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Diabetes Debunked: The Full-Time Job that Comes in All Shapes and Sizes

November 12, 2019

Diabetes can often have a negative connotation; if someone has the disease, it is thought that they brought it on themselves from overeating, says Brianna Hanekom, BSN, RN, CDE, clinical program manager of Nutrition Services at Jefferson Health New Jersey. “This is a common misconception. Diabetes is not limited to one type or cause, and nobody, regardless of body shape, deserves it.”

Diabetes mellitus is one of the most common diseases found equally among men and women in the U.S. It is a group of diseases that cause the inability to produce or respond to the hormone insulin, resulting in the abnormal metabolism of sugars. According to the CDC, approximately 30.3 million people (roughly nine percent of the population) have diabetes, of which 7.2 million people remain undiagnosed and unaware of how to properly manage their health.

Type 1 diabetes occurs in nearly 1.25 million people, of which 1 million people are adults. It’s estimated that there are around 18,000 new cases of diabetes each year.

Living with type 1 diabetes herself, Brianna knows how physically and emotionally exhausting it can be. “It’s important that we raise awareness of what it means to have diabetes. Whether it is type 1 or type 2, it is a 24/7, 365-days-a-year job. It’s even more important that we don’t compare the level of suffering each individual has to go through.”

So, what is different about the way the body works in each type of diabetes?

In type 1, beta cells in the pancreas, which are responsible for creating insulin, are nearly or completely destroyed (resulting in relative or total insulin deficiency).

“Beta cell destruction can take months or years; it’s difficult for us to pinpoint the exact start,” explained Brianna. “Symptoms don’t occur gradually, but abruptly. The individual will experience extreme thirst, frequent urination, and weight-loss. In children, it’s commonly misdiagnosed as the flu, until the child’s health continues to decline.”

Beta cell deficiency can also occur in type 2 diabetes, however, the body’s cells will also be insulin-resistant. “The body makes more and more insulin to encourage the cells to process sugar, but eventually it can’t keep up. Individuals may notice dark spots around their neck, or acanthosis; blurry vision; or wounds that don’t heal,” explained Briana.  

A common precursor to diabetes – often unnoticed for years, because it’s asymptomatic – is prediabetes. According to the CDC, approximately 84 million adults have prediabetes, the majority of which are undiagnosed.

Latent autoimmune diabetes in adults (LADA) is typically diagnosed around or after age 35; because of this, it’s sometimes misdiagnosed as type 2, however it is autoimmune, similar to type 1, and is treated the same.

The only accepted and effective treatment for both type 1 and LADA is insulin injections. For type 2, treatment plans may include weight loss, healthy eating, regular exercise, diabetes medication, insulin therapy, and blood sugar monitoring.

“We approach the risk factors we can modify, and create comprehensive lifestyle changes pertaining to diet and daily routine,” said Brianna.

According to Brianna, teaching about proper portion sizes is often the most eye-opening tool, and is essential for making progress in prevention of both type 2 diabetes and obesity.  “Over time, society and the media have skewed the general public’s perception of what a normal, healthy meal is. We’re focused on getting the most ‘bang’ for our ‘buck,’ when in reality, our bodies can function better on much less.”

Additionally, Brianna notes that healthy food is still not as affordable as junk food, which places individuals of a lower socioeconomic status at a greater risk.

Each person with diabetes may be more or less open to discussing what they go through. If you want to offer a helping hand, do so respectfully, without overstepping, says Brianna. “Don’t try to manage their disease for them. Chances are, they’ve lived with it long enough to know what they’re doing. They can have their cake and eat it too.”