Will I Get Diabetes if it Runs in My Family?

Understanding diabetes and your risks for developing diabetes can be challenging and a little scary, especially when diabetes runs in your family. What's the difference between prediabetes, type 1 diabetes and type 2 diabetes? If people in my family have it, is it inevitable I will get it, too? How will I know if I have diabetes? Dr. K answers these questions and more in this episode of Q&A with Dr. K.

Additional resources for this episode:
Your primary care doctor!
https://diabetes.org/
https://www.mayoclinic.org/diseases-conditions/diabetes/

If you have a question for Dr. K, email QandAwithDrK@mpqhf.org. Your question will remain anonymous.

Transcript

Beth Brown: 0:10

Welcome to Q&A with Dr. K. A podcast by Mountain Pacific Quality Health, where we sit down with Dr. Doug Kuntzweiler and get your health questions answered. Because on Q&A with Dr. K, the doctor is always in. Hello, everyone, this is Beth Brown, your host and hello to Dr. Consuela. Oh, always a pleasure to get to talk with you. And today we're going to dive into our patient question, which is about pre diabetes and diabetes. So here's the question. Diabetes runs in my family. My mom had it, my grandmother had it, and my brother currently has it. I have tested in out of pre diabetes numbers, but continue to try to keep my blood sugar down with diet and exercise. Sometimes, though, I feel like this might be a lost cause. Is it inevitable that I will get diabetes at some point? So there's the question. So just a quick stat for you here, Dr. Kay, I read that diabetes affects 415 million people worldwide. And that's according to the Centers for Disease Control and Prevention or the CDC. So let's first start what is diabetes?

Dr. Doug Kuntzweiler: 1:22

Well, there are a couple of different types. But in general, diabetes is failure of the body to control its blood sugar, level of sugar in the bloodstream. There are actually a number of different types. The first type that we usually think about is what we used to call juvenile diabetes or type one. And these are people who their their pancreas just quits making insulin. Insulin is a hormone that's made by the pancreas flipped around in our bloodstream after we eat a meal. And that helps sugar get into our cells so that our cells can use it as fuel with the sugar can't get into those cells, and the cells can't absorb it and the sugar level in the bloodstream just keeps mounting. And that has a whole variety of bad outcomes. That's the first type is where you don't have enough insulin. Type two diabetes, which is actually much more common is where your pancreas still makes sense on what your cells don't use it very effectively, your cells become somewhat resistant to insulin, and the outcome is the same blood sugar rises and flips around and can't get used. And then there are a bunch of others that are not as common as gestational diabetes, which is elevated blood sugar only when you're pregnant. That usually resolves after the baby is still there. There are some people who are sort of somewhere in between that they don't manufacture as much insulin as they should, and their bodies are resistant to it. Those are sort of in between type syndromes. But that's in a nutshell, it's an elevated sugar from a variety of causes.

Beth Brown: 3:13

And so our patients question mentions pre diabetes, where does that fall in in there?

Dr. Doug Kuntzweiler: 3:17

Yeah, so pre diabetes. There are people who are beginning to have resistance to insulin and so their blood sugar's beginning to rise a little bit. There are some markers that are used to determine complete diabetes. And that has to do with what your fasting blood sugar is, in the morning before you eat anything. It has to do with a test called hemoglobin a one C, which is sugar is attracted to red blood cells and will coach them. And if you look at the red blood cells and see how much sugar is coated on them, it gives you an idea of what the average blood sugar has been over the last few weeks. And if that's elevated, then that is diagnostic of diabetes. There's another test called the glucose tolerance test, where your provider will give you a known amount of sugar and then two hours later, check the sugar in your bloodstream. And if everything's working right, your pancreas will pick out some insulin and sugar will go into your blood cells and you won't have an elevated level. But if you have diabetes that will be elevated. So in pre diabetes, all of these tests are slightly abnormal, not high enough to diagnose difficult diabetes, but high enough to be worrisome and, and usually if you don't do something like diet and exercise or sometimes even medication, you're going to go on and develop and abuse so it's not inevitable but you definitely even inevitable at all. Type Two Diabetes yours does tend to run in families, much more so than type one. So I understand the question that, you know, my whole family has, it looks like I'm going to get it too. But, you know, that's, that's good. That's a warning sign. And what we know is that activity Trumps genetic. So even though you may have the genetic background to get it, if you eat a healthy diet, and you exercise regularly, and you take care of yourself, you don't necessarily have to get diabetes.

Beth Brown: 5:30

Okay. So are there symptoms? Can people recognize diabetes?

Dr. Doug Kuntzweiler: 5:36

Yes, or no type one, usually Yes, because they don't have any insulin at all. And they usually get very sick. And this typically presents at a young age school age or early adulthood, but sometimes we'll see it later in life. But those people because the sugar level is so high, the kidneys have to get rid of it. And it takes water to make urine. And so these people get very dehydrated. So they're passing urine all the time, they're dying of thirst, they get, you know, into a shock state where they are so dehydrated that they get very, very sick. That tends not to happen so much and type two diabetes has the same phenomenon is going on, but it goes on at a slower pace. And so it's not as easy to recognize. But some other things that do show a blurry vision, a high blood sugar kind of interferes with how our lenses work in our eye. And so you can have some troubles, blurry vision, headache, fatigue, kind of vague symptoms, but ones that you shouldn't ignore.

Beth Brown: 6:49

So let's talk about trying to stave off pre diabetes, which it sounds like that's a type two diabetes situation. Now the type one diabetes. So you mentioned if you eat healthy, what does that look like? As far as does it matter? Do you still eat the same way with type one or type two? I'm assuming that type one you're managing, and maybe type two is prevention or managing

Dr. Doug Kuntzweiler: 7:11

Type one, you can take insulin and uncover your diet. So you can eat pretty much a well balanced diet. Type Two, the devil is carbohydrates. And you really have to cut down on carbs to control type two diabetes. In type one, you can eat carbs in a reasonable amount, as long as you cover it with insulin. I did add that if that doesn't work out so well. And so you really have to watch your carbohydrate intake. You know, you also you want to eat healthy protein, you want to get a lot of fiber in your diet. So something like a Mediterranean diet that's heavy on vegetables and fruits, heavy, whole grains and pretty light on processed foods, very light on sugar, and light red meat. Those are what is usually recommended.

Beth Brown: 8:04

Okay, darn. Everyone loves carbs. I don't know somebody who does not love carbs. So that's a tough one. So, you know, I talked about that 415 million people world worldwide have diabetes. And I'm sure because the symptoms can be tricky. Probably more than that, that don't know it. What are we doing here? Or is there something we can be doing that doctors can be helping with this? Why is this so prevalent?

Dr. Doug Kuntzweiler: 8:30

Because of our lifestyle. Yeah, type two diabetes is is an industrialized country problem for the most part. But as we see developing countries adapt to more Western diet, especially fast food that we see in other parts of the world as well. It has to do with high sugar, highly processed foods, highly sugary drinks, and a more sedentary lifestyle. People aren't as active as they get industrialized, we go to our cars, we don't walk as much as we used to.

Beth Brown: 9:13

Okay, so we could all be eating better. We need to make sure we're staying active, we need to be careful about sugar, especially those tricky carbs. Are there other things that we should be doing to try to help stave off diabetes, either as mankind or just us as an individual?

Dr. Doug Kuntzweiler: 9:32

No, it's not rocket science. Watching how many calories you eat, and burning them off by exercise is kind of the answer.

Beth Brown: 9:42

Okay. How does diabetes affect you as you get older?

Dr. Doug Kuntzweiler: 9:47

It has a lot of negative effects. It is very hard on your kidneys. And so one of the primary causes of people having kidney failure and having to go on dialysis is diabetes. It has very adverse effects on our heart and blood vessels. So it makes you at high risk for heart attack, high risk for stroke. And it also is detrimental for nerve function. So people lose sensation in their feet in their fingers. And when you don't have sensation, then you you tend to have injuries that you don't notice. So people get infections, especially with the hands into gangrene, they wind up having toes amputated, and feet amputated legs amputated. So it's pretty devastating. I neglected another one. It's, as I mentioned, it's hard on the heart and on blood vessels, and it's very hard on the tiny blood vessels in our eyes. It's a leading cause of blindness is is diabetes.

Beth Brown: 10:59

And so sugar is the main cause it does all that. Okay, so that's hopefully scary enough for somebody to cut down how many Snickers bars or whatever there. But where can people get more information about diabetes or pre diabetes?

Dr. Doug Kuntzweiler: 11:14

There is an American Diabetes Association and it has a website that's quite good. You can always, of course, talk to your primary caregiver because they should be familiar with treating diabetes since it's so calm. The Mayo Clinic website has a lot of good information. And CVS CDC website has a lot of good information about Cleveland Clinic. So there's, there's a lot of sources.

Beth Brown: 11:39

Okay, great. Well, thank you, Dr. K. That's it. And thank you for listening. We'll put some of those diabetes resources for you along with this episode. And if you have a question for Dr. K, please email us at QandAwithDrK@mpqhf.org. And that email address will be with this episode as well. Send us your questions the doctor is always in