Understanding Diabetes

Armen Hareyan's picture

According to the American Diabetes Association (ADA), there are 16 million people in the US who have diabetes, and 5 million of them don't know it. The fact that diabetes often goes undetected is why it is sometimes referred to as "The Silent Killer." People often do not become aware that they have diabetes until they develop one of its life-threatening complications. This is why, during National Diabetes Awareness Month, all health care organizations are encouraging people to talk with their doctors about the warning signs of diabetes, and to ask whether it might be wise to have a diabetes screening test.

What is Diabetes?

Diabetes is a disease related to the production of insulin, a hormone that enables the body to convert sugar, starches and other foods into energy. Just as a heating system needs some form of fuel in order to function, a similar principle is at work in the human body. Food is our fuel. It must be converted into energy, which enables our organs, brain and all systems to fulfill their purpose and function. The exact causes of diabetes are not known. It is believed to be caused by a combination of genetic and environmental factors.

There are different types of diabetes. The two most prominent, are referred to as Type 1 and Type 2. Kathleen Casper, R.N. MA Ed., a certified Diabetes Educator at Newton-Wellesley Hospital explains, "Type 1, or insulin dependent diabetes, is a condition in which the body does not make insulin. People with this type of diabetes, must take insulin daily by injections to stay alive." Five to ten percent of people who suffer from diabetes, have Type 1. This type occurs mostly in children and young adults.

"At this time, "states Casper," no one knows the exact cause of Type 1 diabetes. But it can be linked to a family history of Type 1 diabetes, or a defect in the body's immune system that causes it to destroy the cells that make insulin in the pancreas."

Warning Signs of Type 1 Diabetes

  • Frequent urination
  • Excessive thirst
  • Extreme hunger
  • Unusual weight loss
  • Extreme fatigue
  • Irritability

Casper explains that, "Type 2 diabetes is a condition in which the body does make insulin, but it may not make enough, or it is unable to use the insulin it does produce. People with Type 2 diabetes can be treated with diet, exercise, medication and/or insulin." Nine out of ten people with diabetes, have this form of the disease. Type 2 appears to be related to obesity and lack of exercise. In fact, Type 2 diabetes has become an increasing problem nationwide over the past several decades. Our culture has not only become more fast food, and snack food oriented, but also more physically sedentary.

Warning Signs of Type 2 Diabetes

  • Any type 1 symptoms
  • Frequent infections
  • Blurred vision
  • Cuts and/or bruises that are slow to heal
  • Tingling and/or numbness in hands and feet
  • Repeated skin, gum or bladder infections

A Serious Disease

Diabetes is a very serious illness. It is incurable, and the sixth leading cause of death by disease in the US. According to the ADA, 2,200 people are diagnosed with diabetes every day, 798,000 per year, and nearly 200,000 people die every year as a result of being diabetic.

Complications of Diabetes

Diabetes is life threatening because it often results in the development of very serious health complications. These include:

  • Heart Disease and Stroke. The ADA states "People with diabetes are 2 to 4 times more likely to suffer a stroke and have heart disease, which is present in 75% of diabetes-related deaths. More than 77,000 deaths are due to heart disease every year.

  • Nerve Damage. Diabetes is very likely to cause mild to severe nerve damage. From 60% to 70% of diabetics are affected by this complication. In severe cases, amputations of lower limbs are necessary. The ADA reports that 56,000 amputations are performed on diabetics each year, and the risk of needing an amputation is 15 to 40 times more likely among diabetics.

  • Blindness. Every year, from 12,000 to 24,000 people lose their eyesight as a result of diabetes.


  • Kidney Failure. Diabetes is also the leading cause of end-stage renal failure, or kidney disease. In fact, diabetes accounts for 40% of the cases of kidney failure among the US population every year.

Diabetes Treatment

For people with Type 1 and Type 2 diabetes, the following guidelines to help achieve good blood sugar levels are recommended by Newton-Wellesley Hospital's Certified Diabetes Nurse Educator, Kathleen Casper:

  • Monitor your blood sugars. Ask your doctor or diabetes educator what your testing schedule should be. To monitor how well you are controlling your diabetes, they will probably have you check your blood sugar level before meals, and do some testing after meals as well.

  • Have a glycosylated hemoglobin test (HgbA1C). This is a blood test that should be done three to four times per year. This shows an average of your blood sugar for the previous three months.

  • Consult with a nutritionist to work out a meal plan that is acceptable to your lifestyle. It is important to know how different types of foods affect your blood sugar.

  • Develop an exercise program. Exercise can increase energy and decrease stress, control blood pressure and blood fats (blood lipid levels), make insulin work better, and make you feel better.

  • Work with a health care team that has diabetes expertise in a variety of key areas:
  1. An MD/Doctor/Endocrinologist for an overall assessment of your diabetes.
  2. An Ophthalmologist for a complete dilated eye exam.
  3. A podiatrist for a complete foot exam.
  4. A Certified Diabetes Nurse Educator can help you manage your diabetes and assist you with diabetes management skills.
  5. A Nutritionist that is a Certified Diabetes Educator can assist you with a meal plan that is right for you and your specific nutritional needs.

The Diabetes Management Program at Newton-Wellesley Hospital (NWH) offers an on-going Diabetes Management Program for people with diabetes and their families. The program is recognized by the American Diabetes Association. This program includes individual education in all day-to-day aspects of managing your disease. The NWH program ensures consistently high standards of care for patients with diabetes, which, in turn, improves the quality of their lives.

For more information or an appointment call CareFinder at 1-866-NWH-DOCS (866-694-3627), or (617) 243-6566.

This material is intended to provide general educational information and to help users arrange more easily for health care services. This site is not an attempt to practice medicine or provide specific medical advice and should not be used to make a diagnosis or to replace or overrule a qualified health care provider's judgment. Nor should users rely upon this information if they need emergency medical treatment. We strongly encourage users to consult with a qualified health care professional for answers to personal questions.


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