Diabetes affects millions of Americans, yet many people remain unsure about how the condition develops, the differences between its types, and—most importantly—what they can do to prevent or control it. According to Dr. Christian Moore with The Columbia Medical Group Trenholm Road, understanding diabetes starts with understanding how the body uses insulin.

Type 1 vs. Type 2 Diabetes: Two Very Different Conditions
Type 1 diabetes occurs when the immune system mistakenly attacks the insulin-producing cells in the pancreas. As Dr. Moore explains, "Type 1 diabetes is classified as an autoimmune condition—our own bodies recognize our insulin factories as foreign invaders and mark them for destruction." Without these insulin-producing cells, patients must rely entirely on prescribed insulin.

Type 2 diabetes, however, is typically related to lifestyle factors and family history. Over time, a diet high in sugar and carbohydrates can strain the pancreas, eventually exhausting its ability to keep up with the body's insulin needs. "Eating too many carbs forces the pancreas to work overtime,” Dr. Moore says. “Eventually, the insulin factories can’t keep up, and sugar stays trapped in the bloodstream—that’s why blood sugar gets so high.”

What Causes Diabetes?
Type 1 diabetes often appears in childhood, though a form of late-onset autoimmune diabetes in adults (LADA) can occur. 

With Type 2 diabetes, the main driver is chronic overconsumption of sugar and carbohydrates.

To bring sugar into cells, the body requires insulin—think of insulin as the key that opens the door. Without it, sugar remains in the bloodstream, leading to rising blood glucose levels.

Pre-Diabetes: A Critical Warning Sign
Pre-diabetes indicates that blood sugar levels are elevated, but not high enough to be classified as diabetes. Dr. Moore calls it “the canary in the coal mine… an important warning sign to start taking diet and exercise seriously.”

Lifestyle changes at this stage can prevent or significantly delay progression to Type 2 diabetes.

Preventing Diabetes Through Diet and Lifestyle
For those with pre-diabetes—or anyone wanting to reduce their risk—diet is the most powerful tool.

“The number one thing I advise my patients to do is eliminate excess sugars and carbohydrates,” Dr. Moore says. Giving the pancreas a break helps preserve its ability to produce insulin.

Weight loss, even in small amounts, also improves how efficiently the body uses insulin.

Recognizing the Symptoms of Undiagnosed Diabetes
Common early signs include:

• Excessive thirst
• Frequent urination
• Increased hunger
• Fatigue

When the body doesn’t have enough insulin to process sugar, the kidneys must work overtime to flush out excess sugar, causing frequent urination and ultimately dehydration. 

When sugar cannot enter cells for energy, the body feels as though it’s starving—driving persistent hunger. 

Why Proper Management Matters
Uncontrolled diabetes can damage blood vessels throughout the body, leading to serious complications affecting the heart, brain, kidneys, nerves, eyes, digestive system, and feet. Dr. Moore emphasizes how far-reaching the impact can be: heart attacks, strokes, kidney failure, neuropathy, blindness, severe digestive issues, and even amputations are all linked to poorly controlled diabetes.

How to Manage Diabetes
Effective management usually begins with dietary changes, focusing on reducing carbohydrate intake. Sugar molecules are made up of small carbons, oxygens, and hydrogens, hence the word carb-o-hydrate. We want to avoid carbohydrates because they allow your body to produce more sugar, contributing to the high sugar/low insulin cycle. 

Understanding the glycemic index (GI)—a measure of how much a food raises blood sugar—can be a helpful guide. Foods with a GI under 55, such as most vegetables, are ideal. Higher GI foods, like baked potatoes, can spike blood sugar quickly.

Weight loss significantly improves insulin's effectiveness. When lifestyle alone isn’t enough, a variety of medications can help control blood sugar and protect high-risk organs, such as the heart and kidneys.

Encouragement for Newly Diagnosed Patients
A new diabetes diagnosis can feel overwhelming, but Dr. Moore offers reassurance: “If any of this were easy, nobody would have a problem. It takes motivation and elbow grease, but managing diabetes can absolutely be done.”

Many people achieve excellent control—and some even meet their goals without medication. The key is staying consistent and understanding that diabetes is a condition that must be taken seriously, even when you feel well.

“Think of it like the check engine light on your car,” Dr. Moore says. "You can ignore it for a while, but eventually you'll pay for it. Unlike our cars, we only get one body for our whole lives—and I want to help keep it running well for as long as possible."


Christian Moore, MD, The Columbia Medical Group Trenholm Road