The link between obesity and insulin resistances comes in when there is excess fat stored in the body.

Excess body fat tends to get stored in places where it's not supposed to be in. This can be around the abdomen between muscle and in our organs. For example, this can be in the liver causing Fatty liver disease.

There are process in our body and organs that need flexibility and room to function properly. When there is excess fat being stored where its not supposed to be in, those process no longer have the room to function properly. For example, excess fat can stop oxygen from getting where it needs to go.

Some of these processes happen when we eat or when we are fasting. Our body works hard and fast to respond and regulate itself when we eat or skip a meal. When there is excess fat, it can't respond as fast or properly.

In response to the fat the body also creates extra chemicals that in large quantities are bad for us. Or the opposite where it doesn't create enough chemicals. This is what causes things like insulin resistance leading to the diagnosis of Type 2 Diabetes.

Minor mobility throughout the day can store glucose from the food we consume throughout the day and will eventually be stored as excess fat stored in our body. As the blood glucose rises, type 2 diabetes is presented.

Pancreas(Beta Cells in the Islets of Langerhans) :

The pancreas produces insulin, the hormone responsible for helping cells absorb glucose from the bloodstream. In type 2 Diabetes, the pancreas either does not produce enough insulin or its function is impaired, leading to high blood sugar levels.

Liver :

The liver helps regulate blood sugar by storing excess glucose as glycogen and releasing it when needed. However, in Type 2 Diabetes, the liver may become insulin resistant, causing it to release too much glucose into the bloodstream, even when it’s not needed.

Together, dysfunction in these two organs contributes to high blood sugar levels, a hallmark of Type 2 Diabetes. Managing this condition often involves lifestyle changes, medications, and monitoring to support proper glucose regulation.

Mnemonic to Remember !

Think

“PL = Pancreas & Liver, the Problematic Leaders of Type 2!”

• Pancreas = produces insulin( but struggles in type 2)

• Liver = Let’s out too much glucose ( even when it shouldn’t)

  
  

So how is Type 2 Diabetes Diagnosed?

It results in a percentage that will determine where the individual is Normal, Pre-diabetic, or has evidence of diabetes.

• Normal : Below 5.7%

• Pre diabetes : 5.7% - 6.4%

• Diabetes: 6.5% or higher

Why is the A1C test recommended?

• Does not require fasting, making it convenient

• It gives a long term image of the blood sugar levels ( past 2-3 months) rather than a snapshot

• It helps diagnose and monitor diabetes management over time.

Tip to remember the A1C Test :

The A1C test is like a report card for your blood sugar- AIM FOR THE STRAIGHT A1Cs!

American Diabetes Association – A1C Test

CDC | Diabetes Testing

https://www.cdc.gov/diabetes/diabetes-testing/index.html

How is Type 2 Diabetes diagnosed with a FBS test?

Your fasting blood sugar level is measured in milligrams per deciliter ( mg/dL ) of blood.

• Normal : 100 mg/dL

• Prediabetes : 100 - 125 mg/dL

• Diabetes: 126 mg/dL or higher

Why is the FBS test an essential form of diagnosis?

• It helps detect diabetes early, even before the symptoms tend to be observable or before it occurs.

• A fasting test provides more of an accurate reading of how the body regulates blood sugar.

• It also goes hand in hand with A1C test in diagnostic testing to provide confirmation of condition

Tip to remembering the FBS test :

(remembering FBS results)

Under 100, you’re a champ.

100-125, take are one glance.

126 or more, diabetes is at the door.

Mayo Clinic – Glucose Tests

https://www.mayoclinic.org/tests-procedures/glucose-tolerance-test/about/pac-20394296

NIDDK – Diabetes Testing & Diagnosis

https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis

Insulin resistance leads to Type 2 Diabetes.

Before developing Diabetes, the individual would first develop visual concerns on their skin like skin-tags, acanthosis for example.

The importance of the visual insulin resistance is showing that the organs are already affected as the body is showing its sign on the skin.

Some of the major consequences are:

Heart attack: it’s known that high blood sugar weakens arteries, increasing plaque buildup and blockages.

Stroke : reduced blood flow to the brain can result in permanent damage or disability.

Heart Failure: the heart struggles to pump efficiently, which leads to fatigue, shortness breath or swelling.

Peripheral Artery Disease(PAD) : poor circulation in the legs and feet can cause pain, slow healing hands and eventually amputation. (my great aunt actually had a few of her toes amputated because of this condition).

Now, why does it happen ?

• The excess of sugar actually damages blood vessels which makes them become fragile over time.

• High Blood Pressure and Cholesterol tends to be common in diabetes which puts an extra strain on the heart. (this is actually genetic in my family as well)

• Inflammation and poor circulation creates the perfect environment for cardiovascular diseases.

I learned that diabetes isn’t just about cutting sugar; it’s also about taking care your heart’s health.

Saying regarding cardiovascular diseases and diabetes:

Managing your blood sugar is key because a sweet tooth today could lead to a heartache tomorrow!

American Heart Association | Target : Type 2 Diabetes

https://www.heart.org/en/professional/quality-improvement/target-type-2-diabetes

As someone who has hearing loss and is in the speech and hearing sciences program with goals to become an audiologist, I thought I understood the many factors that contribute to hearing loss. But after conducting my research on the connection to hearing health and diabetes, I was surprised to discover that high blood sugar can also lead to hearing loss. I never realized that people with diabetes are at higher risk for hearing problems. This new insight really emphasized the wide spectrum of aural rehabilitation especially on those with Type 2 Diabetes.

What is the connection between Diabetes and Hearing Loss?

Hearing Loss - High Blood Sugar can damage the nerves and blood vessels in the ear, leading to gradual hearing loss.

Social Isolation - Already dealing with a stigmatized condition like type 2 diabetes, hearing loss can make communication harder, leading to emotional and social challenges.

Aural Rehabilitation: Diabetics may eventually benefit from hearing aids, auditory training, or speech therapy to improve communication quality of life.

Why does hearing loss occur to diabetics?

• Chronic high blood sugar weakens blood vessels including those in the ears.

• Nerve damage from diabetes can affect the auditory system, leading to hearing decline.

• Many diabetics are unaware of how hearing loss can develop slowly, which is why early intervention is important.

Treatment Options

• Hearing Aids - hearing aids amplify sounds to improve communication

• Auditory Training - this training helps individuals retrain their brain to better process sounds and speech especially in loud environments.

• Speech Therapy - SLPs can help diabetics develop strategies for clear communication and help them understand speech related issues caused by their type 2 diabetes condition.

• Regular Auditory Monitoring - Routine hearing assessments are important in providing early intervention to catch signs of hearing loss to best provide treatment.

Diabetes and Hearing Loss | American Diabetes Association

https://diabetes.org/about-diabetes/complications/hearing-loss/diabetes-and-hearing-loss

Diabetes and Hearing Loss | American Academy of Audiology

https://www.audiology.org/consumers-and-patients/hearing-and-balance/diabetes-and-hearing-loss/

Both of these conditions, hyperglycemia and hypoglycemia, can lead to long term damage such as memory loss, irritability, confusion, and dementia.

Prediabetes

• Prediabetes is often a precursor for Type 2 diabetes. Like Type 2 Diabetes, it involves high glucose levels caused by insulin resistance, but not high enough to meet the requirements for Type 2.

• Unlike Type 2 Diabetes, prediabetes is reversible and treatable with lifestyle and diet changes. In some cases, medication is needed.

• While prediabetes is a common precursor to prediabetes, it's possible to develop Type 2 without having prediabetes.
  

Gestational Diabetes

• During a woman's pregnancy, the placenta releases hormones that lead to insulin resistance. When the woman's pancreas is unable to produce enough insulin to combat the insulin resistance created by the hormones it results in gestational diabetes.

• Like prediabetes, if left untreated it causes the development of Type 2 Diabetes.

Key takeaway - both conditions share the same pathophysiological processes involved in Type 2 Diabetes such as insulin resistance, but in a lesser severity. The difference being that these conditions are treatable. However if left untreated, the body grows more resistant to insulin causing the development of Type 2 Diabetes.

https://th.bing.com/th/id/OIP.6DEqsnwyeoxyrIp3uo-HnQHaEK?rs=1&pid=ImgDetMain

https://www.webmd.com/diabetes/diabetes-eye-problems

The most common type, peripheral neuropathy, affects the feet and legs, then the hands and arms later. The most common symptoms of peripheral neuropathy are numbness, sharp pains, tingling. I have heard of the affects of diabetes on feet, which can lead to amputation, but have never known why that happens until now.

Other types of neuropathy include autonomic neuropathy, which affects the autonomic nervous system, and a common symptom is weakness or fainting when standing; proximal neuropathy, which focuses on the thighs, hips, or buttocks; and mononeuropathy, which affects only a single nerve.

Nerve damage can often go undetected until it is too late, which could explain why it affects so many people with type 2 diabetes. Neuropathy can be prevented or delayed by managing blood sugar and taking care of your feet.

• Poor management of one's blood sugar can deprive our brain of oxygen by damaging the blood vessels.

• Chronic inflammation.

• Insulin resistance- This can cause something called "plaques and tangles" which damaged our neuron communication. This is what happens in the brain when someone has Alzheimer's Disease.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8925983/#:~:text=Cognitive%20impairment%20is%20common%20in,less%20than%2010%20years%20ago

https://www.health.harvard.edu/blog/whats-the-relationship-between-diabetes-and-dementia-202107122546#:~:text=There%20are%20multiple%20reasons%20why,features%20among%20diabetes%20and%20Alzheimer's

Secretagogues are medications that send signals to the pancreas to release more insulin.

Glitazone helps treat Type 2 diabetes by increasing insulin sensitivity.

https://emedicine.medscape.com/article/117853-treatment?form=fpf

https://www.ncbi.nlm.nih.gov/books/NBK518983/

Here is more information on the Ozempic medication and how it can potentially help Type 2 Diabetics reduce their blood sugar and stabilize their sugar and reduce harm to other organs.

Symptoms suggesting that the diabetic patient may need LLA is when a fungal infection is present, swelling of the feet that does not go away and more.

Peripheral arterial disease can narrow the blood vessels that carry blood to your legs and feet. Poor blood supply can make even a tiny cut heal slowly or not at all.

Peripheral nerve damage can cause loss of sensation so you may not notice cuts, sores, or ulcers on your feet.

With these complications, even a small cut can become a serious infection.

CDC link best explains how to prevent Diabetes-related amputations, when to see a doctor and more.

Here's the breakdown:

Freaquent Urination (Medical term: Polyuria)

• What to look out for 🔎 - An individual will find themselves having to constantly go urinate, especially at night. Often waking up from sleep to go urinate.

• What is happening 🧐 - Because the body of the individual isn't producing enough insulin, there is excess sugar in the blood that is not being used by the body. 👉 The kidneys then work extra hard to expell the excess sugar in the blood from the body. 👉 The kidneys often have to pull in extra water from the body to achieve this. 👉 This leads to the production of extra urine. 👉 Which leads to the following symptom 👇

Excessive Thirst ( Medical Term: Polydipsia)

• What to look out for 🔎 - An individual will have an inextinguishable thirst and will find themselves having to drink a lot of fluid.

• What is happening? 🧐 - The kidneys are pulling extra water from the body to expell the excess sugar in the body. 👉 This causes the individual to be dehydrated. 👉 The body signals the individual to replenish the lost fluid.

• The cycle repeates 🔁 - The intake of fluid leads to more urination.

Adjacent Symptom: Dry Mouth (Medical Term: Xerostamia)

• What to look out for 🔎 - The individual experiences a persistent feeling dryness, thirst and discomfort in the mouth. This leads to increased thirst.

• What is happening? 🧐 - Due to the frequent urination, an individual will become dehydrated leading to dry mouth. In addition, the high blood sugar levels caused by diabetes can damage the salivary glands and reduce saliva production.

^{(https://my.clevelandclinic.org/health/symptoms/22495-diabetes-and-dry-mouth)}

Key Takeaway 🔑

• Lack of insulin production and increased blood sugar levels caused by diabetes affect the kidneys. Which leads to these symptoms.

• Frequent urination and excessive thirst are said to be hallmark symptoms of diabetes.

• Each of these symptoms alone should not be a cause for concern and can be caused by other factors.

• 🚩 When these symptoms present together, and are disruptive to an individuals life - it's a sign to get tested for diabetes.

       https://health.clevelandclinic.org/what-you-should-know-about-unexplained-weight-loss-and-diabetes

     https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193

https://cdn.images.express.co.uk/img/dynamic/11/750x445/1041659.jpg

As we learned, the high blood sugar levels associated with Diabetes, long term, cause damage to blood vessels all over the body. This leads to loss of function or malfunction of many body parts. One of these affected body parts is the eyes. This is refered to as Diabetic Rhetinopathy. Which just means "disease or condition of the retina".

This condition is caused when the excess sugar either weakens or causes blockages in the tiny blood vessels in the eye.

• Weakened blood vessels leak into the center of the eye.

• Blocked blood vessels die off.

• The eye attempts to grow new vessels.

• These new blood vessels are abnormal. They are fragile and prone to leakage.

This condition and consequences range in severity. Its severity depends on the management of blood sugar levels. The longer blood sugar levels remain unmanaged, the more damage is done.

This can lead to the following long term consequences :

• Vitreous hemorrhage - This is when weakened or abnormally grown blood vessels in the eye leak into the vitreois. This part of the eye contains a clear jelly like substance. The bleeding causes a spotty vision. If the bleeding is severe, it can completely obstruct the vision, but will NOT cause permanent vision loss. It can take weeks or months for the blood to clear from the eye.

• Retinal detachment - The new abnormally grown blood vessels (in the eye) stimulate the growth of scar tissue. This can pull the retina away from the back of the eye. This can cause spots floating in the vision, flashes of light or severe vision loss.

• Glaucoma - When new blood vessels grow in the iris (colored part of the eye, in the front) disrupting the regular flow of fluid out of the eye. This causes pressure to build in the eye, which can damage the optic nerve (the nerve that carries images from the eye to the brain).

• Macular Edema - When the damaged blood vessels leak into the macula, a critical component of the eye responsible for sharp, detailed, color vision. The leakage causes it to swell which affects the vision.

• Cataracts - The damage to the blood vessels in the eye can cause the accumulation of proteins and glucose in the lens of the eye. This causes cloudy vision.

• Blindness - Diseases in the eye, Macular Edema, and Glaucoma or a combination of these conditions can lead to complete vision loss. Especially when these conditions are poorly managed.

Key Takeaway 🔑

In conclusion, diabetes leads to long term vision problems. From limited vision to complete blindness. An individual with Diabetes is at risk to completely losing their vision if they don't manage the condition or their blood sugar levels. The onset of these conditions aren't always preventable, however they can be slowed down.

National Eye Institute. “Diabetic Retinopathy .” Nih.gov, 10 Dec. 2024, www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy.

NIDDK. “Diabetic Eye Disease | NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases, 25 Mar. 2019, www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease.

Diabetes.co.uk. “Many People with Diabetes Will Describe Themselves as Feeling Tired, Lethargic or Fatigued at Times.” Diabetes, 15 Jan. 2019, www.diabetes.co.uk/tiredness-and-diabetes.html.

Kalra, Sanjay, and Rakesh Sahay. “Diabetes Fatigue Syndrome.” Diabetes Therapy, vol. 9, no. 4, 4 June 2018, pp. 1421–1429, pmc.ncbi.nlm.nih.gov/articles/PMC6064586/, https://doi.org/10.1007/s13300-018-0453-x.

       https://www.webmd.com/diabetes/diabetes-constipation-diarrhea

https://static.toiimg.com/thumb/92284163.cms?width=680&height=512&imgsize=93248

Symptoms rarely show up until 5-10 years after kidney damage begins, but testing for higher rates of albumin in urine can help detect kidney problems. People with severe or chronic kidney disease might have fatigue, headaches, nausea, swelling in legs, and shortness of breath.

High blood pressure can damage kidneys more, and many people with type 2 diabetes have high blood pressure. Kidney disease can also make it harder to lower blood pressure, making managing blood pressure an important way to prevent or slow kidney damage.

https://medlineplus.gov/ency/article/000494.htm

Approximate Cost:

• With insurance : $35 - $300/ month (depends on insulin type and plan)

• Without insurance: $300 - $1,000+ /month

• Supplies ( syringes, test strips, glucose monitors) : $100 - $300/ month

• Insulin pump(usually optional) : $4,000- $6,000 initially, with $3,000 - $6,000/ year for supplies

Costs can vary widely based on the brand of insulin, delivery methods, and insurance coverage.

* learning about these costs was mind blowing as I did not realize how expensive it is to manage and live with diabetes ( type 1 &2 )

Insurance Coverage

Most private insurance plans, as well as Medicare and Medicaid, cover insulin therapy for people with Type 2 diabetes. However, patients may face copays, deductibles, or restrictions based on insulin type. Some insurance plans, may require individuals to partake in step therapy in which they try cheaper medications must be tried before adjusting to and approving insulin.

Long Term Consequences of Not Seeking Treatment due to Cost :

Avoiding insulin therapy because of cost can lead to serious and fatal consequences.

• Cardiovascular disease: increased risks of heart attacks and strokes

• Kidney Failure: leading to dialysis or transplant

• Vision Loss : diabetic retinopathy

• Peripheral neuropathy: results in pain, numbness, or amputations

• Increased hospitalizations: uncontrolled blood sugar levels.

* Instead of adding more financial strain, these complications can be prevented if treated with the proper treatment immediately. Although it is easier said than done for many individuals experiencing this condition when in need of a crucial medical treatment like insulin.

American Diabetes Association. (2023). Insulin Basics. https://diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-basics

Mayo Clinic. (2023). Type 2 Diabetes Treatment. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-treatment/art-20044084

Tseng, C. W., Masuda, C., Chen, R., & Hartung, D. M. (2020). Impact of higher insulin prices on out-of-pocket costs in Medicare Part D. Diabetes Care, 43(4), e50–e51. https://doi.org/10.2337/dc19-1294

Crawford, S. (2023, April 27). The Price of Insulin: A Q&A with Kasia Lipska. Yale School of Medicine. https://medicine.yale.edu/news-article/the-price-of-insulin-a-qanda-with-kasia-lipska/

The cost for people who are insured ranges between $10-$50. Without insurance, the cost can get up to $100 per month. On a scale 1-5, the likelihood of insurance covering the medication is about a 4. Most insurances are likely to cover the medication with or without copay.

If the medication is not taken as prescribed, the individual can experience loss of blood sugar control, which can lead to the long term consequences discussed previously.

https://www.nhs.uk/medicines/metformin/about-metformin/

https://health.costhelper.com/cost-diabetes-care.html

https://www.goodrx.com/metformin/side-effects-when-you-stop-taking-metformin

This can be used to treat depression, which is common among persons diagnosed with Type 2 diabetes. The rate for depression among T2DM patients is 3x higher than those without the disease.

This type of rehabilitation is provided by a mental health professional such as a psychologist, psychiatrist, therapist, or licensed clinical social worker.

https://diabetesjournals.org/care/article/39/12/2126/31378/Psychosocial-Care-for-People-With-Diabetes-A

https://www.ncbi.nlm.nih.gov/books/NBK279297/

1. Nutritional and Behavioral Therapy (Occupational Therapy)

   • Helps individuals develop consistent, healthy eating routines and coping strategies for stress and body image. Therapists may work on meal planning, insulin timing, and building positive habits.

   • Treats long-term effects of disordered eating behaviors and poor self-management habits; improves daily functioning and emotional regulation.

2. Exercise Therapy with Blood Sugar Awareness (Physical Therapy)

   • Creates safe and structured movement plans tailored to manage blood glucose levels, build strength, and promote a healthy relationship with exercise.

   • Treats physical inactivity, insulin resistance, and energy imbalance; improves strength, endurance, and overall health.

" Disordered eating in T2D patients often goes unrecognized due to overlapping symptoms and the focus on weight management in diabetes care."

Resources:

• National Eating Disorders Association: nationaleatingdisorders.org

• American Diabetes Association: diabetes.org

• Diabulimia Helpline: diabulimiahelpline.org

This type of treatment would need to be preformed by a licensed occupational therapist.

https://diabetesjournals.org/spectrum/article/29/4/224/32739/Management-of-Adults-With-Diabetes-and-Cognitive

This co-occurring condition significantly affects daily functioning and long-term physical and emotional health. Individuals may struggle with fatigue, mood swings, self-blame, depression, and difficulty adhering to treatment plans, making psychosocial rehabilitation critical.

• Cognitive Behavioral Therapy (CBT)

  • CBT helps individuals identify distorted thoughts related to food, body image, and insulin use and replaces them with healthier beliefs and coping strategies.

  • CBT helps target long-term emotional distress, body image dysmorphia, and disordered eating behaviors; it promotes emotional regulation and more consistent diabetes self-care.

  • This treatment is provided by a licensed mental health therapist or psychologist trained in both eating disorders and chronic illness.

• Motivational Interviewing (MI) & Diabetes Self Management Education and Support (DSMES)

  • MI is a collaborative counseling style that helps individuals explore their ambivalence about change. DSMES gives them the practical tools and emotional support needed to manage diabetes.

  • MI enhances motivation to stop insulin manipulation and encourages health-promoting behavior; DSMES supports long-term treatment adherence and confidence in self-management.

  • This treatment is provided by therapists, counselors, or social workers; DSMES is delivered by Certified Diabetes Care and Education Specialists (CDCES), nurses, or dietitians

  
  

  Why It Matters:

  • Without psychosocial support, individuals with Diabulimia and T2D face serious health risks like diabetic ketoacidosis, vision loss, nerve damage, and severe emotional burnout. These therapies not only address the physical side of diabetes but also the psychological pain and shame that drive disordered behaviors.

    
    

    
    

  Resources

  • National Eating Disorders Association nationaleatingdisorders.org

  • Diabulimia Helpline: diabulimiahelpline.com

    
    

Study suggests that muscles need glucose to function, so movement helps clear sugars from the bloodstream.

With the help of medication, physical activity after meals and choosing better meal options can help the patient stay on track to a healthier lifestyle and better glucose readings.

CNN posted a great article describing and persuading its readers to walk after our meals to lower our blood sugar levels.

It's no secret that home cooked meals taste better but does require time to prepare and cook unlike fast foods. But home cooked meals is a step further to a healthier lifestyle and to stabilize blood sugar.

More recommendations are provided here by the CDC.

A person with T2DM can develop difficulty swallowing overtime, due to damage to the nerves, diabetic neuropathy. Difficulty swallowing is referred to as dysphagia.

This type of rehabilitation must be done with a Speech-Language pathologist who can assess the individual's situation and provide a person centered treatment.

chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://griffinshare.fontbonne.edu/cgi/viewcontent.cgi?article=1044&context=slp-posters-2023

https://www.woosterhospital.org/responsibilities-of-a-speech-pathologist/#:~:text=A%20speech%20pathologist%20or%20a%20speech%20therapist,disorders%20and%20swallowing%20disorders%20from%20health%20conditions

The price of Ozempic can vary based on several factors, including insurance coverage, pharmacy choice, and medication supply and dosage. In this video, one woman still pays over $200 a month for Ozempic, despite being on Medicare. On a website from the manufacturer, the list price for Ozempic is just under $1000/pen.

Some ways to save on Ozempic include using coupons or ordering medicine through mail-order pharmacies, telemedicine providers, or as video above suggests, from another country. The manufacturer of Ozempic also offers a savings program and a savings card, but they cannot be combined with Medicaid or Medicare.

https://www.healthline.com/health/drugs/ozempic-cost

https://www.ozempic.com/why-ozempic/how-ozempic-works.html

https://www.novocare.com/diabetes/products/ozempic/explaining-list-price.html

https://www.webmd.com/drugs/2/drug-174491/ozempic-subcutaneous/details

https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199

https://www.wegovy.com/coverage-and-savings/wegovy-coverage-options.html?showisi=true&&utm_source=bing&utm_medium=cpc&utm_term=wegovy%20shot&utm_campaign

https://www.houstonpublicmedia.org/npr/2023/01/30/1152039799/wegovy-works-but-heres-what-happens-if-you-cant-afford-to-keep-taking-the-drug/

https://th.bing.com/th/id/OIP.i-dSTo7g8-OrYlWwsV3diwAAAA?rs=1&pid=ImgDetMain

https://pmc.ncbi.nlm.nih.gov/articles/PMC10184896/#sec022

https://cuevaslab.com/2021/11/22/the-mapss-dm-study-what-should-participants-expect/

https://diabetesjournals.org/care/article/25/10/1722/25464/Diet-and-Exercise-Among-Adults-With-Type-2

https://th.bing.com/th/id/OIP.pYNm3db8mjGPigFSz9k02QHaFL?rs=1&pid=ImgDetMain

https://diabetesjournals.org/spectrum/article/16/2/88/696/Psychosocial-Group-Interventions-in-Diabetes-Care

https://www.ncbi.nlm.nih.gov/

https://ezcareclinic.io/wp-content/uploads/2022/03/Ezcare-Support-1-2022-03-07T223020.129.jpg

Type 2 diabetes. (2025, March 19). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21501-type-2-diabetes#management-and-treatment 

Cdces, M. a. M. R. (2025, January 17). How a registered dietitian can help people with diabetes. culinahealth.com. https://culinahealth.com/how-a-dietitian-can-help-with-diabetes/ 

Ld, K. Z. R. (2024, May 21). Cost of nutritionists & dietitians (Insurance & Out-of-Pocket). Zaya Care. https://zayacare.com/blog/how-much-do-nutritionists-and-dietitians-cost/ 

Dysarthria. (2025, March 19). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17653-dysarthria

Marzbani, H., Marateb, H., & Mansourian, M. (2016). Methodological note: Neurofeedback: a comprehensive review on system design, methodology and clinical applications. Basic and Clinical Neuroscience Journal, 7(2). https://doi.org/10.15412/j.bcn.03070208 

Which professionals use neurofeedback? | About Neurofeedback. (n.d.). https://www.aboutneurofeedback.com/neurofeedback-info-center/faq/which-professionals-use-neurofeedback/ 

Kris Swartzendruber, Michigan State University Extension. (2017, July 31). Swimming benefits for people with diabetes. MSU Extension. https://www.canr.msu.edu/news/swimming_benefits_for_people_with_diabetes

Åsa, C., Maria, S., Katharina, S. S., & Bert, A. (2012). Aquatic Exercise Is Effective in Improving Exercise Performance in Patients with Heart Failure and Type 2 Diabetes Mellitus. Evidence-based Complementary and Alternative Medicine, 2012, 1–8. https://doi.org/10.1155/2012/349209 

Living close to less healthy food options such as fast food, convenience stores, and bars can also increase the risk of developing type 2 diabetes and may exacerbate T2D. These areas, although not exclusive to food deserts but encompassing them, are not ideal for those living with T2D. Rather, an environment with available sources for healthier foods, such as supermarkets and grocery stores would be a better option.

Environmental intervention, including moving to an area that has increased walkability, more green space, and grocery stores would help with many symptoms of type 2 diabetes, and can help mitigate further issues from arising.

Amuda, A. T., & Berkowitz, S. A. (2019). Diabetes and the Built Environment: Evidence and Policies. Current diabetes reports, 19(7), 35. https://doi.org/10.1007/s11892-019-1162-1

Neuromuscular electrical stimulation is where electrical currents are passed through muscles, having them contract similarly to physical exercise therapy. This allows for muscle strengthening and retraining. Physical therapists and other healthcare professionals may administer neuromuscular electrical stimulation.

https://www.aiam.edu/massage-therapy/neuromuscular-massage-therapy/

Nussbaum, E. L., Houghton, P., Anthony, J., Rennie, S., Shay, B. L., & Hoens, A. M. (2017). Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice. Physiotherapy Canada. Physiotherapie Canada, 69(5), 1–76. https://doi.org/10.3138/ptc.2015-88

https://www.cdc.gov/diabetes/diabetes-complications/effects-of-diabetes-brain.html

https://www.belmarrahealth.com/wp-content/uploads/2016/11/type-2-diabetes-cognitive-impairment-linked-tobrain-atrophy-resembling-early-stage-alzheimers-500x400.jpg

What all medications have in common is that they all work to improve the lives of type 2 diabetic patients but there is a high cost that comes with it. Not all insurances cover the costs that are essential for diabetics.

According to the American Diabetes Association, "the average cost of healthcare for a person with Diabetes is $16,752 a year--more than twice the cost of health care for a person without diabetes."

Good news is, Medicare has been a fundamental health insurance company whom helps cover medicines and supplies for diabetics. Although Medicare is usually covers individuals whom are 65 years or older; they have special rules for specific groups of people, like those whom are diabetic and need financial assistance with their medication for example.

Medicare can also cover diabetes screening tests, self- management training, etc.

The National Institute of Diabetes and Digestive and Kidney Diseases explain more on how Medicare plan A and/or B can help diabetics financially with their medications and therapies.

One of the new habits a newly diabetic will face is to monitor their blood glucose levels. Is it too high of a range? Is it too low? Constantly checking for the status of their blood glucose level can create an unhealthy habit of checking constantly and developing anxiety because of it.

The purpose of checking your blood glucose level is to determine whether the patient needs a higher dose of medication or is on the right track of stabilizing their blood sugar. The fear one may develop is constantly thinking of hyperglycemia and hypoglycemia - both of which could occur depending on whether blood glucose is too high or if the medication they take will drop their levels too low. Both conditions are very scary and can lead to a serious health effects/emergencies.

The National Library of Medicine states more about the anxiety built up of hyperglycemia and hypoglycemia.

Fortunately, there are various rehabilitation approaches to help speech, hearing and cognitive functions. It is important to begin rehabilitation so that symptoms can disperse or remain stable.

The patient can also visit an endocrinologist for diabetes management. An audiologist for hearing assessments and more.

It is important to educate one another as much as possible in regards to type 2 diabetes and the risks factors one may face if left untreated.

This can be a free lifestyle change that can begin on a very small level, depending on a person's physical capabilities, and work up to a larger scale.

On a scale of 1-10, I'd put the level at a 3. This is based on motivation and determining what physical activities one can do and what may be beneficial based on a person's specific circumstances.

A Primary Care Physician or Physical Therapist can help guide a patient through this lifestyle change.

https://diabetesjournals.org/care/article/39/11/2065/37249/Physical-Activity-Exercise-and-Diabetes-A-Position

https://www.cdc.gov/diabetes/living-with/physical-activity.html

Managing stress is not just helpful, it’s essential for individuals with type 2 diabetes. Chronic stress triggers the release of hormones like cortisol and adrenaline, which can increase insulin resistance and spike blood sugar levels (American Diabetes Association). By learning how to manage stress through practices like mindfulness meditation, physical activity, talk therapy, and deep breathing, individuals can gain better control over both their emotional well-being and their blood glucose levels. Stress management isn’t a luxury,it’s a key part of diabetes care that can transform someone’s health journey.

Difficulty Level: 6/10 – Building new habits around stress relief can be challenging at first, especially for individuals with busy lifestyles or those unfamiliar with self-care techniques. However, with the right support and consistency, these practices can become second nature and incredibly empowering.

Supporting Professional: A mental health counselor, psychologist, or certified diabetes care and education specialist (CDCES) can work closely with patients to identify stress triggers, teach coping strategies, and help establish a sustainable self-care routine. According to the CDC (2023), integrating mental health care into diabetes management has been shown to significantly improve outcomes.

References:

• American Diabetes Association. (2022). Ease Diabetes Stress. https://diabetes.org/health-wellness/mental-health/ease-diabetes-care-stress.

• Centers for Disease Control and Prevention. (2023). Diabetes and Mental Health. https://www.cdc.gov/diabetes/managing/mental-health.html

Diabetes management: How lifestyle, daily routine affect blood sugar. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-management/art-20047963 

Living with Diabetes. (2024, May 15). Diabetes. https://www.cdc.gov/diabetes/living-with/index.html 

When a person quits smoking, their lungs and circulation begin to improve within a few months, and past a year, their risk of heart disease is cut in half. Quitting smoking can also lower blood sugar levels, so checking blood sugar should happen more frequently until the body adjusts to a smoke-free lifestyle; as a result, blood sugar management becomes easier for those with T2D.

Quitting smoking can be extremely difficult, and many people don't succeed on their first try. On a scale of 1-10, quitting smoking would be at least an 8. With nicotine replacement products, this number might drop to 4 or 5.

A person may stop smoking cold turkey (immediately), over time, or with alternatives such as nicotine patches or gum. These products can double your chance of quitting smoking, but can also raise blood sugar. A primary care physician (PCP) can help with quitting smoking, and people with T2D should talk to their PCP before starting nicotine replacement products.

https://www.heart.org/en/health-topics/diabetes/prevention--treatment-of-diabetes/living-healthy-with-diabetes#

https://www.heart.org/en/healthy-living/healthy-lifestyle/quit-smoking-tobacco/5-steps-to-quit-smoking

https://www.cdc.gov/diabetes/risk-factors/diabetes-and-smoking.html

https://www.heart.org/en/health-topics/diabetes/prevention--treatment-of-diabetes/living-healthy-with-diabetes

https://www.verywellhealth.com/can-i-drink-alcohol-if-i-have-type-2-diabetes-1087730

https://tse1.mm.bing.net/th/id/OIP.rgR_mRdR5oNHSfDySgtYvgHaEK?rs=1&pid=ImgDetMain

Why They're at Greater Risk:

• Higher rates of insulin resistance and family history of diabetes.

• Traditional diets may be high in refined carbs, sugars, and saturated fats.

Unique Challenges:

• Language barriers and immigration status can limit access to healthcare.

• Cultural stigma around illness may delay diagnosis or treatment.

• Lack of health insurance and lower health literacy can hinder disease management.

Reference

• Dabelea, D., & Bell, R. A. (2019). Racial and Ethnic Disparities in Type 2 Diabetes and Its Complications in the United States: An Overview. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC6953173/

• Addie L. Fortmann, Kimberly L. Savin, Taylor L. Clark, Athena Philis-Tsimikas, Linda C. Gallo; Innovative Diabetes Interventions in the U.S. Hispanic Population. Diabetes Spectr 1 November 2019; 32 (4): 295–301. https://doi.org/10.2337/ds19-0006

Why It Works:
At least 150 minutes of moderate-intensity exercise per week can significantly reduce the risk of developing type 2 diabetes by improving insulin sensitivity and glucose uptake in the muscles.

Challenges:

• Many individuals face barriers like lack of safe spaces to exercise, time constraints due to work/family responsibilities, and limited access to fitness resources.

• In underserved communities, there may also be a lack of culturally appropriate or accessible exercise programs.

Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., Braun, B., American College of Sports Medicine, & American Diabetes Association (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes care, 33(12), e147–e167. https://doi.org/10.2337/dc10-9990

Benoit J. Arsenault, Jean-Pierre Després; Physical Activity for Type 2 Diabetes Prevention: Some Is Better Than None, More Is Better, and Earliest Is Best. Diabetes Care 1 June 2023; 46 (6): 1132–1134. https://doi.org/10.2337/dci22-0065

Potential Downsides:
Despite their benefits, CGMs can be expensive and not always covered by insurance, limiting access for low-income individuals. Some users may experience skin irritation, feel overwhelmed by constant data, or lack the tech skills to use the device effectively. These challenges can create disparities in care and reduce the potential impact of this innovative tool.

American Diabetes Association. (n.d.). CGM (Continuous Glucose Monitors). https://diabetes.org/advocacy/cgm-continuous-glucose-monitors

Mamkin, I., Ten, S., Bhandari, S., & Ramchandani, N. (2008). Real-time continuous glucose monitoring in the clinical setting: The good, the bad, and the practical. Journal of Diabetes Science and Technology, 2(5), 882–889. https://doi.org/10.1177/193229680800200520

🎯 Target: Individual & Environment

 Implementation Challenge:
Barriers include limited program availability in underserved or rural areas, lack of culturally tailored resources, transportation issues, and challenges with maintaining participant engagement over time.

Video: Sarah's Journey

Sarah's journey highlights the importance of resilience and support in overcoming health challenges. Her story serves as an inspiring example of how addressing personal health conditions, such as Type 2 diabetes, requires not only individual effort but also a community of resources and guidance. It emphasizes that long-term success in managing health conditions often involves lifestyle changes, consistent support, and a mindset focused on growth.

• Sarah's Journey: National Diabetes Prevention Program
  Sarah’s personal narrative highlights her experience with the National Diabetes Prevention Program, emphasizing the importance of lifestyle modifications in managing Type 2 diabetes.
  YouTube. (2023). Sarah's Journey - National Diabetes Prevention Program

• Choctaw Nation of Oklahoma. (n.d.). Preventing Diabetes: Sarah's Story.
  Retrieved from https://www.choctawnation.com

• Verywell Health. (2022). How I Changed My Life to Better Manage Type 2 Diabetes.
  Retrieved from https://www.verywellhealth.com

I enjoyed this Padlet as it introduced me to the efforts made to support those with Type 2 Diabetes, but also put faces to the condition

*

This prediction is based on data from 2002-2017 where they examined the number of young people under 20 with type 2 diabetes and how cases have increased.

The rise of cases could be contributed by the artificial foods and dyes found in our foods especially those that are specifically advertised for children (candy, cereal boxes etc). The level of inactivity in children and teens - growing up in the 90s, 2000s children were out playing and being active as much as possible without giving it a thought. Nowadays most children and teens are focused on the latest devices and putting their sole focus on that instead of any active play.

Could this be a reason why the rise of diabetes is increasing? Researchers and I believe so. The CDC explains and shows the graphical data that supports their findings.

Educating ourselves, families and friends on the different food groups will be a lot easier to form our plates and can even encourage us to cook our own meals instead of takeout where we aren't sure exactly how our food was prepared.

Food should be treated as medicine with the occasional sweet treat.

Another great example is to educate ourselves with the many foods that are considered low-glycemic which means that the food group will not create a spike in our glucose levels.

For more healthy eating tips, I strongly recommend to read the How to Eat Healthy article by the American Diabetes Association.

How the Smart Insulin Pen works is it is a reusable injector pen with a connection to a smartphone app to not only keep track of glucose readings but it can remind the patient to check their levels. It can send alert to your phone when inactive.

The Smart Insulin pen has been rapidly growing in popularity because it is considered more affordable that what's on the market as well as easy to use and great option on checking your blood glucose.

To learn more, please consider visiting the Devices and Technology article for the pros and cons of the smart insulin pen.

It can be very stressful, emotional time for anyone diagnosed with any illness especially one that could have been prevented. But here are, fully diagnosed, what can we do now to better our quality of life? Luckily, you are not alone.

The American Diabetes Association has provided a link where one can learn everything there is about diabetes from what foods to consume, which foods to avoid, how to check blood glucose levels, what exercises are best to incorporate based on your schedule etc. It is an amazing tool and I highly recommend it for those who are not only diagnosed with diabetes but friends and family members to learn about the disease as well and how to best support their loved one.

This is likely due to the fact that people with a lower socioeconomic status tend to have a lower income, lack in education, and limited access to healthcare and healthy food options due to the neighborhood this populations lives in. When seeking care it can be expensive if there is no health insurance and some could lack the transportation needed to make it to the doctor for routine visits.

https://diabetesjournals.org/care/article/44/1/258/33180/Social-Determinants-of-Health-and-Diabetes-A

Smoking can damage our blood vessels, which can lead to insulin resistance. Additionally, It has been found that nicotine raises your blood sugar. According to the CDC, you face a higher rate of 40% of being diagnosed with T2DM than people who do not smoke.

Quitting smoking is beneficial for your overall health. However, this can be a very difficult habit to kick as many people are addicted to smoking. It would be important not to turn to sugar, unhealthy foods, or other substances to replace the habit.

https://www.cdc.gov/diabetes/risk-factors/diabetes-and-smoking.html#:~:text=Increased%20risk%20of%20type%202,products%2C%20raises%20your%20blood%20sugar

https://diabetes.org/living-with-diabetes/treatment-care/diabetes-technology-guide

https://www.medicalnewstoday.com/articles/323387#:~:text=initial%20weight%20gain%20as%20the,cough%20when%20taking%20inhaled%20insulin

https://hcp.medtronic-diabetes.com.au/insulin-pump-costs

A challenge that this educational measure faces is a lack of referrals from providers, simply because they may not be aware of the program.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7445538/#:~:text=Increasing%20Provider%20Referrals%20to%20the%20NDPP&text=These%20results%20are%20fully%20consistent,NDPP%20uptake%20with%20provider%20referrals.&text=Despite%20the%20comparably%20low%20rate,individuals%20to%20intensive%20lifestyle%20interventions.&text=Relatively%20few%20point%2Dof%2Dcare,the%20NDPP%20are%20made%20currently.&text=First%2C%20many%20providers%20are%20unaware,referred%20patients%20to%20the%20program.&text=To%20address%20this%20issue%2C%20NDPP,Research%20and%20Quality;%20R18HS026172).

https://pmc.ncbi.nlm.nih.gov/articles/PMC6682852/

https://health.clevelandclinic.org/diabesity-the-connection-between-obesity-and-diabetes

https://pmc.ncbi.nlm.nih.gov/articles/PMC6953173/

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/image_data/file/74843/6.4364_PHE_Health_Matters_Online_960x640_72dpi_3.png

Diabetes and polycystic ovary syndrome (PCOS). (2024, May 15). Diabetes. https://www.cdc.gov/diabetes/risk-factors/pcos-polycystic-ovary-syndrome.html 

Darraj, A. (2023). The Link between sleeping and Type 2 Diabetes: A Systematic review. Cureus. https://doi.org/10.7759/cureus.48228 

https://pmc.ncbi.nlm.nih.gov/articles/PMC5210175/

https://www.cdc.gov/pcd/issues/2017/16_0437.htm

https://www.gaucherdisease.org/wp-content/uploads/2020/08/ACA.jpg

Diabetes Technology Guide | ADA. (n.d.). https://diabetes.org/living-with-diabetes/treatment-care/diabetes-technology-guide 

https://pmc.ncbi.nlm.nih.gov/articles/PMC10090889/

https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/pdi.2393

Peer, N., Balakrishna, Y., & Durao, S. (2020). Screening for type 2 diabetes mellitus. Cochrane Library, 2020(6). https://doi.org/10.1002/14651858.cd005266.pub2 

https://www.goodrx.com/freestyle-libre-2/what-is

https://myehcs.com/wp-content/uploads/FreestyleLibre2.png

https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-prevention/art-20047639

https://www.godigit.com/content/dam/godigit/directportal/en/contenthm/weight-lose-for-women.jpg