Diabetes is the inability of the body to create or use insulin, a hormone secreted by the pancreas that enables sugar or glucose, to enter the cells. Diabetes is a serious, chronic metabolic disorder in which the body either does not produce enough insulin or does not respond to the insulin being produced.

The body normally breaks down most of our food into glucose, a sugar that serves as the body’s main source of energy. In order for glucose to move into the cells of the body, it requires the help of insulin, a hormone produced by the pancreas. In healthy individuals, the body usually produces enough insulin to do this, but for people with diabetes, this does not occur. This causes glucose to build up in the blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems that may damage the blood vessels, nerves, heart, eyes and kidneys. While diabetes can lead to serious complications, it can often be successfully managed through diet, lifestyle modifications or medication.

request an appointment

Types of Diabetes

There are several different forms of diabetes.

Type 1 Diabetes

Type 1 diabetes is sometimes referred to as juvenile diabetes, because it is often diagnosed in children, however it can also affect adults. Type 1 diabetes is the result of an autoimmune disease in which the body attacks the insulin-producing cells of the pancreas, disabling the body’s ability to produce insulin.

Type 2 Diabetes

Type 2 diabetes is the most common form of preventable diabetes and is influenced by age, obesity and family history. Although the pancreas usually produces enough insulin, the body cannot use it effectively and production slowly decreases.


Prediabetes is a condition in which blood glucose levels are high but not high enough to diagnose diabetes. A diagnosis of prediabetes puts the patient at a higher risk of developing type 2 diabetes. Prediabetes is often addressed by losing weight and incorporating a daily exercise regimen.

Gestational Diabetes

Gestational diabetes is characterized by high levels of blood sugar during the later stages of pregnancy. While the exact cause is not completely understood, it is suspected that the hormones produced during pregnancy prevent insulin in the mother’s body from working, resulting in insulin resistance and hyperglycemia. Gestational diabetes does not cause birth defects but it can affect the baby’s glucose levels and result in a larger birth weight. Most cases of gestational diabetes resolve at the end of the pregnancy but may increase the risk of developing again in future pregnancies.

Most forms of diabetes can be managed, and with medical treatment or lifestyle modifications, people can live relatively healthy lives.

Symptoms of Diabetes

While type 1 diabetes usually develops during childhood or adolescence, it can also manifest during adulthood. Symptoms of type 1 diabetes may include:

  • Frequent urination
  • Increased thirst
  • Hunger
  • Unusual weight loss
  • Fatigue
  • Irritability

Symptoms of type 2 diabetes commonly develop in adulthood and may include the same symptoms as type 1 diabetes as well as:

  • Blurry vision
  • Frequent infections
  • Tingling or numbness in the hands or feet
  • Cuts or bruises that heal slowly
  • Recurring skin, mouth, vaginal or bladder infections

Some people with type 2 diabetes may not notice any symptoms at all.

Risk Factors of Diabetes

The exact cause of diabetes is not clear, however, there are risk factors for developing diabetes. Risks of developing type 1 diabetes include: the presence of autoantibodies (damaging immune system cells), a family history of diabetes and environmental factors. Risks for developing type 2 diabetes and prediabetes increase as people age and also may include:

  • Being overweight
  • Lack of exercise
  • Family history
  • Being black or a hispanic race
  • History of gestational diabetes
  • Polycystic ovary syndrome
  • High blood pressure
  • Low level of HDL cholesterol
  • Elevated triglycerides

The risks of gestational diabetes include:

  • Being over the age of 25
  • Being overweight prior to pregnancy
  • A family history of diabetes
  • Gestational diabetes in a prior pregnancy
  • Being black or a hispanic race

The risk of gestational diabetes increases if a woman is diagnosed with prediabetes prior to pregnancy.

Diagnosis of Diabetes

If symptoms occur and diabetes is suspected, tests may include urine tests and blood tests to measure glucose and blood sugar levels. Tests may include:

  • Random blood sugar test
  • Oral glucose tolerance test
  • Fasting blood sugar test

Risks for gestational diabetes are usually evaluated early in pregnancy and blood sugar levels are checked through an initial glucose challenge test.

Treatment of Diabetes

Treatment of diabetes varies depending on the type. Individuals with any type of diabetes benefit from eating a healthy diet, maintaining a healthy weight and participating in regular physical activity. Prediabetes may be controlled with healthy lifestyle modifications that can bring blood sugar levels back to normal, therefore lowering the risk of developing type 2 diabetes.

Type 1 Diabetes

Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump to administer needed insulin to the body. People with type 1 diabetes need insulin therapy to survive. In addition, frequent blood sugar checks, and carbohydrate monitoring are also necessary on a daily basis.

Type 2 Diabetes

In addition to maintaining a healthy weight and eating a healthy diet, treatment of type 2 diabetes also involves blood sugar monitoring, along with diabetes medications, insulin or both. Medication may also be prescribed to to help control blood pressure or cholesterol levels.

Gestational diabetes can often be addressed with maintaining a healthy diet and exercising. The treatment plan may also include monitoring blood sugar levels and in extreme cases, using insulin or oral medications.

Complications of Diabetes

Left untreated, uncontrolled blood sugar levels caused by diabetes may result in serious complications. If not treated properly, diabetes can lead to nerve damage, heart disease, stroke and kidney failure. It can also cause permanent eye, foot, skin and bone damage. A lifelong commitment is necessary to prevent these complications from occurring. It is important for people with diabetes to take an active role in the management of their condition. Adhering to a healthy lifestyle and monitoring blood glucose levels are essential in preventing complications.

High Blood Pressure

High blood pressure, also known as hypertension, occurs when the pressure of the blood flowing against the artery walls is above the normal range. Blood pressure is determined by the amount of blood the heart pumps and the blood flow resistance in the arteries. If the heart pumps more blood than normal, and the arteries are narrower than normal, the result is high blood pressure. Untreated high blood pressure can cause serious health problems, including heart attack, kidney failure and stroke. There are two types of high blood pressure: primary and secondary. Primary hypertension is high blood pressure that develops gradually over the course of time, and secondary hypertension is high blood pressure that results from an underlying medical condition.

Symptoms of High Blood Pressure

Most people with high blood pressure do not have any symptoms. High blood pressure can gradually develop over the course of time without any symptoms. Prolonged and untreated high blood pressure may cause headaches, dizzy spells or nosebleeds.

Causes of High Blood Pressure

In most cases, the cause of high blood pressure, especially primary hypertension, is unknown. Secondary hypertension may be caused by various conditions or medications including:

  • Kidney problems
  • Thyroid problems
  • Congenital defects in blood vessels
  • Birth control pills
  • Decongestants
  • Certain prescription medications
  • Obesity

Alcohol or illegal drug abuse may also lead to high blood pressure.

Risk Factors for High Blood Pressure

Risk factors for developing high blood pressure may include:

  • Family history
  • Being African-American
  • Increased age
  • Obesity
  • High sodium intake
  • Excessive alcohol consumption
  • Lack of physical activity or exercise
  • Smoking
  • Stress

Chronic conditions such as kidney problems, hormone problems, diabetes, and high cholesterol may all increase an individual’s risk of high blood pressure.

Blood Pressure Diagnosis and Measurement

Blood pressure is commonly measured during a physical exam. An inflatable arm cuff is fit around the arm and measures the blood pressure using a pressure-measuring gauge. This gauge yields two sets of numbers. The first number is the systolic reading, which is the pressure when the heart is beating. The second number is the diastolic number, the pressure when the heart is resting. High blood pressure occurs when the systolic reading is at 140 or higher and the diastolic reading is 90 or above.

High Blood Pressure Treatment

High blood pressure is often initially treated with lifestyle changes that may include:

  • Losing weight
  • Eating a healthy diet that is low in salt and fat
  • Limiting alcohol intake
  • Exercising and staying physically active
  • Quitting smoking

Hypertension that does not respond to lifestyle changes alone, is often treated with medication that may include alpha blockers, vasodilators, aldosterone antagonists, and central-acting agents. Treating any underlying conditions can also help to control high blood pressure.

Complications of High Blood Pressure

High blood pressure is a serious condition. Left untreated, hypertension may cause:

  • Heart failure
  • Kidney failure
  • Heart attack
  • Aneurysm
  • Stroke

Controlling blood pressure can reduce the risks of these complications.

High Cholesterol

Cholesterol is produced by the liver, the intestines and nearly all tissues in the body. Cholesterol is needed for the production of hormones, vitamin D and the bile necessary to digest the fats in food. Cholesterol also protects cell membranes from changes in temperature. While a certain amount of cholesterol is needed, too much cholesterol is unhealthy. An excessive amount of cholesterol can block blood flow in the arteries. This lack of blood flow can lead to a stroke. While there are no symptoms of high cholesterol, a simple blood test can provide patients with results. Cholesterol levels can be controlled or reduced with an active and healthy lifestyle. In some cases, medication may be necessary to control high levels of cholesterol.

Types of Cholesterol

There are three different types of cholesterol. Different blood tests are performed to individually measure each type of cholesterol.

High-density Lipoprotein

High-density lipoprotein (HDL) is the “good” cholesterol because elevated HDL levels may reduce the risks for heart disease or stroke. It is believed that HDL returns excess cholesterol to the liver for elimination from the body.

Low-density Lipoprotein

Low-density lipoprotein (LDL) comprises the majority of the body’s cholesterol. It is considered to be the “bad” cholesterol because it builds up in the walls of the arteries causing them to narrow, blocking blood flow and leading to heart disease or stroke.

Very-low-density Lipoprotein

Very-low-density lipoprotein (VLDL) is composed of cholesterol, triglycerides and proteins. VLDL contains the highest amount of triglycerides than any other lipoprotein and is considered to be a “bad” type of cholesterol.

A total cholesterol test measures all types of cholesterol in the blood and the results indicate whether the bad cholesterol levels are too high.

Risks for High Cholesterol

Risks for developing high cholesterol increase with age. People who are at a higher risk for developing high cholesterol include those who:

  • Smoke
  • Are obese
  • Have diabetes
  • Eat a poor diet, high in saturated fat
  • Have high blood pressure
  • Do not exercise regularly

People with a family history of high cholesterol and heart disease have a greater risk for developing high cholesterol.

Complications of High Cholesterol

High cholesterol levels increase the risk of developing heart disease, the leading cause of death in the United States. High levels of “bad” cholesterol can lead to serious complications, including:

  • Coronary artery disease
  • Angina
  • Heart attack
  • Stroke

Initially, high cholesterol can cause atherosclerosis, an accumulation of cholesterol and fat deposits on the walls of the arteries. Atherosclerosis can then cause any of the conditions listed above.

Treatment of High Cholesterol

A low-fat diet and losing weight in general may help lower LDL and triglyceride levels. While these lifestyle changes are usually effective in treating high cholesterol, they may not be enough. If lifestyle changes have been made and the total cholesterol levels remain high, the following medication may be suggested:

  • Statin medication to reduce LDL cholesterol levels
  • Niacin, or nicotinic acid, to raise HDL levels and lower LDL levels
  • Fibrates to reduce triglyceride levels
  • Bile acid sequestrants to eliminate bile acids

Many medications do have side effects, so it is important to discuss any potential risks with a doctor before taking any medication.