Diabetes is an incurable disease characterized by the body’s inability to produce insulin, produce enough insulin, or use insulin properly. It is the seventh leading cause of death in the United States, afflicting approximately 18.2 million people in 2003, according to Health and Human Services Secretary Tommy Thompson.
Type 1 diabetes refers to the inability of the body to produce insulin and accounts for approximately 5 to 10 percent of the cases of diabetes. Type 2 diabetes refers to the body’s inability to make enough insulin or to use the insulin properly and accounts for approximately 90 to 95 percent of the cases.
Diabetes can lead to other health problems such as heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease, dental disease, complications with pregnancy, and amputations. But many, if not most, people who are at risk of developing Type 2 diabetes can prevent the disease.
Certain risk factors make some people more prone than others to develop diabetes. People who are 65 years old or older, have a close relative who has diabetes, are overweight or obese, or are not physically active are more at risk. Also, the disease is more prevalent in African Americans, Hispanic Americans, Pacific Island Americans and Native Americans.
Even if a person has some or all of these risk factors, he or she may still be able to prevent the development of diabetes. Eating a healthful diet and being physically active for just 30 minutes every day can reduce the risks. Limit carbohydrate intake and eat unsaturated fats instead of saturated fats. Eat a breakfast high in protein, and try to eat several small meals during the day instead of two or three large meals. Eat only whole-grain flours and drink lots of water.
These are easy ways to exercise throughout the day. If you are only going a couple of blocks, try walking instead of driving. Take the stairs instead of the elevator. Start parking farther away from the door instead of up close. Be aware of other opportunities for exercise during the day and try to become more physically active.
Approximately one-third of Americans who have diabetes do not even know they have it. That makes it very important for people to get regular check-ups from their family physician and know the symptoms of diabetes, which include:
- Frequent urination
- Sudden weight loss
- Wounds that will not heal
- Constant hunger
- Sexual problems
- Blurred vision
- Numb or tingling hands or feet
- Constant thirst or dry mouth.
If you are experiencing any of these symptoms, talk to your doctor right away.
If you are at risk of developing diabetes, remember that in more than half of the current cases of diabetes, the disease could have been prevented. Diet and exercise will not only help prevent diabetes, but will also make you healthier and may help prevent other diseases and health problems.
News From the Diabetes Front
Living Bandages
British scientists have developed "living bandages," made from a patient’s own cells, which speed healing for burns and for wounds in people with diabetes.
The biological bandages, launched at a recent British Burns Association meeting, have already been used successfully on patients with severe burns and diabetics with chronic wounds.
"It is a convenient way of using the patient’s own cells to heal wounds," said Professor Sheila MacNeil, University of Sheffield. "This is a simple dressing to take laboratory-expanded cells and deliver them back to patients’ wounds."
MacNeil, who developed the bandages with her Sheffield colleague Professor Robert Short, said the bandages can be placed on wounds five to seven days after a sample of cells has been taken from the patient and grown on specialized discs in the laboratory.
After the bandage has been applied to the wound, the discs release the cells and prompt new layers of skin to grow in the damaged areas. The bandage is removed after the cells have migrated to the wound.
"It makes it simpler all around," said MacNeil. "You can get a much faster healing than you would have done without them."
The biological bandages have also helped to heal chronic wounds from persistent ulcers in patients with diabetes. In Britain alone, 3 million people suffer from chronic wounds, and 5,000 foot or toe amputations are performed each year on people with diabetes because of ulcerous wounds.
Are You Borderline?
A surprising 41 million Americans have prediabetes, high enough blood sugar to dramatically increase their risk of getting the disease, say new government figures that double previous estimates.
The number leaped because doctors changed the criteria for diagnosing prediabetes after research showed that they were missing too many at-risk patients.
Doctors once thought blood sugar levels below 110 milligrams as measured by the "impaired fasting glucose" test -given before eating anything in the morning were normal. But the American Diabetes Association (ADA) in November 2003 changed the definition of normal to below 100 milligrams -meaning anyone with a fasting glucose between 100 and 125 milligrams is now classified prediabetic.
That seems like a small change. But one-third of a lot of people are in that 100 to 110 range, and the data conclude that about 40 percent of people ages 40 to 74 are Americans prediabetic, explained CDC diabetes chief Dr. Frank Vinicor.
Changing the prediabetes cut-off "isn’t an arbitrary decision," Vinicor said. "It’s based on emerging science from the last two to three years" that found that the risk of glucose-spurred heart disease began rising at lower levels than once thought.
Cut-offs for a second test -where blood know they sugar levels are measured two hours after a glucose-rich drink -remain unchanged. Levels between 140 and 199 milligrams are considered prediabetic in that test.
So who needs to seek one of these tests?
The ADA says:
- Anyone 45 or older who is overweight should seek testing during the next routine doctor visit.
- Anyone over 45 of normal weight should ask their doctor if testing is appropriate.
- Doctors should consider testing younger people if they are overweight and have another risk factor: a diabetic relative, bad cholesterol, high blood pressure, diabetes during pregnancy or giving birth to a baby bigger than 9 pounds, or belonging to a racial minority group.
Doctors typically repeat the test every three years if results are normal, but they may test people with multiple risk factors more often.
If the test diagnoses prediabetes, there are proven ways to lower the risk of full-blown illness, Vinicor stressed, such as walking 30 minutes a day five days a week and losing 5 to 7 percent of body weight.
Sources
National Diabetes Fact Sheet: www.cdc.gov/diabetes/pubs/factsheet.htm
American Diabetes Association: www. diabetes.org
Special Insoles Prevent Foot Ulcers in People With Diabetes
Compared with regular shoes, therapeutic footwear insoles of various types prevent foot ulcers in patients with diabetes, according to the results of a new study from India. As a result, the need for amputation could be reduced.
As described in the medical journal Diabetes Care, Dr. Vijay Viswanathan and colleagues, of the Hospital for Diabetes and Diabetes Research Center in Royapuram, India, compared the effectiveness of different types of footwear insoles in 241 diabetic patients with previous foot ulcers and those considered at high risk for foot ulcers.
On average, the patients were 58 years old and had been living with diabetes for 12 years. One hundred of them were given sandals with insoles made with microcellular rubber, 59 were given sandals with polyurethane foam, and 32 were provided with molded insoles, while the remaining 50 used their own footwear containing leather board insoles.
After nine months of follow-up, the investigators found that patients using therapeutic footwear had significantly lower foot pressures than the regular-footwear group.
The rate of new ulcers in the regular-footwear group was 33 percent, much higher than the 3 to 4 percent rates seen in the groups wearing special insoles, the authors reported.
They concluded: "Use of this footwear is recommended to reduce ulceration and, consequently, the amputation rate in the diabetic population."
Source: Diabetes Care, February 2004
