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What's Your Type? Types of Diabetes and How to Manage the Disease

Understanding diabetes and its impact on the body is the first step to managing it. Carmen Parks explains what a diabetes diagnosis means and how you can manage it.
What's Your Type? Types of Diabetes and How to Manage the Disease
Carmen Parks, FNP-BC, CDE
Carmen is a Certified Diabetes Educator at the Magnolia Diabetes Center, which is located at the Magnolia Specialty Clinic in Corinth, MS. At the Magnolia Diabetes Center, Carmen works closely with Dr. Delali Blavo, board certified Endocrinologist, helping patients manage their diabetes and the complications associated with the disease. In addition to being a Certified Diabetes Educator, Carmen is a board certified Family Nurse Practitioner, and has over 20 years of experience in the treatment and management of diabetes in North Mississippi.

Prakash Chandran (Host): Did you know that roughly 30 million people are affected with diabetes in America? Today we will learn about the forms of diabetes and how you can manage it effectively if you have it. I’m Prakash Chandran and in this episode of The Magnolia Matters Healthcast, we will discuss the different forms of diabetes and how you can manage them effectively. I’m pleased to welcome Carmen Parks, a Nurse Practitioner and Certified Diabetes Educator at the Magnolia Regional Health Center’s Specialty Clinic. Pleasure to have you here Carmen. So, why don’t we start with the basics. What does it actually mean when someone is diagnosed with diabetes?

Carmen Parks, FNP-BC, CDE (Guest): When somebody is diagnosed with diabetes this means that the blood glucose or the blood sugar levels are higher than expected or higher than normal levels. Typically, a normal fasting glucose or sugar level which is before you eat food in the morning should be between 70 and 100. If the sugar in the morning before eating is greater than 126, this does indicate diabetes and of course, if a level shows up between 100 and 126, this indicates prediabetes and the old terminology for prediabetes is what we used to call borderline diabetes.

When the sugar levels are elevated, this indicates that the body is unable to process or metabolize food normally. More specifically, the body is not converting food into energy normally.

Host: So, that’s a really good technical description of what diabetes is, but what are the symptoms or signs that you might have diabetes and when might be a good time to come in and see your doctor?

Carmen: Okay well symptoms can include fatigue, or increased thirst or increased urination. Also, sometimes people will have an increased hunger. They will have weight changes particularly weightloss. Possibly they can have some numbness and tingling in their hands or feet or both. Sometimes they will describe a burning sensation in their feet. They can have vision changes typically a blurred vision and also notice having sores that are taking longer to heal. They can also have recurrent fungal type skin infections or yeast infections. These symptoms can also indicate other medical issues but if a person has a lot of these symptoms, they should see their provider as soon as they notice that to see if they are related to or connected to problems with their sugar levels.

Host: Okay, that makes a lot of sense. But I had one more clarifying question around that. I’m curious could you paint the portrait of someone that might be susceptible to diabetes? Is it someone that may be eats a lot of fast food or I just want to get a good sense of what that looks like?

Carmen: Well susceptibility can come from genetic predisposition or it can come from possibly be brought about by weight gain, lack of exercise, maybe an improper diet. Those are things that can predispose an individual to developing diabetes over time.

Host: Got it. So, if you are experiencing some of the symptoms that you mentioned, that weightloss, or that tingling in your fingers, the hunger fluctuations; then it might be a good idea to go in and see someone about it. So, I want to shift to the different types of diabetes. I have heard of type 1 and type 2 diabetes. Can you maybe talk about those differences?

Carmen: Yeah, that’s a great question. I’m often asked which type of diabetes is worse and I think often people fear that they have the “bad type” of diabetes. The type of diabetes does differ dramatically but either of these if not controlled can lead to complications. So, I try to tell people that the only type of bad diabetes is the type that’s not managed. Our body is supposed to manufacture and store insulin which is a vital hormone and this hormone helps convert sugar from our food into energy. It basically transports sugar from our blood into our tissues or basically our muscle cells where our body is able to use that glucose for energy. We should eat from all of the food groups for healthy status and for energy to occur.

Scientists do think that the immune system which is our system for fighting infection can become confused leading to an attack on the cells in our pancreas that produce insulin, leaving them damaged and unable to produce insulin. And when this occurs, we just have no way to transport the sugar into our muscles for energy and the sugar becomes trapped in our blood. This actually is what we call type 1 diabetes. This doesn’t occur often, usually it’s about one in every ten people with diabetes or about 10% of our diabetic population or less than about 200 cases per year. They used to call this juvenile diabetes because it does tend to occur more in children, but we also do see this occur in adults and when it does occur after age 30, sometimes it’s actually referred to as type 1 and ½ diabetes. It’s not common at all.

The most common type of diabetes that we see is type 2 and this occurs in 80-90% of the population of diabetic patients. And with this, the sugar is abnormally high because the body either does not make enough insulin or the insulin it makes does not work properly or efficiently. And several factors can lead to the inefficient insulin. Like I said before, genetic predisposition or heredity, gaining weight, or obesity, lack of exercise, and abnormal production of sugar by the liver especially at night while we are asleep. And also, problems with cell signaling in the body and the cells in the pancreas being unable to secrete the insulin that it makes properly.

Host: So, I know you talked about type 1 diabetes being only a small percentage of people especially it generally occurs when we are younger. But for those people that are diagnosed with type 1; what kind of treatments are available to them?

Carmen: We have wonderful treatments for both type 1 and type 2 diabetes. We actually live in a time where treatment has advanced, and technology has advanced. With type 1 diabetes, because you totally lack the hormone insulin, you do have to replace that insulin with insulin injections so that your body has that insulin to be able to transport sugar into the body where it needs to go. You do have to coordinate the insulin with the meals and the amount of carbohydrates that is in the meals since the carbohydrate in food is what contains sugar. A lot of people think that if you have type 1 diabetes you can’t have sugar. That’s sort of a myth. So, it is important that you are educated properly on how to coordinate your meals with your insulin.

Host: And when you get your insulin, what is that come in the form of? Is that a shot? Is that a pill? How do people take in that insulin during mealtime?

Carmen: Well, unfortunately, we are not able to take insulin orally because of stomach acids in the stomach can destroy insulin and so those have to be injected through the skin into the subcutaneous tissue. We have many types of insulins and luckily the insulins that we use now will mimic almost exactly what our natural insulin would do if our pancreas was able to make it.

Host: Okay, so I actually want to move to type 2 diabetes now and this is the type that you mentioned that most people are dealing with. What actions do people take to manage their symptoms?

Carmen: Type 2 diabetes is much more a focus on healthy diet, taking in the correct amount of carbohydrates that our body can use for energy without taking in too much which will cause the sugar to elevate more. We also always want to include exercise and a big portion of the time, if we are having struggles with weight and we can lose as little as ten to fifteen pounds; over time, we will notice that sugars will typically improve automatically. There are however, many different oral medications that target up to eight defects that can occur in type 2 diabetes causing the sugar to elevate. And getting those on board early on with exercise, weightloss and appropriate diet; usually gives us the very best outcomes.

The key there is early detection and treatment. Because if you can start doing these things early on, work with your provider, you can typically stop the progression or worsening of type 2 diabetes. People can definitely live normal lives, feel good with treatments that we have. Once the sugars are stabilized, usually symptoms pretty much will resolve.

Host: That’s amazing. And I think what you said there is really important. If you start noticing some of the symptoms that you talked about earlier in this interview that it’s important to go see your doctor about it and see if it’s something that you can catch early. You mentioned diet and I want to focus on that for a minute. I have actually heard of people curing their diabetes through changing their diet alone. Is that a method that you recommend for those who are willing to make that drastic diet change?

Carmen: I think that that is a pretty individual thing. I have seen it occur when people are really doing their diet correctly and very persistent and exercising that they are able to sometimes get off some of their medications; but there are some medications that providers like to keep them on because some of the oral medications themselves can prevent progression of diabetes by correcting some underlying defects, but definitely the exercise and the diet is key in controlling the symptoms and not only controlling the symptoms now but preventing progression of the disease in the future.

Host: Well thank you so much Carmen for giving us all this information and also educating us on how to best manage diabetes type 1 and type 2. Diabetes self-management training and classes are actually offered at Magnolia Regional Health Center and covered under Medicare and many insurance plans. So, for more information please visit, and go to the nutritional department under the services menu. My guest today has been Carmen Parks. I’m Prakash Chandran. Thank you so much for listening.