Diabetes mellitus is a medical condition in which insulin and blood glucose (sugar) function is abnormal. Insulin is a hormone released from your pancreas every time you eat. It moves the glucose from your blood into your cells to give them energy. Diabetes is considered a metabolic disorder because it interferes with how your body uses the energy from food.
This article will provide an overview of treating type 1 and type 2 diabetes.
Type 1 and 2 Diabetes Comparison: Is One Worse Than the Other?
Type 1 diabetes is an autoimmune disorder in which antibodies attack the pancreas. The resulting damage prevents the pancreas from releasing insulin. People with type 1 diabetes produce very little or no insulin, so they must inject insulin daily to survive. In type 2 diabetes, the pancreas may produce enough insulin, but the body doesn’t use it well and must produce more. This is known as insulin resistance.
Some may think type 1 diabetes is worse because your body doesn’t produce insulin. This isn’t true. Both types 1 and 2 diabetes can cause serious health complications, including cardiovascular disease, kidney disease, nerve damage, and vision loss.
Types of Diabetes
Forms of diabetes besides types 1 and 2 are:
- Prediabetes occurs when blood sugar is higher than average.
- Gestational diabetes develops during pregnancy in a person who did not have diabetes before being pregnant.
- Diabetes insipidus happens when the kidneys cannot prevent the body from excreting too much water. This is caused by a defect in the kidneys or with the antidiuretic hormone (ADH), which regulates water levels in the body.
Symptoms That Could Suggest Diabetes Mellitus
Symptoms of diabetes mellitus can vary, depending on the type. For instance, prediabetes and gestational diabetes often show no signs. In fact, for some people, types 1 and 2 may not show signs either. However, if you experience the following symptoms, call a healthcare provider to get your blood sugar checked:
- Blurry vision
- Increased need to urinate (pee) more, especially at night
- Increased thirst
- Sores or wounds that heal slowly
- Unintended weight loss
With type 1 diabetes, you may also experience nausea, vomiting, or stomach pains.
Causes and Risk Factors
Researchers don’t know the exact cause of diabetes mellitus. Type 1 is believed to be caused by an overactive immune reaction that mistakenly attacks the pancreas. The following puts you at higher risk for type 1 diabetes:
- Have a sibling or parent with type 1 diabetes
- Young age (child, teen, or young adult)
For type 2, prediabetes, and gestational diabetes, health history and lifestyle play a more apparent role. Risk factors for prediabetes and type 2 diabetes include:
- Age (being 45 years or older)
- Exercising less than three times a week
- Having a history of gestational diabetes or giving birth to a baby who weighed over 9 pounds
- Having a sibling or parent with type 2 diabetes
- Being overweight or having obesity
- Having prediabetes (a significant risk factor for developing type 2 diabetes)
Risk factors for gestational diabetes include:
- Being older than 25 years old
- Gestational diabetes during a previous pregnancy
- Giving birth to a baby over 9 pounds
- Having a family history of type 2 diabetes
- Being overweight or having
- Having polycystic ovarian syndrome (PCOS)
Can You Prevent Diabetes Mellitus?
There is no way to prevent type 1 diabetes. Physical activity and eating a healthy diet are the primary factors preventing or delaying type 2 diabetes. Prediabetes can even be reversed. A prediabetes diagnosis is a warning signal that presents an opportunity to avoid type 2 diabetes.
There are diabetes prevention programs recognized by the Centers for Disease Control and Prevention (CDC) for people diagnosed with prediabetes or with a high risk of developing type 2 diabetes. Prevention tips include:
- Adding physical activity that you can maintain to lose weight
- Managing stress
- Eating healthy without giving up your favorite foods
- Getting back on track when you stray from your plan
Once you are pregnant, it’s not safe to attempt to lose weight to prevent gestational diabetes. You need to gain weight to have a healthy baby. Your healthcare provider will guide you through that process.
Getting a Timely Diabetes Mellitus Diagnosis
Most people with type 2 diabetes have a four- to seven-year delay in a clinical diagnosis. This happens because there are often no symptoms during that time, or they are so minor that they go unnoticed. But it’s crucial to get a diabetes diagnosis as early as possible.
By the time people with undiagnosed diabetes are diagnosed, they already have damage to their blood vessels. Lack of access to care, underscreening, and healthcare providers failing to follow up with recorded hyperglycemia (high blood sugar) are some reasons for delayed type 2 diabetes diagnosis.
If you have health insurance, make sure you get your blood sugar checked regularly. The frequency depends on individual risk factors for developing diabetes. Talk to your healthcare provider about any concerns or health changes you experience, no matter how minor.
Limited access to care makes it harder to see a healthcare provider. If you don’t have health insurance, some options include:
- A Marketplace plan with costs based on household income
- Children’s Health Insurance Program (CHIP)
Complications of Untreated or Mismanaged Diabetes Mellitus
When diabetes goes untreated or is managed poorly, serious health complications can occur. The following are the most common impacts on the cardiovascular system, kidneys, skin, and eyes.
Skin conditions caused by diabetes include:
- Localized itching: This is due to poor circulation, yeast infections, or dry skin.
- Bacterial infections: Styes (infection of eyelid glands), boils, folliculitis (hair follicle infection), nail infections, and carbuncles are types of bacterial infections.
- Fungal infections: A fungus called Candida albicans is a common cause of fungal infections in people with diabetes. It thrives in the warm, moist folds of the skin.
Over time, high blood sugar damages your heart’s nerves and blood vessels. This decreases blood flow, causing high blood pressure and raising the risk of heart attack and stroke. In addition, too much low-density lipoprotein (LDL) cholesterol creates extra plaque inside arteries, further decreasing blood flow.
Your kidneys help control blood pressure and filter waste from your blood (including extra water, which makes urine). When the blood vessels in the kidneys become damaged, it causes high blood pressure and waste buildup in your body.
Vision loss is another complication of untreated or mismanaged diabetes. The cause is diabetic retinopathy, a condition that occurs when blood vessels in the retina become damaged and leak. Blood flow to the eye is restricted, resulting in blurry vision and eventually blindness.
A diabetic emergency is hyperglycemia, hypoglycemia (low blood sugar), or diabetic ketoacidosis (when the body breaks down fat too fast). Symptoms of hypoglycemia can include:
- Clammy skin
- Excessive sweating
- Extreme hunger
- Loss of consciousness
Diabetes Mellitus Treatment With Medications
A diabetes treatment plan will always include lifestyle changes such as regular exercise and eating healthy foods. Depending on the type of diabetes you’re diagnosed with, you may also need to take medication, as follows:
- Type 1 diabetes: Because your pancreas makes very little or no insulin, you must take insulin daily to control blood sugar.
- Prediabetes: For many people with prediabetes, a treatment plan will focus on eating healthy foods, losing weight, exercising more, and taking oral/non-insulin medication as prescribed.
- Type 2 diabetes: You may need insulin, but many people with type 2 diabetes take non-insulin medications. These might include metformin, DPP- inhibitors, thiazolidinediones (TZDs), or SGLT2 inhibitors.
- Gestational diabetes: During pregnancy, your healthcare provider will help you keep blood sugar levels in check with specific meal plans and scheduled exercise. You may need to check your blood sugar regularly and take insulin.
Lifestyle, Habits, and Self-Awareness
While taking diabetes medications is essential, it’s not the only thing that helps you manage diabetes. Staying consistent with diet, physical activity, managing stress, and getting emotional support is all part of the journey. The following are some areas of your health that need attention when you are living with diabetes:
- Diet: Eating well means eating the right foods at the right times to keep your blood sugar as normal as possible. You’ll need to learn how to meal plan, read food labels, count carbs, and make healthy choices when eating out.
- Exercise: Being physically active helps control blood sugar and makes your body more sensitive to insulin.
- Mental health: What you think and how you feel can impact your physical health. Managing diabetes can sometimes feel overwhelming, causing stress, anxiety, and depression. Mental health issues that are left untreated can worsen your diabetes.
- A healthy weight: Belly fat and being overweight increases your risk of developing cardiovascular disease and stroke. You don’t need to lose much weight; even losing 5% to 10% of your body weight will make a big difference.
How to Monitor Blood Sugar At Home
One aspect of managing your diabetes is checking your blood sugar daily, especially when taking insulin. This will give you information to help you decide what and when to eat, exercise, and take medications.
A glucometer is a device you can use to check blood sugar at home. You prick a fingertip with a lancet, then place the blood drop on a test strip. Inserting the strip into the meter will show how much sugar is in your blood. A healthcare provider will tell you how often to check your blood sugar. Some standard times are before meals, two hours after meals, and at night.
Another way that some people keep track of blood sugar levels is continuous glucose monitoring (CGM). A tiny sensor is placed under the skin that measures glucose levels every few minutes. A CGM is most helpful for people who need to take insulin and have problems with low blood sugar.
Long-Term Management and Provider Support
Your healthcare team will include more than a primary healthcare provider. To successfully manage your diabetes, you will need several providers to help you in various specialties. They may often communicate with one another when needed and may include:
- Certified Diabetes Care and Education Specialist
- Endocrinologist (hormone specialist)
- Eye doctor
- Foot doctor
- Mental health provider
- Nurse navigator (helps coordinate healthcare needs)
- Personal trainer or physical therapist
- Registered dietician
Resources for People With Diabetes Mellitus
It takes a long time to get used to managing diabetes. One primary resource is Diabetes Self-Management Education and Support (DSMES) services. You will get support on eating balanced meals, safe exercise options, checking blood sugar, and using insulin. Your healthcare provider can refer you for DSMES services. You can also get information and resources from the American Diabetes Association.
Diabetes mellitus is a condition in which insulin function and blood glucose are abnormal. The varieties of diabetes include type 1, type 2, prediabetes, and gestational diabetes. It’s crucial to get diagnosed with diabetes as soon as possible. Untreated diabetes causes health complications that impact your heart, kidneys, skin, and eyes.
Once you are diagnosed, your healthcare provider will help create a plan to manage your diabetes to prevent further damage to your body.
Article by Carisa Brewster for verywell health