Take Control Of Your Diabetes in 2008

By Nabil Andrawis, MD

Diabetes mellitus, also called diabetes, is a metabolic disorder characterized by high blood sugar (glucose) levels. The condition results from a defect in the bodys ability to produce or utilize insulin. Insulin is a hormone secreted by the pancreas that is necessary to convert glucose into a form that can be used by cells for growth and energy. Diabetes causes abnormally high glucose levels (hyperglycemia) that may end up in heart attack, stroke, kidney failure, blindness and nerve damage.

Diabetes cannot be cured, but it often can be managed with proper medical care, diet, and regular exercise.

Types

There are three main types of diabetes type 1 (accounts for 10% of cases), type 2 (accounts for about 90% of cases), and gestational diabetes (affects approximately 4% of pregnant women in the United States).

Type 1 diabetes, formerly called juvenile diabetes, is an autoimmune disease in which the immune system destroys insulin-producing cells in the pancreas. Type 1 diabetes occurs most often in children and young adults, but it can develop at any age. Because their bodies do not produce it, patients with this type must take insulin daily to regulate blood sugar levels.

Type 2 diabetes accounts for over 90% of cases. In most cases, patients with this type produce enough insulin but are unable to utilize it (called insulin resistance). Type 2 diabetes occurs most often in patients over the age of 40 who are overweight.

Gestational diabetes occurs during pregnancy and usually resolves (goes away) after childbirth. Women who develop gestational diabetes have an increased risk for developing type 2 diabetes later in life.

Incidence and Prevalence

According to the National Institutes of Health (NIH), approximately 18 million people in the United States have diabetes and of those, about five million people are unaware that they have the condition. According to the Centers for Disease Control and Prevention (CDC), diabetes is the seventh leading cause of death in the U.S.

Signs and Symptoms

Symptoms of diabetes include the following

Blurred vision

Constant hunger

Fatigue

Frequent urination

Increased thirst

In most cases, symptoms of type 1 diabetes develop suddenly. Type 2 diabetes, which may be asymptomatic, i.e., may not cause symptoms, often develops gradually over time and also may cause nausea, infection, and slow healing of wounds and bruises.

Chronic complications of diabetes include the following

Coronary heart disease (CHD; e.g., atherosclerosis) that increases the chances of a heart attack.

Diabetic nephropathy that may lead to kidney failure and the need to be on dialysis.

Diabetic neuropathy which causes loss of feeling in the hands and feet.

Diabetic retinopathy that may lead to blindness.

Diagnosis

The fasting blood glucose test is used to diagnose diabetes. Type 2 and gestational diabetes may be diagnosed using the oral glucose tolerance test. The fasting blood glucose test is a blood test that is performed after the patient has fasted for at least eight hours. Normal blood glucose levels are less than 100 mg/dL (milligrams per deciliter) and a level of 126 mg/dL or higher on two different blood tests indicates diabetes mellitus. Gestational diabetes is indicated in pregnant women when blood glucose levels are higher than 95 mg/dL.

It is very important to have early diagnosis and treatment for diabetes since recent research has proven that when the level of blood glucose is kept down in diabetic patients, this decreases remarkably the above mentioned complications of diabetes.