Diabetes 101: Causes, Complications, & Treatment

    
Kiah Connolly, MD

If you’re not personally suffering from diabetes, you almost certainly know someone who is. Limb amputations, strokes, heart disease and death are just a few of it's complications.

And almost half of the United States (43%)  has either diabetes (9.4%) or prediabetes (33.9%) (1).

Luckily, it's is almost always treatable by everyday actions we can control. 

This diabetes guide will take you step by step through what the disease is, who's at risk, dangerous complications and how to prevent and treat the condition for good.  



Diabetes Definition

When you hear the word ‘diabetes’ it is almost always referring to diabetes mellitus. 

Diabetes mellitus is a condition that prevents the body from properly using glucose because of a problem with insulin. 
 

But let’s break that down a little more. Glucose is a sugar that is critical to our survival. It is the main source of energy that the cells in our body need to function. Insulin is the hormone in charge of actually bringing glucose into our cells allowing them to use it.

People with diabetes actually often have plenty of glucose in their blood; it just can’t be used by cells because insulin isn’t doing its job (2). This leads to high blood sugar levels. 

Types of Diabetes

While there are two different diseases that are called ‘diabetes’ , the  most common type is diabetes mellitus. 

Diabetes Insipidus 

Just to be extra confusing, there is another very separate form of ‘diabetes’, called diabetes insipidus - and it has nothing to do with sugar, glucose, or insulin. It’s a completely different disease process that involves a problem with another hormone, called vasopressin. 

This dysfunctional vasopressin results in, well, a lot of peeing. Unfortunately, this leads to more than just frequent bathroom breaks. Excessive urination causes terrible dehydration and unquenchable thirst which leads to a myriad of other problems. While diabetes mellitus can also cause frequent urination, it happens for different reasons. Luckily, diabetes insipidus is extremely rare (3).

As a general rule, it’s pretty safe to assume that unless ‘insipidus’ is specifically stated you can count on the word ‘diabetes’ referring to diabetes mellitus.

 

Diabetes Mellitus

Diabetes mellitus is broken down into two different types - conveniently labeled ‘type 1 diabetes’ and ‘type 2 diabetes’. They are similar in that both types involve a problem with insulin that results in cells not being able to use glucose correctly, but for different reasons. Symptoms of both types of diabetes are very similar as are their complications and treatment.

TrifectaHealth_Keywords_Diabetes 2 (1)-1

What is the Difference Between Type 1 & Type 2 Diabetes Mellitus?

The main difference between type 1 and type 2 diabetes is where the problem with insulin originates. In type 1 diabetes insulin isn’t produced (at least as much as it needs to be). With type 2 diabetes, insulin is produced, but it eventually stops working as well as it needs to.  You may hear this referred to as ‘insulin resistance’. 

Type 1 diabetes is normally thought to occur in younger individuals (less than 30 years old) and because of this is sometimes referred to as juvenile diabetes. Type 2 diabetes more often occurs in older individuals.

Unfortunately, because of the growing obesity epidemic, it is becoming increasingly more common for younger individuals and even children to be diagnosed with type 2 diabetes (3).

What Causes Diabetes?

Type 1 diabetes is an autoimmune disease that occurs when the immune system starts inappropriately attacking an important organ called the pancreas, which is in charge of producing insulin. When enough of the pancreas is damaged, it can no longer produce enough insulin to support the needs of the body.

Like so many illnesses, an exact cause for type 2 diabetes isn’t known.

However, it is well established that obesity, a sedentary lifestyle, smoking, high blood pressure and certain genetics all create a higher risk of developing type 2 diabetes (4). 

Some medications can also lead to higher sugars and the development of the disease. These medications include steroids, as well as some treatments for high blood pressure and mental health (5). Pregnancy can also trigger gestational diabetes, which also increases the risk of type 2 diabetes even after the baby is born (6).  

Diabetes Symptoms

Both types of diabetes mellitus can present with similar symptoms (7).

  • Frequent Urination
  • Excessive Thirst 
  • Numbness 
  • Blurry Vision 
  • Hunger 
  • Weight Loss or Weight Gain
  • Generalized Weakness
  • Nausea & Abdominal Pain

These symptoms can occur much more quickly and can appear more dramatic in people with type 1 diabetes, whereas people with type 2 diabetes may have more mild symptoms that develop gradually and may not be very noticeable for long periods of time.

Diabetes Complications  

There’s a reason you hear people making such a big fuss about living with diabetes - it can cause devastating complications, many of which are life-threatening and include:  

 

Diabetes Diagnosis

As mentioned above, the symptoms of diabetes can be so mild that some people may not even be aware they have them.

Diabetic tests like hemoglobin A1c and fasting blood glucose levels are used to solidify the diagnosis of diabetes and help to determine how severe it is. These same tests can be used to track how the disease is progressing and determine how much medication should be taken on a daily basis.

Diabetes Treatment  

The best way of tackling the treatment of diabetes is to attack the disease at all ends. 

TrifectaHealth_Diagrams-03_Diabetic Pentad Option 2 (2)

1) Diabetes Diet 

Dietary modifications are arguably the most important element in treating type 2 diabetes and are also critical in the management of type 1 diabetes. 

So what exactly is the best diabetic diet? 

There are some basic principles that all diabetics should follow. 

LEAN PROTEIN
  • Helps repair tissue
  • Helps build and maintain bones and muscle
  • Helps create many hormones and enzymes
  • Helps weight loss (makes you more satiated) 
UNSATURATED FATS (monosaturated) 
  • Increases your 'good cholesterol' (HDL)
  • Lowers your 'bad cholesterol' (LDL)
  • Lowers blood pressure (when they replace carbohydrates or unhealthy fats)
VEGETABLES
  • Nutrient dense: rich in vitamins, minerals, fiber and antioxidants
  • Low in calories
  • High in fiber 
FRUIT
  • Nutrient dense: rich in vitamins, minerals, fiber and antioxidants 
  • Low in calories 
  • High in fiber
  • Excellent ‘sweet tooth’ substitute 
WHOLE GRAINS
  • Nutrient dense: rich in vitamins, minerals and fiber 
  • Reduce risk of chronic health conditions including heart disease, diabetes and some cancers. 
  • Reduce risk in overall mortality 
FIBER
  • Improves glycemic control
  • Improves bowel health 
  • Recommended 14 grams of fiber for every 1000 calories of food you consume 

    TrifectaHealth_Diagrams-Diabetes Diet-1

Diabetic Diets Should Avoid: 

  1. Added Sugar 
  2. Saturated Fats
  3. Processed Foods 
  4. Salt 
ADDED SUGAR
  • Diabetics biggest enemy
  • No nutritional value 
  • Causes high glucose spikes 
  • Causes weight gain 

If you or a loved one is diagnosed with diabetes, eliminating added sugar should be one of the first things you tackle. This is easy to do by looking at nutritional labels under ‘added sugar’ and avoiding these foods. 

SATURATED FATS 
  • Cause a rise in ‘bad cholesterol’ (LDL) 
  • High calories (weight gain)
  • Low nutritional value 

Saturated fats increase the risk of developing and/or accentuating high cholesterol (hypercholesterolemia) and high triglycerides (hypertriglyceridemia) as well as damaged blood vessels (atherosclerosis). All of this increases the risk of heart disease and other vascular diseases including stroke. 

PROCESSED FOODS
  • Often high glycemic index 
  • Often low nutritional value 
  • Often high calories 
  • Often high sodium 
SALT

A diet low in sodium (salt) (<2300mg/day) is recommended because it helps  decrease other risk factors including high blood pressure. If you already have high blood pressure or heart disease, your doctor may recommend this number to be even lower. 

Best Diabetic Diet

So what exactly  is the best diabetic diet? 

Well, there’s a lot of controversy on this.

One thing that isn’t debated is that weight loss is key. Many different diets can be effective - as long as they consistently achieve a calorie deficit. (8, 9).

Bottom line: no matter what diet you choose, you need to eat fewer calories than you burn for weight loss success. 

Low Carb Diet for Diabetes

Some people advocate for low carbohydrate diets. Since the problem in diabetes is with sugar, (and ingested carbohydrates turn into sugar) a low carb diet theoretically may help the disease process more than just weight loss alone. Studies looking at this have suggested that low carbohydrate diets are more effective in treating type 2 diabetes than other diets, including calorie deficit diets alone (10, 11, 12, 13) .

While low carbohydrate diets may offer many benefits, diabetics on insulin can be at risk for hypoglycemia if they cut too many carbs without adjusting their medication . So to get all the benefits without the risk, it is important to work with your doctor when starting a low carbohydrate diet if you’re taking medications for your diabetes.

Keto Diet for Diabetics

The ketogenic diet is an ultra-low carbohydrate diet that when carefully followed over time transitions the body into utilizing a different source of fuel, called ketone bodies. For most people, this requires eating less than 20grams of net carbohydrates per day. Anyone that has attempted this would probably agree that’s really low!

While some people are strongly advocating that keto is superior, there aren’t enough well-done studies to determine if it is more effective than basic calorie controlled other low carb non-ketogenic diets alone.

Want to learn more about the low carb and keto diet for diabetics? Read this article.

2) Weight Loss 

One of the biggest risk factors for type 2 diabetes is obesity. Weight loss and healthy weight maintenance in of itself can treat the disease. It also helps to treat and prevent other comorbid conditions like hyperlipidemia and hypertension. While exercise and diet are the ideal actions for achieving weight loss goals, other options like bariatric surgery may be considered in some individuals. 

3) Exercise 

Exercise independently improves glucose control in people with diabetes, in addition to contributing to weight loss.  It also similarly helps comorbid conditions like hypertension and cardiovascular disease.

Exercise has been shown to have a powerfully positive effect on our mood and emotions. It helps symptoms of many mental health conditions including depression and anxiety. In this way it often leads people to make healthy lifestyle choices including improved abstinence from unhealthy substances like smoking and alcohol and better food choices. 

4) Smoking Cessation

Quitting smoking also improves comorbid conditions like  cardiovascular disease and hypertension in addition to improving glycemic control. When you make the choice to quit smoking, you also reduce your risk of developing many other serious medical conditions including a myriad of cancers and lung disease.  

5) Type 2 Diabetes Medications 

While lifestyle modifications are paramount in treating diabetes, medications are often necessary - especially at first. It is obviously, important to take the medications your doctor prescribes. These may be in the form of a pill or injections. People with type 1 diabetes will always need to incorporate insulin injections into their daily lives.

Diabetic Cure

While people with type 1 diabetes can live very full and healthy lives there is unfortunately not yet a known cure for this disease. 

The amazing news about type 2 diabetes is that many cases can be resolved with major lifestyle changes.

Implementing these lifestyle changes can actually reverse the disease process - and all of the health problems  associated with it (4). 

 



 

Related Posts

Trifecta-ebook-iPad-Pro_v1

FREE Weight Loss Ebook:
"Lose 10lbs in 30 Days"+
Secret Bonus

(Valued at $99)

Your new secret weapon! This quick-read e-book shows you—step by step—how to 3x your rate of weight loss over the next 30 days.

Yes. Let’s learn how to torch pounds.