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  • Michael Sparks, MD

Diabetes - Diagnosis And The Basics

November is American Diabetes Month. What better time to review the basics.

There are two main types of Diabetes; Type 1 and Type 2.

  • Type 1 diabetics are typically diagnosed earlier in life. The immune system turns on itself and attacks the insulin producing cells in the pancreas leaving the body unable to regulate sugar. Insulin injections are required.

  • Type 2 diabetics usually still make insulin (at least at first) but the body is not using it properly. Cells in the body become resistant to insulin. Treatment is focused on lowering sugar in the blood, but not necessarily by using insulin. We have a lot of medication options, including many newer medications.

How do we diagnose diabetes? Most commonly, we check a blood test called Hemoglobin A1C or A1C. We can also check a fasting glucose (blood sugar) with blood work. However, we can also check a random finger stick glucose level or a quick urinalysis in the office can give us a rough idea on how your body is handling glucose.

A1C Scale
An A1C 6.5% or higher is diagnostic of Diabetes. From American Diabetes Association:

How do we treat diabetes without medication?

  • Many "Pre-Diabetics" and even some Diabetics can reverse their disease and return to normal glucose levels with nothing more than diet and exercise. The American Diabetes Association has many great resources on making healthy dietary choices but there are a few simple concepts:

    • No one diet is perfect. Find the healthy foods that are sustainable and work for you. It might be the Mediterranean diet, a low carb, or even plant based diet.

    • Moderation and portion size are just as important as the foods you eat.

    • More vegetables and less ultra processed foods and sugars.

  • Get moving. Exercise really helps. The goal is 150 minutes a week of moderate intensity activity.

    • Thats just 30 minutes a day 5 days a week.

    • Can't get all 150 minutes at first? That is okay, build towards 150 minutes as a goal.

    • You don't need to go run a marathon. Brisk walking is perfect!

  • Weight loss of even just 10-15 pounds will help with glucose control dramatically.

What medications are there? The options available to us have dramatically improved over just the last few years. We have oral pills that can help improve your A1C, help with weight loss and help protect your heart and kidneys against future problems. We also have non-insulin injections that can impressively control glucose levels and weight while decreasing future risks of heart attacks and strokes. And of course, when absolutely needed, we have insulin. The right medication for you depends on a lot of factors and Dr. Sparks will work with you directly to find it.

How do we monitor blood sugar? Do I need to prick my finger every day?

  • Routine A1C lab tests are typically sufficient for most. We'll check it every 3 to 6 months in most cases.

  • If you are taking a medication that can abruptly lower blood sugar or just simply want to see the real time impacts of the foods you eat, continuous glucose monitors (CGM) are now a great option. These are essentailly a small patch that you wear for 10-14 days at a time and they track your sugar continuously.

  • CGMs are still expensive and not every insurance covers them yet. Other options include glucometers and lancets to test glucose on demand; usually around 3-4 times a day.

This is just the first post in a series of diabetes educational posts. Future topics include a more in-depth look at some of the newer medication options, the important of diabetic foot exams and more!

Have a particular diabetes question you want Dr. Sparks to answer? Let us know!

More Reading and Resources:



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