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DIABETIC INFORMATION

What is Diabetes?

Diabetes mellitus is a chronic disease in which blood glucose (sugar) levels are too high. Cells in the body break down glucose in order to provide energy for movement, growth, and repair. The hormone insulin is responsible for regulating glucose levels in the blood. Abnormally high levels of glucose can damage the small and large blood vessels, leading to diabetic blindness, kidney disease, amputations of limbs, stroke, and heart disease.

There are three types of Diabetes:

  • Diabetes type 1 is usually (but not always) diagnosed in children and young adults. Persons with Diabetes type 1 make no insulin and must take insulin every day.
  • Diabetes type 2 is either the person is not making enough insulin or the body is resistant to insulin and cannot use it properly.
  • Gestational Diabetes occurs during pregnancy: 2-4% of all pregnant women have gestational Diabetes. If a woman has gestational Diabetes, she has about a 40% chance of having Diabetes type 2 later in her life.

There are 20.8 million people or 6.9% of the population in the United States who have Diabetes. While an estimated 14.6 million have been diagnosed, unfortunately, 6.2 million people are not aware that they have the disease.  

What are the risk factors?

  • Family history of Diabetes
  • Being overweight and do not exercise regularly
  • Low HDL or high triglycerides
  • Certain racial and ethnic groups (e.g., African Americans, Hispanic Americans, Asian & Pacific Islanders, and Native Americans)
  • Being over age 45, but these statistics are changing

How do I know if I have Diabetes?

Over 50% (one-half) of people with Diabetes type 2 are unaware that they have the disease. For this reason, it is particularly important to pay attention to the signs and symptoms of Diabetes and its risk factors.

  • being very thirsty
  • urinating often
  • feeling very hungry or tired
  • losing or gaining weight without trying
  • having sores that heal slowly
  • having dry, itchy skin
  • losing the feeling in your feet or having tingling in your feet
  • having blurry eyesight

Symptoms of Diabetes type 1 often develop over a short period of time. In Diabetes type 2, symptoms develop more slowly, and some persons never have any symptoms of the disease. If you are regularly having any of these signs and symptoms, you should contact your practitioner.

How will my Practitioner determine if I have Prediabetes or Diabetes?

Diabetes is diagnosed using either the fasting plasma glucose test (FBG) (Part of your CMP – Complete Metabolic Panel test which also contains your FBG), or the 2 hour oral glucose tolerance test (2-hour OGTT). Both tests are performed in a medical lab.   

FBGT is performed by measuring your blood glucose after an overnight fast (8-12 hours).  This is the test that most commonly diagnoses Diabetes.  A blood glucose level of 100-125mg/dl from a FBGT means you have Prediabetes.  A blood glucose level over 126mg/dl from 2 FBGTs means you have Diabetes. 

The 2-hour OGTT is most often performed after an overnight fast (8-12 hours) by measuring before and 2 hours after drinking a 75 gram glucose solution.  A blood glucose of 140-199mg from a 2-hour OGTT means that you have Prediabetes.  A blood glucose level over 200mg from two 2-hour OGTTs means that you have Diabetes.

How can I reduce my chance of getting Diabetes? 

A recent study funded by the Federal government of 3,234 persons at high risk for Diabetes showed that diet and exercise can sharply lower the risk of getting Diabetes type 2.

The Diabetes Prevention Program (DPP) was a major clinical study of ways to prevent or delay Diabetes in persons at high risk for Diabetes type 2. Patients were overweight and had higher than normal levels of blood glucose, called impaired glucose tolerance. Both conditions are strong risk factors for Diabetes type 2. Because of the high risk among some minority groups, about half of the DPP participants were African American, American Indian, Asian American, Pacific Islander, or Hispanic.

The DPP compared two methods for preventing Diabetes: (1) an intensive program of healthy eating and exercise and (2) the use of metformin, a Diabetes drug.

  • Persons who engaged in moderate physical activity for about 30 minutes a day, followed a low-fat and low-calorie diet, and lost 5-7% of their body weight (or about 12 pounds for someone who weighs 200 pounds) cut their risk of getting Diabetes type 2 by about one half (58%).
  • The good news is that you can make a difference to reduce your risk for Diabetes and its complications.

How does Diabetes affect the body?

Diabetes can affect the small vessels in your body such as the nerves in your hands and feet and the retinas in your eyes:

  • About 60-70% of people with Diabetes have mild to severe forms of diabetic nerve damage.  In fact, Diabetes is the most frequent cause of non-traumatic lower limb amputations.

·         Diabetes is the leading cause of new cases of blindness in people ages 20-74.  Each year, as many as 25,000 people go blind from diabetic retinopathy.

Diabetes can also affect the larger organs of your body such as your heart and your kidneys:

  • Diabetes is the leading cause of end-stage renal disease that accounts for about 40% of new cases. In 2002, 44,400 people with Diabetes began treatment for end-stage renal disease.
  • People with Diabetes are 2 to 4 times more likely to have heart disease which is present in 65% of Diabetes-related death.  They are also 2 to 4 times more likely to suffer a stroke and the risk of death from stroke is 2.8 times higher among people with Diabetes.

Remember, by making simple lifestyle changes such as food choices and physical activity level, you can prevent complications of Diabetes.

Compiled by Jacki Abbott, Dr. PH, RD, LD and Mike Salvey, BS

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