Could You Have Diabetes?

Wednesday, November 23, 2005

Could you be one of millions of Americans with undiagnosed diabetes? The American Diabetes Association (ADA) estimates that 5.2 million people are unaware that they have diabetes. (Another 13 million Americans have been diagnosed with the disease). Some people with diabetes may go undiagnosed for years.

Diabetes is a disease in which the body doesn’t produce or properly use insulin. Insulin is a hormone that converts sugar, starches, and other food into energy needed for daily living. If your body doesn’t make enough insulin, or if the insulin doesn’t work the way it should, glucose can’t get into your cells and stays in your blood instead. When the blood glucose level gets too high, the result is diabetes—a chronic disease that can be managed, but not cured.

Genetics (family history) and lifestyle factors such as obesity appear to play roles in the onset of diabetes. The disease is also associated with age; the longer a person lives, the more likely he or she is to develop diabetes. In fact, 18.3% of people age 60 or older have diabetes, according to the ADA.

Symptoms
The signs of diabetes include excessive thirst, frequent urination, fatigue, unexplained weight gain or loss, sores that heal slowly, blurry eyesight, and tingling or loss of feeling in your feet. Recurrent infections, especially urinary tract or vaginal yeast infections in women, are also a sign.

You may have had one or more of these signs—or you may have had no signs at all. About 25–50% of people with diabetes have no symptoms. That’s why it’s important for your doctor to test your blood glucose level. The ADA recommends that diabetes screening every three years beginning at age 45.

People at high risk for diabetes—due to obesity, high blood pressure, a family history of diabetes, abnormal lipid levels, or those with a history of gestational diabetes—should be tested more often. Other people at higher risk include African Americans, Hispanics, Asian Indians, and Native Americans.

Types of Diabetes
Type 1 diabetes (insulin-dependent)—This type is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the pancreas no longer makes insulin. Symptoms are often acute prior to diagnosis. To survive, people with type 1 diabetes must receive insulin delivered by a pump or injections. Type 1 diabetes may account for 5–10% of all diagnosed cases of diabetes. There is no known way to prevent type 1 diabetes.

Type 2 diabetes (non-insulin dependent)—In type 2 diabetes, which can develop at any age, the pancreas doesn’t make enough insulin and the cells don’t use insulin properly. It’s not uncommon for people to have no symptoms and to learn they have type 2 diabetes following a routine blood test at the doctor’s office.

Obesity increases the chances of developing type 2 diabetes. As obesity increases in this country, so does the prevalence of type 2 diabetes. Today, type 2 diabetes is increasingly being diagnosed in obese children and adolescents. In addition to obesity, the onset is associated with increasing age, a family history of diabetes or gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. Type 2 diabetes may account for about 90–95% of all diagnosed cases of diabetes.

Many people with type 2 diabetes can control their blood glucose by following a careful diet and exercise program, losing excess weight, and taking oral medication or insulin. Research has found that lifestyle changes (diet and exercise) can prevent or delay the onset of type 2 diabetes among high-risk adults.

Gestational diabetes—About 5% of pregnant women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes requires treatment to normalize the woman’s blood glucose levels to avoid complications in the infant. This form of diabetes usually ends after the baby is born.

Pre-diabetes—Pre-diabetes is a condition in which the blood sugar level is elevated but not high enough to be classified as diabetes. People with pre-diabetes are at increased risk of developing diabetes. Studies suggest that weight loss and increased physical activity among people with pre-diabetes can prevent or delay diabetes. Over time, however, up to 50% of people with pre-diabetes will develop full-blown diabetes.

Complications of Diabetes
Diabetes is associated with serious complications and premature death. Complications usually first appear about 10 years after the onset of the disease. If the disease is not controlled, a diabetic is at high risk for heart disease, blindness, kidney disease, nerve damage, peripheral vascular disease, stroke, amputations, and other serious problems.

People with diabetes can effectively manage their disease with insulin, oral medications, diet, and exercise to lower the risk of complications. Many also need to take medication to control their cholesterol and blood pressure. Many diabetics don’t strictly adhere to their management regimen, however, perhaps because they don’t feel “sick” or find it inconvenient to follow their care plan. The best chance for a healthier life, with fewer complications, lies in following your doctor’s care plan.


Dr. Marcus Perry specializes in internal medicine at Northlake Medical Associates, one of 26 Columbia St. Mary’s community clinics. For more information, call 291-1467.
 

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