Wellness Wednesday: Diabetes? I Don’t Think So!

Persons with newly diagnosed diabetes mellitus experience various emotions such as disbelief, fear, vulnerability, and depression. It is a fact that 7 percent of adults in the United States have diabetes mellitus. It is a condition in which the level of blood glucose (sugar) is elevated because of an abnormality in how the body absorbs the glucose from the blood or utilizes it. The glucose level in the blood is regulated mainly by insulin, which is a hormone produced by the beta cells of the pancreas (an organ in the gastrointestinal tract). Insulin lowers the glucose level in the blood by causing it to be absorbed into the cells of organs source of energy that uses it as build up proteins. Elevated blood glucose (hyperglycemia), when it is persistent, results in the harmful effect or complications of diabetes. The main effect of this is seen in the large blood vessels in the body, where the development of atherosclerosis (narrowing of the lumen of vessels) is accelerated. This also happens in small blood vessels that supply end organs such as kidneys, eyes, and nerves. Eventually, blindness, kidney failure, lack of sensation in the feet, and subsequent development of infection may lead to amputation, increased risks of stroke, and heart attack.

Types of Diabetes

There are two main types of diabetes mellitus—type 1 and type 2. Type 1 diabetes is usually found in young adults and children. It makes up approximately 10 percent of all cases. It is more prevalent in Caucasians. The pancreas produces little or no insulin in this entity due to an autoimmune response. The person’s immune system is attacking the beta cells of the pancreas. This autoimmune response may be triggered by exposure to certain viruses or foods.

Type 2 diabetes accounts for 90 percent of all cases of diabetes. It is usually referred to as “adult-onset.” It is precipitated when the pancreas produces insufficient amounts of insulin and sometimes when the end organs in the body become resistant to normal insulin levels. It is believed that a combination of genetic causes, environmental factors, diet, and activity level affects the development of type 2 diabetes. The increasing incidence of type 2 diabetes is closely associated with increasing obesity worldwide. Type 2 diabetes is most common in people of Hispanic, African, and Asian descent.

Symptoms

Persons with diabetes, primarily type 1, may exhibit symptoms of hyperglycemia, such as excessive thirst, frequent urination, blurred vision, and dehydration. A potentially life-threatening condition called diabetic ketoacidosis may result in coma and develop into type 2 diabetes. In other persons, especially with type 2 diabetes, the symptoms may be insidious and not noticed until the complications of diabetes mentioned above have set in.

Diagnosis

The diagnosis of diabetes is made by measuring the level of glucose in the blood at various times. A person is considered normal when the fasting blood glucose is less than 100mg/dl (5.6mmol/L). Diabetes mellitus is diagnosed when the fasting blood glucose is 12mg/dl (7mmol/L) or higher and when random blood glucose is 200mg/dl (11.1mmol/L) or higher.

Treatment

A combination of dietary modifications, weight loss programs, exercise, and medication is utilized in managing diabetes mellitus. Medications used include insulin, which is administered by injection; this is most commonly used in type 1 diabetes. Oral hypoglycemics are pills also used to help lower blood glucose. The goal is to keep the blood glucose level under control, thereby avoiding complications. Hemoglobin AIC, which measures the average blood glucose level during the previous two to three months, helps monitor the adequacy of blood glucose control in diabetics. The condition is cured in persons with type 1 diabetes undergoing pancreatic transplantation and those with type 2 diabetes with associated morbid obesity who achieved significant weight reduction either by a weight loss program or gastric bypass surgery. It is essential to consult your healthcare provider for further information related to you.

References

CDC National Diabetes fact sheet: general information and national estimates on diabetes in the United States. 2005. http:www.cdc.gov/diabetes/pubs/pdf/ndfs_2005.pdf. Accessed November 14, 2006. Report of Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20:1183.

More from Muyiwa Adedokun, M.D.

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