Diabetes happens when the body does not have enough insulin to move glucose from the blood to the cells. This causes it to build up in the blood instead of being used by the cells for energy. Type 2 is more common in adults.
Type 1 diabetes happen when the body does not make insulin (this usually happens at a young age, but not always.)
Type 2 happens when the body becomes resistant to insulin or when the pancreas cannot make enough. This may be due to a person’s genes and habits.
Type 2 is more common in people with obesity and those over 45 years of age. People who are American Indian, Alaska natives, Afro American, and Hispanic are at higher risk. Some other common risks are:
- Prediabetes—formerly known as “borderline diabetes”
- Metabolic syndrome—fat around the belly and high cholesterol, high glucose, and blood pressure
- Polycystic ovary syndrome
- Past gestational diabetes or having a baby that weighs over 9 pounds at birth
- Poor eating habits
- Lack of exercise
- High blood pressure
- Taking certain medicines, such as glucocorticoids or thiazides
Most people do not have problems right away. Others may have:
- Excessive urination
- Excessive thirst
- Blurry eyesight
- Weight loss
- Being very tired
- Frequent infections (especially urinary tract and vaginal yeast infections)
The provider will ask about your symptoms and health history. A physical exam will be done.
Diabetes is diagnosed with blood tests that check for high glucose levels. More than one test may be done.
These blood tests will also be done to find out whether it is type 1 or type 2:
- Insulin level or C-peptide tests to see how much insulin is being made by the pancreas
- Tests that look for antibodies that are working against the pancreas
The goal is to keep glucose levels at close to target levels. This can be done with:
Healthy habits can help manage type 2, such as:
- Testing blood glucose levels as needed or recommended
- Working with a dietitian to make a meal plan that will help keep blood glucose levels normal
- Getting enough exercise
- Reaching a healthy weight
Most people may need medicine to control blood glucose. Metformin is a common oral medication that is given as a first step.
There are many options including oral and injectable medications for treating diabetes if the initial treatment choice is inadequate. This may include insulin which may be given by injection, inhalation or pump.
Although it may not be possible to prevent the onset of diabetes, following healthy habits such as exercising, staying at a healthy weight, and eating right will lower the risk of developing diabetes.
American Diabetes Association: http://www.diabetes.org
National Diabetes Information Clearinghouse: http://diabetes.niddk.nih.gov
Canadian Diabetes Association: http://www.diabetes.ca
Public Health Agency of Canada: http://www.phac-aspc.gc.ca
Importance of a Primary Care Physician
An established relationship with your Primary Care Provider enables you to have insight into wellness options and resources available which can greatly impact your overall health.
For a complete listing of Primary Care Providers:
When to consult with a Specialist
Your Primary Care Provider will assist you in determining if a specialist is required to manage your care. If it is determined that treatment by an Endocrinologist is required, it is still important to visit your Primary Care Provider annually to review other aspects of your care and complete other tests or labs as needed.
Diabetes Nurse Educator
Certified Health Coach
Medical & Surgical Weight Loss
What does the Hemoglobin A1c blood test measure and why is it important?
The HbA1c is a blood test that estimates a patient’s average blood sugar level over a period of two or three months. It is not a lab requiring fasting. This test is important in that it indicates how well the diabetes is managed and what interventions are required to avoid issues due to high blood sugar levels.
How does diabetes affect my vision and what are the benefits of an eye exam?
Exposure to high blood glucose can damage the walls of the blood vessels in the eyes and result in diabetic retinopathy.
Although retinopathy cannot be cured, it is important to catch early as treatment at early stages can be very effective in preserving vision. Additionally, annual comprehensive eye exams can detect glaucoma and cataracts which are often diagnosed earlier in patients with diabetes.
How does diabetes affect my kidneys?
Elevated blood sugar levels can result in damage to the kidneys, a condition called diabetic nephropathy. This condition results in increased levels of protein in the urine detected by a simple non-fasting microalbumin urine test. It is important to diagnose diabetic nephropathy at an early stage for more effective treatment.
Do I need to see my Primary Care Provider if my diabetes is managed by an Endocrinologist?
It is important to visit your Primary Care Provider at least once per year even if you are seeing an Endocrinologist. Your PCP will be managing your blood pressure, cholesterol and additional areas of your overall care. When seeing an Endocrinologist within our network the notes for both providers are easily accessed through your electronic medical record enabling enhanced communication for the providers and though the Lahey Portal.
What are the benefits of seeing the Diabetes Nurse Educator?
A Diabetes Nurse Educator has time to evaluate and assess areas of a patient’s care that require more information for sustainable self-management. This important resource is most valuable at the initial diagnosis of diabetes and if a patient requires added guidance and support. The education can include information custom to each patient with instruction on medications, signs and symptoms of hypoglycemia, and medication peak performance. Additionally, pharmacy questions and options may be included.
What are the benefits of meeting with the health coach and registered dietician?
Weight loss, appropriate nutrition and learning techniques to move wellness goals forward are an important aspect of managing diabetes. Additionally, moderate exercise can help with losing body fat which can improve insulin sensitivity in patients with type 2 diabetes, and positively affect blood pressure and cholesterol.
Can weight loss impact my diagnosis of type 2 diabetes?
Yes, weigh loss can usually improve insulin resistance. Often the Hemoglobin A1c percentage can be reduced with improved control by losing just 5-10% of your body weight.
Do my labs need to be completed at my appointment or can I visit a lab prior to my visit?
Your provider will be adding labs to be completed in your electronic medical record so that you are able to visit a Winchester Hospital lab prior to your visit. A list of lab collection sites can be obtained from your primary care practice. Additionally, some providers prefer to draw the Hemoglobin A1c and collect the microalbumin urine lab during your visit. Please ask the practice when you schedule your appointment or contact the provider through your Lahey Portal.