If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

OVERVIEW

What is diabetes?

Diabetes is a disease that occurs when a person’s body doesn’t make or use the hormone insulin properly. It causes too much blood glucose (sugar) to build up in the blood. There are 2 main types of diabetes.

Type 1 diabetes occurs when your body doesn’t produce any insulin. It’s sometimes called juvenile diabetes because it’s usually discovered in children and teenagers, but it may appear in adults, too.

Type 2 diabetes occurs when the body doesn’t produce enough insulin or the body’s cells ignore the insulin. In the past, healthcare providers thought that only adults were at risk of developing type 2 diabetes. However, an increasing number of children in Canada are now being diagnosed with the disease. Healthcare providers think this increase is mostly because more children are overweight or obese and are less physically active.

Pre-diabetes occurs when blood sugar levels are higher than they should be, but not so high that your healthcare provider can say you have diabetes. It greatly increases the risk of developing type 2 diabetes. The good news is that you can take steps to prevent or delay the onset of full-blown type 2 diabetes by making lifestyle changes, such as eating a healthy diet, reaching and maintaining a healthy weight, and exercising regularly.

Can I live a normal life with diabetes?

Yes, you can live a normal life. You can stay healthy if you do what it takes to control your diabetes.

SYMPTOMS

What are the symptoms of diabetes?

Symptoms vary from person to person. The early stages of diabetes have very few symptoms, so you may not know you have the disease. But damage may already be happening to your eyes, your kidneys and your cardiovascular system.

Common symptoms include the following:

• Extreme hunger
• Extreme thirst
• Frequent urination
• Unexplained weight loss
• Fatigue or drowsiness
• Blurry vision
• Slow-healing wounds, sores or bruises
• Dry, itchy skin
• Tingling or numbness in the hands or feet
• Frequent or recurring skin, gum, bladder or vaginal yeast infections

People who have type 2 diabetes may also show signs of insulin resistance, such as darkening skin around the neck or in the armpits, high blood pressure, cholesterol problems, yeast infections and skipped or absent periods in teen girls and women.

If blood sugars are extremely high, people can develop diabetic ketoacidosis (DKA). This is a very dangerous complication of uncontrolled diabetes. People with DKA might have:

• Nausea or vomiting more than once.
• Deeper, faster breathing.
• The smell of nail polish remover coming from your breath.
• Weakness, drowsiness, trembling, confusion, or dizziness.
• Uncoordinated muscle movement

If diabetes is left untreated, your blood sugar levels become too high. When this happens, symptoms may include shortness of breath, pain in the abdomen, vomiting, dehydration, and even coma and death.

CAUSES & RISK FACTORS

What causes diabetes?

Type 1

In type 1 diabetes, your body doesn’t make insulin. This is because the immune system attacks and destroys the cells in the pancreas that make the insulin. Healthcare providers aren’t sure why this happens. You have a greater risk of type 1 diabetes if one of your parents or one of your siblings has it

Type 2

When you eat, your body changes most of the food you eat into glucose (a form of sugar). A hormone called insulin allows this glucose to enter all the cells of your body and be used as energy. Insulin is produced by the pancreas. In someone who has type 2 diabetes, the pancreas doesn’t make enough insulin or the body’s cells can’t use insulin properly (called insulin resistance). This causes glucose to build up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems that may damage the blood vessels, nerves, heart, eyes and kidneys.

Certain risk factors for type 2 diabetes include:

Weight

Obesity is the single most important risk factor for type 2 diabetes. The more overweight you are, the more resistant your body is to insulin. To figure out if you’re overweight, check the chart and contact your healthcare provider. A healthy, low-fat diet and regular exercise can help you lose weight gradually and keep it off.

Age

The risk for type 2 diabetes increases with age, especially after 45 years of age. Although you can’t change your age, you can work on other risk factors to reduce your risk.

Family history

Although you can’t change your family history, it is important for you and your healthcare provider to know if diabetes runs in your family. Your risk for diabetes is higher if your mother, father or sibling has diabetes. Tell your healthcare provider if anyone in your family has diabetes.

Pregnancy

Gestational diabetes is a kind of diabetes that happens only during pregnancy. It occurs in about 4% of pregnant women. Although gestational diabetes goes away after pregnancy, research has shown that 50% of women who had gestational diabetes are diagnosed with type 2 diabetes within 15 years.  Even if they don’t have gestational diabetes, women who give birth to babies who weigh 9 pounds or more are more likely to develop type 2 diabetes later in life.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a condition that occurs when an imbalance of hormone levels in a woman’s body causes cysts to form on the ovaries. Women who have PCOS are at an increased risk of developing type 2 diabetes.

Smoking and Alcohol

Alcohol and tobacco use may increase your risk of type 2 diabetes.

The risk of developing type 2 diabetes increases with the number of risk factors you have. If you have 2 or more risk factors, talk to your healthcare provider about how to delay or prevent type 2 diabetes.

DIAGNOSIS & TESTS

How is diabetes diagnosed?

After examining you, discussing your symptoms, and going over your health history, your healthcare provider may test for diabetes if they suspect you’re at risk. To check for diabetes, your healthcare provider may request the following tests:

• Fasting blood sugar test. This test is usually done in the morning, after an 8-hour fast. This means that you shouldn’t eat any foods or drink any liquids except for water for 8 hours before the test. At the end of the fast, a healthcare provider or nurse measure the amount of glucose in your blood. If your blood sugar level is 7.0 millimoles per litre (mmol/L) or higher, your healthcare provider will probably want to repeat the test. A blood sugar level of 7.0 millimoles per litre (mmol/L) or higher on 2 occasions indicates diabetes. Test results from 6.1 millimoles per litre (mmol/L) to 6.9 millimoles per litre (mmol/L) suggest prediabetes.
• Oral glucose tolerance test. During this test, you will drink a beverage containing 75 grams of glucose dissolved in water. Two hours later, a healthcare provider or nurse will measure the amount of glucose in your blood. A blood sugar level of 11.1 millimoles per litre (mmol/L) or higher indicates diabetes.
• A1C blood test. This test measures the level of glucose in your blood at any time of day, regardless of when you last ate. Combined with symptoms of diabetes, a blood glucose level of 11.1 millimoles per litre (mmol/L) indicates diabetes.

PREVENTION

Can diabetes be prevented or avoided?

Talk to your healthcare provider about your risk factors for diabetes. Although you may not be able to change all of them, you can make changes to significantly lower your risk.

Exercise and weight control. Exercising and maintaining a healthy weight can reduce your risk of diabetes. Any amount of activity is better than none. Try to exercise for 30 to 60 minutes most days of the week. Always talk with your healthcare provider before starting an exercise program.

Diet. A diet high in fat, calories, and cholesterol increases your risk of diabetes. A poor diet can lead to obesity (another risk factor for diabetes) and other health problems. A healthy diet is high in fibre and low in fat, cholesterol, salt, and sugar. Also, remember to watch your portion size. How much you eat is just as important as what you eat.

TREATMENT

The single most important thing you can do is control your blood sugar level. You can do this by eating right, exercising, maintaining a healthy weight and, if needed, taking oral medicines or insulin.

Diet

Your diet should include lots of complex carbohydrates (such as whole-grain breads, cereals and pasta), fruits and vegetables. It’s important to eat at least 3 meals per day and never skip a meal. Eat at about the same time every day. This helps keep your insulin or medicine and sugar levels steady. Avoid empty calories, such as foods high in sugar and fat, or alcohol.

Exercise.

Exercising will help your body use insulin and lower your blood sugar level. It also helps control your weight, gives you more energy and is good for your overall health. Exercise is also good for your heart, your cholesterol levels, your blood pressure and your weight–all factors that can affect your risk of heart attack and stroke. Exercise also seems to make people feel better about themselves and feel less anxious. Talk with your healthcare provider about starting an exercise program.

Maintain a healthy weight.

Losing excess weight and maintaining a healthy body weight will help you in 2 ways. First, it helps insulin work better in your body. Second, it will lower your blood pressure and decrease your risk for heart disease.

Take your medicine.

If your diabetes can’t be controlled with diet, exercise and weight control, your healthcare provider may recommend medicine or insulin. Most people who have type 2 diabetes start with an oral medicine (taken by mouth). Oral medicines can make your body produce more insulin or help your body use the insulin it makes more efficiently. Some people need to add insulin to their bodies with insulin injections, insulin pens or insulin pumps. Always take medicines exactly as your healthcare provider prescribes. Oral medicine doesn’t work for everyone, though. It is not effective in the treatment of type 1 diabetes. Insulin therapy is necessary for all people who have type 1 diabetes and for some people who have type 2 diabetes. If you need insulin, you’ll have to give yourself a shot (either with a syringe or with an insulin pen). Your healthcare provider will tell you which kind of medicine you should take and why.

You will need to use a blood glucose monitor to check your blood glucose on your own. This involves pricking your finger for blood and putting a test strip in the blood. Putting the test strip in the monitor gets the results.

If your blood sugar gets too low, you might feel tired, experience problems with muscle coordination, sweat, have difficulty thinking or speaking clearly, twitch, feel like you’re going to faint, become pale, lose consciousness, or have a seizure. At the earliest sign of any of these symptoms, eat or drink something that will raise your blood sugar fast. This could include :

• Glucose tablets- 3 tablets (5 grams each) (preferred choice)
• Table sugar -15ml or 3 packets dissolved in water
• Non-diet soda – 175 ml/cc (3/4 cup)
• Fruit juice – 175 ml/cc (3/4 cup)
• Honey – 15 ml (1 Tbsp) do not use for children less than 1 year old

If you don’t feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate. Always keep a supply of these items on hand for emergencies.

You may not know if your blood sugar is too high unless you test it yourself. However, you may experience common symptoms such as frequent urination, extreme thirst, blurry vision, and feeling tired. Some factors unrelated to food can make your blood sugar high. This includes not taking your insulin correctly, overeating at a meal, illness, having hormonal changes, and stress.

If your blood sugar level is too high and you take insulin, you may need to take an extra dose of rapid- or short-acting insulin to return it to normal. Your healthcare provider can tell you how much insulin you need to take to lower your blood sugar level.

 LIVING WITH DIABETES

You can live a normal life with well-controlled diabetes. However, you have to pay attention to your diet, weight, exercise, and medicine. If you don’t control your diabetes, you will have too much glucose in your blood. This can lead to serious health problems, including heart disease and damage to the nerves and kidneys. These are known as diabetic complications. Complications include:

Diabetic Neuropathy (nerve damage)

Diabetic neuropathy makes it hard for your nerves to send messages to the brain and other parts of the body. If you have nerve damage, you may lose feeling in parts of your body or have a painful, tingling or burning feeling.  Neuropathy most often affects the feet and legs. If you have neuropathy, you may not be able to feel a sore on your foot. The sore can become infected and, in serious cases, the foot may have to be amputated (removed). People who have neuropathy may continue walking on a foot that has damaged joints or bones. This can lead to a condition called Charcot foot that causes swelling and instability in the injured foot. It can also cause the foot to become deformed. However, this problem can often be avoided. Check your feet every day. If you see swelling, redness and feel warmth in your foot, contact your healthcare provider immediately. These can be signs of Charcot foot. Your healthcare provider should also check your feet frequently.

Erectile dysfunction (in men) and vaginal dryness (in women)

Diabetic Retinopathy (eye problems)

This affects the part of your eye called the retina. The retina is the part of the eye that is sensitive to light and sends messages to your brain about what you see. Diabetes can damage and weaken the small blood vessels in the retina.  When the blood vessels of your retina are damaged, fluid can leak from them and cause swelling in your macula. The macula is the central part of the retina and gives you sharp, clear vision. The swelling and fluid can cause blurry vision and make it hard for you to see. If retinopathy gets worse, it may lead to blindness. Laser surgery can often be used to treat or slow down retinopathy, especially if the problem is found early. People who have diabetes should have an eye exam once a year.

Diabetic Nephropathy (kidney damage)

This is damage to the blood vessels in your kidneys. This means your kidneys have trouble filtering out waste. Some people who have nephropathy will eventually need dialysis (a treatment that eliminates waste from the blood) or kidney transplant. The risk for nephropathy is increased if you have both diabetes and high blood pressure, so it is important to control both of these conditions. Protein in the urine is usually the first sign of nephropathy. This should be checked yearly.

Heart Disease and Stroke

People who have diabetes are at greater risk for heart disease and stroke. The risk is even greater for people who have diabetes and smoke, have high blood pressure, have a family history of heart disease or are overweight. Heart disease is easiest to treat when it is caught early. It is very important to see your healthcare provider on a regular basis. They can test for early signs of heart disease. It’s very important to see your healthcare provider on a regular basis. They can test for early signs of heart disease. This includes checking cholesterol levels. If your cholesterol is higher than the recommended level, your healthcare provider will talk to you about lifestyle changes and medicine to help get your cholesterol under control.

The longer your diabetes is uncontrolled, the more damage you do to your health. That’s why treatment is important at any age. Keeping blood sugar levels very close to the ideal can minimize, delay, and in some cases even prevent the problems that diabetes can cause.

FOR MORE INFORMATION

NS Diabetes Care Program Website
http://diabetescare.nshealth.ca

NS Government Website
http://www.novascotia.ca/dhw/publications/diabetes_fact_sheet.pdf

PEI Government Website
https://www.princeedwardisland.ca/en/topic/diabetes

Diabetes Canada
Nova Scotia and PEI Toll Free: 1-800-326-7712
http://www.diabetes.ca

Public Health Agency of Canada website
https://www.canada.ca/en/public-health/services/chronic-diseases/diabetes.html

Government of Canada website
http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-faits-chiffres-2011/index-eng.php#toc