Theresa Garnero

You can be healthy with diabetes, especially if you are consistent.

When we eat, food eventually turns into glucose, the main source of energy for the millions of microscopic cells in our body. The only way for the cells to get this glucose is with insulin. Insulin is made by specialized beta-cells within the pancreas. The pancreas is a gland situated behind the stomach. It releases insulin into the bloodstream in response to the blood glucose rise after meals and snacks. Insulin is the key that unlocks the cell door to allow the glucose to enter where it is used for energy.

In people with diabetes, the pancreas is on an early retirement plan, so less insulin is available in the body.

Left untreated, blood glucose levels go even higher. Lack of exercise, obesity, smoking and secondhand smoke, high blood glucose, sleep problems, stress, and hereditary factors all play a role in the development of insulin resistance.

Prediabetes is a condition in which glucose levels are rising but are not high enough to be categorized as type 2 diabetes. (See the section ) Research has shown that people with prediabetes are at a high risk for developing type 2 diabetes, which often can be prevented or delayed by getting 150 minutes of physical activity a week (e.g., 30 minutes of physical activity 5 days a week) and for those who are overweight, by losing 7% of weight (e.g., if you weighed 200 pounds, that would mean losing 14 pounds to reduce your weight by 7%).

Type 2 diabetes is the most common type of diabetes and is caused by the body’s resistance to insulin and a decline of insulin production. Type 2 diabetes typically arises in adults (occurring most often in 45- to 64-year-olds); children and teenagers also may develop type 2 diabetes, especially if they are overweight and have a family history of diabetes. Treatment often requires medication (including pills, injectable medication, or insulin). The symptoms often are subtle, varying from none to tiredness (especially after a large meal), blurred vision, frequent urination at night, and dry, itchy skin.

The A1C test measures how much glucose is stuck to the hemoglobin part of the red blood cell. Red blood cells live for 2–3 months, carry oxygen and nutrients throughout the bloodstream, and carry away the waste. When a glucose molecule is nearby, it attaches to the red blood cell and won’t let go; that’s how we can tell what has happened for the past 3 months. The goal for many people newly diagnosed with diabetes is to have an A1C of less than 7%.

After you eat, your blood glucose level goes up. Foods containing carbohydrates (also known as “carbs”) raise glucose the most. A lot of people are fearful of carbs as a result. We need carbohydrates for brain function and energy, so please don’t cut them out entirely!

1. You can have carbohydrates, but stick with sensible portion sizes that are consistent from day to day.

2. Choose a variety of foods that are rich in vitamins and minerals and low in calories.

3. Eat regularly; this means three meals a day and snacks, if needed, 2–3 hours after a meal.

4. Skipping meals may cause blood glucose fluctuations and eating too much late in the day may cause weight gain.

5. Products that claim that they have “No Added Sugar” or are “Sugar Free” often still have carbs!

6. Check food labels (i.e., the Nutrition Facts label) for serving size and the total carbohydrate amount to start learning about carbs.

*Contains carbohydrates; †may contain carbohydrates; ‡recent controversial research suggests that fructose converts to fat more easily and increases insulin resistance, although a consensus has still not been reached by the scientific community.

Being active

• Improves blood glucose levels and insulin sensitivity

• Helps you lose weight or maintain weight loss

• Lowers blood pressure and stress

• Raises good cholesterol levels (high-density lipoprotein [HDL])

• Improves heart function, sex life, and sleep

• Helps to prevent and manage depression

• Keeps bones healthy

• Increases life span

• Saves money (fewer health issues and less medicine mean more money in your pocket)