What You Need To Know About Diabetes

Diabetes is rather common, and so is confusion about it. Essentially a chronic disease of the pancreas, unmanaged diabetes makes blood sugar climb to unhealthy, even lethal levels.

The high blood sugar that’s associated with Type 1 and Type 2 diabetes is a risk factor for heart disease, stroke and premature death. Untreated diabetes can also raise your risk of vision loss and kidney disease.

Symptoms of the disease may include:

• Blurry vision
• Feeling hungrier or thirstier than usual
• Fatigue
• Frequent urination
• Weight loss
• Sores that do not heal

Type 1 and Type 2 diabetes are very different

Type 1 is an autoimmune condition in which your pancreas can’t produce insulin. It is unpreventable and afflicts only five percent of the diabetes community, according to the American Diabetes Association.

Type 2 can develop due to family history, genetics or lifestyle, and involves a pancreas that doesn’t produce enough insulin or cells that can’t use insulin properly. Carrying too much weight and consuming a lot of sweets are risk factors for Type 2 diabetes, but don’t guarantee you’ll develop it.

Slightly high blood sugar may indicate prediabetes, which is often reversible by adopting healthy fitness and exercise habits. If you don’t take steps to reverse prediabetes, it can lead to Type 2 in a few years.

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Take the A1C blood test

If you're in the early stages of Type 2 diabetes, you may not show symptoms. That's a danger because the disease increases your risk of developing nerve damage, kidney disease, hypertension, heart attack and stroke.

To address high rates of undiagnosed Type 2 diabetes, physicians at the Long Island Jewish (LIJ) Medical Center Observation Unit give every inpatient an A1C blood test, which gauges average blood-sugar levels over the past three months.

During a recent screening with more than 250 adults, nine percent of them were surprised by their Type 2 diabetes diagnosis; 52 percent didn't know they were prediabetic.

“Most people with diabetes had no symptoms prior to their diagnosis,” said Rifka Schulman, MD, director of inpatient diabetes at LIJ. “If they did have symptoms, they didn’t associate the warning signs with the disease.”

Anyone with high AC1 levels started oral medication or insulin, and the LIJ team encouraged them to visit an endocrinologist for continued management. The LIJ team coached the inpatients with prediabetes or less severe cases of diabetes on lifestyle changes to improve their health and encouraged follow-up with their primary care doctors.

"Treatment compliance makes all of the difference,” Dr. Schulman said. “I have seen some excellent success stories of patients who had atrocious A1C levels when I saw them in the unit, who were then able to reach their target levels when they came to see me in the office. In some cases, they could even stop taking insulin and other medications. It really depends on adherence to the plan."

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The difference between Type 1 and Type 2 diabetes

Type 1 diabetes:

• Often diagnosed in childhood*
• Not associated with excess body weight
• Often associated with higher-than-normal ketone levels at diagnosis
• Treated with insulin injections or insulin pump
• Must be controlled with insulin

Type 2 diabetes:

• Usually diagnosed in adults over 30**
• Often associated with excess body weight
• Often associated with high blood pressure and/or cholesterol levels at diagnosis
• Initial treatment doesn’t usually include medication
• Sometimes possible to stop taking medication

* Affects all ages, so the designation juvenile diabetes is obsolete.
** Incidence is rising among children and teens, so the term adult-onset diabetes is outmoded.
Source: Diabetes.co.uk

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