Diabetes Awareness

November is Diabetes Awareness Month. Let's learn something about Diabetes in order to understand it better.


Did you know there are several kinds of Diabetes? The most common are Type1, Type 2, and Gestational Diabetes. Gestational type occurs during pregnancy, so it affects less people, and usually stops after the birth of the baby. We're going to share information here about Type 2 and Type 1.

                                                         Type 2

90% of people who have Diabetes, have Type 2. Whether you develop Type 2 is mostly dependent on lifestyle and heredity: If you have a close blood relative that has it, you are at higher risk as well. Being overweight increases this risk. However, many Type 2 Diabetics are of average or slender build.

With Type 2, your pancreas is still functioning, but not at 100% efficiency. If you closely monitor the foods you eat, with Type 2 you can still keep diabetes under control to some extent. Type 2 involves an insulin resistance and sometimes a reduction in insulin production. Your body's cells do not use insulin the way they are supposed to. Sometimes people with Type 2 Diabetes are able to control their blood glucose (blood sugar) levels with diet and exercise, but often treatment requires medication. Often, medication in a pill form will help cells use insulin more efficiently, and so insulin is not necessary. However, sometimes people with Type 2 Diabetes aren't able to achieve good control of their blood glucose levels and begin to use insulin injections. When taking the pill form of medication, it's necessary to check blood glucose levels by doing a finger stick. The drop of blood goes on a test strip, and the test strip is inserted in a glucose meter which tells the level of glucose in your blood at that moment. You would check your levels before meals and at bedtime, so about 4 times each day. You gauge how many carbs you should take in if your glucose level is high, or if you are about to eat something with carbs in it, which would raise your glucose level. If you run high too often, you may need to inject insulin to help regulate the level (keep it down but not too low).  When taking insulin, much more frequent checks are needed.

The type of doctor a diabetic sees is an endocrinologist. These specialists understand the endocrine system more thoroughly than a family practice physician, and are often the only doctor a Type 1 diabetic sees. It's important to have a good relationship with your doctor, but especially with this condition.

Here is someone checking her blood glucose using a meter: The drop of blood is put on a test strip, and the test strip is inserted into the meter, which gives the blood glucose reading.

                                                                             Type 1
Type 1, or Juvenile Diabetes (also called T1D), occurs when your pancreas isn't functioning at all. In this case, you will need to give yourself insulin when you need it and monitor your food intake much more closely than with Type 2.

It was originally called 'Juvenile Diabetes' because it usually shows up in people under the age of 20-including newborns and toddlers-but can appear at any age. Type 1 is considered an autoimmune disease, or an attack from within. It does not have a connection to your lifestyle. However, it can be genetic ("runs in the family").

People with Type 1 must rely on insulin injections for treatment. Your body requires insulin at all times. Insulin works as a type of "key" that lets glucose into all your cells. Glucose is needed by your cells in order for the cells to function. Without it, glucose can't enter cells, so the cells don't have fuel to work, and your system shuts down. In Type 1, insulin must be injected so that the glucose can always enter your cells and your body can function. 


Ways to take insulin: Insulin can be carried with a person in a device that looks like a fat pen and is pre-loaded with insulin. It has a needle on the end that needs to be changed after every use.  Insulin needs to be refrigerated until it is opened. Once opened, it can be out of the fridge for 28 days and then must be thrown away. 

When you have Type 1 Diabetes, your life is much more influenced by the disease than with Type 2 (usually). A typical day for a Type 1 Diabetic includes up to 12 finger sticks/meter readings per day, with injected insulin (shots) occurring with each meal as well as long-acting insulin to get through the day. Activities that lower or raise your glucose mean more testing, as does illness (it tends to run high while fighting off an illness) while exercise usually lowers the glucose level. Having too high a level can cause nerve damage if it's left uncontrolled, and running too low of a glucose level can result in the person going into a coma. A young woman describes a day with Type 1 here: https://lyfebulb.com/2017/10/16/day-life-type-1-diabetic/




Another option for someone with Type 1 Diabetes is an insulin pump. Here is what it looks like:

The pump, as you can see, looks somewhat like a pager. It has a tendency to make security alarms go off, and can be a bother to allow for if you're wearing certain clothing; however, it does save you from several injections every day. You can take it off completely for an hour to shower or take a swim, but the pump cannot get wet. The device to your left is a Continuous Glucose Monitor. It communicates with the pump to tell it when your glucose is very low. The CGM can be worn on the shoulder as well.

With the pump, insulin is constantly being administered to the person, 24/7. This provides the person with a steady supply of insulin, since their body isn't making any insulin, and the body's cells always need it ready to dispense. The person does a blood test (finger stick) and based on that, tells the pump to deliver a "bolus" (dose) of extra insulin when they eat or when their blood sugar is running high. Since the tubing is already sitting under the skin, the pump eliminates the need for several insulin shots per day. Every 3 days a new 'set' is inserted, using  a needle and a little tool. Once the new set is inserted, the needle is then removed, leaving behind a cannula, which is a very small hollow plastic tube, underneath the skin. This connects to the insulin pump via a small plastic tube that's about 12 inches long. The pump itself is typically worn on the front of pocket of your pants. The needle is attached to your skin in the abdomen area with a large round bandage patch. The pump needs to be refilled and the infusion site (the place where the tubing was connected to the body) changed every two to three days. The insulin needs only to be infused into the fatty layer of tissue just beneath the skin. From there, it is absorbed into the body and dispersed to the cells that need it. 

How do you know if someone with diabetes might need your help? A person whose glucose level is running very low will become disoriented, may not make sense, will seem a little drowsy or shaky. If you know the person is diabetic, offer some juice or a small piece of soft candy-you don't want him or her to choke. A very small amount of soda will work, but is extremely high in sugar so don't give a large amount. Even a little milk will probably provide enough sugar to stabilize the person so he/she can decide what to do. Do not pour something down the person's throat! Your aim is only to bring the blood glucose (sugar) level up enough so the person becomes fully alert. Stay calm so the person will also stay calm, and stay close by to watch over him or her. In a few minutes, you should see an improvement. Once the blood glucose level comes back up, the person will be fine and probably will not need medical intervention. However, if you are not having success, call 911 right away. It's important to be a concerned and caring friend, but once the episode has passed, don't make a big thing of it. Your diabetic friend already probably feels self-conscious about it.

Here's a vid of a day in the life of a college student with Type 1. He is not using a pump. Notice how his vision gets blurred when he's running low. https://www.bing.com/videos/search?q=type+1+diabetic+for+a+day&view=detail&mid=956341D0FFFACD6E8DFA956341D0FFFACD6E8DFA&FORM=VIRE

Please also visit jdrf.org to learn more about Diabetes, and when you donate to charity, keep in mind people experiencing a natural disaster in their area: There are usually diabetics in need of help with their supplies and meds.