Diabetes – so many misconceptions, so little time! This complicated health problem is made even more challenging to understand because it often travels with friends – kidney disease, heart disease, neuropathy, etc.
How many of the facts below did you already know? By sharing what we learn, we can help others to avoid common complications of diabetes and inspire them
to advocate for themselves.
- Often parents think there’s no way that their child can have type 1 diabetes because it doesn’t run in their family. The reality is that between 80 and 90% of families of children with newly diagnosed type 1 diabetes do not report any history of the disease.
- Ninety percent of type 2 diabetes can be attributed to lifestyle factors that have caused a combination of insulin resistance and chronic inflammation. Factors that increase the risk of developing diabetes include being overweight, not exercising, smoking, eating a diet that is low in fiber and high in saturated fat, and drinking sugar-sweetened beverages.
- People with prediabetes who lose seven percent of their body weight and do 150 minutes of exercise a week can prevent or delay the onset of diabetes.
- Symptoms of insulin resistance include fluctuations in energy throughout the day (often most energetic in the morning), frequent hunger and not feeling full for very long after eating, binge eating, having frequent cravings for sweets and other refined carbohydrates, feeling irritable and shaky if going for too long without eating, and severe intolerance to very low-calorie diets.
- Individuals with type 1 diabetes have five to ten times the risk of developing celiac disease compared to someone without diabetes. Symptoms of celiac disease in someone with diabetes include unpredictable blood glucose levels and unexplainable hypoglycemia, as well as growth or weight failure, gastrointestinal symptoms, and anemia.
- Between 65 and 80% of all deaths among people with diabetes are related to heart disease and the rate of heart disease death and stroke are increased 200-400% with diabetes. Women with heart disease and diabetes far worse than men. Inflammatory factors might interfere with female sex hormones – decreasing their protective effect on body fat distribution and insulin action. Women are also less likely to have modifiable risk factors controlled and to receive lipid-lowering treatment.
- Dietary changes can reduce LDL cholesterol by 15-25 mg/dl. Many doctors want patients with diabetes to have an LDL of <70 mg/dl. This LDL is often impossible to achieve with lifestyle modification alone, and statins are usually necessary.
- Certain medications, including some blood pressure medications (such as diuretics and certain beta blockers) and LDL-lowering statins, are more likely to promote hyperglycemia in people with prediabetes, metabolic syndrome, or obesity.
- Among the general population, 9% of women and 24% of men have sleep-disordered breathing. However, it’s been estimated that up to 50% of people with diabetes do. These sleep disorders can cause decreased quality of life and cognitive defects, which are sometimes misdiagnosed as Attention Deficit Disorder or dementia. A sleep study is necessary to make the diagnosis.
- Diabetes can damage the nerves of the gastrointestinal tract, causing dysphagia and heartburn. Gastroparesis (delayed stomach emptying) causes severe loss of appetite, frequent nausea and vomiting, and feeling uncomfortably full even after eating tiny amounts of food. It is challenging to use insulin to control the blood glucose of someone with gastroparesis, and the absorption of oral medications can also be affected.
- About half of all people with type 2 diabetes for 20 years will develop retinopathy. Annual eye exams and appropriate treatment can decrease vision loss by 50-60%.
- Among individuals with kidney disease, restricting dietary protein intake can be quite beneficial. If kidney disease stages 1-4, protein intake (in grams per day) can be calculated at 0.8 grams per kilogram of body weight. If kidney function continues to decline, this should be modified to 0.6 grams per kilogram of body weight.
- Many people don’t know that people with diabetes often experience loss of bone density and more bone fractures than the general population. Frozen shoulder, carpal tunnel syndrome, trigger finger, and hand contracture are also more common with diabetes.
- Individuals diagnosed with diabetes are more likely to develop gum disease, tooth loss, cavities, oral candidiasis (yeast), burning mouth syndrome, and alterations in taste. Periodontal disease in pregnancy can be quite severe and is correlated with preeclampsia, premature labor, and unplanned c-section. Avoidance of sugary foods and beverages, smoking cessation, use of fluoridated toothpaste, daily flossing, and brushing teeth twice daily will help to prevent periodontitis.
- Symptoms of hypoglycemia differ by person and can include: shortness of breath, tremor, heart palpitations, paleness, anxiety, high blood pressure, cognitive impairment (inability to think clearly), fatigue, visual changes, hunger, inappropriate behavior, and altered sensation of the skin.
- Many factors can alter an A1c result, including iron and vitamin B12 deficiency, alcohol abuse, certain medications, hemodialysis, hypothyroidism, and the aging process itself. A1c should never be used to diagnose diabetes or to judge blood glucose control soon after an acute illness or hospitalization. To illustrate how poorly A1c assesses glucose control, consider that the A1c of someone with blood glucose results ranging from 125-175 will be the same as someone with a set of ranges from 75-225.
- Low or moderate exercise will usually cause blood glucose levels to drop, which is why a reduction in insulin and snacks are recommended based on the intensity and duration of the activity. For more extended duration exercise, many individuals require 15-20 grams of carbohydrate and seven or eight grams of protein every hour.
- With very high-intensity activities such as sprint training, football, soccer, or ice hockey, there is a tendency for blood glucose to increase. The tradition of “carb loading” before a sporting event combined with this natural increase in blood glucose can be very dangerous.
- Supplements once believed to be helpful for blood glucose control and now proven useless include cinnamon, chromium, bitter melon, and lipoic acid.
- Most oral medication will drop A1c about 1% if only one drug is used. Anyone with an A1c of 7.6%-9% will need more than one medicine. No oral medication will reduce A1c more than 2%; insulin needs to be considered for people who are more than 2% above their A1c goal.