Diabetes, also known as diabetes mellitus is a common metabolic disorder that affects 23.6 million Americans. One of the first symptoms is when blood glucose levels become elevated. This occurs due to a lack of sufficient insulin production by the pancreas, or another cause may be the body failing to recognize and use the insulin properly. In some instances serious organ damage can result from diabetes, particularly if left untreated.
With proper care from your diabetes team and diligence, this disease, unlike many other diseases, may be managed and complications can be reduced, delayed or perhaps even prevented.
What are the causes of diabetes?
Whenever you eat, your body converts the food into glucose (sugar) to fuel blood cells for energy. In order for this process to work, a hormone produced by the pancreas called insulin must be present to transport glucose from the blood to the cells. Some people produce little or no insulin. Therefore, glucose builds up in the blood instead. When blood sugar remains too high, blurry vision, headache, dull skin, and frequent urination are likely to follow. People with consistently high blood sugars are at risk for organ damage.
There are two major types of diabetes: type 1 and type 2. Type 1 is an autoimmune disorder in which the immune system attacks and destroys insulin-producing beta cells in the pancreas. Although it's not clear why this cellular genocide occurs, it is believed that abnormal antibodies, and possibly viral infections, may be factors. Type 1 diabetes accounts for 5-10% of diagnosed diabetes, occurring most commonly in children and young adults, and requires daily insulin injections, sometimes more than once a day. Without this intervention, the body is forced to break down fats for energy use. This is a process that produces ketones (waste products) in the blood, which can result in diabetic ketoacidosis (DKA), a highly toxic state that can lead to organ damage, and a life-threatening coma.
In Type 2 diabetes, the pancreas may produce adequate insulin, but for some reason the body ignores it, setting up insulin resistance. In response to this, the pancreas pumps out even more insulin to forcing glucose into the cells since the glucose is accumulating in the bloodstream, resulting in elevated blood glucose. This form of diabetes is more common, and occurs in up to 90-95% of diabetics. This type is associated with age, family history, obesity, and certain ethnic groups. The good news is that type 2 is largely preventable, even reversible with proper care.
Contrary to popular belief, having a sweet tooth isn't necessarily a precursor to diabetes for most people. A sensible diet low in fat and refined sugar does provide resistance. According to Ruchi Mathur, MD, Assistant Professor of Medicine at the Keck School of Medicine, University of Southern California, "It's a matter of smaller portion sizes more than anything else. Some people go to extremes by avoiding starches, but it doesn't work that way." Instead, she recommends limiting simple carbohydrates such as sodas, breads and pastas made from white flour and other highly processed foods. What most people don’t realize that 1 slice of bread or ⅓ cup of cooked rice breaks down into 4 teaspoons (over one tablespoon) of sugar in the bloodstream!
Double the Trouble – Diabetes Complications
Unfortunately, more than half those living with diabetes can eventually expect to experience signs of neuropathy, a tingling sensation (or lack of any feeling) in the extremities brought on by insufficient blood flow. In severe cases, especially when coupled with untreated ulceration, bone infection can occur and lead to the need for amputation.
Nephropathy, or kidney disease, is another complication of diabetes that is characterized by the presence of too much albumin (protein) in the urine. This usually remains undetected until too much damage has occurred, possibly renal failure. However, elevated blood pressure and triglyceride levels are often early warning signs.
According to the American Diabetes Association (ADA), 12,000 to 24,000 annual cases of blindness are reported in diabetic patients ranging 20-74 years of age, primarily due to damage to eye vessels by high blood glucose levels. Eventually, lipid infiltration and deformed blood vessels attack and destroy the retina. Approximately 76% of eye damage can be prevented with good blood sugar control.
Awareness is key to the prevention of this disease, especially since the occurrence of diabetes in children and adults is rising on an epidemic scale. Over 3 million people have diabetes now than just two years ago. The American Diabetes Association estimates that by 2025, there will be 50.2 million people with diabetes in the United States (in 2008 there are 23.6 million – 17.9 million are diagnosed and 5.7 million don’t know they have the disease). The World Health Organization estimates that by 2030, there will be 366 million people worldwide with diabetes.
Did You Know?
- Heart disease and stroke account for about 65% of deaths in people with diabetes.
- About 73% of adults with diabetes have high blood pressure.
- Mexican Americans are almost twice as likely and non-Hispanic blacks are almost 50% as likely to develop diabetic retinopathy as non-Hispanic whites.
- About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.
- More than 60% of non-traumatic lower-limb amputations occur in people with diabetes.
In 2005, 46,739 people with diabetes began treatment for end-stage renal disease (ESRD) and in 2002, a total of 178,689 people were living on chronic dialysis or with a kidney transplant. With good blood sugar control people with diabetes can reduce damage to their kidneys by 35-56 percent.
Types of Diabetes
There are three main types of diabetes. Pre-diabetes is also a condition you may want to be aware of.