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Subject:	A colleague recommends Diabetes: Early Detection, Good Management Make The Difference
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Diabetes—a condition that affects how your body uses the food you eat—is a chronic disease that more than 18 million Americans have today. A third of them are unaware of it. Almost 800,000 new cases are diagnosed every year.

Left untreated, diabetes can lead to heart disease, blindness, and kidney failure, along with circulatory problems that can result in lower-extremity amputations.

Diabetes is detected through a blood glucose test, and experts recommend that Americans over age 35 with a family history of diabetes or other risk factors (such as being overweight) should consider asking their physicians for a blood test annually. The earlier diabetes is detected, the earlier complications may be treated and/or prevented.

What is Diabetes?

Diabetes is a condition in which the body does not produce or properly use insulin, a hormone made in the pancreas. Insulin is necessary as a "key" to allow glucose from the food we eat to move out of the bloodstream and into the cells. As the blood sugar level becomes higher than normal, it eventually spills into the urine and is eliminated from the body—even though the cells need its nourishment.

Types Of Diabetes

There are four types of diabetes. Type 1 and Type 2 are the most common. Gestational and pre-diabetes also need to be monitored.

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 is not able to control blood sugar levels. People with this form of diabetes do not produce enough of their own insulin, so they need daily injections to survive.

Warning signs of this type include:

• Frequent urination accompanied by unusual thirst or extreme hunger
• Rapid weight loss with easy tiring, weakness and fatigue
• Irritability, nausea and vomiting

An estimated 1 million Americans have this type of diabetes.

Type 2 diabetes is much more common, accounting for about 90 percent of those with diabetes. It usually occurs in people over 40 years of age; often they are overweight. These people may not produce sufficient insulin on their own, or the insulin cannot be properly used. 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 sight
• Tingling or numbness in legs, feet or skin
• Frequent skin infections or itchy skin
• Slow healing of cuts and bruises
• Drowsiness

An estimated 20.8 million Americans have Type 2 diabetes. But 6.2 million of those are undiagnosed.

The past decade has brought a dramatic rise in the incidence of Type 2 diabetes in children and teens. This group now represents nearly half of all new Type 2 diabetes diagnoses and is the most rapidly growing group with diabetes in the United States. Weight management and regular physical activity are vital to improve glucose control in this population.

Who Gets Diabetes?

Researchers do not know the exact cause for diabetes, but believe there is a strong correlation between family history and development of the disease. However, not all people with the tendency actually develop the disease. Other factors, such as illness or obesity, must come into play. Diabetes is not contagious.

The Dangers of Diabetes

Diabetes has been called a "silent killer," because people can have it and be unaware of it until they develop a severe complication, such as blindness, kidney disease, or heart disease. It is the sixth leading cause of death in the U.S.

Managing Diabetes: the Team Approach

The diagnosis of diabetes calls for a new way of living. "Working with a medical team gives a patient a full spectrum of assistance in making diabetes management part of their daily lives," says Sharon Paulucci, R.N., C.D.E., clinical manager of John Muir Diabetes Center - Walnut Creek. "The team approach can make incorporating new changes much easier and more permanent."

"The team of diabetes educators can include a patient's physician, registered nurses, registered dieticians, counselors, and others," according to Carolyn Cox, R.D., C.D.E., clinical manager at the John Muir Diabetes Center - Concord. The staff works under the medical direction of an endocrinologist (physician specialist in diabetes and hormonal conditions).

"Education about diabetes is important to help achieve good self-management of glucose levels. But ongoing support from the family, the health care team and other resources is also vital," says Cox.

"Our staff assists people from many diverse backgrounds to learn 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 have seen a tremendous increase in positive lifestyle changes in the past few years."

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

The risk of complications from diabetes are dramatically reduced if people manage their weight, blood pressure, cholesterol and blood sugar levels and follow a regular regime of exercise.