Commonly Asked Questions About Diabetes
What is Diabetes?
Diabetes is a disease that affects how your body processes food and drink and converts it to energy. In a normal, non-diabetic person, the hormone insulin is secreted from the pancreas in response to a meal, and works to "unlock" the body's cells so that glucose can be used.
There are two primary types of diabetes - Type 1 (juvenile or auto-immune) and Type 2 (often called adult-onset diabetes). The causes of the disease differ, but the effect is largely the same. A lack of sufficient insulin causes blood glucose to rise, as excess glucose remains unused by the body. Without the ability to tap into energy from meals, the body begins to break itself down, releasing acids and resulting in a dangerous, potentially fatal condition known as ketoacidoisis.
The symptoms of diabetes, including lethargy, excessive thirst and hunger, and dramatic weight loss are due to the body's attempt to "flush out" the blood sugar that builds up, and its desire for fuel/energy. Left untreated, it is as if the diabetic patient is not eating. Symptoms eventually progress to include a loss of consciousness, seizures and possibly death.
I have been living with Type 1 diabetes for nearly a decade. Both of my grandfathers developed Type 2 diabetes late in life, and I also have a first cousin that has had Type 1 diabetes for most of his life.
If you suspect that you or a loved one may have diabetes, a simple blood test can be a life-saver. Discuss the symptoms with a doctor, or immediately go to the emergency room in the case of fainting or seizure.
How Do you Get Diabetes?
Type 1 diabetes results from an auto-immune disorder and researchers are not yet certain as to why the body attacks itself, killing off the cells that make insulin. Type 1 is not generally heriditary, although there may be a long list of other auto-immune diseases in the family tree (e.g., Chron's Disease, Graves Disease, Rheumatoid Arthritis).
Only about 5% of all people with diabetes has Type 1. Overall, the risk of developing Type 1 diabetes is about 0.4 percent. Because there is no cure for Type 1 diabetes, the patient will be insulin-dependent for the rest of their life, requiring shots and/or the use of an insulin pump. Some people regard Type 1 diabetes as the more serious of the two diseases.
The causes of Type 2 diabetes also are not 100% known, although a number of risk factors have been identified: excess weight, poor diet and family history. Unlike Type 1, the disease usually progresses slowly over time with the body becoming more and more unable to make sufficient insulin. Most of the people diagnosed with diabetes has Type 2, and experts predict that 1 in 3 people will develop diabetes in this lifetime (48 million people by 2050).
Over the past decade, the number of adults diagnosed with type 2 diabetes has increased 10-fold.
Fortunately, development of Type 2 diabetes can be slowed or even prevented by losing weight and making healthy diet choices. If you suspect you are at risk for diabetes, schedule an appointment with your doctor. A certified nutritionist can help plan menus, and simply adding 20-30 minutes of exercise each day may significantly reduce the potential of Type 2 diabetes in pre-diabetic patients.
Again, be sure to consult your doctor for detailed advice specific to your situation if you receive a diagnosis of diabetes.
Statistics from the 2011 National Diabetes Fact Sheet
25.8 million children and adults in the United States—8.3% of the population—have diabetes.
Diagnosed: 18.8 million people
Undiagnosed: 7.0 million people
Prediabetes: 79 million people
New Cases: 1.9 million new cases of diabetes were diagnosed in people aged 20 years and older in 2010.
Can Diabetes be Cured?
At the date of this publication, there is no cure for diabetes, whether Type 1 or Type 2. However, some people have been able to successfully avoid development of full-blown Type 2 diabetes, or even reverse early stages of the disease, by losing weight and changing their diet. That said, not everyone that is overweight or eats poorly will develop diabetes. And, some normal weight, otherwise healthy people may still get diabetes.
With Type 1 diabetes, the pancreas is compromised due to the body turning on itself and attacking the cells that make insulin. Some limited successes have been reported via pancreatic cell transplants in Type 1 patients, but the "cure" is not permanent.
Type 2 diabetes is often progressive, particularly in people who lack motivation or resources to make necessary lifestyle changes. At first, oral medications may be prescribed to help the effectiveness of insulin produced. However, some patients eventually require insulin shots, as well or in lieu of oral meds.
Again, there is no cure for Type 2 diabetes for that percentage of the population that is unable to take steps to prevent progression of the disease.
Diference Between Type 1 and Type 2 Diabetes
What Can you Eat with Diabetes?
It is a common misperception that diabetics only need to avoid sugar in their diet. In reality, any food that contains carbohydrates is converted to blood glucose. Thus, diabetics need to watch consumption of carbohydrates and, if taking insulin, need to tailor their dosages to the number of carb grams ingested at each meal.
Not all carbohydrates are created equal, which means that different foods will have a different impact on blood sugar. Most fresh fruits and vegetables are high in fiber, which actually reduces the carbohydrate count. Starchy selections, like potatoes, other root vegetables, and corn are generally higher in carbs than leafy vegetables and citrus fruits. High fiber bread (100% whole grain) and wheat pasta are also better selections than white bread and white pasta.
Foods that are high in fat take longer to digest, which can have a delayed result of high blood sugar hours later. Fried food, pizza and just about any fast food fare should be reserved for rare occasions as a special treat.
Candy, cookies, cake and ice cream obviously are high in both sugar and carbohydrates. This is not to say that low-sugar versions are any better, however. As with high fat foods, sweets generally should be avoided, with occasional indulgences on special occasions. Insulin-dependent diabetes usually carry glucose tablets or hard candies with them to treat low blood sugar (hypoglycemia) episodes. When a diabetic becomes confused, shaky or disoriented, quick treatment with juice, regular soda, or chewable candy is usually the fastest way to bring them out of a low. A regular meal or snack should be followed to help stabilize blood sugar.
American Diabetes Association Explains Diabetes
What Medications are Required to Treat Diabetes?
As noted above, prediabetes and Type 2 diabetes may be treated or resolved simply by improving your diet and/or adding exercise and losing weight. However, medications are usually required due to the body's inability to produce sufficient amounts (if any) of insulin.
For Type 1 diabetics, insulin injections are required, either by syringe or insulin pump. If you use a pump, only one type of insulin is required: fast acting. A basal rate is set, to give you small doses of insulin over a 24-hour period to counteract the body's automatic release of stored glucose from the liver. Bolus shots are calculated at mealtime, based on the amount of carbohydrates to be ingested. If you do not use an insulin pump, you will need long-acting insulin to provide a basal (typically taken once a day), plus, fast-acting insulin at meals.
If you have Type 2 diabetes, oral medications may be required. Generally speaking, these drugs work to lower blood sugar by either:
- Stimulating the pancreas to release additional insulin
- Slowing or stopping the production of glucose by the liver
- Improving body cells' sensitivity to insulin
- Preventing the stomach from breaking down carbohydrates
Of the drugs prescribed to Type 2 diabetics, include metformin, glipizide, and pioglitazone. Other oral medications include sitagliptin, saxagliptin, repaglinide and nateglinide. Injectible medications, other than insulin are Exenatide and liraglutide.
Some Type 2 diabetics may get to the point that they can no longer manage blood sugar levels with drugs other than insulin. This should not be considered a failure in any regard, but a positive step toward better health!
Is Diabetes Fatal?
Unfortunately, diabetes is a potentially fatal disease. In fact, in 2007, it was the 7th leading cause of death in the U.S., and may even be higher because the disease is often under-reported.
People can die from diabetes as a result of ketoacidoisis, from excessively high blood sugar. Insulin-dependent diabetics can suffer life-threatening hypoglycemia, as well. But there are other complications of diabetes that can lead to death, including heart disease, stroke, high blood pressure and kidney disease. People with diabetes often take longer to heal than other people, as well. Of course, there is also a risk of blindness, nerve damage (neuropathy) and amputations.
Generally, a person with diabetes has twice the risk of dying as another person of the same age/sex without diabetes.
With a diagnosis of diabetes - whether Type 1 or Type 2 - you should immediately take steps to add exercise to your routine and improve your diet, under medical guidance and supervision.
© 2011 Stephanie Hicks
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