This post was written based on the appearance of Emily Schroeder, MD, on the program PBS HealthLine.
Diabetes remains one of the most pressing chronic diseases, affecting 38 million Americans. For those at risk or diagnosed with this condition, understanding its risks, management strategies and impact on mental health is key to improving outcomes and leading a long, healthy life.
What is diabetes?
Diabetes is a condition in which the body doesn't correctly process food for energy, leading to elevated blood sugar levels. There are three main types of diabetes:
-
Type 1 diabetes - An autoimmune disorder where the body produces antibodies that destroy the insulin-producing part of the pancreas.
-
Type 2 diabetes - A condition in which the body does not efficiently use insulin created by the pancreas, leading to insulin resistance and elevated blood sugar levels.
-
Gestational diabetes - High blood sugar that occurs during pregnancy is caused by hormonal changes that make the body resistant to insulin. Usually, blood sugar levels return to normal after delivery.
What are the risk factors?
There are different risk factors for type 1 diabetes and type 2 diabetes; however, there is a genetic predisposition for both types. Individuals whose direct relatives have had diabetes are at an increased risk of developing the condition. Additionally, women who experience gestational diabetes, as well as their children, face a higher risk of developing type 2 diabetes later in life.
Other lifestyle and environmental risk factors that contribute to type 2 diabetes include excess weight, a sedentary lifestyle and an unhealthy diet.
What lifestyle modifications can someone diagnosed as a prediabetic make to prevent diabetes?
Prediabetes occurs when blood sugar levels have increased but have not yet reached the threshold for diabetes. Lifestyle changes that can reduce the progression of type 2 diabetes include:
-
Achieving or maintaining a healthy weight - Many studies have shown that even a 5-7% decrease in weight in individuals with prediabetes reduces their risk of developing diabetes.
-
Eating a balanced diet - Ideally, people should get most of their nutrients and calories from whole foods like fruits, vegetables, whole grains, nuts, beans, unprocessed meats and fish. Decreasing the amount of carbohydrates and processed foods consumed helps, too.
-
Increasing physical activity - Experts recommend that most adults aim for at least 150 minutes of moderate-intensity physical activity per week to prevent diabetes and heart disease.
-
Monitoring the ABCs of diabetes - It's essential for everyone, even those not at risk for diabetes, to keep their A1C, blood pressure and cholesterol levels within their target ranges for overall health.
These recommendations may vary depending on individual health goals or other preexisting medical conditions. It's important to discuss specific strategies with a physician or advanced practice provider to ensure that dietary and exercise changes promote safe and sustainable progress.
Can lifestyle modifications reverse diabetes?
For some, losing excess body weight and changing their diet can help reverse the insulin resistance in type 2 diabetes and restore their blood sugars to normal. Although many people experience positive outcomes, reversing type 2 diabetes is not always possible. In such cases, a provider may recommend medication or alternative interventions to manage the disease effectively. Along with insulin injections, medications for type 2 diabetes include those that can improve the body's use of insulin, block glucose reabsorption in the kidneys, slow food digestion, and suppress appetite by decreasing hunger signals in the brain.
Unlike type 2 diabetes, type 1 diabetes is not reversible through lifestyle modifications. However, in 2023, the U.S. Food and Drug Administration approved islet transplantation for treatment of type 1 diabetes. This procedure transfers healthy insulin-producing cells from an organ donor's pancreas into a vein that carries blood to the liver of a person with type 1 diabetes. The islets then produce and release insulin in the recipient's body. Currently, this procedure is only approved for the treatment of adults with type 1 diabetes who are unable to approach target blood sugar levels due to recurrent episodes of severe hypoglycemia despite intensive diabetes management and education. When detected early, it may be possible to delay the onset of type 1 diabetes through a medication (TZIELD® (teplizumab-mzwv)), which works to preserve pancreatic function. This medication is approved for children 8 years or older.
For more on slowing the progression of type 1 diabetes, read this post.
How do diabetes and mental health intersect?
Managing chronic diseases can be stressful. Diabetes, in particular, requires constant blood sugar monitoring, medication adherence, and maintaining a healthy diet and exercise routine. This added toll can lead to diabetes burnout or worsen existing mental health conditions like depression and anxiety. When this happens, it becomes increasingly difficult to stick to essential self-care practices.
Signs of diabetes burnout include:
-
Disconnection from concerns
-
Feelings of hopelessness
-
Isolation or sharing negative or self-blame thoughts
-
Disengagement from self-care tasks
-
Unhealthy or uncontrolled eating
-
Missing clinic appointments.
Stress management techniques like meditation, yoga or spending time in nature can be effective tools for coping with these challenges. If feelings of distress persist, it's crucial to share these concerns with a primary care physician. They can offer additional resources for support or help develop a more sustainable care regimen.
Learn more
Living with diabetes or supporting a loved one with the condition can feel overwhelming at times. The Diabetes Care Team at Parkview is here to provide comprehensive education, support and empowerment for those with diabetes. For more information about available programs and resources, call Parkview Diabetes Care Services at 260-373-4280 to speak with a diabetes educator, registered dietitian or lifestyle change specialist.
