Your Body, Your Journey: Understanding and Monitoring Type 2 Diabetes
Hey there! If you're new to the world of Type 2 Diabetes, you might be learning some things for the first time, and that's okay. What's most important is that you're here, ready to learn and take charge of your health!
It's a big topic, but let's break it down. Type 2 Diabetes is a condition that can affect many different systems in your body over time. Some of these effects might not be obvious at first, which is why staying on top of your blood glucose control is absolutely key. Think of it as your superpower to protect your body! Regular check-ups, tests, and open conversations with your medical team are your best allies in this journey.
A Friendly Heads-Up: Please consider this advice a gentle nudge to take the very best care of yourself. Being proactive makes all the difference! If we let Type 2 Diabetes go unchecked, it can lead to serious complications. But by taking an active role, you empower yourself to live your life to the fullest!
How Diabetes Can Affect Your Body (and Why Monitoring Helps!)
Over time, high blood sugar can impact various parts of your body. Here's a look at some areas that can be affected:
Nerve Damage (Neuropathy): This can show up as pain, tingling, or numbness, especially in your hands and feet. It can also affect digestion and, for men, make it harder to get or maintain an erection. Even your amazing Vagus nerve, which helps regulate things like your heartbeat, digestion, blood pressure, and breathing, can be impacted.
Foot Problems: Poor circulation and nerve damage can make your feet more vulnerable to ulcers, sores, and infections. Left untreated, these can become very serious, sometimes even leading to amputation. Regular foot checks are a must!
Eye Problems: The tiny blood vessels in your eyes can be damaged, potentially leading to vision loss, cataracts, and light sensitivity. Regular eye exams are super important for catching these issues early.
Heart Disease and Stroke: Diabetes can increase your risk of heart attack and stroke. Keeping your blood sugar, blood pressure, and cholesterol in check is vital for heart health.
Kidney Problems: High blood sugar can put a strain on your kidneys, potentially leading to damage that might eventually require dialysis or a kidney transplant.
Weakened Immune System: When blood sugar is high, your body's ability to fight off infections can be compromised, making you more susceptible to illnesses.
Increased Cancer Risk: Unfortunately, high blood sugar levels can also create an environment where certain forms of cancer may thrive.
Your Health Toolkit: Important Tests to Discuss with Your Doctor
To help you and your medical team monitor how Type 2 Diabetes is affecting your body, here are some suggested medical tests. Some might not always be covered by insurance or Medicare, and others might be overlooked, so it's great to be informed and discuss what's relevant for your situation. (Remember, I'm not a medical professional, so always chat with your doctor about what's best for you!)
Understanding Your Glucose Levels
These tests help you and your doctor see how your blood sugar is doing:
Fasting Plasma Glucose (FPG): This measures your blood sugar after you haven't eaten for at least 8 hours (usually overnight).
Hemoglobin A1c (HbA1c): This is a fantastic test that gives you an average of your blood sugar levels over the past 2-3 months. It's like a long-term report card!
Oral Glucose Tolerance Test (OGTT): This test shows how your body handles glucose after you drink a sugary beverage.
Random Plasma Glucose (RPG): This measures your blood sugar at any time of day, regardless of when you last ate.
Postprandial Glucose: This measures your blood sugar 2 hours after a meal, giving insight into how your body processes food.
Continuous Glucose Monitoring (CGM): My absolute highest recommendation! These amazing devices use a small sensor to track your glucose levels throughout the day and night. They offer incredible insights into how your body responds to food, exercise, stress, and even hot showers (as I learned!).
Why CGMs are Game-Changers: If diabetes is new to you, wearing a CGM for even a month or so, combined with diet tracking, can provide invaluable knowledge. You'll see in real-time how different foods, activities, and even medications impact your blood sugar.
Good News on the Horizon! As of Spring 2024, Medtronic was granted Over-The-Counter (OTC) status for a CGM that reports to your smartphone, expected to be available later this year without a prescription for non-insulin-dependent individuals.
Current Access: Until then, you'll likely need a prescription. For example, Costco sometimes offers two Abbott FreeStyle Libre sensors (each lasting 14 days) for around $75 cash price. Insurance often covers them for those on insulin therapy. While they can be an investment, the detailed information you gain is truly worth it!
Important Note: Be aware that high doses of supplemental Vitamin C can sometimes affect CGM readings.
Traditional Glucose Monitoring: Fingerstick Meters
If a CGM isn't an option, fingerstick glucose meters are still incredibly important:
What's in the Kit: A typical kit includes the meter, test strips, a lancet (for a tiny prick), and calibration solution. Always store test strips as recommended by the manufacturer.
How to Use: It's quite simple: clean your finger with an alcohol wipe, use the lancet to get a small drop of blood, place it on the test strip inserted into the meter, and in a few seconds, your reading appears!
Features: Most meters have memory, and many offer Bluetooth connectivity to smartphone apps. I always recommend having a backup meter nearby.
When to Test: Common times include upon waking (fasting), two hours after each meal, and as needed for medication dosing. The more data, the better! A diabetes educator at your local hospital can offer detailed guidance.
Insurance & Budget: Your doctor will likely recommend a brand covered by your insurance. If you need a budget-friendly option, the Relion brand from Walmart is a reliable choice that many, including myself, have used for years. Remember, all FDA-approved meters must be within pm15 accuracy.
A Gentle Nudge: If you're hesitant about finger pricks or injections, please know that modern lancets and syringes are incredibly thin and nearly painless when used correctly! Your medical team can offer support and professional help if you need it. Seriously, your life depends on this vital self-monitoring!
Understanding Your Insulin Picture
These tests help assess your body's insulin production and sensitivity:
Fasting Insulin: Measures your insulin levels after an overnight fast.
C-Peptide: This test tells you how much insulin your pancreas is currently producing.
Insulin Resistance Tests: These can help evaluate insulin resistance, a common factor in Type 2 Diabetes.
Protecting Your Heart & Kidneys
Diabetes can impact your cardiovascular and kidney health, so these tests are crucial:
Lipid Profile:
Total Cholesterol: Your overall cholesterol level.
LDL Cholesterol: The "bad" cholesterol that can build up in arteries.
HDL Cholesterol: The "good" cholesterol that helps remove LDL.
Triglycerides: Another type of fat in your blood that can contribute to heart disease.
Lp(a) test: This measures lipoprotein(a), a type of cholesterol that can increase your risk of heart disease and stroke.
Kidney Function Tests:
Albumin-to-Creatinine Ratio (ACR): An early indicator of kidney damage, measuring a protein in your urine.
Estimated Glomerular Filtration Rate (eGFR): Shows how well your kidneys are filtering waste.
Blood Urea Nitrogen (BUN) and Creatinine: Also assess kidney function.
Other Important Checks
Blood Pressure: Measures the force of blood against your artery walls.
Complete Blood Count (CBC): Checks different types of blood cells, which can be affected by diabetes.
Liver Function Tests: Assess your liver health, as some diabetes medications can impact the liver.
Thyroid Function Tests: Checks your thyroid hormone levels, as thyroid issues can sometimes occur with diabetes.
Vitamin B12: Metformin, a common diabetes medication, can interfere with B12 absorption, so this level is good to monitor.
Foot Exam: A physical check of your feet for any signs of nerve damage or poor circulation.
Eye Exam: A comprehensive exam to check for diabetic retinopathy, an eye complication of diabetes.
Going Deeper: Advanced Cardiovascular Monitoring
Beyond the routine, there are some additional tests that can provide even more insight into your cardiovascular health, especially given the link between diabetes and heart issues.
Ankle Brachial Index (ABI)
This is a quick and simple test to check for Peripheral Artery Disease (PAD), where narrowed arteries reduce blood flow, usually to your legs or arms. PAD can cause leg pain when walking and increases your risk of heart attack and stroke.
How it Works: The ABI test compares the blood pressure in your ankle to the blood pressure in your arm. A lower number can indicate narrowing or blockages in your leg arteries.
When it's Useful: It's helpful for those with leg pain during walking or who have PAD risk factors like a history of tobacco use, diabetes, high blood pressure, high cholesterol, or atherosclerosis.
Getting Tested: You can get this screening done through services like
Life Line Screening https://youtu.be/QcK_-rtu9Ww?si=2dJhgBV83NHMwkGy
CIMT and Arterial Plaques
Arterial plaques can be quite problematic, and people with diabetes have an increased risk of developing them. These plaques are deposits of cholesterol, fat, calcium, and other substances that build up on the inner walls of your arteries, narrowing them and reducing blood flow. I had to have Triple Bypass open Heart Surgery due to my own lack of glucose control !
Why Diabetes Contributes:
High Blood Sugar: Can damage blood vessel linings.
Insulin Resistance: Also plays a role in plaque formation.
Inflammation: Diabetes is linked to chronic inflammation, which promotes plaque. Even exogenous insulin therapy can contribute to arterial inflammation.
Abnormal Cholesterol: Diabetics often have higher "bad" LDL cholesterol and lower "good" HDL cholesterol.
Risks of Plaques: These can lead to serious issues like heart attack, stroke, peripheral artery disease (potentially amputation), kidney disease, and vision problems.
Carotid Intima-Media Thickness (CIMT) Screening: The American Heart Association (AHA) recommends this non-invasive ultrasound for certain individuals (men 45+, women 55+ with risk factors, those under 60 with cardiovascular risk factors). It measures the thickness of your carotid arteries and can detect soft plaque before it hardens.
Benefits: No harmful radiation, no blood drawn, no special prep, and no recovery time.
Actionable Insights: CIMT helps determine your cardiovascular disease risk, guiding your provider to recommend medications, exercise routines, or heart-healthy eating plans.
Where to Get Screened: Services like
Life Line Screening Cardio Risk Labs
Daily Home Blood Pressure Monitoring
If you have Type 2 Diabetes, it's highly likely you also have high blood pressure. Monitoring your blood pressure daily provides a much more complete picture for you and your doctor.
Why Morning and Night Readings Matter:
Fluctuations: Blood pressure naturally varies throughout the day.
Morning Surge: An excessive rise in the morning can increase cardiovascular risk.
Nocturnal Dip: Ideally, blood pressure should dip at night. If it doesn't, it could signal a problem.
Masked Hypertension: Sometimes blood pressure is normal at the doctor's office but high at home, especially at night.
Medication Effectiveness: Monitoring helps assess how well your medication works throughout the day.
How to Monitor at Home:
Choose the Right Monitor: Get an accurate, validated upper arm cuff that fits well.
Prepare: Rest for 5 minutes, avoid caffeine, alcohol, and smoking for 30 minutes prior. Sit with your back supported, feet flat, and arm at heart level.
Take Readings: Take two readings 1-2 minutes apart, both in the morning (before breakfast/meds) and in the evening (before bed).
Record: Keep a log of your readings with dates and times.
Talk to Your Doctor: Share your readings so they can adjust your treatment if needed.
Tips for Accuracy: Use the correct cuff size, position your arm correctly, stay still and quiet, take multiple readings, and be consistent with your timing.
Advanced Monitoring with CONNEQT Pulse: Devices like the CONNEQT Pulse go beyond standard blood pressure. As a cardiac patient, I find these metrics incredibly helpful for tracking recovery and sharing reports with my healthcare team.
Core Measurements: Brachial (standard arm) and Central Blood Pressure (closer to your heart, a more accurate risk indicator).
Arterial Health Indicators: Central Pulse Pressure, Augmentation Pressure, Augmentation Index (all reflect arterial stiffness and heart workload), and Subendocardial Viability Ratio (SEVR) which shows heart muscle blood supply/demand balance.
Why These Matter: They offer a comprehensive view of your cardiovascular health, helping assess arterial stiffness, central blood pressure, and overall cardiovascular risk. This leads to earlier detection, personalized insights, and improved management with your doctor.
Taking an active role in monitoring your health is one of the most powerful steps you can take on your Type 2 Diabetes journey. You've got this!
