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Diabetes, Part 2

In my November column on diabetes, I discussed the definition, symptoms, causes, risks and complications of this common disease (“Diabetes a common peril,” Page 20, Nov. 23). Today, I would like to discuss the diagnostic tests and treatments for diabetes, prevention and the impact of the disease on our society.

Before I do so, though, a reader who has a child with Type 1 diabetes has asked me to clarify a few points. Type 1 (childhood) diabetes is not caused by eating too much sugar; it is caused by the body not having enough insulin, which causes increased blood sugar. Also, a child will not “grow out of it.” Type 1 diabetes is a lifetime health issue.

Now, on to today’s topics:

Blood tests are used to diagnose diabetes. The fasting blood sugar test is the one most commonly used. It tests the amount of sugar in the bloodstream after a period of fasting. A more reliable blood test is called the A1C test and measures a person’s average blood sugar over several months.

Specific treatment for Type 1 diabetes involves the use of insulin, frequent monitoring of one’s blood sugar level and counting carbohydrates. Treatment of Type 2 diabetes involves oral diabetes medications, possible use of insulin, blood sugar monitoring, maintaining a proper diet and routine exercise.

Type 1 diabetes can’t be prevented and can only be treated with insulin. However, Type 2 diabetes can be prevented by the same lifestyle choices that also treat the condition, including:

– Eating healthy foods.

– Getting plenty of physical activity.

– Losing extra pounds, if overweight.

About 26 million Americans have diabetes, and the numbers are growing yearly. About 2 million of these diabetics have Type 1 diabetes, and the remaining 24 million have the more preventable Type 2 diabetes. Twenty-six percent of all hospital costs are related to the treatment of diabetes and its complications, costing $175 billion to $200 billion per year.

In summary, we know that Type 1 diabetes usually begins in childhood, is most often caused by genetic or other unknown factors, is not caused by a poor diet and can be treated with insulin injections. It is incurable.

Type 2 diabetes affects mostly adults and is treated and often cured by diet, exercise and preventing obesity.

About 25 million Americans have prediabetes, a precursor to Type 2 diabetes. I would advise patients to talk with their physicians at their next routine visit about being screened for this common disease.

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Diabetes, Part 1

November is National Diabetes Month. Most of us know someone with diabetes, but we may not understand just what this disease is.

Diabetes occurs when the body doesn’t make enough insulin or when the insulin becomes ineffective. Insulin is a hormone made by the pancreas that helps move glucose (blood sugar) from the blood into the cells of our bodies, where the glucose acts as a source of life-sustaining energy for our muscles and tissues. When insulin is insufficient or ineffective, the sugar level in our blood increases, causing diabetes.

There are several types of diabetes. In type 1 diabetes, one’s pancreas does not produce enough insulin. This is usually a genetic problem where one’s own immune system attacks and destroys the cells that create insulin in the pancreas. This type of diabetes often starts in childhood and has the most serious health complications.

Type 2 diabetes occurs when one’s cells become resistant to the effects of insulin, causing sugar to build up in the bloodstream. Being overweight is a major contributing factor. Genetics and environmental factors may also play a role in this type of diabetes. Type 2 diabetes is the most common type and can occur at any age. It is also preventable.

Prediabetes often precedes type 2 diabetes. This condition occurs when the blood sugar is higher than normal, but not high enough to cause any obvious health problems. It is estimated that perhaps 80 million people in the U.S. have this condition, which, if not recognized and treated, could go on to type 2 diabetes.

Symptoms of diabetes depend on how high one’s blood sugar is. These include:

– Frequent urination

– Increased thirst

– Extreme hunger

– Unexplained weight loss

Risk factors for diabetes depend on the type of diabetes. For type 1, these factors include genetics, environment, dietary habits, race and geography. Risk factors for type 2 include obesity, inactivity, family history, age and pregnancy.

Complications of diabetes take time to develop. The longer one has diabetes and the higher the blood sugar, the worse the complications. Eventually, these complications can cause significant disability and possibly early death. Diabetic complications include:

– Cardiovascular disease, especially heart attacks and strokes.

– Nerve (neuropathy) and blood vessel damage involving the legs and feet sometimes leading to amputation.

– Eye damage.

– Kidney damage, often leading to dialysis or even to kidney transplantation.

– Increased risk of Alzheimer’s disease as well as certain cancers.

My next column will cover the tests, treatment and prevention of diabetes.

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Interesting facts from medical literature

Beginning today, I will occasionally share with you some interesting facts from articles I have read during my review of current medical literature.

Did you know:

  • Skin cancer on the head or neck is more deadly than on other parts of the body.
  • 30 minutes of aerobic exercise five days a week can reduce blood pressure between 5 and 8 points
  • Extensive use of flip-flop shoes can cause pain in the heel, ankle, lower leg and toes.
  • Pessimistic heart patients are almost twice as likely to die within six to 10 years as heart patients with an optimistic outlook.
  • Trans fats, found in many processed foods, not only increase the risk of heart disease but also increase the risk of breast cancer.
  • If you think you’re having a heart attack, call 9-1-1, then chew and swallow one 325 mg. aspirin
  • Exercising in water burns more calories than doing the same exercise on land.
  • People, who engage in vigorous cardiovascular activities regardless of their size, are healthier and live longer than their sedentary counterparts.
  • Fish oil may help to ease depression.
  • To halt a lower leg calf cramp, flex your foot by pointing it up toward your shin. You can grab and pull the toes and ball of your foot to help flex it.
  • Sixteen percent of people between the ages of 20 to 69 suffer significant hearing loss.
  • Memory loss is linked to low levels of “good” (HDL) cholesterol
  • The spread of flu is linked to airline travel. The fewer people who travel by airline over the Thanksgiving holiday, in particular, the slower the flu moves across the country.
  • Vitamin C may fight wrinkles.
  • Excessive drinking of alcohol leads to increased risk of pre-diabetes.
  • Eating or drinking food high in cocoa improves blood flow to the brain and may help prevent stroke and dementia.
  • People with type 2 adult onset diabetes are two to four times more likely to develop heart disease, mostly because of increasing cholesterol and blood pressure.
  • Those who receive the pneumococcal pneumonia vaccine may be at a lesser risk of heart attacks.
  • Adult muscle mass decreases by 1 percent a year after the age of 30.
  • Drinking up to three cups a day of black or green tea reduced stroke risk by 21 percent.
  • Symptoms of depression can be improved by eating less processed sugary foods and increasing foods such as grains and vegetables.
  • For acute low back pain, a day or two of bed rest may be helpful. For more rapid healing, it is best to get out of bed and move around as soon as possible.
  • Newer cooking recipes have larger portion sizes. Stay conscious of portion size when eating.
  • Drowsy driving is linked to 100,000 motor vehicle accidents causing 1,000 deaths and 40,000 injuries.
  • Accidents with dogs and cats cause 80,000 emergency room visits annually for their owners in the United States.

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