|
A Few Facts About Diabetes |
What is diabetes?Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose. There are three main types of diabetes. They are Type 1 diabetesType 1 diabetes is an autoimmune disease. An autoimmune disease results when the body's system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. Someone with type 1 diabetes needs to take insulin daily to live. At present, scientists do not know exactly what causes the body's immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. Type 1 diabetes develops most often in children and young adults, but the disorder can appear at any age. Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis. <Go to Top>Type 2 diabetesThe most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes usually develops in adults age 40 and older and is most common in adults over age 55. About 80 percent of people with type 2 diabetes are overweight. Type 2 diabetes is often part of a metabolic syndrome that includes obesity, elevated blood pressure, and high levels of blood lipids. Unfortunately, as more children and adolescents become overweight, type 2 diabetes is becoming more common in young people. When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but, for unknown reasons, the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes--glucose builds up in the blood and the body cannot make efficient use of its main source of fuel. The symptoms of type 2 diabetes develop gradually. They are not as sudden in onset as in type 1 diabetes. Some people have no symptoms. Symptoms may include fatigue or nausea, frequent urination, unusual thirst, weight loss, blurred vision, frequent infections, and slow healing of wounds or sores. <Go to Top>Gestational diabetes develops only during pregnancy. Like type 2 diabetes, it occurs more often in African Americans, American Indians, Hispanic Americans, people with a family history of diabetes. Though it usually disappears after delivery, the mother is at increased risk of getting type 2 diabetes later in life.
Type 1 diabetes
Type 2 diabetes People who are overweight are particularly likely to develop Type 2 diabetes. It tends to run in families and is more common in Asian and African-Caribbean communities. Some people wrongly describe Type 2 diabetes as 'mild' diabetes. There is no such thing as mild diabetes. All diabetes should be taken seriously and treated properly. The people most at risk of developing Type 2 diabetes are:
Other causes of
diabetes People sometimes misunderstand what it is that causes diabetes, so here is a short list of some things that do not cause diabetes:
How do people know if they have diabetes?People with diabetes frequently experience certain symptoms. These include:
In some cases, there are no symptoms ！ this happens at times with type 2 diabetes. In this case, people can live for months, even years without knowing they have the disease. This form of diabetes comes on so gradually that symptoms may not even be recognized. <Go to Top>Who gets diabetes?Almost everyone knows someone who has diabetes. An estimated 17 million people--6.2 percent of the population--in the United States have diabetes mellitus--a serious, lifelong condition. About 5.9 million people have not yet been diagnosed. Each year, about 1 million people age 20 or older are diagnosed with diabetes.
Figure 1--Prevalence of diabetes in men and women in the U.S. population age 20 years or older, based on the National Health and Nutrition Examination Survey III. Diabetes includes previously diagnosed and undiagnosed diabetes defined by fasting plasma glucose greater than or equal to 126 mg/dL. (age-std=age-standardized) Diabetes can occur in anyone. However, people who have close relatives with the disease are somewhat more likely to develop it. The risk of developing diabetes also increases as people grow older. People who are over 40 and overweight are more likely to develop diabetes. So are people of African American, Hispanic or Asian heritage. Also, people who develop diabetes while pregnant (a condition called gestational diabetes) are more likely to develop full-blown diabetes later in life. Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase the risk of developing diabetes. Type 1 diabetes occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are not known. Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, Asian and Pacific Islander Americans, and Hispanic Americans. On average, non-Hispanic African Americans are twice as likely to have diabetes as non-Hispanic whites of the same age. Hispanic Americans are nearly twice as likely to have diabetes as non-Hispanic whites. American Indians have the highest rates of diabetes in the world. Among the Pima Indians living in Arizona, for example, half of all adults have type 2 diabetes. On average, American Indians and Alaska Natives are 2.6 times as likely to have diabetes as non-Hispanic whites. Although prevalence data for diabetes among Asian Americans and Pacific Islanders is limited, some groups, such as Native Hawaiians, are 2.5 times more likely to have diabetes as white residents of Hawaii. The prevalence of diabetes in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanic Americans and other minority groups make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates, the prevalence of diabetes in the United States is predicted to be 8.9 percent of the population by 2025. <Go to Top>How is diabetes treated?There are certain things that everyone who has diabetes, whether type 1 or type 2, needs to do to be healthy. You need to have a meal (eating) plan. You need to pay attention to how much you exercise, because exercise can help your body use insulin better to convert glucose into energy for cells. Everyone with type 1 diabetes, and some people with type 2 diabetes, also need to take insulin injections. Some people with type 2 diabetes take pills called "oral agents" which help their bodies produce more insulin and/or use the insulin it is producing better. Some people with type 2 diabetes can manage their disease with weight loss, diet and exercise alone and don't need any medication. Everyone who has diabetes should be seen at least once every six months by a diabetes specialist (an endocrinologist). You should also be seen periodically by other members of a diabetes treatment team, including a diabetes nurse educator, and a diabetes dietitian educator who helps you develop a meal plan that works best for you. Ideally you should also see an exercise physiologist for help in developing an exercise plan, and if you think you need it, a social worker, psychologist or other mental health professional for help with the stresses and challenges of living with a chronic disease. Everyone who has diabetes should have regular eye exams (once a year) by an ophthalmologist to make sure that any eye problems associated with diabetes are caught early, and treated before they become serious. Also, people with diabetes need to learn how to monitor their blood sugars day-to-day at home using home blood sugar monitoring. This daily testing, which your diabetes educator can explain to you, will help you see how well your meal plan, exercise, and medication are working to keep your blood sugars in a normal range. <Go to Top>Are there proven alternative therapies for diabetes?Yes, there are effective alternative therapies for diabetes, proven by National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health Alternative therapies are treatments that are neither widely taught in medical schools nor widely practiced in hospitals. Alternative treatments that have been studied to manage diabetes include acupuncture, biofeedback, guided imagery, and vitamin and mineral supplementation. The success of some alternative treatments can be hard to measure. Many alternative treatments remain either untested or unproven through traditional scientific studies. Acupuncture Acupuncture is a procedure in that a practitioner inserts needles into designated points on the skin. Some Western scientists believe that acupuncture triggers the release of the body's natural painkillers. Acupuncture has been shown to offer relief from chronic pain. Acupuncture is sometimes used by people with neuropathy, the painful nerve damage of diabetes. Biofeedback Biofeedback is a technique that helps a person become more aware of and learn to deal with the body's response to pain. This alternative therapy emphasizes relaxation and stress-reduction techniques. Guided imagery is a relaxation technique that some professionals who use biofeedback do. With guided imagery, a person thinks of peaceful mental images, such as ocean waves. A person may also include the images of controlling or curing a chronic disease, such as diabetes. People using this technique believe their condition can be eased with these positive images. Chromium The benefit of added chromium for diabetes has been studied and debated for several years. Several studies report that chromium supplementation may improve diabetes control. Chromium is needed to make glucose tolerance factor, which helps insulin improve its action. Because of insufficient information on the use of chromium to treat diabetes, no recommendations for supplementation yet exist. Magnesium Although the relationship between magnesium and diabetes has been studied for decades, it is not yet fully understood. Studies suggest that a deficiency in magnesium may worsen the blood sugar control in type 2 diabetes. Scientists believe that a deficiency of magnesium interrupts insulin secretion in the pancreas and increases insulin resistance in the body's tissues. Evidence suggests that a deficiency of magnesium may contribute to certain diabetes complications. Vanadium Vanadium is a compound found in tiny amounts in plants and animals. Early studies showed that vanadium normalized blood glucose levels in animals with type 1 and type 2 diabetes. A recent study found that when people with diabetes were given vanadium, they developed a modest increase in insulin sensitivity and were able to decrease their insulin requirements. Currently researchers want to understand how vanadium works in the body, discover potential side effects, and establish safe dosages. <Go to Top>What other problems can diabetes cause?Your health care team will encourage you to follow your meal plan and exercise program, use your medications and monitor your blood sugars regularly to keep your blood sugars in as normal a range as possible as much of the time as possible. Why is this so important? Because poorly managed diabetes can lead to a host of long-term complications ！ among them are heart attacks, strokes, blindness, kidney failure, blood vessel disease that requires an amputation, nerve damage, and impotence in men. But happily, a recent nationwide study completed over a 10-year period showed that if people keep their blood sugars as close to normal as possible, they can reduce their risk of developing some of these complications by 50 percent or more. <Go to Top>Can diabetes be prevented?Maybe, with a combination of diet control, exercise, alternative therapies, as well as certain medications. Recent research suggests that type 2 diabetes risk can be lowered by as much as 58% through a program of moderate sustained weight loss and moderate daily exercise. Metformin, a medication used to treat type 2 diabetes, has been shown to lower diabetes risk by 31%. This is particularly important if it runs in your family, you are overweight, lead a sedentary lifestyle, have had gestational diabetes, or if you are a member of an ethnic group (African Americans, Native Americans, Hispanic Americans), that is more prone to this disease. |