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Diabetes Services: 3 Questions to Ask to Understand Diabetes

By Megrette Fletcher, M.Ed., RD, CDE, Wentworth Health Partners Diabetes Services

The hardest thing to understand about type 2 diabetes is that it isn’t one problem. You have probably heard that if you “lose weight” or “eat low carbs” your blood sugar will improve. We’ve all heard those suggestions, but are they true? 

In type 2 diabetes there are eight different factors that contribute to elevations in blood sugar. Type 2 diabetes is a surprisingly complex disease and your provider must gather a lot of information to determine the best approach to manage it. Meeting with a diabetes educator can help you develop a personalized plan!

To understand diabetes, we will focus on understanding digestion and what insulin does in the body.

When you eat any food, your body has to digest it into one of four macronutrients. For example, when you take a bite of the apple and chew it up, nothing changes to the apple, it simply becomes apple sauce. Yet, apple sauce isn’t what travels around in your blood stream. When your body digests the apple, which is a carbohydrate, it becomes glucose. If you had some peanut butter on that apple, the protein in the peanut butter would become an amino acid and the fat would become a fatty acid. All the foods you eat are broken down into these three macronutrients or alcohol (when alcohol is consumed) before it can enter the blood stream.

Once in the blood stream, insulin is needed to move the macronutrient glucose from the blood stream into the cell. When an individual has diabetes or prediabetes there is something wrong with the insulin which prevents that process from working. To understand what is wrong with insulin think of it like a knife.

Three Question to Ask about Your Insulin Knife

Your provider must ask and answer three questions about your insulin knife to help you manage your blood sugar:

  1. “How Big” is your insulin knife? That question is evaluating how well your body produces insulin.
  2. “How Sharp” is your insulin knife? There are many things that can dull your insulin knife and working with your diabetes team you can learn about different ways it might get dull and the many ways you could sharpen it.
  3. “How Much Work” are you asking your smaller, duller insulin knife to do? This is looking at your diet.

To Learn more about the Insulin Knife and Wentworth-Douglass Hospital’s Diabetes Services call (603) 740-2887 or listen to our Sweet Support Podcast.


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