Brush up on the diabetes basics

Control diabetes — not the other way around

By Gary Kim, MD, diabetes services and internal medicine, The Portland Clinic-Northeast

Family hiking in the forest in autumn

Diabetes is not a disease to be taken lightly. It can cause damage silently for years before it’s diagnosed — damage like heart disease, vision loss, kidney disease and neuropathy. And once the damage begins, it’s likely to be irreversible. Diabetes complications nearly double the chances of having a heart attack and cause more deaths each year than breast cancer.

On the positive side, taking control of this chronic condition can help you avoid serious complications. That’s why everyone should know a few diabetes basics.

Basically, it’s about blood sugar

When you eat, your body turns nutrients from food into sugars, or glucose, which all of your cells use for energy. Insulin, a hormone released by your pancreas, allows your cells to absorb and use these sugars.

When you have diabetes, your cells can’t process these sugars properly, either because your pancreas can’t produce insulin (type 1 diabetes), or because it no longer makes enough or your cells no longer respond to it well (type 2 diabetes). Either way, the result is that too much blood sugar stays in the bloodstream, rather than being used by your cells, and can cause serious problems over time.

Thirst, hunger, urination — more than normal could be a symptom of diabetes

Talk to your health care team if you notice any of these diabetes symptoms:
• Urinating a lot, often at night
• Feeling very thirsty and/or hungry
• Losing weight without trying
• Blurry vision
• Numbness or tingling in the hands or feet
• Feeling very tired
• Very dry skin
• Sores that heal slowly
• More infections than usual

Even with no risk factors, you still could be at risk

You may be at higher risk of developing diabetes if you are overweight, older in age, inactive (or you’re only active one or two days a week), have parents or siblings with diabetes, or have had gestational diabetes yourself. But even if you have none of these risk factors, you still can develop diabetes — another good reason to be aware of the basics and to practice prevention.

You can’t change your health history, but you can change your health future

While your age and your family history are beyond your control, the other risk factors for developing type 2 diabetes are within your power to change. If you’re overweight, losing just 5-7% of your weight (10-14 pounds if you weigh 200) can lower your risk. If you’re inactive, fitting in 30 daily minutes of brisk walking or similar activity, five days a week, can prevent or delay diabetes. See my blog at for more preventive tips.

If you’ve been diagnosed with diabetes, the same preventive advice can help you avoid the most serious diabetes complications. Getting regular physical activity, managing your weight, and eating to control blood sugar (see page 8) are vital. Taking medications as directed by your provider is essential. Reducing stress and getting enough sleep will help, too.

Probably the most important thing you can do for yourself is to be an active participant in managing your diabetes. Many people know what changes they need to make to help themselves. Taking charge and making these changes can feel very empowering. My patients show me just how important — and effective — this empowerment is every day.

Living with diabetes is a lifelong journey. With some personal effort, in partnership with your treatment team, you can control diabetes, not the other way around.