Broward Health Physician Group Endocrinologist Wu Wen, M.D., Ph.D., explains diabetes basics, including how new treatments make the disease more manageable.

What’s the difference between Type 1 and Type 2 diabetes?

Both types of diabetes are related to a hormone called insulin, which regulates blood sugar levels. People with Type 1 diabetes develop autoimmune antibodies that destroy the pancreas’ ability to make insulin. Without insulin, too much sugar stays in the blood instead of entering the cells, leading to high blood sugar levels.

In Type 2 diabetes, the body doesn’t use insulin well, which is called insulin resistance. Many people with Type 2 diabetes also don’t make enough insulin.

What’s the difference between Type 1 and Type 2 diabetes?

Symptoms depend on the severity and duration of high blood sugar levels. Some people may not experience significant symptoms. Others may develop fatigue, drowsiness (especially after meals), poor concentration, blurred vision, frequent urination, increased thirst and unexplained weight loss.

How do medical providers diagnose diabetes?

We diagnose diabetes based on blood sugar levels or A1C, a test that shows your average blood sugar level over the past three months. You can be diagnosed with diabetes if you have a fasting blood sugar (measured after not eating overnight) of 126 milligrams per deciliter (mg/dL) or higher, a random blood sugar (measured anytime without fasting) of 200 mg/dL or higher, or an A1C of 6.5% or higher on two occasions.

What is your first recommendation for newly diagnosed patients?

Diabetes is a self-management disease, which is different from many other diseases, like cancer. With diabetes, you’re in control.

Healthy lifestyle changes play a significant role in self-management. These include losing weight, exercising on most days of the week, eating plenty of fruits, vegetables, whole grains and protein-rich foods, and limiting your intake of added sugars, saturated fat and sodium.

What treatments are available for diabetes?

Patients with Type 1 diabetes require lifelong insulin therapy, and those with Type 2 diabetes often need medications to help control their blood sugar levels.

Newer medications are giving people more options for treatment. Two recent exciting developments include glucagon-like peptide 1 (GLP-1) agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide, such as tirzepatide. These medications improve blood sugar control and provide other benefits, such as weight loss, decreased insulin requirements and cardiovascular and kidney protection.

Medications called sodium-glucose cotransporter 2 inhibitors, such as empagliflozin and dapagliflozin, also provide benefits beyond blood sugar control. These medications have been shown to preserve or improve kidney function, delay the need for dialysis in people with chronic kidney disease, and reduce the risk of heart failure, heart attack and stroke.

Continuous glucose monitors have also revolutionized diabetes management. These devices improve blood sugar control, reduce the risk of high blood sugar levels, help guide lifestyle modifications and medication adjustments and improve quality of life.

How can people living with diabetes keep it under control?

Patients should monitor their blood sugar according to their physician’s instructions. Some may need to check their levels several times a day, others less often. They should also have their A1C checked every three to six months.

You can check your random blood sugar level at home, and your physician will check your fasting blood sugar level and A1C. Current guidelines recommend striving for a fasting blood sugar level of less than 130 mg/dL, a random blood sugar level of less than 180 mg/dL and an A1C of 7% or lower for most people with diabetes.

Just like high blood sugar, low blood sugar can cause symptoms, such as feeling shaky or lightheaded, and complications without treatment. To avoid these problems, keep your blood sugar above 70 mg/dL.

To find a Broward Health primary care physician or endocrinologist, visit BrowardHealth.org/Wellness.