Diabetes control: Warning signs and tips to reduce your risk

Educating ourselves on chronic diseases that are significant risks to our health can significantly improve and even save our lives. Although we may worry about genetically modified foods and pesticide contamination, diabetes is a greater risk to your health and well being.

Diabetes is a disorder of insulin production or use. Insulin is secreted by the pancreas in response to the food we consume. Disruption in the production or use of insulin causes alteration in the way food is used. It is critical to know the differences between both Type 1 and Type 2 diabetes so you can be aware of signs, symptoms and treatment options.

Type 1 diabetes

Type 1 diabetes is often considered juvenile-onset diabetes since the usual patient is less than 20 years old. According to the CDC, more than 13,000 Americans are diagnosed with the disease each year. Type 1 diabetes accounts for about five percent of total cases. Signs and symptoms include increased thirst, urination, hunger and rapid weight loss. In Type 1 diabetes, the body stops producing insulin and insulin must be given via injection in a way that mimics normal pancreatic function.

Type 2 diabetes

As opposed to Type 1 diabetes, those with Type 2 diabetes make insulin but don’t use the hormone effectively. The body subsequently responds by making more insulin. This excess insulin can cause an increase in appetite and other undesirable health changes. Being overweight and lack of physical activity increases the risk.

Although the symptoms of Type 1 and Type 2 diabetes are similar, the latter disease is stealth like. Type 2 diabetes symptoms are subtle and gradual in onset. Prior to the onset of Type 2 diabetes, blood sugars are elevated along with hemoglobin A1C but below the threshold of Type 2 diabetes. This is often referred to as prediabetes.

An alarming statistic from the CDC indicates that one in three Americans (approximately 86 million) have prediabetes. Those diagnosed with prediabetes are at increased risk of stroke and heart disease. We should view this as a significant health risk and not just a “touch of sugar” as many people believe. A study entitled the Diabetes Prevention Program demonstrated that lifestyle changes such as improving nutrition, weight loss and exercise can prevent those at high risk of developing Type 2 diabetes from developing the disorder. In this study, medication was less effective than lifestyle changes.

This disease also has a genetic link and is more common in African-Americans and Hispanic-Americans.

Warning signs

As an adult, what can you do? Be a partner with your health care provider and track your warning signs. Since the symptoms are subtle, many cases of Type 2 diabetes go undiagnosed for years. However, there are warning signs for you to consider. Some of these warning signs you can see and others you can measure.

• Acanthosis nigricans: When the body produces too much ineffective insulin, it increases the amount of melanin or pigment in the skin, which is a condition known as acanthosis nigricans. This pigment appears as a dark, thickened skin most visible around the neck. It’s often confused with poor personal hygiene but it can’t be scrubbed away.
• Obesity: As weight increases, particularly around the midsection, it is a risk factor. Losing body fat is a key solution in the prevention and treatment of Type 2 diabetes.  This is best accomplished by lowering calories and exercising at least 30 minutes most days of the week.
• Blurred vision: An increase in blurred vision is common and reflects the impact of high blood sugars. Elevated sugar can cause changes in the eye and loss of vision if left untreated.
• Increased blood sugar: Hemoglobin A1C is a measure of your blood sugar over the last three months and can be ordered by your physician if you are at risk. Fasting blood sugars are often within the normal range at the onset of the disease but it is the after-meal blood sugars that go haywire. Request this lab test when you go for your annual physical.

Strategies to reduce risk

The elimination of all sugared-sweetened beverages and lowering the fat and sugar content of foods reduces the risk of  Type 2 diabetes for all age groups.

Whole grains are good sources of magnesium and fiber, which may help with improved nutritional status and weight control.  As with all foods, portion control is a key to weight management.

Exercise is also critical as it makes the body more sensitive to the effects of insulin. It can reduce body fat if calories are controlled. All major public health organizations recommend 60 minutes per day of exercise or play for children as well as 30-60 minutes of physical activity for adults.

Look for ways to build activity throughout your day by taking the stairs or walking to a co-worker’s office rather than sending an email. Limiting total screen time to less than two hours per day is another recommendation to help control weight in children and adolescents.

The prevention and treatment of diabetes is essential. The goal is preventing the complications of the disease. The first step is assessing your risk. Make 2017 special by understanding your risk, modifying your food choices and increasing your physical activity!

-By Roberta Anding, dietitian with Baylor College of Medicine