Symptoms may develop quickly, but damage to the insulin-producing beta cells in the pancreas may have been going on for some time.
It’s important to know and recognize these symptoms because a person who develops diabetes and is not diagnosed and treated can lapse into a life-threatening diabetic coma. This coma is known as diabetic ketoacidosis.
There is no cure for diabetes, but it can be treated, or managed. The main goal in diabetes management is to keep blood glucose levels, cholesterol, and blood pressure as close to normal range as possible. A combination of insulin, physical activity, and healthy diet are the basic tools for treating type 1 diabetes. Type 2 diabetes is managed by healthful eating, regular physical activity, and blood glucose testing to keep track of blood glucose levels. Some people with type 2 diabetes also take medicines (pills, insulin, or other injectable medicine) to help control glucose levels.
Management of diabetes has improved in recent decades. Innovations include quick-acting and long-acting insulins for insulin-dependent (type 1) diabetes, more oral drugs for type 2 diabetes, improved blood glucose monitors, and external insulin pumps to replace daily injections. As well, care for diabetes-related conditions has improved; for example, laser surgery can treat eye disease, and kidney and pancreas transplantation is a possibility for people with organ failure.
Treatment of diabetes is often handled by primary care physicians, though other specialists may be part of the healthcare team. Additional specialists may include an endocrinologist who specializes in diabetes care, a dietician to help with sound food choices, educators certified in diabetes, and a podiatrist and/or ophthalmologist (eye and foot issues are possible complications of diabetes). And, depending on an individual’s overall health, the healthcare team may extend to other specialists—cardiologists for those with heart concerns and obstetricians for pregnant women, for example.
A regular visit to the doctor for someone with diabetes should include:
Diabetes has a large impact in the United States: it’s been widely recognized as one of the leading causes of death and disability. Cardiovascular disease is a serious risk for people with diabetes, which contributes to the high rate of death among people with diabetes from heart disease or stroke (at least 65 percent). As a result, people with diabetes need to manage their blood glucose levels as well as their blood pressure and cholesterol levels. Healthy diet, physical activity, and medicines prescribed by a doctor can help protect cardiovascular health. Some healthcare providers also recommend regular Aspirin use. Avoiding or quitting smoking is another important part of cardiovascular health.
Serious Health Complications of Diabetes
There are other complications related to diabetes that, while not always immediately life-threatening, can become long-term problems. Fortunately, by controlling your blood glucose levels, maintaining a healthy weight, exercising regularly, and managing your blood pressure and cholesterol levels, many of the potential complications of diabetes can be prevented or managed or their onset may be delayed. Learn more about these complications and how to manage them in the next section, “Living with Diabetes and Caring for Yourself.”
If you have diabetes, your healthcare team is important, but you make a big difference in your health by the steps you personally take to manage diabetes. Daily management involves keeping blood glucose at target levels (avoiding levels that are too low or too high), knowing how to respond if blood glucose rises or drops, and making healthy choices about diet and exercise. As well, understanding potential common complications of diabetes and how to manage or prevent them will help you stay healthy.
Maintain healthy blood pressure. Normal blood pressure (less than 130/80) can help prevent damage to eyes, kidneys, and blood vessels among people with diabetes. High blood pressure is common among people with diabetes. Keep blood pressure within a healthy range through healthy diet and physical activity, and in some cases, with medicines prescribed by your doctor.
Maintain healthy cholesterol. High blood cholesterol levels are a potential complication of diabetes and, due to resulting narrowing or clogging of blood vessels, can raise risk for heart disease and stroke (two particularly significant health concerns among people with diabetes) and cause circulation problems. Try to keep blood cholesterol at healthy levels (a total cholesterol of under 200, LDL under 100, HDL above 40 in men and 50 in women, and triglycerides under 150) with a healthy diet, exercise, and possibly medications.
Don’t smoke. Smoking is a health risk for the general population and can be particularly dangerous for people with diabetes. Ill effects include raising blood glucose, blood pressure, and cholesterol levels. As well, tobacco further increases the risk of heart and blood vessel complications among people with diabetes. If you do smoke, quitting has significant health benefits—risk for heart attack and stroke and nerve, kidney, and oral diseases are all lowered.
Get an annual flu shot. Because diabetes can make your immune system more vulnerable to severe cases of the flu, it’s important to protect yourself by getting a flu shot every year, preferably in the fall before flu season begins. Talk your doctor about other vaccinations, like one for pneumonia.
Keep your blood glucose as close to normal as possible. Test your blood glucose regularly (several times a day, as indicated by your healthcare team); doing so can prevent or delay the onset of certain diabetes-related complications. Watch for both low blood glucose and high blood glucose. By keeping track, you’ll better understand how food, physical activity, and diabetes medicines affect blood glucose and, as a result, how to better manage these levels.
Recognize what triggers low blood glucose readings (lower than 70 mg/dL). Eating less than usual, getting more exercise, or taking too much diabetes medicine can cause a drop, and so can drinking beer, wine, or liquor. Your doctor can tell you about ways to treat low blood glucose, including which foods to eat and the right amounts. Examples include fruit juice (1/2 cup), hard candy (three to five pieces), and glucose tablets (three to four).
It’s also important that you tell people around you (friends, family, and coworkers) that you have diabetes and how to respond if your blood glucose falls too low. They should know about foods and medications to give you, including timing and amount or dosage.
High blood glucose (higher than 140 mg/dL) before a meal can damage body organs over time. Blood glucose can be high as a result of too much food, less physical activity than usual, or too little diabetes medicine. You can help prevent levels from becoming too high by maintaining a consistent food and exercise program, drinking enough water, taking diabetes medicine at regular times, and maintaining a healthy weight.
Be prepared for work, school, and travel. When you leave home, plan to follow your regular schedule as closely as possible, including when you eat, test blood glucose, take medicine, and exercise. Take along all necessary supplies, including snacks, water, medicines, and blood glucose testing supplies and wear a form of identification (like a bracelet) to indicate that you have diabetes.
Take proper care of your feet, eyes, and oral health. Get routine exams with appropriate specialists (a podiatrist for feet, and an ophthalmologist for eyes, and a dentist). Prevent injury to your feet by checking them regularly and wearing properly-fitting shoes and cotton socks. Practice good oral hygiene—brush your teeth at least twice a day and floss at least once.