Understanding Type 2 Diabetes - Sutter Health

Understanding

Type 2 Diabetes

Your Guide to Healthy Living

February 2017

Understanding Type 2 Diabetes

If you have diabetes, prediabetes or high blood glucose (blood

sugar)¡ªor if you simply want to learn more about diabetes¡ª

this book is for you. Inside, you will find the basics of diabetes

care, plus tools to help you manage your diabetes. As you

read, keep in mind that diabetes is a complex disease. The

knowledge and skills you need for diabetes self-management

take time to learn. As you learn, you will be better equipped

to adjust your lifestyle for better health. You are not alone.

You have the support of a health care team that includes your

health care provider and other diabetes experts.

7 Self-Care Behaviors

The American Association of Diabetes Educators has a list of

seven key behaviors, known as the AADE7TM Self-Care Behaviors,

to help patients successfully manage type 2 diabetes and prevent

complications. These include: healthy eating, being active,

monitoring, taking medication, problem solving, reducing risks

and healthy coping. When making healthier lifestyle choices, it

helps to set goals in each of these seven key areas. Your health

care provider can help you develop a diabetes management plan.

Table of Contents

What is Diabetes? . . . . . . . . . . . . . . . . . . . . . . 2

Hyperglycemia (high blood glucose) . . . . . . . . . 25

What Causes Glucose Levels to Become Elevated . . 2

Managing Sick Days . . . . . . . . . . . . . . . . . . . . . 26

Types of Diabetes . . . . . . . . . . . . . . . . . . . . . . . . 3

Diagnosis of Diabetes . . . . . . . . . . . . . . . . . . . . . 3

Screening for Diabetes . . . . . . . . . . . . . . . . . . . . 4

Risk Factors for Type 2 Diabetes . . . . . . . . . . . . . 4

Reducing Risks . . . . . . . . . . . . . . . . . . . . . . . . 27

Complications and Symptoms of Diabetes . . . . 27

Heart Disease and Stroke . . . . . . . . . . . . . . . . . 29

Caring for Your Feet . . . . . . . . . . . . . . . . . . . . . . 30

Healthy Eating . . . . . . . . . . . . . . . . . . . . . . . . . 5

Protecting Your Teeth and Eyes . . . . . . . . . . . . 31

Make Healthy Choices . . . . . . . . . . . . . . . . . . . . 5

Preventing Kidney and Nerve Disease . . . . . . . 31

Choose the Right Portions . . . . . . . . . . . . . . . . . 5

Maintaining Your Sexual Health . . . . . . . . . . . . . 32

The Plate Method . . . . . . . . . . . . . . . . . . . . . . . . 6

Immunizations . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Carbohydrate Counting . . . . . . . . . . . . . . . . . . . . 7

Diabetes and Pregnancy . . . . . . . . . . . . . . . . . . 33

Guidelines for Reading Food Labels . . . . . . . . . . 9

Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Being Active . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Healthy Coping . . . . . . . . . . . . . . . . . . . . . . . . 34

Exercise Offers Important Benefits . . . . . . . . . . 10

Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Types of Physical Activity . . . . . . . . . . . . . . . . . 10

Recognizing Depression . . . . . . . . . . . . . . . . . . 35

Preparing for Exercise and Physical Activity . . . 12

Diabetes Burnout . . . . . . . . . . . . . . . . . . . . . . . . 36

How to Create a More Active Lifestyle . . . . . . . 13

Taking Action . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Exercise Precautions . . . . . . . . . . . . . . . . . . . . . 13

Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Monitoring Your Blood Glucose . . . . . . . . . 15

Diabetes Health Record . . . . . . . . . . . . . . . . . . 39

Blood Glucose Goals . . . . . . . . . . . . . . . . . . . . 15

Blood Glucose Record . . . . . . . . . . . . . . . . . . . 41

A1C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Carbohydrate Choices . . . . . . . . . . . . . . . . . . . . 42

Non-starchy Vegetables . . . . . . . . . . . . . . . . . . 46

Taking Medicine . . . . . . . . . . . . . . . . . . . . . . . 18

Proteins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Oral Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Injectable Medicine . . . . . . . . . . . . . . . . . . . . . . 20

Disposal of Medical Waste . . . . . . . . . . . . . . . . 52

Insulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Diabetes Resources . . . . . . . . . . . . . . . . . . . . . 53

Problem Solving . . . . . . . . . . . . . . . . . . . . . . . 23

Hypoglycemia (low blood glucose) . . . . . . . . . . 23

Social Media Sites . . . . . . . . . . . . . . . . . . . . . . 53

Mobile Apps . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

What is Diabetes?

Diabetes is a medical condition that develops when your body cannot

regulate the level of glucose (sugar) in the blood. As a result, your blood

glucose (blood sugar) levels become higher than normal. When blood

glucose climbs too high, this affects the cells and tissues of your body.

As a result, you can have uncomfortable symptoms¡ªsuch as fatigue, blurry

vision or extreme thirst. But that¡¯s not all. Over time, unstable blood glucose

can lead to serious and harmful complications.

What Causes Glucose Levels

to Become Elevated

1

Glucose is made by the liver.

2

Glucose is also made in the gut by the breakdown

of carbohydrates from food and drinks.

3

In response to glucose, the pancreas makes

and releases insulin.

4

Glucose and insulin flow throughout the

bloodstream to all the parts of the body.

5

Insulin attaches to cells throughout the body,

which open ¡°channels¡± that allow glucose to

move from the bloodstream into the cells.

6

The cells in the body use glucose for energy.

7

Without a trigger by insulin, the channels remain

closed, and glucose is unable to enter the cells.

8

This causes glucose levels in the body to

become elevated.

8

7

6

1

2

2

3

4

5

Types of Diabetes

Type 1 diabetes

Type 1 diabetes occurs when the immune system

mistakenly attacks the pancreas, damaging it so

that it can no longer make insulin. Without any

insulin, the glucose level in the body becomes

elevated. People with type 1 diabetes need to take

insulin to manage the disease.

This type of diabetes most commonly strikes

children, teens and young adults, but it can occur

at any age. To date, scientists do not know what

causes type 1 diabetes, and type 1 diabetes cannot

be prevented.

This is the most common type of diabetes. It can

often be managed with healthy eating, exercise and

prescription medicine (pills). Some people may

also need insulin injections to manage the disease.

Prediabetes

Prediabetes occurs when blood glucose levels

are higher than normal, but not high enough to be

diagnosed as diabetes. Prediabetes increases the

risk of developing type 2 diabetes. Research has

shown that healthy eating and lifestyle changes can

help delay or prevent the onset of type 2 diabetes in

people with prediabetes.

Gestational diabetes

Type 2 diabetes

Type 2 diabetes occurs when the body becomes

unable to use the insulin you make. The pancreas

is then unable to make enough insulin to overcome

the resistance. Without adequate insulin to

overcome this resistance, the glucose level in the

body becomes elevated.

Gestational diabetes, also known as GDM, is high

blood glucose that first shows up during pregnancy.

GDM occurs when the body becomes resistant

to insulin due to the hormones from the placenta.

It is usually diagnosed after the 24th week of

pregnancy. High blood glucose is harmful to both

the mother and her developing baby. Women who

have had gestational diabetes have a higher risk of

developing Type 2 diabetes.

Diagnosis of Diabetes

In-range

Prediabetes

Diabetes

Fasting Blood Glucose (mg/dL)

less than 100

100-125

126 or higher

Blood Glucose two hours after a

75 gram glucose tolerance test (mg/dL)

less than 140

140-199

200 or higher

200 or higher

(in a person having symptoms)

Random Blood Glucose (mg/dL)

A1C (%)

less than 5.7

5.7-6.4

6.5 or higher

Without clear symptoms of diabetes, test should be repeated to confirm diagnosis.

3

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