The Facts About Diabetes

An estimated 34.2 million Americans—10.5 percent of the United States population—have diabetes, according to the 2020 National Diabetes Statistics Report published by the Centers for Disease Control and Prevention (CDC). The number of cases in the U.S. continues to rise every year.

There are two types of diabetes: type 1 and type 2. Both types of diabetes are chronic diseases that require ongoing treatment. No cure exists for either type. However, treatments such as diet control, exercise, oral medications and injectable insulin can help sufferers live a full and otherwise healthy life.

Type 1 (T1) diabetes is a chronic condition that affects the pancreas's insulin cells. With this type of diabetes, your pancreas doesn't make enough insulin, a hormone that allows your cells to store blood glucose and produce energy. The cause of type 1 diabetes is unknown and complex. It is still being studied but is currently believed to be autoimmune in etiology.

Type 2 (T2) diabetes is more common. The difference between them is that with T2 your body produces enough insulin but doesn't use it properly.

Both types of diabetes require constant blood glucose monitoring to ensure levels don't get too high (hyperglycemia) or too low (hypoglycemia).

Prediabetes is when a person's blood sugar levels are higher than the normal range but don't fall within the range for a diabetes diagnosis. Some people with prediabetes can reduce their chances of getting diabetes by following early, preventive treatment. This kind of intervention includes losing weight and exercising at moderate levels, which in turn can help regulate blood sugar levels.

Preventive treatment may also include:

• Adopting a healthier lifestyle by doing activities you enjoy
• Eating more vegetables and protein
• Making sure you get adequate rest
• Staying hydrated

The good news is that 50 percent of type 2 diabetes can be prevented or delayed, according to Diabetes U.K., an organization based in the United Kingdom that supports people affected by diabetes.

Type 1 diabetes is considered an autoimmune disease in which your immune system attacks insulin-producing cells in the pancreas. Scientists believe type 1 diabetes could be caused by genes or environmental factors such as viruses.

On the other hand, type 2 diabetes is caused by genes and lifestyle factors. For example, some individuals who are classified as overweight or obese may go on to experience insulin resistance over time, which can lead to T2 diabetes. Unlike with T1 diabetes, your body produces enough insulin, but your muscle, liver and fat cells don't use it efficiently. This then causes your body to make too much or too little insulin, which in turn causes blood glucose levels to rise.

Many people who develop prediabetes are asymptomatic, but symptoms become more apparent when they reach the point of diagnosis with type 1 or type 2 diabetes. These symptoms can include:

• Blurry vision and confusion
• Discomfort and trouble sleeping
• Excessive thirst and urination
• Extreme fatigue and rapid weight loss
• Numbness in the feet and legs
• Sexual complications such as erectile dysfunction (ED) and low libido

People who develop diabetes can struggle with body image and the physical changes the disease brings on. Low mood, fluctuating energy levels and reduced sex drive can also be difficult symptoms to manage.

Some racial and ethnic groups suffer a higher risk of developing diabetes. These include Black people of African descent, Hispanics or Latin Americans, Alaska Natives, American Indians, Asian Americans and Native Hawaiians. Having a family history of diabetes can also increase risk.

Other at-risk groups include:

• Women with polycystic ovary syndrome (PCOS)
• People with a sedentary lifestyle or people who don't exercise regularly
• People who are older than 45 and overweight

Diabetes can be diagnosed in several ways. One method doctors use is to measure blood glucose levels with an A1C test, which is carried out by drawing blood. This test helps determine your average blood sugar levels over a period of time, about two to three months. A normal A1C level is less than 5.7 percent. Prediabetes levels are between 5.7 percent and 6.4 percent, and diabetes is diagnosed with levels of 6.5 percent or higher.

Another method is to test fasting blood glucose levels. This test requires you to fast, which in practical terms means not eating or drinking anything except water for eight hours before the blood draw. The normal range for fasting plasma glucose (FPG) levels is less than 100 milligrams per deciliter (mg/dl). Prediabetes levels are between 100 mg/dl and 125 mg/dl, and diabetes is diagnosed when FPG levels are 126 mg/dl or higher.

People with prediabetes don't automatically develop type 2 diabetes. One of the best prevention methods is healthy weight loss. For most people, that equates to 7 percent of your body weight. For people who weigh more than 200 pounds, a healthy weight loss is about 15 pounds, according to the American Diabetes Association.

Another prevention method is a healthy entry into moderate exercise. That can be speed-walking or swimming at a fast pace for 30 minutes per day, five days per week. The key is to find a form of exercise you enjoy doing that gets your body moving.

Treatment for diabetes requires or begins with regular monitoring of blood glucose levels with a glucose meter or a glucose monitoring system. It may also involve taking insulin when glucose levels get too low. Many people with insulin-dependent T1 or T2 diabetes take more than one type of insulin.

Oral medication is another form of treatment that helps lower blood sugar, and it works best in combination with diet and exercise. Diabetes pills can work well for people who have recently developed diabetes or need little to no insulin to keep blood sugar levels within a normal range.

The most common effects of diabetes medication are low blood sugar, upset stomach, weight gain and nausea. Each type of medication will have its own set of side effects. You should talk to your doctor if you start experiencing pain or discomfort.

While you don't have to completely upend your diet, adding more plant-based meals to your routine can help you adopt a healthier lifestyle and aid in treating and managing diabetes.

For example, studies have shown the Mediterranean diet can help manage type 2 diabetes. This diet includes low amounts of cheese, yogurt, and chicken and lots of vegetables, legumes, nuts, seafood and whole grains.

As men grow into middle age and older, they begin to have interrelated health issues. One of those coinciding conditions is type 1 or type 2 diabetes and low testosterone. A study by the Journal of Clinical Endocrinology & Metabolism indicated 43 percent of men with low-T had T2 diabetes.

The good news is preliminary studies also found that treating low testosterone levels can help men from progressing to T2 diabetes. Adopting a healthier lifestyle that includes moderate exercise and a clean diet can help as well.

Men with diabetes are three times more likely to develop ED, a physical condition that causes them to have trouble getting or maintaining an erection satisfactory for intercourse.

Diabetes can cause numerous complications which, in turn, cause ED:

• Blood vessel damage. When blood sugar levels are unregulated, blood vessels can suffer damage. If blood can't flow freely to the genitals, men may have trouble achieving or maintaining an erection.
• Kidney disease. The kidney helps your body produce hormones. However, when the kidney is damaged, the hormones associated with your sexual response can be altered or produced in a lesser quantity.
• Nerve damage or neuropathy. One of the first signs of diabetes is nerve damage, which can happen to the genitals as well as the legs and feet.

Diabetes can affect sex drive in men and women.

In men, diabetes can coincide with low testosterone levels, the hormone responsible for sexual desire, and that can reduce libido.

In women, diabetes can negatively affect libido in a number of ways, including fatigue from poor sleep, vaginal dryness, painful sex due to nerve damage and changing hormones.

New research from John Hopkins University suggests that uncontrolled diabetes could be linked to Peyronie's disease, which is a build-up of scar tissue that can lead to painful and curved erections. Increased blood glucose levels can have an impact on the severity of Peyronie's.

More studies are needed to confirm the link, but as with most medical conditions, the sooner you can take action, the more control you'll have over both diabetes and Peyronie's.

What are the first signs of diabetes?

The first symptoms of diabetes are excessive thirst, extreme fatigue and weight loss. Symptoms may include numbness in the lower extremities (feet and legs), discomfort and trouble sleeping, too.

What is the main cause of diabetes?

Both type 1 and type 2 diabetes can be caused by genes and a family history of the disease. Type 2 diabetes is often caused by being overweight and having a sedentary lifestyle and unhealthy eating habits.

How do you prevent diabetes?

One of the best ways to prevent diabetes is to exercise moderately, for at least 30 minutes five times a week. Adopting a healthy diet full of fruits, vegetables and whole grains—simultaneously limiting dairy and red meat—can help, too.