Understanding and Living with Diabetes

You probably know someone living with diabetes, the high blood sugar condition that affects how the body converts food into energy. Perhaps you know a relative, a friend, a co-worker, or even you, who is diabetic. About one in 10 Americans—37.3 million people—have diabetes. Another 96 million American adults, more than one in three, have prediabetes in which their blood sugar levels are higher than normal but not elevated enough for a diabetes diagnosis. 

November is American Diabetes Month® when millions who are at risk for the long-term health condition are encouraged to learn about the disease and helpful resources. American Diabetes Month is also a time for diabetics to share their stories and inspire all of us in finding a cure.

What is diabetes?

Diabetes mellitus is a group of diseases that affect how the body uses sugar in the blood, also known as glucose. When a person consumes carbohydrates, the body processes the carbs to produce glucose for energy. Glucose is a main energy source for cells in muscles and tissues, and glucose is the brain’s primary fuel.

Diabetes is divided into four categories: type 1, type 2, prediabetes and gestational diabetes. Any type of diabetes can lead to extra sugar in the blood, which can then cause serious health problems. 

Type 1 diabetes often starts during childhood or teen years but can start at any age. With type 1 diabetes, the body fails to produce insulin. Insulin is the hormone that the body uses to move glucose from the bloodstream into cells. Insulin therapy is needed for a type 1 diabetic to manage their condition.

Type 2 diabetes, in which the body doesn’t use insulin properly, is the most common form of diabetes. Some individuals can control their type 2 diabetes with healthy eating and exercise, while others need medication or insulin to keep their blood sugar in check.

Prediabetes is the stage in which the body does not fully use insulin or is unable to produce enough insulin to maintain healthy blood sugar levels. Prediabetes can lead to diabetes if left unchecked. In many cases, a prediabetic can bring their blood sugars down in the normal range with some medical intervention including dietary and exercise changes and oftentimes medications.

Gestational diabetes occurs during pregnancy when certain hormones can interfere with a mother’s ability to use insulin. Gestational diabetes is treatable, and it is important for the pregnant woman to work with her doctor on managing blood glucose levels. 

Although rare, diabetes can also develop from other causes such as diseases of the exocrine pancreas and the side effect of using certain drugs to treat HIV/AIDS or after an organ transplant. People can also become diabetics after a virus or other medical event has affected their pancreas.

What are symptoms of diabetes?

Diabetes symptoms vary with a person’s level of blood sugar. Some people with prediabetes or type 2 diabetes may not present with common symptoms. Excessive thirst, polydipsia, is one of the main telltale signs of diabetes. A person drinks a lot of water but can’t really satisfy the thirst. Needing to urinate more often, polyuria, goes along with the increased consumption of fluids. 

In the beginning of the disease, it’s likely the person will gain some weight, but if they go undiagnosed over time, they lose weight because the body begins to break down muscle. When a person does not get enough insulin, the breakdown of muscle and fat causes ketones to build up in the urine. Ketones in urine is another indicator of diabetes. When the body accumulates high levels of ketones this diabetic ketoacidosis (DKA) condition can poison the body. DKA can be life-threatening.

Other symptoms of type 1 and type 2 diabetes include: 

  • Fatigue and weakness
  • Irritability and mood changes
  • Blurry vision
  • Sores or cuts that heal slowly
  • Infections, such as skin, gum and vaginal

What are health complications of diabetes?

The American Diabetes Association reports that the leading cause of death for diabetics is cardiovascular disease (CVD) in which the heart and blood vessels are compromised. Two-thirds of people with type 2 diabetes die from CVD. Compared to people without diabetes, diabetics are twice as likely to have heart disease or a stroke. The positive news is proper diabetes management, diet and exercise can reduce the risk of CVD.

Another complication of diabetes is kidney disease. High blood glucose levels force the kidneys to work harder at filtering out waste products. High blood pressure is another common condition associated with diabetes. More than 60% of diabetics report having high blood pressure or take a prescription medication for their hypertension.

In people 18 to 64 years old, diabetes is a leading cause of vision loss. An annual comprehensive vision exam can help prevent almost all vision loss caused by diabetes. The feet are another trigger area for diabetics. Diabetes can cause neuropathy, painful nerve damage in the feet. Other foot problems with diabetes include weakness, loss of feeling, decreased blood flow and changes in the shape of the feet or toes. With these foot complications, diabetics may injure their feet and not know it. 

How is diabetes diagnosed?

Checking for high blood sugar is typically done through a simple blood test. During an annual physical, routine doctor’s visit or on a more emergent trip to the think walk-in clinic, our healthcare providers will check your glucose level through a blood draw. Typically, if your fasting blood sugar level is in the 80-125 mg/dL range, you are not considered diabetic.  

If a patient’s glucose is over a 100 mg/dL and they have symptoms of diabetes, we almost always check blood sugar through a hemoglobin A1C blood test. The more specific hemoglobin A1C test will show average blood glucose levels over the past three months. The diagnosis guidelines consider an A1C level between 5.7% and less than 6.5% as prediabetes. A1C levels of 6.5% or higher is in the diabetes range. The once more common oral glucose tolerance test is now primarily used to check women’s blood sugar during pregnancy.

Can diabetes go undetected? 

People almost always have prediabetes before they develop type 2 diabetes. Because prediabetes may have no clear signs of diabetes, people may unaware they have higher blood sugar. The Centers for Disease Control and Prevention (CDC) finds that about 20% of people with diabetes do not know they have it. More than 80% of Americans with prediabetes are unaware of their condition. 

There are symptoms associated with diabetes, but some people want to think that they’re fully healthy. Some individuals prefer to ignore diabetes symptoms because it can be difficult for them to consider they have a long-term disease that needs to be managed. Not reporting diabetes symptoms to your doctor can lead to the more complex health problems that can be life-altering or life-ending. 

How does a person manage their diabetes?

Some diabetics require insulin and other injectable drugs or oral medications to manage their blood sugars. Our think clinical pharmacists are well-trained in working with prediabetics and those with diabetes to find the best, affordable medication solutions. Our pharmacists are vital partners in managing diabetes with patients and helping each individual with nutritional advice and how medications can affect energy levels, weight loss and more. 

Maintaining a healthy diet is central in managing diabetes. Making healthy nutrition choices can feel daunting at times for a diabetic, but there are many healthy eating plans available. Here at think, our healthcare professionals work together to help people living with diabetes know what and how much to eat and how to incorporate regular fitness activities into their life. Keeping off extra weight is also essential in avoiding added problems with diabetes. 

Managing one’s diabetes is not always simple, but it is possible to do well with the disease when the think whole person healthcare group walks alongside you. Our team of physicians, clinical pharmacists, physical therapists, podiatrists, ophthalmologists and other specialists are here to help all ages of diabetics remain in charge of staying healthy and enjoying life. Together we look at the physical and the emotional side of thriving despite a diabetes diagnosis. If a patient is willing to make a commitment to do their best, we can meet them with helpful resources.


Think makes it easy to receive both preventative care and treatment for a wide range of health conditions. From that troubling cough to painful back, our healthcare providers and specialists are committed to your lifelong health and well-being.Our walk-in clinic treats anyone, even those who are not a think patient or do not have a primary care provider currently. To learn more about our comprehensive healthcare services, visit our Services page online and choose your own think medical professionals by visiting our Meet Your Doctor page. 

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