Health Conditions : Diabetes

Number of people affected:
14.6 million diagnosed, another 6.2 million undiagnosed

Who gets it:
Older-aged adults, obese individuals, those with family history

Symptoms:
Fatigue, frequent urination, increased thirst, blurred vision and slow healing of wounds

Treatments:
Management of blood glucose levels through a combination of medication, insulin injections and lifestyle changes.

Doctors to see:
Primary care and endocrinologist

Diabetes is a disorder of metabolism—the way the body uses digested food for growth and energy. Most food we eat is broken down into glucose, the form of sugar in the blood, and the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas.

The pancreas automatically produces the right amount of insulin to move glucose from blood into our cells when we eat. In people with diabetes, however, the pancreas produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body through urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Diabetes is associated with long-term complications that affect almost every part of the body: blindness, heart and blood vessel disease, stroke, kidney failure, amputations and nerve damage.

There are 3 main types of diabetes: Type 1, Type 2 and Gestational. The most common form – and the one to which adults and the elderly population is most prone – is Type 2.

About 90 to 95 percent of people with diabetes have type 2 – most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.

- summarized from information from the National Institutes of Health (NIH), the nation’s medical research agency.

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Diabetes is often called a silent disease because many people have no signs or symptoms before they are diagnosed. Symptoms can be so mild that you don’t even notice them. More than 6 million people in the United States have type 2 diabetes and do not know it.

The signs of diabetes are:

• Extreme thirst or hunger
• Urinating often
• Feeling very fatigued or tired
• Losing weight without trying
• Having sores that heal slowly
• Having dry, itchy skin
• Losing the feeling in your feet or having tingling in your feet
• Blurry eyesight
• Headache
• Rapid breathing

The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes.

The following tests are used for diagnosis:

• A fasting plasma glucose test measures blood glucose after you have gone at least 8 hours without eating.
• An oral glucose tolerance test measures blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a glucose-containing beverage.
• A random plasma glucose test checks blood glucose without regard to when you ate your last meal.

Treatment

Diabetes cannot be cured, but it can be controlled. Strict control of blood glucose, or blood sugar, as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes.

Good control of blood glucose requires:

• Following a meal plan
• Getting regular physical activity
• Taking diabetes medicine every day
• Checking blood glucose as recommended
• Monitoring diabetes
• Insulin shots (most people need at least two a day for good blood glucose control)

Many types of diabetes medications can help type 2 diabetics lower blood glucose. Each type lowers blood glucose in a different way. Doctors prescribe medication from one of these groups ( you might know the generic name):

• Sulfonylureas stimulate your pancreas to make more insulin.
• Biguanides decrease the amount of glucose made by your liver.
• Alpha-glucosidase inhibitors slow the absorption of the starches you eat.
• Thiazolidinediones make you more sensitive to insulin.
• Meglitinides stimulates your pancreas to make more insulin.
• D-phenylalanine derivatives help your pancreas make more insulin quickly.
• Combination oral medicines put together different kinds of pills.

- summarized from information from the National Institutes of Health (NIH), the nation’s medical research agency.

Certain factors can increase the risk of developing type 2 diabetes:

• Overweight or obesity, with a body mass index (BMI) of 25 or more
• Having a parent or sibling with type 2 diabetes
• Being of African American, American Indian/Alaskan Native, Asian American, Pacific Islander or Latino descent
• A history of gestational diabetes, or having at least one baby weighing more than 9 pounds at birth
• Hypertension. High blood pressure of 140/90 mm Hg or higher
• Poor cholesterol profile. HDL cholesterol ("good" cholesterol) levels of 35 or lower and/or triglyceride levels of 250 or higher
• Inactivity and sedentary lifestyle
• Being an older adult. Approximately 18.4% of Americans over age 65 have type 2 diabetes.
• Having diagnosed pre-diabetes

There are certain skills that caregivers can learn to assist a loved one living with diabetes. Education is key. Learn the following:

• Your loved one’s blood glucose target range (ask their doctor)
• Symptoms and treatments for high and low blood glucose
• How to do a fingerstick and check blood glucose levels
• The importance of balancing food, exercise and insulin
• How to inject insulin
• Medication doses, schedule and side effects
• The effects of foods and beverages on blood glucose levels
• Planning meals, measuring portions and counting carbohydrates

In addition to the caregiver, it is important that the older individual know how to care for themselves, including:

• When and how to test blood glucose levels
• Dosing and frequency of medications
• What types of food to eat to stay in balance with blood glucose medicines

Breaking down complicated tasks into small simple steps helps the elderly person to not feel overwhelmed and confused.

- summarized from information from the National Institutes of Health (NIH), the nation’s medical research agency.