Diabetes is a condition where the body’s blood glucose (sugar) levels are too high. Every year, thousands of people with diabetes come through our doors in search of living their healthiest lives. We support them with a variety of treatments ranging from education on how best to manage their condition to insulin pumps and self-monitoring techniques.
Finding your healthy balance to treat diabetes
Glucose is important because it's our cells' main source of energy. But for people with diabetes, too much of a good thing can lead to organ damage and other health risks.
Your pancreas creates a hormone called insulin that allows cells to absorb the glucose from your blood for energy. Think of it like this: Insulin is the key that unlocks the door of your cells to allow for energy absorption. But when your body doesn't produce enough insulin or none at all, your glucose goes unchecked and can build up in your blood instead.
While there are different kinds of diabetes — type 1, type 2, gestational diabetes and pre-diabetes — our goal is to bring balance to your condition with a wellness plan that aligns with your lifestyle rather than defining it.
Dr. Miguel Ariza, Medical Director for the Diabetes and Endocrine Center at Tufts Medicine Lowell General Hospital covers need-to-know facts about diabetes, associated risk factors and how to treat diabetes for a happier, healthier you.
Glucose travels throughout your entire body using your bloodstream. So, high or fluctuating glucose levels can place a lot of stress on blood vessels and ultimately take a toll on your:
- Eyes (diabetic retinopathy)
- Heart (coronary artery disease)
- Kidneys (diabetic nephropathy)
- Nutrition supply to the nerve endings (diabetic neuropathy)
Diabetes can develop at any point in life. It's good to understand the different types of diabetes, so you can take the right steps with your doctor if you're more likely to get it.
Type 1 diabetes
Type 1 diabetes occurs when your pancreas doesn't make enough or any insulin. This means your cells can't get the energy they need because the insulin is like a special "key" that opens the cell doors. It's believed that your immune system accidentally attacks the insulin-making cells in your pancreas.
If diabetes runs in your family, you might have a higher chance of getting it. People living with type 1 diabetes will need insulin injections to keep sugar levels in check.
Type 2 diabetes
Type 2 diabetes is the most common form of diabetes and occurs when your body doesn't respond well to insulin. Imagine the insulin acting as a "key" that doesn't quite fit the lock on your cells' doors. This makes it hard for your body to use glucose for energy.
With type 2 diabetes, you might not even notice any problems for a while – it can be months or even years before any complications surface. There are several root causes for why people develop type 2 diabetes, such as:
- Elevated triglycerides
- Genetic predisposition
- History of gestational diabetes
- Low HDL
- Race and ethnicity
- Sedentary lifestyle
Diabetes + family planning
If you have diabetes and are looking to grow your family, talk with your doctor about how to control your hemoglobin A1C better.
People who have diabetes and become pregnant are considered a high-risk pregnancy. To make sure the parent and baby are as healthy as possible, we'll help manage your condition with diet, exercise, medications and glucose monitoring.
About 7 in 100 pregnant people in the United States develop gestational diabetes during pregnancy. Gestational diabetes presents an increased health risk for the parent and baby, so doctors make it a point to manage the pregnant person's glucose levels carefully.
Typically, a pregnant person is screened for diabetes 2–3 times during their pregnancy.
Diabetes insipidus is a condition in which the kidneys can't conserve water.
A person with pre-diabetes has higher glucose levels than normal but not quite within the diabetic range. They're at a greater risk of developing type 2 diabetes if they practice unhealthy habits like a poor diet and an inactive lifestyle.
It's a smart idea to receive a regular check-up with your primary care doctor. During these appointments, your doctor can perform a fasting blood sugar test or an oral glucose tolerance test — especially if you're at high risk for developing diabetes. People over the age of 45 are more likely to form type 2 diabetes and should receive an annual screening.
The 2-hour post meal glucose level is an important number to know because it identifies how efficiently the pancreas or diabetes medications are working.
The A1C marker represents the glucose average for the past 90 days. Anyone with diabetes or pre-diabetes should know what their A1C value is and share this with all healthcare providers.
Fasting glucose measures blood sugars 8 hours after eating or drinking. We can perform this test in our lab, or you can measure it at home with your home blood glucose monitor.
Known as the happy housekeeper, the high density lipoprotein (HDL) removes bad fats from the bloodstream. The HDL is a number that you would like to be high because a number less than 35 increases the risk of type 2 diabetes.
Triglycerides are typically tested in a lipid panel to measure the level of fats in your blood. You want these levels to remain low.
Elevated triglycerides occur when the liver cannot process carbohydrates properly, or after drinking a lot of alcohol. A number greater than 250mg/dL is a risk factor for type 2 diabetes. The good news is that this number responds quickly to diet, exercise and medication.
This is a lab test that your doctor must order. It requires you to fast overnight, then visit our lab so we can further evaluate your glucose. You will then drink a glucose mixture that will require follow-up testing in 2 hours.
We understand that diabetes can be a lot to manage. At Tufts Medicine, you have a whole healthcare support village behind you. There are a number of ways we can manage and treat your diabetes, like through a combination of insulin pumps, lifestyle changes, self-monitoring methods and medications.
Everyone living with type 1 diabetes and some people with type 2 diabetes will need insulin injections to manage their blood sugar. Giving yourself daily insulin injections can be a time-consuming routine, and missing an injection can have a serious impact on your health.
To help manage your diabetes, an insulin pump may be recommended to continuously release insulin into your body so you don’t have to give injections a second thought.
An insulin pump is a small electronic device that does the work for you. It’s about the size of a deck of cards, attached to a short catheter. You can attach the device itself to your belt or clothes, while the catheter is inserted beneath your skin and pumps insulin into your bloodstream.
If we recommend an insulin pump for you, we’ll train you on everything you need to know about your pump. And as a safety net, you’ll benefit from round-the-clock support in case any issues with your pump arise.
We may pair a continuous glucose monitor sensor (CGMS) with your insulin pump to track your daily blood sugar patterns. This data may help your pump adjust its insulin doses. Many people can benefit from CGMS, especially those having difficulty controlling their glucose.
We can prescribe medications to help control weight, blood glucose, cholesterol and blood pressure. Some oral medications can also help control glucose levels for people living with diabetes.
Lifestyle Coaching Program for Diabetes + Weight Loss
Eating healthy and getting active are key ways to manage your diabetes. Our Lifestyle Coaching Program for Diabetes + Weight Loss will teach you how to make diet and exercise changes to manage your diabetes, prevent health-related complications and possibly even halt the progression of type 2 diabetes altogether.
As part of this program, we'll explore diabetes self-management education and medical nutrition therapy. We’ll connect you to our certified diabetes educators for lifestyle tips and to our dietitians who have special expertise in helping manage blood glucose levels through what you eat and when.
Support groups for diabetes
Living with diabetes can bring changes and challenges to your life that are best understood by others walking in similar shoes. Our support groups offer a safe space to discuss topics and personal experiences.
The Diabetes Self-Management Education (DSME) group is open to people aged 18 and older who are living with any type of diabetes. Group sessions focus on topics like glucose monitoring, nutrition and medication use.
We can give you about 30 trillion reasons why glucose is so important. For starters, that’s the average number of cells in the body that use glucose as their major energy source. However, too much of a good thing can lead to serious health risks. That’s where the hormone insulin comes into play.
Your pancreas creates insulin and releases it into the bloodstream to regulate glucose levels. If your cells are locked doors, then insulin is the key that opens them so glucose can get absorbed for energy. But when your body produces too little or no insulin at all, the cell doors remain locked and glucose continues to build up in the blood instead.
People with diabetes can benefit from the peace of mind an insulin pump offers. The device regulates insulin doses to match what your body needs to maintain balance.
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