Short, practical guide to spotting, preventing, and managing type 2 diabetes — learn the symptoms to watch for, which tests to ask your clinician, how modern glucose monitors work, and simple diet + exercise steps you can start today.
Jeffrey Snyder, Broadcast Retirement Network
Well, Toni, it’s great to meet you.
Thanks for joining us on the program this morning.
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Thank you for having me.
Jeffrey Snyder, Broadcast Retirement Network
I love that we’re talking about diabetes. Let me start with a basic question. I’m not asking for exact statistics, but how prevalent in our society are type one and type two diabetes?
You’re educating the public where you’re located, but what percentage, by and large, would you expect have this disease?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Type two diabetes is much more common than type one diabetes, but the numbers are just, as the years go on, they just skyrocket from one to 10. One in every 10 Americans has diabetes, either type one or type two.
Jeffrey Snyder, Broadcast Retirement Network
I mean, that’s like 10%, but I think that’s still a big number. Has that number increased over time?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Yep, over the years, starting from like the 1950s, it’s just, it’s an epidemic now where the amount of people with diabetes just each year continues to climb. And it’s just, there’s many reasons. Lifestyle, we’re just less active.
We’re eating more. We’re eating bigger, bigger portions. So there’s a lot of reasons why those numbers just keep going.
And we’re living longer.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, I would argue living longer is probably pretty good, especially if you’re a mature person. I’d like to live as long, but obviously we’re gonna deal with chronic health conditions like diabetes. How do you differentiate between type one and type two diabetes?
I think that might be helpful for myself and the audience.
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
So type one diabetes, they call it, it’s an autoimmune disease where your immune system attacks the part of your pancreas that makes insulin. All right, so insulin is a hormone which regulates blood sugar. And when you have any kind of autoimmune, your immune system just kind of goes haywire and is attacking you instead of protecting you.
So with type one diabetes, the body no longer makes any insulin and there are certain blood tests that they can draw antibodies to definitively diagnose you with type one diabetes. Type two diabetes, there’s no definitive antibody test, but there’s blood work. There would be your glucose level, whether it be a fasting glucose level or a random.
And then another test called the hemoglobin A1c. So those are some of the blood tests that they can tell if you have diabetes, type two diabetes.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, I see the PSA ads all the time for A1c, get your A1c tested. It seems like that’s something that pretty much everyone probably could do or should do. Let me ask you, how would I know without the blood work?
Are there certain indications that I might have diabetes if I haven’t gone to the doctor recently, if I haven’t had my blood work or urinalysis?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Mm-hmm, so classic symptoms are extreme thirst, very tired, very hungry, blurred vision. But those are when the blood sugars get really high, right? So you can be walking around with a mildly high number, but not have the symptoms, right?
Or you can say, wow, I’ve been thirsty. You know, maybe it’s what I ate. Maybe I just had a hot out, certainly very hot in New Jersey.
Jeffrey Snyder, Broadcast Retirement Network
And Charlotte, I might add, it’s close to 90 today.
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Yeah. Okay, I love it. You know, so those are not always things that are good, like, you know, run to the doctor when I’m thirsty.
You know, so, you know, let’s just say like on average, a normal blood sugar, say like 100 to 120. You’re not gonna really feel those symptoms until your blood sugar is 250 and above. You can be walking around with a 190, a 200 and not even really know.
But if you’re urinating all night long, you know, you cannot quench that thirst. Blurred vision, you know, very tired. Those are the classic symptoms of high blood sugars or hyperglycemia.
Jeffrey Snyder, Broadcast Retirement Network
You were talking about the blood, the glucose, I guess. It’s the glucose or the sugar measurement. There are a lot of available detectors now.
It used to be that there was blood work that you would do like a finger prick that people who had diabetes they could test their blood. It seems like the technology though has evolved so that if you are curious and wanna track your blood sugar you can do that even over the counter or get a prescription.
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Correct, correct. So there are, they’re called continuous glucose monitors. It’s something that you wear typically on your arm and it measures the glucose level, not in the blood.
It measures it a little bit differently. It’s the interstitial fluid, but it’s still pretty accurate. So certain insurance companies will cover it if you have diabetes and are on certain medicines.
But there is one brand that you don’t even need a prescription that you can buy over the counter.
Jeffrey Snyder, Broadcast Retirement Network
So let’s talk about, so let’s just say that you’ve gone to the doctor or at least you’ve had some of these indications. You’ve gone to the doctor, you’ve been diagnosed. Let’s stick with type two, because I think type one, as you said, that’s more of an autoimmune reaction that requires a lot of medical advice and direction.
But let’s talk about type two. What can we do? Can you reverse?
So say you have type two diabetes, can you eliminate or reverse that completely?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
So once you’re diagnosed with type two diabetes you can’t reverse it, okay? So you can control it. You can keep those blood sugars normal with a healthy diet and exercise or medicine, but you can’t go back to not having diabetes.
If you have pre-diabetes, you can prevent the progression to type two, but you can go into what they call remission where your numbers are normal for your hemoglobin A1Cs, not at the normal, normal range, but at target.
Jeffrey Snyder, Broadcast Retirement Network
So let’s talk about the pre-diabetes for a second. What can I do? If someone’s watching this, I’m in my fifties, but let’s just say a younger person is watching the show.
What can they do to avoid even getting into the pre-diabetic or the diabetic stage, the type two diabetic stage?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
So exercise, we really need to just exercise. More often the recommendations are 60 minutes a day. And eat healthy, but you know what, everybody, oh, eat healthy.
What does that mean really? Really sitting down, like, you know, I’m from the Molly Diabetes Education Center. So what we do is we educate.
So we have nurses and we have dietitians. I learned something new from the dietitians all the time. I’m a nurse, but you know, that, you know, I didn’t realize how many calories are in a chunk of cheese.
So actually sitting down with someone and having them help you with your diet, because your diet is different than my diet. What I like may be different than what you like. And we, you know, we work around that.
We don’t eliminate what you like. We, you know, we modify your diet for you and make it work for you for the rest of your life.
Jeffrey Snyder, Broadcast Retirement Network
And I would imagine that there are certain, like certain foods you probably want to stay away from or minimize. I mean, look, you know, moderation is probably the key, but you probably want to stay away from like refined, ultra processed foods is one that comes to mind, but you’re the expert. So are there things that we should maybe minimize or eliminate completely?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Take away all the regular sodas and juices.
Jeffrey Snyder, Broadcast Retirement Network
All right, that’s off, gone.
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
There’s no need for regular sodas. No, no need for regular, for juices. They’re just, they’re not healthy.
There actually are emergency treatment for a low blood sugar because it shoots itself up. Yes, the refined foods, you know, those things that have a shelf life forever. And, you know, you could sit them on your counter and they’re never gonna get moldy.
You know, those are ultra processed, ultra processed foods. You know, you want more of your whole foods, your whole grains, your vegetables, your fruits, you know, and a lot of people are, well, they’re expensive. You know, you catch them in season, catch them when they’re on sale.
Frozen vegetables and frozen fruits are just as healthy as the fresh. You know, so there’s really a way to eat healthy and not, you know, go broke on a healthy diet. Yeah, I mean- We even have a shopping tour and a lot of your supermarkets have dieticians there too that you can tap into to find out what to eat.
Jeffrey Snyder, Broadcast Retirement Network
Are there certain, you know, I’ve heard of the glycemic index. So like when you think of fruits, fruits have sugars, maybe, you know, apple, grapes, peaches. I mean, they all have watermelon comes to mind because it’s almost summer.
Should you kind of really reevaluate the types of fruits you’re eating?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Well, it’s, you know, the amount. So the great thing about fruit is it has so much fiber in it also. So the fiber, we all need more fiber in our diet and the fiber also slows down the absorption of glucose.
Right, so when you eat that apple, eat the skin. You know, when you have the grapes, you know, the skin on the grapes too are great. And if you have a fruit, have a little protein or a handful of nuts or a little string cheese or something with it because it’s the combination of foods too that impact your blood sugar, right?
But it’s easy to just keep eating that watermelon, right? Especially- Oh, it’s so good.
Jeffrey Snyder, Broadcast Retirement Network
I mean, watermelon and cantaloupe. My grandmother could pick a cantaloupe and a watermelon like no one’s business. And I grew up on that stuff.
Anyway, I’m sorry to interrupt. Go ahead.
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Okay, no, those are great. But yeah, you just have to, you know, everything in moderation. We, you know, we don’t need to eat the whole watermelon.
We don’t need to eat the whole cantaloupe even though it’s easy to do. Again, it is healthy, but it’s, yeah, it has natural sugar in it. That’s what we all need to be careful.
Jeffrey Snyder, Broadcast Retirement Network
I know you work at the Molly Diabetes Education Center. If we need additional information, obviously people should go to their primary care physician on a regular basis to be, to get all their blood worked on. But let’s just say they’re in between and they want to get resources working, they go to find just basic information, all the things we’re talking about today.
And again, it kind of gets steered, steered in the right direction. I don’t even know if that’s a word, but where do they go?
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
They can go onto the American Diabetes Association website. They have a lot of good material on there. You know, Hackensack has a lot of good material on there.
Or it used to be called JDRF. Now it’s called Type 1 Nation. Those are for those with Type 1 diabetes.
So there’s a lot of good resources on that too.
Jeffrey Snyder, Broadcast Retirement Network
Yep, got it. Got to read up on it. And for you youngsters out there, now’s the time.
Don’t get into your fifties and start having problems. Tony, we’re going to have to leave it there. Great, great piece on the Hackensack site, which is how we found you.
Thanks so much for joining us. You’re a wealth of diabetes knowledge. I’m sure other types of knowledge as well.
And we look forward to having you back on the program again very soon.
Toni Isabella, BSN, RN, CDCES, Hackensack Meridian Health
Thank you so much for having me. This was great.
