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What is Diabetes? Dr. Sarah N. Fischer

Diabetes Basics


Diabetes is a common disease diagnosed every year that affects more than 30 million people in the United States. It is a chronic condition that causes your body to alter the way it breaks down food and uses it for energy. You may have heard it commonly referred to as a condition that causes “low blood sugar”. When your blood sugar is chronically low, it can lead to many complications including organ and nerve damage, including your heart and kidneys. It is the number one cause of kidney failure, amputations involving the lower-limbs, and adult onset blindness.

Glucose vs. Insulin:

Glucose is the molecule that is oftentimes called “blood sugar”. When your body breaks down the carbohydrates you eat, it is turned into the molecule glucose. From there, glucose is absorbed and circulates through your blood stream. By itself, glucose cannot enter the cells in your body. When your body senses the glucose level in your blood stream is too high (hyperglycemia), it will signal your pancreas to release insulin. Insulin is a hormone that is released into the blood, attaches to your cells, and signals them to allow glucose to enter. Think of it like a key that unlocks and opens up the door of the cell. This is how the cell is able to use glucose. Insulin can also tell the liver to store glucose.

In someone with diabetes the balance of insulin and glucose is altered, which can happen for a few different reasons. If a person consistently eats a diet high in sugar or carbohydrates this overwhelms the pancreas and it can stop making insulin over time. A diet high in sugar can also cause the body’s cells to become desensitized to insulin, which means they stop responding to insulin in the same way. In some patients, it may be a combination of both of these.



Signs and Symptoms:

The classic symptoms reported by patients are having to urinate often, are very hungry or thirsty, experience blurred vision, numbness, tingling or fatigue. Type 1 diabetes usually presents over the course of a few weeks or months and symptoms tend to present more intensely. Patients with type 1 can also present with nausea, vomiting or stomach pains. Type 2 diabetes symptoms occur slowly over many years and may go without being noticed as they can be generally less severe.

What are the Types of Diabetes?

There are a few types of this disease which can be classified and diagnosed by your primary care physician:

  1. Type 1 diabetes is an autoimmune disease that you are born where the immune system destroys the cells in the pancreas that make insulin. Without insulin, glucose cannot enter the other cells throughout the body. This type of diabetes usually presents in younger patients and must be treated with insulin medications.
  2. Type 2 diabetes accounts for the majority of diagnoses and happens over time as the cells of the pancreas become damaged from high glucose levels. Patients may continue to produce some insulin, but usually not enough to address the amount of glucose present in the body. It is strongly associated with certain lifestyle choices and reducing your risk factors can be helpful in the treatment of type 2 diabetes. There are also a number of medications targeted to treat these patients.
  3. Gestational diabetes, or diabetes during pregnancy, is defined as either a woman with diabetes who becomes pregnant or a woman who becomes pregnant and then develops diabetes during her pregnancy. The presence of diabetes can cause complications to the baby and have to be closely monitored and managed by a physician.
  4. Prediabetes is the stage just before a diagnosis of diabetes is made. This means a patient that has a higher than normal glucose level and is at an increased risk of developing diabetes in the future. The risk can be decreased by following dietary and exercise recommendations.

How can I reduce my risk for developing diabetes?

Identifying a primary care physician and scheduling regular check-up visits will be the most beneficial step as your physician can tailor monitoring and risk reduction strategies to each individual patient based on their needs. For type 1 diabetes, your family history is the most important risk factor your physician will discuss with you. For type 2 diabetes, it is strongly associated with physical inactivity, obesity, family history and other health conditions or diagnoses you may have, such as high blood pressure, high cholesterol, and heart disease). If you are a planning to become pregnant or are already pregnant, your OBGYN will evaluate and discuss your risks with you over the course of your routine pregnancy care appointments. Lifestyle modifications are a great way to reduce your risk of diabetes. This can include weight loss through eating a healthy diet and regular physical exercise.

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Dr. Sarah N. Rajkovic

Dr. Sarah N. Fischer is a pharmacist completing a Clinical Neurology Research Fellowship specializing in pharmacologic management of neurologic disease states including epilepsy, multiple sclerosis, Parkinson’s Disease, and other movement disorders. She received her doctorate of pharmacy degree from the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences where she also practices in an outpatient neurology clinic. Dr. Fischer has previous experience working in a community retail pharmacy setting where she developed a passion for empowering her patients through education to help optimize their health outcomes.




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