What is Diabetes?

Testing with a Diabetes Blood Glucose Monitor

Diabetes is a condition where the body cannot use food properly. When you eat, food is broken down into a sugar called “glucose”. All food, whether it is a sandwich, vegetables, fruit or sweets, turns into glucose. Carbohydrates turn into sugar (glucose) faster and in greater amounts than other food. Glucose is the body’s major source of fuel for energy, but the glucose cannot get into cells by itself. It needs insulin. Insulin is made in the pancreas. It works like a key to help the glucose enter the cell so you have enough energy for the day.

Diabetes happens when the sugar in your bloodstream is too high because the pancreas isn’t making enough insulin, or the body is resistant to its own insulin. Through ongoing research, we continue to learn about the causes and treatment of diabetes. There are two basic types of diabetes:

Type 1 Diabetes

Type 1 diabetes is usually diagnosed in children and young adults and was previously called juvenile onset diabetes. It now occurs in older adults too. In Type 1 diabetes the body does not make insulin and symptoms of high blood sugar usually happen quickly. Symptoms include thirst, urinating frequently and rapid weight loss. People feel better as soon as they receive insulin, but are “dependent” on daily insulin to stay alive. Only 5% of the people with diabetes have Type 1. It is believed to be caused by an autoimmune disease, causing the body to reject the cells that make insulin in the pancreas.

Type 2 Diabetes

Type 2 diabetes occurs when the body still makes insulin, but the body cannot use it properly. Extra weight and stress cause insulin to not work like it should. This is called insulin resistance. At first the pancreas makes extra insulin to make up for the resistance, but over time the pancreas wears out and cannot make enough insulin for blood glucose to stay normal. In 2011, it is estimated that 18.8 million people in the USA (8.3% of population) have type 2 diabetes. Risk factors for having Type 2 diabetes include

  • Family history of type 2 diabetes

  • Lack of physical activity

  • Being overweight

  • Being over age 40

  • Being African American, Native American, Hispanic, Asian American, Asian Indian or Pacific Islander.

Gestational Diabetes and Diabetes and Pregnancy

Gestational diabetes can occur after the first 28 weeks of pregnancy to a woman with no history of diabetes. Controlling blood sugar levels during this time is important to prevent problems for the mother and baby. Woman with Type 1 and Type 2 diabetes are also closely followed before and throughout pregnancy to ensure a healthy baby and mother.

In all types of diabetes, it is important to keep blood glucose levels as normal as possible to avoid potential complications. Long term problems such as heart disease and stroke, blindness, kidney disease, nervous system disease (neuropathy) and amputations can occur.

Diabetes Treatment

Our goal in the treatment of diabetes is to help every patient use the tools available to help keep blood glucose as normal as possible. Self-monitoring of blood sugar levels, healthy eating and exercise and medications are available. There are many new medications available, but traditional medicines are often helpful. When making recommendations for treatment, we will discuss all diabetes treatment options, including older medications as well as the latest developments. We consider the expense of these options in trying to achieve the most cost effective regimen with the least side effects for each individual. We are sensitive to the emotional, social and physical issues surrounding the management of diabetes. We try to use creative ways of helping you manage both Type 1 and Type 2 diabetes.

Resources for Diabetes Patients Include:

  • Downloading of all blood glucose meters to simplify seeing and interpreting accurate results.

  • Group visits where we combine patients with similar needs into the same appointment to share common struggles, and ways for help. This has been more popular with patients with Type 1 diabetes wearing insulin pumps, but we are expanding this valuable service in the future.

  • Insulin pump therapy. We see many patients who use insulin pump therapy when appropriate. Insulin pump therapy offers the ability to change a basal rate for different times of the day or different activity or illness. An insulin pump also offers the ease of using a bolus calculator to do the math for calculating the amount of insulin needed for a certain carbohydrate amount and the insulin dose for correcting a high blood sugar. We stay up to date on all insulin pumps available on the market. Each of these devices have features that may be helpful in some patients. We work with our patients and diabetes educators to help the patient and family members find the best fit for their individual needs. We realize starting pump therapy is a major decision for most people. We have had years of expertise in insulin pump therapy, providing a caring, supportive and educational environment. Our goal is to support your decision of what is right for your treatment of diabetes.

  • Continuous Glucose Sensors. This newer technology measures blood glucose 24 hours a day every 5 minutes. You can set alarms for low and high blood sugar levels. It is available to use for all people using insulin when used through our office for 1 week at a time. A certified educator will help you interpret the results. Continuous sensors are also available for personal use for many people with Type 1 diabetes meeting insurance requirements. Increasingly some patients with type 2 diabetes are finding continuous glucose sensors very helpful in managing their diabetes

  • Diabetes Education: We have CDEs (certified diabetes educators) in our office to provide help and education for basic diabetes education, carbohydrate counting, insulin pump and sensor use and other diabetes needs.

We follow the other conditions associated with diabetes such as hypertension, dyslipidemia, kidney disease, nerve problems and depression. As a specialist we communicate with other health care providers. We know you are living with diabetes 24 hours a day and support your journey of making daily decisions for a healthy and happy life.

Schedule Your Appointment

If you would like schedule an appointment with one of the leading endocrinologists in Washington state or one of our certified diabetes educators, or one of our nurse practitioners please call us at 253-927-4777. We serve all diabetes patients in Federal Way, Tacoma, Seattle and surrounding areas. We look forward to empowering you with the diabetes education and management tools to help you achieve a healthy lifestyle!