DIABETES - do you have it? If you'd like to know whether or not you're suffering from elevated blood sugar levels, take a look at your hand. According to the American Academy of Dermatology Association (AAD), the condition can cause skin irregularities
Whether it's pre-diabetes – meaning you're at increased risk of diabetes – or you've had the condition for a while, digital sclerosis might appear. What does it look like? According to AAD, the back of the hands will feel "tight" and the skin will look "waxy". Digital sclerosis can cause the fingers to become stiff and difficult to move.
If diabetes has been poorly controlled for a number of years, or you've been unaware of the condition, it can feel like there are pebbles in the fingertips.
"Hard, thick, and swollen-looking skin can spread, appearing on the forearms and upper arms," warned the AAD.
This skin condition can also develop on the upper back, shoulders, and neck. Sometimes the thickening skin can spread to the face and chest area. Any area of thickened skin caused by digital sclerosis often has "the texture of an orange peel".
Digital sclerosis isn't the only warning sign of high blood sugar.
Another physical manifestation of type 2 diabetes is necrobiosis lipoidica. "This skin condition often begins as small raised solid bumps that look like pimples," said the AAD. As the condition progresses, the bumps can turn into yellow, reddish, or brown patches of swollen and hard skin.
You may also notice:
The surrounding skin has a shiny porcelain-like appearance
You can see blood vessels
The skin is itchy and painful
The skin disease goes through cycles where it is active, inactive, and then active again.
Another telling sign of diabetes can be acanthosis nigricans, which is areas of darkened, velvety skin.
These usually appear:
On the back of the neck
In the armpit
In the groin area
Uncontrolled blood sugar levels can lead to poor circulation and nerve damage over time. This can cause difficulty with wound healing, especially on the feet, where diabetic ulcers might appear.
These open sores might not feel painful because of the nerve damage that has been done. If the wound gets infected, there's a risk this could lead to gangrene, warned the NHS.
Diabetes type 2: Your hand could be revealing (Image: Getty)
Shin spots are also another possible indication of high blood sugar levels, added the AAD. These spots (or lines) create a "barely noticeable depression in the skin". The medical term for this skin condition is called diabetic dermopathy, and it usually appears on the legs.
In rare instances, the skin depressions might appear on the arms, thighs, trunk, or other areas of the body.
When you live with diabetes, particularly if you take insulin, there’s always a need to think about safety behind the wheel. You need to ensure that your blood sugar levels won’t dip into a danger zone that could cause you to lose control of your vehicle.
Most people with diabetes (PWDs) are well aware of this, and conscientious about checking their glucose levels before driving. But you never know…
That’s why there’s a market for window decals, seat belt straps and an array of other items designed to flag the fact that the person driving a car has diabetes.
While these items could be extremely helpful in an emergency, not everyone is “on board” with the idea of advertising their medical condition on their vehicle for all the world to see.
There are pros and cons to be sure, and we at DiabetesMine looked into them by querying our community on social media, and interviewing several healthcare professionals in the diabetes space.
First off, we wondered if there are any official rules beyond applying for a driver’s license that mandate disclosure of your illness while driving.
Laws regarding driving and diabetes vary by state, but it appears that even in the strictest jurisdictions, a medical ID placed on a vehicle isn’t required or even recommended for PWDs.
Be aware, however, that if you do have a driving issue caused by hypoglycaemia, you will lose your license immediately in most states.
Of course there’s always a personal imperative to make sure that police or paramedics responding to an emergency know about your condition in order to treat you properly. That’s often addressed by wearing a medical ID bracelet or other med alert jewellery (or a tattoo). But there’s no guarantee that first responders or bystanders will see your personal ID.
So, on the pro side, some people believe these vehicle decals are an excellent choice to alert authorities in a medical crisis or emergency situation. There’s also a benefit to bystanders or fellow drivers seeing the sticker, who may be able to notify EMTs about an emergency if they notice erratic driving or anything out of the ordinary. These decals also can certainly help avoid having a diabetes emergency being mistaken for a drug or alcohol issue.
But the other side of the coin is a touchy subject: Who wants to “advertise” their illness and open themselves up to possible judgement or stigma?
The cons of choosing to publicly display your diabetes are clear. Why do strangers need to know? Some PWDs worry that police could target them and use that as an excuse to pull them over, or other drivers could point to the diabetes alert even if it’s not a factor in an accident or other driving incident (i.e. “It’s not MY fault I hit her!“).
More than 100 people responded to our DiabetesMine social media query about whether displaying diabetes on your vehicle is a good idea or not. Roughly 73 percent of commenters said “no,” while only 14 percent said “yes.” The rest offered an answer somewhere in between, describing how it depends on the particular situation or circumstance.
Victoria Cassedy, who’s lived with type 1 diabetes (T1D) for many years in Virginia, said she has displayed stickers stating, “I’m not drunk, I’m diabetic” ever since she saw a news story about a woman pulled over and forced by police to lay face down on the hot asphalt while being handcuffed. It turned out the woman had T1D and was having a severe hypoglycaemic episode.
“(Police) treated her like total trash because they thought she was drunk. She could have died in the time it took them to treat her like a human being,” Cassedy shared with DiabetesMine.
Lauri Salsbury, who lives with T1D and autism in Arkansas, was also a “yes” to putting a diabetes decal on her car. “I do!! For 2 reasons: 1) I’m proud of who I am, 2) If I am in an accident, MAYBE someone will see the sticker and know to give me glucose,” she wrote.
But it’s a strong “no” from T1D Allison Marx in Georgia, who doesn’t see a reason to call out one’s health condition on your vehicle unless it’s required by law.
“While it may be somewhat common to put ‘student driver’ on a car for the safety of others, I don’t see any medical conditions being regularly called out,” she said. “We don’t ask elderly people to badge their car ‘elderly driver,’ so why would we expect diabetics or people with other diseases to? If I want an emergency responder to know I’m diabetic, my medical alert bracelet, phone medical alert, pump and CGM (continuous glucose monitor) should be plenty. I don’t need it otherwise advertised on my car for people to judge.”
Kathy Marmolejo was also against it, writing: “No, because some people (already) believe that diabetics shouldn’t be able to have a license because we’re a risk. I have a medical ID and an alert card on me.”
DiabetesMine reached out to several endocrinologists and diabetes care and education specialists (DCES) across the United States. Interestingly, most of them said the topic rarely ever came up in conversations with patients.
They said most conversations with patients around driving had to do with state laws, and they usually advise patients to contact their state driving agency or consult the American Diabetes Association resources available on driving rules per state.
Well-known DCES Gary Scheiner in Pennsylvania (who lives with T1D himself) said it comes down to a personal choice whether patients are comfortable using a car sticker.
Though he’s not a personal fan of labelling a vehicle with a diabetes alert, Scheiner says that in his practice they teach patients to always have a medical ID card front and centre in their wallet and also wear one if possible. They hand out a business card-sized alert made by Ascensia Diabetes Care that says, “I have diabetes” and “Please call 911” in big, bold print on the font. The back has one’s personal information for first responders, bystanders, or medical professionals.
In Ohio, paediatric endocrinologist Dr. Jennifer Dyer says her state’s Bureau of Motor Vehicles asks each person if they have diabetes when applying for a license. If so, they must then have their doctor complete a diabetes history and assessment to sign off on whether that PWD is “adherent” to their particular management routine. Specifically, the doctor is asked on the form if that person should maintain their license and when that HCP believes the patient should be re-assessed.
Dyer says she’s refused to sign a few teenagers’ forms, particularly when they have “recklessly stopped checking their blood glucose, as I am legally responsible for any damage they do while driving related to their diabetes.” She notes that teens are highly motivated to drive: She’s seen many change their behaviours and consent to start wearing a continuous glucose monitor (CGM) or check their sugars much more often to get her to sign off on the form. “It’s a bit of a bargaining tool that works really well with teens.”
When it comes to the topic of using diabetes car decals, Dyer says: “It would be helpful to have more obvious signage about diabetes on a vehicle, so that when EMT workers arrive at a scene they would know that a person in the car has diabetes.”
Even so, the approach varies by region. Dyer says that in her particular Ohio county, paramedics always assume that any injured or unconscious driver has diabetes and they do a glucose check, unless told otherwise. So, a driver’s vehicle ID might be less impactful there, compared to other places.
I personally have been driving with T1D since 1996, and have gone low and experienced dangerous scares that made me question whether I should even have a license. This happened at two key points in my life:
The first was in my late teens not long after my high school graduation in 1997, long before I became an insulin pumper. I ended up swerving on the road and eventually getting pulled over by police in a parking lot. Thankfully, no accident occurred and no one was hurt.
The second incident was in roughly 2009, just before starting on a CGM. As a result of a fast-dropping blood sugar that didn’t show itself with an in-the-moment fingerstick test at work, I had a “sudden” hypo that led me wandering from my office in a daze into the parking garage. I apparently climbed into my red Ford Escape and began driving towards home. I ended up in front of my subdivision in a ditch, after taking out a street sign with my car. Luckily (incredibly so!), no one was injured that time either.
In that second experience, when paramedics arrived on the scene I was stunned, but still behind the wheel. Unsure of my surroundings but able to see my subdivision entrance, I tried to get away. A paramedic leaned into the open window and pulled the keys from the ignition to stop me from trying to flee.
That incident inspired me to get a CGM, and ever since, I’ve not been behind the wheel without knowing where my blood sugars stand.
In addition, that motivated me to start displaying a decal on my front windshield, rear window, and driver’s side window. For years, I also carried a medical alert on my keychain, along with a plastic case for 4 glucose tablets.
As a white man who has never been profiled or targeted, I didn’t have any concerns with displaying a medical alert on my vehicle. But I recognize my privilege — especially now, in 2021.
Of late, my newest vehicle (and keys) haven’t had any diabetes alerts displayed for two reasons: I’ve been working from home full-time since 2012 and therefore don’t drive often, and as mentioned, I now wear a CGM and automated insulin delivery device that keeps my glucose levels in range more than 60 percent of the time. Those two points lead me to be less immediately concerned about diabetes driving emergencies.
Clearly the choice whether to use a car decal is a personal one. I would just remind my fellow T1Ds that driving is a privilege, and please take precautions to stay safe — with or without a car sticker.
(NewsUSA) - Taking ownership of your heart health by monitoring some basic health numbers can contribute to a longer, healthier life. Paying attention to blood pressure, cholesterol, and weight are important for everyone, but especially for individuals living with diabetes, who are twice as likely to develop and die from heart disease, strokes or heart failure.
Type 2 diabetes is also a risk factor for severe complications from COVID-19, so it is more important than ever for people living with diabetes to be aware of critical numbers and keep their diabetes well managed.
Diabetes management is especially essential for Hispanic/Latino Americans, who have a 50 percent chance of developing type 2 diabetes and suffering devastating complications from it, according to the Centres for Disease Control and Prevention.
"My message for others living with diabetes is that we have control and choices," says Lupe Barraza, who lives with type 2 diabetes and is a spokesperson for Know Diabetes by Heart, an initiative of the American Heart Association and the American Diabetes Association.
"Managing key health numbers can help you prevent complications from diabetes, like heart failure and kidney disease," Barraza says.
"You don't have to wait until you get sick to go to the doctor. You and your doctor should work together now to keep you from getting sick," she emphasizes.
Five key numbers all people living with diabetes should measure regularly are:
BMI (body mass index). Your BMI is an estimate of body size based on height and weight that is used to help determine if you're overweight or obese. A normal BMI usually ranges from 18.6 to 24.9 and can be calculated at home using a BMI calculator or in a doctor's office.
Blood Pressure. Blood pressure is how strongly the blood pumps through your body when your heart beats, and is a sign of heart health. A healthy blood pressure for most people is less than 120/80, but your doctor may give you a different goal based on your diabetes. Blood pressure can be measured at home if you have a blood pressure monitor, or in a doctor's office.
A1C. Your A1C is a measure of average blood glucose levels for the past two to three months. A healthy A1C for someone with diabetes is 7 percent or less. A1C is measured by a blood test and should be checked at least every six months if you have diabetes.
Cholesterol. Cholesterol is a waxy substance in the blood. If cholesterol levels are too high, they can cause fatty deposits in blood vessels that can lead to a heart attack or stroke. Cholesterol is measured by a fasting blood test in a doctor's office.
Kidney function. Early detection of chronic kidney disease (CKD) can make a huge difference. An often overlooked, simple test is the UACR (urine albumin to creatinine ratio) which can detect early signs of trouble. Kidney function is measured in a doctor's office and should be done every year.
In my diabetes clinic, I’m so often asked by my patients: “Why have I got type 2 diabetes? My friends are all fatter than me and they don’t have this disease.” The answer is this: we all have a different degree of susceptibility to fat.
Type 2 diabetes is caused by an individual acquiring more fat than they personally can cope with – something I demonstrated in my work as a diabetes researcher a decade ago. When it comes to this illness, there is no one size fits all approach to the question: how fat is too fat?
This week, a study by researchers at the University of Michigan found the number of people around the world who are living with diabetes has more than quadrupled since 1980. Today, almost half a billion people globally have the disease, and 90 per cent of them have the type 2 version. The frightening part is most don’t even realise it.
As someone who has studied type 2 diabetes for many years, these new findings don’t surprise me at all. There’s no mystery surrounding the reason for such an explosion in the condition, which causes the level of sugar in the blood to become too high and can lead to complications such as heart disease and stroke, vision loss and kidney problems: it’s a sickness of modern lifestyles, in which we cook less food from whole ingredients and buy more of it ready-prepared.
But the correlation between type 2 diabetes and obesity is less straightforward than you might think (hence those puzzled patients of mine). Almost three-quarters of those with a BMI of over 45 (in other words, those who are morbidly obese) actually don’t have type 2 diabetes. Meanwhile, 10 per cent of those with the disease have a BMI of under 25, meaning their weight is theoretically healthy. But in the case of these people, crucially, their weight isn’t healthy for them. Our genes determine how much weight each of us can carry before we enter the danger zone, and for some it’s far less than for others.
Our diets have changed dramatically in recent decades. As a result, both men and women are approximately 10kg heavier today than they were 30 years ago. The problem is not the hugely obese people; it’s that most people are walking around with a few extra kilograms they shouldn’t have.
The finger of blame often points towards ultra-processed foods, and rightly so: these foods are designed to fill us up less and leave us craving more. Thirty to 40 years ago, most people were cooking more meals from scratch, and our shift to prepared food has had a disastrous effect.
Exercise plays a part too, of course, but to a lesser degree. If a large man does a good workout, he could still regain all the calories burned by eating some chocolate. Exercise is important for keeping your weight healthy in the long-term, but nothing beats diet when it comes to shedding pounds fast.
So how do you know if you’re one of the unlucky many who’s walking around without knowing you are diabetic? The short answer is you don’t. This is a disease that creeps up on you silently, not making itself known until it’s well on its way. If you’re passing more urine than usual, feeling thirsty, tired, or succumbing to more skin infections, then yes you should get yourself checked. But by the time these red flags appear, it’s likely the disease has already been present a while.
It is, however, possible to know if you are at risk before the symptoms appear. If you come from a family with a history of the disease, you stand a fair chance of developing it if your weight goes above a certain level. It’s a genetic predisposition, but it never happens unless a person becomes too heavy for their own body.
As a rule of thumb, if your waist size is much larger than when you were 21, you are carrying too much fat. Even women who have given birth should be able to get their waist size back to what it was (if not their hip size). And no, you don’t have to subsist on a lettuce leaf a day. But you do have to watch your portion size, as standard servings today far exceed what the average woman should really consume.
Men, for their part, get type 2 diabetes at a lower BMI than women. Even if a man is quite slim, an extra layer of belly fat in midlife should be viewed as a warning sign. So-called middle-aged spread should be tackled and not laughed off.
The risk increases steadily through life and rises sharply after 60. This is partly because the average 60-year-old is larger than the average 20-year-old. But also, as we age, we lose muscle mass. Even a 60-year-old who can proudly say they’re the same weight now as they were at 40 may still be unwittingly at risk, as they’ve probably lost muscle and gained fat.
So what can we do? We must understand that any weight gain after we’ve stopped growing is entirely fat. We can find out what percentage of our body weight is fat by using one of the machines many gyms and pharmacies have, which give you an instant reading. If you’re outside the healthy range (between nine and 20 per cent for men, and between 20 and 32 per cent for women) it’s time to take action.
But if you do turn out to be one of those walking around without knowing you have type 2 diabetes, take heart in the knowledge it can, in fact, be reversed. The science behind this, which is my area of special interest, is still evolving; but we do know that losing the excess fat you have gained can reduce the fat inside the liver and pancreas that builds up to cause diabetes. The sooner you start, the better, as initial findings suggest that those who have been diabetic for more than 10 years may well struggle to reverse it.
There remains an unfair stigma attached to this illness. Yes, it’s possible to reduce our personal risk; but the failure of governments to regulate the food industry is to blame. The same people who cry “nanny state” at the thought of curbing the market’s ability to make us ill are also the taxpayers picking up the bill for our sickness: more than £10 billion a year is spent on treating type 2 diabetes in England and Wales alone.
It’s time for us all to wise up and act now to send this trend into reverse.
These symptoms can sneak up on you. Don't ignore them.
Diabetes is at record levels in the United States. Almost 34 million Americans—just over 10.5% of the population—are affected by the body's inability to adequately process blood sugar. The condition's ubiquity may make it seem like no big deal, but nothing could be further from the truth: Untreated diabetes can damage blood vessels throughout the body, leading to heart disease, stroke, blindness, even amputation.
Type 1 diabetes tends to develop in childhood, and it's unclear whether it can be prevented. But the American epidemic of diabetes is driven by Type 2, which generally develops in adulthood because of avoidable unhealthy habits, like a poor diet and sedentary lifestyle. We asked two experts from Harvard Medical School (and contributors to the new documentary Better) how to recognize the subtle signs you might have diabetes.
You're Getting Older
People should first be screened for diabetes at age of 45, then every three years after that, says JoAnn Manson, MD, DrPH, professor of medicine at Harvard Medical School and chief of preventive medicine at Brigham & Women's Hospital. According to the CDC, being over 45 is a risk factor for type 2 diabetes.
You Have Obesity or Are Gaining Weight
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If you have obesity, screening should begin earlier than age 45, says Manson. The CDC says overweight or obesity are both risk factors for developing type 2 diabetes.
You Have Unexplained Weight Loss
While overweight is a risk factor for diabetes, losing weight over a period of time without trying can be a subtle sign of the condition. "With diabetes, people can lose weight initially, without knowing that they're in the midst of their blood glucose being out of control," says John Ratey, MD, associate clinical professor of psychiatry at Harvard Medical School. A friend of Ratey's lost 20 pounds over six months before being diagnosed—his blood glucose level was three times the normal level when he was hospitalized, before it was brought back under control with medication, diet, and exercise.
You're Urinating Frequently or Are More Thirsty
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"What people will often start to notice is that they're urinating more often or they're thirsty more than usual," says Manson. That's because excess blood sugar (glucose) is delivered to the kidneys, which work overtime to flush it out, causing frequent urination. Meanwhile, the excess blood sugar pulls electrolytes and fluids from tissue and organs, causing dehydration and thirst.
You Have Blurred Vision
"Sometimes someone with diabetes will start to develop a little blurred vision," says Manson. "In fact, it's not unusual for the eye doctor to pick up signs of diabetes, especially in someone who is not having regular screenings for their blood sugar."
You Feel Tingling Here
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"Sometimes people will have what we call parasthesias or neuropathy—tingling or change in sensation in the nerve endings, especially in the hands and feet," says Manson. "That can also be a sign of blood sugar being elevated."
You Have Fatigue You Can't Shake
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Persistent fatigue is also a common sign of diabetes, says Ratey. If you're getting enough sleep and your lifestyle hasn't changed, but find you don't have the energy to go through your day as usual, it's a good idea to talk with your healthcare provider.
ANN ARBOR, Mich. — As one pandemic begins to fade away, a new study finds another is continuing to grip the entire world. Researchers find that almost half a billion people globally have diabetes, although many don’t know they have it. The number of cases have more than quadrupled since 1980, when there were around 108 million living with the condition.
The study also shows, however, that only one in 10 are getting the level of care they need to make their lives healthier, longer, and more productive. Although researchers say diabetes was more common in affluent countries in the past, it is now more likely to affect impoverished nations in Africa, the Americas, and South East Asia.
“Diabetes continues to explode everywhere, in every country, and 80 percent of people with it live in these low and middle income countries,” says lead author Dr. David Flood from the University of Michigan in a release.
Failing to control blood sugar levels can have devastating health consequences. Diabetes triples the risk of a heart attack and leaves people 20 times more likely to undergo a leg amputation. It can also lead to stroke, kidney failure, blindness, nerve damage, and complications during pregnancy.
“We can prevent these complications with comprehensive diabetes treatment, and we need to make sure people around the world can access treatment,” Dr. Flood explains.
Diabetes is a growing problem in the developing world
Around nine in 10 patients have type 2 diabetes, which can be a result of engaging in unhealthy lifestyles. As the world’s waistlines have ballooned, with one in three now registering as overweight, so too has the number of diabetes cases.
The CDC estimates that over 34 million Americans is currently living with diabetes and 90 percent have type 2 diabetes. The latest study, appearing in the journal Lancet Healthy Longevity, pooled data on 680,000 people between 25 and 64 years-old in 55 low and middle income countries.
Researchers discovered more than 37,000 had diabetes, but over half had never received an official diagnosis. Blood samples revealed a key biomarker of elevated sugar in these patients.
Study authors add cheap medicines that reduce glucose, blood pressure, and cholesterol could combat the growing crisis. Counselling on diet, exercise, and weight can also help lower the risks from under-treated diabetes.
The study also identified major gaps in specific areas. Fewer than one in two patients with the condition are taking a blood sugar or blood pressure lowering drug. Moreover, only one in 16 people are using cholesterol-lowering medications. The team adds less than a third have access to advice on diet and exercise, which can encourage healthy habits.
Patients in poorer nations face many barriers to care
Among patients who have received a diabetes diagnosis, 85 percent are taking a medication to lower blood sugar and 57 percent have a prescription for a blood pressure drug. However, only nine percent are taking something to control their cholesterol. Additionally, a majority of diabetes patients have received diet or exercise and weight counselling. Overall, Dr. Flood says fewer than one in five are “getting the full package of evidence-based care.”
The study’s model, examining economic and demographic data about these countries, reveals the poorer the people in these nations are, the bigger the diabetes problem becomes. Nations in the Oceania region of the Pacific had the highest prevalence of diabetes – both diagnosed and undiagnosed – but the lowest rates of diabetes-related care.
Researchers did find some exceptions, such as Costa Rica. The Latin American and Caribbean regions ranked second only to Oceania in diabetes prevalence, but had much higher levels of care available.
These efforts could improve care in wealthy countries like the U.S., which does not consistently deliver good care to patients with diabetes. The team finds women, wealthier individuals, older people, and the obese are more likely to get good quality treatment. However, diabetes in people of normal weight is not uncommon in low and middle-income countries. Dr. Flood is calling for more focus on these individuals.
“The fact diabetes-related medications are available at very low cost, and individuals can reduce their risk through lifestyle changes, mean cost should not be a major barrier,” Flood concludes. “In fact, studies have shown the medications to be cost-effective, meaning the cost of their early and consistent use is outweighed by the savings on other types of care later.”
This week we are going to focus discussion on Type 2 Diabetes, as it is the most common form, striking more than 24 million people in the U.S.
Diabetes is often called – the silent killer. The ADA says that half of Americans 65 and older have prediabetes, which means that nearly 25 million seniors are at risk for developing type 2 diabetes.
That is a staggeringly high number, given that another 25 percent of the senior population already has diabetes. An issue with prediabetes, though, is that there are generally no symptoms. If you are experiencing symptoms associated with diabetes, you may already have it.
The symptoms may build over time and can be attributed to other illnesses, then, by the time you are diagnosed, the disease could have progressed to a dangerous level. This includes damage to organs and blindness. Early treatment can prevent or minimize the damage.
Here are some of the common symptoms. This is not to alarm you, but to make you watchful.
Re-occurring infections. You become immune-suppressed; your body will have trouble fighting off infections and will be susceptible to a variety of bacterial infections—such as yeast (or Candida) infections, pneumonia, urinary tract infections (UTIs), and skin rashes.
Increased urination. Individuals with type 2 diabetes have overactive kidneys working to eliminate excess glucose in the blood, and the fastest way to eliminate anything from the body is through urination. Keep in mind that this increased urine output may not only keep you up at night, it can also cause dehydration so be sure to hydrate.
Increased appetite. A ravenous appetite occurs when blood sugar levels drop dangerously and the body demands glucose to function. Oftentimes, hunger pangs will rouse you at night and keep you up until you eat something.
Unquenchable thirst. Excessive thirst often occurs with type 2 diabetes onset, signalling that your body is trying to replenish fluid levels lost due to more frequent urination, and sometimes, perspiration.
Exhaustion. General discomfort, plus the draining effects that excess glucose elimination has on the body will rob you of energy and much needed rest.
Sudden unexplained weight loss. Onset of diabetes can result in sudden and unexplained weight loss of 10 to 20 pounds in a matter of a few weeks or months’ time. This weight loss is due to a lack of calories from insulin elimination (via increased urination) and lack of insulin hormone, which provides vital energy.
Mood swings. When blood sugar is high, moods can be giddy and downright silly, but when blood sugar drops, mood can turn to irritable and downright nasty until energy stores are replenished with food.
Slow to heal. Due to blood vessel damage from increased glucose in the veins, type 2 diabetes sufferers often experience restricted blood flow. This often causes a decrease in the time needed to heal surface abrasions, bruises, cuts, skin rashes and infections.
Numb fingers and toes. Chills, inflammation, tingling and prickly numbness in the fingers and toes are other symptoms linked to type 2 diabetes. This discomfort occurs when excessive glucose in the body causes neuropathy (or nerve damage).
Vision problems. Eye vision is closely linked to blood sugar levels, which means when blood sugar drops, a person suffering from type 2 diabetes will experience blurred vision, floaters and even light sensitivity. Luckily, once blood sugar is stabilized, vision will return to normal as well. But leaving blood sugar unbalanced for too long may permanently damage vision.
If you notice one or more of these symptoms, please consult with your doctor. They will probably want to do A1C blood test and provide you with a glucometer to test your blood over a few weeks to get a reading of your high and low sugar levels.
Diabetes will not just go away on its own, but it can be managed and often reversed with proper diet, exercise and medication when needed.
Jody Holton writes about health for Port Arthur Newsmedia. She can be reached at jholton3@gt.rr.com.
Your weight can affect diabetes, but diabetes can also affect your weight. This may depend on the type of diabetes that you have — type 1 or type 2.
Diabetes is a metabolic disease that causes high blood sugar, or glucose. With diabetes, the body either doesn’t make enough of a hormone called insulin or can’t effectively use the insulin it does make. Insulin controls the levels of glucose in the blood after you eat a meal.
People with type 1 diabetes may lose weight unintentionally since they can’t use the sugar they eat for energy. In this case, the pancreas doesn’t make insulin, and sugar is removed from the body during urination.
Being overweight or obese increases a person’s risk for developing type 2 diabetes. People with type 2 diabetes have a condition called insulin resistance. This means that the pancreas can typically still make insulin, but the body can’t use it properly. The pancreas tries to compensate by making more insulin, but it eventually wears out.
Weight loss, which can be achieved through diet changes, exercise, and certain medications, can be an important way to help combat insulin resistance and treat type 2 diabetes, and in some instances type 1.
Unexpected or unintended weight loss is often a symptom of unmanaged diabetes, both type 1 and type 2.
With type 1 diabetes, the immune system attacks cells of the pancreas that make insulin. Since there’s no insulin available to move glucose into the body’s cells, glucose builds up in the bloodstream. The kidneys then work to remove this unused sugar through urination. The sugar isn’t used as energy, so the body starts burning fat and muscle for energy, resulting in weight loss.
Weight loss in type 1 diabetes may be unintentional. If people with type 1 diabetes need to lose weight, this can be done safely by reducing calorie intake. Some people may under-treat their diabetes to lose weight, but this is highly dangerous. Skipping insulin can lead to very high blood sugar levels, a serious complication known as diabetic ketoacidosis, and potentially death.
Under-treating diabetes to lose weight can be a symptom of an eating disorder. If you think you have an eating disorder, reach out to your doctor or a mental health professional to get specialized support and treatment.
Type 2 diabetes occurs when your body becomes resistant to insulin, causing sugar to build up in the blood. Having overweight or obesity puts you at a much higher risk for developing diabetes, and it makes blood sugar levels harder to manage.
In fact, research shows that losing just 5 to 7 percent of body weight may reduce the chance of developing type 2 diabetes by over 50 percent in adults at high risk for the disease.
There are many benefits to losing weight when you have type 2 diabetes. These include:
decreased insulin resistance, which makes it easier to reach target blood sugar levels
improvements in overall energy level and mood
improvements in mobility
lower total cholesterol, triglycerides, and LDL cholesterol levels
lower chance of developing complications from diabetes, like kidney or heart disease
In some cases, weight loss can even restore blood sugar to a normal level and eliminate the need to take type 2 diabetes medications.
If you have type 1 diabetes, weight gain may occur once you start taking insulin. Losing weight may require fine-tuning your calorie and carbohydrate intake and insulin dose.
People with type 1 diabetes can also develop insulin resistance, and in that situation, would benefit from weight loss to help them need less insulin.
Certain medications used to treat diabetes also help with weight loss, including:
Metformin
Metformin is a commonly prescribed diabetes medication that is used to control blood sugar. Research shows that it may also help some people lose weight over time.
GLP-1 agonists
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are very effective at lowering blood sugar levels. They may also help with weight loss.
Examples include:
dulaglutide (Trulicity)
exenatide extended-release (Bydureon)
liraglutide (Victoza)
semaglutide (Ozempic)
SGLT2 inhibitors
Another class of medications associated with weight loss and improved blood sugar control is the sodium glucose cotransporter 2 (SGLT-2) inhibitors. These include:
canagliflozin (Invokana)
dapagliflozin (Farxiga)
empagliflozin (Jardiance)
Adjusting medications for weight loss
As you lose weight, your may need less medication to keep your blood sugar in target range. This can cause some people to develop low blood sugars. If you notice this occurring during your weight loss journey, talk with a medical professional to adjust your diabetes medications.
If you have diabetes and wish to lose weight, combining a balanced diet with physical activity is likely the best strategy. Even small changes to your diet can go a long way.
In general, you should aim for a diet high in non-starchy vegetables, lean protein, and whole grains.
Diet
The American Diabetes Association recommends using the Diabetes Plate Method when preparing meals.
For this method, use a plate approximately 9 inches in width and follow these three simple steps:
Fill half the plate with non-starchy vegetables. Non-starchy vegetables are lower in carbohydrates and high in vitamins, minerals, and fibre. If you don’t have access to fresh vegetables, canned or frozen vegetables work just fine. Examples include leafy salad greens, peppers, broccoli, tomatoes, and Brussel sprouts.
Fill one quarter of the plate with lean protein, such as chicken, fish, turkey, tofu, tempeh, and beans.
Fill the other quarter of the plate with complex carbohydrate foods like brown rice, quinoa, oats, whole grain bread or pasta, and dairy products like low fat yogurt.
For drinks, stick with water or unsweetened tea whenever possible.
You should avoid snacking on high sugar, high fat, or heavily processed foods, like:
candy
cookies
cakes
fast food
fried foods
Exercise
In addition to diet changes, exercise is also important for weight loss. Always talk with your doctor before starting a new exercise program.
Start by setting modest goals. You can begin by walking either outside or on a treadmill for 10 to 20 minutes each day. After a week or so, increase the time or the speed you’re walking.
Research shows that getting moderate intensity aerobic exercise for at least 150 minutes each week is enough to produce significant improvements in blood sugar control and help you lose weight.
Aerobic exercise includes activities like:
walking
running
swimming
dancing
hiking
playing tennis
To help get you motivated, you can join a gym or a group fitness class or exercise with a friend.
If you’re not sure how best to eat for diabetes, or if you want help with managing your weight, consider meeting with a dietitian or nutritionist.
If you have Medicare, you may be eligible for Intensive Behavioural Therapy for Obesity. This includes up to a year of in-person weight-loss counselling visits with a healthcare professional.
Certified Diabetes Care and Education Specialists (CDCES) are professionals who provide personal one-on-one support to people living with diabetes. They can help with:
medications
diet
exercise
blood sugar control
The Diabetes Foundation or the Association of Diabetes Care and Education Specialists can help you locate a free or low cost CDCES.
If you or a loved one are restricting insulin to lose weight, it can have very serious consequences. This practice is considered a type of eating disorder, and professional help is available.
Weight loss can be an unintended symptom of untreated type 1 diabetes. If you have type 1 diabetes and you’re losing too much weight, talk with a medical professional.
On the other hand, weight loss is an important part of the treatment program for people with type 2 diabetes and people with type 1 diabetes and overweight. Losing weight can decrease insulin resistance and make blood sugar easier to control.
If you have type 2 diabetes and are trying to lose weight, the best approach is to set realistic weight-loss goals and aim for moderation. Take steps to eat a more balanced diet, include more physical activity in your daily routine, and be sure to take all prescribed medications.
If you’re still concerned with your weight, don’t hesitate to talk with a medical professional or meet with a Certified Diabetes Care and Education Specialist.
When an individual has diabetes, it requires a lifestyle change. If changes aren’t made, diabetes can lead to other health conditions.
As a person with diabetes, it is important to fully follow the plan that is given by your doctor to help your condition and possibly prevent long-term complications.
This article outlines comorbidities that can occur alongside diabetes.
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Cardiovascular Disease
Research shows it is common that people with diabetes also have cardiovascular disease and other heart-related issues. These conditions are intertwined and can create complications.
It is possible for people who have longstanding diabetes and heart-related conditions to develop other complications such as:
Stroke
Congestive heart failure
Coronary artery disease
Peripheral vascular disease
When a person has type 2 diabetes, their risk for cardiovascular mortality and morbidity is higher than those who do not have diabetes. This is due to the lack of glycaemic control.
Other risk factors include:
Obesity
Smoking
Lack of physical activity
All of these are factors of both conditions.
Research shows that when a person has type 1 diabetes, cardiovascular disease is a major cause of mortality. It is important to work with your healthcare professional to understand your conditions and follow the specified treatment plan related to both.
Dry Mouth
Diabetes can cause too much glucose in the blood. As a result, this can cause infection, pain, and dryness in the mouth.
High amounts of glucose will reduce the ability of saliva to produce effectively. When there are high glucose levels in the saliva, this increases the growth of bacteria. This can also increase the risk of:
Gum disease
Plaque
Tooth decay
Some of the symptoms along with dry mouth include:
Pain
Cracked lips
Mouth infection
Problems eating
Problems swallowing
Problems talking
Along with taking your medicine prescribed by your doctor, other treatments that can help include:
Consuming frequent sips of water
Rinsing the mouth with fluoride to prevent cavities
Avoiding caffeine, tobacco, and alcohol
Consuming sugarless gum or mints to increase the flow of saliva
Avoiding foods with high amounts of sodium and foods that are spicy
Using a humidifier at night
Having a good oral hygiene regimen
It is important to develop a treatment plan with your healthcare professionals. Both your doctor and dentist can help with a plan that is effective.
Erectile Dysfunction
Research has shown that erectile dysfunction is known to be a complication of diabetes. It is also an under-reported and under-diagnosed condition. Therefore, treatment and the age of diagnosis are delayed.
People who are older and have poor glycaemic control are known to have a higher risk of getting severe erectile dysfunction.
Fatigue
Fatigue is known as mental or physical exhaustion. It can be triggered by:
Overwork
Physical illness
Medication
Stress
Disease
Mental illness
When a person is fatigued, it can impair the mental and physical function for both short-term and long-term activities. Studies recommend that if an individual presents with complaints of fatigue, a healthcare professional should conduct a focused medical and endocrine check-up.
Fatigue is a common factor for both type 1 and type 2 diabetes. Along with diabetes medication, there are other risk factors of fatigue, including:
Inflammation
High body mass index
Depression
Poor diet
Lack of exercise and physical activity
Poor sleep habits
Some people with diabetes become depressed, which is another condition that is, at times, diagnosed as fatigue.
It is important to speak with a healthcare professional about your specific symptoms so they can accurately diagnose the condition. If the lifestyle, nutritional, and medical factors are ruled out, a targeted gluco-endocrine evaluation should be done to determine a diabetes fatigue syndrome diagnosis.
Foot Ulcers
Diabetic foot ulcers occur in approximately 15% of people with diabetes. The length of time a person has had diabetes is a factor as to whether or not a patient will get a foot ulcer.
The condition can show up as:
Numbness in the foot
Poor circulation
Foot deformities
About 6% of people with diabetes could be hospitalized due to complications or infections of a foot ulcer.
If a person has type 1 or type 2 diabetes, they can get a foot ulcer. Certain individuals are at higher risk, including those who:
Have peripheral vascular disease
Have neuropathy
Have poor glycaemic control
Smoke cigarettes
Have diabetic nephropathy
Have had previous foot ulcerations/amputations
Use insulin
Are overweight
Consume alcohol
People who have diabetes-related eye disease, heart disease, and kidney disease are also at a higher risk.
Treatment for diabetic foot ulcers includes:
Applying medication or dressings to the ulcer
Managing blood glucose
Taking the pressure off the area
Removing dead skin and tissue
Ulcers are not always infected. If one does become infected, see your healthcare professional regarding proper medication and care.
Gum Disease
Gingivitis or gum disease occurs when plaque builds up around your teeth and inflammation in the gums occurs. For people who have diabetes, the inflammatory response to the plaque is greater.
Some of the symptoms of gum disease include:
Loose teeth
Sensitive teeth
Gums that are swollen, red, or bleeding
Bad breath
If a person does have gum disease and it goes untreated, it can turn into periodontitis. This is an infection that damages the soft tissue of the gum, and it can damage the bones that support your teeth.
Some of these suggestions can help prevent gum disease:
Avoid acidic drinks—they are known to erode the enamel on the teeth
Floss regularly
Regularly brush your teeth and gum line gently
Brush your tongue to help get rid of bacteria
It is important to go to your regularly scheduled dental and doctor appointments. Your healthcare professionals can help you create a plan and possibly prevent complications.
Hearing Loss
A large number of people have both hearing loss and diabetes. It is estimated that 34.5 million people have hearing loss and more than 34 million people in the United States have diabetes.
A recent study reported that hearing loss is twice as common with people who have diabetes. It is speculated that high blood glucose levels in diabetic patients may cause damage to the small blood vessels in the inner ear. However, more research needs to be conducted to confirm this theory.
Although hearing loss is gradual over time, it is important to look for symptoms. Some of the signs of hearing loss are the following:
Turning up the television to a volume that is too loud
Asking people to repeat themselves
Trouble following conversations that have more than two people
If you feel you are experiencing hearing loss, contact your doctor so they can assist you in getting the help that you need.
Hypoglycaemia
Hypoglycaemia happens when the blood sugar falls below a certain range. If the blood sugar falls below 70 mg/dL, that is considered too low. It is important to check with your healthcare professional about your specific numbers.
If you are diabetic and hypoglycaemic, this may cause an insulin shock.
Some ways to stay current with your blood sugar numbers is to:
Regularly check your blood sugar
Use a monitor
Keep an eye out for symptoms
Hypoglycaemia symptoms include:
Being nervous or anxious
Sweating or chills
Irritability or impatience
Confusion
Tiredness
Feeling weak or having no energy
Blurred/impaired vision
Tingling or numbness in the lips, tongue, or cheeks
Headaches
Clumsiness
Nightmares or crying out during sleep
Seizures
If you have any of these symptoms, contact your doctor right away.
Kidney Failure
The kidneys are an important function of the body. Diabetes is the leading cause of kidney disease. In fact, about one out of three adults with diabetes have kidney disease.
A healthy kidney filters waste out of the bloodstream and controls blood pressure. If a kidney is not healthy, it can’t filter properly and the waste will build up.
An unhealthy kidney can also lead to other health problems. If a person has diabetes over a period of years, the kidney will become damaged, disease can occur, and eventually kidney failure can occur. This is due to the blood pressure and glucose being too high.
It is important to talk to your doctor and check your kidneys to make sure they are healthy. It is recommended that you get tested every year if you have type 2 diabetes and if you’ve had type 1 diabetes for more than five years.
If a person has diabetes and is not active, eats foods high in sodium, doesn’t follow the eating plan, smokes, has heart disease, or is obese, they are at an increased risk of developing kidney disease and/or failure.
Memory Loss
When a person has diabetes, it may increase the risk of memory loss and other cognitive problems.
When the blood glucose is higher than normal, it is known to damage nerve cells and blood vessels in the body and brain. Diabetes is also known to damage the capillaries which could also cause a slow progression of memory loss.
Research has shown that people with type 2 diabetes could have a higher risk of developing dementia. Overall, if the diabetes is not properly controlled, the chances of having complications with memory are higher. It is important to manage your condition and follow the plan provided by your doctor.
Neuropathy
Diabetic neuropathy happens when there is nerve damage due to diabetes. There are different types with different symptoms. Some of the symptoms affect the internal organs, heart, and bladder.
A person who has this condition may experience pain and numbness in the feet and issues with internal organs.
With diabetic neuropathy, nerve damage happens over time. This is due to the high blood sugar, and high levels of triglycerides in the blood due to diabetes. There are different types of diabetic neuropathy, and the symptoms for each vary. These include:
Peripheral neuropathy: This is very common and is known to affect primarily the feet and legs. There are times that the arms and hands are affected too. Approximately one-half to one-third of patients with diabetes have peripheral neuropathy.
Autonomic neuropathy: This affects the nerves that control the internal organs. It is also known to lead to hypoglycemic unawareness. This can create complications with the digestive system, bladder, sweat glands, eyes, heart rate, and blood pressure.
Focal neuropathies: This causes damage to single nerves that are common in the head, leg, torso, or hand. Carpal tunnel syndrome is the most common type of this condition.
Proximal neuropathy: This typically affects one side of the body. The areas that are impacted are the buttock, thigh, and hip. The symptoms are known to improve over a period of months or years.
Obstructive Sleep Apnoea
Obstructive sleep apnoea commonly affects people who have type 2 diabetes. Research shows that up to 83% of people with type 2 diabetes have this condition.13
There is an association between this condition, insulin resistance, and glucose intolerance. More research needs to be done to conclude that treatment of obstructive sleep apnoea can prevent the compilations and development of type 2 diabetes.
Skin Infections
Diabetes affects the skin in different ways. Sometimes, certain problems with the skin such as itching, fungal infections, and bacterial infections are a sign that a person has the condition. If an individual has diabetes, they are known to get these types of skin conditions easier.
Other skin conditions that people specifically with diabetes could develop include:
Acanthosis nigricans: This appears on the side of the armpits, neck, and groin as tan or brown raised areas. They can occasionally appear on the hands, knees, and elbows.
Diabetic dermopathy: These are patches that are circular or oval. The texture and colour are scaly and light brown. They primarily appear on the front of the legs. The patches are not known to hurt or itch.
Necrobiosis lipoidica diabeticorum: This is a rare condition that is commonly known to affect adult women. Necrobiosis lipoidica diabeticorum begins as a raised area that is red and dull. Over time it develops into a shiny scar with a violet border. This skin condition is known to be painful and itchy, and the spots may crack open. If this happens, contact your doctor to get treatment.
Vision Impairment
When an individual has diabetes, they can develop problems with their eyes. Diabetic retinopathy can cause complete blindness and vision loss in people with diabetes.
This condition affects the blood vessels in the retina. Diabetic retinopathy can lead to:
Neovascular glaucoma: This happens when fluid is blocked from draining out of the eye due to abnormal blood vessels growing out of the retina.
Diabetic macular edema: When this condition occurs, the vision becomes blurry because there is extra fluid in the macula. The extra fluid is due to the blood vessels in the retina that leak fluid and cause swelling in the macula area of the eye.
Although there are no direct symptoms, it is important to notice any changes in the eyes. As a person with diabetes, it is important to get an eye exam once a year, including a comprehensive dilated exam. This can help with prevention and vision protection.
A Word From Verywell
If you are an individual who is living with diabetes, it is important to follow the plan that your doctor has created for you. It is also important to educate yourself on your condition so you can have a healthy quality of life and prevent any complications. If you have questions or concerns about your condition, your doctor can help.
- Taking ownership of your heart health by monitoring some basic health numbers can contribute to a longer, healthier life. Paying attention to blood pressure, cholesterol, and weight are important for everyone, but especially for individuals living with diabetes, who are twice as likely to develop and die from heart disease, strokes or heart failure.
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