A diabetes diagnosis is a serious one. The two types of diabetes are very different in nature.

Type I, said Brian Jameson, D.O., Geisinger endocrinologist, is immune mediated, meaning the pancreas is attacked due to a loss of insulin function. This disease develops in childhood or early teens.

Type II, Jameson said, is often shared within families and is an overproduction of insulin.

“Basically you don’t use the insulin you make very well,” Jameson said.

This form develops in mid-life and linked more and more with obesity.

Type II, Jameson said, is also preventable.

If you have a family history of Type II, Jameson said, keep an eye on your body mass index.

Diet and exercise are essential ways to keep that index under control.

This is also the key for managing diabetes once it is diagnosed.

“Diet and exercise are key lifestyle changes that can be made to improve health and wellness and manage diabetes. Along with other benefits, following a healthy meal plan and being active can help you keep your blood glucose level, also called blood sugar, in your target range,” said Kathryn Patetta, diabetes program coordinator with UPMC Susquehanna.

Jameson said this is important for Type I patients, too, because the disease cannot be prevented.

“Diet and exercise is the cornerstone for everything,” Jameson said, pointing out the diabetes rates across the nation are on the rise.

The Geisinger coverage area, Jameson said, which is a large portion of the state, has a higher diabetes rate than the national average. Nationally 14 percent of Americans have diabetes. In the Valley and beyond, the rate is 17 percent.

“The reason is obesity,” Jameson said, “If everybody just loses five to 10 pounds, it would be better. Half of the cases are preventable.”

Keeping your insulin levels in check is critical in this process of maintaining one’s diet.

“To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine, if you take any. What you choose to eat, how much you eat, and when you eat are all important in keeping your blood glucose level in the range that your health care team recommends,” said Patetta.

Keeping track of your diet can even mean a patient may not need medicine, Jameson said, or maybe not right away.

Jameson said his main concern is that some patients think diabetes is “not so bad.”

The truth is, he said, “All diabetes is bad.”

The impact of the insulin levels can cause vascular concerns.

“Having diabetes means that you are more likely to develop heart disease and have a greater chance of a heart attack or a stroke. People with diabetes are also more likely to have certain conditions, or risk factors, that increase the chances of having heart disease or stroke, such as high blood pressure or high cholesterol. If you have diabetes, you can protect your heart and health by managing your blood glucose, also called blood sugar, as well as your blood pressure and cholesterol. If you smoke, get help to stop,” said Patteta.

Patetta said there are factors to consider in terms of your heart and diabetes. The longer a patient has diabetes, the chances are heightened for heart disease. People who have diabetes develop heart disease at a younger age than others. These patients are twice as likely to die from a heart attack or stroke.

Jameson said high blood sugar levels can damage blood vessels. This can cause damage to the eyes and kidneys.

“It causes damages to your nerves,” Jameson said, “And it means pain in the extremities and loss of sensations. Patients may experience unknown infections.”

Stress, Patetta said is another player in terms of impacting glucose levels.

“When under stress you may be less likely to take good care of yourself,” she said, “Checking blood glucose levels is an important part of diabetes self-care, but it can also become a source of stress when levels aren’t ideal even with your best efforts.”

Patetta suggested patients work with a diabetes educator to help deal with these concerns.

Patients also need to understand that having diabetes “under control,” or not needing medications because of good exercise and diet habits does not mean they are cured.

“You can stop the medications,” Jameson said, “but you are predisposed if you back slide. It can come back. Control is key.”

Patetta said this is where professionals such as diabetes educators and even a diabetes support group can help keep patients on track.

“Managing diabetes is a life-long process. Managing diabetes requires forming new habits,” Patetta said.

The sooner a patient proactively responds to the diabetes diagnosis, the better.

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