|HOME | PAST ISSUES | SUBSCRIPTIONS | LINKS | ADA INFO | CONTACT US | SEARCH|
out of every one thousand Americans reading this article have a disease
that will, on average, shorten their lives by about twenty years. Twenty
of these sixty people are not even aware that they are ill. That disease
in question is diabetes and the likelihood of acquiring it is increasing.
The Centers for Disease Control in Atlanta, Georgia, project that current
dietary and lifestyle trends should lead to an increased prevalence of
the disease over the next twenty-five years. However, with the proper
treatment and lifestyle changes, many of the possible complications of
this disease, such as blindness, amputations, heart problems, kidney failure,
and premature death, can be prevented or delayed.
Insulin is essential to the metabolic process. Trying to
burn glucose without insulin is like trying to set fire to a pile of logs
without a match. It can't be done. And that's the problem with people
who have diabetes. They either don't produce enough insulin to properly
metabolize glucose or the insulin they have works inefficiently. Without
insulin to turn glucose into energy the glucose piles up in the bloodstream
and spills into the urine showing as sugar in the urine. Excessively high
levels of sugar in the blood and the urine are the hallmarks of untreated
Out of about eight million people diagnosed with diabetes,
one million are Type I and seven million are Type II. Another eight million
people are Type II but have not yet been diagnosed. The root cause(s)
of either type of diabetes remain unidentified but doctors do understand
the tendencies that put one at risk. Diabetes is not strictly genetic.
Most children of diabetic parents do not develop the disease. However,
a family history of the disease appears to increase the risk. Scientists
have long suspected that heredity plays a role since Type I diabetes tends
to run in families. While researchers have found several genes that appear
to increase the risk of developing Type I diabetes. they haven't identified
a single gene that actually causes the disease.
Some studies suggest that exposure to cow's milk during
infancy may increase the risk of Type I diabetes. Cow's milk contains
a protein similar to a protein found on beta cells. The theory is that:
If infants develop antibodies to the cow's milk protein, the antibodies
may mistake the beta cells for milk and destroy them. The cow's-milk connection
has always been controversial, and it recently became more so when a well
designed study by University of Colorado researchers showed no link between
cow's milk exposure in infancy and increased risk of Type I diabetes.
However, even a remote chance that cow's milk might increase risk of diabetes
strengthens the case for breast-feeding.
Age also plays a role in Type II diabetes. Half of all new
diagnoses are people over 55, and nearly 11 percent of Americans aged
65 to 74 have type II diabetes. However, it's not clear whether age, per
se, is a cause of Type II diabetes, or simply a reflection of the fact
that people tend to gain weight and become less physically active as they
Symptoms appear rapidly but each individual has a personal set of symptoms which are unique to them. Care must be taken to identify those symptoms. Some patients show no preliminary symptoms at all and therefore need to monitor their blood sugar levels more frequently. The most common notable signs of Hypoglycemia include: inappropriate responses, crankiness, confusion and inattention, lack of coordination, drowsiness, pale complexion, perspiration, headache, trembling, sudden hunger and dizziness.
If a diabetic falls into a state of hyperglycemia and the condition isn't treated immediately, a dangerous biological process occurs. Since the body can't use the sugar to supply its energy needs, it starts to steal energy from the fats stored in the body. When fats are broken down, acids called ketones are formed in the body. Too many ketones in the system become poisonous. Without proper treatment, the diabetic may fall into a coma requiring hospitalization. This condition can be fatal. Fortunately, it develops gradually—over several hours or days. Prompt attention to the warning signs can help avert a serious problem. Usually a diabetic coma occurs only in Type I diabetes. Symptoms occur gradually and may include: extreme thirst, drowsiness, lethargy, sugar in urine, dry hot skin, lack of appetite, high levels of sugar in the blood, fruity, sweet or wine-like odor on breath, heavy, labored breathing and eventual stupor or unconsciousness.
These problems can be easily avoided by properly monitoring blood sugar levels. Indeed, one of the most important advances in diabetes treatment and control has been the ability to measure and monitor blood sugar levels at home. Whether insulin-dependent or non-insulin-dependent, people with diabetes must understand how the disease works and learn how to manage their blood sugar levels. They should test their blood at specified times of the day in order to maintain a healthy glucose to insulin balance. Diabetics must also take very good care of themselves, paying attention to diet, eating habits and exercise. Blood sugar levels can be measured at home with a blood glucose monitoring system. It involves placing a drop of blood on a chemically treated strip, which is then put into a meter for a blood sugar reading. Another method relies on a visual comparison of the strip with a color-coded chart. It is believed that with more precise monitoring and better control, the complications of diabetes can be reduced, even reversed.
Type I diabetic patients must take insulin injections every
day to make up for the hormone their bodies do not produce. An insulin
injection is only a rough estimate of what is really needed. If you take
one shot in the morning, and then suddenly decide to do some vigorous
exercise without taking into account the extra sugar that will be burned,
the body may be left with too little sugar and too much insulin. This
may lead to hypoglycemia as described above. Any person with Type I diabetes
learns that before engaging in strenuous activity, they must either consume
extra carbohydrates to compensate for the sugar that will be burned, or
take less insulin that day. This regimen should be discussed with one's
personal physician. Other factors which can upset the balance include:
physical activity, illness, infection, periods of growth, fatigue, excitement,
anxiety, and hormonal changes.
Check with your physician before starting an exercise program to determine what activities will be best for you. Exercise is important both because it helps to control weight and because it burns food, reducing demand on the pancreas to produce insulin. Weight loss through diet is a must for the overweight person with diabetes. Often, once the desired weight is maintained, no other treatment is necessary. A personal meal plan should aim for a fixed number of calories each day. Cholesterol and saturated fats should be restricted because people with diabetes are at a higher risk of heart attack.
Maintain a regular pattern of eating, exercising, and resting. Changes of schedule require adapting the diet or insulin dosages appropriately. For instance, if you have Type II diabetes and are going to a very late dinner, you should work in a little snack at your normal dinner hour. Concentrated sugars should be avoided since the body cannot produce insulin fast enough to burn them.
Over time, diabetes can cause complications in organs and systems throughout the body. It affects the blood vessels and the heart, increasing the risk of heart disease, stroke, and other problems caused by poor circulation, such as gangrene. Diabetes is the leading cause of adult onset blindness in North America. Damage to the blood vessels in the retina is evident in 90 percent of all persons who have had diabetes for 15 years or longer. Kidney disease is also a major complication resulting from diabetes. About 30 percent of new dialysis patients have diabetes induced kidney failure. In addition, the incidence of stroke is two to six times higher in people with diabetes. Simply put, diabetes is a chronic, complicated and destructive disease.
However, there is increasing hope that diabetes and its related problems can be cured. Researchers are beginning to understand how the body's own immune system destroys insulin-producing cells. Others are attempting to identify the genes involved in diabetes to define those at risk. Research and development is currently investigating insulin pumps and other experimental insulin-delivery systems along with new ways to monitor blood glucose. Pancreas transplants are perhaps the most effective method of treatment currently in use. This procedure continues to be the only available procedure that, when successful, keeps blood sugar levels balanced and eliminates the need for insulin injections altogether, markedly improving the quality of life for the patient. The simpler and less-invasive transplant of insulin producing pancreatic cells (islet cell) is done less frequently in diabetic patients and is still considered experimental. The downside for patients who have had a successful transplant is the lifelong need to take potentially harmful immunosuppressive drugs. However, recent advancements have improved the odds for whole-organ recipients, while islet research is producing promising initial results as well.
The benefits of finding a cure or even producing more effective
treatments for diabetes would be enormous. The total annual economic cost
of diabetes in 1997 was estimated to be $98 billion dollars. That includes
$44.1 billion in direct medical and treatment costs and $54 billion for
indirect costs attributed to disability and mortality. In 1997, the per
capita costs of health care for people with diabetes amounted to $10,071
while health care costs for people without diabetes amounted to $2,699.
|HOME | PAST ISSUES | SUBSCRIPTIONS | LINKS | ADA INFO | CONTACT US | SEARCH|