Diabetes affects how the food you eat is used or stored for energy.
Imagine a piece of layer cake with lots of chocolate frosting. You put a forkful in your mouth and delight in the taste of the starch and sugar—all those heavenly carbohydrates.
In your digestive tract, those carbohydrates are broken down into the simple sugar glucose, which is used by your body for energy. What’s not used right away is stored for later.
Glucose is absorbed from your digestive tract into your bloodstream, and your blood delivers it to tissues and organs throughout your body. The major target cells for glucose delivery are your liver, skeletal muscles (like the muscles in your arms and legs), and fat tissue.
But glucose can’t enter most cells without the help of insulin. Insulin is made in your pancreas and released when the level of glucose in your blood rises. You could think of insulin as the key that unlocks the doors of the cells so glucose can enter.
Without the action of insulin, most of the glucose from the food you eat stays in the blood until it is filtered out by the kidneys and removed from the body in urine.
This is called “high blood sugar” or hyperglycemia—the main sign of diabetes. It means that you have too much glucose (sugar) in your blood due to a lack of insulin action.
The two major reasons for a lack of insulin action are:
Type 1 diabetes is caused by the loss of insulin-producing cells in the pancreas. These are the only cells in the body that can do this important job, so when they are lost, people with type 1 diabetes must get their insulin from an outside source to survive.
People with type 2 diabetes have insulin-producing cells and can usually make insulin. But the cells that normally take glucose from the blood with the help of insulin do not respond properly to insulin. When this happens, extra glucose builds up in the blood. The extra glucose tells the pancreas to keep releasing more insulin. Over time, this increased demand for insulin "wears out" the cells that make insulin, and their ability to produce insulin drops. Eventually, some people with type 2 diabetes make so little insulin that they require insulin injections, but most do not.
The signs and symptoms of type 1 diabetes often appear suddenly. The signs and symptoms of type 2 diabetes usually appear gradually, over a long period of time. This is why so many people with type 2 diabetes don't know they have it.
Type 1 diabetes tends to affect people under 30 years of age. Most people who develop type 2 diabetes are over 40.
People with type 1 diabetes often have sudden, unexpected weight loss because their bodies lack insulin and cannot absorb and use glucose. About 80% of people with type 2 diabetes are overweight.
If you have type 2 diabetes, you need to get your weight down and keep it down. You need to keep your cholesterol levels in line. And you need to keep a close eye on your blood pressure. But, most importantly, you need to keep your blood glucose at steady levels.
None of these are easy, but all are possible if you learn how.
Education is the key to successful self-management of type 2 diabetes.
The American Association of Diabetes Educators (AADE) has identified seven key behaviors that can help you successfully manage your diabetes. These include:
Diabetes is a disease that YOU manage with the help of your healthcare provider. Because you have to be involved in managing the condition, it is important that you get education and information when you need it. A trained diabetes educator can be a huge help. Visit the AADE Web site for more information on the self-care behaviors described above or to find a diabetes educator in your area.
It's one thing to say I'm going to eat right or I'm going to exercise, but quite another to follow through on those promises. The smart way forward is to set small, achievable goals. Your care team, especially your diabetes educator, understands this and can help you.
Take exercise, for example: Maybe you could start by walking around your neighborhood for 15 minutes in the evening, 4 days a week. Keep a record of the days and length of times walked. After meeting this goal for one or two weeks, you can increase the time spent walking, the number of days you walk, or both. (Additional information on physical activity is available in the article, Get Active, Stay Active).
Your goals for diabetes self-management should be what we call SMART goals:
Specific |
Don't just think: I'm going to start exercising. Make your goal specific: I will walk around the neighborhood this week. |
Measurable |
How will you know you have achieved your goal if you don't have a measurable outcome? How about: I will walk around the neighborhood for 15 minutes, 4 evenings this week. |
Achievable |
Don't set yourself up for failure by biting off more than you can chew. You're probably not going to run a 6-mile road race next month. Be realistic. Start small, and build up over time. |
Rewarding |
Reaching your goal is a reward, but try to think of other ways you can motivate yourself. For example: I will buy myself a nice pair of walking shoes when I can walk briskly for 15 minutes, 5 nights a week. |
Trackable |
Keep a diary to track your progress. Note your goals and the days you achieve them. Also note how you feel about your progress. Don't forget to go back and see where you were and how much progress you've made. |