Type 1 vs. Type 2 Diabetes: Under new management

No doubt, a diabetes diagnosis changes a person’s life.  They may find themselves doing things they’ve never had to do before, like check their blood sugar multiple times a day, count carbohydrates, and perhaps even give themselves insulin shots.  Even starting an exercise plan may be a first for them.  The good news is that diabetes educators are available to help.  They’re health care professionals who teach diabetics how to adjust their lifestyle and behavior so that they can successfully manage their disease. 

Nancy KlugTMC Certified Diabetes Educator

Nancy Klug
TMC Certified Diabetes Educator

TMC Certified Diabetes Educator Nancy Klug developed her passion for educating others about diabetes after two close family members were diagnosed with it.  She’s been helping diabetics understand their disease, and get their blood sugar under control for more than 25 years.  She shares some valuable information about appropriate diabetes testing, and how the disease is managed, as National Diabetes Prevention Month comes to a close.

Type 1 Diabetes

Background:  People with Type 1 diabetes often get strong symptoms that could land them in the Emergency room.  Their blood sugar may be 300 or higher.  Many times they are very sick.  They may be vomiting, and even have trouble breathing.  Other symptoms include increased urination.  They may find themselves getting up many times during the night to use the restroom.  They’re also very thirsty, and extremely tired.  Rapid weight loss is another common symptom we see.  Many times Type 1 affects people who are under age 30.  There is a hereditary factor, but it’s not as strong as it is in Type 2.

Appropriate Testing:  A test called c-peptide is done.  This tells a clinician if the patient is making insulin.  They’ll also do some antibody testing to see if the patient has the antibodies that would kill their beta cells. 

Managing Type 1:  Type 1 diabetics will start on insulin right away.  They’ll need at least four shots a day.  A short-acting insulin at each meal, and then a long-acting insulin.  Or, they may be on an insulin pump.  There is no cure for Type 1, but like Type 2, it can be controlled.

Type 2 Diabetes

Background:  With Type 2 diabetes, there s a very strong hereditary factor, but it is possible for someone to develop it without having a family history.  The tricky part with Type 2 is that oftentimes it’s difficult for people to tell they have the disease, as there are no, or very few, symptoms.  Patients may have to get up in the middle of the night to use the restroom.  They also may be a little thirstier or more tired than usual, and have a wound that is slow to heal.  Unlike Type 1 diabetics, Type 2 diabetics do not have weight loss.  If diabetes goes uncontrolled for several years, complications can develop, including kidney, nerve and eye damage.  The biggest complication, however, is heart attack and stroke.

Appropriate Testing:  A physician who suspects a patient has diabetes will order an A1C test.  The blood test gives the physician an average of the patient’s blood sugar over the last three months.  A non-diabetic person may have an A1C around 4-6 percent.  Prediabetes is 5.7-6.4 percent.  A diabetes diagnosis is 6.5 percent or higher.

Managing Type 2:
  The American Diabetes Association recommends patients start on a medication called Metformin.  Patients are advised exercise at least 30 minutes, five times a week, and attend diabetes education classes where they’ll learn how to count their carbs, and keep them down, along with their saturated fat intake.  Eighty percent of Type 2 diabetics are overweight, so losing even a little weight can be very beneficial. 

The American Diabetes Association (ADA) suggests Type 2 diabetics have a blood sugar range of 70-130 before meals, and 130-180 two hours after meals.  The American College of Endocrinology (ACE) has even stricter guidelines.  They recommend a blood sugar level of under 110 before meals, and under 140 two hours after meals.  At TMC, Klug says they teach patients both sets of guidelines, encouraging them to get into the ADA range first, and then aim for the ACE range.

In conclusion, Klug says, “The good news is that we know how to control diabetes.  Patients have to learn how to do it, but a diabetes educator and their team can work with you.  If you’re able to keep your numbers down, you can minimize the complications and have a fairly healthy life.  There’s nothing that you can’t do with diabetes.  There is no cure, and it will never go away, but you can get it under control.” 

If you or someone you know has diabetes and wishes to speak to a diabetes educator at TMC, please call (520)324-3526 or (520)324-1265.

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Tucson Medical Center | 5301 E. Grant Rd. | Tucson, AZ 85712 | (520) 327-5461
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