Diabetes mellitus is a group of diseases characterized by high blood sugar levels and issues with insulin production or effectiveness, significantly impacting the health and quality of life of millions of people worldwide. Understanding diabetes is essential for managing the condition effectively and preventing complications.
As a chronic condition that impacts nearly 40 million Americans, clinical researchers and physicians continue to conduct clinical trials to find new treatments and therapies that may support improved treatment for patients with diabetes. If you, someone you love, or your patient has been diagnosed with diabetes, consider joining a clinical trial with M3 Wake Research, a leading clinical trial network, to help improve patient outcomes and benefit from new potential treatment modalities.
What is Diabetes?
Diabetes is a metabolic disorder characterized by high blood sugar levels (hyperglycemia) resulting from the body’s inability to produce or effectively use insulin, a hormone that regulates blood sugar. When we eat, our body breaks down carbohydrates into glucose, which enters the bloodstream as blood glucose. Insulin helps transport glucose from the blood into the body’s cells, where it is used for energy. In diabetes, this process is disrupted because the body either does not produce enough insulin or does not use insulin properly, leading to elevated blood sugar levels.
Types of Diabetes
While Type 2 Diabetes is the most common type of diabetes that impacts patients throughout the United States, there are three main types of diabetes: Type 1 diabetes, Type 2 diabetes, and gestational diabetes.
Type 1 Diabetes
Typically diagnosed in children, adolescents, or young adults, Type 1 diabetes is an autoimmune condition where the body’s system attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body produces little to no insulin.
Individuals with Type 1 diabetes require lifelong insulin therapy, along with careful monitoring of blood sugar levels, diet, and physical activity.
Type 2 Diabetes
Type 2 diabetes occurs when the body becomes resistant to insulin or doesn’t produce enough insulin to maintain a normal blood glucose level. Unlike Type 1, the pancreas in Type 2 diabetes still produces insulin, but the body’s cells cannot use it effectively. Type 2 diabetes is most commonly diagnosed in adults over the age of 45, but it is increasingly being seen in younger populations due to rising obesity rates.
Management of Type 2 diabetes involves lifestyle changes such as diet, exercise, and weight loss, as well as medications or insulin therapy as needed.
Gestational Diabetes
Gestational diabetes is a form of diabetes that is diagnosed during pregnancy and usually resolves after childbirth. However, women who have had gestational diabetes are at higher risk of developing Type 2 diabetes later in life. Gestational diabetes occurs when hormonal changes during pregnancy affect the body’s ability to use insulin efficiently.
It is managed through diet, exercise, and sometimes insulin or oral medications to keep blood sugar levels within a target range.
Diabetes Risk Factors and Causes
Understanding the risk factors and causes of diabetes is crucial for prevention and early intervention. Diabetes risk factors include a combination of genetic, environmental, and lifestyle elements. Family history plays a significant role, especially in both Type 1 and Type 2 diabetes. If you have a close relative with diabetes, your risk of developing the condition increases.
Environmental factors, such as exposure to certain viruses and toxins, may contribute to the development of Type 1 diabetes. On the other hand, lifestyle factors are more influential in Type 2 diabetes. Obesity, physical inactivity, and a diet high in sugar and saturated fats are major contributors. Additionally, certain medical conditions like high blood pressure, high cholesterol, and polycystic ovary syndrome (PCOS) can increase the risk of developing Type 2 diabetes.
Gestational diabetes, which occurs during pregnancy, is caused by hormonal changes and insulin resistance. Women who have had gestational diabetes are at an increased risk of developing Type 2 diabetes later in life. Moreover, people with a body mass index (BMI) of 30 or higher are at a higher risk of developing Type 2 diabetes. Physical inactivity and poor dietary choices further elevate this risk.
Certain ethnic groups, including African Americans, Hispanics/Latinos, and American Indians, are also at a higher risk of developing Type 2 diabetes. Understanding these risk factors can help in taking proactive steps to prevent the onset of diabetes.
Symptoms and Diagnosis of Diabetes
Recognizing the symptoms of diabetes is crucial for early diagnosis and management. While symptoms can vary depending on the type of diabetes and the individual, there are common signs to watch for. It is also important to note that diabetes diagnosed during pregnancy, known as gestational diabetes, can increase the risk of developing Type 2 diabetes later in life.
Common Symptoms of Diabetes
Increased Thirst and Urination
- Polydipsia and Polyuria: Excess glucose in the blood forces the kidneys to work harder to filter and absorb it, leading to more frequent urination (polyuria) and increased thirst (polydipsia).
- Impact: These symptoms can lead to dehydration if not managed properly, further complicating the condition.
Extreme Fatigue
- Energy Deprivation: When cells are deprived of glucose, their primary energy source, it leads to extreme tiredness and fatigue.
- Daily Activities: Fatigue can significantly impact daily activities and overall quality of life, making it harder to manage diabetes effectively. Proper management of blood sugar levels is crucial to prevent low blood sugar, which can also contribute to fatigue.
Blurred Vision
- Fluid Imbalance: High blood sugar levels can pull fluid from tissues, including the lenses of your eyes, leading to swelling and changes in shape that cause blurred vision.
- Reversibility: Blurred vision can often be reversed with proper blood sugar management, but persistent high levels can lead to more serious eye complications.
Slow-Healing Sores or Frequent Infections
- Impaired Healing: High blood sugar can impair the body’s ability to heal wounds and fight infections, leading to slow-healing sores, especially on the feet.
- Common Infections: Individuals with diabetes are also more prone to frequent infections, such as skin infections and urinary tract infections.
Unintended Weight Loss
- Insufficient Insulin: In Type 1 diabetes, when the body can’t produce enough insulin, it begins to break down muscle and fat for energy, leading to rapid and unexplained weight loss.
- Malnutrition: Over time, this can lead to malnutrition and loss of muscle mass, especially if not properly managed with insulin therapy.
Diagnosis of Diabetes and Blood Glucose Levels
Diagnosing diabetes involves several tests that measure blood glucose levels. Early detection is crucial for managing the condition and preventing complications.
A1C Test
- What It Measures: The A1C test measures your average blood sugar level over the past 2 to 3 months. It provides an overall picture of how well blood sugar has been controlled.
- Normal Range: A normal A1C level is below 5.7%. An A1C level of 6.5% or higher on two separate tests indicates diabetes.
Fasting Blood Sugar Test
- What It Measures: This test measures blood sugar levels after an overnight fast (usually 8 hours). It is one of the most common tests used to diagnose diabetes.
- Normal Range: A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is considered normal. A level of 126 mg/dL (7.0 mmol/L) or higher on two separate tests indicates diabetes.
Oral Glucose Tolerance Test (OGTT)
- What It Measures: The OGTT measures blood sugar levels before and two hours after consuming a sweet drink. This test assesses how well the body processes glucose.
- Normal Range: A blood sugar level less than 140 mg/dL (7.8 mmol/L) after two hours is normal. A level of 200 mg/dL (11.1 mmol/L) or higher indicates diabetes.
Random Blood Sugar Test
- What It Measures: This test measures blood sugar levels at a random time, regardless of when you last ate.
- Diabetes Diagnosis: A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher, along with symptoms of diabetes, suggests diabetes, especially if confirmed with additional tests.
Confirmatory Tests
- Repetition: To ensure accuracy, diagnosis typically requires confirmatory testing on a different day.
- Combined Testing: In some cases, a combination of tests is used to diagnose diabetes definitively, especially in individuals with borderline or inconsistent results.
Treatment and Management of Diabetes
Managing diabetes involves a combination of lifestyle changes, medication, and regular monitoring. The goals are to keep blood sugar levels within a target range, prevent complications, and maintain overall health.
Lifestyle and Diet
Balanced Diet
Focus on Whole Foods: A diet rich in whole grains, lean proteins, healthy fats, fruits, and vegetables can help maintain stable blood sugar levels and prevent spikes.
Carbohydrate Counting: Monitoring and managing carbohydrate intake is crucial for controlling blood sugar. Carbohydrates have the most immediate impact on blood sugar levels, so portion control and choosing complex carbs are important.
Regular Physical Activity
Exercise Benefits: Physical activity helps the body use insulin more effectively, lowers blood sugar levels, and supports weight management.
Exercise Routine: Aim for at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, cycling, or swimming. Include strength training exercises at least twice a week.
Medications and Insulin Therapy
Medications for Type 2 Diabetes
Oral Medications: Medications like metformin, sulfonylureas, and DPP-4 inhibitors are commonly used to manage Type 2 diabetes by improving insulin sensitivity or reducing glucose production in the liver.
Non-Insulin Injectables: GLP-1 receptor agonists and SGLT2 inhibitors are newer classes of medications that help manage blood sugar and offer additional benefits such as weight loss.
Insulin Therapy for Type 1 and Advanced Type 2 Diabetes
Types of Insulin: Rapid-acting, short-acting, intermediate-acting, and long-acting insulins are used depending on the individual’s needs. Insulin therapy mimics the natural insulin release in the body to regulate blood sugar levels.
Administration: Insulin is administered through injections or an insulin pump. Regular monitoring and dose adjustments are necessary to match insulin levels with food intake and physical activity.
Monitoring and Ongoing Care
Blood Sugar Monitoring
Regular Testing: Regular monitoring of blood sugar levels is crucial for managing diabetes effectively. This can be done using a glucometer or a continuous glucose monitor (CGM). Regular monitoring helps prevent complications such as poor blood flow, which can lead to serious issues like foot ulcers and amputation.
A1C Testing: Regular A1C testing provides an overview of long-term blood sugar control and helps guide treatment adjustments.
Regular Check-Ups
Comprehensive Care: Regular check-ups with a healthcare provider are essential for monitoring diabetes and preventing complications. This includes regular eye exams, kidney function tests, and foot care. Monitoring is crucial as prolonged high blood sugar levels can injure blood vessels, increasing the risk of severe complications.
Living with Diabetes
Living with diabetes requires diligent management of blood sugar levels, diet, and physical activity. People with diabetes need to monitor their blood sugar levels regularly to ensure they remain within a healthy range. This can be achieved through the use of glucometers or continuous glucose monitors (CGMs).
A healthy diet is essential for managing blood sugar levels. This means consuming foods low in sugar and saturated fats while focusing on high-fiber options and whole grains. Regular physical activity, such as walking or swimming, can also help manage blood sugar levels and improve overall health.
Working with a healthcare provider to develop a personalized treatment plan is crucial. This plan should consider individual needs and health goals, including medication, insulin therapy, and lifestyle changes. Managing stress and getting enough sleep are also important aspects of living with diabetes, as they can impact blood sugar levels.
People with diabetes are at an increased risk of developing health problems such as heart disease, kidney disease, and nerve damage if their blood sugar levels are not well managed. Regular health check-ups and screenings can help identify potential health issues early, making them easier to treat.
With effective management and healthy lifestyle choices, people with diabetes can lead long and fulfilling lives. Support from family, friends, and healthcare providers can make a significant difference in managing the condition.
Prevention and Awareness
Preventing Type 2 diabetes is possible through lifestyle changes such as maintaining a healthy weight, engaging in regular physical activity, and eating a balanced diet. Awareness of diabetes risk factors and the importance of early detection and treatment can help prevent health complications.
Screening for diabetes is recommended for individuals at high risk, such as those with a family history of diabetes or who are overweight or obese. Early detection and treatment can prevent complications and improve health outcomes.
Education and awareness programs play a vital role in helping people with diabetes and their families understand the condition and how to manage it effectively. Community-based programs and support groups provide valuable resources and support for those affected by diabetes.
Ongoing research into the causes and treatment of diabetes continues to improve our understanding of the condition and how to manage it. Awareness of the importance of diabetes prevention and management can help reduce the burden of the disease on individuals, families, and communities.
Collaboration between healthcare providers, community organizations, clinical trial networks, and individuals with diabetes is essential for effective prevention and management. By working together, we can reduce the impact of diabetes and improve the health and well-being of those affected.
Society and Culture
Diabetes affects people of all ages, cultures, and backgrounds. Cultural and socioeconomic factors can influence how people with diabetes manage their condition and access healthcare services. Stigma and misconceptions about diabetes can affect how individuals with the condition are perceived and treated by others.
Education and awareness programs are crucial in reducing stigma and promoting understanding and acceptance of people with diabetes. Community-based programs and support groups can provide valuable resources and support for individuals from diverse cultural backgrounds.
Healthcare providers need to be culturally sensitive and aware of the unique needs and challenges faced by people with diabetes from different cultural backgrounds. Research into the cultural and socioeconomic factors affecting diabetes management and health outcomes is ongoing, helping to improve our understanding of the condition.
Collaboration between healthcare providers, community organizations, and individuals with diabetes is essential for effective prevention and management. By working together, we can reduce the impact of diabetes and improve the health and well-being of those affected.
Diabetes is a global health issue that requires a comprehensive and coordinated response from governments, healthcare providers, and communities worldwide. By addressing the cultural and socioeconomic factors influencing diabetes, we can create a more inclusive and effective approach to managing the condition.
Help Find Potential New Treatments for Diabetes with Clinical Trials
Understanding diabetes is the first step in managing it effectively. By recognizing the symptoms, getting an accurate diagnosis, and following a comprehensive treatment plan that includes lifestyle changes, medication, and regular monitoring, individuals with diabetes can lead healthy and fulfilling lives. Early detection and proactive management are key to preventing complications and maintaining overall well-being.
If you, someone you love, or a patient has been diagnosed with diabetes, consider joining a clinical trial to help find innovative potential treatments and therapies to manage this chronic disease. By enrolling in a clinical trial, you not only gain access to new medications that could improve patient outcomes, you also contribute to the future of medical treatment for generations to come. Complete our diabetes survey to see if you could be a candidate for an upcoming clinical study.