November is not only the start of the holiday season, it’s National Diabetes Awareness month. Today, over 20 million Americans suffer from diabetes – with an estimated 30 percent of them unaware of their condition. Of these 20 million diabetics, about 90 percent have Type 2 diabetes. In 2007, the Centers for Disease Control characterized the rise in Type 2 diabetes an epidemic. The greater incidence in America is believed to be the increase in the number of obese Americans, as well as the inactivity of our youth. Let’s take a closer look at current issues surrounding this fairly common, but significant, medical condition.
What is diabetes? Diabetes is a disease that disrupts the body’s metabolism. During metabolism, the body breaks down a majority of food into sugar (glucose) – a ready form of energy for the body. Upon detecting increased blood sugar levels after digestion, the pancreas secretes insulin, which allows cells to absorb the glucose from the bloodstream. Without insulin, you can be well fed, yet be in a state of starvation because your cells cannot access glucose’s calories.
A diabetic is unable to produce, or use and store insulin. Glucose accumulates in the bloodstream, causing one’s blood sugar to rise, and is excreted in urine in whole form. Initially, cells become starved for energy. Over time, the high levels of glucose may hurt one’s brain, eyes, kidneys, nerves or heart.
Type 1 diabetes is a condition that affects about 10 percent of all diabetics. This is an autoimmune condition where the body actually develops a reaction to itself and destroys the pancreas. When this occurs, the patient must take insulin in either shot form or a pump. It is unclear to medical professionals why the body destroys this organ, but some studies have shown an association of preceding viral illness that may trigger the entire process. This type of diabetes usually occurs at a fairly young age and may be associated with hereditary factors.
The most common form of diabetes, Type 2, usually does not require the use of insulin. This condition affects older people and over 80 percent of all Type 2 diabetics are overweight – a major risk factor of concern to health care professionals. This form of diabetes can progress rather slowly and gradually.
What are the symptoms? The symptoms of diabetes may be rather nonspecific and diagnosis may take a while. With Type 1 diabetics, the initial presentation may be rather rapid with significant illness. Many new onset diabetics present to the emergency department after a few days of a flu-like illness, including nausea, vomiting, and severe dehydration. Their blood sugar may be up over 1000 mg/dl, with normal being 100 mg/dl. This is an emergency situation that requires rehydration, control of sugars, and infusion of electrolytes while hospitalized. Left untreated, this patient can die.
Type 2 diabetics usually have a presentation that is slow and may be monitored over a few years. Most of these patients are in their sixties when initially diagnosed, but recently there has been a trend toward younger people being diagnosed. This is most likely due to the epidemic of youth obesity that is present in our country.
The usual Type 2 diabetic symptoms may include increased thirst, increased urination, weight loss, fatigue, poor healing wounds, and visual changes. Fasting blood glucose levels are usually over 110 mg/dl. Many times, weight loss will cure the problem. With more severe cases, a variety of oral medications can be taken to address the problem. There are a few cases that require both oral medications and shots of insulin.
What should I do? Diabetes is a serious illness that if left untreated leads to several other medical complications. It increases the risk of heart disease and stroke, as well as kidney failure. Visual changes including cataracts and blindness can occur. The nerves in the hands and feet can become damaged – called peripheral neuropathy. Breakdown of the skin can lead to chronic skin ulcers, infections, and loss of limbs. These are all serious problems that can be prevented with tight control of the blood sugar through diet, exercise, and medications.
Prevention of diabetes has to start early with good health habits. Obesity issues must be addressed with our youth – healthy eating and exercise must be emphasized in schools and at home. With the advent of the holiday season, this a good time to prevent excessive weight gain and maintain an active exercise regimen. A combination of cardiovascular exercise and weight training is a great combination of activity that will promote a healthy life style. It will definitely pay off later in life, as this debilitating disease can be prevented.
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