What is Diabetes?

Published: November 02, 2021
Hannah Post
By Hannah Post, PharmD

Diabetes is a condition in which blood sugar levels are too high. The body changes the food you eat into sugar. Insulin, a hormone made by the pancreas, helps your cells use this sugar for energy. If you don’t make enough insulin or your body can’t use it properly, you will have high blood sugar.

Diabetes and blood sugar
In people with diabetes, either not enough insulin is being made and released by the pancreas, or cells in the body do not use insulin effectively and become “insulin resistant,” resulting in high blood sugars. 

Since most of the blood sugar in our bodies comes from the food we eat, blood sugar levels are usually higher after eating a meal. The more sugar or carbohydrates (which the body converts to sugar) in a meal, the higher the blood sugar levels after eating. Examples of high carbohydrate foods are breads, rice, pastas, potatoes, chips, cakes, cookies, and sugary drinks like soda and fruit juices.

When blood sugar is too high, it is called hyperglycemia. Common signs and symptoms of hyperglycemia include being more thirsty or hungry, frequent urination, and sometimes blurry vision. If your blood sugar stays continually high for a long time, you may no longer experience these symptoms.

How is diabetes diagnosed?
Diabetes is diagnosed by measuring blood sugar levels and glycosylated hemoglobin (HbA1c). HbA1c, also called A1c, is a blood test that measures average blood sugars over a three-month period. A1c test results are a percentage. The higher the percentage, the higher the blood sugar levels over the past three months. The A1c test can be used to diagnose diabetes and help doctors decide which treatments will help the most.

Are there different types of diabetes?
Yes. The most common are type 1 and type 2 diabetes. Prediabetes is diagnosed when the average blood sugar numbers and A1c level are higher than normal but not high enough to be called diabetes. The fourth type of diabetes is gestational diabetes. This is diagnosed during pregnancy.

Prediabetes is diagnosed when your A1c level is greater than 5.7 percent but less than 6.4 percent. Lifestyle changes can help prevent prediabetes from becoming type 2 diabetes. For everyone diagnosed with either prediabetes or type 2 diabetes, the American Diabetes Association recommends 150 minutes of moderate exercise a week as well as managing diet and weight. Diabetes self-management education and support classes are also recommended.

Type 1 diabetes is usually diagnosed in childhood or in young adults. In type 1 diabetes, the body doesn’t make its own insulin. Insulin is a hormone that the body makes and stores. When the body isn’t able to produce this hormone, blood sugars will eventually get dangerously high. Insulin must be given to keep blood sugars within your goal range.

Type 2 diabetes is often diagnosed later in life. Over time, the body loses response to its own insulin. This is why Type 2 diabetes can be controlled with diet and exercise and treated with medications taken by mouth or injected under the skin. Controlling diabetes includes lowering blood sugar levels and lowering your A1c level. A combination of medications may be taken to reach goal blood sugar levels and A1c level. Most people have the same goal numbers, but goals can change depending on age and other medical conditions. Blood sugars should be checked regularly at home.

In addition to lifestyle changes, the most common medication prescribed for people with prediabetes is metformin.

Gestational diabetes develops in pregnant women who have never had diabetes prior to becoming pregnant. Doctors check for gestational diabetes as part of normal prenatal care. Gestational diabetes usually does not last beyond pregnancy; however, there is an increased risk for developing type 2 diabetes later in life.

Controlling blood sugar in gestational diabetes is important for the health of the mother and the baby. Babies born to mothers with gestational diabetes are at a greater risk for early birth, high birth weight, low blood sugars, or breathing complications following birth. Also, there is a greater risk that the child will develop obesity and type 2 diabetes later in life. Many women use diet and exercise to control their blood sugar levels during pregnancy, but some women require insulin for appropriate control.

How can I lower my blood sugar?
If a doctor diagnoses you with diabetes, they will likely first recommend lifestyle changes that can help lower your blood sugar naturally. Exercising regularly (usually about 150 minutes of moderate exercise a week as a goal), eating a healthy balanced diet that minimizes carbohydrates and maximizes vegetables, and losing weight if you are above your ideal weight goal, can help lower blood sugar levels.  Even if you require medication therapy to treat your diabetes, your doctor will want you to continue these lifestyle modifications as part of your treatment.

Your pharmacist and other healthcare providers can discuss exercise and weight loss goals with you. They can provide information to help you learn about diabetes.

No matter which type of diabetes you have, lowering blood sugar is linked to diet, exercise, weight loss, and taking medications as your doctor prescribed. Pharmacists are always available to discuss how to take medications, any side effects, and other questions related to controlling diabetes.

For more information about diabetes, visit the American Diabetes Association.  

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