Type 1 diabetes occurs most frequently in children and young adults, although it can occur at any age. Type 1 diabetes accounts for 5-10% of all diabetes in the United States. There does appear to be a genetic component to Type 1 diabetes, but the cause has yet to be identified.

Type 2 diabetes is much more common and accounts for 90-95% of all diabetes. Type 2 diabetes primarily affects adults, however recently Type 2 has begun developing in children. There is a strong correlation between Type 2 diabetes, physical inactivity and obesity. People with Type 2 diabetes may hear their condition described as “mild,” but Type 2 diabetes is not a “mild” medical condition.


How is Diabetes connected with
Heart Health?

The longer a person has diabetes, the more damage is being done to the vessels.  Our blood vessels carry glucose (blood sugar) and also carry blood fats or lipids (cholesterol).  If a  person has diabetes and heart disease in their family history, the chances of developing both diseases is greater.

We know ways we can control the blood sugars.  Taking appropriate medications as prescribed by the healthcare providers, making healthy choices in foods and eating appropriate portions of food both contribute to better blood sugar control.  But don’t forget two of the most important factors to control blood sugars:  daily physical activity and weight loss (if necessary).

Ironically, the same factors are the treatment for heart disease.  Medications, healthy food choices and portions, physical activity and weight loss can also benefit the progression of heart disease.

  • Medications:  Some of the newer medications for diabetes (GLP1 class and SGLT2 class) have demonstrated cardio-protective effects.  They may maintain heart health and reduce risk of heart disease and stroke. So, for patients who don’t want to continue taking more and more medicaions for their diabetes and/or heart disease.  But there are more things you can do to better control your health issues.

  • Living in Central California, we have daily fresh vegetables and fruits available to us.  Yet, we are far under the necessary intake of vegetables in our diet.  Learn to buy more varieties of vegetables (carrots, spinach, kale, bell peppers, jicama) that have minerals and vitamins and take them to go with your lunch or to have as a snack before dinner.

  • Our body can only use a certain amount of food at one time.  By controlling our portions at meals and eating small snacks between meals if needed, our body doesn’t have to convert extra food into body fat.  The carbohydrate foods (starches) in particular need to be portioned as these cause the blood sugar to rise the fastest.

  • Daily physical activity is an absolute necessity for managing diabetes or heart disease.  Moving every 30 minutes if stationary can help use up more blood sugars.  This is the best time of year to start a regular activity program – partner up with a family member or dog to commit yourself.  Always check with your healthcare provider before starting an exercise program.

  • Following the above plan, can lead to weight loss if the patient is committed over time. 
  • This is a lifestyle change that can improve your quality of life in the future.  Take ownership of your life and health and make some changes one at a time.

    Susan Smith, Ph.D., CDE, is a nationally Certified Diabetes Educator (CDE) and a specialist in the field of diabetes since 1988.  Since 2002 she has worked with patients individually through all of the physicians in internal medicine and family practice at Visalia Medical Clinic. 


    Diabetes and foot care

    Jeffrey Hagen, DPM, is Board-certified by the American Board of Foot and Ankle Surgery.  He is especially interested in running/athletic injuries, reconstructive foot and ankle surgery and prevention of diabetic complications.

    Uncontrolled diabetes causes damage all over the body and can lead to nerve and circulatory damage to the feet and lower legs. In fact, about 73,000 amputations were performed in the U.S. in one year alone due to uncontrolled diabetes.

    Dr. Hagen works closely with VMC’s certified diabetes educator Susan Smith, Ph.D. to help patients maintain healthy control of diabetes and avoid complications of the feet. Dr. Hagen is now accepting new patients.


    What are the symptoms of diabetes?

    • Blurred vision
    • Unusual thirst
    • Frequent urination
    • Slow-healing cuts
    • Unexplained tiredness
    • Rapid weight loss (Type 1 diabetes)
    • Erectile dysfunction
    • Numbness or tingling in hands or feet

    If you experience more than one of these symptoms, make an appointment with your primary care provider.

    Symptoms may occur rapidly with Type 1 diabetes; however, with Type 2 diabetes the onset is more insidious and may not be noticed.

    How is diabetes diagnosed?

    Through a blood test measuring your blood glucose level. Usually these tests are repeated to confirm the diagnosis.

    If you are diagnosed with diabetes, what should you do?

    • Request a referral to a certified diabetes educator and/or a dietitian
    • Obtain a prescription for a glucometer and testing supplies
    • Begin to make lifestyle changes
    • Begin an exercise program
    • Decrease portion size
    • Make healthy food choices
    • Limit your intake of concentrated sweets
    • Increase your fiber intake
    • Test your blood sugar at varying times of
      the day