December 6, 2005

Middle park times

Diabetes, an often misunderstood disease

 

The other day at grocery story, I heard a woman tell her friend that her husband was recently diagnosed with diabetes.  They both were uncertain of the how or why he got the disease and how it might be cured.  This is a common event in the US today, where diabetes is frequently mentioned, but is rarely discussed in any manner that people can understand. 

 

Diabetes has become an epidemic in the US currently affecting over 21 million US citizens, and there are estimates that over 33% of the children born after 2000 will have diabetes during their lifetime.  More concerning is the fact that people who get diabetes before the age of 40 have an estimated reduction of 15 years of life.

 

So, what is diabetes?  It is a defect in the body’s ability to maintain a constant level of blood sugar.  Maintaining a constant level of blood sugar is a complex task, requiring many different chemicals in the body.  Insulin is one of the main chemicals that help the body store excess blood sugar to keep the sugar level from being too high.  The body uses this stored sugar later when food is not available – such as during sleep.  Diabetes can be caused by a defect in the pancreas (the organ that makes insulin), where it makes too little insulin.  Diabetes can also be caused by a defect in the body’s cells where the cells no longer respond to insulin.  Type 1 diabetes is the name for the first defect (too little insulin from the pancreas), and Type 2 diabetes is the name for the second defect (decreased response to insulin by the body’s cells).  Type 1 diabetes is relatively rare and typically occurs in children.  Type 2 diabetes is more common and typically occurs in adults (although obese children with Type 2 diabetes are becoming more common).  Both types of diabetes lead to elevated blood sugar levels.

 

So, why should you care about elevated blood sugar levels?  Because the high levels of sugar cause many serious problems – some can be deadly.  Diabetes can lead to heart attacks, strokes, kidney failure, blindness, and loss of feeling in feet and hands to name just a few complications.  However, if blood sugar is controlled, by medications and lifestyle changes, these problems can be reduced or eliminated.  How do you “get” diabetes? 

The two types of diabetes have different causes.  Type 1 diabetes usually occurs when the body’s own immune system attacks and kills the cells that make insulin.  We don’t understand why the immune system attacks the cells, but believe that a certain combination of genes and exposure to certain things (a virus, foods, etc.) may be the cause.  Another rare form of Type 1 diabetes occurs when the entire pancreas is destroyed by injuries or infections.  Type 2 diabetes occurs when the body’s cells become “resistant” to insulin.  We believe that this resistance is due to your genes as well as your lifestyle.  Obesity is the most common lifestyle risk for Type 2 diabetes.  The location of fat on your body is also a risk – upper body fat is worse than lower body fat (an apple-shaped body is more dangerous than pear-shaped body).  Poor diet and lack of exercise are also big risks for Type 2 diabetes.  Recent studies also indicate that smoking increases the risk for Type 2 diabetes.

 

Well, what’s the cure for diabetes?  Unfortunately, there is no “cure” for diabetes once you have it.  However, you can control diabetes and it can “disappear” for years if you take the correct actions.  Type 1 diabetes is controlled by taking synthetic insulin multiple times a day.  Type 2 diabetes can be controlled by improving poor lifestyle habits (losing weight, increasing exercise, improving diet and stopping smoking) and taking medication (pills and insulin injections in some cases).

 

How do I know if I have diabetes?  Symptoms of diabetes include increased thirst, increased urination, stomach pain and significant weight loss.  However, most people do not have any symptoms until they have a major complication from diabetes – like a heart attack.  The best way to find out if you have diabetes is see your health care provider.  Your health care provider can check your fasting blood-sugar-level to determine if you have diabetes or are at a high-risk for contracting it.  The American Diabetes Association now recommends that everyone be screened for diabetes every 3 years after the age of 45 -- or even earlier if you have other risk factors for diabetes.  So, make the smart health choice and see your health care provider soon to be screened.