October 23, 2018
Diabetes is a disease that occurs when a person’s pancreas doesn't make enough--or any--of the hormone insulin. This causes too much glucose (sugar) to build up in the blood.
Managing diabetes is not easy. But with better understanding, careful monitoring, and healthy lifestyle choices, you can live a full and active life.
Type 1 vs. Type 2 Diabetes
Whether a person is diagnosed with type 1 or type 2 diabetes determines the appropriate course of treatment.
Type 1 diabetes is pretty straight forward. The body is not making any insulin so the only thing that will help is insulin. There may be a few issues with insulin sensitivity that make type 1 diabetes more complicated; but in a nutshell, if you have type 1 diabetes you will need insulin for the rest of your life.
Type 2 diabetes is a bit more complicated because it involves both a lack of insulin and resistance to insulin. People with type 2 diabetes struggle every day trying to manage their sugars and many times becoming frustrated as their A1C numbers continue to rise. Unfortunately, there is no one size fits all solution.
What is A1C?
One of the first questions you should ask when diagnosed with diabetes is “what is my A1C?” A1C is a blood test that reflects your average blood glucose levels over the past 3 months. Type 2 diabetes is diagnosed when the A1C level is greater than 6.5%, according to guidelines from the American Diabetes Association and the American Association of Clinical Endocrinologists.
Research shows that people with readings between 6-6.5 may already have damage to the walls of the small arteries of the heart, despite not having full blown diabetes.
Diabetes Treatment: The 70/30 Rule
Making lifestyle changes is one of the most important ways people can manage their diabetes. I like to explain to my patients that the treatment breakdown is 70/30. 70% relies on the individual’s efforts and 30% on medications. By limiting carbohydrate consumption to 45-60 grams per meal and increasing physical activity to 30 minutes a day, people can see significant changes in their weight, insulin resistance, and insulin requirements.
I’m always surprised to hear about patients who have been diagnosed with diabetes for decades and never participated in diabetes management classes (not the 10-minute bedside chat with the nurse at the time of hospital discharge). Coaching and mentoring are crucial to successfully managing your diabetes.
Medications for Type 2 Diabetes
Medication is another aspect of successful treatment for type 2 diabetes (not suitable for type 1 diabetes). There are many medications on the market and others being constantly developed. It is important to talk with your provider to understand how the medications work and which treatment is best for you.