- A 44-Year-Old Woman With Type 1 Diabetes and a Recent History of Diabetes “Out of Control”
Home / Health / The Type 2 Diabetes Symptoms that You Should Not Ignore
- Excessive thirst
- Blurry vision
- Rapid weight changes
- Nerve pain and numbness
- Unexplained symptoms of intoxication
- Visit your doctor walk-in clinic for help with diabetes self-management
- 9 Signs Your Blood Sugar Is Out of Control
- ‘Controlled’ Means Different Things to Different People
- Getting high blood glucose into control
- 5 Complications of Uncontrolled Type 2 Diabetes
- 1. Skin conditions
- 2. Vision loss
- 3. Nerve damage
- 4. Kidney disease
- 5. Heart disease and stroke
- The takeaway
- Keith’s story
- Is it a misconception when people say that managing diabetes is out of their control?
- Signs that your diabetes is not under your control
- Other signs that your diabetes is out of control
- Tips to bring it under your control
- Over to you
- UNDERSTANDING TYPE 2 DIABETES
Ask the experts
I’ve been diagnosed with hyperglycemia as a result of my diabetes. It can come on suddenly. What does it feel like when your blood sugar is too high?
In addition to having elevated levels of glucose in the blood, people with hyperglycemia often have glucose detected in their urine (glycosuria). Ordinarily urine contains no glucose because it is reabsorbed by the kidneys.
The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Other symptoms that can occur with high blood sugar are:
- Blurred vision,
- Trouble with thinking or concentrating
Severely elevated blood sugar levels can result in a medical emergency (“diabetic coma”). This can occur in both people with type 1 and those with type 2 diabetes. People with type 1 diabetes may develop diabetic ketoacidosis (DKA), and those with type 2 diabetes can develop hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemi hyperosmolar state). These so-called hyperglycemia crises are serious conditions that can be life threatening if not treated immediately. Hyperglycemic crises cause about 2,400 deaths each year in the U.S.
Over time, hyperglycemia can lead to damage to organs and tissues. Long-term hyperglycemia can impair the immune response, leading to poor healing of cuts and wounds. It can also cause nerve damage, vision problems, and damage to the blood vessels and kidneys (see below).
For more information, read our full medical article on hyperglycemia.
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A 44-Year-Old Woman With Type 1 Diabetes and a Recent History of Diabetes “Out of Control”
The dietitian asked K.P. to fill out a questionnaire at the beginning of her visit. She indicated the following:
Do you feel full before you’ve eaten much? Yes.
Have you had any changes in appetite recently? Yes.
Have you gained or lost weight recently? Yes.
Do you have any unexplained trouble controlling your blood sugars? Yes.
Do you have any of the following symptoms: bloating, heartburn, abdominal cramping? Yes.
Do you have unexplained nausea? Yes.
Do you have unexplained vomiting of undigested food, especially in the morning? No.
Have you had any diarrhea or constipation recently? Is it alternating? No.
K.P. was very upset that she was experiencing blood glucose fluctuations, which did not make any sense to her. The dietitian asked her to keep detailed food, exercise, and self-monitoring of blood glucose (SMBG) records for the next week. (See Figure 1.)
K.P.’s pre-treatment SMBG records. This pattern shows a typical elevated fasting blood glucose level. Two h postprandially, when nutrient absorption is at its peak (assuming a low-fat meal), the blood glucose drops considerably more than the 30–50 mg/dl expected, and yet rises to high levels before the next meal with no additional food intake.
At the next visit, these records were evaluated. They showed low blood glucose levels 1–2 h after meals. The blood glucose levels did not seem to correlate with the expected absorption of nutrients postprandially or with the action of the insulins.
K.P. had some hypoglycemia unawareness, but if she was not very busy, she was able to recognize the subtle cues that she now has with hypoglycemia.
A drug history revealed no use of narcotics, tricyclic antidepressants, or anticholinergics, which might affect stomach motility. Although high-fat meals can cause the same pattern of delayed emptying and later rise in blood glucose, K.P. recorded that she ate low-fat meals. It was suspected that she had diabetic gastroparesis.
The referring physician was consulted and ruled out anemia and celiac disease. He then decided on an empiric trial of a promotility agent and nutrition recommendations as suggested by the dietitian. The nutrition recommendations for mild gastroparesis were as follows:
Eat six or more meals/day.
Avoid foods high in fat, and avoid adding too much fat to foods.
Avoid high-fiber foods.
Chew food well.
Sit up after meals; don’t recline for 1 h following a meal.
Walk after meals when possible to enhance stomach emptying.1
In addition, a new insulin regimen was recommended. K.P. was instructed to increase the frequency of her SMBG, decrease her ultralente dose by 10% before bed, and give a divided rapid-acting insulin bolus—half immediately after the meal and half 2 h postprandially. The rapid-acting insulin bolus was calculated for the grams of carbohydrate in each meal, with any correction factors for high blood glucose added. Figure 2 shows K.P.’s post-treatment SMBG records.
K.P.’s post-treatment SMBG records. This pattern shows a more normalized blood glucose excursion achieved by 1) decreasing ultralente and thus decreasing rebound (one cause of high fasting blood glucose) resulting from low blood glucose levels throughout night, and 2) giving split rapid-acting insulin boluses, one after the meal and another 2 h postprandially.
Although there is a lack of evidence-based nutrition interventions for gastroparesis in diabetic patients, the following nutritional guidelines may be effective:5
Early satiety is one of the hallmarks of gastroparesis. Because larger volume of foods slow gastric emptying, smaller more frequent meals may help.
Liquids usually empty from the stomach more easily and rapidly than solids. Solids require normal functioning of the antrum and fundus for churning, mixing, and exiting. Because patients often report increased fullness as the day proceeds, consuming mostly liquids toward the end of the day may be considered.
Fiber, especially pectin, is known to slow stomach emptying. If bezoar formation is a concern, patients should avoid oranges, persimmons, coconuts, berries, green beans, figs, apples, sauerkraut, brussel sprouts, potato peels, and legumes.
Fatty foods or foods with a significant amount of fat added to them exit the stomach more slowly and may be poorly tolerated. However, many patients tolerate fat in liquid form, such as milkshakes, whole milk, and nutritional supplements.
Other methods of insulin treatment may be used to help with gastroparesis. Some patients benefit from taking a bolus of half rapid-acting and half regular insulin after meals. For patients on an insulin pump, a dual wave may be used to more closely approximate the rise in blood glucose seen with delayed absorption. For patients who use insulin injections, the rapid-acting insulin or regular insulin given with a meal may be divided, with half given as the patient eats and half given 1–2 h postprandially.
Home / Health / The Type 2 Diabetes Symptoms that You Should Not Ignore
Until you know what to watch for, many type 2 diabetes symptoms could get ignored and brushed off. It is important to educate yourself on the symptoms you should not ignore, to help prevent severe diabetes complications from developing.
Many symptoms caused by type 2 diabetes act as a warning system to alert you to the problem – unless they go undetected, that is. The symptoms can start subtly, leading you to believe that you are just overworked, tired or out of shape. Without prompt treatment, however, your blood sugar levels could rise out of control and cause severe complications. You can remain vigilant about protecting your health by learning all about the type 2 diabetes symptoms that you should not ignore.
When you suffer from elevated blood sugar levels, excessive thirst indicates that your body is out of balance. Your kidneys process all that excess glucose in your blood, which increases your urine output. As a result, you can quickly become dehydrated as your body struggles to eliminate the high glucose levels.
Sustained high glucose levels can have a traumatic impact on the health of your eyes as well. You may start to experience blurry vision as your lens swells from the thickened glucose-laden blood circulating through your body. You need to act fast to reverse this condition with great diabetes self-management or you could lose your good vision permanently.
Rapid weight changes
Without excellent blood sugar control, your body turns to your muscles and fat for energy. You might notice a sudden decrease in weight as this starts to occur. A loss rate of more than 10 pounds in a six-month period indicates the need to report your symptoms to a doctor right away.
Nerve pain and numbness
A mild case of nerve pain and numbness can be a cause for concern when caused by uncontrolled blood sugar levels. The pain and other symptoms result from damage to the nerve fibers throughout the body. You have to bring your blood sugar levels into a healthy range to prevent this condition from progressing.
Unexplained symptoms of intoxication
If a stressful event or carb-heavy meal throws your blood sugar levels severely out of range, you might exhibit otherwise unexplained symptoms of intoxication, such as slurring your words, stumbling, and confusion. These symptoms are a serious warning sign that you may be lapsing into a diabetic coma. You must immediately receive medical assistance at your local emergency department at the start of these symptoms.
Visit your doctor walk-in clinic for help with diabetes self-management
If you have a high risk of developing type 2 diabetes, watch for key warning signs and talk with your doctor in Arkansas to see how to prevent this condition. As your trusted place to get a physical and healthcare, our Arkansas doctor walk-in clinic is here to serve your diabetes self-management and prevention needs. Visit your ARcare doctor walk-in clinic or schedule your appointment today by calling (866)-550-4719 to manage your health.
9 Signs Your Blood Sugar Is Out of Control
Blood sugar (glucose) control is crucial when you’re living with type 2 diabetes. Dips and spikes can not only make you feel cranky and sluggish, but they can also wreak havoc on your personal health. (No wonder your primary care doctor was on you about your last A1C checkup.)
The most serious effects of blood sugar swings are a higher risk for diabetes-related health complications such as stroke, heart disease, and nerve damage (neuropathy).
For the record, the American Diabetes Association (ADA) notes that you have diabetes if one of the following applies to you:
- Your blood glucose after fasting (and before a meal) is 126 milligrams per deciliter (mg/dl) or higher.
- Your blood glucose two hours after eating a meal is 200 mg/dl or higher.
- Your hemoglobin A1C (a two- to three-month average measure of how much glucose attaches to the hemoglobin in your red blood cells) is 6.5 or higher.
The tricky part is that with type 2 diabetes you may not feel it when blood sugar levels are too high, according to the ADA. It feels different for everyone. “Not everyone will have the same symptoms, and some individuals will have no symptoms at all,” says Lori Zanini, RD, CDE, a Los Angeles–based former spokesperson for the Academy of Nutrition and Dietetics.
RELATED: The Best and Worst Foods to Eat in a Type 2 Diabetes Diet
Because blood sugar management is so important to your overall health with type 2 diabetes, you need to take action if you think your levels may be out of control, even if you’re feeling totally fine.
“Symptoms of uncontrolled diabetes may not appear until prolonged hyperglycemia (high blood sugar) has been present,” says Mary Ann Emanuele, MD, an endocrinologist, professor, and medical director of inpatient diabetes at Loyola University Medical Center in Maywood, Illinois. She adds that if your healthcare team determines your glucose isn’t well controlled, adjusting your medication with their help can make a difference.
RELATED: 9 Reasons You May Need to Change Your Type 2 Diabetes Treatment
‘Controlled’ Means Different Things to Different People
There’s no one-size-fits-all recommendation for blood sugar control.
The ADA says that a “reasonable” goal for many nonpregnant adults is to aim for an A1C level of less than 7. Yet some patients may be given a more stringent goal by their healthcare providers, such as 6.5, if that’s reachable without harmful side effects, including hypoglycemia.
On the other hand, if you are elderly, managing other health complications, or reliant on insulin, you may be given less stringent goals. “It really becomes more important to just keep in the same place,” says Rahil Bandukwala, DO, an endocrinologist at MemorialCare Saddleback Medical Center in Laguna Hills, California. “Keeping A1C between 7.5 and 8.5 may be very reasonable for such a patient,” Dr. Bandukwala adds, echoing the ADA’s recommendations.
Because elderly people are more likely to have blood sugar that swings too far downward, with fewer warning signs, managing their glucose too tightly can put them at greater risk for hypoglycemia, says Bandukwala. When you have low blood sugar, you’re at a higher risk for becoming dizzy and falling or passing out, notes the ADA.
RELATED: 10 Warning Signs of Low Blood Sugar
The mood-altering effects of high blood glucose are well known to the loved ones of persons with diabetes and well documented by research. But the biological nuts and bolts behind the emotional response aren’t well understood. Also well documented is the fact that high blood sugar causes depression and negatively affects rapid thinking and decision-making skills.
The theories that have been floated to explain the mood-altering effects of high blood sugar range from the mundane theory that because the brain is dependent on a steady supply of glucose for energy, changes in blood glucose concentration rapidly affect cerebral function; to middle-of-the-road theories that high blood glucose affects nerve conduction velocity in the brain; to more exotic theories that the effects are the result of complex relationships between little known hormones and proteins.
But when you consider all the other biological manifestations of high blood sugar — the three polys, infections, slow healing of injuries, itchy skin, blurred vision, headaches, fatigue, and gastrointestinal distress — is it any wonder we might be irritable?
Getting high blood glucose into control
While the causes that lie behind the symptoms of high blood glucose are fascinating, the real value of symptoms is in the message they carry: Blood glucose is too high. The symptoms are warning signs, and we ignore them at our peril. High blood sugar does more than trigger biological and chemical processes that make you feel crummy; over time, high blood glucose causes permanent damage to the body.
But you have it in your power to make the symptoms go away, and to keep them from coming back, by keeping your high blood sugar in control. And you’re not alone in this task. Talk to your doctor. Make time to see a diabetes educator. Ask your family members for their support in helping you to eat right and keep active. Use the tools available to you, such as your blood glucose meter, to see whether your numbers are in target range most of the time. If they are not, talk to your medical team about adjusting your therapy. And keep reading Diabetes Self-Management!
Want to learn more about dealing with high blood sugar? Read “Managing Hyperglycemia,” “Strike the Spike II: Dealing With High Blood Glucose After Meals” and “What is a Normal Blood Glucose Level?“
En Español: Síntomas de un Nivel Alto de Azúcar en Sangre: Causas, Síntomas y Tratamiento
5 Complications of Uncontrolled Type 2 Diabetes
Do your blood glucose levels regularly fall outside your target range? That’s a sign of poorly controlled diabetes. When left uncontrolled, diabetes can cause serious health problems. That’s true whether you have type 1 or type 2 diabetes. However, with type 2 diabetes, lifestyle changes can make a big difference in helping to get your blood glucose levels under control.
Your recommended treatment plan for type 2 diabetes may include healthy lifestyle choices, such as exercising regularly and eating a well-balance diet. Learn about five complications associated with uncontrolled type 2 diabetes, and why it’s so important to follow your treatment plan.
1. Skin conditions
Poorly controlled diabetes puts you at higher risk of bacterial and fungal skin infections. It can also lead to other diabetes-related skin conditions, such as eruptive xanthomatosis.
Diabetes-related complications can cause one or more of the following skin symptoms:
- redness or discoloration
- scaly, shiny, or raised patches
- rashes, blisters, or boils
- styes on your eyelids
- inflamed hair follicles
- firm, yellow, pea-sized bumps
- thick, waxy skin
To lower your risk of skin conditions, follow your recommended diabetes treatment plan and practice good skin care. A good skin care routine may include keeping your skin clean and moisturized, and checking for signs of injury. If you develop symptoms of a skin condition, make an appointment with your doctor.
2. Vision loss
Uncontrolled diabetes increases your chances of developing several eye conditions, including:
- glaucoma, which happens when pressure builds up in your eye
- cataracts, which occur when the lens of your eye becomes cloudy
- retinopathy, which develops when blood vessels in the back of your eye become damaged
Over time, these conditions can cause vision loss. Fortunately, early diagnosis and treatment can help you maintain your eyesight. In addition to following your recommended diabetes treatment plan, make sure to schedule regular eye exams. If you notice changes in your vision, make an appointment with your eye doctor.
3. Nerve damage
According to the American Diabetes Association (ADA), about half of people with diabetes have nerve damage, known as diabetic neuropathy.
Several types of neuropathy can develop as a result of diabetes. Peripheral neuropathy can affect your feet and legs, as well as your hands and arms. Potential symptoms include:
- burning, stabbing, or shooting pain
- increased or decreased sensitivity to touch or temperature
- loss of coordination
- slow-healing sores
Autonomic neuropathy can affect your digestive system, bladder, genitals, and other organs. Potential symptoms include:
- loss of control of your bladder or bowels
- frequent urinary tract infections
- erectile dysfunction
- vaginal dryness
- increased or reduced sweating
Other types of neuropathy can affect your joints, face, eyes, or torso. To lower your risk of neuropathy, keep your blood glucose levels under control. If you develop symptoms of neuropathy, make an appointment with your doctor. They might order tests to check your nerve function. They should also conduct regular foot exams to check for signs of neuropathy.
4. Kidney disease
High blood glucose levels increase the strain on your kidneys. Over time, this can lead to kidney disease. Early-stage kidney disease usually causes no symptoms. However, late-stage kidney disease can cause:
- fluid buildup
- loss of sleep
- loss of appetite
- stomach upset
- trouble concentrating
To help manage your risk of kidney disease, it’s important to keep your blood glucose and blood pressure levels under control. There are also medications that can help slow the progression of kidney disease. You should also visit your doctor for regular check-ups. They can check your urine and blood for signs of kidney damage.
5. Heart disease and stroke
In general, type 2 diabetes increases your risk for heart disease and stroke. However, the risk may be even higher if your condition isn’t well-controlled. That’s because high blood glucose damages your cardiovascular system over time.
People with diabetes are two to four times more likely to die from heart disease than people who don’t have diabetes. They’re also one and a half times more likely to experience a stroke than those who don’t diabetes.
The warning signs of stroke include:
- numbness or weakness on one side of your body
- loss of balance or coordination
- difficulty talking
- vision changes
If you develop warning signs of a stroke or heart attack, contact your local emergency medical services (911) immediately.
The warning signs for a heart attack include:
- chest pressure or discomfort
- shortness of breath
To lower your risk of heart disease and stroke, it’s important to keep your blood glucose, blood pressure, and cholesterol levels in check. It’s also important to eat a well-balanced diet, get regular physical activity, avoid smoking, and take medications as prescribed by your doctor.
Uncontrolled diabetes can cause serious complications. These complications can potentially lower your quality of life, raise your risk of disability, and increase your chances of early death.
Fortunately, you can take steps to manage your diabetes and lower your risk of complications. Follow your doctor’s recommended treatment plan to keep your blood glucose levels under control. For type 2 diabetes, a treatment plan may include lifestyle changes, such as a weight loss program or increased exercise. Your doctor can provide advice about how to make these changes, or refer you to other health professionals, such as a dietician.
If you develop signs or symptoms of type 2 diabetes complications, make an appointment with your doctor. They might order tests, prescribe medications, or recommend other treatments to help manage your symptoms. They might also recommend changes to your overall diabetes treatment plan.
It’s easy to get discouraged when you must deal with your diabetes day in, and day out. With the usual life stressors, the prescription is always “Get away from what is causing you stress for awhile.”
That doesn’t work with diabetes, because if we step away from it and we don’t pay attention to it, or manage it well, we are looking at possible long-term complications.
If you have managed to ignore your diabetes symptoms, the complications that can occur from uncontrolled diabetes are impossible to ignore. What’s more, they can decrease the quality of life that you enjoy, and put you more at risk for an early death related to your diabetes.
Diabetes complications are no joke. They include heart disease, stroke, blindness, loss of limbs from nerve damage, poor circulation, wounds that won’t heal, and more.
They can even cause you to lose your hearing, or have the debilitating gastrointestinal issues that come with nerve damage from diabetes (gastroparesis). The long-term effects of diabetes that is unmanaged can affect every organ and system in the body adversely.
Keith came in after three calls for diabetes education, and two missed appointments. He looked frustrated, and didn’t seem engaged. Keith has had Type 1 Diabetes for the last 12 years. He is now 32 years old, and works the night shift, where his supervisor gives him a difficult time by not allowing him breaks to take care of his diabetes.
Keith has been in and out of the hospital with diabetic ketoacidosis four times in the last six months. Admittedly, Keith has not been taking his insulin as directed by his doctor. His insulin pump failed six months ago, which was what landed him in the hospital the first time.
Now, Keith is afraid of insulin pump therapy, and states he would rather give multiple injections. Still, Keith admits that most of the time lately, he just wishes that he didn’t have diabetes. He’s tired of dealing with it, and he has been letting his guard down on his diabetes management.
At this rate, Keith is indeed headed for a diabetic coma that he wouldn’t come out of if he doesn’t change his attitude towards his diabetes very soon. Digging deeper into Keith’s life, he stated that he didn’t see much reason to keep trying as he felt hopeless, and was feeling down and depressed up to four days out of a week.
When thinking of a prescription that could help Keith, diabetes education is not one. Why? It will not help Keith because he has had diabetes education, and he is able to recall all information related to his diabetes management, so understanding his diabetes is not part of Keith’s problem.
In exploring what might help Keith, he was offered several things that might help. One was a diabetes support group that met in the evenings at a local church. There, Keith would meet other people with Type 1 Diabetes. The group had three Type 1s, and a total of 10 members.
Keith also accepted a mental health referral, so he can talk to someone about his hopeless feelings, and to learn to deal with his depression. We scheduled another visit in a month, to check his progress.
Keith agreed to take his insulin injections as directed in the meantime, and was looking for another job that would better suit him with diabetes that didn’t include the night shift, and an unsupportive supervisor.
One month later, Keith had attended the support group, and been to counselling. He stated that he hadn’t missed his insulin injections, hadn’t been back in the hospital again with DKA, and his blood sugar logs and A1C looked much better.
Sometimes, noncompliance in the patient with diabetes comes from depression. Keith started an anti-depressant treatment, and he went to counselling twice weekly. The counselling, along with the support group, gave him hope to begin taking care of himself again.
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Is it a misconception when people say that managing diabetes is out of their control?
There are many reasons that can make people feel that their diabetes is out of their control. Depression and hopelessness play a big part. People with diabetes tend to have more depression symptoms than people without a chronic illness.
Often, people need education related to their diabetes, and how to better manage it. Once they learn these skills, they can then often become engaged in their healthcare.
In other situations, such as with Keith, they know what to do about their diabetes, but they stop doing it. This can occur after a number of years with diabetes, and can be referred to as “diabetes burn-out.”
Diabetes is a controllable disease
Diabetes is a chronic disease that can be controlled. It’s not easy for people who must take multiple injections or perform other taxing diabetes care to stay on their game all the time. Diabetes burn-out is real, and it affects many people with diabetes, both Type 1 and Type 2.
Sometimes, no matter how much a person tries to manage their diabetes, the situation can take a turn for the worse. This could be due to not understanding what you need to manage your diabetes, deciding that you will not “do diabetes” for awhile, and just ignore it, or when your medications and treatments are not adjusted correctly to your needs.
It can also occur from repeated attempts to get things right, that result in the person with diabetes feeling like they have failed. When incentive to do better is removed, there is no more motivation to try. This can certainly affect the way people with diabetes view their condition, and how much they tend to it.
Lots of planning and caution goes into managing diabetes
Taking care of diabetes is a lifelong process once the person is diagnosed. In some cases, they may be able to reverse their Pre-Diabetes or Type 2 Diabetes, but not with a person with Type 1 Diabetes, that must take insulin to survive.
Similarly, some people with Type 2 Diabetes who take insulin or multiple medications, can have a difficult time getting good control. When this happens over time, and the person feels helpless, they will sometimes give up.
When people get tired of planning their day to day diabetes management, and letting down their caution with relation to high blood sugars, they can put their health at great risk.
Signs that your diabetes is not under your control
The three main signs that your body may give you when your diabetes is out of control are referred to as the “3 Polys,” or the cardinal signs of diabetes.
Polyuria (excessive urination)
When your blood sugar is floating in your blood, and it can’t get into your body cells to be used for energy, it must go somewhere. Your kidneys get rid of it for you through your urine. This results in excessive urination, or polyuria.
Polydipsia (excessive thirst)
When your kidneys send all the blood sugar out through your urine with polyuria, you also get extremely thirsty. You may have one hand on the bathroom door, and one hand holding a jug of water. It can be that severe with excessively high blood sugars.
Polyphagia (excessive hunger)
Your body cells are starving, so even though you have high blood sugar, and you have the sugar that you need in your blood stream to feed your body cells, there isn’t any or enough insulin to get the blood sugar where it needs to be.
This causes excessive hunger, or polyphagia. If you continue to eat with high blood sugar and not enough insulin to deal with it, then you will have an even higher blood sugar.
Other signs that your diabetes is out of control
When blood sugar sits in the blood stream, and it can’t get into the cells of your body to be used for energy, it makes you feel lethargic. Fatigue and low energy can be a sign that your blood sugars are too high, and your diabetes is out of your control.
Blurred vision, or visual changes
If you are having trouble with your vision fading in and out, and sometimes your vision is fuzzy, then your diabetes may be causing the lenses in your eyes to swell, and lose their sharp focusing capabilities. High blood sugars over time can cause blindness, but prior to that, an out of control diabetes can cause a number of visual problems, including glaucoma.
All the hunger that results from high blood sugars causes you to eat more. The fact that your body cells aren’t getting the sugar for energy causes your body to shift to burning fat and muscle for energy.
Even though you are eating more and more, you still lose weight. Loss of muscle mass causes problems with the ability to stand and balance, and the person with diabetes may have muscle aches, and weakened muscles.
Dry skin and skin changes
There are numerous problems that can develop with the skin as a result of diabetes. By far, the most common is dry skin. Dry skin can break down and cause an area of open skin, which then can be difficult to heal. In addition, skin tags can develop.
There is also a condition known as Acanthosis Nigricans, which is the development of darkly pigmented skin on the back of the neck, hands, face, or palms, of a person with diabetes. This is due to high blood sugars, and deposits left in skin.
People with diabetes get skin infections much more often than the general population. If you see problems developing with your skin, no matter how mild and you have diabetes, then make sure to talk with your healthcare provider.
Cuts and sores that won’t heal
Decreased circulation to the arms, and especially the lower legs, along with nerve damage from diabetes, can cause even small cuts and scrapes to cause a problem. High blood sugar is like syrup going through the blood stream, and when it gets in the tiniest veins in the tips of your toes and fingers, it makes the wound bed sweet and sticky.
A sweet and sticky wound bed promotes the growth of bacteria, and infection can progress to gangrene, and amputation quickly. The story of Henrico, in our article, “Diabetes and Hispanic Farmworkers: A Family Affair,” illustrates how quickly a small blister can become gangrenous, and require amputation. Once an amputation is performed, life expectancy is decreased to approximately five years.
Numbness and loss of feeling in the extremities
People with diabetes who develop tingling in their feet and hands, or even the lips are usually experiencing diabetic neuropathy. Nerve damage from diabetes makes it harder to feel if you injure your extremities, so it’s important to check your feet every single day when you have diabetes. Numbness can develop into severe pain, as nerve damage from diabetes becomes worse. 1
Tips to bring it under your control
Since we now know what can happen if we don’t keep our blood sugar under control, let’s look at some tips to get it in control before you develop any of the complications listed below. If you don’t do something now, these complications may creep up on you over time. Once you have the complications, there is no reversing them, but you can do something to prevent them now by being proactive.
Check blood sugars often, and use your results
It’s great to check your blood sugars regularly. If you check them, but don’t use your results to better manage your diabetes, then you are missing the point. It’s not just a number to show your doctor once every three months, so that he or she may adjust your medications.
When you check your blood sugars, you can look at your results, and better figure out how to balance your intake of carbohydrates with your activity. You can decide to take an extra walk if they are high, add in a morning snack for a mid-morning low, or plan to eat less carbohydrates the next time for a high blood sugar.
Check blood sugars for issues at different times of the day
If you check your blood sugar only once or twice a day, and affording blood sugar testing strips is an issue for you, then you can check at different times of the day in order to learn your blood sugar patterns. For example, if you check once daily, on Monday check your fasting blood sugar. On Tuesday, check two hours after breakfast, and on Wednesday, check two hours after lunch. On Thursday, check two hours after supper, and then on Friday, check a fasting blood sugar, and repeat.
This way you will have some readings at all times of the day, which will make it easier to spot your patterns, and make adjustments that better get your diabetes managed.
Get back to the core of your original diabetes education goals
Did you always count carbohydrates faithfully, and now have gotten off your game, and are just eye balling things? If you aren’t truly counting your carbohydrates, then get back to it. Think about the motivation that you once had, how you obtained it, and what you could do to get it back.
Take a diabetes education refresher course, or join a support group
If you know you just need a little extra boost, then getting your two hours of diabetes education that is part of your insurance benefit each year may be all it takes to get your management going again.
Learn your diabetes numbers
If you don’t know what your A1C is, then ask your doctor for your number. Find out how far you need to get it down, so that you will have managed diabetes. In addition, work on getting your blood sugars in your target range. Speak to your Certified diabetes educator, or your healthcare provider to learn what your targets are.
You will also need to know your blood pressure and cholesterol numbers, and work to get those under normal limits, by eating healthy fats, watching your salt intake, and getting enough exercise.
Get a new prescription for exercise
Join a walking group, or ask a family member to participate in physical activity with you. Chances are, there are some people to ask who are just waiting for someone to help them with an extra push to get started. Try new activities, and use exercise for what it really is: the very best prescription for your diabetes.
If you’re not sure that you’ll be safe to move, see your doctor for a physical therapy evaluation to make a plan that will work to get your diabetes in control, without injuring yourself in the process.
Not only will exercise help your diabetes management, but it will also help your outlook on life, as exercise helps the brain to release chemicals that help us to be happier.
Speak to a professional if you feel too depressed to deal with your diabetes
If you know what to do about your diabetes, and you have simply lost your motivation to do it, then seeing a professional about your issues may be the best thing to do. You should speak with your Diabetes Care Team about a counsellor near you, a support group, or both.
Do whatever you need to do to get your motivation back. Your diabetes management is important, and it affects your health and lifespan. Good luck in your efforts to jumping back on the diabetes wagon. If you fall off, get up, brush yourself off, and move on. Taking care of your diabetes can mean that you live healthy with it. 2
What can happen if your diabetes is always out of control?
Diabetes affects the entire body, including all the organs and vessels that feed them. Down to the tips of your toes, your diabetes can affect your circulation. With circulation issues, and nerve damage from diabetes, you may have a non-healing ulcer that progresses to gangrene, and amputation.
You can lose your hearing with diabetes, and this is somewhat of an unknown complication. It rarely gets attention. Loss of hearing with diabetes occurs when nerve endings and circulation to the ears are compromised, resulting in gradual loss of hearing.
When nerves are damaged from diabetes, we asee that there is a decreased muscle control and functioning of the bladder, and also of the gastrointestinal tract. Both can lose ability to function appropriately, resulting in loss of bladder control, or problems with gastroparesis, where the stomach’s ability to empty and move food through the GI tract correctly is impaired, resulting in uncomfortable feelings of fullness, constipation, and other bowel issues.
Dental problems, including infection of gums and underlying structures in the mouth, and periodontal disease are much more common with diabetes. This results in tiny pockets where the gums should hug the teeth. Particles of food and bacteria get in these pockets, causing an inflammation of tissues that can damage bone under the teeth, as well as the teeth themselves.
Your mouth can get dry from prolonged blood sugars, which also contributes to dental problems. Mouth sores, and pain in teeth and gums can develop.
Related to your vision, you may notice that you have more trouble reading the things that you used to read with ease.
Your skin can become dry, and when it cracks, bacteria can get in and cause an infection. People with diabetes are more prone to skin infections, including some particularly aggravating and uncomfortable ones, like folliculitis.
Nerve damage can cause feet and hands to feel numb, and make it more likely for a person with diabetes to step on something sharp and not feel it. There can be a considerable amount of pain that goes along with diabetic neuropathy. Even light covers over your feet and hands may cause pain when you try to sleep.
Sexual intercourse becomes difficult, either due to erectile dysfunction in men, or due to vaginal dryness in women.
Aside from all those things that can happen to you with uncontrolled diabetes over time, there is heart disease, and heart attacks, strokes, and even Alzheimer’s disease. It’s time to get yourself back on track to avoid these complications. Best of luck in your efforts.
Over to you
We hope that this article will help you to decide what you need to do to get back on track to control your diabetes. Let us know how you got back on the wagon after losing your motivation to manage your diabetes. Our readers may gain some insight from your personal experiences.
TheDiabetesCouncil Article | Reviewed by Dr. Christine Traxler MD on September 02, 2018
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Last Updated: Wednesday, September 5, 2018 Last Reviewed: Wednesday, September 5, 2018
UNDERSTANDING TYPE 2 DIABETES
Type 2 diabetes is the most common form of diabetes. For many people (but not all) it can be prevented through following a healthy lifestyle.
While type 2 diabetes cannot be cured, it can be managed and people with type 2 diabetes can and do live active and healthy lives.
What is type 2 diabetes?
Diabetes is the result of the body not creating enough insulin to keep blood glucose (sugar) levels in the normal range. Everyone needs some glucose in their blood, but if it’s too high it can damage your body over time.
In type 2 diabetes, either the body doesn’t produce enough insulin, or the cells in the body don’t recognise the insulin that is present. The end result is the same: high levels of glucose in your blood.
For many people (but not all) type 2 diabetes can be prevented by making healthy food choices and staying active.
There is a clear link between type 2 diabetes and high blood pressure (hypertension) and / or disordered levels of fats (cholesterol) in the blood (the medical name for this is dyslipidaemia). This combination of diabetes with hypertension and dyslipidaemia is sometimes called ‘the Metabolic Syndrome’ or Syndrome X.
When does type 2 diabetes normally occur?
Type 2 diabetes most often occurs in adulthood usually after the ages of 30 – 40 years. However, increasing numbers of teenagers and children are developing type 2 diabetes.
Who is most likely to develop type 2 diabetes?
Some groups of people are more likely to develop type 2 diabetes:
European 40 years of age or older
Diabetes in your family (grandparents, parents, brothers or sisters)
Maori, Asian, Middle Eastern or Pacific Island descent aged 30 years or older
High blood pressure
Overweight (especially if you carry most of your weight around your waist)
Diagnosed as having pre-diabetes (also known as impaired glucose tolerance) – this occurs when the glucose (sugar) in your blood is higher than normal, but not high enough to be called diabetes
Symptoms of type 2 diabetes
You may have had type 2 diabetes for many years without realising it. Not everyone has symptoms. Symptoms may include:
Feeling tired and lacking energy
Going to the toilet often
Getting infections frequently
Getting infections which are hard to heal
Poor eyesight or blurred vision
Often feeling hungry
If you have any of the above symptoms, discuss these with your doctor.
Diabetes is diagnosed by blood tests which can be organised through your doctor. If you are very unwell you should seek medical assistance
Does type 2 diabetes run in families?
If you have a blood relative with type 2 diabetes you are more likely to develop type 2 diabetes yourself. However type 2 diabetes sometimes occurs in people who have no one in their family with the condition.
Is type 2 diabetes curable?
In people with type 2 diabetes, glucose builds up in the blood. But with good management, your blood glucose levels may go down to normal again. But this does not mean you are cured. Instead, a blood glucose level in your target range shows that your treatment plan is working and that you are taking care of your diabetes.
How do I start treating and managing my type 2 diabetes?
In a nutshell: some people with type 2 diabetes may be able to manage their diabetes through diet and exercise, or by taking tablet medication. However, eventually many people with type 2 will manage their diabetes with insulin as well.
Your doctor will advise you on what treatment is best for you, but whatever this may be, healthy food choices and staying active is important. The goal is to lower your blood glucose and improve your body’s use of insulin. This is achieved through:
A healthy diet
The focus of your food choices and regular exercise is to achieve and maintain healthy blood glucose levels. Losing weight helps your body use insulin better.
You may also have to take medication. Type 2 diabetes is a progressive condition. This means that over time you will gradually produce less and less insulin. Although you may be able to manage your blood glucose levels in the healthy range by eating healthy food and having regular exercise for a number of years, most people come to need tablets or insulin as well as their food and exercise plan.
Learn more about Diabetes Management here and download our Take Control Toolkit app from the App Store or Google Play to help you manage your diabetes.