Diabetes is serious disease that does not go away. Doctors refer to this as a “chronic” disease because it is not cured. There are two forms of diabetes: type 1 and type 2. Ninety-five percent of people with diabetes have type 2.

What Causes Type 2 Diabetes?

Researchers are really not sure what causes type 2 diabetes. They do know, however, some things that put people at a greater risk for getting the disease, such as:

* Being overweight
* Being over age 30
* Being African American, Hispanic, or Native American
* Giving birth to a baby weighing more than 9 pounds
* Having a family member with diabetes
* Having high cholesterol
* Having blood pressure of 130/90 or higher

Another Form of Diabetes

A second type of diabetes is called type 1. It tends to occur in children and young adults. In this type of diabetes, for unknown reasons the body totally stops producing insulin. As a result, glucose cannot get into the cells.

Controlling type 1 diabetes requires careful management by health care professionals. A person with type 1 diabetes must take insulin shots several times a day.

Complications of Diabetes

Having either type 1 or type 2 diabetes means that the body is not getting glucose or sugar into the cells. Too much glucose is staying in your blood and not getting into the cells.

If someone has too much sugar in their blood for long periods, they can experience problems, such as tiredness, loss of eyesight, kidney problems, nerve problems in their feet and other places in their body. People often first learn they have type 2 diabetes because they go to see their doctor about such problems.

Symptoms of type 2 diabetes include:

* Failing eyesight
* Frequent urination
* Feeling tired
* Having a sore throat that will not heal
* Pains or burning in your feet
* Other symptoms

Most people do not recognize these as symptoms of diabetes because they develop gradually, unlike for people with type 1 diabetes, who become very sick very fast.

Diagnosis of Type 2 Diabetes

People are diagnosed as having diabetes if they have 126 milligrams or more of glucose per deciliter (mg/dL) in their blood after not eating for 12 hours.

Most people have diabetes for many years before they are diagnosed. In fact, it’s possible to have diabetes for 10 years before someone feels bad enough to go to a doctor for help.

Myths of Diabetes

People with type 2 diabetes did not get the disease because they have a “sweet tooth.” Overeating of anything (candy, meat, etc.) can make anyone gain weight and put them at a higher risk for diabetes, but just because they like to eat sweets does not mean that is what caused their diabetes.

There is also no such thing as a “touch of sugar” or being “borderline diabetic.” Either someone has diabetes or they don’t. It’s like being pregnant—either you’re pregnant or you’re not.

How Food Affects Your Blood

In your blood, you have glucose or sugar—all people have glucose in their blood! The word that doctors use for sugar is glucose.

The glucose or sugar in your blood comes from the food you eat. The moment you put something in your mouth, it starts breaking down. The food is further broken down into smaller parts in your stomach and small intestine, where it is taken into the blood. The glucose from the food you eat ends up in your blood. Glucose helps your cells make energy so you can move around, work and not feel tired.

Eating food raises blood glucose levels even in people without diabetes.

Your body also stores glucose in your liver to help your body through the times when you have not eaten for a while—for example, between meals and at night or any other time your body senses that more glucose is needed than can be supplied by the glucose in your blood at that moment.

When You Have Diabetes

When you have diabetes, too much glucose stays in your blood because it cannot get into your cells where it is needed. Glucose can’t get into your cells because:

1. Your insulin is not working properly. Think of insulin as a taxi or car and glucose as its passenger. If a taxi is broken down, it can’t take you where you need to go—causing a traffic jam of glucose in your blood; or
2. Your pancreas may not produce enough insulin, especially if you have had diabetes for a long time.

You Can Help Your Diabetes

People with type 2 diabetes can do many things to help their insulin work better, such as:

* Eating the right foods in the right amount
* Exercising regularly
* Taking medication if it’s prescribed
* Checking your blood glucose levels often. There is a recommended range for blood glucose. Keeping blood glucose in the recommended range is very important to avoid some of the problems just mentioned, such as eye and kidney problems.

American Diabetes Association Target Ranges for Blood Glucose

According to the American Diabetes Association, before meals, glucose levels should be between 90 and 130 mg of glucose per deciliter of blood.

Less than 180 mg/dl two hours after meals.

At bedtime, your blood glucose levels should be between 100 and 140 mg/dL.

Sometimes doctors will tell you that your blood glucose range may go just a little higher. If your doctor gives you a higher range, ask him or her why. It might be because you’ve had high blood glucose so long that you may need to take a while to work toward a lower level. There may be other reasons in other cases. For example, you may be on insulin and have a history of low blood sugar. If you live alone, your doctor may want you to maintain a little higher blood sugar level so it does not fall seriously low while no one is there to help you. However, it is important for you to know that these ranges are the ones recommended in the diabetes standards of care. These ranges have been shown to significantly reduce the complications of diabetes, such as vision loss and nerve problems.

What Does the mg/dL Mean?

When you look at your blood glucose reports, you will see a number such as 140 followed by mg/dL. What does this mean?

Mg/dL stands for the number of milligrams of glucose (or sugar) for every deciliter of blood; that is the way blood glucose is measured.

Most people just remember the number such as 140 and do not pay attention to the mg/dL part. These numbers are guidelines that apply to many people, but not everyone. Talk with your doctor to see what is the best level for you.

Remember, after age 45, you should have your blood sugar level checked every 3 years! Ask your doctor to include this important test in your physical exam. If your sugars are even a little high, your doctor and registered dietician can help you lower them.

Diabetes is the leading cause of death by disease. When you have diabetes, the glucose levels in your blood are higher than normal. The increased blood sugar slowly damages your nerves and the small and large blood vessels in your body. This leads to a variety of health problems and complications, including:

• Heart disease – Diabetes causes your arteries to narrow, which increases your risk of heart disease, stroke and high blood pressure
• Eye disease – Diabetes is the leading cause of adult blindness. Over time, the blood vessels in your eyes deteriorate, increasing your risk of developing glaucoma and cataracts
• Kidney disease – Over 25% of people with diabetes develop kidney disease. Diabetes damages the small blood vessels in the kidneys and also affects the nerves that control your bladder
• Nerve damage – Nerve damage caused by diabetes can lead to numbness or tingling in your limbs, insensitivity to pain and, if the damage is great enough, possible amputation
• Infections – Because diabetes interferes with blood supply and damages nerves, you are at higher risk of infection. Wounds heal more slowly and your immune system no longer functions properly
• Impotence – Between 8% and 13% of all men with diabetes are impotent, a condition caused by blocked blood vessels
• Pregnancy complications – Women with diabetes have a higher risk of complications in their pregnancies and are more likely to deliver babies with birth defects

There is no cure for diabetes. However, research shows that the disease can be prevented or delayed, simply by making small, but important, changes to your lifestyle. Eating nutritiously, exercising regularly and maintaining a healthy weight will significantly reduce your risk of developing type 2 diabetes. Even if you have already been diagnosed with diabetes, a healthy lifestyle will help you keep the disease under control and reduce your risk of complications.

Here are some steps that you can take to prevent diabetes:

• Increase your physical activity – Regular exercise has many health benefits. It increases your energy levels, improves the health of your heart and lungs, decreases insulin resistance, improves blood glucose control and helps with weight loss. Try to find fun and interesting ways to build exercise into your day. Just 30 minutes of walking at a moderate intensity every day will decrease your risk of developing type 2 diabetes by 47% over a six year period

• Increase the amount of fresh fruit and vegetables you eat – Fruits and vegetables are packed with essential vitamins and minerals and are low in fat. They also contain antioxidants that help fight disease. The most nutritious fruits and vegetables are brightly coloured – your best choices are red, yellow, orange or deep green. Try to eat 5 to 10 servings every day

• Increase the amount of whole grains and low glycemic index foods in your diet – The type of food you eat can affect your blood sugar levels. All foods are broken down into glucose at different rates. Foods that are broken down more slowly have a low glycemic index and will help to keep your blood glucose levels under control. Low glycemic foods are often high in fibre, which is another important part of a healthy diet

• Reduce the fat in your diet – Restrict the amount of saturated fat  and trans-fatty acids that you eat – choose unsaturated fats whenever possible. A diet high in saturated fats can contribute to weight gain, which increases your risk of diabetes. Try to include more foods that are rich in polyunsaturated omega-3 fatty acids, including soybean oil, canola oil, flaxseed, eggs and deep-sea fish or “fatty fish,” such as mackerel and wild salmon. They are a very healthy alternative to saturated fats and will also help to reduce the risk of heart attack and stroke

• Maintain a healthy weight – Keeping your weight within a normal range is one of the best ways to reduce your risk of developing diabetes. If you carry any extra weight around your abdomen, your chances of developing diabetes are even higher. By losing as little as 5% to 10% of your body weight, you can improve your blood sugar levels and improve your body’s ability to use insulin. The best way to lose weight is to reduce the number of calories that you eat and increase the amount of physical activity in your day.

Diabetes is a serious disorder that affects the way that your body uses food for energy. Most of the food you eat is broken down into glucose, which is a type of sugar. Glucose is carried by the bloodstream to the cells, where it is used as fuel for cell growth and energy.

To help glucose enter the cells, your pancreas (a small organ that is part of your digestive system) produces a hormone called insulin. When you have diabetes, your pancreas can’t make enough insulin to meet your body’s needs, or your body can’t effectively use the insulin it produces. Without insulin, glucose can’t pass through cell membranes and stays in your bloodstream. This deprives the cells of an essential energy source and interferes with normal bodily functions.

There are three types of diabetes:

• Type 1 – This type of diabetes usually develops early in life, frequently affecting children and young adults. Type 1 diabetes is caused when the immune system attacks and destroys the insulin-producing cells in the pancreas. People with type 1 diabetes must take insulin every day to stay alive. Approximately 10% of people with diabetes have type 1.

• Type 2 – This is the most common form of diabetes. In type 2 diabetes, the pancreas usually makes the right amount of insulin but the body can’t use it properly – a condition known as insulin resistance. Type 2 diabetes develops gradually and tends to affect people over the age of 40. This type of diabetes is often considered a lifestyle disease because people who are overweight and lead a sedentary lifestyle have a higher risk of developing it. Approximately 90% of people with diabetes have type 2.

• Gestational diabetes – This type of diabetes is temporary. It only affects pregnant women and usually disappears after the baby is born. However, women with gestational diabetes do have a greater risk of developing type 2 diabetes later in life.  Approximately 2% to 5% of all pregnant women develop gestational diabetes.

Chronic diseases, such as heart disease, diabetes and cancer, are the leading causes of death and disability in North America. Although chronic diseases are among the most common and costly health problems, they are also among the most preventable. By paying attention to your health and following good health habits, you can prevent or control the long-term effects of these debilitating diseases.

Risk factors for chronic disease

Chronic diseases are usually the result of a complex web of causes. However, there is clear evidence that certain personal or behavioural factors may increase your risk of developing a serious disease. These factors are:

• Smoking/exposure to secondhand smoke
  o A major risk factor for cancer, respiratory diseases and cardiovascular (heart) disease

• Physical inactivity
  o Associated with high blood pressure, increased the risk of heart attack, type 2 diabetes and osteoporosis

• Unhealthy eating
  o Leads to obesity, which increases the risk of high cholesterol, high blood pressure, cancer and type 2 diabetes

Stress is another factor that has been linked to chronic disease. Repeated stress can trigger a physical response that can compromise your immune system and may lead to depression, heart attack or stroke.