The most common form of diabetes seen in the United States is Type 2 diabetes, often called NIDDM: non-insulin dependent diabetes mellitus. In patients with Type 2 diabetes, the pancreas is still producing insulin (even in reduced amounts), but the body is not effectively using it.
Sometimes a diabetes diagnosis comes as a shock. An otherwise healthy patient has routine blood work completed and finds that their fasting blood sugar is unexpectedly elevated. Rarely, a patient with undiagnosed disease will suffer from an extreme rise or drop in blood sugar that results in unconsciousness, a fall or accident, or another sentinel event that will be traced back to their blood sugar level. Extremes in blood sugar can lead to diabetic ketoacidosis, coma, or even death.
More common, however, is the diabetes diagnosis that creeps up on you. Perhaps you’ve gained a few pounds here and there. With each visit to your physician, your blood sugar has steadily risen. Your physician has likely started monitoring your Hemoglobin A1C in addition to your blood sugar. What does this mean? The typical life span of a red blood cell is 90 days. Hemoglobin A1C tests give us a 90 day snapshot of what your blood sugar has looked like over the course of the life of the red blood cell. This is why this test is often conducted quarterly. It gives a better picture of your overall blood sugar health than does your fasting blood sugar on any one day.
What should these numbers look like? While it varies for each patient, a normal hemoglobin A1C level should be below 7, and a fasting blood sugar level should be below 100.
Working to bring one’s blood sugar under control is very important. If left untreated, diabetes has many potential long term consequences. Consistently high blood sugar levels wreak havoc on the vascular system. Blood flow to and from our organs and extremities is inhibited. This is part of the reason we see so many non-healing wounds and amputations in diabetes patients. We also see an increase in cardiovascular and kidney disease in diabetes patients, partially due to the affected elasticity of the vessels. The list of diabetes related complications goes on and on.
A diagnosis of Type 2 diabetes can be overwhelming and confusing for many patients. While Type 2 diabetes never “goes away,” it is a highly manageable disease. The patient has much control over the progression of their disease by adhering to medication regimens, and making suggested changes to diet and exercise, all of which we will address in more detail in subsequent writings.