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Transcript for Podcast: Get the Facts: Blood Sugar and Diabetes

[Ms. Jonikas] Hello, my name is Jessica Jonikas. Today, we’re talking with my colleague, Dr. Lisa Razzano, about blood sugar and diabetes. Because it’s prevalent among people with serious mental illnesses, she’ll provide basic facts about diabetes to help us better understand the condition. Of course, anyone listening today who thinks they may have a problem with their blood sugar should see a doctor right away.

Dr. Razzano, can you start our conversation by defining blood glucose, and how it relates to diabetes?

[Dr. Razzano] Yes, I’d be glad to. It’s important to understand the role that glucose, or blood sugar, plays in a healthy body.

Most of the food we eat is turned into glucose, or blood sugar. Glucose is critical to our health because it actually fuels our bodies, much like gas fuels a car. Sugars can be found in many types of foods, like fruit, grains with carbohydrates, and of course, sweets and candy.

The pancreas makes a hormone called insulin to help glucose get into our body’s cells. Insulin also helps to balance our hormones. Hormones are chemicals that travel from one part of the body — like the pancreas where insulin is made — to other parts of the body. Hormones help your cells and organs to work properly.

There are different types of diabetes. When you have Type 1 diabetes, your body doesn’t make enough insulin to help the glucose, or blood sugar, fuel your cells. When you have Type 2 diabetes, your body is unable to use the insulin it makes to fuel the cells, or it doesn’t make enough insulin, or both.

Either way, when you don’t have enough insulin or it doesn’t work properly, glucose builds up in your bloodstream. When this happens, a person is usually diagnosed with diabetes. According to the American Diabetes Association, almost 24 million children and adults in the U.S., or nearly 8% of the population, have diabetes. If left untreated, diabetes can lead to other serious health problems like heart disease, stroke, blindness, and kidney failure.

[Ms. Jonikas] We also hear a lot about pre-diabetes. Can you tell our listeners about what that means, and why it’s of concern?

[Dr. Razzano] Like diabetes, pre-diabetes means having a blood sugar level that is higher than normal, but not quite high enough to be called diabetes. People with pre-diabetes usually have no symptoms, but can develop other medical problems like heart disease when their blood sugar is high enough to be considered pre-diabetic.

Also, pre-diabetes almost always comes before developing Type 2 diabetes. So, even if you’re pre-diabetic, it’s important to talk to your doctor about how to reduce your blood sugar. Doing this might prevent you from getting Type 2 diabetes altogether. It also could avert other health problems.

[Ms. Jonikas] Obviously, having untreated high blood sugar is a serious health condition. What causes diabetes or pre-diabetes?

The exact cause of Type 1 diabetes — when the body doesn’t make enough insulin — is unknown. Scientists tend to believe it’s an autoimmune disease. That means the body's immune system attacks the cells in the pancreas that produce insulin. Type 1 diabetes may run in families and environmental factors, like viruses, may also cause it.

Type 2 diabetes — when the body is unable to use the insulin it makes or it makes too little insulin — tends to run in families. Risk factors for developing type 2 diabetes include things like high blood pressure, high blood triglycerides, eating a high-fat diet, a sedentary lifestyle, being obese or overweight, and getting older. Also, certain groups like African Americans, Native Americans, Hispanic Americans, and Japanese Americans have a greater risk of developing type 2 diabetes than non-Hispanic whites.

[Ms. Jonikas] What are the common symptoms of diabetes?

[Dr. Razzano] There are quite a few symptoms or signs that one’s blood glucose may be elevated. If you’re persistently experiencing several of these symptoms, be sure to see a doctor. These are:

Frequent and extreme thirst even after drinking water,
Frequent urination,
Unexplained weight loss,
Increased hunger,
Blurry vision,
Tingling or numbness in the hands or feet,
Frequent skin, bladder, or gum infections,
Wounds that don't heal, and
Extreme and unexplained fatigue.

Regarding symptoms, it’s important to point out that millions of Americans are unaware that they have diabetes because there may be no warning signs like these. This is why it’s critical to have regular check-ups, and to discuss risk of diabetes with a doctor if it runs in your family.

[Ms. Jonikas] What kinds of tests are used to figure out if a person has diabetes or pre-diabetes?

[Dr. Razzano] There are a number of tests used to diagnosis diabetes. At a doctor’s office, the fasting plasma glucose test is generally the preferred method because it’s easy to do, convenient, and less expensive than other tests, according to the American Diabetes Association. For this test, a patient is not allowed to eat anything for at least eight hours. Blood is drawn and sent to a lab for analysis. Normal fasting blood glucose is between 70 and 100 milligrams per deciliter for people who do not have diabetes. The standard diagnosis of diabetes is made when two separate blood tests show that a person’s fasting blood glucose level is greater than or equal to 126 milligrams per deciliter.

[Ms. Jonikas] What would happen next, following a diagnosis of diabetes or pre-diabetes?

[Dr. Razzano] A doctor would discuss healthy lifestyles choices and medications that are needed to manage the illness. As noted by experts at the Mayo Clinic, no single diabetes treatment is best for everyone. What works for one person may not work for another. This is why doctors work with each individual patient to compare the advantages and disadvantages of specific diabetes drugs.

Importantly, like most other chronic health conditions, there is more to treatment than medication. Eating healthy foods, being physically active, and maintaining a healthy weight can help control diabetes, too. Once a person is found to have the condition, a personalized diabetes management plan can help him or her to live a healthy and active life.

[Ms. Jonikas] Dr. Razzano, I want to thank you for giving us the basic facts about the causes, symptoms, tests, and treatments for diabetes. For our listeners, you can learn more about diabetes by talking with a health care provider. There also are many excellent resources on the Internet about this disease. For example, visit the American Diabetes Association at to learn more.

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