One out of every three children born today will face a future with diabetes if current trends continue. Diabetes is not merely a condition. It is an epidemic disease. Join the American Diabetes Association in officially launching a national movement to Stop Diabetes — help confront it, fight it and, most importantly, stop it.
* Nearly 24 million people have type 1 or type 2 diabetes.
* Another 57 million people have pre-diabetes and are at risk for developing type 2 diabetes.
* One out of every 3 children will face a future with diabetes if current trends continue.
What’s Your Type?
Type 1 diabetes, formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. In this form of diabetes, the pancreas no longer makes insulin because the body’s immune system has attacked and destroyed the pancreatic cells specialized to make insulin. These insulin-producing cells are called beta cells.
Type 2 diabetes, formerly called adult-onset diabetes, is the most common form. People can develop type 2 diabetes at any age, even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which muscle, liver and fat cells do not use insulin properly. As a result, the body needs more insulin to help glucose (sugar) enter cells to be used for energy. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, the pancreas loses its ability to secrete enough insulin in response to meals.
Before people develop type 2 diabetes, they almost always have "pre-diabetes" -- blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 57 million people in the United States who have pre-diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes.
Gestational diabetes is diabetes that first occurs during pregnancy. When women are pregnant, their need for insulin appears to increase, and many can develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life.
Who is at greater risk for Type 2 diabetes?
* People with impaired glucose tolerance and/or impaired fasting glucose. In the past, this condition was referred to as “borderline” diabetes and is now also referred to as prediabetes.
* People over age 45.
* People with a family history of diabetes.
* People who are overweight.
* People who do not exercise regularly.
* People with low HDL cholesterol or high triglycerides, high blood pressure.
* Certain racial and ethnic groups (e.g., Non-Hispanic Blacks, Hispanic/Latino Americans, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives).
* Women who had gestational diabetes, or who have had a baby weighing 9 pounds or more at birth.
Symptoms
Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.
* Type 1 diabetes: Frequent urination; unusual thirst; extreme hunger; unusual weight loss; extreme fatigue and Irritability.
* Type 2 diabetes*: Any of the type 1 symptoms, frequent infections, blurred vision, cuts/bruises that are slow to heal, tingling/numbness in the hands/feet, recurring skin, gum, or bladder infections.
* Often people with type 2 diabetes have no symptoms.
If you have one or more of these diabetes symptoms, see your doctor right away.
Diagnosing diabetes
Diabetes can be diagnosed with a simple finger stick blood test or with an oral glucose tolerance test. A finger stick test may be taken fasting, meaning no food or drink for the past 8 hours, or randomly. If an individual has fasted for eight hours, a normal finger stick blood glucose results would be 70-100mg/dl. Blood glucose of 101mg/dl-125mg/dl indicates prediabetes, and fasting blood glucose of 126mg/dl or greater is indicative of type 2 diabetes.
If a finger stick test is taken at any time throughout the day, regardless of when the individual has last eaten, this is referred to as a random test and should be less than 140mg/dl. A result of 141mg/dl to 199mg/dl indicates prediabetes, whereas a result of 200mg/dl or greater indicates type 2 diabetes.
Sometimes diabetes is diagnosed with an oral glucose tolerance test, during which an individual fasts for eight hours and a fasting blood sugar is obtained by drawing blood from the arm or hand. A solution containing a prescribed amount of glucose is then drank and the blood sugar is tested again by drawing blood from the arm or hand at one, two, or three-hour intervals following ingestion of the drink. If the blood sugar rises beyond a certain value at any of these intervals, diabetes may be diagnosed.
The toll on health
* The death rate from diabetes continues to climb. Since 1987, the death rate due to diabetes has increased by 45 percent, while the death rates due to cancer, heart disease and stroke have declined.
* About 60-70 percent of people with diabetes have mild to severe forms of nerve damage that could result in pain in the feet or hands, slowed digestion, sexual dysfunction and other nerve problems.
* The rate of amputation for people with diabetes is 10 times higher than for people without diabetes.
* Two out of three people with diabetes die from heart disease or stroke.
* Diabetes is the leading cause of new cases of blindness among adults.
* Diabetes is the leading cause of kidney failure.
Cost of diabetes
* The total national cost of diagnosed diabetes in the United States is $174 billion.
* Direct medical costs reach $116 billion, and the average medical expenditure among people with diabetes is 2.3 times higher than those without the disease.
* Indirect costs amount to $58 billion (disability, work loss, premature mortality).
* The cost of caring for someone with diabetes is $1 out of every $5 in total healthcare costs.
Prevention
You can prevent or delay the onset of type 2 diabetes through a healthy lifestyle. Change your diet, increase your level of physical activity, maintain a healthy weight — with these positive steps, you can stay healthier longer and reduce your risk of diabetes.
Source: Julie Kamphaus, RN, Certified Diabetes Educator, Fremont Area Medical Center; American Diabetes Association; National Institute of Diabetes and Digestive and Kidney Diseases, a division of the National Institute for Health. Contributing writer: Julie Kamphaus, RN, BSN, CDE, diabetes case manager, Fremont Area Medical Center.
Jackie Beaton is director of public relations, marketing and volunteer services at Fremont Area Medical Center. She can be reached at (402) 727-3565 or jbeaton@famc.org.
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