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HomeMemberHelpful ToolsDiabetes

Diabetes

Diabetes is a disease that happens when your body cannot use insulin the right way. Insulin helps move sugar from your blood into your cells for energy. If your body does not make enough insulin or cannot use it well, too much sugar stays in your blood. This can cause health problems over time. People with diabetes face a higher risk of heart disease, stroke, chronic kidney disease (CKD), blindness (retinopathy), nerve damage (neuropathy), and foot problems. People with diabetes can take steps to stay healthy and lower the chance of serious problems. If you or someone in your family has diabetes or was just diagnosed, Fidelis Care can help.



Identifying the Types of Diabetes

There are different types of diabetes, each with different causes, but they all share the common problem of having too much sugar (glucose) in your bloodstream. Select a class in the dropdown to learn more.

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Type 1 Diabetes

Type 1 Diabetes occurs when the pancreas does not make enough insulin. People with Type 1 diabetes are usually diagnosed as children or adolescents, and depend on insulin therapy and other treatments to make up for the lack of insulin.

Type 2 Diabetes
Type 2 Diabetes occurs when the pancreas makes some insulin, but it’s not enough to meet the body’s needs. People with Type 2 diabetes are usually diagnosed as adults and are not dependent on insulin therapy.
Gestational Diabetes
Gestational Diabetes can occur in pregnant women. While it doesn’t mean a woman had diabetes before pregnancy or will have diabetes after birth, her doctor’s advice should be followed to remain healthy.
Prediabetes

Prediabetes means you have a higher than normal blood sugar level.  Unmanaged prediabetes can lead to Type 2 diabetes. Prediabetes doesn’t always have symptoms, so it’s crucial to get blood sugar levels tested, especially if you’re at high risk. Losing weight, exercising regularly and healthy eating habits can reverse prediabetes and prevent Type 2 diabetes.

Other Types of Diabetes

According to the American Diabetes Association (ADA), about 2% of people have rarer types of diabetes. Including MODY, LADA, cystic fibrosis-related diabetes, and diabetes caused by rare syndromes.

  • MODY ➤ MODY (Maturity Onset Diabetes of the Young) is caused by a mutation in a single gene. If a parent has this gene mutation, any child they have, has a 50% chance of inheriting it from them. If a child does inherit the mutation, the symptoms of MODY are often established before the age of 25, regardless of their weight or lifestyle.  It’s estimated that 90% of those diagnosed with MODY are mistakenly diagnosed with type 1 or type 2 diabetes at first.

  • LADA  ➤ LADA (Latent Autoimmune Diabetes in Adults) is a type of diabetes which straddles type 1 and type 2 diabetes. The symptoms reported of this variant correspond with each Type 1 and Type 2 diabetes, which is why some people call it type 1.5 diabetes or type 1 ½ diabetes. Whereas being overweight is a major risk factor for type 2 diabetes, people with LADA tend to have a healthy weight.

  • CFRD ➤ CFRD (Cystic Fibrosis-related Diabetes) is a type of diabetes that is unique to children and adults with cystic fibrosis (CF). The accumulation of sticky mucus caused by CF can sometimes lead to inflammation and scarring of the pancreas. This can damage the cells that produce insulin, leading to high blood glucose (sugar) levels. When the pancreas can’t produce enough insulin, blood sugar levels may continue to rise and develop into CFRD.



Managing Diabetes

Controlling your diabetes starts with understanding your body. Regular doctor visits and testing are important ways to stay healthy, make informed decisions, and prevent serious complications.

Recommended tests for diabetes management include:

A1C Blood Sugar - At least twice per year

This blood test measures the average amount of blood sugar in a 2-3-month period. A result below 7 percent helps lower your risk of eye, nerve, and kidney damage. 

LDL Cholesterol - At least once per year

This blood test measures “bad” cholesterol (low-density lipoprotein cholesterol) levels in the blood. A result below 100 mg/dL helps lower your risk of heart disease and stroke.  

Kidney Damage - At least once per year

This urine test measures how well kidneys work. The test works by measuring protein in urine, a sign of kidney damage, which can happen if diabetes is not managed. Kidney damage can result in kidney failure and the need for dialysis. 

Eye Exam - At least once per year

A retinal or dilated eye exam by an eye care professional is recommended for people who have diabetes. The eye exam checks the nerves and small blood vessels of your eyes for damage caused by diabetes. This test should be done once a year even if your eyesight seems normal. If left undetected, this damage can lead to blindness.  

Care Management

Fidelis Care offers Care Management services to support members who need extra help with their health. These services help members manage their care, understand their health conditions, and connect with local resources

Learn More


Living with Diabetes

Taking care of your diabetes helps you live a healthy and active life. When you learn how to check and control your blood sugar, make smart choices about food and exercise, and follow your doctor’s advice, you can prevent problems and improve your overall health.

Healthy Eating
A balanced diet rich in whole grains, lean proteins, healthy fats, and fiber supports stable blood sugar and overall health.
Physical Activity
Regular exercise improves insulin sensitivity and helps manage weight, blood pressure, and cholesterol levels.
Medication Adherence
Taking insulin or oral medications as prescribed is vital to maintaining blood glucose within your target range.
Regular Checkups
Routine visits with your healthcare provider help catch potential issues early and ensure your treatment plan stays on track.  To search for a medical professional, service, or facility in the Fidelis Care Network, use our Find a Doctor tool.
Monitoring Blood Glucose

Regular testing helps track your blood sugar levels and identify patterns, making it easier to adjust meals, medication, and activity. For guidance on blood sugar targets for diabetes types and time of day, view our "Recommended Blood Sugar Targets," below. Talk to your provider and diabetes educator about the best goals for you.

Recommended Blood Sugar Targets

For people with type 1 diabetes, the American Diabetes Association recommends that blood sugar targets be based on a person's needs and goals, including whether they are pregnant. Talk to your provider and diabetes educator about the best goals for you. 

General guidelines are:

Before meals, your blood sugar should be:

  • From 90 to 130 mg/dL (5.0 to 7.2 mmol/L) for adults
  • From 90 to 130 mg/dL (5.0 to 7.2 mmol/L) for children, 13 to 19 years old
  • From 90 to 180 mg/dL (5.0 to 10.0 mmol/L) for children, 6 to 12 years old
  • From 100 to 180 mg/dL (5.5 to 10.0 mmol/L) for children under 6 years old

After meals (1 to 2 hours after eating), your blood sugar should be:

  • Less than 180 mg/dL (10 mmol/L) for adults

At bedtime, your blood sugar should be:

  • From 90 to 150 mg/dL (5.0 to 8.3 mmol/L) for adults
  • From 90 to 150 mg/dL (5.0 to 8.3 mmol/L) for children, 13 to 19 years old
  • From 100 to 180 mg/dL (5.5 to 10.0 mmol/L) for children, 6 to 12 years old
  • From 110 to 200 mg/dL (6.1 to 11.1 mmol/L) for children under 6 years old

For people with type 2 diabetes, the American Diabetes Association also recommends that blood sugar targets be individualized. Talk to your provider and diabetes educator about the best goals for you. 

General guidelines are:

Before meals, your blood sugar should be:

  • From 80 to 130 mg/dL (4.4 to 7.2 mmol/L) for adults

After meals (1 to 2 hours after eating), your blood sugar should be:

  • Less than 180 mg/dL (10.0 mmol/L) for adults

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Obesity and Diabetes

Being overweight or having obesity can make it more difficult to manage your diabetes and may compound into additional health problems, including heart disease and high blood pressure. If you are overweight and have diabetes, adopting a healthy eating plan with fewer calories and more physical activity often will lower your blood glucose levels and reduce your need for medicines.

 

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How Obesity Affects Diabetes

Obesity-and-Diabetes

Diabetes & Heart Disease

According to the National Institute of and Digestive and Kidney Diseases (NIDDK), individuals with diabetes are more likely to develop heart disease. People with diabetes are also more likely to have certain risk factors, such as high blood pressure or high cholesterol, that increase their chances of having a heart attack or a stroke.  Learn more below:

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What is the connection between diabetes and heart disease?
  • High blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. Over time, this damage can potentially lead to heart disease.

  • People with diabetes also tend to develop heart disease at a younger age than people without diabetes. In fact, adults with diabetes are nearly twice as likely to have heart disease or stroke as adults without diabetes.

  • The good news is that the steps you take to control your diabetes also help lower your chances of developing heart disease.
What other factors increase my chances of heart disease if I have diabetes?
  • Smoking ➤ Smoking raises your risk of developing heart disease.  If you have diabetes, it is important to stop smoking, because both smoking and diabetes narrow blood vessels.  

  • High blood pressure ➤ If you have high blood pressure, your heart has to pump harder to circulate blood. High blood pressure can strain your heart, damage blood vessels, and increase your risk of heart attack and stroke. Consider having your blood pressure checked regularly, and work with your doctor to regulate or lower high blood pressure.

  • Harmful cholesterol levels ➤ Cholesterol is a type of fat produced by your liver. You have two kinds of cholesterol in your blood: LDL and HDL. LDL, often referred to as “bad” cholesterol, can build up and clog your blood vessels. HDL, sometimes referred to as the “good cholesterol.” Higher levels of HDL is linked to lower risk for heart disease and stroke. To improve LDL and HDL balance, try to limit the amount of fat in your eating plan, consume more plant-based foods, and get regular physical activity.

  • Family history of heart disease ➤ Unfortunately, a family history of heart disease may add to your chances of developing the condition. If one or more of your family members had a heart attack before the age of 50, you have double the chance of developing heart disease, compared with diabetics who have no family history of the disease.  


Testing for Diabetes

Common Tests to Determine and Monitor Type 1 Diabetes, Type 2 Diabetes, and Prediabetes

If diagnosed, your doctor will have you take one or more of the following blood tests:

A1C Test

The A1C test measures your average blood sugar level over the past 2 or 3 months.  

  • An A1C below 5.7% is normal
  • An A1C between 5.7 and 6.4% indicates you have prediabetes
  • An A1C 6.5% or higher indicates you have diabetes

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

Glucose Tolerance Test

This test measures your blood sugar before and after you drink a liquid that contains glucose. You’ll be asked to fast overnight before the test and have your blood drawn to determine your fasting blood sugar level. Then you’ll drink the liquid and have your blood sugar level checked 1 hour, 2 hours, and possibly 3 hours afterward. 

At 2 hours, a blood sugar level of.... 

  • 140 mg/dL or lower is considered normal
  • 140 to 199 mg/dL indicates you have prediabetes
  • 200 mg/dL or higher indicates you have diabetes

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

Fasting Blood Sugar Test

This test measures your blood sugar after an overnight fast. 

A fasting blood sugar level of...

  • 99 mg/dL or lower is normal
  • 100 to 125 mg/dL indicates you have prediabetes
  • 126 mg/dL or higher indicates you have diabetes

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

Random Blood Sugar Test

This measures your blood sugar at the time you’re tested. You can take this test at any time and don’t need to fast prior to your appointment. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

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What Does Insulin Do?

Insulin allows the cells in the muscles, fat and liver to absorb glucose that is in the blood. The glucose serves as energy to these cells, or it can be converted into fat when needed. Insulin also affects other metabolic processes, such as the breakdown of fat or protein.  Learn more below:

How is insulin created?

Insulin is a hormone created by your pancreas that regulates the amount of glucose in your bloodstream at any given moment. It also helps store glucose in your liver, fat, and muscles. In addition, insulin balances your body’s metabolism of carbohydrates, fats, and proteins.

What happens with insulin when you eat?

When you eat, your blood glucose levels elevate, and this leads a typical person’s pancreas to release insulin, so that the sugar can be stored as energy for later use. Without this pancreatic ability, as a person with either type 1 diabetes or advanced type 2 diabetes, one's blood sugar levels may rise dangerously high, or drop too low.

What happens when insulin no longer works?

Without proper insulin function, your body can’t store glucose in your muscles or liver, but neither can it make any fat.  Instead, the fat breaks down and produces, among other things, keto acids.  If the acid levels grow too high, the imbalance can trigger diabetic ketoacidosis, a potentially fatal condition if not treated immediately.

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More on Diabetes

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Ketoacidosis

• Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening problem that can occur with diabetes.

Read This Article


Stroke Awareness Month: Understanding a Global Health Challenge
5/16/2024 • Posted by University of Rochester Medical Center in Diabetes, Health and Wellness, Heart Health, Member News

Mobile Stroke Unit

Stroke is a major global health challenge. It ranks as the second-leading cause of death and the third-leading cause of disability worldwide. Factors such as high blood pressure, heart disease, diabetes, smoking, unhealthy diets, physical inactivity, obesity, and excessive alcohol consumption can all increase the risk of stroke.

Understanding a stroke, recognizing the signs, and knowing the risk factors can help you to act quickly. So, what is a stroke, and what do you do if you or someone else is experiencing symptoms? A stroke occurs when the blood flow to a part of the brain is blocked or when a blood vessel in the brain bursts. Each minute without proper oxygen and blood flow results in millions of brain cells being lost. Swiftly and safely restoring blood flow to the brain is critical to saving as many brain cells as possible. Stroke treatments are most effective when administered early.

What Does a Stroke Feel Like?
The experience of having a stroke can differ greatly from person to person, but several common symptoms often serve as early warning signs. The sudden onset of these symptoms is critical to recognizing a stroke in its early stages, enabling you to seek immediate medical help. Here's an overview of symptoms that can indicate the onset of a stroke:

  • Vision changes
  • Numbness, weakness, or paralysis
  • Severe headache
  • Auditory changes
  • Dizziness, loss of balance, or an unexplained fall

Take Action Now
Spend a few moments today learning the FAST method's signs of stroke and understanding what a stroke might feel like. The FAST Method is:

  • Face drooping: Does one side of the face droop, or does the person report numbness on one side? Ask the person to smile. Is their smile uneven or lopsided?
  • Arm weakness: Check if one arm is weak or numb. Have them raise both arms. Does one arm drift downward?
  • Speech difficulties: Listen for slurred speech. Can they speak clearly and repeat a simple sentence like "The sky is blue"?
  • Time to call 9-1-1: If you see any of these signs, act immediately and call 9-1-1, even if the symptoms go away. Remember when the first symptoms appeared and share these details with emergency services.

Quick detection and treatment can make all the difference in successful outcomes for people who have had a stroke. That’s why it’s important not to delay getting care.

Bridging the Gap
University of Rochester Medical Center and healthcare providers nationwide are pioneering stroke treatment solutions to bridge care gaps, recognizing the importance of quick action in successfully treating stroke. As part of URMC's comprehensive stroke care, Dr. Tarun Bhalla, an endovascular neurosurgeon, introduced a Mobile Stroke Unit (MSU) to Rochester in 2018, the first in the region. The MSU's launch is significant for Monroe County, as fast access to stroke care has historically been challenging, especially in rural areas. In situations where "time is brain," delivering care as quickly as possible is crucial.

Mobile Stroke Units like URMC's are designed to function as mobile emergency rooms, equipped with essential imaging technology, such as CT scanners that quickly provide detailed brain images, and staffed by a team of medical experts, including a CT technologist, a stroke-trained critical care nurse, an EMT, a paramedic, and a neurologist. Using the same symptom checks a patient would receive in a hospital's emergency department, the team evaluates the patient's condition to determine if they are eligible for time-sensitive treatments like IV thrombolytics—medications that dissolve blood clots—right on the MSU.

In stroke care, the 'golden hour' refers to the first 60 minutes after a person was last known to be stroke-free, or in other words, the last time before they first exhibited symptoms. Receiving treatment within this golden hour is linked to the best outcomes and the highest chances of a full recovery. However, due to delays in recognizing symptoms or transportation and diagnosis, emergency rooms can only begin treatment within that golden hour for two to three percent of patients. Because the MSU arrives directly at the patient's location and begins assessment immediately, it can provide faster stroke treatment, achieving initial treatment within the crucial 60-minute window in 30 to 33 percent of cases.

URMC also supports patients and medical staff at URMC-affiliated hospitals and regional partners through teleneurology, another advancement in stroke treatment. Teleneurology uses video conferencing and digital communication tools to perform remote neurological evaluations, making specialist care accessible from almost anywhere.

Through the Teleneurology initiative, URMC neurologists ensure that neurological needs are met beyond the emergency room, with 24/7 remote acute and inpatient neurological support. This round-the-clock support has enabled 16 hospitals across upstate New York to be recognized as Primary Stroke Centers. It allows patients to receive specialized care locally, minimizing the need to relocate to larger centers and keep care close to home. This approach has led to a 15 percent decrease in patients needing to be moved for treatment.

Stroke outcomes can vary significantly. Some people fully recover, while others may face lifelong challenges, including movement, speech, or vision difficulties. However, the best chance of recovery comes from receiving immediate medical attention. Sharing information on the signs and symptoms of stroke, we can ensure more people can spot a stroke and get help immediately.