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What is Diabetes?

Diabetes is a spectrum of diseases involving problems with your body’s insulin, a hormone. Usually, our pancreas produces insulin which helps our body metabolize and store the sugar and fat that comes from our daily food intake. Diabetes occurs when our pancreas fails to produce insulin when the pancreas does not make enough insulin, or the body fails to respond to insulin (a.k.a., insulin resistance).

Over 18 million Americans are living with diabetes, and one-third don’t even know they have it. There are more than 40 million other persons that are pre-diabetic. There is no cure; therefore, people with diabetes have to be assertive and responsible for managing their diabetes. You should have a glucometer, a blood glucose meter, at home to check your blood sugar at least twice per day (morning and evening). I have my patients keep a diary of their blood sugar levels to help them manage their diets and understand the impact of eating the wrong things.

What is glucose?

Glucose is used by the cells in our body as a source of energy. Our bodies extract glucose from the food that we eat and drink. A normal pancreas tightly regulates our glucose levels. Higher than normal glucose levels after a meal stimulates the pancreas to release some insulin. When our glucose level begins to drop, our body will signal us to eat and will release some glucose from the liver storage sites (to avoid hypoglycemia). People with diabetes either don’t produce insulin or their cells are resistant to insulin. This leads to high levels of glucose in the blood. A blood glucose level above 125 mg/dl after an overnight fast is considered diabetes.

Types of Diabetes

Type 1 Diabetes:

People with type 1 diabetes develop the disease because their immune system attacks and destroys the pancreas's insulin-producing cells (beta-cells). People with type 1 diabetes must take insulin to regulate their blood sugar levels. This form of diabetes starts more commonly before the age of 20 years but can occur at any age.

Type 2 Diabetes:

Type 2 diabetics produce insulin, but either don’t produce enough or their bodies are resistant to the insulin they produce. When this occurs, the glucose is unable to be used by the cells for energy. It represents the most common form of diabetes affecting 18 million Americans. Type 2 diabetes is directly linked to obesity in people over the age of 40. There are exceptions, and it can occur in people who are not overweight. It is occurring more in children due to the rise of obesity. Type 2 remains the leading cause of complications secondary to diabetes, including non-traumatic amputations, blindness, chronic kidney failure, and diabetic neuropathy. It is a major contributor to male erectile dysfunction due to vascular damage and neuropathy.

Gestational Diabetes:

Gestational diabetes is caused by pregnancy. The condition occurs in 4% of all pregnancies. It is caused by the effects of hormone changes during pregnancy on the body’s insulin, making it not work correctly.

Risk factors for gestational diabetes:
  • Women over 25 years of age

  • Women who are overweight before pregnancy

  • African-American, Hispanic, Asian, and Native American women

  • Women who have a family history of diabetes

A gynecologist will typically screen for gestational diabetes during the pregnancy. Untreated gestational diabetes increases the risks of complications for the mother and baby. Blood sugar levels usually return to normal after the birth of the child. Women who experience this during pregnancy are at a greater risk of developing type 2 diabetes.

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