At The Art of Being Ill, one of our main goals is to educate and build communication within communities.
After working as a bedside nurse for 40 years
At The Art of Being Ill, one of our main goals is to educate and build communication within communities. After working as a bedside nurse for 40 years, I’ve seen firsthand how diabetes remains one of the most challenging and misunderstood chronic illnesses. People often reduce it to “Oh, I just can’t eat sugar,” but it’s far more complex than that.
Depending on the type of diabetes you’re dealing with, and thanks to new technology and medication, it can be effectively managed. Still, confusion remains. That’s why knowledge, support, and open communication are essential for better outcomes.
In this first of a five-part blog series, we’ll explore what diabetes really is. In the coming weeks, we’ll look at:
- How insulin is used in hospitals—and how misuse can be dangerous
- Discharge with Diabetes
- Complications of Diabetes
- Why diabetes often leads to foot ulcers and impaired healing
But let’s start at the beginning.
Diabetes is a chronic condition that affects how the body processes glucose—your body’s main source of energy. Normally, the hormone insulin, produced by the pancreas, helps glucose enter your cells. In diabetes, either the body doesn’t produce enough insulin or can’t use it properly. This causes glucose to build up in the bloodstream, leading to high blood sugar (hyperglycemia), which over time can damage organs and tissues.
Diabetes can affect anyone, but some people are at higher risk:
- Type 1 Diabetes: Usually diagnosed in children, teens, or young adults. This autoimmune condition causes the body to destroy insulin-producing cells in the pancreas.
- Type 2 Diabetes: More common in adults over 45, but increasingly seen in younger people due to rising obesity and sedentary lifestyles. Risk factors include:
- Family history
- Obesity
- Inactivity
Certain ethnic backgrounds (African American, Hispanic, Native American, Asian American)
- Gestational Diabetes: Develops during pregnancy and typically resolves afterward—but increases the mother’s and baby’s future risk of Type 2 diabetes.
Diabetes is a major public health issue:
- Globally: Over 537 million adults (ages 20–79) lived with diabetes in 2021. This number is expected to rise to 643 million by 2030.
- United States: About 3 million people (11.3% of the population) have diabetes—and nearly 1 in 5 don’t know they have it.
- Type 1: The body produces little or no insulin. Daily insulin is required.
- Type 2: The body doesn’t use insulin properly (insulin resistance) or doesn’t make enough. Often managed with diet, exercise, and medication.
- Gestational: Develops during pregnancy. May require insulin or medication temporarily.
- Prediabetes: Blood sugar is elevated but not yet in the diabetic range. Without lifestyle changes, this can progress to Type 2.
- Increased thirst and urination
- Fatigue
- Blurred vision
- Slow-healing sores
- Unexplained weight loss (especially in Type 1)
- Numbness or tingling in hands and feet (often in Type 2)
Many people with Type 2 or prediabetes may not experience noticeable symptoms.
Simple blood tests can detect diabetes:
- Fasting Blood Sugar: Checks glucose after 8 hours without food
- A1C Test: Measures average blood sugar over 2–3 months
- Oral Glucose Tolerance Test (OGTT): Tracks how the body processes sugar
- Random Blood Sugar: A high level + symptoms may confirm diagnosis
Management depends on the type but usually involves:
- Daily insulin therapy (injections or pump)
- Frequent blood sugar checks
- Diet and exercise planning
- Lifestyle changes: diet, physical activity, weight management
- Oral or injectable medications
- Insulin, in some advanced cases
- Diet and exercise are first-line treatments
- Insulin or metformin may be used if needed
- Regular monitoring to protect both mother and baby
- Metformin – Reduces liver glucose production
- Sulfonylureas – Stimulate insulin production
- DPP-4 Inhibitors – Help regulate insulin
- GLP-1 Agonists – Slow digestion and boost insulin
- SGLT2 Inhibitors – Help remove excess sugar through urine
- Insulin – Required for Type 1 and some Type 2 cases
Nutrition plays a central role in diabetes care. It’s not about avoiding sugar altogether, but about managing carbohydrates, portion sizes, and meal timing to keep blood sugar stable.
- Carbohydrate Management: Focus on complex carbs with a low glycemic index (like whole grains and legumes).
- Balanced Meals: Combine carbs, proteins, and healthy fats to reduce blood sugar spikes.
- Portion Control: Helps with weight management and blood sugar control.
- Consistent Meal Timing: Keeps blood sugar steady throughout the day.
- Non-Starchy Vegetables: Spinach, broccoli, peppers, kale, cucumbers
- Whole Grains: Brown rice, oats, quinoa, whole-grain breads/pastas
- Lean Proteins: Chicken, fish, tofu, eggs, legumes
- Healthy Fats: Nuts, seeds, avocado, olive oil, fatty fish like salmon
- Low-GI Fruits: Berries, apples, pears, oranges (in moderation)
- Dairy Alternatives: Low-fat or unsweetened options like almond milk or Greek yogurt
- Sugary drinks, desserts, and candies
- Refined carbs like white bread and pastries
- Processed snacks high in saturated or trans fats
- High-sodium packaged foods
- Alcohol (limit, as it can disrupt blood sugar)
- Use the Plate Method: Half veggies, one-quarter lean protein, one-quarter whole grains or starchy veg
- Count Carbs with help from a dietitian or care team
- Stay hydrated—water is best
- Plan snacks to avoid blood sugar dips
- Exercise boosts insulin sensitivity and improves blood sugar control
- Monitor Blood Sugar to understand how different foods affect you
- Work With a Dietitian to personalize your eating plan
Diabetes is far more than “not eating sugar.” It’s a complex condition that requires daily decisions and long-term support. But with education, the right tools, and a strong care team, people with diabetes can live long, full, and healthy lives.
Whether you’re newly diagnosed or supporting someone who is, remember: small, consistent changes make a big difference.
