Diabetic prevention, diagnosis and management

By Yun Namkung, M.D.

Diabetes mellitus, a chronic disorder marked by high blood sugar levels, affects millions of people globally. Its rising prevalence necessitates a focus on effective prevention, timely diagnosis and comprehensive management. Addressing this issue is key to improving quality of life and reducing long-term health complications.

Preventing Diabetes

The prevention of type 2 diabetes, which makes up the vast majority of cases, centers on modifiable lifestyle factors. A balanced diet rich in whole grains, vegetables and lean proteins, while limiting processed foods and refined sugars, is fundamental. Losing even a modest amount of weight — 5 to 7% of your body weight — can drastically cut your risk.

Regular physical activity is also essential. Just 30 minutes of moderate exercise daily, like brisk walking, enhances your body’s sensitivity to insulin and helps with weight management. Additionally, managing chronic stress and ensuring adequate sleep are crucial, as they help regulate blood sugar levels.

Beyond individual efforts, community-based programs promoting healthy eating and physical activity are vital. Screening initiatives can identify high-risk individuals, allowing for early intervention before the disease takes hold.

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Diagnosing Diabetes

Early and accurate diagnosis is critical for effective management. Diabetes is primarily diagnosed through blood tests that measure glucose levels. The Fasting Plasma Glucose (FPG) test, which checks blood sugar after an overnight fast, confirms diabetes if levels are 126 mg/dL or higher. The A1C test provides a three-month average of blood glucose, with a reading of 6.5% or above indicating diabetes.

Screening is recommended for adults over 45 or those with risk factors like obesity. The early detection of prediabetes (A1C of 5.7 to 6.4%) is a vital opportunity for lifestyle changes to prevent the full onset of the disease. For type 1 diabetes, which is an autoimmune condition, diagnosis often involves testing for specific autoantibodies.

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Managing Diabetes

Effective management aims to keep blood glucose levels within a healthy range to prevent complications. For type 1 diabetes, insulin therapy is non-negotiable. It’s often delivered via injections or a pump, with doses adjusted based on continuous glucose monitoring.

For type 2 diabetes, management usually starts with lifestyle changes. Depending on the A1C level, doctors may prescribe oral medications like metformin. An A1C between 7% and 8.5% typically calls for one oral medication, while a level between 8.5% and 10% may require two. For A1C levels over 10%, doctors often start treatment with long-acting insulin and metformin.

Regular monitoring with glucose meters or CGM devices is crucial. Patients should also manage related conditions like high blood pressure and cholesterol to reduce cardiovascular risks. Regular screenings for complications like neuropathy and retinopathy, along with psychological support, are also essential for a comprehensive care plan.

By focusing on prevention through lifestyle choices, using accurate diagnostic tools for early detection and implementing comprehensive management strategies, we can effectively combat diabetes and foster healthier communities.