You may have heard about diabetes (diabetes mellitus) and understand that it requires a limited carbohydrate/sugar intake, but what is diabetes? Once you have read this post you will have an understanding of the following:
- What diabetes is
- What types of diabetes there are
- What symptoms diabetes can cause
- How diabetes is diagnosed
- How diabetes is treated
So what does it mean to be diabetic? In short, a person is diagnosed with diabetes when their blood glucose levels (blood sugar levels) are either too high or too low. Having high blood glucose levels can damage blood vessels that supply blood to vital organs and raises the risk of heart disease, stroke, kidney disease, nerve damage and vision problems. Having low blood glucose levels can be very dangerous, it can lead to seizures, loss of consciousness, or death. To fully understand what diabetes is, we should know how our body is supposed to function.
When we eat something, particularly something that’s high in carbohydrates (carbs), our body digests it and turns it into glucose. High amounts of carbohydrates cause a spike in our blood glucose levels. A hormone called insulin, which acts as a transporter for glucose to our cells, should be doing just that… transporting the glucose out of our blood and into our cells to either be used as energy, to be stored as an energy reserve (glycogen) or converted to fat. Insulin regulates the amount of glucose in our blood and keeps it within normal levels.
A diabetic’s body behaves differently, as blood glucose levels are often too high or too low. There are two potential reasons for this:
- The pancreas does not produce enough insulin to transport glucose out of the bloodstream to the cells. The lack of insulin is due to the insulin-producing cells in the pancreas being destroyed and is also known as type 1 diabetes. Type 1 diabetes is usually diagnosed under the age of 40 and is most common in childhood. Treatment for type 1 diabetes includes insulin injections, diet, and exercise.
- Another cause of uncontrolled blood glucose levels is insulin resistance. Insulin resistance is when the body can produce insulin, but the insulin cannot be used very well by the body’s cells. The cells are less able to respond to the insulin and accept the glucose, leaving an excess of glucose in the bloodstream. The pancreas produces insulin, so when it detects that the blood glucose level is not dropping it can continue to release more insulin in an attempt to bring the levels down. The continuous release leads to high levels of circulating insulin and can have implications such as weight gain. Insulin resistance is what causes type 2 diabetes.
Types of diabetes
The two most common types of diabetes are type 1 and type 2. There are also other types that aren’t as common or only occur in pregnant women. These are:
- Gestational diabetes. Gestational diabetes occurs in pregnant women.
- Diabetes LADA. A form of type 1 diabetes that affects adults.
- Diabetes MODY. Diabetes MODY is caused by a genetic mutation.
- Double diabetes. This is when type 1 diabetics develop insulin resistance.
- Type 3 diabetes. Type 3 diabetes is linked with Alzheimer’s disease.
- Steroid-induced diabetes. Type 2 diabetes caused by long-term use of corticosteroids.
- Brittle diabetes. A form of type 1 diabetes that is very hard to control.
- Secondary diabetes. Diabetes caused by another medical condition.
- Diabetes Insipidus. A rare form of diabetes not associated with diabetes mellitus (blood glucose related) and causes excessive urination.
Diabetes.co.uk explains in detail about the different types of diabetes.
Symptoms of diabetes
Type 1 and type 2 diabetes have some symptoms in common. These include:
- Excessive thirst
- Increased urination
- Unexpected weight loss. Although, if diabetes is caused by insulin resistance (more related to type 2) this can lead to weight gain.
- Fatigue or tiredness
- Nausea, perhaps vomiting
- Blurred vision
- Vaginal infections
- Dry mouth
- Slow-healing sores or cuts
- Itching skin, especially in the groin or vaginal area.
These symptoms can develop very quickly for type 1 diabetics. People with type 2 diabetes may not experience any of these symptoms. Personally (I am type 2 diabetic), I experienced fatigue, blurred vision, itchy skin, increased thirst and urination.
If you experience any of these symptoms, you should contact your doctor.
How is diabetes diagnosed?
A screening test will determine the diagnosis of diabetes. Depending on many circumstances your screening test may vary and can include one or more of the following:
- Random blood glucose test. Your blood glucose levels will be measured to see what they currently are.
- Urine glucose test. This test will measure the amount of glucose in your urine.
- Fasting plasma glucose test. A fasting blood test is usually done in the morning after you have been fasting overnight. The aim is to see what your fasting blood glucose levels are.
- HbA1c test. The HbA1c can show what your blood glucose control has been like over the last 2-3 months.
- Oral glucose tolerance test. A sugary drink is given to see whether your body has difficulty in stabilising your blood glucose after having the drink.
Additional diagnostic tests may be carried out as part of the diagnoses and will help to determine what type of diabetes you have. These tests can include a urine ketone test, C-peptide test or a GAD autoantibodies test.
A urine ketone test is used to assess severe hyperglycemia (severe high blood glucose) by looking at the number of ketones in the urine. Our bodies produce high levels of ketones when we are unable to get enough glucose for energy or cannot use glucose due to a lack of insulin. Ketones are a form of acid that breaks down our fat for energy. Ketones flow into the blood and some passes into our urine. As ketones are a form of acid, too many can make your blood very acidic. Acidic blood can lead to a life-threatening condition called diabetic ketoacidosis. Acidic blood can also stop some of the body’s systems from functioning. Ketoacidosis is more common in type 1 diabetes but can occur in type 2 diabetes.
Ketoacidosis is not to be confused with ketosis. Ketosis is what individuals try to achieve when following a ketogenic diet. The aim is to eat an extremely low carb high-fat diet so that our body is unable to obtain energy from carbs/glucose. This lack of glucose encourages the production of ketones. So, what is the difference between ketoacidosis and ketosis? Ketosis is when you have a normal to a high amount of ketones, which puts you in a fat burning state, and is considered safe by many professionals. Ketoacidosis is when the levels of ketones are extremely high and have become unsafe. Discover more about the ketogenic diet and various other diets for managing blood glucose levels.
A C-peptide test (fasting blood test) looks at how much insulin you are producing. This test is particularly useful in determining what type of diabetes you have or whether you have insulin resistance. A C-peptide is a molecule. C-peptide and insulin get released together, and C-peptide stays in the body for longer which makes it a marker for insulin production.
A GAD antibodies test is a blood test that determines whether the body is producing an antibody that destroys GAD cells. A GAD cell is an enzyme in the pancreas and brain that performs several important roles in the body. This blood test is often used to determine whether you have type 1 diabetes or diabetes LADA.
How is diabetes treated?
The main goal of diabetes treatment is to keep blood sugar levels controlled in order to prevent any complications. Dependant on the type of diabetes, lifestyle changes might be enough to manage blood glucose levels, or medication may be needed.
You should understand what a balanced diet is, how some foods affect blood glucose levels and what lifestyle modifications are required to control these levels.
As a diabetic, I view myself as having an intolerance to glucose.
What is a balanced diet?
Everyone should have a balanced diet. Typically, a balanced diet includes food from 5 different groups. These are fruit and vegetables, carbs, protein foods, milk/dairy foods and fats. Each food group provides necessary nutrients:
- Fruit and vegetables provide vitamins, minerals, fibre and antioxidants.
- Carbs are a source of energy, vitamin B, and fibre. There are two types of carbs: simple and complex. Simple carbs are also known as simple sugars. Simple sugars include sweets, cakes, and fruit. It is better to get simple sugars from fruit as this is the only form that will provide nutrients. Complex carbs are also known as starch. Starch is in bread, crackers, pasta, and rice. Similarly to simple sugars, there are some preferred complex carbs. For example, refined grains, such as white rice and white flour, are processed. Processed grains have lost a lot of nutrients and fibre. Whereas unrefined grains such as wholegrain rice, wholegrain bread, oats, legumes, fruits, and vegetables still contain the nutrients and fibre.
- Protein foods such as meat are vital for growth and repair of the body.
- Milk and dairy foods provide calcium which is necessary for healthy bones.
- Fats provide our body with essential energy and support cell growth. Fat comes in three different types: saturated, monounsaturated and polyunsaturated. Many medical professionals believe that eating large amounts of saturated fat can increase your risk of heart disease or high cholesterol. However, some medical professionals deny these claims. Saturated fat is in fatty and processed meat, palm oil, coconut, coconut oil, margarine, coconut milk/cream, crisps, deep-fried foods, cakes, biscuits, sweets, pastries, and pies. Unsaturated fat, such as polyunsaturated and monounsaturated, play a vital part in a healthy diet. Many studies suggest that they help to lessen the risk of heart disease and lower cholesterol levels. Polyunsaturated fat includes omega-3 and omega-6 fats. Omega-3 fats are in oily fish. Omega-6 fats are in some oils (for example safflower oil and soybean oil) and some nuts (for example brazil nuts). Monounsaturated fat is in olive oil, canola oil, avocados, and nuts such as almonds and cashews.
Food that converts to glucose
Most food groups contain carbs. Sugary and starchy foods typically have more. Carbohydrates are converted to glucose when eaten, so to manage blood glucose levels effectively, we must limit our carb intake. The types of foods that are higher in carbs are:
- Starchy vegetables such as potatoes, corn, and green peas. Some root vegetables can cause a spike in sugars if eaten in large amounts.
- Grains such as bread, rice, pasta, noodles and crackers
- Sugary food such as jams, cakes, biscuits, chocolates, sweets, ice cream, table sugar, brown sugar, corn syrup, maple syrup, honey and agave nectar.
- Fresh fruits, canned fruits, and dried fruits. There are some fruits lower in carbs such as the berry family. For example, strawberries, blueberries, and blackberries. The sugar found in fruit is called fructose.
- Milk, yogurt, and some fresh cheese. These contain enough carbs to be able to elevate your blood glucose levels, especially if eaten in large quantities. Dairy, such as butter and cream, do not cause a spike as they contain very few carbs. The sugar found in dairy products is called lactose.
It is imperative to become knowledgeable of carbs and how these affect your blood glucose levels.
I know what you are thinking, what on earth are you allowed to eat? How can you get all the right nutrients when you need to limit certain food groups? Please do not worry. I know this may be overwhelming, but it is not as daunting as it seems.
There are a variety of diets/ways of life that are recommended for diabetes control and I have also written a post about what my diet is like and how I control my blood glucose levels. There are plenty of low carb recipes on this website. And, it only takes a google search to find more. You can still have fun, tasty and nutritious food, even with limitations.
Exercise has numerous health benefits and should be carried out by everyone. Exercise helps to control your blood glucose level by increasing your insulin sensitivity. This benefit not only helps type 2 diabetics with insulin resistance but also benefits type 1 diabetics as they don’t need as much insulin to deal with glucose.
There are a variety of medications that are prescribed to manage blood glucose levels. It will usually come in the form of tablets or insulin injections. You can find out more about diabetic medication on diabetes.co.uk.
So now you should have a better understanding of what diabetes is, what types of diabetes there are, what the symptoms are, how diabetes is diagnosed and treated. I recommend that you read the start here page to get an idea of what your next steps should be and what help is available to you.