As a provider who lives with diabetes herself, Trang Vuong, MD, an internal medicine and pediatric specialist at Atrium Health Primary Care One Health Family Medicine Matthews is passionate about sharing advice on how to best manage the condition.
“I have gestational diabetes, which I developed through pregnancy,” she says. “Fifty percent of diabetes cases involve gestation and can develop into full-blown diabetes. Genetics can also play a role. My grandmother lost both legs and was on dialysis. I saw what that was like for her, and it terrified me.”
A big focus of diabetes awareness and education is on prediabetes and preventing diabetes. According to the Centers for Disease Control and Prevention (CDC), about 88 million U.S. adults have prediabetes, a serious health condition where blood sugar levels are higher than normal – but not high enough yet to be diagnosed as diabetes. The majority of those adults are unaware that they’re prediabetic.
Diabetes is a group of diseases that result in high blood glucose, meaning there’s too much sugar in one’s blood. The most common forms are Type 1 and Type 2. The former is a chronic condition in which the pancreas produces little or no insulin. The latter – which is the case for about 90-95% of patients – affects the way the body processes blood sugar (glucose).
Diabetes, especially if unmanaged, can lead to kidney failure, blindness, amputation, stroke, and heart attack.
“We used to think that Type 1 was ‘juvenile diabetes,” Dr. Vuong says. “But we got away from that and don’t say it anymore. Diabetes is a spectrum; you’re not born with it; it develops.”
Treatment and care
Patients with Type 1 diabetes need insulin because their pancreas cannot function. Symptoms include frequent thirst and urination, weight loss, and a lack of energy. “People can get pretty sick from Type 1 and face the danger of their bodies shutting down. Some need to be resuscitated through IV fluids and insulin. Treatments include insulin (injections or through the use of insulin pumps) and the more definitive way of a pancreas transplant (for severe cases with simultaneous renal complications).”
Patients with Type 2 diabetes have bodies that are more resistant to their naturally-produced insulin. “It’s like having a bunch of locks and keys that don’t fit,” Dr. Vuong says. “Insulin resistant patients might be overweight, but you can have Type 2 diabetes regardless of your size. There are many medications we use for Type 2, but the number one treatment involves diet and exercise.”
She says societal trends toward instant gratification and sedentary lifestyles have played a role in diabetes’ prevalence. “We’re not as active as we used to be, which doesn’t allow our bodies to utilize insulin and sugar better. And the food that’s easily accessible is often high in fats and high in carbohydrates, such as grab-and-go meals. As a result, obesity goes up and so does diabetes.”
Support and encouragement
For Hannah DeBerry, FNP, a nurse practitioner at Atrium Health Primary Care One Health Family Medicine Matthews, emotional assistance is a large part of their job in helping diabetes patients. “Being there as cheerleaders to encourage them about diet and exercise, and how important those things are, is crucial whether they’re prediabetic or already diagnosed,” DeBerry says.
“Sometimes we order a dietitian consultation to help patients with nutrition education. Eating well and exercising are the biggest challenges I see. It can be hard for many to understand they can still enjoy their lives and eat well.”
According to Dr. Vuong, much is up to the patients. “We can’t do the work for them, but we can certainly provide them with the support and resources to be successful,” she says. “They’re in the driver’s seat and they have to do the hard part. I have people who get diagnosed and get upset and don’t give up anything. Others get diagnosed and are quick to make lifestyle changes. The mentality can’t be, ‘I’m going to eat this cake and take my insulin.’ That’s not how it works.”
She says requiring insulin doesn’t have to last forever and patients need to remember that. “They can come off insulin through exercise, diet and taking other medications,” Dr. Vuong says. “If you can reverse diabetes, you can live a happy and healthy life. It doesn’t have to take over you.”
Management and prevention
Here are some tips to help manage prediabetes and prevent diabetes:
- Take small steps. Making changes to your lifestyle and daily habits can be hard, but you don’t have to change everything at once. It is okay to start small. Remember that setbacks are normal and do not mean you have failed – the key is to get back on track as soon as you can.
- Move more. Limit time spent sitting and try to get at least 30 minutes of physical activity, 5 days a week. Start slowly by breaking it up throughout the day.
- Choose healthier foods and drinks most of the time. Pick foods that are high in fiber and low in fat and sugar. Build a plate that includes a balance of vegetables, protein, and carbohydrates. Drink water instead of sweetened drinks.
- Lose weight, track it, and keep it off. You may be able to prevent or delay diabetes by losing 5 to 7 percent of your starting weight.
- Seek support. It is possible to reverse prediabetes. Making a plan, tracking your progress, and getting support from your health care professional and loved ones can help you make the necessary lifestyle changes.
- Stay up to date on vaccinations. The COVID-19 (booster shot, if eligible) and flu vaccines are especially important for people who may be more likely to get very sick from COVID-19 or the flu, such as people with diabetes.
One of the best ways to stay on track of your health and detect early onset of diabetes is with regular visits with a primary care provider. To find a provider near you, visit online.
