What Is Diabetes?

Diabetes is a chronic condition that happens when your body cannot make enough insulin or respond to it appropriately, which leads to high blood glucose/sugar. There are a few types. 
 

Type 2 diabetes is the most common. It develops when the body becomes resistant to insulin, a hormone that helps move glucose from the bloodstream into cells where it can be used for energy. In response to insulin resistance, the pancreas initially produces more insulin to try to maintain normal blood glucose levels. However, over time the increased demand and stress placed on the pancreas can lead to a reduction in insulin production, causing blood sugar levels to rise even further.  Prediabetes means blood sugar is higher than normal but not yet high enough to meet the criteria for diabetes. Without intervention, many people with prediabetes eventually develop type 2 diabetes.

Other forms of diabetes exist too. Type 1 diabetes is an autoimmune condition in which the immune system destroys the insulin-producing cells of the pancreas. There is another autoimmune type of diabetes that is slower-progressing and is called latent autoimmune diabetes in adults (LADA). While these types may sometimes resemble type 2 diabetes, they often require a different treatment approach. Additional testing, including pancreatic autoantibodies and C-peptide levels, may be recommended to help distinguish these conditions. Medical conditions, aside from the autoimmune ones, and drugs can result in specific classifications of diabetes too.

What Causes It?

Type 2 diabetes, and its insulin resistance and progression, develops from one's polygenetic biological baseline and a combination of general factors including:
 

• Age

• Body weight

• Physical activity

• Diet

• Chronic inflammation

Other conditions and medications can also cause or contribute to diabetes or hyperglycemia, including:
 

• Medical conditions (chronic pancreatitis = pancreatogenic diabetes, PCOS = may increase risk of type 2 diabetes, cystic fibrosis = cystic fibrosis–related diabetes, excessive growth hormone = diabetes secondary to growth hormone excess, chromosomal conditions, Cushing syndrome = diabetes secondary to Cushing syndrome)

• Medications = drug-induced diabetes (corticosteroids, antipsychotics, immunosuppressants, growth hormone)

Some factors that have been linked to autoimmune diabetes include:
 

• Genetics

• Viral infections

What Are The Symptoms?
 

Early diabetes may cause no symptoms.

As blood sugar rises, symptoms may include:
 

• Increased thirst

• Frequent urination

• Increased hunger

• Fatigue

• Blurred vision

• Slow-healing wounds

• Frequent infections

• Unexplained weight loss

• Darkened patches of skin
   

How Is It Diagnosed?
 

Testing may include:
 

• Hemoglobin A1c ≥ 6.5% = diabetes; 5.7-6.49% = prediabetes

• Fasting blood glucose ≥126 mg/dL; 100-125 mg/dL = prediabetes

• Random blood glucose

• Oral glucose tolerance test

What Happens If It Isn't Treated?
 

Uncontrolled diabetes increases the risk of:
 

• Heart disease

• Stroke

• Kidney disease

• Nerve damage

• Vision loss

• Foot ulcers

• Serious infections

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Treatments
 

• Lifestyle changes (nutrition, exercise, etc.)

• Medication

• Addressing secondary causes

HbA1c goals are individualized based on age, kidney and liver function, comorbidities, medications, life expectancy, and risk of hypoglycemia. However, a general HbA1c goal is less than 7.

                                                            Common Medications

Biguanides - Metformin
 

Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists - Semaglutide (Ozempic, Rybelsus), Dulaglutide (Trulicity), Liraglutide (Victoza)
 

Dual GIP/GLP-1 Receptor Agonists - Tirzepatide (Mounjaro)

Insulin Therapy - Rapid-acting insulin: Lispro (Humalog), Aspart (Novolog); Short-acting insulin: Regular insulin; Intermediate-acting insulin: NPH; Long-acting insulin: Glargine (Lantus), Degludec (Tresiba)
 

Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors - Empagliflozin (Jardiance), Dapagliflozin (Farxiga), Canagliflozin (Invokana)
 

Thiazolidinediones - Pioglitazone (Actos), Rosiglitazone (Avandia)
 

Sulfonylureas - Glipizide (Glucotrol), Glimepiride (Amaryl), Glyburide (DiaBeta)
 

Dipeptidyl Peptidase-4 (DPP-4) Inhibitors - Sitagliptin (Januvia), Linagliptin (Tradjenta), Saxagliptin (Onglyza)

Alpha-Glucosidase Inhibitors - Acarbose (Precose), Miglitol (Glyset)

Meglitinides - Repaglinide (Prandin), Nateglinide (Starlix)
 

How Loria Mobile Medicine Can Help

I provide assessment, diagnosis, and management of primary and secondary diabetes. I excel at medication management and lifestyle counseling to help you achieve your blood sugar goals and reduce your risk of complications. I provide a  thorough review of the different medications, their benefits, their costs and coverage, their side effects, their administration, and their efficacy. I also provide education on the guidelines set forth by the American Diabetes Association (ADA), including goal blood sugars and HbA1c scores. 


                                                                                     References & Guidelines
 

American Diabetes Association (ADA). Standards of Care in Diabetes—2026.

ADA Professional Practice Committee. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026.

ADA Professional Practice Committee. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2026.

ADA Professional Practice Committee. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes—2026.