What is diabetes?
Diabetes is a chronic health condition that develops when the pancreas doesn’t produce or effectively use the hormone insulin, which it needs to turn glucose (sugar) into energy.
At present, there is no cure for diabetes, but there are treatments to manage it so people with diabetes can improve their quality of life.
About 3.6 million Canadians (9.5% of the population) live with diabetes. This number is expected to rise as the country ages and grows.
Types of diabetes
There are 3 main types of diabetes.
Type 1
Type 1 diabetes, also known as insulin-dependent diabetes, is an autoimmune disease. People with Type 1 diabetes don’t produce their own insulin (and can’t regulate their blood sugar) because their body destroys their pancreas’ beta cells. Five to 10 % of people living with diabetes have Type 1.
Type 1 diabetes generally develops in childhood or early adulthood. People with Type 1 need to inject insulin or use an insulin pump to ensure their bodies have the right amount of insulin.
Type 2
This is the most common type of diabetes (about 90 to 95% of diabetics). People with Type 2 diabetes can’t properly use their body’s insulin, or their body doesn’t produce enough insulin.
It’s common to develop Type 2 diabetes in adulthood, though it can occur in childhood.
Type 2 diabetes can sometimes be managed with lifestyle choices:
- Eating a balanced nutrient-rich diet vs. high sugar and processed foods
- Maintaining a healthy body weight vs. being obese
- Getting regular exercise vs. living a sedentary lifestyle
- Managing stress
- Getting quality sleep
- Not smoking and limiting alcohol consumption
However, even with lifestyle changes, patients may also require medications or insulin therapy.
When blood sugar levels are higher than normal but are not high enough to be diagnosed with Type 2 diabetes, this is known as prediabetes. Many people diagnosed with prediabetes develop Type 2 diabetes later. Research indicates some long-term complications associated with diabetes (e.g., heart disease) may begin during prediabetes.
Gestational diabetes
Gestational diabetes is a form of temporary diabetes that develops during pregnancy and disappears after delivery. Gestational diabetes develops in about 10% of pregnant women depending on their risk factors, and may increase the risks of developing Type 2 diabetes later in life.
Diabetes risk factors
The risk for developing diabetes depends on the type.
Family history and genetics may play a part in all types.
Environment and geography can add to the risk of Type 1 diabetes.
Those who have diabetes immune system cells (autoantibodies), are at an increased risk of developing Type 1 diabetes. But not everyone who has these autoantibodies develops diabetes.
Ethnic background is also a factor. Being of African, , Asian, , Indigenous, or South Asian descent can increase the risk Type 2 diabetes.
Risk of prediabetes, Type 2 diabetes or gestational diabetes is greater for those who are overweight or obese.
Having any of these conditions can increase chances of developing diabetes:
- High blood pressure
- High levels of cholesterol or other fats in the blood
- High body mass index (BMI) or being overweight (especially if that weight is mostly carried around the tummy)
- Prediabetes (impaired glucose tolerance or impaired fasting glucose)
- Polycystic Ovary Syndrome (PCOS)
- Psychiatric disorders (schizophrenia, depression, bipolar disorder)
- Obstructive sleep apnea
- Darkened patches of skin called acanthosis nigricans
- Glucocorticoid medications
Symptoms of diabetes
- Feeling very thirsty and hungry
- Needing to urinate more often than usual
- Blurred vision
- Feeling tired
- Unintentional or unexplained weight loss
- Frequent infections
- Slow-healing sores
Diabetes can cause permanent vision loss by damaging blood vessels in the eyes.
Many people with diabetes develop problems with their feet from nerve damage and poor blood flow. This can cause foot ulcers and may lead to amputation. However, if the diabetes is controlled, the risk of these complications can be reduced.
Diabetes treatments
Medications
Insulin – Essential for Type 1 and sometimes needed for Type 2
Oral hypoglycemics – Help lower blood sugar in Type 2 diabetes
Other injectables – GLP-1 receptor agonists
Management strategies
Diet management – Eating a balanced diet with fiber, lean proteins, and healthy fats and controlling carbohydrate intake.
Consistent meal timing – This helps maintain steady blood sugar levels.
Proper hydration – Keeping hydrated can help keep blood sugar levels stable while dehydration can cause blood sugar levels to rise.
Limit alcohol intake and avoid smoking – To reduce blood sugar fluctuations and help manage blood sugar levels.
Physical activity – Regular exercise to maintain weight and improve insulin sensitivity.
Blood sugar monitoring – Regular checking of blood glucose levels and medication timing. Managing episodes of hypo- or hyperglycemia.
Regular check-ins with healthcare providers – Regular monitoring of overall health allows adjustment of treatment plans as required and identification of any complications before they worsen.
Education and support – Diabetes education programs and support groups. Understanding the psychological impact of diabetes and the need for emotional support.
Stress management – Meditation, yoga, and adequate sleep.
A holistic approach
There is evidence that diabetics have improved outcomes with a holistic approach that combines lifestyle management with medications. This could include medication, working with a diabetes educator (nurse and/or dietitian), an endocrinologist, pharmacist, social worker, exercise physiologist, psychologist, foot-care specialist and eye-care specialist.