Diabetes, a disease which alters the body’s capability to utilize glucose effectively, plays a significant role in the deaths of more than 200,000 Americans each year, six times the number in 1950. Diabetes is the fifth deadliest disease in the United States, and it has no cure. Blindness, the chance of amputation and kidney disease are complications associated with diabetes. Approximately 17 million person in the U.S. are affected by this major health concern. In addition, it is estimated that another five million have the condition but are not aware of it. These numbers increase every year along with the rising costs associated with health care provisions. This discussion examines what diabetes is, the lifestyle and genetic risk factors of the disease and its potential health consequences. It will also discuss preventative measures as well as proper diet and care for those afflicted with the disease.
There are generally two types of diabetes that have been identified, differing primarily in the onset and cause and referred to as Type One and Type Two diabetes. Juvenile diabetes, or Type One Diabetes, is the result when the body cannot produce the proper amount of insulin. Type Two refers to ‘non-insulin-dependent’ or ‘adult-onset diabetes’ and describes the condition in which the body manufactures insulin but cannot process it. More than 90 percent of diabetics suffer this type which normally afflicts those over 40 years of age. “Type Two diabetics have an abnormal glucose-tolerance test and higher than normal levels of insulin in their blood” (Freudenrich, 2002). The environment, genetics and the body’s immune system are the dynamics that bring about Type One diabetes. The Type Two Diabetes factors are more plainly defined. These factors include elderly persons, physical inactivity, and obesity, a family history of diabetes, a weakened tolerance for glucose and a history of gestational diabetes. Race is another possible factor. “African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for Type Two diabetes” (American Diabetes Association, 2006).
Although about 33 percent of people with the illness are unaware of their condition, nearly three million or almost 12 percent of the African American population over 20 years of age suffer with symptoms of diabetes. Because of this, African Americans have been identified as being at greater risk than those of Anglo descent to suffer macro-vascular problems such as strokes and heart disease. “African Americans are 1.6 times more likely to have diabetes than non-Latino whites. One in four African American women over 55 years of age has diabetes” (American Diabetes Association, 2006).
Hispanic Americans, American Indians, African Americans, and persons with a genetic history of diabetes have a better chance of getting gestational diabetes than other persons. “Studies have confirmed that nearly all women with a history of gestational diabetes have about a 40 percent chance of developing diabetes in the future. Other specific types of diabetes, which may account for one to two percent of all diagnosed cases, result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses” (National Center for Chronic Disease Prevention and Health Promotion, 2005). Women with gestational diabetes experience an abnormal tolerance to glucose and have somewhat elevated insulin levels. While pregnant, the effects of insulin are blocked by various hormones which act to desensitize the patient to the insulin her body produces. Normally, the symptoms of gestational diabetes do not continue in the woman following the birth of the baby.
Diabetics display numerous symptoms including “excessive thirst (polydipsia), frequent urination (polyuria), extreme hunger or constant eating (polyphagia), unexplained weight loss, presence of glucose in the urine (glycosuria), tiredness or fatigue, changes in vision, numbness or tingling in the extremities (hands, feet), slow-healing wounds or sores and abnormally high frequency of infection” (Freudenrich, 2002). A variety of symptoms are common to both Type One and Two diabetes. However, patients are not necessarily subject to all of the signs mentioned.
The diabetic who has not received treatment may show levels as high as 10 percent while a person not afflicted with the disease tests at close to five percent. As previously discussed, the lack of insulin production allows higher levels of glucose in cells. High levels of blood glucose (or sugar) in the bloodstream leads to various diabetic related health complications if allowed to go unchecked (Becton & Dickinson, 2006). According to the Florida Department of Health, the proper management of glucose in the bloodstream benefits people with both type of diabetes. “For every one point reduction in A1C, the risk for developing micro-vascular complications (eye, kidney and nerve disease) decreases by up to 40 percent. Blood pressure control can reduce cardiovascular disease (heart disease and stroke) by 33 to 50 percent and can reduce micro-vascular disease (eye, kidney and nerve disease) by approximately 33 percent. Improved control of cholesterol and lipids (e.g. HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20 to 50 percent. Detection and treatment of diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50 to 60 percent. Comprehensive foot care programs can reduce amputation rates by 45 to 85 percent.” (“Prevention of Diabetes”, 2003). Proper weight control, increased activity and not smoking should also coincide with regular visits to the doctor in order to better regulate blood pressure, glucose and cholesterol levels. The patient would be best served if they form a team-like relationship with their health care professionals. “Because people with diabetes have a multi-system chronic disease, they are best monitored and managed by highly skilled health care professionals trained with the latest information on diabetes to help ensure early detection and appropriate treatment of the serious complications of the disease” (American Diabetes Association, 2006).
Though there is yet no cure known for diabetes, the disease can be regulated successfully with appropriate treatment. “The key to treating diabetes is to closely monitor and manage your blood-glucose levels through exercise, diet and medications” (Freudenrich, 2006). The type of diabetes dictates the type of treatments to be followed. Type One diabetics must examine their blood-glucose levels many times per day and inject insulin accordingly, usually at mealtime so as to help manage the glucose being ingested. The supplementation of insulin assures that blood glucose levels maintain stability. Type Two diabetics have the ability to control the disease through personal lifestyle decisions such as the loss of weight, exercising more and not smoking at all. In severe instances, medication may need to be given to control glucose levels. Diabetics are able to significantly decrease the risks of complications due to the disease if they are willing to educate themselves then apply that knowledge to their daily lives.
References
American Diabetes Association. (2006). “Diabetes Statistics for African Americans.” All About Diabetes. American Diabetes Association. Web.
Becton & Dickinson. (2006). “Hemoglobin A1c Testing.” BD Diabetes. Web.
Freudenrich, Craig. (2006). “How Diabetes Works.” How Stuff Works.
National Center for Chronic Disease Prevention and Health Promotion. (2005). “Basics About Diabetes.” Diabetes Public Health Resource. Center for Disease Control. Web.
“Prevention of Diabetes.” (2003). Florida Department of Health. Web.