What is Diabetes? Everything You Need to Know

Dr. Gina Lynem-Walker
Dr. Gina Lynem-Walker

| 7 min read

Dr. Gina Lynem-Walker, MD, is a quality medical director for...

More than 37 million U.S. adults have diabetes – yet one in five don’t know they have it. As diabetes continues to affect more and more Americans, understanding this chronic condition is critically important. Especially because prediabetes, which affects more than 96 million U.S. adults, is reversible with the right lifestyle changes.
Catching signs of diabetes and prediabetes early is possible by staying up to date with annual physicals with a health care provider. These yearly visits include screenings for chronic conditions like diabetes, and can help you stay on top of your health.

What is diabetes?

Diabetes is a chronic condition that affects how your body processes food into energy.
When people digest food, carbohydrates and starches break down into blood sugar, also known as blood glucose. This triggers the body to produce insulin, a hormone naturally made by the pancreas to regulate glucose levels in the blood.
When a person has diabetes, their body either doesn’t produce enough insulin or doesn’t produce any at all, leading to unregulated blood sugar. As a result, an individual managing this condition must ensure their body has enough insulin to compensate.
There are several types of diabetes:
  • Type 1 diabetes was previously known as juvenile diabetes because it usually develops in children and young adults. But Type 1 can occur at any age. With this form, the body cannot produce insulin at all.
  • Type 2 diabetes, in which the body cannot produce enough insulin or the body’s insulin is unable to store excess blood sugar properly. Although there is no cure, Type 2 can be managed with exercise, diet and medications (if prescribed). Type 2 diabetes can often be prevented with healthy lifestyle changes.
  • Prediabetes: A diagnosis for this condition is given when blood sugar levels are higher than normal, but not yet high enough to be diagnosed Type 2.
  • Gestational diabetes occurs in pregnant women when their bodies are not producing enough insulin, or they are unable to store excess blood sugar. It’s typically diagnosed around week 24 and is subject to all women regardless of their diabetic history.

What are the symptoms of diabetes?

While individuals with type 2 diabetes or prediabetes may not have any noticeable symptoms due to their slow development, individuals with type 1 diabetes may develop symptoms quickly over weeks or months. Talk with a health care provider if you experience any of these symptoms:
  • Blurred vision
  • Fatigue
  • Frequent skin or vaginal yeast infections
  • Frequent urination
  • Increased thirst and a dry mouth
  • Numbness or tingling in the hands or feet 
  • Slow-healing sores and cuts
  • Unexplained weight loss

What is a diabetes screening?

There are several types of tests that can be used to screen for and diagnose diabetes. All involve a blood test. Here are the different types:
  • A1C test: This measures your average blood sugar over the past two to three months. A1C below 5.7% is normal, 5.7% to 6.4% indicates prediabetes and 6.5% or higher indicates diabetes.
  • Fasting blood sugar test: This measures your blood sugar overnight without eating. A level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates prediabetes and 126 mg/dL indicates diabetes.
  • Glucose tolerance test: This measures your blood sugar before and after drinking a high-glucose drink. You fast before taking a blood test and then drinking a high-glucose liquid and having your blood drawn over several hour-long intervals. Your doctor will help you interpret the results.
  • Random blood sugar test: This measures your blood sugar at the time you’re tested. A level of 200 mg/dL indicates diabetes.
Screening for gestational diabetes also relies on blood tests:
  • A glucose screening test involves drinking a high-glucose liquid, and then having your blood drawn to check your blood sugar level. If the level is higher than a certain threshold, you’ll be asked to take a glucose tolerance test.
  • In a glucose tolerance test, you fast before taking a blood test and then drinking a high-glucose liquid and having your blood drawn over several hour-long intervals. Your doctor will help you interpret the results.

When should I be screened for diabetes?

Adults should be screened for prediabetes and type 2 diabetes beginning at age 35 with a blood sugar test. Continue screening every three years if you have no risk factors or normal results.

How does diabetes affect the feet?

Diabetes can decrease the amount of blood flow in your feet, which can lead to a multitude of foot problems. Without enough blood flow, infections and sores heal slowly or not at all. One common foot problem is called diabetic neuropathy, which can cause loss of feeling in your feet, tingling and pain. Early signs of this include a lowered ability to feel pain, heat or cold.
Once people with diabetes lose their sense of feeling in their feet, they may not realize they have foot issues like cuts or sores. Foot cuts and sores may not heal properly and get infected.
Gangrene can develop as a result, meaning the muscle, skin and other tissue begins to die. Some infections can quickly go from bad to worse and can ultimately lead to the amputation of the infected toe, foot or part of the leg.
However, with daily foot care and diabetes management, people with diabetes can keep their feet healthy.

How does diabetes affect the eyes?

It’s important to visit the eye doctor every year if you have vision issues, or if you use glasses or contacts, or if you have additional risk factors including diabetes, high blood pressure or a family history of eye disease. That’s because eye exams can detect the early signs of diabetes– and people with diabetes are at a higher risk for eye issues.
Over a short period of time, higher blood sugar can cause blurry vision. People who are changing their diabetes medications or treatment plans may experience blurred vision as their bodies adjust. However, over a longer period of time, high blood sugar can cause serious issues. This can begin during prediabetes, the condition in which your blood sugar is elevated but not high enough to be a diagnosis of diabetes.
Elevated blood sugar levels can begin to damage the blood vessels in the back of the eyes. These blood vessels may leak fluid, causing swelling. Additionally, newer and weaker blood vessels may start to grow, which can bleed into the middle of the eye. These growths can cause scarring or dangerously high blood pressure inside the eye.

What are the risk factors for diabetes?

Some risk factors for diabetes cannot be controlled, such as:
  • Genetics
  • Race
  • Ethnicity
  • Age
  • Medical history
Other risk factors are lifestyle choices that can be controlled. Talk to your health care provider about your personal health history and risk factors, as well as your diet and lifestyle, to see what you can do to improve your overall health.

How do I prevent diabetes?

Certain lifestyle choices can help lower your risk of diabetes. Here are some healthy lifestyle tips to employ:
  • Eat nutritious, well-balanced and portion-controlled meals
  • Focus on fruits, vegetables, whole grains, lean proteins and heart-healthy fats in everyday meals
  • Incorporate exercise and physical activity
  • Practice stress management techniques
  • Get good sleep
If you are concerned about your risk for diabetes, make an appointment with your doctor to discuss your personal health history and lifestyle.

What are myths about diabetes?

FACT: Diabetes concerns blood sugar – also known as glucose – which is the form of energy the body makes when it digests food. Insulin is a hormone naturally produced by the pancreas. It is the key to help store the extra blood sugar in the body's cells to be used as energy later. But when a body’s insulin isn’t working right – or when there isn’t enough insulin – that’s when blood sugar levels rise. That condition is called diabetes. And, excess consumption of carbohydrates to raise blood sugar without burning energy can lead to weight gain.
FACT: Being overweight does not necessarily mean a person is going to develop type 2 diabetes. A body mass index greater than 25 is considered a controllable risk factor for diabetes – but there are many other factors. People are at higher risk for diabetes if they have a poor diet, don’t exercise, experience stress and lack of sleep. There are also uncontrollable risk factors for diabetes, including age, gender, race/ethnicity and genetics.
FACT: While individuals with type 1 diabetes need insulin, type 2 diabetes can be managed with proper diet, exercise and oral medications. Insulin may be needed later, but each case is different. What’s most important after a diabetes diagnosis is making healthy lifestyle changes: stop smoking, eat healthier, well-balanced and portion-controlled meals and exercise regularly.
FACT: Controlling blood sugar means controlling all carbohydrates and consuming them in the right portions for your body. This includes everything from pasta and bread to cereal and rice as well as high-sugar foods like candy and desserts. Fruit, starchy vegetables and some dairy, milk and yogurt, are carbohydrate food sources. Understanding how many carbohydrates are in your food will allow you to manage your blood sugar – and to stay healthy.
FACT: Diabetes is serious – and common – but there are some controllable risk factors like healthy lifestyle choices, especially if you have type 2 diabetes.
Follow your treatment plan
If you have diabetes, be sure to follow your doctor’s treatment plan – including taking all medications as prescribed – and stay up to date with annual physicals and any additional visits your doctor may recommend.
Check with your health insurance provider to see if your benefits include diabetes management or prevention programs. Many Blue Cross Blue Shield of Michigan and Blue Care Network members have options available to them. Beginning Sept. 1, 2023, select BCN members will also be eligible for a diabetes improvement and prevention program through Twin Health. The pilot program is available at no cost to members of a fully insured BCN group health plan with Type 2 diabetes. Using a smart phone app, the program creates a digital health profile from wearable sensors. Members are connected to a care team that can help you lose weight, take less medications and improve your blood sugar. Find out more at partner.twinhealth.com/bcn.
Learn more about how preventive care can help you live a healthier life here on MIBluesPerspectives.com.
Photo credit: Getty Images
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association