Diabetes

Diabetes - General Information

The following information is provided by the Centers for Disease Control and the National Diabetes Education Program. For more information, visit www.cdc.gov/diabetes or www.ndep.nih.gov.

What is diabetes?

Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.

Diabetes is a serious chronic disease that can be managed through lifestyle changes and medication. Nearly 21 million Americans have diabetes, and at least 54 million people over age 20 have pre-diabetes. Whether you just found out you have diabetes or have been dealing with it for years, you can control your diabetes and live a long, active life. If you are at risk or have pre-diabetes, you can take small steps to prevent the disease.

Definitions

Diabetes (diabetes mellitus): a condition characterized by hyperglycemia resulting from the body's inability to use blood glucose for energy. In type 1 diabetes, the pancreas no longer makes insulin and therefore blood glucose cannot enter the cells to be used for energy. In type 2 diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly.

pre-diabetes: a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with pre-diabetes are at increased risk for developing type 2 diabetes and for heart disease and stroke. Other names for pre-diabetes are impaired glucose tolerance and impaired fasting glucose.

type 1 diabetes: a condition characterized by high blood glucose levels caused by a total lack of insulin. Occurs when the body's immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. Type 1 diabetes develops most often in young people but can appear in adults.

type 2 diabetes: a condition characterized by high blood glucose levels caused by either a lack of insulin or the body's inability to use insulin efficiently. Type 2 diabetes develops most often in middle-aged and older adults but can appear in young people.

Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years.

How many Americans have diabetes?

• 20.8 million Americans have diabetes — 7.0 percent of the U.S. population. Of these, 6.2 million do not know they have the disease.

• Each year, about 1.5 million people ages 20 or older are diagnosed with diabetes.

• The number of people diagnosed with diabetes has risen from 1.5 million in 1958 to 14.6 million in 2005, an increase of epidemic proportions.

What is the prevalence of diabetes by type?

• Type 1 (previously called insulin-dependent or juvenile-onset) diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes.

• Type 2 (previously called non-insulin-dependent or adult-onset) diabetes accounts for 90 to 95 percent of all diagnosed cases of diabetes.1 Type 2 diabetes is increasingly being diagnosed in children and adolescents.

What is the prevalence of diabetes by gender?

• 10.9 million men have diabetes (10.5 percent of all men ages 20 years and older).

• 9.7 million women have diabetes (8.8 percent of all women ages 20 years and older).

What is the prevalence of diabetes by age?

• 20.6 million Americans ages 20 or older have diabetes — 9.6 percent of this age group.

• 10.3 million Americans ages 60 or older have diabetes — 20.9 percent of this age group.

• 176,500 people under age 20 have diabetes – 0.22 percent of this age group.

Treating diabetes

* To survive, people with type 1 diabetes must have insulin delivered by injections or a pump.

* Many people with type 2 diabetes can control their blood glucose by following a careful diet and exercise program, losing excess weight, and taking oral medication.

* Many people with diabetes also need to take medications to control their cholesterol and blood pressure.

* Diabetes self-management education is an integral component of medical care.

* Among adults with diagnosed diabetes, 12% take both insulin and oral medications, 19% take insulin only, 53% take oral medications only, and 15% do not take either insulin or oral medications.

Prevention or delay of diabetes

Research studies have found that lifestyle changes can prevent or delay the onset of type 2 diabetes among high-risk adults. These studies included people with IGT and other high-risk characteristics for developing diabetes. Lifestyle interventions included diet and moderate-intensity physical activity (such as walking for 2 1/2 hours each week). In the Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, the development of diabetes was reduced 58% over 3 years.

Studies have also shown that medications have been successful in preventing diabetes in some population groups. In the Diabetes Prevention Program, people treated with the drug metformin reduced their risk of developing diabetes by 31% over 3 years. Treatment with metformin was most effective among younger, heavier people (those 25-40 years of age who were 50 to 80 pounds overweight) and less effective among older people and people who were not as overweight. Similarly, in the STOP-NIDDM Trial, treatment of people with IGT with the drug acarbose reduced the risk of developing diabetes by 25% over 3 years. Other medication studies are ongoing. In addition to preventing progression from IGT to diabetes, both lifestyle changes and medication have also been shown to increase the probability of reverting from IGT to normal glucose tolerance

There are no known methods to prevent type 1 diabetes. Several clinical trials are currently in progress or being planned.

Prevention of diabetes complications

Diabetes can affect many parts of the body and can lead to serious complications such as blindness, kidney damage, and lower-limb amputations. Working together, people with diabetes and their health care providers can reduce the occurrence of these and other diabetes complications by controlling the levels of blood glucose, blood pressure, and blood lipids and by receiving other preventive care practices in a timely manner.

Glucose control

*Research studies in the United States and abroad have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, for every 1% reduction in results of A1C blood tests (e.g., from 8.0% to 7.0%), the risk of developing microvascular diabetic complications (eye, kidney, and nerve disease) is reduced by 40%.

Blood pressure control

* Blood pressure control can reduce cardiovascular disease (heart disease and stroke) by approximately 33% to 50% and can reduce microvascular disease (eye, kidney, and nerve disease) by approximately 33%.

* In general, for every 10 millimeters of mercury (mm Hg) reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12%.

Control of blood lipids

* Improved control of cholesterol or blood lipids (for example, HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20% to 50%.

Preventive care practices for eyes, kidneys, and feet

* Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50% to 60%.

* Comprehensive foot care programs can reduce amputation rates by 45% to 85%.

* Detecting and treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30% to 70%. Treatment with ACE inhibitors and angiotensin receptor blockers (ARBs) are more effective in reducing the decline in kidney function than other blood pressure lowering drugs.

What You Must Know About Diabetes

Kay Lowe

Diabetes mellitus, usually referred to as simply "diabetes", is a disease of glucose or "sugar" metabolism. Diabetes is a common condition in the United States and the incidence is increasing; as many as 20% of Americans may be affected. Few diseases wreak more havoc on the body than diabetes. Complications of diabetes can cause problems with the heart and circulation, nervous system, kidneys, and eyes. Diabetics are at greater risk for high blood pressure and stroke. The circulatory problems of diabetes can lead to gangrene and amputations and diabetics also have difficulty healing.

What Is Diabetes?

Diabetes is disorder of glucose metabolism. Glucose is a simple sugar that is required by every cell in the body for energy. Dietary carbohydrates (sugar, starch, etc.) are broken down by a substance called insulin into simple glucose. The diabetic, however, either lacks insulin because the pancreas stops making it (or isn't making enough), or the cells of the body become resistant to the insulin. Without insulin, the diabetic consumes
carbohydrate foods and the sugar remains in the bloodstream but is unavailable to the cells of the body. Untreated, this elevated blood sugar can lead to coma and even death.

How to Treat Diabetes

Blood sugar control is a key factor in improving outcomes for diabetics and avoiding the complications. There are many treatment options available today for diabetes; however, any effective program will address diet, exercise and possibly medication. The person with diabetes should find a physician or health care provider and establish a good relationship with that provider.

Proper management of diabetes can allow the individual to lead a life that is "normal" and avoid the devastating complications. Partner with your health care provider to manage your disease and enjoy life.

About the author:
Ms. Lowe holds a Master's degree in Nursing and has worked for 30+ years in health care. She is webmaster for http://www.health-infosource.com, a resource for health information on the web.

*The opinions and assertions of these authors are in no way associated with or verified by Tuxedo Pharmacy. As always, these articles are provided for information purposes only and should not be used as a substitute for medical care. Consult you doctor about your specific medical conditions. For more informational articles addressing everyday health concerns, visit www.goarticles.com.