- How Is Diabetes Diagnosed?
- How Is Diabetes Treated?
November is Diabetes Awareness Month. Thank you to everyone who has spent time spreading awareness and educating others on diabetes treatment so far this month.
In an effort to keep spreading awareness ourselves, this is a quick article that answers a common diabetes-related question:
Is the insulin shot the only way to treat it or are there other options?
The answer is yes, there are other ways to treat it. We’ll explain it in a little more detail.
But first, it’s important to know how diabetes is diagnosed. It sheds a lot of light on why the treatments are what they are.
1. How Is Diabetes Diagnosed?
There are four main tests that are used to confirm diabetes.
With a blood test called the glycated hemoglobin test. It’s also called the A1C test. The test is designed to reveal the last 2-3 months of your sugar levels.
- Anything below 5.7% is considered normal.
- Anything between 5.7-6.4% is considered prediabetes.
- Anything above 6.4% is diabetes (after two confirmed tests).
There are some areas where the glycated hemoglobin test isn’t available. Also, a person can have a hemoglobin variant that causes interference with the A1C test making it obsolete.
If you find yourself in this situation, the alternate test is a random blood sugar test.
This test doesn’t require eating or not eating for a certain amount of time beforehand. It works regardless. If your test shows a blood sugar level higher than 199 mg/dl (milligrams per deciliter), you likely have diabetes. It’s not a guarantee, but it’s very likely.
Particularly if you have some of the other symptoms like perpetual thirst or constant urination.
If results are not satisfactorily confirmed after a random blood sugar test, then a fasting blood sugar test is done.
For this test, you skip dinner and breakfast the next morning before having the test done. Then a blood sample is taken. A normal reading is anything lower than 100 mg/dL.
Anything between 100-125 mg/dL is what’s called prediabetes. Results higher than 125 mg/dL is diabetes. You have to test higher than 125 on two consecutive tests to officially confirm.
The oral glucose tolerance test isn’t used very often. When pregnant women are being tested for diabetes, that’s pretty much the only time this test is used.
For this test, you fast just as you would for the fasting blood sugar test. When you arrive, the doctor will have you drink a sugary drink. For the next two hours, your blood sugar levels are tested.
Normal levels are anything under 140 mg/dL after two hours. 140-199 mg/dL after two hours is prediabetes. 200 mg/dL or higher after two hours is diabetes.
2. How Is Diabetes Treated?
Because Type 2 Diabetes represents 95% of all diagnoses, the information here is about treating Type 2 specifically.
Now that we’ve discussed how diabetes is diagnosed, let’s talk about how it’s treated. Unfortunately, diabetes cannot be cured. Only managed. There are 6 primary forms of diabetes treatment for Type 2:
- Blood sugar monitoring
- Regular exercise
- Healthy eating
- Weight loss
- Insulin therapy or other medication
- Bariatric surgery
Blood Sugar Monitoring
If you have diabetes, it’s more than likely you’ll need to check and record your blood sugar level often. Especially if you’re on insulin. Depending on how severe your case is, you may need to check 2-3 times a day.
Your doctor will recommend the right course of action for your particular case. Proper blood sugar monitoring is imperative to making sure your levels stay in the safe range.
Regular exercise is a diabetes treatment that lowers blood sugar levels. This is why physical exercise is so important for people with diabetes.
Make sure to talk to your doctor about this before initiating a workout schedule or something like that. And do things you like doing. Biking, swimming, running, walking, sports, whatever. Just make sure that you exercise every day, at least 30-60 min.
Studies show that aerobic exercise is the most beneficial if you have diabetes. Your routine doesn’t have to be all aerobic but mix it in with other things. Those other things can be yoga or weightlifting or other kinds of resistance training.
Before exercising, check your blood sugar and eat at least a snack. This is especially important for people who take meds for their diabetes.
There’s no particular diet that people with diabetes should follow. But if you have diabetes, eating healthy needs to be a priority. Eating healthy in general is what we mean here. If you have diabetes, try to:
- Eat fiber-rich food
- Eat fruits and vegetables regularly
- Go easy on saturated fats
- Eat refined carbohydrates very sparingly (candy, soda, etc.)
- Don’t eat a lot of calories
The best thing to do is get with a dietitian and have her put a personalized meal plan together. That’s the best way to implement this diabetes treatment.
Obesity is a significantly more harmful condition for people with diabetes. It’s much harder to maintain a healthy blood sugar level when you’re overweight.
Even just losing 5-10% of your body weight does wonders for your overall health while living with diabetes. Obviously, the closer you can get to optimal weight is better. But even just slow and steady weight loss, if needed, is ideal.
Insulin Therapy Or Other Medication
For some people, eating healthy and exercising regularly, unfortunately, isn’t enough to maintain a safe blood sugar level. In this case, a diabetes treatment that includes medication or insulin therapy may be necessary.
Not every person with diabetes needs insulin, but many do. In the early days of diabetes treatment, insulin was thought to be dangerous and used only as a last resort.
Now, it’s benefits are more fully understood and it’s often used as the first line of attack.
The only possible side effect of diabetes treatment is hypoglycemia (low blood sugar).
The only way to administer this medication is via injection. This is because digestion interferes too much with it. There are multiple kinds of insulin. A doctor may even prescribe different types to the same person. In these situations, they’re instructed to take them at different times of the day.
It’s very common for doctors to prescribe other medicines to be taken regularly alongside insulin. These usually include:
- aspirin in a low dosage
- blood pressure meds
- cholesterol-lowering meds
Bariatric surgery is the formal name of all weight-loss surgeries. If your BMI (body mass index) is over 35, your doctor will likely discuss this diabetes treatment with you.
Bariatric surgery can lead to improved blood sugar levels and a more comfortable existence in general.
These surgeries are usually costly and present more risks than most medications. Some side effects, though uncommon, include osteoporosis, and various nutritional deficiencies.
Other Types Of Diabetes Medication
There are many different diabetes treatment meds available. Your doctor will know which one is right for you. Sometimes more than one medication is necessary. The one prescribed for you depends on a few things, but mainly:
- Your blood sugar level
- Other health problems
Here’s a brief explanation of the 8 most common diabetes medications other than insulin:
If you have Type 2 diabetes, this is almost always the first medication prescribed. It’s designed to heighten your body’s sensitivity to insulin. The result is that your liver doesn’t produce as much glucose.
Your body is much more effective at using the insulin you put into it when taking metformin. There are two side effects. Nausea and diarrhea.
Not everyone who takes it experiences these, but some do. When you take it with a meal, the possibility of a side effect goes down. Metformin also comes in injection and oral forms.
This medication promotes insulin secretion. For some people, weight gain and low blood sugar are side effects.
Promotes insulin just like sulfonylureas but does it faster. However, the effect doesn’t last as long. Weight gain and low blood sugar are possible side effects.
Like metformin, it heightens your body’s sensitivity to insulin. However, thiazolidinediones have more severe side effects in comparison. So they aren’t prescribed as often.
These keep your blood sugar levels down, but they aren’t quite as effective as other drugs. A good thing about this medication is that weight gain is not a side effect. A small number of people who take this experience joint pain.
GLP-1 Receptor Agonists
These are designed to bring your blood sugar levels down and slow down your digestion. Diabetes patients who have a great need to lose weight are often prescribed these. The only way to administer this medication is via injection.
Sometimes diabetes increases the risk of strokes and heart attacks. Particularly in those that have already experienced them or have family members who have. Exenatide is designed to lower those risks.
SGLT2 inhibitors prevent the kidneys from reabsorbing sugar into the bloodstream. This medication promotes the excretion of sugar through the urine instead.
Side effects sometimes include low blood pressure, urinary tract infections, and vaginal yeast infection.
As mentioned previously, diabetes treatment is different for pregnant women. Insulin therapy is very common, even for women who didn’t need it before they got pregnant. Medications that are usually taken in conjunction with insulin cannot be taken during pregnancy.
Pregnancy sometimes causes diabetic retinopathy to worsen. If you have this condition, consult your doctor within the first 1-2 months of becoming pregnant.
What To Watch Out For
Diabetics are used to being alert pretty much all the time. They need to be cognizant of their health status at all times. Your blood sugar can be affected by so many different things, so being on alert is necessary.
Sometimes, immediate care is needed to fix certain problems, even when proper precautions were taken. Here are some of those circumstances.
High Blood Sugar
There are so many things that can cause an increase in blood sugar. The most common ones are:
- eating too much
- being sick
- not taking enough glucose (not taking your medication
Watch out for these signs of high blood sugar:
- frequent urination
- constant thirst
- dry mouth
- blurred vision
If you’re experiencing any of these, check your blood sugar or contact a specialist.
HHNS is a life-threatening condition that stands for hyperglycemic hyperosmolar nonketotic syndrome.
Blood sugar levels coming in higher than 600 mg/dL is this condition’s main sign. Other symptoms include:
- dark-colored urine
- extreme thirst
- dry mouth
When blood sugar gets that high, the blood becomes syrupy and thick. Elderly people with diabetes are at a higher risk for this condition. An infection or illness almost always precedes HHNS.
It goes without saying that if you experience the signs of HHNS, you need to contact your doctor right away.
Your body starts to break down fat cells if other cells are starved for energy. When your body has to do this, ketones are produced. Ketones are toxic acids that show up in your urine.
A urine test will determine if you have this. Signs of ketone-rich urine include:
- strange, fruity-smelling breath
- shortness of breath
- frequent urination
- very dry mouth
People with Type 1 diabetes are more likely to develop this condition.
Low Blood Sugar
This is called hypoglycemia. Common things that cause this are lack of regular exercise, taking too much medication, and not eating enough. Signs include:
- slurred speech
- heart palpitations
- blurred vision
Pretty much anyone with diabetes knows what it feels like for them when their blood sugar gets too low. To counteract this, you need to eat foods like soda, hard candy, glucose tablets, or fruit juice. Anything that will get your blood sugar level up fast.