Too Sweet: A Deeper Dive into Understanding Pre-Diabetes and Type 2 Diabetes

Individuals with uncontrolled diabetes have too much sugar in their bloodstream. The sugar found in your blood comes from both your diet — food eaten or beverages consumed — and that which is produced by the liver.

Normally, the sugar in your bloodstream is taken up by your muscles or other cells to be used as energy or it is stored as fat. Insulin serves as the taxicab driver that transports sugar from the blood vessels to the muscles and cells, as well as the key that lets sugar into these cells to be used as energy. When there is not enough insulin or the insulin key is not working, as in the case of diabetes, sugar particles stay in the bloodstream, causing blood sugars levels to be higher than desired.

Consequently, in Type 2 diabetes, the pancreas must work overtime to produce more insulin to compensate for the lack of properly functioning insulin. Initially, the pancreas is successful in doing so, but eventually, after several years of working overtime with no to little breaks, it becomes worn out and unable to produce much insulin.

Screening for diabetes generally requires a blood test. Your health care provider will either measure your fasting (no caloric intake for at least eight hours) blood sugar level, your blood sugar reading two hours after drinking a beverage containing 75 grams of glucose dissolved in water (called an oral glucose tolerance test or OGTT) or your hemoglobin A1c (a1c). A random blood sugar level may be taken if you are exhibiting symptoms of diabetes.

The fasting, random or OGTT blood sugar reading provides information on your blood sugars levels for that specific day and time of which the blood sample was drawn. The A1c gives an average of blood sugars levels over the past three months. Your doctor can give greater insight to your test results and what it specifically means for you.

Once diagnosed with Type 2 diabetes, the general goal is to maintain fasting and pre-meal blood sugars between 70 – 130 mg/dl and two-hour post-meal readings to less than 180 mg/dl. The A1c goals is less than 7 percent. Ultimately, the goal is to treat the patient (not numbers), so you and your health care provider should discuss reason and healthy goals for you.

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