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What Precisely is Diabetes?

By: Ann Marie Coppen

Anne Marie Coppen

PhD, FNP, Nurse Practitioner

For a personal response to your health question, Ask Ann Marie at askannmarie@lindora.com. Selected questions will be featured in future columns.

Every day allows you the opportunity to make small changes in your eating habits and exercise that can benefit your health and reduce health risks.


What precisely is Diabetes and Pre-Diabetes?

Having diabetes means that you have too much glucose (sugar) in your blood.  Basically there is a malfunction where your body is not properly utilizing blood sugar for fuel.  This can stem from the body not making any or enough insulin, not using the insulin effectively or both. Insulin is a hormone that is needed to convert your food to fuel/energy.

There are three different types of diabetes: Type 1, Type 2 and Gestational Diabetes.

  • Type 1 Diabetes previously known as Juvenile Diabetes, is usually initially diagnosed in children, or young adults.  With Type 1 diabetes there is no insulin produced since the body’s own immune system has attacked the organ that makes the insulin (pancreas).
  • Type 2 Diabetes is the most common.  95% of people with diabetes have Type 2.  Anyone can develop Type 2 Diabetes at any age.  Type 2 Diabetes is associated with physical inactivity and excess weight.
  • Gestational Diabetes occurs during pregnancy.

Having diabetes can result in serious health consequences.  These include:

  • Cardiovascular disease: heart attack, stroke, high blood pressure, coronary artery disease and narrowing of the arteries (atherosclerosis).
  • Kidney damage (nephropathy). Diabetes can lead to kidney failure requiring dialysis or a kidney transplant.
  • Nerve damage (neuropathy). Diabetes can cause numbness, burning, tingling or pain that could ultimately affect all limbs.
  • Eye damage (retinopathy).  Uncontrolled diabetes can potentially lead to blindness.
  • Amputations.  Nerve damage and poor blood flow can lead to increased risk of infections causing severe damage that can result in amputation of a toe, foot or leg.
  • Cancer.  Individuals with diabetes have a higher risk of developing certain types of cancer.


 How would I know if I have Diabetes?

According to the American Diabetes Association, (2011):

  • 25.8 million children and adults in the Unites States have diabetes.
  • 18.8 million know they have diabetes.
  • 7 million people do not know they have diabetes.
  • 79 million people have pre-diabetes.

Millions of people have diabetes and don’t know it because many people do not experience any symptoms or the symptoms develop gradually.

A diagnosis of diabetes is made when fasting blood sugar levels are above 126 and Hemoglobin A1c (HgbA1c) is 6.5 or greater.  The HgbA1c reflects the average of a person’s blood sugar over the past 3 months. Another test that is done to identify diabetes is the oral glucose tolerance test (OGTT).  When your blood sugar is 200 or greater you have diabetes.

Symptoms of diabetes include:

  • Fatigue
  • Increased thirst
  • Frequent urination
  • Blurred vision
  • Frequent infections (skin, gum, bladder)
  • Cuts/bruises that are slow to heal
  • Numbness and or tingling in the hands/feet.


What is Pre-Diabetes?

Pre-Diabetes is when a person’s blood sugar is higher than normal but not high enough to be diagnosed with Type 2 Diabetes.   Individuals that have Pre-Diabetes are more likely to develop Type 2 Diabetes and may already have some health problems.

A person with Pre-Diabetes has:

  • Fasting blood sugar between 100 and 125 mg/dl
  • HgbA1c between 5.7% – 6.4%

If you have been informed you have Pre-Diabetes by a health care provider the time to make changes is now before you develop Type 2 Diabetes!

What can I do to delay or prevent Type 2 Diabetes?

A Diabetes Prevention Program proved that people with Pre-Diabetes were able to significantly reduce the risk of developing diabetes by losing 5 to 7 percent of their body weight via weight loss and physical activity. People can manage their diabetes by eating healthy, and exercising regularly.

Can I drive a Commercial Vehicle if I have Diabetes?

If you have Type 2 Diabetes and do not take insulin, you may obtain your CDL or continue to drive. If your diabetes worsens and you need to start taking insulin to maintain your glucose levels, or are a Type 1 Diabetic, you may apply for a FMCSA Diabetes Exemption Program to allow you to operate a commercial vehicle.  This exemption process is a bit complicated with over 50 tests to complete and a 16 page application to fill out. This is to show that you have your diabetes under control and will require information from your doctors. The American Diabetes Association is available to help you through the process at 1-800-DIABETES. Once the application is submitted to the department of transportation, the approval process can take up to 180 days. Please be aware that your state DMV may have additional requirements for you to obtain your CDL.

Can I reverse Type 2 Diabetes?

Yes! Start now by doing the following:

  • Eat healthy. Eat a variety of foods including vegetables, non-fat dairy foods, whole grains, fruits and lean meats.
  • Why whole grains? Whole grains take longer for the body to break down, which may help with sugar spikes.
  • Eat healthy snacks in between meals. Space your meals evenly throughout the day. Do not skip these snacks for best results.
  • Move more. Even moderate exercise will help. Try to commit yourself to 3-4 10 min walks a day while at rest stops or dropping off each load.

Diabetes is slowly becoming the number 1 killer disease, along with Heart Disease, especially in the trucking industry with the lack of activity, limited healthy food options, and lack of proper sleep.  Healthier eating and regular exercise will help reduce weight, and help you to manage day to day stress. Be sure to regularly check your glucose levels to help you manage your sugar levels and evaluate which healthy habits work best for you.

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