While millions of Americans are living with diabetes, the American Diabetes Association reports that many of them don’t know it. But knowledge is power: Diabetes can lead to heart disease, dementia and other serious health issues. Early diagnosis and knowing how to manage the condition if you have it are critical to living well and preventing those complications.
“When diagnosed, you really want to fully understand the principles behind the diagnosis,” says Regina Hanna, APRN, CDCES, diabetes clinical nurse specialist and certified diabetes care and education specialist at Weill Cornell Medicine. “Medical professionals sometimes have the habit of using unfamiliar vocabulary, so ask questions so you can learn and take care of your diagnosis, whether it’s prediabetes or diabetes.”
What Is Diabetes?
Put simply, diabetes occurs when your blood glucose, or blood sugar, levels are too high. Blood glucose is a type of sugar that comes from certain food and drinks and serves as your main source of energy. If you don’t eat for a while, your liver steps in and makes glucose.
Insulin is a hormone produced by your pancreas. Its purpose is to help your cells use glucose for energy. With diabetes, something goes wrong with your body’s production or use of insulin:
- Type 1 diabetes develops when your immune system attacks insulin-producing cells in your pancreas. This drastically reduces the production of insulin or stops it altogether.
- Type 2 diabetes occurs when your body doesn’t use insulin properly and/or the pancreas doesn’t produce enough insulin to maintain normal glucose levels. It is often associated with factors such as overweight/obesity and a family history of the disease.
A diagnosis of prediabetes means you have elevated blood glucose. With proper management, you may be able to prevent prediabetes from developing into Type 2 diabetes.
Diabetes Management Begins With Diagnosis
Regardless of how your body handles blood glucose, diagnosis is a crucial part of managing diabetes.
“It’s really important to know your diabetes numbers and discuss these with your caregiver,” Hanna says.
If you don’t know your numbers, all it takes is a finger prick or blood draw. Three simple blood tests help determine if you have diabetes or prediabetes.
- A1C test. This test measures your average blood glucose level over a two- or three-month period. Normal A1C levels are below 5.7%. Your doctor will diagnose you with prediabetes if your A1C falls between 5.7% and 6.4%. Anything over that is diabetes.
- Fasting plasma glucose test. You fast for eight or more hours before a blood draw. Laboratory medicine experts then measure the amount of sugar in your blood. Less than 100 mg/dL is normal, and you have diabetes if your level is 126 mg/dL or higher. Levels between 100 and 125 mg/dL are considered prediabetes.
- Glucose tolerance test. A member of your healthcare team measures your blood glucose levels, then gives you a sweet liquid to drink. Two hours later, you get retested to see how your body processes sugar. Levels 200 mg/dL or higher indicate diabetes, and 140–199 mg/dL mean you have prediabetes. A healthy level is lower than 140 mg/dL.
Diabetes Management and Treatment
“Diabetes can’t always be totally eliminated, but you can keep it well controlled,” Hanna says. “Your treatment plan has to be something we agree on and one that allows you to monitor and manage your diabetes at home.”
Often, there are two key components to managing your diabetes: medical management and self-management.
Medical Management of Diabetes
Medication and other treatments can help maintain normal blood glucose levels. Depending on your diabetes management needs, your health provider may recommend one of the following:
- GLP-1 agonists. This medication helps encourage your pancreas to release insulin. It also keeps food in your stomach for longer and helps you feel full for a longer period. As a result, you gain better management over your blood glucose levels and lose weight simultaneously, which helps with long-term diabetes management.
- Other glucose-lowering medications. There are many glucose lowering medications. Metformin is an oral medication that limits the amount of glucose your liver produces and makes better use of available insulin. DPP-4 inhibitors help keep GLP-1 hormones active in your body longer, lowering blood glucose levels only when necessary. Thiazolidinediones (TZDs) reduce the liver’s production of insulin and help insulin work better within the body’s muscles and fat. Each option helps lower blood sugar levels.
- Insulin. If your pancreas doesn’t produce any or enough insulin, this medication picks up the slack. All individuals with type 1 diabetes require insulin, and it is also used by some individuals with type 2 diabetes. Insulin can be delivered in several ways based on personal preference, treatment goals and lifestyle. These methods include insulin pens, needle and syringe, inhaled insulin, insulin patches, and insulin pumps.
- Weight loss surgery. According to the American Society for Metabolic and Bariatric Surgery, weight loss surgery is the most effective treatment for Type 2 diabetes. It can lead to significant improvements in or even remission of symptoms.
Your Role in Diabetes Management
Your daily routine plays an important part of managing diabetes. Here are a few lifestyle changes that can help keep your blood sugar levels within a safe range.
- Eat a healthy diet. A registered dietitian nutritionist (RDN) and a diabetes care and education specialist (DCES) can help you develop a diabetes meal plan that emphasizes nutrient-dense whole foods such as fruits, vegetables, legumes and lean sources of protein and plenty of fiber, while reducing foods and drinks high in sugar, sodium and saturated fat.
- Exercise regularly. Squeeze in at least 150 minutes of moderate-intensity physical activity each week. Not sure where to start? “Walking is the first step,” Hanna says. “Get a partner and start to exercise.” This helps you burn calories, lose weight and reduce the risk of diabetes complications.
- Learn to manage stress. Stress can lead to unhealthy eating habits and a spike in blood glucose levels. Unmanaged stress can also affect your sleep, energy levels and emotional health.
- Stop smoking. Diabetes causes nerve damage and increases your risk for heart disease and stroke, and smoking makes these risks more likely. By quitting tobacco, you protect your heart and your overall well-being.
- Use monitoring technology. Your healthcare provider might recommend that you monitor your glucose at home. Blood glucose monitoring and continuous glucose monitoring can help you understand how lifestyle factors like food, exercise and stress affect your glucose levels throughout the day and night. This data helps you and your care team make informed decisions to adjust your medication, diet and lifestyle, leading to better health outcomes.
Conclusion
Effective diabetes management begins with education. A proper diagnosis, medication and lifestyle changes can help you keep your blood glucose levels from reaching dangerous heights.
- A simple blood test can help determine if your blood glucose levels indicate you have prediabetes or diabetes.
- Medication can lower your blood glucose, help prevent and manage other conditions caused by diabetes. If necessary, surgery can help you lose weight and improve your condition.
- What you do every day affects how well you manage diabetes. For ongoing management, meal planning, regular exercise, stress management, and quitting smoking all help lower blood glucose levels.
Want help keeping an eye on your blood glucose levels? Find a doctor at Weill Cornell Medicine today.
