DIABETES DECODED:
NAVIGATING DIABETES WITH CONFIDENCE
Most people develop diabetes without major symptoms. In the early stages, there is no pain. As it goes untreated the symptoms can seem like normal parts of daily life. For example, feeling tired might be blamed on stress or not enough sleep. Being thirsty could be thought to come from hot weather or salty food. Needing to pee more often might seem like a result of drinking more water. Blurred vision might be blamed on aging or too much screen time. Cuts that heal slowly might just seem normal, and feeling extra hungry could be linked to skipping meals or working hard.
These are all symptoms of abnormally high blood sugar levels. Left untreated and unmanaged, complications become severe and even deadly. Diabetes is very treatable. The earlier, the better.
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WHY IS THIS IMPORTANT?
Understanding diabetes helps you notice early signs, prevent complications, and make healthier choices like eating well and staying active. By learning how to manage it people can live longer, healthier lives and avoid issues like heart disease, stroke, loss of sight, need to amputation of body parts, or nerve damage. Remember, DIABETES (type 2) IS VERY TREATABLE IN THE EARLIER STAGES.
THINGS YOU SHOULD KNOW
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Diabetes does not always require medication for management. With early diagnosis diet and lifestyle changes may be enough
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No amount of medication can make up for poor food choices and lack of exercise
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Losing just 7% of your body weight, if you're overweight or obese, can reduce the need for medication—and in some cases, eliminate the need for it altogether.
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Early detection is key. See your doctor at least yearly
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One shot of insulin per day makes you eligible for Medicare coverage
What is Diabetes?
Diabetes is not just about eating or drinking too much sugar. In diabetes, your body either doesn’t make enough insulin or can't use it the right way. Since insulin is the key that allows sugar into the cell for energy, this causes too much sugar to stay in your blood.
The extra sugar builds up in blood vessel walls and nerves. Blood vessels are like tiny roads that carry oxygen and nutrients to your body. If they get damaged, it’s harder for blood to flow properly. This means tissues, like your skin, muscles, and organs, don’t get the nutrients and oxygen they need to stay healthy. Over time, this can lead to problems like slow healing (loss of toes, feet, even part of the leg may have to be removed), pain, kidney disease, stroke, heart attack, and bad heart function.
Important Terms to Understand
Glucose - a type of sugar that is found in the blood and is the primary source of energy for the body’s cells. It is derived from the food we eat, particularly carbohydrates, and is transported through the bloodstream to cells, where it is used for energy. Glucose is essential for normal body function, but if levels become too high (as in diabetes) or too low, it can cause health problems.
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Diabetic kidney disease | Chronic kidney disease | Diabetic nephropathy
- kidney damage that occurs as a result of long-term diabetes. When someone has high blood sugar for a long period, it can damage the tiny blood vessels in the kidneys, making it harder for them to filter waste and excess fluids from the blood. This damage can lead to kidney disease and, if not treated, can eventually result in kidney failure.​
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Juvenile Diabetes - an old term used to describe Type 1 diabetes. The term Type 1 diabetes more accurately reflects the nature of the disease, which is an autoimmune condition where the body’s immune system attacks the insulin-producing cells in the pancreas.
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Insulin - a hormone produced by the pancreas (in beta cells) that helps regulate blood sugar by allowing cells to absorb glucose for energy. It is the key that opens the cell to take in glucose.
Blood Sugar Tests Results to Know - Diagnosing Diabetes
Insulin Resistance and
Making it Better
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What is insulin resistance?
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When the body’s cells become less responsive to insulin, making it harder for glucose to enter cells. This is a key feature of Type 2 diabetes and contributes to high blood sugar levels.
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What can you do to make your body more sensitive to insulin?
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Regular Physical Activity
Exercise is one of the most effective ways to improve insulin sensitivity. Both aerobic activities (like walking, running, or cycling) and strength training (like weightlifting) help muscles use glucose more efficiently, reducing the need for insulin.
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Healthy Diet
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Eat a balanced diet rich in fiber, whole grains, lean proteins, and healthy fats. High-fiber foods, such as vegetables, fruits, legumes, and whole grains, help regulate blood sugar and improve insulin sensitivity.
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Limit processed foods, sugary snacks, and refined carbs that cause rapid spikes in blood sugar and can worsen insulin resistance.
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Weight Loss
Losing excess weight, particularly abdominal fat, can greatly improve insulin sensitivity. Even a modest weight loss (5-10% of total body weight) can have a positive effect on insulin resistance.
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Adequate Sleep
Getting enough restful sleep is important for managing insulin resistance. Chronic sleep deprivation can worsen insulin sensitivity, so aiming for 7-9 hours of sleep per night is recommended.
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Stress Management
Chronic stress can raise levels of cortisol, a hormone that may contribute to insulin resistance. Practices such as meditation, deep breathing exercises, yoga, or other relaxation techniques can help manage stress.
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Medications (if necessary)
In some cases, medications such as metformin are prescribed to improve insulin sensitivity. Metformin helps the body use insulin more effectively and can be an important part of managing insulin resistance, particularly in those with prediabetes or Type 2 diabetes.
HAVE YOU HEARD ABOUT
HEMOGLOBIN A1c?
What is this test?
Hemoglobin A1c (HbA1c) is a blood test that measures your average blood sugar (glucose) levels over the past 2-3 months. It is used to diagnose and monitor diabetes, as well as prediabetes.
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What is Hemoglobin A1c?
When glucose (sugar) levels in the blood are high, it attaches to hemoglobin, a protein in red blood cells. The HbA1c test measures the percentage of hemoglobin that has sugar attached to it.
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What do the test results mean?
Normal: Less than 6.5%
Prediabetes: 5.7-6.4%
Diabetes: 6.5% or higher
UNDERSTANDING YOUR PILLS/MEDS
Metformin
Your liver naturally makes glucose. Metformin decreases this process. It also makes muscle cells more sensitive to insulin
Dual GLP-1/GIP Receptor Agonists
GIP (Gastric Inhibitory Polypeptide) is another hormone produced in the gut. Together w/ GLP-1 Receptor agonists they stimulate insulin release when blood sugar is high, especially after eating. It promotes fat burning and weight loss and better control of glucose levels in your blood. Example: tirzepatide (Mounjaro, Zepbound)
SGLT2 Inhibitors
Sodium-glucose cotransporter 2 (SGLT2) works by taking glucose out of urine before you pee it out. These meds work by block this so you pee out more glucose. Examples: Bexagliflozin (Brenzavvy), canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance)
Sulfonylureas
They stimulate beta cells in the pancreas to release more insulin. They are more likely to cause low blood sugar and weight gain. Examples: glimepiride, glipizide, and glyburide
GLP-1 Receptor Agonists
GLP-1 (Glucagon-like peptide-1) is a hormone naturally produced in the gut when you eat food. It stimulates the release of insulin, stops the release of glucagon, a hormone that signals the body to release stored glucose, and helps the cells in your pancreas that produce insulin to work better. It also makes your stomach empty slower so you feel full longer Example: Dulaglutide (Trulicity), Exenatide (Byetta), Exenatide extended-release (Bydureon), Liraglutide (Victoza), Lixisenatide (Adlyxin), Injectable semaglutide (Ozempic)
QUESTIONS TO ASK YOUR DOCTOR
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What type of diabetes do I have? Type 1, type 2, MODY, LADA (see links for more info below)?
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When I check my sugar, what should my target glucose (sugar) reading be?
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What is my goal Hemoglobin A1C (HgbA1c) percentage?
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How often should I check my blood sugar on my own?
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If on insulin, when is the best time to take it? Will I be on insulin therapy the rest of my life?
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How is my kidney function doing?
TO DO LIST
Make sure you are fasting for the right amount of time before getting your glucose level checked. NOTHING to eat or drink (except water) for 8 hours before testing. NOTHING!!
Get tested
Avoid sugary drinks (ex. Sprite and cola products, juices, sweet coffee drinks, beer)
Get a glucose monitor. Make it a game for yourself
Make a list when you go grocery shopping (vegetables, lean meats/protein, fruits)
Avoid the inside shelves of the grocery store. Lots of hidden and not-so-hidden sugar is found in those products
ADDITIONAL READING & RESOURCES
VIDEO
VIDEO
Yuka analyzes food items, providing a detailed data sheet for each product to explain how it was evaluated.