Diabetes

Diabetes Basics

Diabetes is one of the leading causes of death in the world. A metabolic disorder, diabetes affects the way the body uses digested food for growth and energy. This disorder can be seriously disabling and can lead to fatal complications if treatment is not pursued and sometimes given aggressively. With proper treatment and preventative measures, people with diabetes can live relatively normal and healthy lives in most cases.

About Diabetes

The body breaks most food down into glucose, a form of sugar in the blood that provides the body with the majority of its fuel source. Glucose in the blood is used by cells for growth and energy. However, insulin must be present in the blood for glucose to get into the cells. Insulin, a chemical produced by the pancreas (a large gland located behind the stomach), is thus a key factor in proper digestion and health. Normally after eating the pancreas produces the correct amount of insulin to allow the body to properly process the glucose. But in people with diabetes, little or no insulin ends up being produced by the pancreas, or the cells in the body do not respond appropriately to the insulin that is produced.

When this occurs, the body will experience a build up of glucose in the bloodstream. The glucose will accumulate and overflow into the body’s urine as it is produced. It will then pass out of the body. When this happens, the body loses the majority of its main fuel source. Even if the blood has such a high amount of glucose, it does no good if the cells cannot absorb it to make energy.

The signs and symptoms of diabetes vary, but if you are experiencing any symptoms, it is advisable to contact your doctor immediately. The different types of diabetes have different onset times, and the symptoms may vary, so it is important to keep abreast of your symptoms and to report them to your healthcare provider. As with most diseases, the earlier treatment for diabetes is sought, the better the eventual outcome may be. Proper treatment and a continuing plan will ensure a better quality of life in a patient diagnosed with the disease.

The Types of Diabetes

Diabetes is a serious disease that can vary in its severity and resulting complications. These variances usually depend on the type of diabetes a patient has. There are two main types of diabetes, as well as gestational diabetes, which occurs in women during pregnancy. Each type has its own symptoms and complications, and the type you have may very well influence your treatment and the preventative measures you may take.

Type One

Type one diabetes is an autoimmune disease. This means the immune system in the body turns against another part of the body. In the case of diabetes, beta cells that produce insulin in the pancreas are attacked. This results in interrupting the production of insulin, as the pancreas will then produce very little to no insulin as a result of the attacks. The reason for these attacks is unknown. The five to ten percent of people who are diagnosed with this type of diabetes must usually take insulin daily in order to survive. The disease usually shows onset in children or young adults, but symptoms can appear at any age. They include thirst, frequent urination, frequent hunger, weight loss, blurred vision, and extreme fatigue. In some cases, the person may enter into a life-threatening diabetic coma.

Type Two

Type two diabetes is the most common form of the disease, affecting about 90 to 95 percent of people, usually those who are older in age. People with a history of obesity or family members with the disease, or women who have had gestational diabetes, may be more likely to develop this form of the disease. About 80 percent of people with type two diabetes are overweight. In many cases, the pancreas usually makes a decent amount of insulin, but the body is not using it effectively. Glucose can build up gradually and cause certain tell tale symptoms. These symptoms include fatigue, nausea, frequent urination, thirst, weight loss, and blurred vision. Frequent infections may also occur. Some people may not experience symptoms until later in the disease. Although these are similar to the type one symptoms, they usually appear more gradually than those in type one diabetes.

Pre-Diabetes Illnesses

People with pre-diabetes type illnesses are somewhere between having the disease and being normal. These people may be at increased risk for diabetes, heart attack, and stroke. Certain lifestyle changes can help to decrease the risk for diabetes, including weight loss. Increased physical activity may help to prevent diabetes or may help to at least delay its onset.

Types of Illnesses

There are two types of pre-diabetes illnesses. These include impaired fasting glucose and impaired glucose tolerance. The first form of illness simply means that after fasting, the person’s glucose level in the blood is between 100 to 125 mg/dL. This means that the person’s blood sugar level is higher than normal but not quite high enough to classify the person as diabetic.

The second type of illness, called impaired glucose tolerance, also consists of a person having a high level of glucose but not such a high level that the person is diagnosed with the disease. Fasting impaired glucose affects over 35 million people ages 40 to 74, while over 16 million people of the same age group are affected by impaired glucose tolerance. Some patients experience both forms of pre-diabetes illnesses, though, bringing the total of people ages 40 to 74 with the diseases up to 41 million.

People with these illnesses can help to prevent the onset of diabetes by making wise decisions. Eating a healthy, balanced diet low in sugar can help to decrease the likelihood of developing diabetes. Exercise is great for people with pre-illnesses, too. Walking or other aerobic activity helps to stimulate the body and to encourage a healthy and active existence. Since being overweight is such a big factor, losing excess weight is the key to maintaining a long and healthy life. People with pre-diabetes type illnesses should schedule frequent appointments with their healthcare provider in order to better ensure their monitoring and blood sugar levels. It is important that healthy lifestyle changes be made as soon as possible, so that future damage is kept to a minimum.

People who suspect they may have pre-diabetes illnesses should talk to their doctor about having a blood test done. Knowing what you have definitively can help making wise choices seem like a more doable task.

People at Risk for Diabetes

Since diabetes is one of the leading causes of death in the United States, there are several factors that can put people at an increased risk for developing the disease. These factors are widespread but resemble the influencing factors for many other common diseases in the United States. Diabetes is certainly not a disease to take lightly, so if you or a loved one has one or more of these risk factors, it is a good idea to visit a healthcare provider to determine your chance for developing the disease.

Risk Factors

As with most diseases such as heart disease, cancer, and high blood pressure, people with a family history of diabetes are more likely to develop the disease than people without a family history. Although scientists have not isolated the specific factors that link the disease through heredity, genes may play a large part in influencing the development of the disease. People whose immediate relatives have had diabetes will be much more prone to developing the disease. Also, while type one diabetes can strike anyone at any age (although it usually develops in children and teenagers first), type two diabetes generally affects the older population. People in their middle-age years and up are much more likely to develop diabetes if they are also not taking proper care of themselves.

Lifestyle, therefore, is one of the biggest factors that influences whether a person may develop type two diabetes. Someone who is overweight has a much greater chance of developing the disease than someone of a similar age who is at a healthy weight. This goes hand-in-hand with practicing a good diet and exercise routine. Exercise helps to get the blood flowing and stimulate the heart, which burns calories and helps to work off excess glucose in the blood. A healthy diet can also help to control the amount of glucose in the blood. Both are part of a healthy lifestyle that can help to decrease your chances of developing diabetes later in life. Often times, people with mediocre diets may develop the disease because they lead a largely sedentary lifestyle.

Changing to a healthy lifestyle as well as visiting the doctor for a thorough risk analysis and evaluation can help to determine if your chances of developing the disease are risky or not.

Diagnosing Diabetes

Diagnosing diabetes as soon as symptoms appear is the most important thing a patient can do for himself. At the first sign of symptoms, it is advisable to seek the help of a doctor immediately. Type one diabetes tends to have a more sudden onset than type two, but since the diseases have similar symptoms, it is a good idea to visit your doctor for a thorough evaluation instead of waiting. There are a few tests the doctor can perform to determine if you do, in fact, have diabetes and if so, what type of the disease you have. After the diagnosis is made, you can begin a recommended treatment regimen as soon as possible.

The Diagnosis Process

There are a few tests your doctor may choose to perform to determine if you diabetes. One test is called a fasting plasma glucose test, and this test is the preferred way for many doctors to diagnose type one or type two diabetes. The test is usually done in the morning and confirmed with a second test on a different day at a different time. After fasting for eight hours, the patient is given a blood test. If the glucose value of the plasma is 126 mg/dL after fasting, the patient may be given the diagnosis of diabetes.

Doctors can also choose to test randomly. A random plasma glucose value of 200 mg/dL or more with symptoms for the disease may indicate diabetes. This test can also be repeated at different times on different days. There is also the oral glucose tolerance test. This test involves the patient consuming a drink with 75 grams of glucose diluted in water. After two hours, a blood sample is drawn. If the blood sample shows a glucose level of 200 mg/dL, the person may be considered diabetic. This test is again repeated after a couple of hours and can be repeated as necessary.

While undergoing repeated blood tests may sound irritating, testing for diabetes is necessary in order to begin properly treating the disease. Patients who suspect they have symptoms will first be given a thorough physical examination, and their medical history will be considered. Then they begin the testing process described above to determine if they do have the disease.

Who Gets Diabetes?

While some risk factors do increase a person’s chance of developing diabetes, there are other factors that may determine if someone develops the disease or not. Determining who may get the disease is not fool-proof, but there is evidence to suggest that ethnicity, location, and age may influence the outcome of who develops diabetes. Regardless, early evaluation and starting a treatment program immediately are the keys to living healthily after the diagnosis is made.

Different Groups, Different Risks

Type one diabetes affects different people than does type two diabetes. Type one diabetes occurs equally in males and females, but the disease is more common in whites than in nonwhites. The disease is rare in most American Indian, Asian, and African populations, although some northern European countries like Finland and Sweden have reported high rates of the disease for some unknown reason.

Type two diabetes, on the other hand, generally affects older people who lead a pretty sedentary lifestyle. These people tend to be overweight. Surprisingly, this disease occurs more often in African Americans, American Indians, and some Asian Americans. It also occurs more often in native Hawaiians, Pacific Islanders, and Hispanics. On average, non-Hispanic African Americans are 1.6 times more likely to have diabetes than non-Hispanic whites of a similar age. Also, American Indians have one of the highest rates of type two diabetes in the world, along with Alaskan natives. Alaskan natives are 2.2 times as likely to develop type two diabetes.

The prevalence of type two diabetes may also increase as the population ages. Since Hispanics and other minorities are the fastest growing groups in the United States, the numbers may also tend to increase. Overweight and sedentary people are also on the rise, so this may also contribute to the increasing development of the disease. It is estimated, in fact, that by 2025 about 8.9 percent of the population will be diagnosed with type two diabetes.

If you are a part of these at-risk ethnic groups for either type of diabetes and are experiencing symptoms or have a family history of the disease, schedule an appointment with your doctor immediately to be evaluated.

The Impact of Diabetes

Since diabetes is such a prevalent disease, it has a huge impact on people in the United States and across the world. It is one of the leading causes of death or disability in the United States, and as reported in 2000, was the sixth leading cause of death in the United States. In fact, deaths as caused by diabetes may be underreported on death certificates as diabetes tends to be an underlying cause of deaths by heart disease or stroke, among other types.

A Great Influence

It is estimated that about 65 percent of deaths of diabetes’ patients are related to heart disease or stroke. Diabetes is also associated with long-term complications. These include debilitating complications like blindness, heart and blood vessel damage, stroke, kidney failure, and amputations due to a weakening circulatory system. Nerve damage is also common among diabetic patients with poor disease management. Diabetes can even affect pregnancies. Uncontrolled, the disease can cause pregnancy complications and birth defects, which are more common to babies born to mothers with diabetes.

The economic impact of the disease is equally as great. Statistics from 2002 reveal that the disease cost the United States alone a total of 132 billion dollars. Indirect costs from the disease such as those associated with disability payments, time lost from work, and premature death totaled approximately 40 billion dollars. Direct costs as a result of the disease like medical care, hospitalizations, and treatment supplies cost about 92 billion dollars. Overall, the disease has cost the United States a large chunk of change.

The unfortunate thing about diabetes is not all complications and side effects can be prevented or effectively dealt with. Daily treatment for the disease that enables many type one patients to survive and some type two patients involves insulin injections. These injections cost money for the drug and supplies. There are also testing kits, doctor’s appointments, and tests to keep up with. The disease is certainly a costly one, but the catch-22 is that these costs are necessary in order to help people with the disease lead a better quality life.

Diabetes and Fitness

Since type two diabetes mostly affects older, overweight people, it is especially important to incorporate an active fitness routine into your lifestyle if you are at risk for developing the disease. Both aerobic exercise and resistance are helpful on their own, but a combination of the two is better for patients with diabetes or who are at risk for the disease.

The Importance of Fitness

A regular fitness routine can actually be a life-saver to people with the disease. The combination of resistance and aerobic exercise is extremely helpful in keep a person fit and controlling the level of glucose in the blood. Exercise also helps to greatly reduce the risk of heart disease or stroke. The resistance part of an exercise routine helps to build muscle, which is vitally important in burning fat and excess glucose. People over 70 years old are recommended to add slightly more resistance to their routines. Resistance certainly helps in posture, balance, and blood sugar control for everyone.

Aerobic exercise is also important in raising the body’s activity level and helping to get the blood flowing. People with diabetes have a number of options when it comes to aerobic exercise, but if the disease has caused problems such as neuropathy in the feet, it is wise to seek your doctor’s advice before beginning a routine. People with bad backs for example, can choose to use a stationary bike. Swimming is one of the best and gentlest ways to get in shape. The water helps to soften the impact of the routine and enables patients with poor circulation or pain to get moving.

Even though a regular routine can help to reduce stress and blood sugar, patients may still need to take insulin either daily or on occasion. Sometimes, blood sugar can go up after exercise as the liver may produce more glucose to compensate for the blood sugar lost in exercise, so you may still need to take medication. However, a regular fitness routine with aerobic exercise and resistance can certainly enable patients to lead longer, healthier lives and to possibly take less medication than before. People who have not yet developed the disease but who are at risk may find their chances significantly decrease after beginning a regular routine.

Diabetes and Erectile Dysfunction

Not surprisingly, diabetes is one of the many underlying factors that may cause erectile dysfunction in men. In fact, at least 50 percent of diabetic men will experience difficulty getting and maintaining an erection. As they age, their chances of experiencing difficulty will continue to increase. There are a few treatments men with diabetes and erectile dysfunction can consider, but whether these treatments will be effective depends largely on the patient’s disease.

Available Treatments

There are treatments available to help men with diabetes and erectile dysfunction. There are three oral treatments men can try, Viagra, Cialis, and Levitra. However, these medications have been shown to have less success in men with the disease. There is also a treatment that can be directly injected into the erection chamber which may facilitate an erection. This particular treatment has about a 60 to 80 percent success rate. Yet the treatment may be needed several times and over half of the patients receiving this type of treatment choose to stop after a few years.

Why Erectile Dysfunction?

Men with diabetes may be likely to develop erectile dysfunction over 10 to 15 years earlier than their non-diabetic counterparts. This is because diabetes has several complications that can influence the development of erectile dysfunction. A few of the main complications of diabetes include impairments in the nerves, blood vessels, and muscle function of the afflicted person. Since these are all key elements in a male’s maintaining an erection, once impaired, it can be extremely difficult for men with the disease to achieve and maintain an erection without assistance.

Even with the necessary hormones for erection present, though, it is still difficult for men to have and to maintain an erection. This is due to the fact that the blood vessels and nerves necessary in achieving an erection have been damaged by the disease. Men who have diabetes and who are concerned about developing erectile dysfunction should speak with their doctors about oral medications or alternative treatments. The effectiveness may depend on the type of diabetes present, so a doctor’s advice is the best route to take when deciding among erectile dysfunction treatments.

Diabetes and Pregnancy

Diabetes that develops during pregnancy is known as gestational diabetes. Like type two diabetes, gestational diabetes tends to occur more often in African Americans, American Indians, Hispanic Americans, and women with a family history of the disease. Having gestational diabetes is not something to take lightly. Women with the disease may have a 20 to 50 percent chance of developing type two diabetes in five to 10 years. It is highly recommended that women with gestational diabetes remain closely monitored during and after pregnancy.

What Happens

About seven percent of women are diagnosed with gestational diabetes during pregnancy. The disease is often the result of hormonal changes due to pregnancy. These hormonal changes occur in order for the body to deliver nutrients from the mother to the fetus. They also help to prevent low blood sugar in the mother by stopping the actions of insulin. Yet, if the pancreas can’t produce enough insulin or if the body’s cells do not respond appropriately, gestational diabetes can develop.

Gestational diabetes can result in birth defects, over nutrition of the baby, and excess growth of the baby. This can, in turn, increase the risk of labor and delivery to both the mother and the baby. The baby may also experience low glucose. Women who are at risk for developing gestational diabetes include women who are overweight or part of an at-risk ethnic group, including Hispanics and African Americans. Women with a family history of the disease are also at greater risk, as are women with a history of giving birth to babies over nine pounds.

The key to helping women with gestational diabetes is to monitor their glucose levels closely. The doctor will also monitor the amount of glucose in the urine, as this can indicate vital nutrients are being passed through the body. A balanced diet and exercise (with your doctor’s permission) can help to reduce the risk of gestational diabetes. Controlling other factors like hypertension and even taking insulin may be necessary to control gestational diabetes. In order to avoid further complications, women with gestational diabetes should schedule regular appointments with their obstetrician.

The Complications of Diabetes

People who are diagnosed with diabetes are at an increased risk for developing several complications associated with the disease. These complications can range from being simply irritating to potentially life threatening, so it is a good idea to investigate which types of complications you may have and to seek a doctor’s advice on how best to treat them. Keeping a watchful eye on any complications you may have will enable you to lead a more enjoyable life down the road.

Various Complications

People with diabetes can have complications ranging from dental complications to larger problems like heart disease. Since the disease impacts all parts of the body, it is important to be watchful and to consult your doctor about any out of the ordinary infections that may arise.

People with diabetes are more vulnerable to germs in the mouth, so they may have more frequent infections of the gums and the bones that hold their teeth in place. Diabetes can also affect vision, as an increase in blood sugar can cause the lens of the eye to swell, blurring vision. The disease can also cause permanent blindness through cataracts or macular degeneration, glaucoma, and retinopathy.

Diabetes also affects the nerves and circulatory system. Diabetic patients may experience neuropathy of the feet. The damage done to the nerves in their legs and feet means the patients can’t feel heat, cold, or pain very well. This can be especially harmful if they get a cut or sore on the affected parts as it has a greater chance of becoming infected, so patients with neuropathy should examine their legs and feet on a regular basis to prevent this from happening.

Peripheral vascular disease affects the blood flow in diabetic patients. This means it can take longer for a cut or sore to heal. Patients with diabetes can also be more likely to develop athlete’s foot, corns, and other foot problems, along with skin problems like rashes, bumps, and blisters. More serious complications like dehydration, heart disease, stroke, and high blood pressure can also occur, so a doctor’s constant monitoring is necessary –even in patients with few symptoms of complications.

Treatments for Diabetes

Of course, the most basic part of a good treatment plan for diabetes includes a healthy diet and exercise. Since most people with type two diabetes are overweight, maintaining a balanced diet and exercise routine will help to ward off more negative complications of the disease. But diet and exercise is often not enough to control more moderate to severe cases of type two diabetes, as well as type one diabetes –which often requires daily treatment—so there are other treatment options available.

Different Solutions

Oral medication may be given to people whose bodies still produce some insulin. These oral medications are not insulin and are also usually administered to people along with a recommendation for a healthy diet and exercise routine. These oral medications can include sulfonylureas, which works to stimulate the pancreas to release more insulin. Biguanides are also forms of oral medication that work to improve insulin’s ability to move glucose into the body’s cells, especially the muscle cells. Meglitinides are other forms of oral medication that help to lower blood glucose by stimulating the pancreas to produce more insulin. Side effects of these oral medications can range from low glucose, upset stomach, and skin rash to weight gain and a metallic taste in the mouth.

Insulin is sometimes necessary for type two diabetics and is usually administered daily to type one diabetics. There are different forms of insulin available, from rapid and short acting to intermediate and long acting insulin. Pre-mixed insulin is also available. The drug can be injected under the skin, into the muscle, or into the vein. The abdomen is the source of fastest absorption, but patients will need to alternate injection sites to avoid complications. Side effects of insulin can include hypertrophy, which is a reaction to too many injections in one site of the body. Other effects can include rashes or they may vary according to the individual.

Some patients may need a constant supply of insulin, given by an insulin pump carried on the person. What you will need treatment-wise depends on the type and severity of your diabetes, so it is best to have a thorough consultation with your doctor when discussing treatment plans.