Diabetes is a disease that afflicts 26 million Americans, although 7 million of those people don’t even know it. Another 58 million have a precursor form of the disease, called pre-diabetes. The number of people with this diagnosis has increased at epidemic proportions. Here’s a brief review on diabetes – symptoms and diagnosis, treatment, and most importantly, prevention.
“Diabetes” refers to a group of diseases that cause high blood sugar because either the body doesn’t produce insulin or the cells are not sensitive to insulin. Insulin is a hormone that regulates sugar in the body and it causes cells to take up sugar from the bloodstream. High sugar levels over time are harmful to the body, resulting in nerve damage, increased rate of heart attacks and strokes, kidney failure, infections, and blindness.
Type 1 diabetes
Type 1 diabetes accounts for just 5 to 10 percent of all cases and occurs when the body stops producing its own insulin. It is typically diagnosed in children or young adults and was previously known as juvenile diabetes.
Symptoms are increased thirst, urination, and hunger (though one typically loses weight). We don’t know how to prevent it. It is treated with insulin injections or a pump.
Type 2 diabetes
Type 2 diabetes is by far the most common type and is the focus of the rest of this article. It occurs when the body’s cells start to ignore or become less sensitive to the insulin. It was previously referred to as “adult-onset diabetes” because it is primarily diagnosed in older people.
Symptoms are vague and may develop slowly and a person could have it for years and not realize it. Type 2 diabetes is screened for and diagnosed most commonly with a fasting (first thing in the morning) sugar level that is elevated. Risk factors are age, obesity, and sedentary lifestyle. You can’t do much about aging, but lifestyle changes of improving diet and exercise can prevent the disease or slow its progression.
Obesity is the main factor contributing to the epidemic of diabetes. Ben Franklin’s famous quote is: “An ounce of prevention is worth a pound of cure.” If that’s the case, how much is a pound of prevention worth?
A study shows losing just 7 percent of one’s body weight (14 pounds for a 200 pound person) reduced the risk of diabetes by 58 percent. That’s big! Please see Children and Type II Diabetes: How to make healthy decisions, by Emily Fonnesbeck for St. George Health and Wellness and St. George News. When it comes to exercise, the key initially is simply putting in the time: 30 minutes times 5 days a week equals 1,500 minutes; and include some resistance training. There are plenty of resources for this.
Now for those of you that have already been diagnosed with Type 2 diabetes, you hopefully understand that there are three main aspects to treating the disease.
1) Lifestyle change (diet/exercise). This is still the most important and the active component of your treatment. The next two aspects typically involve your doctor and taking inexpensive medications.
2) Manage other cardiovascular risk factors. Keep your blood pressure in a good range (less than 130/80 is usually the goal). Your goal for cholesterol level is also much lower when you have diabetes. A daily aspirin is usually appropriate.
3) Get your sugar levels under control. Most diabetics (unless they have kidney problems) take a pill called metformin that along with a healthy diet and avoiding sweets, has a huge impact in bringing down sugar levels to a safe range. Depending on how advanced the diabetes is, some people have to take multiple pills or shots, but it can be controlled. It’s important to see your doctor every six months if you have diabetes. In fact, insurances now grade or rate physicians based on appropriate management at those visits.
Many of my patients report that getting diagnosed with diabetes was one of the best things that happened to them. How could this be? It basically boils down to the fact that the diagnosis was a wake-up call, and a call to action. As a healthy lifestyle becomes a priority again, people feel better– body and soul.
Written by N. Chris Busk, M.D. for St. George Health and Wellness
N. Chris Busk is a member of St. George Clinic providing family health care. He grew up in Richfield, Utah, graduated from BYU and the Medical College of Wisconsin, served in the Air Force and was deployed in Operation Iraqi Freedom.
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