Diabetes Type 1

Diabetes means your blood glucose, or blood sugar, levels are too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth.

Type 1 diabetes happens most often in children and young adults but can appear at any age. Symptoms may include:

• Being very thirsty
• Urinating often
• Feeling very hungry or tired
• Losing weight without trying
• Having sores that heal slowly
• Having dry, itchy skin
• Losing the feeling in your feet or having tingling in your feet
• Having blurry eyesight

A blood test can show if you have diabetes. If you do, you will need to take insulin for the rest of your life. A blood test called the A1C can check to see how well you are managing your diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes Type 2

What is type 2 diabetes?

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

What causes type 2 diabetes?

Type 2 diabetes may be caused by a combination of factors:

• Being overweight or having obesity
• Not being physically active
• Genetics and family history

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

Who is at risk for type 2 diabetes?

You are at higher risk of developing type 2 diabetes if you:

• Are over age 45. Children, teenagers, and younger adults can get type 2 diabetes, but it is more common in middle-aged and older people.
• Have prediabetes, which means that your blood sugar is higher than normal but not high enough to be called diabetes
• Had diabetes in pregnancy or gave birth to a baby weighing 9 pounds or more.
• Have a family history of diabetes
• Are overweight or have obesity
• Are Black or African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
• Are not physically active
• Have other conditions such as high blood pressure, heart disease, stroke, polycystic ovary syndrome (PCOS), or depression
• Have low HDL (good) cholesterol and high triglycerides
• Have acanthosis nigricans - dark, thick, and velvety skin around your neck or armpits

What are the symptoms of type 2 diabetes?

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

• Increased thirst and urination
• Increased hunger
• Feeling tired
• Blurred vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Unexplained weight loss

How is type 2 diabetes diagnosed?

Your health care provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

• A1C test, which measures your average blood sugar level over the past 3 months
• Fasting plasma glucose (FPG) test, which measures your current blood sugar level. You need to fast (not eat or drink anything except water) for at least 8 hours before the test.
• Random plasma glucose (RPG) test, which measures your current blood sugar level. This test is used when you have diabetes symptoms and the provider does not want to wait for you to fast before having the test.

What are the treatments for type 2 diabetes?

Treatment for type 2 diabetes involves managing your blood sugar levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine.:

• A healthy lifestyle includes following a healthy eating plan and getting regular physical activity. You need to learn how to balance what you eat and drink with physical activity and diabetes medicine, if you take any.
• Medicines for diabetes include oral medicines, insulin, and other injectable medicines. Over time, some people will need to take more than one type of medicine to control their diabetes.
• You will need to check your blood sugar regularly. Your health care provider will tell you how often you need to do it.
• It's also important to keep your blood pressure and cholesterol levels close to the targets your provider sets for you. Make sure to get your screening tests regularly.

Can type 2 diabetes be prevented?

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Diet

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood glucose levels.

Prediabetes means that your blood glucose levels are higher than normal but not high enough to be called diabetes. If you have prediabetes, you are more likely to develop type 2 diabetes.

How do the foods I eat affect my blood glucose levels?

The glucose in your blood comes from certain foods called carbohydrates, or "carbs." Foods that are high in carbs include candy and sweets, sodas, breads, tortillas, and white rice. The more carbs you eat, the higher your blood glucose level will be.

Whether you have type 1 or type 2 diabetes, making the right food choices is an important way to keep your blood glucose at a level that is healthy for you. When you control your blood glucose, you lower your chance of having serious health problems from diabetes, such as vision loss and heart problems.

And if you have prediabetes or are at risk for diabetes, eating foods that keep your blood glucose levels healthy may help prevent type 2 diabetes later on.

What's the best diet for diabetes?

There isn't a specific diet or meal plan that works for everybody. Your health care provider may have you see a registered dietician (RD) or a diabetes educator who can help design the best eating plan for you. The plan will consider:

• Any medicines that you take
• Your weight
• Any other health conditions you have
• Your lifestyle and tastes
• Your goals

All eating plans for diabetes have a few things in common, including eating the right foods in the right amounts at the right times.

What foods should I eat if I have diabetes?

Eating the right foods for diabetes means eating a variety of healthy foods from all the food groups:

• Fruits and vegetables
• Whole grains, such as whole wheat, brown rice, barley, quinoa, and oats
• Proteins, such as lean meats, chicken, turkey, fish, eggs, nuts, beans, lentils, and tofu
• Nonfat or low-fat dairy, such as milk, yogurt, and cheese

What foods should I limit to control my blood glucose?

To keep your blood glucose under control, you may need to cut back on certain foods and drinks. This doesn't mean that you can never enjoy them. But you will need to have them less often or in smaller amounts.

• High-carb foods and drinks, such as:
  • Sugary foods, such as candy, cookies, cake, ice cream, sweetened cereals, and canned fruits with added sugar
  • Drinks with added sugars, such as juice, regular soda, and regular sports or energy drinks
  • White rice, tortillas, breads and pasta - especially those made with white flour
  • Starchy vegetables, such as white potatoes, corn, and peas
• Fried foods and other foods high in saturated trans fats.
• Foods high in sodium (salt).
• Alcohol. If you do drink, you should drink moderately. This means no more than one standard drink a day if you're a woman or two standard drinks a day if you're a man.

What else do I need to know about diabetic diets?

If you have diabetes, it's important to eat the right amount of food every day. Your eating plan will include how much to eat, so that you get the right amount of carbs in each meal or snack. You'll learn how to count carbs and measure your food.

Eating at the right times is also important. You will want to plan for regular, balanced meals to avoid blood glucose levels that are too high or too low for you. Eating about the same amount of carbs at each meal can be helpful.

Your eating plan will also teach you how to stick with your plan at home and when you eat out.

Eating healthy to control your blood glucose does take some effort. But the reward is a chance to live your healthiest life with diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Eye Problems

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood sugar levels.

What eye problems can diabetes cause?

Over time, high blood sugar may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetes eye problems include:

• Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). The blood vessels may swell and leak fluid into your eye. If it's not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
• Diabetic macular edema (DME), which happens when blood vessels in the retina leak fluid into the macula (a part of the retina needed for sharp, central vision). This usually develops in people who already have other signs of diabetic retinopathy.
• Glaucoma, a group of eye diseases that can damage the optic nerve (the bundle of nerves that connects the eye to the brain). Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris (the colored part of your eye). The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
• Cataract, which happen when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.

Who is more likely to develop diabetic eye problems?

Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you:

• Have had diabetes for a long time
• Don't have good control over your high blood sugar or high blood pressure
• Are pregnant
• Have high blood cholesterol
• Smoke tobacco

What are the symptoms of diabetic eye problems?

In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.

You should also watch for sudden changes in your vision that could mean an emergency. Call your doctor right away if you notice any of these symptoms:

• Many new spots or dark wavy strings floating in your vision (floaters)
• Flashes of light
• A dark shadow over part of your vision, like a curtain
• Vision loss
• Eye pain or redness

Talk with your doctor if you have these symptoms, even if they come and go:

• Spots or dark wavy strings floating in your vision
• Blurry or wavy vision
• Vision that changes a lot
• Trouble seeing colors

How are diabetic eye problems diagnosed?

Eye doctors do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your doctor can look for signs of eye problems and treat them before they harm your vision. Your doctor will also test your vision and measure the pressure in your eyes.

What are the treatments for diabetic eye problems?

Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:

• Lasers to stop blood vessels from leaking
• Injections (shots) in the eye to stop new, leaky blood vessels from growing
• Surgery to remove blood and scar tissue or replace a cloudy lens
• Eye drops to lower fluid pressure in the eye

But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Foot

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose can't get into your cells as quickly as usual. The glucose builds up in your blood and causes high blood sugar levels.

How does diabetes cause foot problems?

Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet.

If you can't feel pain, you may not know when you have a cut, blister, or ulcer (open sore) on your foot. A wound like that could get infected. The infection may not heal well because the damaged blood vessels can cause poor blood flow in your feet.

Having an infection and poor blood flow can lead to gangrene. That means the muscle, skin, and other tissues start to die. If you have gangrene or a foot ulcer that does not get better with treatment, you may need an amputation. This is a surgery to cut off your damaged toe, foot, or part of your leg. It may prevent a bad infection from spreading and could save your life.

But there's a lot you can do to prevent a foot wound from becoming a major health problem.

How can I protect my feet if I have diabetes?

The best way to protect your feet is by controlling your blood sugar levels every day. This will help keep nerve and blood vessel damage from getting worse. The next step is to keep the skin of your feet healthy.

Good foot care for people with diabetes includes:

• Checking your feet every day. Look for cuts, redness, and other changes in the skin and toenails, including warts or other spots that your shoes could rub. Make sure to check the bottoms of your feet too.
• Washing your feet every day. Use warm water and soap. Don't soak your feet because that can dry out your skin. After you dry your feet, you can use talcum powder or cornstarch between your toes. They soak up moisture that can cause infection. If you use lotion, don't apply it between your toes.
• Asking your doctor how to remove corns and calluses safely. Thick skin on your feet can rub and lead to sores. But removing it the wrong way could damage your skin. So you don't want to cut the skin or use medicated pads or liquid removers.
• Trimming your toenails straight across with a clipper. If it's hard for you to trim your own toenails, or if they're thick or curve into the skin, have a podiatrist (foot doctor) do it for you.
• Always wearing well-fitting shoes and socks or slippers to protect your feet when walking. You don't want to walk barefoot, even indoors. And be sure your shoes are smooth inside. A seam or pebble could rub your skin raw.
• Protecting your feet from heat and cold. Use sunscreen on exposed skin and don't walk barefoot at the beach. In cold weather, wear warm socks instead of warming your feet near a heater or fireplace.
• Keeping the blood flowing in your feet. Put your feet up when you're sitting. Wiggle your toes and circle your feet throughout the day. Don't wear tight socks. And get plenty of activity that's not too hard on the feet, such as walking.
• Getting your feet checked at your health care visits. Even if you haven't noticed a problem, it's good to have your health care provider look at your feet.

When should I see my health care provider about diabetic foot problems?

Serious foot problems can develop quickly. See your health care provider right away if you notice:

• A cut, blister, or bruise on your feet that doesn't start to heal in a few days
• Red, warm, or painful skin on your feet
• A callus with dried blood inside
• A foot infection that becomes black and smells bad that could be gangrene

Remember, controlling your blood sugar and caring for your feet every day are the best steps you can take to prevent serious diabetic foot problems.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases