The Basics of Diabetes and Its Management



  • Our bodies are made of many, many (trillions) tiny cells.  These cells need sugar (also known as glucose) to work.
  • Insulin is a hormone that tells cells to take sugar in from the blood so they can use it as fuel.  Insulin is made by an organ in your belly called the pancreas.
  • Diabetes (also known as diabetes mellitus) happens when there is too much sugar in the blood.  This can happen for two reasons.  1) The pancreas is not making enough insulin.  2) The cells do not listen to the insulin when it tells them to take sugar in from the blood.
  • Blood sugar level or blood glucose level is a test that tells us how much sugar there is in your blood right now.
  • Hemoglobin A1c (HbA1c) is a test that tells us what your blood sugar levels have been over the last 2 to 3 months.

Types of Diabetes

  • Type 1 diabetes most often occurs in kids or younger people.  The pancreas makes very little or no insulin.  There is no signal for cells to take in sugar from the blood and blood sugar levels get high.  People with type 1 diabetes will usually need insulin injections for life because their body does not make any.  This type of diabetes is not preventable.
  • Type 2 diabetes is most common in older people but can happen in kids.  It happens slowly over time and the risk of getting it is mainly related to lifestyle choices.  Early on in type 2 diabetes the cells stop listening to insulin and do not take in sugar from the blood.  This leads to high blood sugar levels.  If untreated, the pancreas can become tired overtime and will stop making insulin.  People with type 2 diabetes are often treated with lifestyle changes and medicines but may also need insulin injections. This type of diabetes is largely preventable.

Who is at risk for type 2 diabetes?

  • People older than 45 years
  • Those who have a family member with type 2 diabetes
  • People with a poor diet or who eat unhealthy foods
  • Those who get no or little exercise
  • Being overweight or obese
  • Those who smoke

How to prevent type 2 diabetes?

  • Focus on eating healthy foods.  This includes fruits, vegetables, whole grains, and low-fat dairy products.  Whole grains are things like brown rice, whole grain bread, and whole grain pasta.  Try to eat only small amounts of sweets or processed grains.  Processed grains are things like white bread, white rice, white flour, or regular white pasta.  Limit the amount of red meat (pork, beef) you eat and focus on chicken or fish.  Avoid soda, juice, or sugar sweetened drinks. Also try to avoid alcohol and fried or fatty foods.
  • Stay active!  Aim for 30 to 60 minutes of activity each day. This could include walking, jogging, dancing, or gardening as a few examples.  The goal should be to get your heartrate elevated!
  • Lose weight if you are currently overweight.  We know this can be challenging, but it really is one of the best things you can do for your overall health and diabetes prevention.  Diet and exercise are great places to start!
  • Quit smoking!
  • Follow-up with your healthcare provider as directed.

What are the signs of type 2 diabetes? How do I find out if I have type 2 diabetes?

  • Most people will have no signs or symptoms that they have diabetes.  Others may notice an increase in how often they need to urinate or how thirsty they are.
  • Most people find out they have diabetes after their healthcare provider does blood tests as part of routine medical screening based on your age and other health concerns.  Your healthcare provider will check your blood sugar level, HbA1c, or both.  Based on these tests, they will be able to tell if you have diabetes or if you are at risk of getting diabetes in the future.

Why care about type 2 diabetes?

  • If you have type 2 diabetes, and it is not treated or well controlled, you are at risk for many health issues.  These include:
    • Eye Disease (Diabetic Retinopathy) that can lead to vision loss or blindness
    • Stroke
    • Heart Attack
    • Kidney Disease (Diabetic Nephropathy).  The kidneys make urine and help filter the blood
    • Nerve Damage (Diabetic Neuropathy) that can lead to numbness, tingling, or pain in the hands and feet
    • Needing to have toes, fingers, or other body parts removed (amputation)
    • Infections
    • Wounds that do not heal

What is the treatment for type 2 diabetes?

  • Treatment is different from person to person.  However, all people should work on improving diet, exercise, and weight in the same ways that were mentioned above in the “How to prevent type 2 diabetes?” section.  Quitting smoking is also really important.  Some people may be able to control their type 2 diabetes with these changes alone, but others may require daily medications, insulin injections, or blood sugar checks.
  • Your healthcare provider may also put you on medications to help with high blood pressure or cholesterol to further lower your risk of health issues.

What else will my healthcare team do to help prevent health issues caused by type 2 diabetes?

  • Monitoring your blood sugar levels is very important.  Your healthcare provider will usually check your HbA1c anywhere from one to four times per year depending on your situation. This allows them to monitor how well your diabetes is being controlled and recommend lifestyle or medication changes as needed.  A typical goal is to have your HbA1c be less than 7% but this may vary by person.  Some people may require daily blood sugar checks at home as well so that they can monitor their blood sugar levels on a day-to-day basis.
  • Routine eye exams to look for signs of damage to the eye are also very important.  This allows your healthcare provider to identify concerns early and intervene before vision loss or blindness occur.  Eye exams are usually performed every year or two, but this may vary depending on your situation.
  • Routine foot exams are important for preventing wounds or infections that could lead to loss of the toes or feet.  Your healthcare provider will want to look at your feet and check the blood flow and sensation in the feet as well.  This will often be done once per year but may vary.
  • Routine urine or blood tests may be collected to look for any early signs of kidney damage.
  • Your healthcare provider will also routinely check your blood pressure and cholesterol to make sure they are well controlled.  High blood pressure and cholesterol can worsen damage caused by diabetes and further increase your risk of future health issues.

What else can I do to help prevent health issues caused by diabetes?

  • Check your feet every day for any signs of skin breakdown, blisters, or areas that are red or swollen.  A mirror or assistance from another person may be helpful for this.
  • Avoid activities that might injure or burn your feet such as walking barefoot.
  • Be careful when trimming your nails.  Trim the nails straight across and not too short.  Use a nail file to remove any sharp edges.
  • Wash your feet daily with lukewarm water and soap.  Pat dry your feet completely and make sure to get in between your toes.  Apply a moisturizing cream or lotion afterwards.
  • Avoid tight fitting shoes and choose shoes with lots of space for your toes.
  • Practice good dental care.  Brush your teeth two times per day and floss at least once per day.  Make sure to see a dentist for regular check-ups.
  • Eat right! (See “How to Prevent Type 2 Diabetes?” section for details)
  • Stay active and get plenty of exercise! (See “How to Prevent Type 2 Diabetes?” section for details)
  • Lose weight if currently overweight.
  • Quit smoking!