Diabetes has become a widespread health concern, touching countless lives. Dr. Mohammadi recently presented on this topic to the Assisted Living Training School.

This blog post covers his presentation and offers a deep dive into the complexities of this condition, exploring the various types of diabetes, their underlying causes, common symptoms, and potential complications. We'll also examine current management strategies and shed light on promising advancements in diabetes care.

Click here to watch the full video today.  

What is Diabetes?

In essence, diabetes is a chronic condition that affects how your body utilizes food for energy. It's characterized by an inability to properly regulate blood sugar levels. Let's break down the different types of diabetes:

• Type 1 Diabetes: This occurs when the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. Individuals with type 1 diabetes depend on insulin therapy for survival.  
• Type 2 Diabetes: The most prevalent form of diabetes, type 2 is characterized by the body's insufficient production of insulin or its resistance to the effects of insulin. Ninety percent of individuals that have diabetes have Type 2 Diabetes.
• Gestational Diabetes: This type of diabetes emerges during pregnancy and typically resolves after childbirth.
• Other rare types: These encompass less common forms of diabetes, such as Maturity Onset Diabetes of the Young (MODY), which is caused by genetic mutations, and diabetes resulting from damage to the pancreas.

The Link Between Diabetes and Dementia

Recent research suggests a potential link between diabetes and dementia, sometimes referred to as "type 3 diabetes." This underscores the importance of effectively managing blood sugar levels to possibly mitigate the risk of cognitive decline.

Causes of Type 2 Diabetes

Diabetes arises from a complex interplay of various factors. Here's a closer look at the causes:

• Genetics: Family history can significantly increase your risk of developing diabetes. Research continues to identify specific genes associated with diabetes susceptibility.
  
  “However, as we always say in medicine, the genes load the gun but it’s the environment that pulls the trigger,” shared Dr. Mohammadi.
  
  
• Environmental Toxins: Exposure to certain chemicals and heavy metals can disrupt the delicate balance of insulin and glucose regulation. These toxins include BPA (commonly found in receipts), arsenic (present in water and seafood), and pesticides.
  
  
• Lifestyle Factors: Lifestyle choices play a crucial role in diabetes development. Obesity, physical inactivity, and a diet high in processed foods and sugary drinks contribute to insulin resistance and chronic inflammation.
  
  
• Age: The risk of diabetes escalates with age. This is attributed to the natural decline in pancreatic function and a decrease in insulin sensitivity.
  
  
• Race: Certain racial and ethnic groups face a higher risk of diabetes, including African Americans, Hispanics, Native Americans, and Asians.
  
  
• Other Conditions: Pre-existing health conditions, such as hypertension, high cholesterol, and polycystic ovarian syndrome (PCOS), can increase the likelihood of developing diabetes.
  
  
• Gut Microbiome: The gut microbiome, comprising trillions of bacteria residing in our digestive system, plays a crucial role in health. An imbalance in gut bacteria, known as dysbiosis, can contribute to diabetes risk, weight gain, and obesity.

Symptoms of Diabetes

Recognizing the signs and symptoms of diabetes is crucial for early diagnosis and intervention. 

Common symptoms include:

• Frequent urination (polyuria)
• Excessive thirst (polydipsia)
• Increased hunger (polyphagia)
• Unexplained weight loss
• Fatigue
• Blurred vision
• Slow wound healing

Diagnosing Diabetes

Healthcare professionals utilize several tests to diagnose diabetes:

• Fasting Blood Sugar Test: This test measures blood sugar levels after an overnight fast. A level of 126 mg/dL or higher is indicative of diabetes.
  
  
• A1C Test: The A1C test provides an average of blood sugar levels over the past 2-3 months. An A1C of 6.5% or higher indicates diabetes.
  
  
• Random Blood Sugar Test: This test measures blood sugar levels at any given time. A level of 200 mg/dL or higher, accompanied by diabetes symptoms, suggests a diagnosis of diabetes.
  
  
• Oral Glucose Tolerance Test: Primarily used during pregnancy, this test measures blood sugar levels before and after consuming a sugary drink.

Complications of Diabetes

Uncontrolled diabetes can lead to a range of serious complications. These complications fall into two main categories:

Microvascular Complications: These arise from damage to small blood vessels, impacting various organs:

• Retinopathy: Damage to the blood vessels in the retina of the eye, which can lead to vision loss and blindness if not managed effectively.
• Nephropathy: Damage to the kidneys' blood vessels, impairing their function and potentially leading to kidney failure, often requiring dialysis.
• Neuropathy: Damage to the nerves, causing numbness, tingling, pain, and foot ulcers. Neuropathy increases the risk of infections and, in severe cases, amputations.

Macrovascular Complications: These involve damage to larger blood vessels, increasing the risk of cardiovascular events:

• Heart Disease: People with diabetes have a significantly higher risk of heart attack and heart failure.
• Stroke: Diabetes elevates the risk of stroke due to impaired blood flow to the brain.
• Peripheral Artery Disease (PAD): PAD affects the blood vessels in the limbs, particularly the legs and feet, leading to pain, numbness, and impaired wound healing.

Preventing and Managing Diabetes

Effectively managing diabetes involves a multifaceted approach encompassing lifestyle modifications, medications, and in some cases, insulin therapy or surgery.

Lifestyle Modifications

There are a number of things we can do to help prevent the onset of diabetes. Consider incorporating these modifications into your daily routines and habits.

Diet: A healthy diet is paramount in diabetes management. Focus on a low-carbohydrate, high-fiber eating plan that includes lean proteins, healthy fats, fruits, vegetables, and whole grains.

• Glycemic Index (GI) and Glycemic Load (GL): Opt for foods with a low GI and GL to minimize fluctuations in blood sugar levels.
• Hidden Sugars: Become a savvy label reader and learn to identify the various names for sugar that manufacturers use in processed foods.
• Artificial Sweeteners: Limit or avoid artificial sweeteners, as they can disrupt the gut microbiome and potentially impact metabolic health.

Exercise: Regular physical activity is crucial for improving insulin sensitivity and overall health. Aim for at least 150 minutes of moderate-intensity exercise per week. Incorporate a variety of activities, including cardio, strength training, and flexibility exercises.

Stress Management: Chronic stress can elevate blood sugar levels. Practice stress-reducing techniques like meditation, deep breathing exercises, yoga, and spending time in nature.

Adequate Sleep: Prioritize sleep! Aim for 7-9 hours of quality sleep each night, as sleep deprivation can disrupt hormone balance and increase insulin resistance.

Vaccinations: Stay current with recommended vaccinations to protect against infections, as diabetes can compromise the immune system.

Medications to Manage Blood Sugar Levels

A range of medications is available to help manage blood sugar levels:

• Metformin: A commonly prescribed first-line medication, metformin reduces glucose production in the liver and enhances insulin sensitivity.
• Sulfonylureas: These medications stimulate the pancreas to release more insulin.
• Thiazolidinediones (TZDs): TZDs improve insulin sensitivity but may cause weight gain and fluid retention.
• DPP-4 Inhibitors: These drugs prevent the breakdown of incretin hormones, which play a role in blood sugar regulation.
• GLP-1 Receptor Agonists: Mimicking the action of incretin hormones, GLP-1 receptor agonists promote insulin release and reduce glucagon secretion.
• SGLT2 Inhibitors: This class of medications blocks the reabsorption of glucose in the kidneys, leading to increased glucose excretion in the urine.
• Insulin: Individuals with type 1 diabetes and some with advanced type 2 diabetes require insulin therapy. Various types of insulin are available, categorized by their speed of onset and duration of action.

Insulin Delivery Methods

Insulin can be administered through different methods:

• Syringes: The most cost-effective option.
• Pens: More convenient and user-friendly than syringes.
• Inhalers: An alternative for those who prefer not to use needles.
• Pumps: Insulin pumps provide continuous insulin delivery, offering greater flexibility and potentially tighter blood sugar control.

Surgical Treatments

• Bariatric Surgery: For some individuals with obesity and type 2 diabetes, bariatric surgery may be an option. However, it's essential to weigh the risks and potential long-term nutritional deficiencies associated with these procedures.

Monitoring Diabetes

Ongoing monitoring is vital to ensure optimal blood sugar control and to detect any potential complications early on.

Home Blood Glucose Monitoring: Regularly checking blood sugar levels using a glucose meter is essential for tracking daily fluctuations and making necessary adjustments to diet, exercise, or medication.

Continuous Glucose Monitors (CGMs): CGMs offer continuous, real-time blood sugar readings throughout the day and night, providing valuable insights into glucose patterns and trends.

A1C Testing: The A1C test should be performed every 3-6 months to assess long-term blood sugar control and to evaluate the effectiveness of treatment strategies.

Regular Checkups: Routine visits with your healthcare provider are crucial for monitoring blood pressure, cholesterol levels, kidney function, eye health, and foot health.

The Future of Diabetes Management

The field of diabetes management is constantly evolving, with exciting advancements on the horizon that hold the promise of transforming care for people with diabetes.

• Artificial Intelligence (AI): AI is being utilized to develop predictive models and to provide personalized treatment recommendations based on individual patient data.
• Closed-Loop Systems: "Artificial pancreas" systems are being developed that combine continuous glucose monitoring with automated insulin delivery, aiming to achieve tighter blood sugar control and reduce the burden of diabetes management.
• Microbiome Correction: Research is exploring therapies to restore gut health and improve insulin sensitivity by modulating the gut microbiome.
• Genetic-Based Diet Recommendations: In the future, we may see personalized dietary advice based on an individual's unique genetic makeup, optimizing nutrition for diabetes management.
• Peptide Therapy: New medications based on peptides, which are short chains of amino acids, are being developed to mimic natural hormones involved in blood sugar regulation.
• Organ Transplants: Scientists are working on developing artificial pancreases and other organs for transplantation, offering a potential cure for some individuals with diabetes.
• Gene Therapy: Gene therapy holds the potential to reverse or prevent diabetes through genetic engineering, though this field is still in its early stages.

Diabetes is a challenging condition, but with the right knowledge, resources, and support, individuals with diabetes can live full and healthy lives. At Lifescape, we're committed to providing comprehensive and compassionate care for people with diabetes. Our team of experienced healthcare professionals can help you understand your condition, develop a personalized management plan, and navigate the latest advancements in diabetes care.

Want more tips on how to manage your diabetes effectively?  Request a Meet & Greet with one of our concierge providers today.

Watch Dr. Mohammadi’s Full Video on Diabetes

And, to get an even deeper understanding of diabetes management, watch the full presentation by Dr. Mohamadi on YouTube: