Know Your Numbers: Kidney Function
A yearly test to check for protein in your urine can tell your doctor if diabetes has affected your kidneys. Kidney damage and failure is a common complication of diabetes. Microalbumin levels above 30 suggest kidney damage. It’s treatable if caught early, but if you wait until these numbers are above 300, the damage has a tendency to be permanent, Levesque says.
How To Tell If You Or Your Child Has Type 1 Diabetes
Type 1 diabetes is a permanent condition. That means youll likely have to deal with symptoms at least a few times in your life, no matter how diligently you monitor your blood sugar. Were here to empower you with clear answers to all your pressing Qs.
When To See A Dermatologist
Diabetes can cause many other skin problems. Most skin problems are harmless, but even a minor one can become serious in people who have diabetes. A board-certified dermatologist can recognize skin problems due to diabetes and help you manage them.
Are all dermatologists board certified?
No. See what it takes to become board certified.
ImagesImage 1: Image Courtesy of Clark C. Otley, MD. All Rights Reserved
Images 3, 7, 8, 9: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Image 2 from DermNetNZ
Some images used with permission of Journal of the American Academy of Dermatology
ReferencesCohen Sabban, EN. Cutaneous manifestations of diabetes mellitus from A to Z. Focus session presented at: 74th Annual Meeting of the American Academy of Dermatology March 4-8, 2016 Washington D.C.
Duff M, Demidova O, et al. Cutaneous manifestations of diabetes mellitus. Clinical Diabetes. 2015 33:40-8.
Kalus AA, Chien AJ, et al. Diabetes mellitus and other endocrine disorders. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008:1461-70.
McKinley-Grant L, Warnick M, et al. Cutaneous manifestations of systemic disease. In: Kelly AP and Taylor S. Dermatology for Skin of Color. . The McGraw-Hill Companies, Inc. China, 2009:481-4.
Morgan AJ and Schwartz RA. Diabetic dermopathy: A subtle sign with grave implications. J Am Acad Dermatol. 2008 58:447-51.
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What Medications And Other Treatments Can Help Gastroparesis
Your doctor may recommend medication to improve gastric emptying or reduce nausea, such as the following:
- Metoclopramide. This is a commonly used gastroparesis drug approved by the Food and Drug Administration . It stimulates movement in your stomach and gut while relieving symptoms like nausea and vomiting. It belongs to a category of drugs called prokinetics, several of which have been used to successfully manage gastroparesis.
- Antiemetics. This type of medication may also help reduce nausea and vomiting.
Your doctor may also review any medications that youre taking that could be contributing to the problem. For example, can slow down the process, including:
- opioid painkillers
gastric neuromodulation , which stimulate your GI system and improve symptoms.
In severe cases, some people may need to turn to enteral nutrition. This essentially means liquid nutrition but it can also mean feeding through a tube thats inserted in your stomach or small intestine. A surgeon can perform a gastrostomy, which is a procedure that creates an opening for the placement of a feeding tube.
Might I Have Diabetes And Not Realise
With type 1 diabetes, the body stops producing insulin, meaning the effect on the body is usually rapid and noticeable. However, type 2 diabetes develops slowly – the body still produces insulin, but it may be insufficient, or the body might not respond to it properly. This means that the development of symptoms is gradual. “Symptoms for type 1 diabetes often develop very fast,” explains Macciochi. “But with type 2 diabetes you may not even know you have it, as symptoms can be very subtle.”
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A Short History Of Types
Described and treated since ancient times, diabetes has specific characteristics that were recognized long ago. Before the discovery of insulin, people found to have sugar in their urine under the age of 20 usually died in their youth. In contrast, those diagnosed when over the age of 40 could live for many years with this condition.
Beginning in the mid-1920s, those who got diabetes when young started on insulin, and those who got it when older often were not. However, the mechanisms that led to this difference in treatment were unknown. The only marker that differentiated the two types at that time was the presence in the urine of moderate or large levels of ketones when blood sugars were high. When significant ketones were present because the person could no longer make enough insulin, injected insulin was needed to control the glucose, and they were called insulin-dependent.
|Differences In The Three Major Types Of Diabetes|
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|* may occur at any age if all antibody-positive cases are included, i.e. Type 1 and Type 1.5|
Is There Anything I Can Do To Prevent Diabetes
Type 2 diabetes can be prevented for some people. While unchangeable things like genetics, age, and family history can affect your risk for developing diabetes, there are a few things you can do to help keep your risk as low as possible:
Eat healthy. Eating a lot of red meats, processed meats , and sugar is linked to higher rates of type 2 diabetes. The American Diabetes Association recommends increasing your consumption of fruits, vegetables, nuts, and whole grains to help reduce your risk.
Be active. Consistently remaining inactive is another risk factor for type 2 diabetes. The ADA recommends at least 150 minutes of physical activity a week to help lower your risk of developing diabetes. Discuss exercising with your doctor before starting any new routines.
Lose weight if youre overweight. Being overweight is also linked with a higher risk of diabetes. The more you weigh, the higher your risk. Talk to your doctor about how to safely lose weight before starting any diets.
If youre worried about your risk of developing diabetes, make an appointment to see your doctor and talk to them about making some of these healthy changes. Taking charge of your health now will only benefit you in the long run.
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Check If You Have Type 2 Diabetes
Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell.
Symptoms of type 2 diabetes include:
- peeing more than usual, particularly at night
- feeling thirsty all the time
- feeling very tired
- losing weight without trying to
- itching around your penis or vagina, or repeatedly getting thrush
- cuts or wounds taking longer to heal
- blurred vision
You’re more at risk of developing type 2 diabetes if you:
- are over 40
- have a close relative with diabetes
- are overweight or obese
- are of Asian, African-Caribbean or black African origin
How Is Diabetes Diagnosed
Many people get tested for diabetes because they develop symptoms that are potential early warning signs.
For example, people with type 1 diabetes may experience unintentional weight loss or develop flu-like symptoms. People with type 2 diabetes may experience extreme thirst or frequent urination.
You may experience one or more of the warning signs associated with diabetes. If you do, its important to contact your doctor for an appointment.
You may also discover a diabetes diagnosis after visiting your doctor for another condition or for routine blood work.
If you make an appointment with your doctor due to diabetes warning signs, they will want to know:
- your symptoms
Your doctor will ask you questions about your symptoms and will likely run some blood tests.
There are several tests that can diagnose diabetes. These include:
- A1C: This test shows what your blood glucose level has averaged for the last 2 or 3 months. This does not require you to fast or drink anything.
- Fasting plasma glucose : You will need to fast for at least 8 hours before this test is done.
- Oral glucose tolerance : This test takes 2 to 3 hours. Your blood glucose levels are tested initially and then repeated at intervals for 2 hours after youve consumed a specific sweet drink.
- Random plasma glucose test: You can have this test done any time and do not need to be fasting.
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How To Reverse Prediabetes
The CDC-led National Diabetes Prevention Program helps people with prediabetes make lasting lifestyle changes to prevent or delay type 2 diabetes.
Working with a trained coach, youâll learn to eat healthy, add physical activity into your life, and manage stress. With other participants, youâll celebrate successes and work to overcome challenges.
If you have prediabetes, now is your time to take action.
Who Is At Risk Of Getting Diabetes
Type 1 diabetes is an autoimmune condition, and the causes arenât known, but people with a family history of the condition are at higher risk of developing it than those with no familial connection.
Type 2 diabetes is more common in people who are overweight , who have very low levels of physical activity and who eat an unhealthy diet.
âThings like family history, obesity, poor diet â and by poor diet, I mean processed foods, high-carbohydrate foods, ice-cream, soft drinks, processed foodâ¦ theyâre all risk factors,â says Hamish.
Women who are overweight and have polycystic ovarian syndrome
Being older than 35 and from an Aboriginal or Torres Strait Islander, Pacific Island, Indian subcontinent or Chinese cultural background
Having had gestational diabetes during pregnancy.
Living a healthy lifestyle can reduce your risk of developing type 2 diabetes â think: maintaining a healthy weight, moving regularly, eating a balanced diet and not smoking. If you have high blood pressure or cholesterol, managing those is also important.
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What Are The Different Types Of Diabetes
There are three main types of diabetes: type 1, type 2 and gestational diabetes. In people with type 1 diabetes, the pancreas canât create insulin while with type 2 diabetes, one or more of these scenarios may be at play:
the body doesnât respond properly to the insulin being produced
the insulin doesnât work as it should
the pancreas doesnât produce enough insulin.
Type 2 is the most common form, accounting for 85% of all diabetes . Gestational diabetes can occur in expectant mums and generally goes away after the baby is born. There are rarely warning signs of gestational diabetes, which is why all pregnant women are screened for it.
Thereâs also a condition called prediabetes, in which blood glucose levels are higher than normal, but not at type 2 diabetes level. However, if you have this condition, you are 10 to 20 times more likely to go on to develop type 2 diabetes and should be on the lookout for diabetes warning signs.
Yellow Reddish Or Brown Patches On Your Skin
This skin condition often begins as small raised solid bumps that look like pimples. As it progresses, these bumps turn into patches of swollen and hard skin. The patches can be yellow, reddish, or brown.
You may also notice:
- The surrounding skin has a shiny porcelain-like appearance
- You can see blood vessels
- The skin is itchy and painful
- The skin disease goes through cycles where it is active, inactive, and then active again
- Get tested for diabetes, if you have not been diagnosed.
- Work with your doctor to better control your diabetes.
- See a dermatologist about your skin. Necorbiosis lipodica is harmless, but it can lead to complications.
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You Have To Pee All The Time
When you have excess sugar coursing through your blood stream, your body instinctively tries to get rid of it, says Mary Vouyiouklis Kellis, M.D., an endocrinologist at Cleveland Clinic. “Water follows sugar, so you end up having high-volume urine loss, she explains.
If you notice youre suddenly peeing a lot, and more often, for no real reasonespecially if youre waking up a few times during the night to goits time to talk to your doctor, she says.
What Is Type 1 Diabetes
Type 1 diabetes, sometimes known as juvenile diabetes, is a chronic autoimmune condition in which your pancreas loses the ability to produce insulin. It can be triggered by a virus, such as the common cold or flu, and there is evidence that it has a genetic component as well.
Following a viral infection, your body can sometimes malfunction and respond by attacking its own cells. This process is known as an autoimmune response. In type 1 diabetes, your bodys immune system specifically attacks cells in your pancreas called beta cells, which produce the hormone insulin. In that case, damaged beta cells mean your body either stops producing enough insulin, or it cant produce insulin at all.
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Your Vision Seems Blurry
Dont be alarmed: This is not diabetic retinopathy, where the blood vessels in the back of the eye are getting destroyed, says Dr. Cypess. In the early stages of diabetes, the eye lens is not focusing well because glucose builds up in the eye, which temporarily changes its shape. Youre not going blind from diabetes, Dr. Cypess says he assures patients. In about six to eight weeks after your blood sugars are stabilized, youre not going to feel it anymore the eye will adjust.
Signs Symptoms And Diagnosis Of Diabetes
The signs and symptoms of Type 1 diabetes usually develop quickly, especially in children, over a period of weeks. In babies and young children, the first indication of Type 1 diabetes may be a yeast infection that causes a severe diaper rash that’s far worse than the common red, puffy and tender skin rash. In young children and infants, lethargy, dehydration and abdominal pain also may indicate Type 1 diabetes.
Once the symptoms appear, a blood test generally will reveal very high blood glucose.
Type 2 diabetes can be detected easily during a routine screening exam and blood test. However, it frequently can go undiagnosed for years unless a physician draws a blood sample to check the blood glucose.
In the early stages of Type 2 diabetes, you experience few to no noticeable signs of the disease. As time goes by and the untreated blood glucose continues to rise, symptoms begin.
If you’re over 40 or have parents or siblings with diabetes, be sure to have your blood glucose checked routinely.
The most common symptoms of undiagnosed Type 1 and Type 2 diabetes are:
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Risk Factors For Prediabetes
Sometimes the symptoms of prediabetes can go away if you take better care of your health, but they can come back if you fall back into an unhealthy lifestyle.
Its important to be aware of prediabetes, especially if youre over 45 years of age. Youre also at risk for developing prediabetes if you have any of these medical issues:
- Cardiovascular disease
- Unusual fatigue
- Wounds that wont heal fast
A blood test can tell you if you have prediabetes. There are several different types and they are the same tests that diagnose Type 2 diabetes. Talk with your primary care provider to see if they think you need one of these tests.
What Warning Signs And Symptoms Of Diabetes Are The Same In Men And Women
There are diabetes warning signs and symptoms that both women and men have in common, for example:
- Excessive thirst and hunger
Men who have type 2 diabetes are twice as likely to have low testosterone than men who do not have diabetes. Because of the low levels of the hormone testosterone, men with diabetes can have unhealthy symptoms that are not seen in women with diabetes.
Erectile dysfunction , or inability to get or maintain an erection, is a common symptom of diabetes in men. Diabetic men experience erectile dysfunction at earlier ages than men who do not have diabetes.
Another diabetes-related sexual dysfunction symptom in men is reduced amounts of ejaculation, or retrograde ejaculation. Retrograde ejaculation is a condition in which the semen goes into the bladder, rather than out of the body through the urethra. Diabetes and damage to the blood vessels causes nerve damage to the muscles that control the bladder and urethra, which results in this problem.
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Unexpected And Unintentional Weight Loss
Rapid and unintentional weight loss is one of the more obvious signs of diabetes. This could be anywhere from 5-10 kg in a matter of weeks or months.
This symptom is much more typical of those with type 1 diabetes, where sugar metabolism can shutdown very quickly.
Why does this happen?: Without new energy coming into the cells, the body is tricked into thinking you are in starvation. In order to provide energy, the body responds by breaking down protein in the muscle, which leads to muscle deterioration and the unexpected weight loss.
Who Is At Risk
Type 1 diabetes is an autoimmune condition and as yet the triggers for this condition are unknown. However, type 2 diabetes has a number of risk factors, including being overweight or obese, living a sedentary lifestyle, or eating an unhealthy, high-calorie diet. “With type 2 diabetes your body’s still producing at least some insulin but you can’t respond to it – you’ve lost that sensitivity.”
“If the system gets overworked – eating the wrong things, eating too frequently, too much – the system gets worn out and we lose the sensitivity to it,” explains Dr Jenna Macciochi, Doctor of Immunology at the University of Sussex.
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