Ask The Doc - Diabetes

Thursday, November 13, 2014

Question: How can I tell if I'm at risk for diabetes? And what can be done about it?

By Dr. Mitchell Jacobson, MD, Endocrinology, Columbia St. Mary’s and Madison Medical Affiliates

Diabetes has long been a serious health issue in America, and it only seems to be getting worse.

In 2012, 29.1 million Americans (or 9.3 percent of the population) had diabetes, either officially diagnosed or undiagnosed. That’s a stark increase from 2010, when those figures were 25.8 million Americans (or 8.3 percent).

The explanation for this increase is two-fold. One, of course, is more people are developing diabetes. At the same time, though, screening and early detection has improved, which results in more identified cases. It’s likely a large percent of these “new” cases already existed and previously would have gone undiagnosed.

Whatever the root cause for this increase, diabetes continues to be a major public health concern. But it doesn’t have to be.

Before we get started, we should define what diabetes is. Diabetes is a disease in which your body is unable to properly use the glucose (sugar) in your blood. Glucose provides energy for your body to function properly and its use is regulated by a hormone called insulin. Those with diabetes have too much sugar in their blood because either they have an inadequate supply of insulin (Type 1 diabetes) or because their body’s cells are unable to properly utilize the glucose and they have a relative deficiency of insulin (Type 2 diabetes). If left untreated, diabetes can cause severe insulin resistance and damage the nerves and small blood vessels of the eyes, kidneys and heart.

Type 1 diabetes is an autoimmune disease that damages the pancreas. Though it can present later in life, the majority of patients are diagnosed as children. While relatively rare (Type 1 makes up only about 5 percent of all diabetes cases), it is not preventable.

Type 2 diabetes is primarily the result of a genetic disposition, but behavioral influences – such as an unhealthy lifestyle, including obesity and a lack of sufficient physical activity – are extremely important. Race, age and family history also play a role, but by and large the likelihood of Type 2 diabetes may be reduced or delayed with a healthy lifestyle. So, what can do you about it?

First and foremost, know the symptoms. Often the warning signs of diabetes can be very subtle, so it’s important if you are at-risk to stay vigilant about any physical changes. Common symptoms include increased frequency of urination, feeling very thirsty and hungry, fatigue, blurred vision, slow-healing cuts and bruises, tingling, pain or numbness in the hands and feet and unexplained weight loss. If you experience any combination of these symptoms, consult your doctor immediately.

From there, it’s time to reduce your risk. You can’t change your race or your family history, but you can take charge of your weight and physical fitness. Being overweight not only greatly increases your risk for Type 2 diabetes, but a host of other health problems, including heart disease, stroke and high blood pressure. For those with pre-diabetes or officially diagnosed Type 2 diabetes, weight loss is also a vital tool to help manage the disease. The good news is losing as little as 10-15 pounds can make a huge difference.

The keys to any successful weight-loss regimen are patience and commitment. People often get frustrated if the results aren’t immediate. Just know that if you reduce your intake of calories and fat and perform some form of moderate physical activity three to four days a week, the weight will come off – and stay off.

For anyone starting a new exercise program, remember to start slowly and set realistic goals. Going too fast, too hard, too soon will only result in burnout and injury.

In the beginning, aim for 5-10 minutes a day at least five days a week of moderate physical activity. Start by taking a nightly walk. After a few weeks, you can ramp up to jogging for a few minutes or riding a bike. Remember, it doesn’t have to be traditional “exercise” to count. Taking the stairs instead of the elevator or getting up from your desk during the day and taking a short walk counts just the same.

It’s also important to partake in a variety of activities, both aerobic and anaerobic. This will not only yield better overall results, but it’ll keep you from getting bored. Walk, jog, run, dance and swim but also lift weights and do yoga. Muscle takes energy to maintain, so the more muscle you have the more calories you burn, even while resting.

Even the most rigorous exercise program won’t do any good if you’re not providing your body with the proper fuel. A healthy diet is crucial and it all starts at the grocery store. Buy fresh fruits and vegetables, whole grain breads and pastas, lean proteins and low-fat dairy while avoiding sugar-filled beverages and salty snacks. Canned fruits and vegetables are better than none, but be sure to look for low sodium vegetables and fruits packed in juice, not syrup.

Ultimately, when it comes to implementing new, healthy habits, think of them not as a temporary “diet” but as a permanent lifestyle changes. That’s the only way you’ll ultimately see lasting results and help prevent or control your diabetes.

Dr. Mitchell Jacobson is an endocrinologist with Columbia St. Mary’s and Madison Medical Affiliates. For more information, please call 262-243-5000.

This article appeared in the November 13 issue of The Ozaukee News Graphic.



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