In type 2 diabetes, the pancreas may still continue to produce some insulin. Because some insulin is present, blood sugar levels rise intermittently or so slowly that a person usually does not have symptoms and may have the disease for many years before diagnosis. A person may have all or some of the symptoms. It’s also possible not to have any signs or to be aware of them.
Think and review:
What are the symptoms of diabetes?
What should you do if you have any symptoms?
Complications:
Diabetes can lead to many complications including:
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Heart disease
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Stroke
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Kidney disease
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Vision problems (often leads to blindness)
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Nerve damage (may lead to amputation of toes, feet and legs)
The good news is that complications can be prevented or delayed by keeping blood sugar levels close to normal levels. It’s important for people who have diabetes to find out they have it and begin treatment to keep blood sugar levels close to normal.
Goal of Diabetes Treatment: The goal of diabetes treatment is to lower blood sugar and keep it close to normal levels. Research studies (Diabetes Control and Complications Trial - DCCT and the United Kingdom Prospective
Diabetes Study -UKPDS) showed that controlling blood glucose levels to keep them close to normal levels greatly reduces the risk of complications.
Doctors tell diabetic patients the blood glucose levels they should aim for. People with diabetes should test blood regularly so they will know if blood sugar is controlled. Blood sugar levels should not get too high or too low. High blood sugar (hyperglycemia – discussed earlier) causes diabetes complications.
Diabetic ketoacidocis (DKA – discussed earlier) can cause coma and death. Low blood sugar (hypoglycemia) also may occur in diabetes, especially in type 1 diabetes when the person is taking insulin and not eating sufficient food. Symptoms of type 1 diabetes include anxiety, sweating, tremor , palpitations, nausea, and pallor and weakness. Hypoglycemia also starves the brain of glucose energy, which is essential for proper brain function. Lack of glucose energy to the brain can cause symptoms ranging from headache, mild confusion and abnormal behavior, to loss of consciousness, seizure and coma. Severe hypoglycemia can cause death.
To find out how well the blood sugar is being controlled, a person with diabetes checks blood glucose regularly (sometimes several times a day).
People with diabetes should also have another test called the hemoglobin A-1C test, which tells how well blood glucose levels have been controlled for two or three months.
Another goal for type 2 is to improve the body's use of insulin. With type 2 diabetes, the pancreas may still make some insulin but the body can’t use it properly.
To lower blood sugar levels, it’s important to:
Eat regularly planned nutritious meals and snacks.
Type 1 diabetes treatment - People with type 1 diabetes must take insulin by injection or pump because their bodies don’t make any insulin. Because insulin is a protein, it must be given under the skin because it would be digested in the digestive tract if swallowed. Other important parts of the treatment include healthy eating and regular physical activity.
Type 2 diabetes treatment - Healthy eating (nutritious meals and snacks) and physical activity (exercise) are important in treating diabetes. In addition, it’s important to be a healthy weight and not gain too much weight. Research studies show that a small weight loss of only 5% – 10% helps lower blood glucose and may decrease or eliminate the need for medications with type 2. Being a healthy weight may possibly prevent or delay type 2 diabetes from developing. If diet and exercise are not enough, oral medications (pills) or insulin may be needed. Oral diabetes medications for type 2 include pills that help the body to produce more insulin, use the insulin more efficiently or block glucose absorption. People with type 2 may need insulin if their bodies don’t make enough.
Not only are healthy eating and physical activity important in taking care of diabetes, they may also help prevent or delay the development of type 2 diabetes by helping lower blood sugar and help avoid gaining too much weight.
Healthy eating has many other benefits including:
Physical activity can help manage diabetes in several ways:
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Helps body use insulin better (helps cells become more sensitive to insulin so that insulin can help glucose move across cells walls and be used for energy). If the body uses insulin better, this may decrease the need for medications (insulin or pills).
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Lowers blood glucose (sugar)
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May decrease need for medications
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Helps avoid overweight
Other health benefits - healthy heart, lower cholesterol, improved well-being or feeling better physically and mentally
Exercise can help prevent and manage diabetes in several ways.
Physical activity helps control weight and prevent weight gain.
Exercise also lowers blood glucose by helping the body use insulin better.
Exercise may decrease medication needs of people with diabetes.
Exercise may also help to prevent or delay development of type 2 diabetes by helping avoid gaining too much weight.
Other health benefits of exercise include a healthy heart, lower cholesterol, stronger bones, improved well-being and healthy self-esteem
Fewer than one in four kids gets the recommended 20 minutes of vigorous activity every day (60 total minutes recommended).
The typical American child spends 21 hours a week watching TV – roughly a month and a half a year. Television is associated with extra eating. As much as 25% of children’s food intake occurs while they are watching TV. If a child eats an extra 100 calories a day (a small bag of fries or a can of soda), he can put on 10 extra pounds in a year.
Children with type 2 diabetes:
Eating healthy meals, adding more physical activity and being a healthy weight will help control blood sugar levels. It’s important for children and youth to eat nutritious foods for proper growth and development. Treatment for children with type 2 usually begins with helping them choose healthier meals and snacks and becoming more active to avoid gaining excessive weight.
Health care professionals should provide guidance on helping children achieve and maintain a healthy weight. Children shouldn’t be put on strict diets.
Think and review:
Do housework chores such as mopping, raking leaves or walking the dog count as physical activity?
Name some physical activities you like to do.
If you or a family member has diabetes (either type 1 or type 2), think of some ways you might help him or her take care of diabetes. Some ideas are….
Being physically active together – taking walks, dancing, bicycling, swimming, etc.
Choose active hobbies that don’t center on food (instead of watching TV and snacking, take a walk).
Making and eating healthy snacks together
Helping her remember to take medicines as needed.
Helping him remember to check blood sugar levels regularly.
You may also help yourself or a family member from developing type 2 diabetes by eating healthy foods and being physically active. If you or a family member has diabetes, prompt treatment and good care can help to prevent diabetes health complications!
Let’s review what happens in diabetes. Sugar can’t get into the cell to be used for energy because there’s no insulin to act as a key to open the cell door. In type 1 diabetes, the cell door is completely closed and no sugar can get in; however, type 2 diabetes develops when the body's tissues become resistant to insulin. The body's cells and tissues do not fully respond to the action of insulin and the cell door is partially closed. The body then needs more insulin to control its blood sugar levels.
The pancreas produces more insulin to try to keep blood sugar levels normal. In addition, the liver releases extra glucose in an effort to make more glucose available to the cells. As time goes on, the pancreas becomes less able to produce enough insulin, and the tissues become more resistant to insulin, causing type 2 diabetes to develop.
Preventing Diabetes
Type 1 – There is no way to prevent type 1 diabetes.
Type 2 - Being a healthy weight and being physically active may possibly prevent or delay the onset of type 2 diabetes. Preventing or delaying type 2 diabetes will prevent damage to blood vessels and nerves that cause health problems. When children and youth get type 2 early in life, there is more time for damage to blood vessels and nerves to occur. Children and young adults with diabetes are more likely to suffer severe and costly complications as they get older.
[Children and Teens: Helping children and teens avoid gaining too much weight by eating nutritious meals and snacks and being more physically active may keep them from developing type 2 diabetes. Children should not be placed on strict diets. Health experts recommend that children increase their physical activity and change their eating habits.]
[Adults: Research studies of adults show that a small weight loss of only 5% to 10% may prevent or delay development of type 2 diabetes and may decrease or eliminate the need for medications. Example: A person who weighs 180 pounds would be helped by losing only 9 to 18 pounds. Always check with your doctor to determine if weight loss may be helpful.]
Although type 1 and type 2 are both diabetes, there are some differences. Can you name some of these?
Type 1 – can’t be prevented
Type 2 – may possibly be prevented or delayed
Type 1 – most people lose weight
Type 2 – many people are overweight
Type 1 – treatment: always need insulin by injection
Type 2 – treatment: diet and exercise may control some cases; some need oral pills and/ or insulin
Type 1 – body doesn’t make any insulin
Type 2 – body may make some insulin but it can’t be used correctly
Healthy eating and exercise are important in taking care of diabetes.
Healthy eating and exercise may possibly help prevent or delay the development of type 2 diabetes by helping avoid gaining too much weight.
Think and review:
Why is healthy eating important for people with diabetes?
Why is physical activity important for people with diabetes?
What are some benefits of healthy eating and being physically active?
Meal Planning: Many people with diabetes follow a meal plan, a guide for planning daily meals to control the amounts of calories, carbohydrates, protein and fat eaten each day.
Carbohydrates
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Main source of body's energy
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Increase blood glucose more than other fat or protein
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Sources of carbohydrates: starches - bread, pasta, rice, beans, potatoes, corn and peas, sugars - in milk, fruits, honey and veggies; and added sugars - in candy, desserts, beverages.
Proteins
- Build and repair body issues.
- Raise blood sugar less than carbohydrates.
- May occur in combination with carbohydrate as in milk and beans.
Fats
- Saturated fats - raise blood cholesterol levels - found in animal foods, coconut and palm oils, hydrogenated shortening and margarine
- Polyunsaturated oils - lower total blood cholesterol levels but may also lower HDL (healthy) cholesterol - vegetable oils
- Monounsaturated fats - lower cholesterol but don't lower HDL (healthy) cholesterol - canola, peanut, olive oils, most nuts