Smart-Take: Type 2 Diabetes

In the most basic terms, diabetes is a disease in which the body cannot properly manage blood sugar. When you eat, your body turns food into glucose. The pancreas then releases insulin, which acts as a doorway to open the body’s cells to glucose and convert it into energy. In type 1 diabetes (commonly called juvenile or insulin-dependent diabetes), the body sees insulin-producing cells as an attack and revs up the immune system to shut them down. In type 2 diabetes, which we will discuss further here, the body either cannot produce enough insulin or it fails to “open the door” to cellular uptake of glucose (commonly known as insulin resistance).

Once diagnosed, type 2 diabetes almost always requires lifelong intervention and treatment. Failing to bring blood sugar under control can result in very serious complications, including disability and even death. In fact, the direct and indirect costs to the healthcare system for treating diabetes is a whopping $245-plus billion annually.

Among those complications are:

  • An increased risk of cardiovascular disease, including heart attack and stroke
  • Major damage to organs, such as kidneys (requiring dialysis or transplant) and eyes (including cataracts, glaucoma, and blood vessel damage that can lead to blindness)
  • Nerve damage, especially to the feet, which can result in amputation. Nerve damage can also impact other system functions, such as in the digestive system (nausea and irregular bowel movements), and may also lead to erectile dysfunction
  • Increased probability of hearing loss, skin problems, and forms of dementia


  • Eat healthy. The American Diabetes Association has a range of plans and tips to get you started. A nutritionist is also a great ally in the fight to manage diabetes through any healthy eating plan. Generally, include a range of fruits, vegetables, whole grains, and legumes; increase fiber; and limit saturated fat.
  • Stay active. Check with your doctor and start slow. Walking 30 minutes most days is recommended, and combining walking with a couple of sessions of other activity—dancing, yoga, strength training—is even better.
  • Educate yourself. A diagnosis is frightening, and managing diabetes is a lifelong commitment. Learn all you can. You’ll see your doctors every six months to a year and your pharmacist every 30-90 days. Use those visits to ask questions.
  • Pay attention. Diabetes wreaks havoc on many of the body’s systems. Make sure that eye and dental exams are part of your regular checkups. Keep your immunizations up to date (flu, pneumonia, and hepatitis B), as your doctor recommends. Note whether you have cuts, sores, or blisters—especially on your feet—that are slow to heal.
  • Avoid smoking and drinking. Smoking increases your chances of suffering from potentially fatal cardiovascular events. Quit. Get help to do so from your doctor, pharmacist, or local cessation program. If you drink, do so in moderation (one a day for women and the 65-plus crowd, two for men under 65)—and always with food.
  • Manage stress. Stress hormones impair the body’s ability to regulate blood sugar by preventing insulin from working properly. Get plenty of sleep, learn your limitations, and investigate relaxation techniques.
  • Monitor your blood sugar. Learn how your body responds to certain foods, activity, stress, and time of day. Commit to a regular regimen of monitoring and learn how to do so properly (testing equipment use, needle disposal, and journaling results). Your community pharmacist is a good resource to ask for help.


To learn more about diabetes management, visit Mayo Clinic or the American Diabetes Association and listen in to a two-part radio series on diabetes management hosted by Northfield, Minnesota, pharmacist Jessica Astrup Ehret, available at