Diabetes

Diabetes

Diabetes—a condition that affects how your body uses the food you eat—is a chronic disease that more than 26 million Americans have today. Another 78 million have pre-diabetes, a condition that puts people at risk of developing the disease.

Without treatment, diabetes can lead to heart disease, blindness, and kidney failure, along with circulatory problems that can result in lower limb amputations.

A laboratory blood glucose test can detect diabetes, and experts recommend that those who are overweight and have other risk factors should ask their physicians for a blood test.  Those risk factors includes:

  • sedentary lifestyle
  • family history of diabetes
  • high-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander)
  • women with a history of gestational diabetes or who delivered a baby weighing >9 lbs
  • high blood pressure (≥140/90 mmHg or on blood pressure medication)
  • women with polycystic ovarian syndrome (PCOS)
  • other conditions associated with insulin resistance (e.g., severe obesity, history of cardiovascular disease)

    In the absence of the above criteria, testing for diabetes should begin at age 45 years.

The earlier your doctor diagnoses and treats diabetes, the lower your risk of developing diabetes-related complications.

Diabetes basics

Diabetes is a condition in which the body does not produce or properly use insulin, a hormone made in the pancreas.

When you eat food, your body breaks down all the sugars and starches into glucose. Glucose acts as your body’s fuel.

Insulin is necessary to allow glucose from the food we eat to move out of the bloodstream and into the cells. With diabetes, the blood sugar level becomes higher than normal and it eventually spills into the urine where it leaves the body—even though the cells need its nourishment.

Types Of Diabetes

Type 1 and Type 2 are the most common types so diabetes. Other types include diabetes during pregnancy, or gestational diabetes, and pre-diabetes.

Type 1 is less common, and occurs mostly in children or young adults, although it can occur at any age. It is an autoimmune disorder in which the body destroys its own insulin producing cells.  People with this form of diabetes will need to inject insulin for the rest of their lives until such time a cure for Type 1 diabetes is found. 

Warning signs of this type include:

  • Frequent urination 
  • Unusual thirst or extreme hunger
  • Unexplained, rapid weight loss
  • Extreme fatigue and irritability

An estimated 1½ to 3 million Americans have this type of diabetes.

Type 2 diabetes is much more common, occurring in 90 percent or more of those with diabetes in the US. It usually occurs in adults, although more and more children are developing it.

These people may not produce sufficient insulin on their own, or their body cannot properly use insulin. In addition to controlling Type 2 diabetes with proper diet and exercise, many people must use insulin or oral medications.

Warning signs of this type:

  • Symptoms mentioned for Type 1
  • Blurred vision or any change in vision
  • Tingling or numbness in legs, feet, or skin
  • Frequent skin/vaginal/urinary tract infections or itchy skin
  • Slow healing of cuts and bruises

Many people with type 2 diabetes have no symptoms. The American Diabetes Association estimates that about 8 million people have the disease and don’t know it.

The past decade has brought a dramatic rise in Type 2 diabetes in children. Weight management and regular physical activity are vital to improve glucose control in children and teens with diabetes.

Risk factors

Researchers do not know the exact cause for diabetes. Risk factors include:

  • Being overweight or obese
  • Leading a sedentary lifestyle
  • Family history of diabetes
  • High-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander)
  • Women with a history of gestational diabetes or who delivered a baby weighing >9 lbs
  • High blood pressure (≥140/90 mmHg or on blood pressure medication)
  • High cholesterol levels
  • Women with polycystic ovarian syndrome (PCOS)
  • Other conditions associated with insulin resistance (ie. severe obesity, history of cardiovascular disease)

The dangers

Diabetes has been called a "silent killer," due to the fact that people can be unaware that they have diabetes until they develop a severe complication, such as blindness, kidney disease, or heart disease. Diabetes is a major cause of heart disease and stroke and is the seventh leading cause of death in the United States.

Team approach

The diagnosis of diabetes calls for a new way of living.

Diabetes management includes: weight reduction (when appropriate); management of blood pressure, cholesterol, and blood sugar levels; and following a regular exercise program – all of which can help those with diabetes dramatically reduce the risk of diabetes-related complications. It takes a team approach to achieve good diabetes management.

"Working with a medical team gives a patient a full spectrum of assistance in making diabetes management part of their daily lives," says Gayle Curto, RN, BSN, CDE, clinical manager for the Diabetes Center at John Muir Health.

"The team of diabetes educators can include a patient's physician, registered nurses, registered dieticians, pharmacist, counselors, and others," according to Ms. Curto. The staff works under the medical direction of an endocrinologist (physician specialist in diabetes and hormonal conditions).

"Diabetes education is important to help achieve good self-management skills. Ongoing support from the family, the health care team, and other resources is a vital part of continued success," says Gayle.

"Our staff assists people from many diverse backgrounds in learning to manage the condition. New approaches to dealing with traditional eating patterns, eating out, special events, travel, and other needs can be adopted," she says.

"We offer patients tools to help them understand diabetes, and how they can confidently manage it over the long term," adds Gayle. "The ability to tailor a program to each individual, with a healthy eating plan, oral medication or insulin injections, when needed, or a combination of medications, leads to great success. In this way, people can fit diabetes into their lives, rather than having their lives controlled by diabetes."