By Scott Crossen
The news can be devastating; you or someone you know has been diagnosed with diabetes. It’s a life-changing pronouncement that affects not only the diagnosed, but also those related to that person.
According to the Center for Disease Control, diabetes is “the epidemic of our time.” Nearly 18 million people are known to have diabetes in the United States. Another 5.7 million people are believed to have the condition but remain undiagnosed. The number is expected to continue to rise, and the cost to the Federal Government (taxpayers) in 2005, exclusive of treatments for secondary complications, ran $45 billion dollars.
According to the 2007 CDC National Diabetes Fact Sheet, there are three primary forms of diabetes:
Type 1, known as insulin-dependent diabetes, accounts for nearly three million cases in the country. This form of diabetes develops when the body’s immune system destroys pancreatic beta cells, which make the hormone called insulin responsible for regulating blood glucose. This form of diabetes requires that insulin be delivered through external means either by injection or a pump to enable a person to live.
Type 2, non-insulin dependent diabetes, accounts for 90 to 95 percent of cases of the disease. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. Type 2 diabetes used to be called adult-onset diabetes and was associated with older age. However, these days, type 2 diabetes affects people in every age group. It is most common in those who are obese, have a family history of diabetes or gestational diabetes, have impaired glucose metabolism or are physically inactive. Race and ethnicity also play a role. Many people with type 2 diabetes can control their blood glucose by following a healthy meal plan and exercise program, losing excess weight and taking oral medication. Some people with type 2 diabetes may also need to take insulin to control their blood glucose levels.
Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy. Gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. Immediately after pregnancy, five to 10 percent of women with gestational diabetes are found to have diabetes, usually type 2. Women who have had gestational diabetes also have a 40 to 60 percent chance of developing diabetes in the next five to 10 years.
The symptoms of undiagnosed diabetes vary depending on the form of diabetes and the individual. For example, prolonged undiagnosed type 1 diabetics typically experience symptoms of frequent urination, excessive thirst, weight loss, blurred vision, and may end up with flu like symptoms such as vomiting, diarrhea and continuous nausea. Those with undiagnosed type 2 diabetes may not experience obvious symptoms and risk running dangerously high blood sugar levels for years, resulting in the onset of secondary complications (see below) before diagnosis occurs.
Average normal blood sugar levels for non-diabetic individuals range between 70 and 115 deciliters. It’s difficult, if not impossible, to keep blood sugars in the normal range without testing them often and making appropriate adjustments with medication or diet. Even then, there are many factors that can effect blood sugar control, including diet, exercise, stress, sickness, insulin resistance, insulin efficacy, delivery method, allergies and puberty, to name a few.
Blood sugars are monitored by diabetics through the use of glucometers. These devices have significantly improved over the years and can provide results in a matter of seconds. Most glucometers provide historical readings and ratios, including 15- and 30-day blood sugar averages. There is also an important test called the glycosylated hemoglobin (A1c) that can be performed through a doctor’s office. This test provides the doctor and diabetic a 90-day average of blood sugar control.
The downside of poorly controlled diabetes is not emphasized through diabetic associations, organizations or the general media, but it deserves attention. Poor blood sugar control can result in hypoglycemic (dangerously low blood sugar) events, which could lead to unconsciousness, convulsions or coma. Consistently high blood sugar levels will likely result in the onset of secondary complications. Depending on the individual, these complications may include heart disease, stroke, kidney failure, retinopathy (retinal damage in the eyes resulting in blindness), neuropathy (nervous system damage), gum disease and amputations. It doesn’t matter what type of diabetes a person has – the overall health of the diabetic is determined to the greatest degree by how well blood sugar is controlled.
Believe or not, there is an upside to having diabetes. The diabetic committed to achieving and maintaining good health through testing blood sugar, regular exercise and a good diet will benefit by preventing, if not eliminating, the onset of secondary complications. That person is also likely to be in better shape than most, if not all, of their peers.
Any approach or program to improve one’s health begins with a positive attitude and firm commitment to live well. If life is worth living well, the means are available to help that happen. As I frequently remind my clients, living well with diabetes is tough, but it can be done and it’s worth the effort. It’s much easier than dying from diabetes.