Diabetes is a chronic (long-lasting) disease that affects how your body turns food into energy.

Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. Your pancreas makes a hormone called insulin, which acts like a key to let the blood sugar into your body’s cells for use as energy¹ .

If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream, which over time can cause serious health problems, such as heart disease, vision loss, and kidney disease² .

There isn’t a cure yet for diabetes, but healthy lifestyle habits, taking medicine as needed, getting diabetes self-management education³ , and keeping appointments with your health care team can greatly reduce its impact on your life.

Types of Diabetes

There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant).

Type 1 diabetes is caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin. About 5% of the people who have diabetes have type 1. Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need to take insulin every day to survive. Currently, no one knows how to prevent type 1 diabetes.

With Type 2 diabetes, your body doesn’t use insulin well and is unable to keep blood sugar at normal levels. Most people with diabetes—9 in 10—have type 2 diabetes. It develops over many years and is usually diagnosed in adults (though increasingly in children, teens, and young adults). You may not notice any symptoms, so it’s essential to get your blood sugar tested if you’re at risk. Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight if you’re overweight, healthy eating, and getting regular physical activity.

Gestational diabetes develops in pregnant women who have never had diabetes. If you have gestational diabetes, your baby could be at higher risk for health complications. Gestational diabetes usually goes away after your baby is born but increases your risk for type 2 diabetes later in life. Your baby is more likely to become obese as a child or teen, and more likely to develop type 2 diabetes later in life too.

This Centers for Disease Control (CDC)‬ video shows how people with ‎prediabetes‬ can postpone type 2 ‎diabetes‬ through ‎lifestyle‬ ‪‎changes‬. Learn even more by reading the post “Prediabetes: Am I at Risk?”  The CDC’s website also includes a National Diabetes Prevention Program, which provides valuable information for diabetics.

Insulin in a Nutshell⁴ 

Insulin is a critical player in developing type 2 diabetes. This vital hormone—you can’t survive without it—regulates blood sugar (glucose) in the body, a very complicated process. Here are the high points:

• The food you eat is broken down into glucose.
• Glucose enters your bloodstream, which signals the pancreas to release insulin.
• Insulin helps glucose enter the body’s cells so it can be used for energy.
• Insulin also signals the liver to store glucose for later use.
• Glucose enters cells, and glucose levels in the bloodstream decrease, signaling insulin to decrease too.
• Lower insulin levels alert the liver to release stored glucose, so energy is always available, even if you haven’t eaten for a while.

That’s when everything works smoothly. But this finely tuned system can quickly get out of whack, as follows:

• A lot of glucose enters the bloodstream.
• The pancreas pumps out more insulin to get glucose into cells.
• Over time, cells stop responding to all that insulin—they’ve become insulin resistant.
• The pancreas keeps making more insulin to try to make cells respond.
• Eventually, the pancreas can’t keep up, and glucose keeps rising.

What is the evidence base for the prevention of diabetes through lifestyle change interventions?

The American Medical Association (AMA) and the Centers for Disease Control (CDC) provides proof that lifestyle changes are important with diabetes care⁵ . This fact sheet provides short summaries of studies conducted over the last 15 years, creating the evidence base for the prevention of diabetes through lifestyle change interventions. Over the last 15 years, a number of scientific studies have evaluated the design and effectiveness of lifestyle change interventions for delaying or preventing the onset of type 2 diabetes among overweight or obese adults who have blood glucose levels in the prediabetes range.

1. A 15-year follow-up of 2,776 participants from the original NIH-funded research study revealed that diabetes incidence
   in the 15 years since study randomization was reduced by 27 percent in the lifestyle group compared with placebo.
2. Funded by the National Institutes of Health (NIH), a multi-center randomized controlled clinical trial of 3,234 overweight adults with prediabetes proved that a structured, intensive behavioral counseling intervention that lowered body weight by 7 percent through a low-fat diet and increased physical activity reduced the risk of progression to diabetes by 58 percent over three years
   compared with placebo. Among adults 60 years and older, the risk reduction was even greater at 71 percent.
3. A systematic review of studies examining the cost-effectiveness of diet and physical activity promotion programs concluded that these programs are cost-effective when delivered to persons at increased risk for type 2 diabetes. Three studies reported cost savings and group-based programs (modeled after the original Diabetes Prevention Program Research Study) were found to be
   highly cost-effective at a median cost of $1,819 per quality-adjusted life year gained, when examined from a health system perspective.

Jay Harold recognizes that Diabetes is an important health problem in the African-American community. Taking advantage of all available resources is important in maintaining a healthy lifestyle. The National Diabetes Education Program Online Resource Center⁶ ! The Resource Center provides tools to support your educational programs and activities to help people manage diabetes or prevent type 2 diabetes.

Enjoyed this post? Share it and read more here.  Jay Harold has put together a Resource page that you may find useful when trying to improve your health and wealth. Please take this advice from  Muhammad Ali and give back to others. “Service to others is the rent you pay for your room here on earth.”

Bibliography

1. https://www.cdc.gov/diabetes/basics/diabetes.html
2. https://www.cdc.gov/diabetes/programs/initiatives/kidney.html
3. https://www.cdc.gov/diabetes/managing/education.html
4. https://www.cdc.gov/diabetes/library/spotlights/diabetes-insulin-resistance.html
5. https://assets.ama-assn.org/sub/prevent-diabetes-stat/downloads/AMA-evidence-supporting-dpp.pdf
6. https://nccd.cdc.gov/DDT_DPR/