Let's Talk About Diabetes

November is American Diabetes Month; November 14th is World Diabetes Day. This article is for educational purposes only; all health matters and concerns should be directed towards a licensed medical professional.


Imagine losing weight without even trying; sounds great, right? This is what happened when I was seventeen; it wasn't due to a diet or lifestyle change but a change taking place in my endocrine system. My Mother is a registered nurse and saw odd symptoms appearing in me and decided it was time for me to see a specialist. I remember sitting with her in the endocrinologist's office crying and feeling scared. I was diagnosed with Type 1 Diabetes. However, with treatment and proper management, life can be normal with diabetes. I'm sure the majority of Americans know at least one person who has some form of diabetes. It's an epidemic, to say the least. This article will explore what diabetes is, who's at risk, symptoms, prevention measures, and additional resources.


What Is Diabetes?

There are three most common forms: Type 1, Type 2, and Gestational. Diabetes impacts a body's function to produce insulin; insulin is a hormone that is responsible for processing and metabolizing sugar, carb, proteins, and so on. Many diabetics do not produce enough insulin which results in high blood sugar; if this is left untreated, it can damage the body and lead to health complications down the road. Type 1 diabetics are often dependent on insulin since their body produces very little or none at all; Type 2 is when the body becomes resistant to insulin; Gestational diabetes develops during a parent's pregnancy (Mayo Clinic "Diabetes").

Scott Hanselman of Microsoft, who is diabetic, explains diabetes using a creative airplane analogy on his blog. Hanselman writes, "You are flying from L.A. to New

York. You have to maintain a consistent altitude the whole way…. Food raises

blood sugar (altitude.) Insulin lowers it. Non-diabetics don’t have to think about altitude, as you all have a working pancreas (autopilot) and don’t sweat altitude. Diabetics, on the other hand, have to constantly wonder if they are at a safe altitude." Hanselman then explains that being at a "high altitude", which is having high blood sugar, can cause sickness, whereas being at a "low altitude" can make you crash (Hanselman).


Who is affected/at-risk?

According to the American Diabetes Association, in 2018, 10.5% of all Americans had a form of diabetes, and "Nearly 1.6 million Americans have type 1 diabetes, including about 187,000 children and adolescents." They also state that "88 million Americans age 18 and older had prediabetes" ("Statistics About Diabetes").

Genetic history, diet, and lifestyle can affect the risk rate of diabetes including relatives with diabetes, fluctuations in weight, high cholesterol, and high blood pressure. Even socioeconomic factors can influence the risk of developing diabetes since health foods are often more expensive and high co-pays make regular screenings and check-ups inaccessible for many.

Diabetes also greatly affects Black, Indigenous, and People of Color (BIPOC). The ADA states, "The rates of diagnosed diabetes in adults by race/ethnic background are:

  • 7.5% of non-Hispanic whites

  • 9.2% of Asian Americans

  • 12.5% of Hispanics

  • 11.7% of non-Hispanic blacks

  • 14.7% of American Indians/Alaskan Natives"

Prevention

You might be wondering if diabetes is genetic; the ADA states, "Type 1 and type 2 diabetes have different causes, but there are two factors that are important in both. You inherit a predisposition to the disease, then something in your environment triggers it" ("Learn the Genetics of Diabetes"). Keep in mind, you can get your blood sugar tested at Health Services at Reedley College.

It may sound like repetitive steps but diet and exercise are truly vital in managing and lowering the risk of developing diabetes! Eating healthier can be difficult for some since a lot of healthy foods tend to be pricier and it may be hard to find the time to meal prep or cook at home but there are food programs - like the new and improved Tiger Pantry, that can help supply groceries. As for exercise, a gym membership is definitely not required to stay fit. Exercise can be everyday tasks like mopping the kitchen floor, gardening, scrubbing those dang hard-water stained shower doors, going for a walk, or playing sports. Movement is key. When muscles start to tire, it helps metabolize sugar.


Expenses

There is an epidemic of diabetes in the USA and a health care system disaster of Americans being unable to afford their life-saving medications and supplies. Many diabetics, especially those with Type 1, rely on insulin to keep their blood sugar in check. According to Benita Lee of GoodRX, the least expensive insulin pen costs $63.95 - that's for one pen that might last a little over a week depending on the recommended dosage. Personally, if I did not have medical insurance, my monthly box of five Humalog insulin pens would cost $709.19.According to a 2018 study, the cost to produce one vial of different kinds of insulin is approximately between $2 to $6 which means that IT SHOULD cost a diabetic $48 to $138 FOR AN ENTIRE YEAR SUPPLY. But the reality of the situation is that one vial of insulin is sold from $160 to $446 which can cost thousands every year for someone living with diabetes (Torres). This is a scary reality that many Americans must face every day.


My Personal Experience

When I first was diagnosed, I took a medication called metformin. These are chalky tablets that help lower blood sugar; however, they made me sick to my stomach and made it difficult to eat. I now use insulin; I don't wear a pump, but I give myself injections from a pen (which are practically painless). I take two types of insulin: Humalog for meals (fast-acting), and Tresiba for sleep (long-acting). I wear a Freestyle Libre glucose sensor on my arm; I scan it (like self-checkout) with my smaller meter and it has given me the luxury of checking my blood sugar as often as I like; however, many diabetics check their sugar by poking their finger and placing their blood on a test strip into a meter (I did this for years). Depending on where my blood sugar is, it can affect my mood, focus, energy and anxiety levels, it can even make me foggy-brained, but checking my sugar often helps me to keep it in control.

What do I do differently?

No sugary drinks like regular soda, boba, or fancy coffees; I've limited my overall sugar and carb intake (though I can always get better at this), and I take supplemental vitamins because insulin can deplete one's body of magnesium (which is an essential vitamin!) (If you are able, get a blood test for vitamin deficiency because being deficient in a vitamin can greatly affect your body!) Most importantly, I live a normal life. Diabetes is like being asthmatic; you have to be careful, treat your symptoms, keep your medication with you, and carry on.


What means a lot to me is when someone remembers that I'm diabetic and takes an interest in it. For example, I have a friend who suggested she would carry candy in her purse just in case my blood sugar dropped. Just the thought of that moves me. If you know someone who is diabetic, it's okay to ask how you can make it easier on them. Remember that they may not be able to eat the same foods as you; also be aware that sometimes their blood sugar can drop and they will need something to bring it back up (fruit juice is usually a go-to choice, but listen to their recommendation). You don't have to feel bad for someone who is diabetic, and don't apply stereotypes to them; not all diabetics are overweight, many are kids or young adults, we're not lazy, and don't assume someone is taking drugs because they could just be taking insulin (this happened to Supreme Court Justice Sonia Sotomayor). When in doubt, Google it, or politely talk to a diabetic loved one about their experience (if they are comfortable doing so). Be sensitive. Be sweet (pun intended).


Informational Videos

A kid-friendly introduction to diabetes: "What Is Diabetes" by Jumo Health


A lecture and interesting analogy to explain diabetes: "Parking Lot Analogy Explained" by Glucose Zone.


A comedic take of understanding Type 1 and blood sugar levels. "If Your Blood Sugar Could Talk [Type 1 Diabetes]" by Between Two Lines.


References/Additional Resources


American Diabetes Association. "Diabetes Symptoms." American Diabetes

Association. https://www.diabetes.org/diabetes/type-1/symptoms

GlucoseZone. "Parking Lot Analogy Explained. 2017. Youtube.

https://youtu.be/vl2F2VUPY9I

Hanselman, Scott. "Scott's Diabetes Explanation: The Airplane Analogy."

Hanselman. 4 May. 2004. https://www.hanselman.com/blog/scotts-

diabetes-explanation-the-airplane-analogy

Lee, Benita. "How Much Does Insulin Cost? Here’s How 27 Brands and

Generics Compare." Good RX. 2020. Nov 6.

https://www.goodrx.com/conditions/diabetes-

type-2/how-much-does-insulin-cost-compare-brands

Mayo Clinic. "Diabetes." N.d. Mayo Clinic.

https://www.mayoclinic.org/diseases-

conditions/diabetes/symptoms-causes/syc-20371444

Torres, Krisi C. "Insulin prices: How much does insulin cost?" SingleCare.

2020. Jan 7. https://www.singlecare.com/blog/insulin-prices/

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