Getting Up to Speed on Diabetes Basics

By Sherri Shafer

Diabetes is a condition of abnormal blood-glucose regulation. Lack of insulin (type 1 diabetes) or ineffective insulin (type 2 diabetes) both lead to elevated blood-glucose levels and a diagnosis of diabetes.

Diabetes and diet are intimately intertwined. It’s impossible to talk about managing diabetes without discussing food in great detail. Blood-glucose levels are influenced by what you eat, how much you eat, and when you eat. The goal is to eat healthy foods, properly portioned, at appropriate times. The following sections introduce the basics of managing diabetes.

Checking out concerning trends in the diabetes epidemic

Nearly 30 million Americans are living with diabetes. Type 2 diabetes accounts for roughly 95 percent of cases. More than 86 million American adults have prediabetes, a condition where blood-glucose levels are above normal but not yet high enough to be classified as diabetes.

The best way to turn that trend around is to improve dietary choices, lose weight if you are overweight, and exercise regularly. Prediabetes can progress to type 2 diabetes, but lifestyle changes cut the risk by up to 58 percent. If you already have diabetes, eating right and exercising comprise the foundation of treatment.

Improving outcomes and preventing complications

Keep in mind that when people developed diabetes many years ago, they simply did not have the resources, knowledge, tools, medications, and technologies needed to adequately manage their disease. Those tools are available now: blood-glucose monitors, insulin and other medications, insulin-delivery options, and knowledge. The roles of diet and exercise in managing diabetes are understood. Multiple studies from around the globe provide a hopeful message, which is taking care of your diabetes has a big payoff: your improved health.

While the onset of type 1 diabetes is more obvious, type 2 diabetes can go undiagnosed for many years. Screening is critically important and may alert you to your risk long before diabetes develops.

You should take diabetes seriously. Uncontrolled diabetes may lead to complications. For example, elevated blood-glucose levels over time can damage blood vessels and tissues. People with diabetes are twice as likely to suffer a heart attack or stroke. Your eyes, kidneys, feet, and nerves are all vulnerable to the damages inflicted by persistently elevated glucose levels.

If you currently have complications, talk to your diabetes specialist for appropriate treatment. Request a referral to a registered dietitian if treating your complication has a dietary component. Two examples: Kidney disease may impose restrictions on dietary sodium, potassium, phosphorus, fluid, and possibly protein. Treating gastroparesis (nerve damage that alters the digestive system) involves dietary modifications to improve digestion and absorption of food. When diet becomes part of the treatment for a disease, it’s referred to as medical nutrition therapy. A registered dietitian is a trained medical professional who can help you learn to make dietary changes that support the treatment of diabetes, heart disease, lipid problems, hypertension, and more.

A landmark study called the Diabetes Control and Complication Trial (DCCT 1983–1993) followed 1,441 people with type 1 diabetes for ten years. Results showed definitively that improving blood-glucose control reduces the risks of developing complications. The results were astounding: 76 percent reduction in eye disease, 50 percent reduction in kidney disease, and 60 percent reduction in nerve disease. The United Kingdom Prospective Diabetes Study (UKPDS 1977–1997) focused on people with type 2 diabetes. With 5,102 study participants, it was shown conclusively that both blood-glucose control and blood-pressure control are important in reducing complications.

Building your diabetes team

Your diabetes team starts with you. You are the team captain, and you get to pick who will be there to assist you on your diabetes management journey:

  • Your primary care provider manages your overall healthcare needs. Look for one who has experience with diabetes.
  • If you have type 1 diabetes or your type 2 diabetes is not under adequate control, your general practitioner may refer you to an endocrinologist, a doctor who specializes in diabetes.
  • You may also benefit from the expertise of a diabetes nurse educator (RN or NP), who can teach you how to monitor your glucose levels, keep and review blood-glucose records, properly administer insulin, handle travel and sick days, and more. In addition, a registered dietitian (RD or RDN) can help you plan balanced meals, teach you to read Nutrition Facts labels and count carbs, and provide dietary advice to help you achieve weight goals, manage blood pressure, improve cardiovascular health, understand the impact of alcohol, treat hypoglycemia, and more.
  • A certified diabetes educator (CDE) is a healthcare provider who has advanced training in diabetes management and has passed a comprehensive national exam. To maintain the CDE status, the healthcare professional must complete 75 hours of continuing education in the field of diabetes every five years.
  • Also on the roster to join your team are an eye doctor (either an ophthalmologist or an optometrist), a dentist, and a pharmacist.
  • At times you may choose to see a mental-health specialist: a counselor, social worker, psychologist, or psychiatrist.
  • Should you need them, a podiatrist is available for foot care and an exercise physiologist or physical therapist can guide your physical fitness plan.
  • Don’t forget your loved ones, family, and friends. Enlist the support and help of the important people in your life. People want to help; just let them know how best to assist you.

Staying up to date with advances in diabetes care

Diabetes specialists stay up to date on the latest advancements in the field of diabetes. Capitalize on their knowledge; stay up to date with your medical appointments and healthcare screenings.

Keep in mind that not everything you read online is factual.