Diabetes is a condition where your body has trouble managing the sugar (called glucose) in your blood. 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
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, monogenic, medication-induced 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.
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Conditions
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:
- Brain (cerebrovascular disease)
- Eyes (diabetic retinopathy)
- Heart (coronary artery disease)
- Kidneys (diabetic nephropathy)
- Liver (metabolic dysfunction-associated steatotic liver disease)
- Nutrition supply to nerves (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:
- Age
- Elevated blood pressure
- Genetic predisposition
- History of gestational diabetes
- History of polycystic ovary syndrome
- Obesity
- Social and environmental factors
- Sedentary lifestyle
- Smoking
- The ratio of triglycerides to HDL cholesterol (TG/HDL)
Diabetes + family planning
If you have diabetes and are planning to grow your family, talk with your doctor about managing your hemoglobin A1C which represents your average blood sugar levels over the past 2 to 3 months.
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.
Gestational diabetes
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.
Pre-diabetes
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.
Testing
We recommend regular check-ups with your primary care doctor. During these appointments, your doctor can perform a fasting blood glucose test, A1C blood test, or an oral glucose tolerance test — especially if you're at high risk for developing diabetes. People over the age of 35 are more likely to form type 2 diabetes and should receive an annual screening.
Fasting glucose
Fasting glucose measures blood sugars 8-12 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.
2-hour post meal
The 2-hour post-meal glucose level is an important number to know because it identifies how efficiently your pancreas or diabetes medications are working after meals.
A1C
The A1C marker reflects the average blood glucose levels over the past 2 to 3 months (about 90 days). Anyone with diabetes or pre-diabetes should know their A1C value and share it with all of their healthcare providers.
Lipid panel
A lipid panel test is a blood test that measures the levels of different types of fats (lipids) in your blood. It usually checks for:
- Total cholesterol: The overall amount of cholesterol in your blood.
- LDL cholesterol ("bad" cholesterol): Can build up in your arteries and increase the risk of heart disease.
- HDL cholesterol ("good" cholesterol): Helps remove bad cholesterol from your bloodstream.
- Triglycerides: A type of fat that can also increase the risk of heart disease if levels are too high.
We aim to keep your lipid levels healthy because diabetes and high cholesterol (LDL and non-HDL) can increase the risk of heart and blood vessel issues, as well as pancreatitis, which occurs when the pancreas becomes inflamed and painful.
Treatments
Managing diabetes can feel overwhelming, but at Tufts Medicine, you're supported by a dedicated healthcare team. We offer several diabetes management options, including insulin pumps, continuous glucose monitors, lifestyle changes and support and medications.
Diabetes management tools
Insulin pump
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, we may recommend an insulin pump to continuously release insulin into your body, so you don’t have to give injections a second thought.
If we recommend an insulin pump, we’ll train you in everything you need to know about it. As a safety net, you’ll benefit from around-the-clock support in case any issues with your pump arise.
Continuous glucose monitor (CGM)
We may pair a continuous glucose monitor (CGM) 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 a CGM, especially those having difficulty controlling their glucose. A CGM can also be paired with your smartphone and can be used without an insulin pump.
Glucometer
A glucometer measures your blood glucose levels by analyzing a small drop of blood, usually taken from your fingertip using a lancet. The blood is placed on a disposable test strip, which the glucometer reads to provide a blood glucose reading.
Glucometers can help you monitor your blood sugar levels throughout the day to ensure they remain within a healthy range and can help you make informed decisions regarding your food, exercise, and insulin injections.
Medications
We can prescribe medications to help control weight, blood glucose, cholesterol and blood pressure. Some medications can also help patients with diabetes reduce the risk of heart, kidney and liver complications.
Diabetes + weight loss
Eating healthy and staying 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.
Support groups for diabetes
Living with diabetes can bring changes and challenges to your life that are best understood by others who have experienced similar situations. Our support groups offer a safe space to discuss topics and personal experiences.
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