ACLS Library: Guide to Diabetes
Diabetes is a disease which is characterized by abnormally high blood sugar (glucose) levels and commonly affects 7.8% of the population.
The disorder occurs for two different reasons: either the pancreas does not produce sufficient insulin, or the body does not use insulin efficiently to maintain blood sugar levels.
Insulin is a hormone secreted by the beta cells of the pancreas. The primary function of this hormone is to use glucose from digested food as a source of energy.
Classification of Diabetes
Type 1 diabetes is primarily an autoimmune condition manifesting in children and young adults. These people do not produce insulin; they require routine injections of insulin to aid in glucose metabolism. Without insulin injections type 1 diabetics cannot use the sugar in their blood for energy.
People with type 2 diabetes produce small amounts of insulin, or they cannot properly use the insulin hormone, also known as insulin resistance. This condition usually develops later in life. Many people with type 2 diabetes use diet, exercise, and other non-insulin medications. Some type 2 diabetics, however, may require supplemental insulin.
Signs and Symptoms
Signs and Symptoms of Hyperglycemia and Hypoglycemia
|Signs & Symptoms||Hyperglycemia||Hypoglycemia|
|Signs & Symptoms||Thirst, nausea, symptoms of dehydration, excessive urination, possible abdominal pain, dry mouth||Hunger, weakness, headache, trembling, numbness in hands and feet, unsteady gait|
|Response||Restless, agressive, gradual loss of consciousness||Restless, agressive, irritable, drowsy, confusion|
|Breathing||Rapid and deep, sighing breaths, possible sweet odor||Normal to rapid, odorless|
|Circulation||Tachycardia, rapid weak pulse, warm-dry skin||Rapid, weak pulse, pale-clammy skin|
Every cell in the body requires glucose as a foundation of energy. People with diabetes, though needing glucose, have an inability to process, or metabolize, it efficiently because the pancreas is either producing too little insulin or none at all—either way, glucose can accumulate to dangerously high levels.
A healthy pancreas regulates the production of the insulin hormone proportionate to the amount of glucose in the blood. When food is digested in the intestine, sugar molecules are directly absorbed into the bloodstream, and the blood glucose level rises. The increase in blood glucose signals the beta cells in the pancreas to secrete insulin into the bloodstream. Insulin then allows glucose to enter into the body cells to be used for energy or stored.
In the case of type 1 diabetes, beta cells of the pancreas release little or no insulin. In the absence of the hormone, sugar molecules present in the bloodstream fail to enter into the body cells, and as a result, blood glucose level rises. The body fails to use glucose for energy even though there is an increased sugar level in the bloodstream.
On the other hand, type 2 diabetes usually occurs due to obesity or being overweight and frequently develops in older people. In this kind of disease, the pancreas produces insulin, but the body fails to use it effectively. The hormone insulin does not access fat and muscle cells. As a consequence, glucose cannot enter into these cells to release energy. This leads to hyperglycemia or high level of blood glucose.
Risk Factors for Diabetes
There are several risk factors associated with diabetes. However, they differ significantly in both type 1 and type 2 diabetes.
Some of the risk factors related to type 1 diabetes include genetic predisposition, family history of autoimmune disease, child of an older mother, and lack of breastfeeding.
In contrast, type 2 diabetes risk factors include a family history of diabetes, middle age, obesity, high cholesterol level, high blood pressure, and depression.
Treatment and Management of Diabetes
Individuals who have diabetes can improve their condition by making some lifestyle changes. Some of the lifestyle changes include diet, exercise, and more.
Diet: Diabetic patients should consume a diet rich in whole foods with limited processed foods. Whole food, such as green leafy vegetables, whole fruit, and whole bread. Bread, however, may have added sugar and has been shown to raise a person’s blood sugar more than two tablespoons of table sugar.
The National Institutes of Health (NIH) recommend low-fat dairy in a healthy eating plan. A 2016 study published in Circulation may have a strong influence on policymakers, in the future, to reevaluate their position against full-fat dairy. Researchers found that out of 3,300 people, the individuals with the highest intake of full-fat dairy products had a 46% decrease in the risk of developing type 2 diabetes compared to people with low-fat dairy.
Protein content should vary from 15 to 20% of total calories consumed on a daily basis. Carbohydrate intake must be reduced because of the direct effect on blood glucose level. It is always a good idea to talk to a doctor or nutritionist regarding the kind of diet to follow.
Exercise: Physical activity is critical for the prevention and management of diabetes. Body conditioning plays a significant role in burning calories and thereby, helps reduce blood sugar level, and allows insulin to work effectively.
Medications: Many people can control their diabetes by making lifestyle changes. However, those who are severely affected by diabetes take medicines as per the doctor’s advice.
There are three broad categories of medications for diabetes, insulin, injectable medications, and oral pills. Insulin and other medications are injected directly into subcutaneous tissues to be readily absorbed by the body to lower the blood glucose level.
Supplements and Herbal Medicines: In addition to medications, supplements and herbal remedies may offer a therapeutic effect against diabetes. Some supplement and herbal medicines include alpha-lipoid acid, vitamin D, magnesium, omega-3s, chromium picolinate, fenugreek, bitter melon/bitter gourd, onion, and garlic to name a few.
Consult a physician before starting any supplement or herbal program—herbal medications and dietary supplements do have side effects. Because of the unverified use of many herbal remedies, an expert’s advice is recommended.
Diabetes Overview: Comprehensive information on diabetes including what is diabetes, types of diabetes, who gets diabetes, and how diabetes is managed, among others.
Diet and Diabetes: Valuable information on diet and diabetes including goals of diabetes management, major nutrient recommendations, and methods for planning diet.
Written by Sarah Gehrke, MSN, RN and last updated Apr 10, 2017
Last reviewed by Jay Frank Vijar on Sep 11, 2016