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About Diabetes

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Diabetes is characterized by high blood sugar levels, which can lead to a range of complications if not managed effectively. People living with diabetes must monitor their blood glucose levels, make dietary adjustments and often take medication. Guided by the expertise of the American Diabetes Association and the dedicated care of Florida Digestive Health endocrinologists, this in-depth exploration of diabetes focuses on its symptoms, underlying causes, treatment options, various types and preventive measures.

diabetes blood sugar testing and treatment


Diabetes mellitus, commonly referred to as diabetes, manifests through an array of symptoms that can vary in intensity and presentation among individuals. These symptoms serve as essential indicators for timely diagnosis and management. Key symptoms include the following: 

Frequent Urination (Polyuria): Individuals with diabetes often experience an increased urge to urinate, especially at night. This excessive urination is a result of the body’s attempt to eliminate excess glucose through urine. 

Excessive Thirst (Polydipsia): Unquenchable thirst is a common symptom of diabetes, stemming from the dehydration caused by frequent urination. 

Unexplained Weight Loss: Despite increased hunger and food consumption, individuals with diabetes may lose weight unintentionally. This occurs when the body cannot effectively utilize glucose for energy. 

Fatigue: Persistent fatigue and a feeling of low energy levels are common among those with diabetes because of the body’s inability to utilize glucose efficiently. 

Blurred Vision: Diabetes can affect the lenses of the eyes, leading to blurred vision. This symptom often improves with proper diabetes management. 

Slow Healing Wounds: Diabetes can impede the body’s ability to heal wounds and infections, leading to delayed recovery from injuries. 

Tingling or Numbness: Nerve damage, a complication of diabetes, can result in tingling or numbness in the extremities, often starting with the feet and hands. 

Recurrent Infections: Diabetes can weaken the immune system, making individuals more susceptible to frequent infections, particularly skin and urinary tract infections. 

Increased Hunger (Polyphagia): Despite consuming larger quantities of food, individuals with diabetes may feel constantly hungry, as their cells are not receiving adequate glucose for energy. 

Hypoglycemia (Low Blood Sugar): In cases of low blood sugar (hypoglycemia), symptoms like shakiness, sweating, irritability and confusion may occur, signaling the need for immediate intervention. 

Recognizing these symptoms is crucial for early detection and prompt management of diabetes, as untreated diabetes can lead to severe complications. 


The underlying causes of diabetes are complex and depend on a variety of factors. Diabetes primarily arises from issues related to insulin, a hormone produced by the pancreas that regulates blood sugar levels. The primary causes include the following: 

Type 1 Diabetes: This form of diabetes results from an autoimmune response, where the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. The exact cause of this autoimmune reaction remains unclear but likely involves genetic and environmental factors. 

Type 2 Diabetes: The most common form of diabetes, Type 2, is closely associated with insulin resistance. It occurs when the body’s cells do not respond effectively to insulin, leading to elevated blood sugar levels. Genetic predisposition, obesity, physical inactivity and poor dietary choices are key risk factors for Type 2 diabetes. 

Gestational Diabetes: Occurring during pregnancy, gestational diabetes is believed to result from hormonal changes that affect insulin sensitivity. While it typically resolves after childbirth, it increases the risk of developing Type 2 diabetes later in life. 

Other Types: There are several other less common types of diabetes, such as monogenic diabetes and secondary diabetes, which result from specific genetic mutations or other medical conditions. 

Understanding the cause of diabetes is pivotal for tailoring effective treatment strategies and preventive measures. 


Type 1 and Type 2 diabetes causes and treatment info sheets

The treatment of diabetes revolves around achieving and maintaining optimal blood sugar levels. The American Diabetes Association emphasizes a patient-centered approach, often involving a multidisciplinary healthcare team, including endocrinologists, dietitians and diabetes educators. Key treatments encompass the following: 

Lifestyle Modifications: Lifestyle changes form the cornerstone of diabetes management. These changes include adopting a balanced diet, engaging in regular physical activity and maintaining a healthy weight. These steps are fundamental in improving insulin sensitivity and managing blood sugar levels. 

Oral Medications: For individuals with Type 2 diabetes, oral medications may be prescribed to enhance insulin sensitivity, stimulate insulin production or slow down the absorption of glucose from the digestive tract. 

Insulin Therapy: Type 1 diabetes and some cases of Type 2 diabetes require insulin therapy. Various insulin formulations are available, allowing for tailored treatment plans to match individual needs. 

Continuous Glucose Monitoring (CGM): CGM systems offer real-time monitoring of blood sugar levels, providing individuals with diabetes and their healthcare providers valuable data to adjust treatment regimens. 

Hemoglobin A1c (HbA1c) Testing: HbA1c tests offer a long-term view of blood sugar control, aiding in treatment adjustments. The target HbA1c level varies based on individual circumstances but is a crucial metric for diabetes management. 

Education and Support: Diabetes education programs and support groups empower individuals with diabetes to manage their condition effectively. These resources offer guidance on meal planning, monitoring blood sugar, and coping with the emotional aspects of diabetes. 

Medication and Insulin Adjustments: Diabetes treatment plans often require periodic adjustments to medications or insulin dosages to maintain blood sugar within the target range. 

Customized treatment plans, based on the type of diabetes and individual health factors, are essential to achieving and sustaining optimal blood sugar control. 


Diabetes encompasses several distinct types, each with its unique characteristics and treatment approaches. These include the following: 

Type 1 Diabetes: Also known as insulin-dependent diabetes, Type 1 diabetes results from the autoimmune destruction of insulin-producing beta cells in the pancreas. Individuals with Type 1 diabetes require lifelong insulin therapy to manage their blood sugar levels effectively. 

Type 2 Diabetes: Type 2 diabetes is characterized by insulin resistance and impaired insulin production. Lifestyle modifications, oral medications and insulin therapy may be part of the treatment plan for Type 2 diabetes. 

Gestational Diabetes: Occurring during pregnancy, gestational diabetes requires careful monitoring and dietary adjustments. While it often resolves after childbirth, it increases the risk of Type 2 diabetes later in life. 

Monogenic Diabetes: This rare form of diabetes results from mutations in a single gene. It typically presents in childhood or young adulthood and may respond well to specific treatments. 

Secondary Diabetes: Secondary diabetes arises as a result of other medical conditions or treatments, such as certain medications, hormonal disorders or pancreatic diseases. 

Prediabetes: Prediabetes is a precursor to Type 2 diabetes, characterized by elevated blood sugar levels that do not yet meet the criteria for diabetes diagnosis. Lifestyle changes can prevent or delay the progression to Type 2 diabetes in prediabetic individuals. 

Understanding the type of diabetes is vital for tailoring appropriate treatment and management strategies. 


Preventing diabetes and its complications is a top priority for healthcare professionals and individuals at risk. The American Diabetes Association recommends the following preventive measures: 

Healthy Eating: Adopt a balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats. Limit the consumption of sugary, high-calorie and processed foods. 

Physical Activity: Engage in regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise per week. Physical activity improves insulin sensitivity and helps maintain a healthy weight. 

Weight Management: Maintain a healthy weight or work toward achieving it if overweight or obese. Even modest weight loss can significantly reduce the risk of Type 2 diabetes. 

Regular Screening: Individuals with risk factors, such as a family history of diabetes or obesity, should undergo regular screening for diabetes. Early detection enables timely intervention. 

Stress Management: Chronic stress can contribute to insulin resistance and diabetes risk. Practicing stress-reduction techniques like mindfulness and relaxation can be beneficial. 

Limit Alcohol Consumption: Excessive alcohol consumption can increase the risk of Type 2 diabetes. Moderation is key. 

Tobacco Avoidance: Smoking is associated with an increased risk of Type 2 diabetes. Quitting smoking is a vital step in diabetes prevention. 

Blood Pressure and Cholesterol Control: Managing blood pressure and cholesterol levels within a healthy range is essential, as these factors influence diabetes risk. 


The outlook for individuals with diabetes hinges on early diagnosis, effective management and following recommended treatment plans. With proper care and lifestyle adjustments, many individuals with diabetes can lead full, healthy lives. Regular monitoring of blood sugar levels, adherence to medication and insulin regimens and ongoing communication with healthcare providers are essential for achieving the best possible outcomes. 


In summary, diabetes is a complex and prevalent medical condition with various types and distinct treatment approaches. Recognizing the symptoms, understanding the underlying causes and implementing appropriate treatment modalities are paramount for effectively managing diabetes. Prevention strategies, including a healthy lifestyle and regular screenings, play a crucial role in reducing the risk of diabetes onset. The support and guidance of healthcare professionals, including endocrinologists, are invaluable in the journey toward diabetes management and prevention. Together, with the expertise of the American Diabetes Association, healthcare providers and the commitment of individuals, we can navigate the challenges posed by diabetes and strive for a healthier, more vibrant future. 

Diabetes FAQs

The first sign of diabetes varies among individuals, but it is often increased thirst (polydipsia) and frequent urination (polyuria). This occurs when your body can’t effectively process glucose, leading to high blood sugar levels. Excess sugar in your bloodstream causes fluid to be drawn from your tissues, making you thirsty and resulting in increased urination. 

Dealing with diabetes involves a multifaceted approach. It starts with education and understanding your condition. Managing your diet is crucial, as is focusing on balanced meals, portion control and carbohydrate monitoring. Regular physical activity helps regulate blood sugar levels, while medications or insulin may be prescribed as per your healthcare provider’s recommendations. Monitoring your blood sugar levels is essential, and regular check-ups are necessary to track your progress. 

Diabetes typically starts when your body becomes unable to effectively use or produce insulin, a hormone responsible for regulating blood sugar. This can occur as a result of various factors, including genetics, obesity, an unhealthy diet, lack of physical activity or autoimmune processes. Insulin dysfunction leads to elevated blood sugar levels, marking the beginning of diabetes. 

When blood sugar levels are high, you may experience symptoms such as excessive thirst, frequent urination, fatigue, blurred vision and unexplained weight loss. High blood sugar can also lead to nausea and confusion. If left untreated, it can progress to a diabetic emergency known as diabetic ketoacidosis (DKA), characterized by symptoms like vomiting, rapid breathing and fruity-smelling breath. If you suspect high blood sugar, it’s crucial to monitor your levels and seek medical advice. 

Before the onset of diabetes, individuals often experience prediabetes, a condition characterized by elevated blood sugar levels that are not yet in the f range (a fasting glucose measurement). During this stage, there are typically no noticeable symptoms. However, it’s a critical warning sign, as it indicates a higher risk of developing Type 2 diabetes. Lifestyle modifications, such as diet and exercise changes, can help prevent or delay the onset of diabetes. 

In uncontrolled diabetes, urine may appear pale yellow to clear. However, if blood sugar levels are very high and spill into the urine (a condition known as glucosuria), it can make the urine smell sweet or fruity. It’s important to note that changes in urine color can be a sign of uncontrolled blood sugar and should be discussed with a healthcare provider. 

In diabetes management, it’s important to limit or avoid foods high in sugar, refined carbohydrates and saturated fats. Specifically, steer clear of sugary beverages, sweets, white bread, sugary cereals and fried or heavily processed foods. Monitoring carbohydrate intake, especially from sources like white rice and sugary snacks, is crucial. Consult a registered dietitian for personalized dietary recommendations. 

Lowering blood sugar levels quickly in the short term often involves insulin or medication prescribed by a healthcare provider. To achieve stable, long-term control, focus on lifestyle modifications such as a balanced diet, regular exercise, weight management and taking proper medication. These strategies, when combined, can help reduce and maintain healthy blood sugar levels. 

Diabetes affects various systems in your body. High blood sugar can damage blood vessels, nerves and organs over time, leading to complications like heart disease, kidney problems, neuropathy (nerve damage), vision impairment and slow wound healing. Proper diabetes management is essential to reduce the risk of these complications and maintain overall health. 

Drinking water alone does not significantly lower blood sugar levels. However, staying well-hydrated is essential for overall health, and it can help support kidney function, which plays a role in blood sugar regulation. To lower blood sugar, it’s essential to manage your diet, exercise regularly and follow prescribed medications or insulin regimens. 

Three signs of a diabetic emergency include the following: 

Severe Hypoglycemia: Symptoms of low blood sugar (hypoglycemia) can include shakiness, confusion, rapid heartbeat, sweating and irritability. 

Diabetic Ketoacidosis (DKA): DKA is a potentially life-threatening condition characterized by symptoms such as vomiting, excessive thirst, rapid breathing, fruity-smelling breath and confusion. 

Hyperosmolar Hyperglycemic State (HHS): HHS is a severe condition resulting from extremely high blood sugar levels. Symptoms include extreme thirst, dehydration, confusion and sometimes seizures or coma. 

Any of these signs requires immediate medical attention. 

Water is the best drink to help regulate blood sugar levels, as it doesn’t contain carbohydrates or sugar that can raise blood sugar. Additionally, unsweetened herbal teas, particularly those with cinnamon or bitter melon, may have mild blood sugar-lowering effects. However, it’s crucial to consult with a healthcare provider before using herbal remedies to manage diabetes. 

Diabetes-related fatigue can feel overwhelming and persistent. It often involves extreme tiredness, low energy levels, difficulty concentrating and an overall lack of vitality. Fatigue in diabetes may be linked to fluctuating blood sugar levels, especially if they are consistently high or low. 

Type 2 diabetes can sometimes be reversed or effectively managed through lifestyle modifications, particularly in its early stages. Weight loss, dietary changes and increased physical activity can lead to improved blood sugar control. However, diabetes reversal is not always achievable, and it varies among individuals. 

As of now, there is no known cure for diabetes. However, with proper management, many individuals with diabetes can achieve stable blood sugar levels and lead healthy, fulfilling lives. Research into potential cures and more effective treatments is ongoing. 

Ignoring diabetes or failing to manage it effectively can lead to serious complications, including heart disease, kidney problems, neuropathy (nerve damage), vision impairment, slow wound healing and an increased risk of infections. Uncontrolled diabetes can also result in diabetic emergencies like DKA or severe hypoglycemia, which can be life-threatening. 

It’s possible to have diabetes for several years without knowing it, especially in cases of Type 2 diabetes. Symptoms may be subtle or absent initially. Regular check-ups and blood sugar screenings are essential for early diagnosis and intervention. 

The stage at which you become diabetic depends on factors like genetics, lifestyle and health history. Prediabetes is an intermediate stage where blood sugar levels are higher than normal but not yet in the diabetic range. Timely intervention during this stage can prevent or delay the onset of diabetes. 

Clear urine can indicate that you are well-hydrated, which is generally a good thing. However, diabetes-related changes in urine color are not typically associated with clear urine. It’s essential to monitor blood sugar levels and other diabetes-related symptoms rather than relying solely on urine color. 

Diabetic itching, often associated with dry skin, can feel like persistent, uncomfortable itching on various parts of the body. It may be accompanied by skin dryness, redness and flaking. Managing blood sugar levels and using moisturizers can help alleviate this symptom. 

The number of times you should urinate in a day varies from person to person and can be influenced by factors like hydration, activity level and age. On average, most adults urinate around 4 to 7 times a day. 

Frequent nighttime urination, known as nocturia, can be common in some cases but may also indicate an underlying health issue, including diabetes or an enlarged prostate (in men). If you find yourself consistently urinating three or more times at night, it’s advisable to consult a healthcare provider for evaluation. 

Frequent urination every 2 hours during the day may be normal for some individuals, particularly if they consume a lot of fluids or have certain medical conditions. However, if this pattern is significantly different from your usual urination frequency, or if it’s accompanied by other concerning symptoms, it’s essential to seek medical advice. 

Frequent nighttime urination can be a symptom of diabetes, especially if it disrupts your sleep. It’s not the number of times but the change in your usual pattern that may be indicative of a problem. If you experience this symptom, consider discussing it with a healthcare provider. 

A “diabetic belly” is a non-medical term that refers to abdominal weight gain often associated with insulin resistance in Type 2 diabetes. This central or abdominal obesity can increase the risk of cardiovascular complications and is usually managed through lifestyle changes and proper diabetes management. 

Diabetic legs can exhibit various symptoms and signs, including neuropathy (tingling or numbness), poor circulation (cold or discolored skin), slow wound healing and the development of ulcers or sores. Swelling and changes in skin texture may also be present. 

Diabetes-related itching can affect various parts of the body, but it’s commonly reported in the lower legs, feet and genital area. Itchiness may be attributed to dry skin, poor circulation or neuropathy (nerve damage). 

Yes, individuals with diabetes can have a flat tummy through a combination of a healthy diet, regular physical activity and weight management. Maintaining a healthy weight is essential for overall diabetes management and reducing the risk of complications. 

Diabetes can lead to various bowel problems, including constipation or diarrhea. Gastroparesis, a condition where the stomach takes longer to empty, can also occur in individuals with diabetes, leading to digestive issues like bloating, nausea and vomiting.

Individuals with diabetes can face weight challenges because of factors like insulin resistance, which can promote weight gain. However, weight management is crucial in diabetes management, and with proper dietary and lifestyle choices, individuals with diabetes can achieve and maintain a healthy weight. 

The availability of free diabetes-related resources varies by location and healthcare system. In some cases, individuals with diabetes may have access to free or subsidized diabetes education programs, screenings or support groups. It’s advisable to check with local healthcare providers or diabetes organizations for available resources. 

Moderate alcohol consumption may be acceptable for some individuals with diabetes, but it must be done cautiously and in consultation with a healthcare provider. Alcohol can affect blood sugar levels, and individuals on medication or insulin should be aware of potential interactions. 

Skipping meals can lead to blood sugar fluctuations in Type 2 diabetes. It’s essential to maintain regular meal patterns and consult with a healthcare provider or dietitian for guidance on meal planning. Not eating can also lead to hypoglycemia (low blood sugar), which can be dangerous if left untreated. 

Three common symptoms of undiagnosed diabetes include increased thirst (polydipsia), frequent urination (polyuria) and unexplained weight loss. These symptoms often occur because of elevated blood sugar levels and the body’s inability to use glucose effectively. 

You can test yourself for diabetes by using a blood glucose meter to measure your fasting blood sugar levels or by taking an oral glucose tolerance test (OGTT) as directed by a healthcare provider. However, it’s recommended to seek professional medical advice and diagnostic testing for an accurate diagnosis. 

The three classic signs of diabetes are polyuria (frequent urination), polydipsia (excessive thirst) and unexplained weight loss. These symptoms often prompt individuals to seek medical attention, leading to a diabetes diagnosis.