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Diabetes

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Eye Problems

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood sugar levels.

What eye problems can diabetes cause?

Over time, high blood sugar may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetes eye problems include:

  • Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). The blood vessels may swell and leak fluid into your eye. If it's not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
  • Diabetic macular edema (DME), which happens when blood vessels in the retina leak fluid into the macula (a part of the retina needed for sharp, central vision). This usually develops in people who already have other signs of diabetic retinopathy.
  • Glaucoma, a group of eye diseases that can damage the optic nerve (the bundle of nerves that connects the eye to the brain). Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris (the colored part of your eye). The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
  • Cataract, which happen when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.
Who is more likely to develop diabetic eye problems?

Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you:

  • Have had diabetes for a long time
  • Don't have good control over your high blood sugar or high blood pressure
  • Are pregnant
  • Have high blood cholesterol
  • Smoke tobacco
What are the symptoms of diabetic eye problems?

In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.

You should also watch for sudden changes in your vision that could mean an emergency. Call your doctor right away if you notice any of these symptoms:

  • Many new spots or dark wavy strings floating in your vision (floaters)
  • Flashes of light
  • A dark shadow over part of your vision, like a curtain
  • Vision loss
  • Eye pain or redness

Talk with your doctor if you have these symptoms, even if they come and go:

  • Spots or dark wavy strings floating in your vision
  • Blurry or wavy vision
  • Vision that changes a lot
  • Trouble seeing colors
How are diabetic eye problems diagnosed?

Eye doctors do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your doctor can look for signs of eye problems and treat them before they harm your vision. Your doctor will also test your vision and measure the pressure in your eyes.

What are the treatments for diabetic eye problems?

Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:

  • Lasers to stop blood vessels from leaking
  • Injections (shots) in the eye to stop new, leaky blood vessels from growing
  • Surgery to remove blood and scar tissue or replace a cloudy lens
  • Eye drops to lower fluid pressure in the eye

But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Blood Glucose

What is blood glucose?

Blood glucose, or blood sugar, is the main sugar found in your blood. It is your body's primary source of energy. It comes from the food you eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. When your blood glucose goes up, it signals your pancreas to release insulin. Insulin is a hormone that helps the glucose get into your cells to be used for energy.

What is diabetes?

Diabetes is a disease in which your blood glucose levels are too high. When you have diabetes, your body doesn't make enough insulin, can't use it as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells. Over time, having too much glucose in your blood can cause serious health problems (diabetes complications). So if you have diabetes, it's important to keep your blood glucose levels within your target range.What are blood glucose targets?

If you have diabetes, your blood glucose target is the range you try to reach as much as possible. The typical targets are:

  • Before a meal: 80 to 130 mg/dL
  • Two hours after the start of a meal: Less than 180 mg/dL

Your blood glucose targets may be different, depending on your age, any additional health problems you have, and other factors. Talk with your health care team about the best target range for you.

When and how should I check my blood glucose?

If you have diabetes, you'll likely need to check your blood glucose every day to make sure that your blood glucose numbers are in your target range. Some people may need to check their blood glucose several times a day. Ask your health care team how often you need to check it.

The most common way to check your blood glucose level at home is with a blood glucose meter. A blood glucose meter measures the amount of glucose in a small sample of blood, usually from your fingertip.

Continuous glucose monitoring (CGM) is another way to check your glucose levels. Most CGM systems use a tiny sensor that is inserted under your skin. The sensor measures your glucose level every few minutes. It can show changes in your glucose level throughout the day and night. A CGM system is especially useful for people who take insulin and have problems with low blood glucose.

Your provider will also check your blood glucose with a blood test called an A1C. It checks your average blood glucose level over the past three months. People with diabetes usually have an A1C test at least twice a year. But you may need the test more often if you aren't meeting your diabetes treatment goals.

What happens if my blood glucose level becomes too high?

High blood glucose is called hyperglycemia. Symptoms that your blood glucose levels may be too high include:

  • Feeling thirsty
  • Feeling tired or weak
  • Headaches
  • Urinating (peeing) often
  • Blurred vision

If you often have high blood glucose levels or symptoms of high blood glucose, talk with your health care team. You may need a change in your diabetes meal plan, physical activity plan, or diabetes medicines.

High blood glucose may also be caused by other conditions that can affect insulin or glucose levels in your blood. These conditions include problems with your pancreas or adrenal glands.

What happens if my blood glucose level becomes low for me?

Hypoglycemia, also called low blood glucose, happens when your blood glucose level drops below what is healthy for you. For many people with diabetes, this means a blood glucose reading lower than 70 mg/dL. Your number might be different, so check with your health care team to find out what blood glucose level is low for you.

Symptoms of low blood glucose tend to come on quickly. The symptoms can be different for everyone, but they may include:

  • Shaking
  • Sweating
  • Nervousness or anxiety
  • Irritability or confusion
  • Dizziness
  • Hunger

Low blood glucose levels can be common in people with type 1 diabetes and people with type 2 diabetes who take certain diabetes medicines. If you think you may have low blood glucose, check your level, even if you don't have symptoms. Low blood glucose can be dangerous and should be treated as soon as possible.

Although it's rare, you can still get low blood glucose without having diabetes. The causes can include conditions such as liver disease, kidney disease, and hormone deficiencies (lack of certain hormones). Some medicines, such as certain heart medicines and antibiotics, can also cause it. See your provider to find out the cause of your low blood glucose and how to treat it.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes and Pregnancy

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. When you are pregnant, high blood sugar levels are not good for your baby.

About seven out of every 100 pregnant women in the United States get gestational diabetes. Gestational diabetes is diabetes that happens for the first time when a woman is pregnant. Most of the time, it goes away after you have your baby. But it does increase your risk for developing type 2 diabetes later on. Your child is also at risk for obesity and type 2 diabetes.

Most women get a test to check for diabetes during their second trimester of pregnancy. Women at higher risk may get a test earlier.

If you already have diabetes, the best time to control your blood sugar is before you get pregnant. High blood sugar levels can be harmful to your baby during the first weeks of pregnancy - even before you know you are pregnant. To keep you and your baby healthy, it is important to keep your blood sugar as close to normal as possible before and during pregnancy.

Either type of diabetes during pregnancy increases the chances of problems for you and your baby. To help lower the chances talk to your health care team about:

  • A meal plan for your pregnancy
  • A safe exercise plan
  • How often to test your blood sugar
  • Taking your medicine as prescribed. Your medicine plan may need to change during pregnancy.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes Complications

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

What health problems can diabetes cause?

Over time, having too much glucose in your blood can cause complications, including:

  • Eye disease, due to changes in fluid levels, swelling in the tissues, and damage to the blood vessels in the eyes
  • Foot problems, caused by damage to the nerves and reduced blood flow to your feet
  • Gum disease and other dental problems, because a high amount of blood sugar in your saliva helps harmful bacteria grow in your mouth. The bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause gum disease and bad breath. Other types cause tooth decay and cavities.
  • Heart disease and stroke, caused by damage to your blood vessels and the nerves that control your heart and blood vessels
  • Kidney disease, due to damage to the blood vessels in your kidneys. Many people with diabetes develop high blood pressure. That can also damage your kidneys.
  • Nerve problems (diabetic neuropathy), caused by damage to the nerves and the small blood vessels that nourish your nerves with oxygen and nutrients
  • Sexual and bladder problems, caused by damage to the nerves and reduced blood flow in the genitals and bladder
  • Skin conditions, some of which are caused by changes in the small blood vessels and reduced circulation. People with diabetes are also more likely to have infections, including skin infections.
What other problems can people with diabetes have?

If you have diabetes, you need to watch out for blood sugar levels that are very high (hyperglycemia) or very low (hypoglycemia). These can happen quickly and can become dangerous. Some of the causes include having another illness or infection and certain medicines. They can also happen if you don't get the right amount of diabetes medicines. To try to prevent these problems, make sure to take your diabetes medicines correctly, follow your diabetic diet, and check your blood sugar regularly.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases