Diabetes

Nearly 26 million children and adults in the United States (8.3% of the population) have diabetes mellitus. About one-third of these people do not know they have diabetes and are not under medical care. Each year, 1.9 million new cases of diabetes are diagnosed in people aged 20 years and older. In Illinois, approximately 800,000 people 18 years of age and older have diagnosed diabetes, with another 500,000 people who are not aware that they have the disease.

Individuals with diabetes are at increased risk for heart disease, blindness, kidney failure, and lower extremity amputations (not related to injuries). Diabetes and its complications occur among all age, racial, and ethnic groups
 
What Is Diabetes?
 
Diabetes is a disease in which blood glucose levels are above normal. Most of the food eaten is turned into glucose (sugar) for the body to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the body’s cells. When you have diabetes, the body either does not make enough insulin or cannot use its own insulin as well as it should. This causes sugar to build up in the blood.

There are 2 main types of diabetes
 
Type 1 – This type of diabetes can occur at any age, although it most often appears in childhood or during the teen years. With this form of diabetes, the body no longer makes insulin. Treatment for type 1 diabetes includes taking insulin and possibly another injectable medicine; making wise food choices; being physically active; taking aspirin daily, for some; and controlling blood pressure and cholesterol.
 
Type 2 – Formerly called adult-onset or non-insulin dependent diabetes, this type is the most common form of diabetes and can develop at any age, even in childhood. Type 2 diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the body keeps up with the added demand by producing more insulin, but, in time, the body is unable to produce enough insulin. Being overweight and inactive increases the chance of developing this form of diabetes. Treatment includes using diabetes medicines; making wise food choices; being physically active; taking aspirin daily, for some; and controlling blood pressure and cholesterol.
 
It is estimated that 79 million adults aged 20 and older have pre-diabetes. Pre-diabetes is a condition where blood glucose levels are higher than normal but not high enough to be called diabetes. Studies have shown that by losing weight and increasing physical activity people can prevent or delay pre-diabetes from progressing to diabetes.
 
What Are the Signs of Diabetes?
 
The signs/symptoms of diabetes are:

  • Increased thirst
  • Increased urination
  • Increased hunger
  • Weight loss, despite eating more than usual
  • Fatigue
  • Blurred vision
  • Slow healing sores or frequent infections

Who Is Most at Risk for Developing Type 2 Diabetes?
 
The following have a greater risk of developing type 2 (non-insulin dependent) diabetes: 

  • Those with a family history of diabetes (first-degree relative – parents or siblings with diabetes)
  • Individuals who are overweight (BMI greater than 25 kg/m2)
  • Members of certain racial/ethnic groups. Compared to non-Hispanic white adults, African Americans, Hispanic/Latino American, Asian American and Pacific Islanders are almost 2 times more likely to have diabetes. American Indians and Alaska Natives are more than 2 times as likely to have diabetes
  • Those who are 45 years of age or older
  • Individuals previously identified as having impaired glucose tolerance
  • Individuals with hypertension (Blood Pressure greater than 140/90)
  • Those with abnormal lipid levels: HDL cholesterol level less than 35 mg/dL; triglyceride level greater than 250
  • Women who have a history of gestational diabetes during pregnancy or who have delivered babies weighing over 9 pounds
  • Individuals who have an inactive lifestyle (being physically active less than three times a week)
  • Children who have a BMI greater than the 85th percentile for their age

Can Diabetes be Prevented?
 
People with diabetes risk factors are at risk of developing type 2 diabetes; however, progression to type 2 diabetes is NOT inevitable.

Lifestyle interventions in people at high risk can reduce their risk of developing type 2 diabetes by more than 50%. This powerful reduction in risk of type 2 diabetes affects all subgroups of people including men and women, high-risk racial/ethnic groups, women with a history of gestational diabetes, and is even greater in people age 60 and older.
 
Lifestyle Modification for Diabetes Prevention 

  • Nutrition therapy – follow up with a registered dietitian who specializes in diabetes.
  • Physical activity – 30 minutes of moderate intensity physical activity five days a week. (Brisk walking is an excellent form of moderate-intensity physical activity). Also physical activity can be broken up into time segments of 5 to 10 minutes
  • Weight loss – set realistic, yet clinically meaningful weight loss goals
  • Follow up – see your primary care physician for control of blood pressure and cholesterol 

What Is a Good Blood Sugar Level?
 
According to the U.S. Centers for Disease Controls (CDC) National Diabetes Education Program, a good blood sugar range for most people with diabetes is from about 70-130 mg/dL. This is before a meal, such as breakfast, or 4 to 5 hours after a meal.

Remember, everyone is different. A good blood sugar range for one person may not be the best for someone else. Ask your physician what the best blood sugar range is for you.
 
What Is the Best Way to Maintain a Good Blood Sugar Level?

  • Get proper nutrition. Follow your physician or registered dieticians instructions regarding your diet.
  • Exercise regularly. Try to exercise regularly, 5 days a week, for 30 to 40 minutes a day. Remember, physical activity can be broken up into time segments of 5 to 10 minutes. Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all examples of good ways to exercise. If you have not exercised for a while, begin slowly and gradually increase intensity and duration. Before beginning any exercise program, be sure to check with your physician.
  • Take your diabetes medicine. Insulin and prescription diabetes pills are the 2 kinds of medicines used to lower blood sugar.
  • If you take insulin, your physician will tell you what kind of insulin to use, how much, and when to give yourself a shot. Your physician or diabetes educator will show you how and where to give yourself a shot. Always use your own needles and never share them with anyone else. If you use insulin, be sure to take it before you eat, eat at about the same time each day, and do not skip meals.
  • If you take diabetes pills, ask your physician when to take the pills. Remember, these pills do not lower blood sugar all by themselves. You will still have to follow your diet and exercise plan to lower your blood sugar.
  • Test your blood sugar. Ask your physician how often and when you should test your blood sugar. To test your blood, you need a small needle called a lancet, special blood testing strips, and a glucose monitor (a special electronic device used to test for blood sugar). Your physician or nurse can show you how to test your blood and give you information on glucose monitors.
  • Two other tests that can help you keep track of your blood sugar. You may need a urine test when you are ill or if your blood sugar is above 240 before eating. This test will tell you if you have ketones in your urine. Ketones are present when there is not enough insulin in your blood: they can make you very sick. Call you physician immediately if you find ketones in your urine. The hemoglobin A1C test shows what your average blood sugar was for the past 3 months. Ask your physician if this test is appropriate every 6 months.