Diabetes Can Have a Ripple Effect on Your Health

Nearly 26 million Americans have diabetes and almost one-third are not aware they have it, according to the American Diabetes Association (ADA). Uncontrolled diabetes can lead to heart disease, kidney failure, leg infections, gingivitis and other serious health problems. The ADA warns that people with diabetes do have a higher risk of blindness than people without diabetes. But people who have diabetes may also experience minor eye disorders. With regular checkups, you can keep minor problems minor.

There are three major types of diabetes:

• Type 1 diabetes is usually diagnosed in childhood, although can occur at any age. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown. Genetics, viruses, and autoimmune problems may play a role.
• Type 2 diabetes is far more common than type 1. It makes up most of diabetes cases. It usually occurs in adulthood, but young people are increasingly being diagnosed with this disease. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to increasing obesity and failure to exercise.
• Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes. Women who have gestational diabetes are at high risk of type 2 diabetes and cardiovascular disease later in life.

Symptoms and Diagnosis

Diabetes results in too much glucose in the blood causing damage to body systems such as the eyes, heart, nerves and circulatory system. Other symptoms include:

• Increased thirst
• Frequent urination
• Increased hunger
• Blurred vision
• Fatigue
• Dry skin
• Moodiness
• Wounds that won’t heal
• Numbness of the hands/feet

The following blood tests are used to diagnose diabetes:

• Hemoglobin A1c test gives an “average” blood glucose level of the last 2-3 months. A person is diagnosed with diabetes if the A1c value is 6.5% or higher.
• Fasting blood glucose level: diabetes is diagnosed if higher than 126 mg/dL on two occasions. Levels between 100 and 126 mg/dL are referred to as impaired fasting glucose or prediabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
• Oral glucose tolerance test: diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours. (This test is used more for type 2 diabetes.)
• Random (non-fasting) blood glucose level: diabetes is suspected if higher than 200 mg/dL and accompanied by the classic diabetes symptoms of increased thirst, urination, and fatigue. (This test must be confirmed with a fasting blood glucose test.)

Treatment

Persons with diabetes need to have their hemoglobin A1c (HbA1c) level checked every 3 - 6 months. The HbA1c is a measure of average blood glucose during the previous 2 - 3 months. It is a very helpful way to determine how well treatment is working.

Our long-term goals of treatment are to:

• Prolong life
• Reduce symptoms
• Prevent diabetes-related complications such as blindness, heart disease, kidney failure, and amputation of limbs

We, along with our patients, accomplish these goals through:

• Blood pressure and cholesterol control
• Careful self-testing of blood glucose levels
• Education
• Exercise
• Foot care
• Meal planning and weight control
• Diabetes medication and/or insulin

If you have diabetes, we recommend you regularly check your blood sugar levels at home. There are a number of devices available, and they use only a drop of blood. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes. It can help us prevent complications.

The American Diabetes Association recommends keeping blood sugar levels in the range of:

• 80 - 120 mg/dL before meals
• 100 - 140 mg/dL at bedtime

Your physician can provide you with information about how much fat, protein, and carbohydrates you need in your diet. A registered dietitian can help you plan your individual dietary needs.

People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugar from becoming extremely high or low. People with type 2 diabetes should follow a well-balanced and low-fat diet.

Feet, Eyesight and Oral Health

People with diabetes are more likely to have foot problems. Diabetes can damage blood vessels and nerves and decrease the body's ability to fight infection. You may not notice a foot injury until an infection develops. Death of skin and other tissue can occur. You should check your feet every day and let your physician know if you are having problems with your feet at your next appointment.

Your physician may also emphasize the need to have regular eye exams if you have diabetes, because the most common eye disorder in diabetes is retinopathy. Diabetes also puts you at higher risk for developing cataracts and certain types of glaucoma.

Diabetes can also lead to oral health issues, so it is important to also have routine dental appointments if you have diabetes.

If you have any questions about Diabetes, or think you may be at risk, please call to schedule an appointment with your physician.