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UPMC Endocrinologist

Understanding and Managing Diabetes
Le Yu Khine, MD
Endocrinology, UPMC

According to the Centers for Disease Control and Prevention (CDC), diabetes affects over 34 million people in the United States or about 1 in every 10 people, and about 20% of those people do not even know they have it. It is the seventh leading cause of death and the number of adults diagnosed with diabetes has more than doubled in the last 20 years.
It’s important to understand what diabetes is, how it affects the body, and ways to prevent and/or manage the condition.
What is Diabetes?

Diabetes is a health condition in which your body has difficulty with insulin, the hormone that helps sugar diffuse into your cells. The insulin either isn’t used properly by your body, or your body simply does not have the ability to produce enough.
There are three types of diabetes:

Type 1 – This is the type of diabetes that occurs as an autoimmune reaction or when your pancreas does not produce insulin. When diagnosed with this type of diabetes, it is likely that you will need daily injections of insulin. Type 1 is usually diagnosed in children, teens, and young adults, but it can develop at any age. It is less common than type 2 — approximately 5-10% of people with diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes, but it can be managed.

Type 2 – This is the most prevalent and preventable type of diabetes. Your pancreas produces insulin, but your body doesn’t respond appropriately – this is known as insulin resistance. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes.

Gestational – Occurs during pregnancy and usually goes away after pregnancy. This affects how your body uses sugar, similar to the other types of diabetes.
How Diabetes Affects Your Health

When you have high blood sugar, or hyperglycemia, your blood vessels may become damaged. This increases the possibility of stroke, heart disease, kidney disease, nerve problems, or vision problems.

In contrast, when your blood sugar is low, your central nervous system can be affected. Early signs of low blood sugar can be weakness, dizziness, headaches, anxiety, and lack of coordination. If your blood sugar level becomes extremely low, you could experience loss of consciousness, seizures, or even death.

Symptoms of diabetes can often go undiagnosed for years and sometimes you may never experience symptoms. Because symptoms can be hard to spot, it’s important to know the risk factors and to see your doctor to get your blood sugar tested if you have any of them.

Type 1 diabetes is believed to be an immune reaction and may be genetic, so risk factors include age and family history. Type 2 diabetes is often related to lifestyle and overall health and wellness with risk factors including prediabetes, overweight, 45 years of age or older, family history of type 2 diabetes, history of gestational diabetes, or if you are African American, Hispanic/Latino American, American Indian, or Alaska Native.

The most common diagnostic test is an A1c. This blood test, which doesn’t require fasting, indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.

An A1c below 5.7% is normal, between 5.7 and 6.4% indicates you have prediabetes, and 6.5% or higher indicates you have diabetes.
Managing Diabetes

Regulation of your blood sugar is key to living a normal life with diabetes. Your doctor will support you through this diagnosis and help create a plan to manage your body’s level of blood sugar. Education of this health condition is one of the main ways of staying on top of it. The more you know about diabetes, the better you can control it.

Healthy eating and physical activity should be a part of everyone’s lives, whether they have diabetes or not. However, the benefits of these practices can make a big difference to those that have been diagnosed. Both eating well and getting active can help improve your body’s levels of glucose, blood pressure, and cholesterol, and help prevent Type 2 diabetes altogether.

If you’re having a difficult time in dealing with new lifestyle changes that are necessary to cope with diabetes, there’s additional help available. Classes, events, and support groups are available to provide extra support and education.

Le Yu Khine, MD, is an endocrinologist with UPMC in North Central Pa. and sees patients at 1100 Grampian Blvd., Williamsport. To schedule an appointment with Dr. Khine, call 570-320-7848. For more information, visit