Dear Lord, give me strength. I have to say this prayer everyday of my life. Type 2 diabetes is killing me. I can’t control my sugar intake or my blood glucose numbers. It seems that no matter what I eat, a salad, or a steak, my blood glucose ends up too high. I do not understand this disease. I have read and tried to understand the physiology of it, but it confuses me. I have put off writing this particular page just because of my misunderstanding of the disease. Hopefully as I build this page, I will learn the things I have been missing in my quest to control diabetes.
Type 2 diabetes is the most common form of diabetes. Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn’t able to keep up and can’t make enough insulin to keep your blood glucose at normal levels.
When glucose builds up in the blood instead of going into cells, it can cause two problems:
- Right away, your cells may be starved for energy.
- Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart.
- Extreme hunger
- Extreme thirst
- Frequent urination
- Unexplained weight loss
- Fatigue or drowsiness
- Blurry vision
- Slow-healing wounds, sores or bruises
- Dry, itchy skin
- Tingling or numbness in the hands or feet
- Frequent or recurring skin, gum, bladder or vaginal yeast infections
I never knew there were symptoms, but now that I’m looking at them, I see that I have had many of them. Weight loss was not one of my symptoms, unfortunately.
Type 2 diabetes is more common in African-Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as the aged population. You are at risk if you are over-weight, have family history of diabetes, don’t exercise and eat a diet high in fat, calories and cholesterol.
Polycystic ovary syndrome (PCOS) is a condition that occurs when an imbalance of hormone levels in a women’s body causes cysts to form on the ovaries. Women who have PCOS are at an increased risk of developing type 2 diabetes.
What causes diabetes?
When you digest food, your body changes most of the food you eat into glucose (a form of sugar). A hormone called insulin allows this glucose to enter all the cells of your body and be used as energy. Insulin is produced by the pancreas. In someone who has type 2 diabetes, the pancreas doesn’t make enough insulin or the body’s cells can’t use insulin properly (called insulin resistance). This causes glucose to build up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems that may damage the blood vessels, nerves, heart, eyes and kidneys.
This is the best answer I have found to the question: What causes diabetes?
Nerve damage from diabetes is called diabetic neuropathy (new-ROP-uh-thee). About half of all people with diabetes have some form of nerve damage.
Peripheral neuropathy can cause tingling, pain, numbness, or weakness in your feet and hands.
- My feet tingle.
- I feel “pins and needles” in my feet.
- Pain or Increased Sensitivity
- I have burning, stabbing or shooting pains in my feet.
- My feet are very sensitive to touch. For example, sometimes it hurts to have the bed covers touch my feet.
- Sometimes I feel like I have socks or gloves on when I don’t.
- My feet hurt at night.
- My feet and hands get very cold or very hot.
- Numbness or Weakness
- My feet are numb and feel dead.
- I don’t feel pain in my feet, even when I have blisters or injuries.
- I can’t feel my feet when I’m walking.
- The muscles in my feet and legs are weak.
- I’m unsteady when I stand or walk.
- I have trouble feeling heat or cold in my feet or hands.
- It seems like the muscles and bones in my feet have changed shape.
- I have open sores (also called ulcers) on my feet and legs. These sores heal very slowly.
Autonomic neuropathy affects the nerves in your body that control your body systems.
- About my digestive system
- I get indigestion or heartburn.
- I get nauseous and I vomit undigested food.
- It seems like food sits in my stomach instead of being digested.
- I feel bloated after I eat.
- My stomach feels full, even after I eat only a small amount.
- I have diarrhea.
- I have lost control of my bowels.
- I get constipated.
- My blood glucose levels are hard to predict. I never know if I’ll have high or low blood glucose after eating
- About my urinary tract
- I have had bladder control problems, such as urinating very often or not often enough, feeling like I need to urinate when I don’t, or leaking urine.
- I don’t feel the need to urinate, even when my bladder is full.
- I have lost control of my bladder.
- I have frequent bladder infections.
- About my sex organs
- (For men) When I have sex, I have trouble getting or keeping an erection.
- (For women) When I have sex, I have problems with orgasms, feeling aroused, or I have vaginal dryness.
- About my heart and blood vessels
- I get dizzy if I stand up too quickly.
- I have fainted after getting up or changing my position.
- I have fainted suddenly for no reason.
- At rest, my heart beats too fast.
- I had a heart attack but I didn’t have the typical warning signs such as chest pain.
- About my body’s warning system for low blood glucose levels (hypoglycemia)
- I used to get nervous and shaky when my blood glucose was getting too low, but I no longer have those warning signals.
- About my sweat glands
- I sweat a lot, especially at night or while I’m eating.
- I no longer sweat, even when I’m too hot.
- The skin on my feet is very dry.
- About my eyes
- It’s hard for my eyes to adjust when I go from a dark place into a bright place or when driving at night.
Other Types of Neuropathy
- Charcot’s Joint, also called neuropathic arthropathy (arthropathy), occurs when a joint breaks down because of a problem with the nerves. This type of neuropathy most often occurs in the foot.
- People at risk for Charcot’s Joint are those who already have neuropathy. They should be aware of symptoms such as:
- strong pulse
- insensitivity of the foot.
- Cranial neuropathy affects the 12 pairs of nerves that are connected with the brain and control sight, eye movement, hearing, and taste.
- Compression mononeuropathy occurs when a single nerve is damaged. It is a fairly common type of neuropathy. There seem to be two kinds of damage. In the first, nerves are squashed at places where they must pass through a tight tunnel or over a lump of bone. Nerves of people with diabetes are more prone to compression injury. The second kind of damage arises when blood vessel disease caused by diabetes restricts blood flow to a part of the nerve.
- Femoral neuropathy occurs most often in people with type 2 diabetes. A pain may develop in the front of one thigh. Muscle weakness follows, and the affected muscles waste away. A different kind of neuropathy that also affects the legs is called diabetic amyotrophy (a type of neuropathy resulting in pain, weakness or wasting of the muscles). In this case, weakness occurs on both sides of the body, but there is no pain. Doctors do not understand why it occurs, but blood vessel disease may be the cause.
- Focal Neuropathy affects a nerve or group of nerves causing sudden weakness or pain. It can lead to double vision, a paralysis on one side of the face called Bell’s palsy, or a pain in the front of the thigh or other parts of the body.
- Thoracic or lumbar radiculopath is another common mononeuropathy. It is like femoral neuropathy, except that it occurs in the torso. It affects a band of the chest or abdominal wall on one or both sides. It seems to occur more often in people with type 2 diabetes. Again, people with this neuropathy get better with time.
- Unilateral foot drop is when the foot can’t be picked up. It occurs from damage to the peroneal nerve of the leg by compression or vessel disease. Foot drop can improve.
“Diabetes distress” isn’t the same as depression, however, diabetes experts note. It’s a condition unique to the 24/7 demands that come with diabetes, particularly for people dependent on insulin.
“The day you develop diabetes, it’s like the universe just handed you a new full-time job that you have to do in addition to whatever else you’re doing. It’s a special job that has a big impact on the rest of your life. There’s no pay and no vacation,” said William Polonsky, president of the Behavioral Diabetes Institute in San Diego.
Eating right, exercising, maintaining a healthy weight and, if needed, taking oral medicines or insulin.
Tips on eating right
- Eat at about the same time every day. This helps keep your insulin or medicine and sugar levels steady.
- Try to eat 3 times a day. Have a snack at bedtime if you’re taking medicine or insulin. Avoid other snacking unless you’re exercising or treating hypoglycemia.
- If you’re overweight, lose weight. Even losing just a little weight, such as 5 to 15 pounds, can lower your blood sugar levels.
- Eat plenty of fiber. Green leafy vegetables, whole grains and fruits are good choices. Fiber helps you feel full and helps with digestion.
- Eat fewer empty calories, such as foods high in sugar and fat, and alcohol.
Exercising will help your body use insulin and lower your blood sugar level. It also helps control your weight, gives you more energy and is good for your overall health.
Maintain a healthy weight.
Losing excess weight and maintaining a healthy body weight will help you in 2 ways. First, it helps insulin work better in your body. Second, it will lower your blood pressure and decrease your risk for heart disease.
Take your medicine.
If your diabetes can’t be controlled with diet, exercise and weight control, your doctor may recommend medicine or insulin. Oral medicines(taken by mouth) can make your body produce more insulin or help your body use the insulin it makes more efficiently. Some people need to add insulin to their bodies with insulin injections, insulin pens or insulin pumps. Always take medicines exactly as your doctor prescribes.
What tests can I use to check my blood sugar level?
There are 2 blood tests that can help you manage your diabetes. One of these tests is called an A1C test, which reflects your blood sugar (or blood glucose) control over the past 2-3 months. Testing your A1C level every 3 months is the best way for you and your doctor to understand how well your blood sugar levels are controlled. The other test is called SMBG, or self-monitoring of blood glucose. Using a blood glucose monitor to do SMBG testing can help you improve control of your blood sugar levels.
How will I know if my blood sugar level is too high?
High blood sugar (also called hyperglycemia) can occur even if you are eating properly and taking your insulin correctly. Eating too much food at a meal, getting sick, having hormonal changes and feeling stressed out can affect your blood sugar.
Symptoms of hyperglycemia include the following:
- Frequent urination
- Extreme thirst
- Blurry vision
- Feeling very tired
What if my blood sugar gets too low?
People who have diabetes may have times when their blood sugar level is too low. Low blood sugar is called hypoglycemia. Signs of hypoglycemia include the following:
- Feeling very tired
- Frequent yawning
- Being unable to speak or think clearly
- Loss of muscle coordination
- Suddenly feeling like you’re going to pass out
- Becoming very pale
- Loss of consciousness
People who have diabetes should carry at least 15 grams of a fast-acting carbohydrate with them at all times in case of hypoglycemia or an insulin reaction. The following are examples of quick sources of energy that can relieve the symptoms:
- Non-diet soda – ½ to ¾ cup
- Fruit juice – ½ cup
- Fruit – 2 tablespoons of raisins
- Milk – 1 cup
- Candy – 5 Lifesavers
- Glucose tablets – 3 tablets (5 grams each)
I think I have a better understanding of diabetes now. I still have some questions, that I can’t find the answers to, and will update this page as soon as I do find them.
- Educational Guidelines for Achieving Tight Control and Minimizing Complications of Type 1 Diabetes by Stephen Havas, M.D., M.P.H., M.S. (American Family Physician November 01, 1999, http://www.aafp.org/afp/991101ap/1985.html)
- The Merck Manual for Healthcare Professionals. Diabetes Mellitus (DM). Accessed January 01, 2011
- National Diabetes Information Clearinghouse. Diabetes Overview. Accessed January 01, 2011
- National Diabetes Education Program. Overview of Diabetes in Children and Adolescents. Accessed January 01, 2011
- National Institutes of Health. Type 1 Diabetes Fact Sheet. Accessed January 01, 2011
- Diagnosis and Classification of Diabetes Mellitus: New Criteria by Jennifer Mayfield, M.D., M.P.H. (American Family Physician October 08, 1998, http://www.aafp.org/afp/981015ap/mayfield.html)
- Attenuating Cardiovascular Risk Factors in Patients with Type 2 Diabetes by Alan J. Garber, M.D., Ph.D. (American Family Physician December 15, 2000, http://www.aafp.org/afp/20001215/2633.html)
- Treatment of Type 2 Diabetes Mellitus by Joe A. Florence, M.D., and Bryan F. Yeager, Pharm.D. (American Family Physician May 15, 1999, http://www.aafp.org/afp/990515ap/2835.html)