Diabetes. Pronounced Die-a-Beet-is to those of us who know it from the commercial. In any case, Type-2 Diabetes, accountable for 90% of all diabetes cases, is a serious illness with serious effects on people’s lives.
To start off, let’s first discuss how Type 2 Diabetes works.
Type 2 Diabetes occurs when the body becomes insulin resistant. In healthy individuals, when one eats any food containing carbohydrates, the body sends out the hormone insulin, which signals to cells to absorb glucose, one of the simplest forms of sugar. When an individual becomes insulin resistant, the body doesn’t respond as it should when insulin in sent out. The cells “leak” glucose, and when the body ceases to overcompensate for this high glucose level, Type 2 Diabetes occurs.
This disease can rise from a number of factors. A few are beyond our control while others are self-inflicted.
Genetics influence one’s propensity to contracting Diabetes, as well as other genetic illness’ such as MODY, Donahue syndrome, Rabson-Mendenhall syndrome, as well as others. Certain non-genetic diseases such as Cushing’s Syndrome and certain types of cancers also contribute to the onset of Type 2 Diabetes.
Other factors though, are entirely/mostly in our control, such as obesity and lifestyle. Obesity has been found to contribute to approximately 55% of all Type 2 Diabetes cases, and increases the mortality of said disease. Other lifestyle factors such as lack of physical exercise and stress also increase your chances at contracting Diabetes. A poor diet is also a leading cause. Drinking lots of artificially sweetened drinks, consuming saturated or trans fats, and interestingly enough, eating lots of white rice reduces your body’s response to insulin and increase your risk for type 2 Diabetes.
This disease, recognized as a global epidemic by the World Health Organization, has far-reaching consequences for the individual. Common signs and symptoms of diabetes include polyuria (increased urination), stomach pains, polydipsia (increased thirst and/or dryness of the mouth), and weight loss.
Other signs that you may have diabetes include peripheral neuropathies, which is when numbness is felt in the fingers and toes, blurred vision, itchiness and fatigue, among other symptoms. However, some patients present with few or no symptoms during the first few years and only discover they have Diabetes on routine visits to the doctor.
The long term, chronic symptoms of Diabetes, however, are far more severe.
A diagnosis of Diabetes almost automatically cuts your life expectancy by 10 years, due to various severe possible complications. A diabetic patient may present with Diabetic Ketoacidosis, where low insulin levels cause the PH of the blood drops and the blood becomes fairly acidic, causing shock, hypotension, and possibly even death.
Diabetes also increases one’s susceptibility to respiratory infections and peridontal (teeth and gums) disease. As if that wasn’t enough, Diabetes increases your risk for cardiovascular disease which in turn causes strokes, heart attacks, and cardiac arrest by 200-400%!
That disease also causes a 20-fold increase in lower limb amputation as circulation becomes poor, causing ischemia and gangrene. In developped countries, Diabetes is also the leading cause of nontraumatic blindness and kidney failure. The disease has also been associated with an increased risk for Alzheimer’s Disease and Dementia.
It’s clear, a diagnosis of diabetes is a life-changing event, and should be treated with such severity.
The American Diabetes Association (ADA) recommends lifestyle changes such as increasing exercise to about 2 1/2 hours a week. Dietary changes such as eating less meat, a higher fiber intake, consuming modest amounts of fats (about ~30% of daily caloric intake), and quitting smoking are highly believed to reduce one’s risk at contracting diabetes.
For those with Impaired Glucose Tolerance, such lifestyle changes in addition to drug therapy with metformin/other drugs have been effective at preventing progression to Diabetes. These are lifestyle changes we should all take into consideration, as our quality of life is drastically reduced once the life-impairing effects of Diabetes set in.
And if you have already been diagnosed with Diabetes?
Well, a good management plan is critical in overcoming it. The goal is an H1C (a unit of measuring long term blood sugar levels) of 6-7% and a fasting blood sugar of 72-108mg/dl. To achieve this, various complete lifestyle changes are necessary, such as changing one’s diet.
Although there is much debate as to the ideal amount of carbohydrates in one’s diet, limiting caloric intake to only what is necessary to maintain a healthy weight is very important. In Type 2 Diabetes, it is also critical to increase physical activity, as well as cut glucose (sugar), carbohydrate, and saturated fat intake with a sustained goal of losing weight. Putting into effect these changes increases insulin sensitivity, even when the weight loss isn’t all that high. Having a personal Blood Glucose Monitor and checking constantly also contributes to good Diabetes management.
When these methods aren’t enough or when the disease is diagnosed in a progressive state, putting into effect these lifestyle changes might not be enough to effectively control blood sugar levels. In that case, drug therapy using products such as Metformin, which has been shown to decrease mortality, are usually used.
When that alone is not enough, stronger drugs such as alpha glucosidase inhibitors, sulfonylureas, and other orals agents may be used in conjunction. In some cases, insulin therapy is prescribed. Much patient education is needed in insulin therapy, as improper administration can cause dangerous hypoglycemic reactions. Speak to your doctor before beginning any insulin therapy plans.
Clearly Type-2 Diabetes is a serious illness and should be considered as such. Just because many people have it does not mean prevention or management of the disease should be taken lightly. A healthy perspective on the disease can lead to a longer life, a better quality of life, and more time to enjoy with the ones you love.