroke
How can lifestyle changes help you prevent and manage diabetes?
Diet, exercise and weight loss are essential in preventing and managing diabetes.
“Avoiding sugary foods and drinks which raise your blood sugar and deliver extra calories is key,” says Dr. Ionescu. “Also, try to avoid refined carbohydrates, such as white bread, rice and pasta. These foods break down easily in your digestive tract and increase blood sugar.”
Dr. Ionescu recommends working with a dietitian to help you make changes to your diet without losing taste and nutrition. She also suggests getting at least 30 minutes of exercise a day.
Together, diet and exercise can help you lose weight and reduce the amount of insulin you need.
What are the types of diabetes?
The main types of diabetes include:
- Type 1 diabetes, also called insulin-dependent diabetes, often starts in childhood. It makes up about 10% of diabetes cases.
- Type 2 diabetes is largely preventable. It accounts for about 90% of people with diabetes.
- Prediabetes is an early form of Type 2 diabetes.
- Gestational diabetes occurs in pregnancy and can increase your risk of developing type 2 diabetes.
Here’s a closer look at the types of diabetes and how doctors treat them:
What is Type 1 diabetes?
Type 1 diabetes is an autoimmune disease that typically appears in children, teens and young adults.
“In Type 1 diabetes, your immune system does not recognize the cells that produce insulin as your own and destroys them,” says Dr. Ionescu. “So, you can no longer make insulin.”
Doctors do not know how to prevent type 1 diabetes.
How is Type 1 diabetes treated?
The treatment is always with insulin, through injections or an insulin pump. Managing your diet, weight and overall health can also help prevent long-term complications.
Pancreas transplant is another treatment option for people with Type 1 diabetes who have insulin reactions or poor blood sugar control.
Transplant requires you to take immunosuppression medications for the rest of your life to prevent organ rejection. These medications can have serious side effects and increase your risk of infections and certain cancers.
It’s important to talk to your doctor about the risks and benefits of a pancreas transplant, says Dr. Ionescu. Transplant is more common in people who also have kidney failure because they can get a kidney-pancreas transplant.
What is Type 2 diabetes?
People with Type 2 diabetes have insulin resistance. Their cells don’t respond properly to insulin, and they require more insulin to keep their blood sugar levels in check.
Type 2 diabetes occurs due to a combination of:
- Genetic factors: Due to their genetic makeup, some people are more likely to develop insulin resistance.
- Lifestyle factors: Eating too much sugar and carrying excess weight place stress on your pancreas to produce more insulin. Eventually, your pancreas fails and you develop diabetes.
“Acute infections can also trigger Type 2 diabetes in people with a genetic predisposition,” says Dr. Ionescu.
“Infections can increase the requirement for insulin and the body can’t keep up. This deficit in insulin leads to an increase in blood sugar levels that sometimes don’t go back to normal. We’ve seen many people develop diabetes after COVID-19 infection.”
How is Type 2 diabetes treated?
Lifestyle changes are the most effective treatment for Type 2 diabetes. One study found that people with newly diagnosed Type 2 diabetes who lost at least 10% of their body weight could reverse the disease.
When lifestyle changes are not enough, medications can also help you manage your blood sugar. There are many types of medications available to treat Type 2 diabetes. Some of the types include:
- Metformin: Increases sensitivity to insulin and prevents the release of glucose from your liver. Metformin is the first line of treatment for Type 2 diabetes.
- Alpha-glucosidase inhibitors: Slow the breakdown of carbohydrates in your digestive tract.
- Glucagon-like peptide 1 (GLP-1) analogs: Stimulate the release of insulin. GLP-1 inhibitors also decrease your risk of heart attack and may help with weight loss.
- Sodium-glucose cotransporter -2 (SGLT2) inhibitors: Help control blood sugar and lower blood pressure. SGLT2 inhibitors may also decrease your risk of cardiovascular events and chronic kidney disease.
- Thiazolidinediones: Enhance sensitivity to insulin and reduce the release of glucose from your liver.
- Sulfonylureas: increase the insulin production by the pancreas
“Years ago, treatment options for Type 2 diabetes were very limited. Many patients would end up on insulin,” says Dr. Ionescu.
“With GLP-1 agonists and SGLT2 inhibitors now on the market, we have more options. These drugs can be effective but they are not a solution to diabetes. Diet, exercise and weight loss are essential. Patients must do their part, or they may still need insulin at some point.”
What is prediabetes?
Prediabetes is defined as a blood sugar that is elevated but is not high enough to meet the criteria for Type 2 diabetes. People with prediabetes are at high risk of developing Type 2 diabetes in the near future.
The Centers for Disease Control and Prevention estimate that approximately one in three people have prediabetes. And more than 80% of those people don’t know they have it.
How is prediabetes treated?
Lifestyle changes can be very effective at treating prediabetes. Loyola Medicine offers a free Fresh Start – National Diabetes Prevention Program to help people with prediabetes delay the onset of Type 2 diabetes. During this 12-month program, you learn how to make healthy choices and how to stay motivated.
Your doctor may recommend medications if lifestyle changes aren’t enough. Several Type-2 diabetes medications are approved for prediabetes, including metformin. “Medications can slow down the progression of diabetes by decreasing the burden on the pancreas,” says Dr. Ionescu.
What is gestational diabetes?
Gestational diabetes occurs due to an increased insulin demand during pregnancy. Usually, blood sugar returns to normal after delivery. But having gestational diabetes means you have a predisposition to insulin resistance and an increased risk of Type 2 diabetes.
Having high blood sugar can cause problems during pregnancy and delivery. It can also affect child growth and development. Low blood sugar can also be dangerous,” says Dr. Ionescu.
How is gestational diabetes treated?
Treatment options for gestational diabetes are limited during pregnancy. Diet, exercise and limiting weight gain can help you control your blood sugar. But if your levels remain high, insulin injections are the next step.
The American Diabetes Association (ADA) currently does not recommend other Type 2 diabetes medications, such as metformin, during pregnancy.
How do I know if I have diabetes?
Symptoms of Type 1, Type 2 and gestational diabetes are similar. They include:
- Increased thirst
- Frequent urination, especially at night
- Feeling hungry
- Unexplained weight loss
- Blurry vision
- Numbness in your feet or hands
In people with Type 1 diabetes, symptoms may appear quickly and be more severe. Since Type 2 diabetes develops slowly, symptoms may start off mild and increase over time.
Doctors diagnose diabetes by measuring the amount of sugar in your blood. These tests include:
- A1C test: Measures your average blood glucose levels over the past two or three months.
- Fasting blood sugar test: Measures blood glucose after an overnight fast.
- Glucose tolerance test: Measures blood glucose after fasting and then at intervals after drinking a glucose-containing liquid.
- Random blood sugar test: Measures blood glucose at any time.
Diabetes care at Loyola Medicine
Diabetes is a complex disease that requires a dedicated multispecialty team. At Loyola, you’ll find a range of specialists and programs to help you manage all aspects of your condition.
Loyola’s Diabetes Care Center provides complete care for people with all types of diabetes, including:
- Group classes
- Individual treatment programs
- Physician evaluations
We offer one-stop appointments so you can see multiple specialists during the same visit.
To make an appointment with a Loyola Medicine health care expert, call 888-584-7888 or schedule an appointment online.
Madalina Ionescu, MD, is an endocrinologist at Loyola Medicine. She is board certified in endocrinology, diabetes and metabolism. Dr. Ionescu earned her medical degree at Universitate De Medicine Si Farmacie Carol Davila in Bucharest, Romania. She completed her residency and fellowship at the University of Illinois.
Dr. Ionescu finds diabetes and other hormone-related conditions fascinating. She enjoys helping patients learn how to control their blood sugar so they can lead a full life.
Book an appointment today to see a Loyola Medicine endocrinologist by self-scheduling an in-person or virtual appointment using myLoyola.
Sources
- CDC — A Snapshot: Diabetes in the United States — https://www.cdc.gov/diabetes/library/socialmedia/infographics/diabetes.html
- CDC — Diabetes Tests— https://www.cdc.gov/diabetes/basics/getting-tested.html
- CDC — What is Diabetes? — https://www.cdc.gov/diabetes/basics/diabetes.html
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