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An Overview of Diabetes

Presented by ETSU Endocrinology

 An Overview of DiabetesDiabetes is a medical disorder of metabolism where a person’s blood sugar is abnormally high because the body has decreased production of insulin or because the body’s cells fail to respond normally to the insulin produced.

What Causes Diabetes?
When the food we eat is broken down in our digestive system, it produces glucose. Glucose is the form of sugar found in blood and is the body’s major source of fuel.

When ingested, glucose enters the bloodstream and is broken down by cells to help with energy production and growth. Glucose must enter cells, but without the insulin hormone, this is not possible. The pancreas is the bodily organ that produces insulin in the body.

Like a machine, the pancreas is programmed to produce just the right amount of insulin to help transport glucose to the cells from the bloodstream. In people with diabetes, the pancreas produces less than average amounts of insulin or none at all. In other cases, pancreas cells do not function the way normal cells respond when insulin is produced. Glucose builds up in the bloodstream and is secreted out of the body through the urine. Therefore, glucose is wasted leaving the body with no source of fuel despite the high level of sugar.

Therefore, glucose is wasted leaving the body with no source of fuel despite the high level of sugar.

Types of Diabetes
Type 1 Diabetes
This type of diabetes is autoimmune. This means the disease happens during the process where the body fights off infection causing the immune system to attack another part of the body. In this case, the immune system affects the beta cells that produce insulin in the pancreas, damaging or destroying them. In effect, the level of insulin produced is little to none. Individuals with this type of diabetes cannot survive without taking in insulin every day.

Type 1 diabetes symptoms can be observed over a short period, but the destruction of beta cells usually happen years before these symptoms appear. Some symptoms of Type 1 diabetes are constant: thirst and urination, weight loss, constant hunger, extreme fatigue, and blurred vision. Without daily insulin injections, a person with type 1 diabetes can lapse into a life-threatening condition called diabetic ketoacidosis.

Type 2 Diabetes
This is the most prevalent type of diabetes affecting more than 90 percent of individuals with diabetes. Risk factors include, but not limited to old age, obesity, family history of diabetes, personal history of gestational diabetes, ethnicity, and sedentary lifestyle.  With a rise in obesity, Type 2 diabetes is being diagnosed at younger ages, sometimes even in children.

In type 2 diabetics the cells are resistant to make use of the insulin produced by the pancreas effectively, and the body tries to overcome this by producing more insulin in the initial phases. Over a period of time, the pancreatic function declines, and it produces less and less insulin.

Unlike type 1 diabetes, type 2 diabetes symptoms are usually evident gradually. These symptoms include but are not limited to nausea or fatigue, constant urination and thirst, blurred vision, weight loss, frequent infections, and slow healing of sores or wounds. In some cases, there are no symptoms at all.

Gestational Diabetes
This type of diabetes happens only during pregnancy. Gestational diabetes is more prevalent in certain ethnic groups: African Americans, Hispanic Americans, and American Indians. Obesity and positive family history of diabetes also pose an increased risk of developing gestational diabetes. Another thing worth noting is that women suffering gestational diabetes have a higher risk of developing type 2 diabetes in the future.

Diabetes Facts and Figures
Diabetes is well known as being among the highest death-causing diseases in the United States. It was considered the 7th leading lethal disease in 2006, but many fatalities due to diabetes remain unreported, especially in death certificates. In 2004, deaths of people aged 65 years and older were known to be caused by diabetes in 68 percent of the cases while stroke accounted for a mere 16 percent.

In fact, the Centers for Disease Control and Prevention estimates that if the diabetes epidemic continues, one in three Americans will develop it in his or her lifetime.

Complications from diabetes can affect every part of the body. Problems such as blindness, diseases of the blood vessel and heart, kidney failure, stroke, nerve damage, and amputations are not uncommon. Uncontrolled diabetes can create problems in pregnancy often resulting in birth defects.

In 2007, the United States spent more than $170 billion to treat the disease. Indirect expenditures, such as time lost from work, disability payments, and decreased productivity amounted close to $60 billion. Direct medical expenditures to care for diabetic patients, such as hospital bills, medical care, and medical supplies, totaled more than $110 billion.

Management of Diabetes
In the years before 1921, anyone with type 1 diabetes died shortly after being diagnosed. It should be noted that although insulin is not a cure, it nevertheless became the first major breakthrough for treating individuals with diabetes.

Healthy diet, exercise, and testing blood glucose levels are basic measures to treat diabetes effectively. Insulin either with injections or via the insulin delivery device (insulin pumps) remains the mainstay of treatment for type 1 diabetes.  Type 2 diabetes can be managed with a combination of oral medications, noninsulin injectables, and insulin. The amount of insulin taken should be balanced with the physical activities and the food eaten.

Patients with diabetes should monitor their blood glucose levels regularly with finger sticks. A laboratory test named A1C, which measures the average blood glucose over a period of 2 to 3 months can be checked every 3 months to assess the blood sugar control further.

Diabetes management does not only mean controlling glucose levels but is a comprehensive plan which includes managing cholesterol levels and blood pressure to lower the risk of heart disease.

Diabetes management can be challenging due limited resources or cost concerns. But personalized treatment plan with proactive involvement of individuals with diabetes will improve outcomes. Emphasis should be placed on self-management of diabetes which involves checking blood sugars, compliance with medications, improving dietary habits and regular exercise.

Hypoglycemia (low blood sugar) is not uncommon when taking medications for diabetes. Excessively low blood glucose can make a person nervous and confused. Too much glucose, on the other hand, can make a person ill. Your health care provider can provide a therapeutic treatment plan to fit your lifestyle.

Consult a health care practitioner for help with diabetes management. It is recommended that patients with diabetes have a team of health care providers including a primary care provider, a dietitian, an endocrinologist, an ophthalmologist and a podiatrist.

www.etsuhealthcare.com/endocrinology

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