Understanding and Managing Diabetes

Diabetic Woman in PoolDiabetes presents unique difficulties for women. If you have diabetes, you're at increased risk of a heart attack — at a younger age — than someone without diabetes. Because diabetes damages the nervous system, it can be more difficult to recognize symptoms of a heart attack. And, if you have diabetes when you get pregnant, you're at higher risk of miscarriage, or of having a baby born with defects.

What Is Diabetes?

When your fasting blood sugar is always higher than 125, you have diabetes.

There are several kinds of diabetes. The two most common are known as type 1 and type 2. They can be caused by genes inherited from your family, but lifestyle, illness, stress, and other factors play a role in whether or not you will develop diabetes — regardless of whether you inherited these genes.

Damage to the pancreas can also cause the disease. The damage can be the result of injury, illness, or from taking certain medicines. In type 1 diabetes, your immune system destroys your body's beta cells, and the body can no longer make any insulin. In type 2 diabetes, your body can't make enough insulin to keep up with the body's needs, or can't use the insulin in the right way. When this happens, the body isn't able to use or store the sugar it gets from food. Instead, the sugar stays in the blood, causing high blood sugar.

A third type of diabetes is gestational diabetes. This type only develops during pregnancy, and usually goes away after the baby is born. Once you've had gestational diabetes, it's important that you're screened for diabetes every year because you have a greater chance of getting type 2 diabetes later in life. Be sure to remind your doctor so you stay on track with regular screening.

Diabetes can come on slowly. At first, you may not have any symptoms. But when blood sugar levels stay at a high level, you may feel more thirsty and tired than usual, and urinate more often. These are often the first signs of diabetes.

Why Insulin Is So Important

Insulin is a hormone made by the pancreas, one of your body's organs. Insulin helps the body turn sugar into energy. It also helps the body store sugar in muscles, fat, and the liver, so it can be used later. Without insulin, the body can't use or store sugar for energy. Instead, the sugar stays in the blood.

See illustration: How Insulin Works

After we eat, the sugar in our blood rises. This rise in blood sugar tells the pancreas to release insulin into the bloodstream. Insulin travels through the blood to our cells and tells our cells to open up and let the blood sugar in. Once the sugar gets inside, the cells convert it into energy or store it for later use.

Insulin Resistance and Impaired Glucose Tolerance

People with diabetes have trouble processing insulin. They may become insulin resistant, meaning that the cells in the body won't allow the insulin to turn blood sugar into energy. Another way diabetes disrupts the body's use of sugar is known as impaired glucose tolerance. This happens when the pancreas can't make enough insulin to keep your blood sugar in a normal range.

Glucose tolerance is measured by blood tests that may return a value under 100 (normal) or between 100–125 (impaired).

Self-Management Is Key

Although diabetes is a serious lifelong condition, it's possible to manage it successfully. The first step is to eat a healthy diet, exercise, and manage stress. You may also need medication — either pills or insulin shots — to keep blood sugar levels in the normal range.

It's important to keep track of your blood sugar levels through regular checks, and to stay on top of regular health care exams and lab tests.
If you don't manage this health condition carefully, diabetes can lead to serious, long-term health problems such as heart disease and damage to the kidneys, eyes, and nerves. You can greatly lower the risk of these complications through good self-care.