Saturday, September 3, 2016

Why Do American Soldiers Miss War?

By Jenara Nerenberg

According to author Sebastian Junger, facing social isolation back at home deepens the trauma.

Sebastian Junger is a former war reporter, the author of several best-selling books, and co-director of the Oscar-nominated documentaryRestrepo.
His latest book, Tribe: On Homecoming and Belonging, explores the loneliness and alienation of modern society and the haunting question of why soldiers miss war upon their return home. The book flips the script on PTSD, arguing that the isolation faced when returning home aggravates the trauma of combat, which raises the question of how to foster a sense of community and belonging separate from disaster or war. We talked with Junger about the causes and potential of communalism.
Sebastian Junger
Jenara Nerenberg: What avenues do you see that can help cultivate a sense of community and belonging to minimize loneliness and alienation in our society?
Sebastian Junger: I think if we actively espouse an ethos of communalism that it would help. Communalism rises to meet the challenge of danger and hardship. It pops up spontaneously. But we live in a safe and more-or-less comfortable society, so we don’t need communalism—so we would have to actively espouse it. The tone of contempt used by our leaders and the lack of responsibility and culpability of those who have harmed our country very, very gravely contributes to the lack of community, as well.
JN: What forces have contributed to us losing that sense of communalism?
SJ: I think it’s affluence. Affluence, income disparity, the automobile. All of those things have made our society more individualistic and less communal.
JN: Why is it so important to get a sense of tribalism back?
SJ: Well, the book is really about communalism, shared resources, and egalitarianism. The title of the book is distracting. “Tribe” is a loaded word. There is an amazing book called Our Beleaguered Speciesby Elizabeth Crouch Zelman about the importance of tribalism to human evolution and survival and the danger that that same tribalism now poses in the modern world. She acknowledges its crucial importance to the rise of human society but the liability that it brings with it in a modern context.
I think she’s the last word on that funny duality of human groups. Once you form a group, you’re immediately forming another group that’s not in your group, right? There’s no way to form a group without creating another category of people that are not in your group, unless you make the entire human population your group, which is then a senseless distinction. Her book addresses that duality very well and should be widely read.
Communalism is what characterizes our evolutionary past—and when we’re forced back to that way of being, it seems to be deeply gratifying to people.
JN: How do you cultivate community and belonging in your own life these days?
SJ: I grew up in the suburbs, where there was no community at all. Now I live in New York City in a poor neighborhood and I feel like there’s something close to a neighborhood community, but it’s certainly not at the level of the Kalahari or Kung or somewhere like that.
JN: It sounds like you’ve accepted modern society the way it is and that it’s not really set up for communalism. Are you interested in exploring solutions?
SJ: I think there are solutions, but they’re just not acceptable to us. Widespread disaster would force communalism, but who would want that? Banning the automobile would do the same thing, but no one’s going to do that. I think there are plenty of solutions, but they’re not palatable to people. You’re not going to have your cake and eat it, too. You’re not going to have the luxury of your cars and air conditioning and planes AND the kind of close communal connections that a survival-level economy forces on people.
JN: So you don’t think the rise of co-living and co-working movements—developments like that—are notable?
SJ: Sure, I think small groups of people can function that way—communes in the 60’s and 70’s, for example—but if you’re talking about a society-wide transformation, I just don’t think that’s going to happen. But that doesn’t mean that small groups of people can’t create their own circumstances—of course they can. Old-age homes are communal societies. Platoons in combat are communal societies. At the micro-level, communalism does exist. But short of a large-scale disaster or banning the automobile, I don’t think it’s going to happen on a society-wide level.
JN: Where does this insight about the automobile come from? I didn’t see that in your book.
SJ: People often ask me what can be done. The automobile has given us the mobility that enables us to work 50 miles from where we live and enables us to be completely divorced from our immediate community. The Amish have banned the automobile and their suicide rate and depression rate is extremely low and it forces them to live within walking distance of their home—in other words, it reverts them back to their evolutionary past.
JN: Was suicide not common in previous tribal societies?
SJ: The data is very hard to find, but it seems to have been virtually nonexistent. There were ritual suicides and suicides to avoid capture by the enemy—but suicide as a result of depression, which is what we mean when we talk about suicide in modern society, seemed to have been virtually nonexistent.

Martin Levya: Don't Ever Give Up

Martin Leyva did time for robbery but knew when he walked out of Chino State Prison he would never come back. He would transform his life. In a remarkable story, a blend of perseverance and the world opening up to show him his path, Leyva used his troubled past to become a beacon of hope for others in similar situations. He says, "The whole process [working with youth] feeds my fire for social justice because these youth are so important to our future -- to everyone's future. And youth are vulnerable. We adults have so much power over them-- to make them or break them-- and because so many people and institutions are threatened by them they use their power to break them. So when the youth get to a program like AHA! where they feel safe, where the adults are really committed to supporting and uplifting and empowering them, it changes the game. It changes how the youth see themselves --as inherently worthwhile people. Seeing them recognize their potential -- even just getting a glimpse of it -- feeds me."

--by Leslee Goodman

Seven yearsMartin-graduating ago when Martin Leyva walked out of Chino State Prison, a guard told him: “We’ll leave the lights on for you…” insinuating that Leyva would be back. Instead, seven years later, Leyva walked across the stage to accept his bachelor’s degree in liberal arts/psychology from Antioch University in Santa Barbara.
Leyva grew up on the Westside of Santa Barbara, a genteel enough place compared to Compton or East Los Angeles, but potentially lethal to low-income Latinos all the same. Both Westside and Eastside Latinos make up the underclass in this wealthy, beachside city that—along with the rest of California—once belonged to Mexico and, before that, to the indigenous people, the Chumash. Now, as minority members of the Santa Barbara community, Westside and Eastside gang members fight each other rather than the issues they have in common.
Leyva’s youth and early adulthood reflected the toughness and bravado he believed were required for survival. Dropping out of school in ninth grade, Leyva was in and out of trouble with the law and sent to jail and prison multiple times.
But those days are behind him now. A certified drug and alcohol treatment counselor and a skilled gang intervention and prevention facilitator, he is also a core facilitator at AHA!, a social and emotional learning program for teens in Santa Barbara. In 2008, he founded the Santa Barbara City College/ Extended Opportunity Programs and Services’ Transitions Program, helping those released from the criminal justice system re-integrate back to society and succeed at furthering their education. The Transitions program won The John G. Rice Award for Diversity and Equity in 2012.
Leyva is the author of “From Corrections to College: The Value of a Convict’s Voice.” He has spoken at universities and criminal justice conferences throughout California. I met Leyva at a fundraiser for AHA! and was struck by how much he loved his work. I asked him if he would talk to The MOON about “The Best Job in the World.”
                                                                                                                                                                    — Leslee Goodman

The MOON: How do you describe yourself and your work? What do you do?

Leyva:  I work with high school students for a program called AHA!—Attitude, Harmony, Achievement—teaching social and emotional learning skills through in-school and after-school programs. It’s the best job I’ve ever had in my life. It’s one of those jobs where you get up in the morning and you can’t wait to go to work. There’s so much meaning there.

I’m a licensed drug and alcohol treatment counselor and before coming to AHA! I did a lot of that work with teenagers for various agencies around town. There’s a lot of beautiful work in that field, but it’s an uphill battle to get young people to see drug and alcohol use as a problem. The agencies want you to focus narrowly on the drug and alcohol abuse—which of course is only a symptom of deeper issues. With AHA! I don’t do drug and alcohol treatment; but I do do drug and alcohol treatment. We work on the emotional issues—the feelings—that cause a person to drink or use drugs—either as a reward, or as a punishment. We also address systemic issues within the Latino community, the Anglo community, the privileged community, the impoverished community, the LGBTQ community—all these communities. We come together and talk about how issues like poverty or privilege, or bullying or discrimination, affect us, and we talk about who we are, where we come from, how we feel. The youth respond beautifully. They get it. You see their light bulbs go off all the time, and it’s amazing to be part of such a beautiful process. I often say I’m overpaid for what I do because get fed emotionally by it, too. These youth teach me something every day. Whether they’re struggling, or they’re happy about getting a better grade, or having a better conversation with their mom or dad, or finally meeting their mom or dad—I mean these kids have so many issues—it’s just great to see the light bulbs go off and to feel like you’ve been there to support them.

This job really requires you to be who you say you are because we lead by example. We don’t tell youth what to do. We honor what’s going on with them and model the fact that there are always options. It’s the most amazing experience to get up in the morning and go to work feeling as if the youth need me, but also that I need them. We’re all part of this community that we’ve created. So we’re all getting paid, one way or another. [Laughs]

The MOON: How do you need these youth? How are they feeding you? Why do you get so excited about going to work?

Leyva: There are still a lot of areas in my life that never got dealt with; a lot of stuff from my childhood. So when I work with these youth, it’s as if I’m seeing a mirror image of myself as a kid. As I support them in healing their own issues, I better understand some of my own issues, like meeting my biological dad; or my stepfather leaving me; or getting incarcerated away from my community and family. The youths give me their stories, their truths, and that helps to shed light on who I was when I was little Martin. When a youth tells me his story and I can say, “Yeah, I totally understand because I’ve been there,” it’s empowering for both of us.

The whole process feeds my fire for social justice because these youth are so important to our future—to everyone’s future. And youth are vulnerable. We adults have so much power over them—to make them or break them—and because so many people and institutions are threatened by them they use their power to break them. So when the youth get to a program like AHA! where they feel safe, where the adults are really committed to supporting and uplifting and empowering them, it changes the game. It changes how the youth see themselves—as inherently worthwhile people. Seeing them recognize their potential—even just getting a glimpse of it—feeds me.

The MOON: How did you happen upon this as a career? What was, or is your motivation? What path did you take to get here? Was it a fluke? Were you responding to a need? Were you just doing what you loved and the work followed?

Leyva: Yeah, we talk about job interviews in Ally group, and we’ll role play. Let’s say I’m the employer and you’re the job applicant. So walk up to me and shake my hand. Then I might say, “Hmmm. That was kind of a weak handshake.” So we talk about what is a good handshake: what is too weak, what is too strong, what is overbearing. How do you give a solid handshake that leaves a little bit of positive impression just with touch?

And we also talk about cultural norms because, for example, eye contact is not always good in some cultures. Gripping someone kind of tight is not okay in some cultures. If you’re a Latino man facing a Latino man, you don’t want to show too much power. If you’re a Latina woman facing another Latina, you might want to give a soft handshake. If you’re facing a white boss, what kind of handshake should you give? We talk about all these possible variations.

Eye contact is good, but only if you’re smiling. [Laughs] So we talk about all this, and we have fun with it too. We have a good time while we’re learning.

The MOON: How does this work make use of your specific talents and gifts?

Leyva: I’m a very patient, open-minded person, very accepting. Although I’m an introvert, I’m also a strong leader. I come from a background that enables me to connect with youth, and I’m motivated to connect with them. I love and respect them. So if that’s a talent, or a gift, it helps me in this work. I know how to be honest—and I swear, that is a talent because a lot of people are afraid to be honest.  I’m real and honest with my co-workers, as well as the teens.

This group of people who works together at AHA! is really important. Our diversity is important. We have white privileged folks who know exactly what that privilege means, and then we have people with backgrounds like mine. It’s a whole gamut of people who work really, really well together, and modeling that behavior to the community shows that it can be done, and how. We have a really clear and strong understanding of who we are and what our mission is. My bosses—the co-directors of AHA!—have done an amazing job of putting it all together and saying “Nobody is better than another person here.” I love that because I come from a world where somebody always has to be bigger; somebody always has to be “tougher.” There’s always a hierarchy of power. At AHA!, I have talents that everybody loves and appreciates. So they say, “Martin, we have a struggling student over here. Will you work with him?” Or, “We’ve got a student with a different issue over here. Who feels like they have an insight to work with her?” We all work together to get the youth whatever it is they need.

It’s easy for me to speak up for an oppressed group, even though I don’t necessarily look like the person who would speak up for them. For example, when men are talking bad about women, they don’t expect me to be the one who challenges them—even about language. If someone uses the “B” word, I’ll be the one who says something like, “Hey, that’s a little dismissive, don’t you think? I mean we were born from women. At least have a little respect.” And the guys will look at me, like, “What?! What did you just say?” They thought, because of the way I look, that I’d be some macho womanizer or something. So the dichotomy between the way I look and who I am can be used in a lot of ways. When the young men who are growing up the way I grew up, where certain people aren’t respected for whatever reason, learn that I actually give ten times more respect than I get, it makes an impression. But I’ve learned that I love to get respect, and to get it I have to give it—ten times more, if necessary.

The way I look and who I am is also a gift for changing stereotypes about people who look like me. You will never see Martin doing bad behaviors. You will never hear me say, “Hey, you shouldn’t do that,” and then see me doing it. You also will never hear me tell a youth, “You shouldn’t drink,” or “You shouldn’t do drugs,” or “You shouldn’t join a gang,” because I know that they wouldn’t consider doing these things without reasons. If we can figure out what those reasons are and work on them, then the youth can make their own decisions—and most likely, they’ll choose positively. Being someone youth will trust and talk to about their reasons is a talent and my work makes use of it every single day.

Right now our phone call just got interrupted by a text message from a young man who’s really struggling with drugs and we’re talking about why he wants to use. He says he doesn’t know why, but he doesn’t have a job and that becomes a reason why he should use. He tells himself that when he gets a job he’ll stop using. Until then, he doesn’t have a reason not to use.  So when we understand this, we can switch the focus of our conversation away from drugs to the topic of feeling bad about himself.  We can concentrate more on ways a job, or school, or other proactive activities will help him to achieve the goal of earning money. I will not shame him for using drugs, what I will do is share with him other coping strategies to ease his pain. Emotional pain is a self-oppressor, and it’s a killer of spirits, and being spiritless can deprive us of our growth. This young man is important, loved and valuable, and he needs to see it, and I will do everything in my power to allow him to see it.

The MOON: I used to do development work for AHA! and I know the facilitators are hired for who they are, not just for their education or experience. You have to bring your whole self to work there. Even if you don’t think you’re bringing it, the nature of the work means that people are going to see who you are; you’re not going to be able to hide. So I’m confident you were hired for who you are—so-called negative history and all—not “just” what you do. It’s a pretty rare and wonderful place where you get to bring your whole self to work.

Leyva: Yeah.  Jennifer and Rendy, AHA!’s co-directors, really do mirror what love is, and it’s contagious. When I worked at the Council on Alcohol and Drug Addiction, it wasn’t the same feeling at all. They were much more hesitant to put me in a leadership position. When I came to AHA! they really did embrace me, for both my past and for who I am today. When they mirror such love, it’s easy to radiate it outward. I feel love at work, so why shouldn’t I love my work? They give you constructive feedback and they push talent forward.

The MOON: Where do you see this work taking you? Will you be doing the same work in five or 10 years? What else would you like to be doing?

Leyva: I just graduated with my bachelor’s degree in liberal arts and psychology, which was a huge accomplishment for me. I was always a horrible student; I have a ninth-grade education. I’m not sure what direction my future path will take. I’m really big on social justice and addressing systems of oppression, the criminal justice system, the prison-industrial complex, particularly the youth prison-industrial complex, and many other issues. I am applying to Ph.D. programs at several universities, so my future will depend to some extent on where I get accepted. I’m applying to UC Santa Cruz to study the history of consciousness or feminist studies; at UC Berkeley, I would be studying sociology, ethnic studies, and/or criminology; and at Stanford, sociology or social psychology.

I really see myself teaching at the community college level. I know from my own experience that there are a lot of people struggling at that level. It’s not just 18-year-olds; it’s 50-year-olds going back to school; it’s people like me coming out of prison and trying to create a better life for themselves. I see myself teaching there. I had a couple of really, really good teachers at City College. Dr. Helen Meloy taught this one class on social deviance, and the way she taught and the things she believed in made me want to work in that field. She really had a huge impact on me.

I know a lot of seniors who just graduated from high school who tell me, “I don’t know if I want to go to school,” because they barely survived high school and they don’t see how they will make it through college. I tell them, “No, you can do it,” and I want to be one of the people there to support them so that they do.

I don’t know if I’ll stay doing the work I’m doing now, but I do see myself staying really active in the lives of people who struggle.

The MOON: What would you advise someone who was inspired to follow in your footsteps?

Leyva:  If they were someone like me who falls victim to their own inner critic, I’d say, “Don’t ever give up.” You read all the time people say that they were their own biggest obstacle to overcome. I’d also say, “Don’t take no for an answer,” and also, “Find lots of avenues to get where you want to go.” That way, if one avenue is blocked, you can take an alternate route.  Another thing I’ve only recently learned how to do—and I’d tell other people to learn this sooner than I did—is to ask for help. Sometimes I can get into this little pity party where I think I have to do everything myself because no one else is going to understand it, or care about it, and it’s not true. There’s nothing that has ever happened to me, or that I have ever done in life, that hasn’t happened to or been done by others. We’re not alone.

The MOON: I think a lot of people have trouble asking for help. Can you give an example of a time when you asked for help, and how you did it?

Leyva: Here’s the example that I think meant the most to me. Six years ago when we started Transitions at City College, I was really struggling. I’d sit in the classroom and listen to the teachers and look at their Power Point presentations, and read the assignments, and I felt as if I had answers to the questions they were asking, but I was afraid to speak out. I felt that I could be a very strong voice regarding whatever it was that we were discussing, but the fear of sounding stupid, or not making sense, or even of being looked at—which of course would happen as soon as I raised my hand—was scary for me because I felt like I didn’t belong. If I couldn’t make myself understood, that would just confirm everyone’s suspicion.

When I started Transitions, it was with people who would have been my enemies in prison because they were of a different race. But one day I walked up to this group of guys and said, “I see you guys at City College and I’m going there too.” So we all shook hands. Then I said, “Do you ever feel like you don’t belong there, like you’re even afraid to raise your hand because then people will realize that you don’t belong?” And every single one of them said, “Yeah.”  They suffered from the same thing I did. So I said, “Maybe we can hang out and talk about these things and support each other.” And they said yeah.

That was me asking for help at a time when, if I’d continued feeling like that at City College, I probably would’ve dropped out. And if they hadn’t said “Yes, let’s hang out; let’s talk; let’s support each other,” Transitions wouldn’t have started. Unfortunately, two of the guys who started Transitions with me are back in prison, but I still keep in touch with one of them. And I continue to say from time to time, “Hey, I need a little bit of help here. Can you help me out?” If I hadn’t learned how to ask for help, I probably wouldn’t have graduated with my B.A. either.

I started out asking for help from people I thought would be like-minded. But now I’ve gone on to ask for help from people who have what I need—a house to live in, or a letter of reference maybe—and the irony is, I’ve rarely heard no when I’ve asked for help. We’re so afraid to ask, and yet most of the time, people are happy to help. It took that first request, though, to give me courage. I was scared to ask those guys, but I still did it.

So, that’s definitely something I’d say to anyone who wanted to follow in my footsteps. And probably the number-one thing I’m always telling people is “Show up. Just show up.” Do that and everything else will be taken care of.

We’re only as strong as our struggles. Life isn’t easy, and we’re usually the ones who make it more difficult. But I’ve made my life difficult for so long, I’m not going to do that anymore. So show up and don’t give up. That’s it. 

16 Tips for Pain-Free Joints

Stay in Motion

It's the golden rule of joint health: The more you move, the less stiffness you'll have. Whether you're reading, working, or watching TV, change positions often. Take breaks from your desk or your chair and get active.

Safety First

Padding is your pal. So suit up when you do things like in-line skating or play contact sports. If your joints already ache, it might help to wear braces when you do activities like tennis or golf.

Lean In to Your Weight

Your size affects some of the strain on your hips, knees, and back. Even a little weight loss can help. Every pound you lose takes 4 pounds of pressure off the knees. Ask your doctor what's the best way for you to get started.

Don't Stretch Before Exercise

Flexibility helps you move better. Try to stretch daily or at least three times a week. But don't do it when your muscles are cold. Do a light warm-up first, like walking for 10 minutes, to loosen up the joints, ligaments, and tendons around them.

Go Low-Impact

What exercise is good? The best choices are activities that don't pound your joints, like walking, bicycling, swimming, and strength training.

Flex Some Muscle

Get stronger to give your joints better support. Even a little more strength makes a difference. A physical therapist or certified trainer can show you what moves to do and how to do them. If you have joint problems, avoid quick, repetitive movements.

Work on Your Range

Are your joints too stiff and inflexible? You'll want to get back as much as you can of your "range of motion." That's the normal amount joints can move in certain directions. Your doctor or physical therapist can recommend exercises to improve this.

Power Up Your Core

Stronger abs and back muscles help your balance, so you're less likely to fall or get injured. Add core (abdominal, back, and hip) strengthening exercises to your routine. Pilates and yoga are great workouts to try.

Know Your Limits

It's normal to have some aching muscles after you exercise. But if you hurt for more than 48 hours, you may have overstressed your joints. Don't push so hard next time. Working through the pain may lead to an injury or damage.

Eat Fish to Reduce Inflammation

If you have joint pain from rheumatoid arthritis, eat more fish. Fatty cold-water types like salmon and mackerel are good sources of omega-3 fatty acids. Omega-3s may help keep joints healthy, as well as lower inflammation, a cause of joint pain and tenderness in people with RA. Don't like fish? Try fish oil capsules instead.

Keep Your Bones Strong

Calcium and vitamin D can help you do that. Dairy products are the best sources of calcium, but other options are green, leafy vegetables like broccoli and kale. If you don't get enough calcium from food, ask your doctor about supplements.

Target Your Posture

Stand and sit up straight to protect joints all the way from the neck down to your knees. To improve your posture, take a walk. The faster you do it, the harder your muscles work to keep you upright. Swimming can also help.

Ease Your Load

Consider your joints when lifting and carrying. Carry bags on your arms instead of with your hands to let your bigger muscles and joints support the weight.

Chill Out Pain

Ice is a natural -- and free -- pain reliever. It numbs the hurt and eases swelling. If you have a sore joint, apply a cold pack or ice wrapped in a towel. Leave it on for up to 20 minutes at a time. You can also try a bag of frozen vegetables wrapped in a towel. Never apply ice directly to your skin.

Supplements? Ask First

Stores are filled with ones that promise to relieve joint pain. Glucosamine and SAMe have the best research behind them. Talk to your doctor if you want to give supplements a try, so you know about what's safe and what might affect your medicines or health conditions.

Treat Joint Injuries

They can add to the breakdown of cartilage in your joints. If you get hurt, see your doctor right away for treatment. Then take steps to avoid more damage. You may need to avoid activities that put too much stress on your joint or use a brace to stabilize it.

Diabetes Warning Signs

What Is It?

When you have this disease, your body does a poor job turning the carbohydrates in food into energy. This causes sugar to build up in your blood. Over time it raises your risk for heart disease, blindness, nerve and organ damage, and other serious conditions. It strikes people of all ages, and early symptoms are mild. About 1 out of 3 people with type 2 diabetes don't know they have it.

What Will You Notice First?

People with type 2 diabetes often have no symptoms. When they do appear, one of the first may be being thirsty a lot. Others include dry mouth, bigger appetite, peeing a lot -- sometimes as often as every hour -- and unusual weight loss or gain.

Later Symptoms

As your blood sugar levels get higher, you may have other problems like headaches, blurred vision, and fatigue.

Signs of Serious Problems

In many cases, type 2 diabetes isn't discovered until it takes a serious toll on your health. Some red flags include:

o Cuts or sores that are slow to heal
o Frequent yeast infections or urinary tract infections
o Itchy skin, especially in the groin area

It Can Affect Your Sex Life

Diabetes can damage blood vessels and nerves in your genitals. This could lead to a loss of feeling and make it hard to have an orgasm. Women are also prone to vaginal dryness. About 1 in 3 who have diabetes will have some form of sexual trouble. Between 35% and 70% of men who have the disease will have at least some degree of impotence in their lifetime.

Risk Factors You Can Control

Some health habits and medical conditions related to your lifestyle can raise your odds of having type 2 diabetes, including:

Being overweight, especially at the waist
o A couch potato lifestyle
o Smoking
o Eating a lot of red meat, processed meat, high-fat dairy products, and sweets
o Unhealthy cholesterol and triglyceride levels

Risk Factors You Can't Control

Other risk factors are out of your control, including:

o Race or ethnicity: Hispanics, African-Americans, Native Americans, and Asians are more likely to get it
o Family history of diabetes: Having a parent or sibling with diabetes boosts your odds.
o Age: Being 45 and older raises your risk of type 2 diabetes.

The more risk factors you have, the more likely you'll get type 2 diabetes.

Risk Factors for Women

You're more likely to get type 2 diabetes later on if you:

o Had gestational diabetes when you were pregnant
o Delivered a baby that weighed over 9 pounds
o Had polycystic ovary syndrome

How Does Insulin Work?

In a healthy person, insulin helps turn food into energy. Your stomach breaks down carbohydrates into sugars. They enter the bloodstream, prompting your pancreas to release the hormone insulin in just the right amount. It helps your cells use the sugar for fuel.

Metabolism Mishaps

In type 2 diabetes, your cells can’t use sugar properly. That means there's a lot of it in your blood. If you have a condition called insulin resistance, your body makes the hormone, but your cells don’t use it or respond to it like they should. If you’ve had type 2 diabetes for a while but haven’t treated it, your pancreas will make less insulin.

How Is It Diagnosed?

Your doctor will take some blood and do an A1c test. It shows your average blood sugar level over the past 2-3 months. If you already have symptoms, he might give you a random blood glucose test, which shows what your current level is.

Your Diet Makes a Difference

You can control blood sugar levels by changing your diet and losing extra weight. That will also cut your risk of complications. Carefully track the carbs in your diet. Keep amounts the same at every meal, watch how much fat and protein you eat, and cut calories. Ask your doctor to refer you to a dietitian to help you make healthy choices and an eating plan.

Exercise Is Important

Regular exercise, like strength training or walking, improves your body's use of insulin and can lower blood sugar levels. Being active also helps get rid of body fat, lower blood pressure, and protect you from heart disease. Try to get 30 minutes of moderate activity on most days of the week.

Relaxation Is Key

Stress can boost your blood pressure and blood sugar. Some people don't do anything for it. Others turn to food to cope with it. Instead, practice relaxation techniques like deep breathing, meditation, or visualization. Talking to a friend, family member, counselor, or a religious leader could help. If you can’t beat it, reach out to your doctor.

Oral Medications Can Help

If diet and exercise can’t get your blood sugar under control, your doctor may add medication. There are many types of diabetes pills available. They’re often combined. Some work by telling your pancreas to make more insulin. Others help your body use it better or block the digestion of starches. Some slow insulin breakdown.

Insulin: It's Not Just for Type 1

Your doctor may prescribe insulin early in your treatment and combine it with pills. It can also help people with type 2 diabetes who develop "beta-cell failure." This means the cells in your pancreas no longer make insulin when blood sugar is high. If this happens, insulin will become part of your daily routine.

New Non-Insulin Injectables

New drugs called non-insulin injectables are available for people with type 2 diabetes. These medications cause your body to make insulin to control blood sugar levels.

Why Blood Sugar Testing Matters

Your doctor can show you how to use a glucose meter to check your blood sugar. This lets you know how your treatment plan is working. How often and when you test will be based on how well controlled your diabetes is, the type of treatment you use, and how stable your blood sugar is. Common testing times are when you wake up, before and after meals and exercise, and at bedtime.

Heart and Artery Troubles

If you don't treat diabetes with a healthy diet and exercise, you're more likely to get plaque in your arteries than people who don't have it. This sticky substance slows blood flow and increases your risk of clots. It leads to hardening of the arteries (called atherosclerosis), which makes you more likely to have a heart attack or stroke. About 2 of 3 people with diabetes die of heart disease.

Kidney Complications

The longer you have diabetes, the greater the chance you’ll get chronic kidney disease. Diabetes is the leading cause of kidney failure. It's to blame for about half of new cases. Controlling your blood sugar, blood pressure, and cholesterol can lower your risk for this complication. Yearly tests and medications can slow the disease and keep your kidneys healthy.

Eye Problems

High blood sugar can damage the tiny blood vessels that bring oxygen and nutrients to the retina, a critical part of your eye. This is known as diabetic retinopathy, and it can lead to vision loss. It’s the leading cause of new cases of blindness in people between the ages of 20 and 74. Pools of blood, or hemorrhages, on the retina of an eye are visible in this image.

Diabetic Nerve Pain

Over time, uncontrolled diabetes and high blood sugar can cause nerve damage. Symptoms include tingling, numbness, pain, and a pins and needles sensation -- often in your fingers, hands, toes, or feet. The damage can’t be reversed, but there are treatments. Controlling your diabetes can help prevent further harm.

Foot Injuries Can Take a Toll

Diabetic nerve damage can make it hard to feel your feet. You might not notice wounds. At the same time, hardening of the arteries reduces blood flow to the area. Even a small injury can cause foot sores and gangrene. In severe cases, infections can result in an amputation.

Teeth and Gums Are Targets

High blood sugar levels can feed the bacteria that make plaque. Plaque buildup leads to cavities, tooth decay, and gum disease. Severe gum disease can cause tooth loss. It weakens gums and the tissues and bones that hold teeth in place. That makes it easier to get an infection, too.

Can It Be Prevented?

One of the most surprising things about type 2 diabetes is that you can avoid it. To lower your risk, follow the same guidelines for warding off heart disease:

o Eat a healthy diet.
o Exercise for 30 minutes, 5 days a week.
o Stay at a healthy weight.
o Talk to your doctor about being tested for prediabetes.

People with prediabetes can avoid getting diabetes with lifestyle changes and medication.