Diabetes

Diabetes mellitus is a condition with elevated blood sugars due to inadequate insulin secretion or insulin resistance.  There are two types of diabetes, type 1 and type 2.  Type 1 diabetes is caused by antibody destruction of the pancreas usually seen in childhood.  Often, children become acutely ill with nausea, vomiting, weight loss and ketoacidosis (build up of acids in the blood).  Type 2 diabetes or adult onset diabetes is due to resistance of cells in the body to use the existing insulin.  Type 2 diabetes is often seen in overweight adults.  For many, type 2 diabetes is initially asymptomatic and may exist for years before it is diagnosed.  More than 90% of Americans with diabetes have adult onset diabetes.

Diabetes is defined as:

Blood glucose 126 or higher after an overnight fast, on more than one occasion or a random blood glucose greater than 200 with symptoms of diabetes.

Symptoms of diabetes may include frequent urination, excessive thirst, blurred vision, excessive fatigue, weight loss or weight gain.

Risk factors for diabetes include obesity, family history of diabetes, lack of physical activity, age over 45 years old, race (increased risk in African American, Hispanic American, and American Indian), and gestational diabetes during pregnancy.

Uncontrolled diabetes can lead to a number of complications.  Diabetes increases the risk for heart attack and stroke.  Diabetes can damage the kidneys and is the leading cause of kidney failure in the U.S.  Uncontrolled blood sugars can damage the eyes leading to blindness, and damage nerves in the body causing numbness, weakness, and pain.  Diabetes can affect the circulation to extremities leading to sores or amputation.

The best way to prevent complications is to control your diabetes, blood pressure and cholesterol.  Target blood pressure to less than 130 / 80.  Work to lower bad cholesterol (LDL) to less than 100.  Avoiding alcohol and quitting smoking can decrease the risk of complications.  Exercise helps the body use insulin better, lower glucose, lower blood pressure and cholesterol, and helps with weight loss.  Hemoglobin A1C is a blood test that measures blood glucose control over the last three months (target:  less than 7).  The American Diabetes Association recommends targeting blood sugars to 90-130 mg/dl before meals and less than 180 mg/dl two hours after a meal.

Diet and exercise can be effective in controlling diabetes.  For some, medications may be required.  There are several classes of diabetic medications available.  If pills are ineffective or not tolerated, insulin may be used to control diabetes.

Diabetes can be a silent disease.  You may feel fine even if your blood sugar is high.  It is important to check your blood sugars every day and take your medicines to prevent problems in the future.

For more information, visit the American Diabetes Association at www.diabetes.org.