I always worry about my patients with diabetes. As I’m a cardiothoracic surgeon, all of my patients are sick by definition, but of all of my patients, it is the diabetics who are the most unpredictable. Diabetes was a disease almost unknown in children and uncommon in adults 20 years ago. Today, it’s one of the most common adult diseases and is on the rise in kids. This potentially devastating disease can affect just about every organ of the body and dramatically shorten your life. Fortunately, we’re turning the tide. Over the years that diabetes has become more common, it’s also become better understood. It’s National Diabetes Month and I want to spend some time talking about diabetes and what you can do to defeat it.
Diabetes Is Just One Piece of the Puzzle
While you probably know that diabetes is a disease that affects your blood sugar, you might not know that it’s part of a larger health problem. Diabetes rose with the growth of obesity and the two diseases are intimately intertwined in ways we don’t fully understand. Both are part of a larger syndrome of associated conditions called the “metabolic syndrome” made up of three to five conditions:
- High blood pressure
- High LDL cholesterol (the bad kind)
- Low HDL cholesterol (the good kind)
The fact that these conditions often appear together indicates that all are symptomatic of a deeper problem with the way your body is dealing with food and energy balance. Healthy bodies can handle cholesterol, fat, and sugar in a way that prevents blood vessel and weight problems. Bodies with metabolic syndrome lose the ability to regulate these systems, which leads to inflammation, hormonal changes, and shifts in metabolism.
Not All Diabetes Are the Same
There are two different types of diabetes that we know about: type 1 diabetes and type 2 diabetes. Type 1 is most commonly seen in children and occurs when the body’s immune system attacks its own insulin-hormone-making cells. As those cells die, the levels of insulin in the body drop, which means the body has no hormone to control the levels of sugar in the blood. These individuals need that insulin replaced for the rest of their lives because those cells don’t ever grow back. Without insulin, their blood sugar will swing between sky high and rock bottom, which can be incredibly dangerous.
Type 2 is almost a completely different disease. While both are related to blood-sugar regulation, their causes are different, which means the treatment is also different. So far as we can tell, type 2 diabetes results when the body’s cells lose their sensitivity to the insulin signal. The pancreas cells that make insulin are pumping the hormone out, but the body isn’t responding the way it should. It eventually picks up on the signal, but it gets more and more sluggish over the course of the disease. Medications are available that both help the pancreas pump out more insulin to meet this greater demand and make the body more sensitive to the insulin it’s already making.
One last point here is that no two people with diabetes are alike. I’ve found that everyone thinks of their health differently and manages their health differently. Different medications work for different people for different reasons. This why it’s so important to have a good relationship with a doctor you trust if you have diabetes: it might take a while to find the right formula, but when you do, the results can be life changing and lifesaving.
Knowing Your Numbers Is Key
One of the hardest parts of ype 2 diabetes is that it’s a mostly invisible disease. It creeps up on you over years and years of poor health. Fortunately, we have great tests to measure what’s going on in your blood keep an eye on what’s going on before symptoms even appear. Asking your doctor about your diabetes risk is the first and most important step. He or she can walk through your risk factors with you and figure out whether further testing is a good idea.
For those who do have diabetes, remember to regularly checking your blood sugars. There’s no way around this. If you aren’t checking your blood sugar regularly, you’re flying blind when it comes to your health. Discuss how often you should be checking with your doctor and ask for prescriptions for the needed medical supplies.
It Often Comes Down to Diet and Exercise
While doctors have a wide range of effective medications within their reach to treat diabetes, diet and exercise are the real heavy hitters when it comes to sugar control. Exercise helps to push up your body’s sensitivity to insulin, essentially acting to reverse the disease. It also works in a variety of other ways to reverse the other components of metabolic syndrome by helping to fix your cholesterol levels, lower your blood pressure, and keep your weight under control.
Diet also makes a huge difference when it comes to diabetes. Dropping your carbs and replacing them with more fruits and vegetables is a great place to start. You can also replace simpler carbohydrates, like white bread or rice, with more complex ones, like whole grain bread or quinoa. Like exercise, boosting the health factor in your diet fights diabetes while also cutting your cholesterol, blood pressure and weight.
Remember to Stay Positive
While it can be hard to believe at the initial diagnosis, people do beat diabetes. They change their diet, start exercising, and find medications that work for them. Their blood sugar problems may not get better overnight and may never completely disappear. But their control of the disease means it probably won’t give them heart disease, lead to blindness, or cause them to lose a leg. They live with their disease and thrive in spite of it. Seeing diabetes as an unchangeable part of your future only sets you up for failure. While it might not feel like it at the time, many have told me that their diagnosis was the warning sign they needed to turn their health, and their lives, around.
So take some time this month to learn about diabetes, to check your risk factors, and to renew your pledge to better health.