Saint Luke’s Diabetes & Endocrinology Centers offer a highly specialized team to help guide patients along a course of treatment that is right for each individual.

Our comprehensive diabetes and endocrinology care includes:

  • Diabetes Self-Management Training by certified diabetes educators, recognized by the American Diabetes Association
  • Treatment of diabetes for patients of all ages
  • Advanced treatments for patients with thyroid disease, osteoporosis, and pituitary tumors
  • Direct access to specialty services, including:
    • Cardiology
    • Podiatry
    • Weight-loss surgery

Resources for People with Diabetes

Resources for People with Diabetes

Having diabetes means many life changes. These changes may seem overwhelming. That’s a normal feeling. When you feel down, reach out to your family and friends. Your healthcare team is also there when you have questions or need advice.

Two men and a woman sitting together, talking.

How to help yourself

These tips can help you care for yourself:

  • Do things that you like. See a favorite movie. Read a good book. Or listen to music.

  • Call a friend to chat.

  • Aim for 7 to 8 hours of sleep each night.

  • Take a walk or garden. Physical activity can ease stress and lift your mood.

  • Break your goals into small, manageable steps.
  • Stick to your treatment program. Keeping your blood sugar in your target range will help you feel better. If you like technology, ask your healthcare team about newer ways of keeping track of your blood sugar and other areas of diabetes management.

  • If you feel your plan isn't working, is too hard to do, or is too costly, talk with your healthcare providers. 

How to get help from others

These tips can help you get help:  

  • Talk to your friends and family about how you feel. Give them information to help them learn more about diabetes.

  • Bring someone with you to your next appointment. This will help them learn how to support you. Write down questions before so all your concerns are addressed.

  • Join a diabetes support group. Here you can talk to others with diabetes and share concerns, experiences, and tips for solving problems. Your healthcare team, library, community center, church group, senior center, or hospital may know about support groups near you.

  • Try an online support group. The American Diabetes Association (ADA) offers one. It can also help you find local ADA chapters.

To learn more

These organizations provide information, educational programs, and other services. They are there to help you.

 Note

Talk with your healthcare provider if you feel helpless or hopeless, aren't interested in your usual activities, or have trouble sleeping or eating. These may be symptoms of depression. This serious condition can be treated.

Type 1 Diabetes

What is type 1 diabetes?

In type 1 diabetes, the body can’t make insulin. Insulin is needed to help sugar (glucose) enter cells for energy. Without insulin, glucose builds up in the blood. This causes high blood glucose or high blood sugar. In the past, type 1 diabetes was also called:

  • Insulin-dependent diabetes mellitus (IDDM)
  • Juvenile diabetes
  • Brittle diabetes
  • Sugar diabetes

Type 1 diabetes accounts for between 5 out of 100 to 10 out of 100 diagnosed cases of diabetes in the U.S. Type 1 diabetes most often develops in children or young adults. But it can start at any age.

What causes type 1 diabetes?

Experts don't know what causes type 1 diabetes. Genetic and environmental factors may play a role.

The body's immune system attacks and destroys the cells in the pancreas that make insulin. Insulin lets glucose enter the cells for energy. When glucose can’t enter the cells, it builds up in the blood. Then the cells don't get enough nutrition. It also causes high blood sugar. People with type 1 diabetes must check their blood sugar levels regularly and take daily insulin shots or wear a pump that continually injects insulin.

What are the symptoms of type 1 diabetes?

Type 1 diabetes often appears suddenly. Symptoms may include:

  • Abnormal thirst
  • Frequent and increased urination
  • Extreme hunger but loss of weight
  • Blurred vision
  • Nausea and vomiting
  • Extreme weakness and lack of energy (fatigue)
  • Irritability and mood changes
  • Fungal (yeast) skin infections in the groin area

In children, symptoms may seem like the flu. Bedwetting may be an important sign.

These symptoms may be caused by other conditions or health problems, including some medicines. Always see your healthcare provider for a diagnosis.

How is type 1 diabetes diagnosed?

There are several ways to diagnose diabetes. It's usually best for the tests to be repeated on a second day to make sure of the diagnosis.

  • Fasting plasma glucose (FPG). This test checks your blood glucose levels after having no calorie intake for at least 8 hours. You may have water before this test is done, but nothing else. Diabetes is diagnosed at a fasting blood glucose level of 126 mg/dL or higher.
  • Oral glucose tolerance test (OGTT). This is a 2-hour test that checks your blood glucose levels before and 2 hours after you drink a sugary drink. This test tells your healthcare provider how your body processes glucose. Diabetes is diagnosed at a 2-hour blood glucose of 200 mg/dL or higher. If this test is used for screening, be sure you have at least 5.25 ounces (150 grams) of carbohydrates per day for 3 days before the test.
  • A1C. The hemoglobin A1C test measures your average blood glucose for the past 2 to 3 months. Diabetes is diagnosed at an A1C of 6.5% or higher.
  • Random glucose test. This blood test is done at any time of the day. Diabetes is diagnosed at blood glucose of 200 mg/dL or higher with the symptoms of hyperglycemia or hyperglycemic crisis.
  • Insulin and c-peptide levels. Levels of these will be low or normal with type 1 diabetes but high with type 2 diabetes.
  • Antibody levels. People with newly diagnosed type 1 diabetes will often have high levels of antibodies against certain proteins found in the pancreas.

How is type 1 diabetes treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

If you have type 1 diabetes, you will need daily shots of insulin to keep your blood sugar level in normal ranges. Other parts of treatment may include:

  • Eating a diet to help manage blood sugar levels
  • Exercising to help the body use blood sugar efficiently
  • Monitoring blood sugar levels by fingerstick testing several times a day or by continuous monitoring, as directed by your healthcare provider, and learning how to adjust your meals and insulin dose as needed
  • Having regular hemoglobin A1C testing. This is advised at least 2 times a year. You may need to do this more often if your blood sugar level stays too high.

Research is being done to find better ways to manage diabetes. This includes looking for other ways to take insulin such as through pens, inhalers, pills, or pumps. Researchers have also found some genetic markers for type 1 diabetes. Pancreas and islet cell transplants are considered experimental treatments.

What are possible complications of type 1 diabetes?

Type 1 diabetes may cause:

  • Hypoglycemia. This is low blood sugar, sometimes called an insulin reaction. It occurs when blood sugar drops below 70 mg/dL. This can happen if the last insulin dose was too high for the amount of food eaten.
  • Hyperglycemia. This is high blood sugar that occurs when the body has too little insulin. It can be a sign that diabetes is not well controlled.
  • Ketoacidosis. When your body doesn't have enough insulin to use glucose for energy, the liver creates ketones out of fat. These ketones are then sent out in the bloodstream to muscles and other tissues to be used for energy. This can be part of the normal body function. But with diabetes, ketones can build up to high levels and become a life-threatening condition, leading to coma or death.

Long-term complications of uncontrolled type 1 diabetes include:

  • Heart disease
  • Kidney disease
  • Eye problems
  • Nerve problems
  • Foot problems

Key points about type 1 diabetes

  • In type 1 diabetes, the body can’t make insulin.
  • It is an immune system disorder. The body's immune system destroys, or tries to destroy, the cells in the pancreas that make insulin.
  • It most often develops in children or young adults. But it can start at any age.
  • It often appears suddenly. Symptoms include abnormal thirst, frequent urination, blurred vision, nausea, and vomiting.
  • For type 1 diabetes, you need daily insulin, either by injections or a pump that continuously delivers it under the skin. You also need to regularly check your blood sugar levels.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions, especially after office hours and on weekends and holidays.

Type 2 Diabetes

What is type 2 diabetes?

Type 2 diabetes is when your body can’t make enough insulin. Or it means your body can't use the insulin well. Insulin helps your cells use sugar (glucose) for energy. Without insulin, glucose builds up in your blood. This leads to high blood sugar.

Type 2 diabetes is an ongoing (chronic) disease. It has no known cure. It's the most common type of diabetes.

What causes type 2 diabetes?

The exact cause of type 2 diabetes is not known. It seems to run in families. But it often takes other things to bring on the disease. These include:

  • Being overweight
  • Not getting enough physical activity
  • Taking certain medicines

Who is at risk for type 2 diabetes?

You are at higher risk for diabetes if you have any of these:

  • Older age. People ages 35 and older are at higher risk for diabetes.
  • Family history of diabetes. It tends to run in families.
  • Extra weight. Being overweight puts you at higher risk.
  • Lack of exercise. Not enough physical activity puts you at risk.
  • Taking certain medicines. These include steroids and some water pills (diuretics). They also include medicines for mental health called antipsychotics.
  • Race and ethnicity. People who have African, Hispanic, Asian, Pacific Island, or American Indian heritage are more likely to develop type 2 diabetes.
  • Gestational diabetes. Having diabetes in pregnancy puts you at higher risk for type 2 diabetes later.
  • Prediabetes. This is when you have blood sugar levels higher than normal, but not high enough to be diabetes. Weight loss and medicines can help prevent type 2 diabetes in people who have prediabetes.
  • Low HDL. This means low levels of the good cholesterol.
  • A high triglyceride level. This is a type of blood fat.
  • Smoking. Being a smoker puts you at higher risk.
  • Other health problems. Polycystic ovary syndrome (PCOS) puts you at higher risk. So do patches of darker skin (acanthosis nigricans), or being born at a low birth weight.

What are the symptoms of type 2 diabetes?

Symptoms may include:

  • Frequent bladder infections
  • Skin infections that don't heal easily
  • Feeling very thirsty
  • Peeing often
  • Weight loss
  • Blurred vision
  • Nausea and vomiting
  • Feeling very weak and tired
  • Irritability and mood changes
  • Dry, itchy skin
  • Tingling or loss of feeling in the hands or feet

Some people don’t have symptoms. Or symptoms may be mild and you may not notice them. Half of all people in the U.S. who have diabetes don't know it.

How is type 2 diabetes diagnosed?

Diabetes can be diagnosed with several tests. It's best to repeat the tests a second time to confirm the results. The tests include:

  • Hemoglobin A1C test. The A1C test measures your average blood glucose for the past 2 to 3 months. An A1C of 6.5% or higher means you have diabetes. Some conditions can affect how accurate the A1C test is. These conditions include sickle cell disease, pregnancy, glucose-6-phosphate dehydrogenase deficiency, HIV, hemodialysis, recent blood loss or transfusion, and erythropoietin therapy.
  • Fasting plasma glucose (FPG). This test checks your blood glucose levels after 8 hours of fasting. You usually get this test before your first meal of the day. This is called your fasting blood glucose level. A result higher than or equal to 126 mg/dL means you have diabetes.
  • Oral glucose tolerance test (OGTT). For this test, your glucose level is measured before and then after 2 hours after you drink a sugary drink. This shows how well your body processes glucose. A result of 200 mg/dL or higher after 2 hours means you have diabetes.
  • Random glucose test. This blood test is done at any time of the day. Blood glucose of 200 mg/dL or higher with symptoms of high blood sugar means you have diabetes.

If you don't have any symptoms of high blood sugar, you will need to have 2 abnormal test results from the same sample or in 2 separate test samples to be diagnosed. An example is a fasting plasma glucose greater than 126 and an A1C greater than 6.5% from the same sample.

How is type 2 diabetes treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Ask your team about a service called diabetes self-management education and support (DSMES). You will learn skills to help you better manage your diabetes and find support when you need it. This service may be given in a group setting or one-on-one with your team.

The goal of treatment is to keep blood sugar levels as close to normal as possible, but not too low. To do this, you will need to control your blood sugar. You will need to check it regularly.

You may be able to control your type 2 diabetes with:

  • Weight loss
  • Exercise
  • Healthy eating habits
But you may also need to take medicine or insulin.

Treatment may include some or all of these:

  • Being more active. Get at least 150 minutes a week of exercise or physical activity. Don’t let more than 2 days go by without being active. When sitting for long periods of time, get up for light activity every 30 minutes.
  • Meal planning. You will need to eat foods that don’t cause your blood sugar to rise too fast. Your healthcare provider will help you get started with a personal nutrition program.
  • Weight loss. Losing just 5% to 7% of your body weight can help. Losing 10% or more of your weight and keeping it off gives you even greater benefits. Your type 2 diabetes may go into remission. Talk with your healthcare provider about ways to help you lose weight.
  • Taking medicine. There are different types of medicines to treat type 2 diabetes. Each type works in a different way to lower blood sugar. You may take 1 or more medicines to improve your blood sugar control.
  • Taking insulin. If oral medicines don’t work well for you, you may need to inject insulin into your body.
  • Getting blood tests. You will need to have your A1C level checked several times a year. Experts advise testing at least twice a year if your blood sugar level is in the target range and stable. You will need this test more often if your blood sugar level is not stable.
  • Routine healthcare. Keep all appointments. This is so your healthcare provider can track your diabetes. You will also need to check your feet daily. This is to look for injuries, sores, or infection. These can lead to severe foot problems.
  • Vaccines. Get a yearly flu shot. And ask your healthcare provider about vaccines to prevent pneumonia, shingles, COVID-19, and hepatitis B.

What are possible complications of type 2 diabetes?

Diabetes that is not treated or controlled well can cause problems. These can include problems with:

  • Kidneys
  • Legs
  • Feet
  • Eyes
  • Heart
  • Nerves
  • Blood flow

This can lead to:

  • Heart failure
  • Kidney failure
  • Gangrene
  • Amputation of feet
  • Blindness
  • Stroke

For these reasons, it's important to follow a strict treatment plan.

How daily issues affect your health

Many things in your daily life impact your health. This can include transportation, money problems, housing, access to food, and child care. If you can’t get to medical appointments, you may not receive the care you need. When money is tight, it may be hard to pay for medicines. And living far from a grocery store can make it hard to buy healthy food.

If you have concerns in any of these or other areas, talk with your healthcare team. They may know of local resources to assist you. Or they may have a staff person who can help.

Key points about type 2 diabetes

  • Type 2 diabetes is when your body can’t make enough insulin, or use it well.
  • Insulin helps the cells in your body use glucose for energy. Without insulin, too much glucose is left in the blood. This causes high blood sugar.
  • Type 2 diabetes is a chronic disease. It has no known cure. It's the most common type of diabetes.
  • The exact cause of type 2 diabetes is not known. It tends to run in families.
  • Diabetes that is not treated or controlled can lead to serious health problems.
  • The goal of treatment is to keep your blood sugar levels as close to normal as possible, but not too low. You will need to control your blood sugar. You will need to get physical activity, plan meals, and get regular healthcare.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Gestational Diabetes

What is gestational diabetes?

Gestational diabetes is a type of diabetes that happens during pregnancy. Unlike type 1 diabetes, gestational diabetes is not caused by having too little insulin. Instead, hormones made by your placenta keep your body from using insulin as it should. This is called insulin resistance. Blood sugar (glucose) then builds up in your blood instead of being absorbed by the cells in your body.

The symptoms of gestational diabetes often go away after delivery. But sometimes they don't. Or you may have a greater risk of developing type 2 diabetes later.

What causes gestational diabetes?

Healthcare providers don't know what causes gestational diabetes. But they do know what happens.

The placenta gives your growing baby nutrients and water. The placenta also makes several hormones to keep the pregnancy healthy. These hormones include:

  • Estrogen
  • Progesterone
  • Cortisol
  • Human placental lactogen

These hormones can affect how your body uses insulin (contra-insulin effect). This often begins about 20 to 24 weeks into your pregnancy and could lead to gestational diabetes.

During pregnancy, more fat is stored in your body, you take in more calories, and you may get less exercise. All of these things can make your blood sugar (glucose) levels higher than normal and possibly lead to gestational diabetes.

As the placenta grows, it makes more of the hormones. The risk for insulin resistance becomes greater. Normally your pancreas is able to make more insulin to overcome insulin resistance. But if it can't make enough to overcome the effects of the placenta’s hormones, you can develop gestational diabetes.

Who is at risk for gestational diabetes?

Any person can develop gestational diabetes during pregnancy. But you may be more likely to get it if you:

  • Are overweight or obese
  • Have a family history of diabetes
  • Are older than 40
  • Are African American, American Indian, Asian American, Hispanic or Latino, or Pacific Islander
  • Have prediabetes (impaired glucose tolerance) or another condition that makes it more likely for you to have diabetes, such as polycystic ovarian syndrome
  • Have high blood pressure
  • Had gestational diabetes during a past pregnancy

What are the symptoms of gestational diabetes?

Gestational diabetes doesn't cause any symptoms. That’s why it’s important to get tested for it if you are at high risk.

If your blood sugar levels are very high, you may have these symptoms:

  • You urinate more than normal.
  • You are hungrier or thirstier than normal.
  • You have blurred vision.
  • You have nausea and vomiting.
  • You lose weight even though you are hungrier.

How is gestational diabetes diagnosed?

You should be tested for gestational diabetes in your 24th to 28th week of pregnancy.

The American Diabetes Association also advises that you be tested for type 2 diabetes if you have risk factors for this condition. This testing should be done at your first prenatal visit.

Screening is done by these tests:

  • 1-hour glucose tolerance test. You drink a special beverage high in sugar. One hour later, the healthcare provider measures your blood sugar (glucose) levels. If your levels are higher than a certain level, this is considered an abnormal result.
  • 3-hour glucose tolerance test. If the 1-hour test is abnormal, you will have a second glucose tolerance test done to confirm the diagnosis. You will drink another special beverage, but with more sugar. Your healthcare provider will measure your blood sugar levels 1 hour, 2 hours, and 3 hours later. You have gestational diabetes if at least two of the glucose measurements are higher than normal.

If you are diagnosed with gestational diabetes, you should get tested for diabetes 4 to 12 weeks after your baby is born. You should also get this screening at least every 1 to 3 years for the rest of your life.

What is the treatment for gestational diabetes?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for gestational diabetes focuses on keeping your blood sugar levels in the normal range. Treatment may include:

  • Special diet. You should eat 5 servings of vegetables, fruits, low-fat or nonfat dairy products, and lean meats per day. Use liquid fats for cooking instead of solid fats. You should eat whole grains and avoid high-calorie snacks or sweet desserts.
  • Exercise. You should do moderate exercise unless your healthcare provider tells you not to.
  • Daily blood glucose monitoring. Your goal is to keep your blood sugar levels lower than 130mg/dL to 140mg/dL 1 hour after eating.
  • Insulin injections. You may need these to control your blood sugar levels. Or you may need other medicines taken by mouth.

What are possible complications of gestational diabetes?

Gestational diabetes usually doesn't cause birth defects. But it can affect your baby in other ways if your blood sugar levels are not under control.

Below are the 2 major health problems that can develop.

Macrosomia

Macrosomia means a baby who is much larger than normal. This happens if the birth parent’s blood has too much blood sugar in it. The baby’s pancreas senses this high level of blood sugar and makes more insulin. The baby then changes the extra blood sugar into fat. This extra fat means a larger baby.

A larger than normal baby can be difficult to deliver. The baby may have trauma or nerve damage, or need to be delivered by cesarean section.

Hypoglycemia

Hypoglycemia is low blood sugar. This can happen to the baby just after they are born if the birth parent’s blood sugar levels are too high. The high levels in the birth parent cause the baby to make more insulin. Once the baby is born, they no longer have the high blood sugar levels from the birth parent. This causes the baby’s blood sugar levels to fall very low.

Your blood sugar levels will be watched very closely during labor. Your healthcare provider may give you insulin to keep your blood sugar in a normal range. This will prevent your baby's blood sugar from dropping greatly after delivery.

Babies born to birth parents with gestational diabetes may also have low levels of calcium or magnesium in their blood.

These complications can be prevented. The key to prevention is careful control of your blood sugar levels just as soon as the diagnosis of diabetes is made.

Key points about gestational diabetes

  • Gestational diabetes is a type of diabetes that happens during pregnancy.
  • It may be caused by the hormones made by your placenta. These hormones can make insulin in your body not work as well as it should.
  • Gestational diabetes happens about halfway through pregnancy and doesn't cause birth defects.
  • If your blood sugar is not under control, your baby can develop problems. One problem is larger growth than normal. The other problem is very low blood sugar just after birth.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are and when they should be reported.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

News

Thumbnail
Apr. 25, 2018
FOX4: New approach takes insulin, risk of heart problems out of Type 2 Diabetes treatments
A different way of treating patients with Type 2 Diabetes takes away the insulin and it also takes away much of the threat of heart problems for patients.

Providers

Brian Todd Allenbrand, MD

Endocrinology, Diabetes, and Metabolism

Amanda Megan Bell, MD

Endocrinology, Diabetes, and Metabolism

Bhavika Bhan, MD

Endocrinology, Diabetes, and Metabolism

Marie L Griffin, MD

Endocrinology, Diabetes, and Metabolism

Jeffrey D Kallsen, MD

Endocrinology, Diabetes, and Metabolism

Renato Mendoza Sandoval, MD

Endocrinology, Diabetes, and Metabolism

Dorota J Walewicz, MD

Endocrinology, Diabetes, and Metabolism