Diabetes is the widely used name for diabetes mellitus, a group of metabolic disorders in which the body either cannot produce the hormone insulin, or is unable to use it effectively. The condition results in elevated blood sugar levels, which can lead to serious health problems, including death.
There is currently no cure for diabetes, which affects more than 400 million adults worldwide. But a variety of treatments allow millions of people to effectively manage their diabetes through insulin therapy or lifestyle and diet changes.
The main kinds of diabetes are:
Type 1 diabetes – Usually diagnosed in children or young adults, this form of diabetes occurs when the pancreas is unable to produce sufficient amounts of insulin. The body needs insulin to break down complex sugars and starches into glucose, a simple form of sugar that supplies energy to the brain, muscle and tissues. Type 1 diabetes accounts for only about 5 percent of diabetes cases, and those with the condition must take insulin every day – usually through injections oran automated insulin pump – to survive.
Type 2 diabetes – The most common form of diabetes, type 2 diabetes accounts for close to95 percent of adult cases. In this disorder, the body does not make or use insulin well, leading at first to hyperglycemia, in which blood sugar rises while the body is starved for energy. Over time, elevated glucose levels in the blood can lead to serious damage to the eyes, kidneys, nervous system or heart. Some type 2 diabetics can control their blood glucose levels through exercise and healthy eating. Others require oral medications or insulin.
The American Diabetes Association (ADA) estimates that nearly 26 million people in the U.S. are now living with diabetes, while 1.4 million new cases are diagnosed each year.
Besides its direct impacts, diabetes also contributes to a variety of other longer-term health issues including amputations, blindness, cardiovascular disease, foot ulcers, heart attacks, high blood pressure, kidney disease and strokes. While not all diabetics experience these complications, the connection between diabetes and many of these conditions is well documented. Having diabetes, for instance, nearly doubles the chance of having a heart attack. And diabetes was listed as the primary cause of kidney failure in 44 percent of all new cases in 2011.
According to the National Institutes of Health (NIH), diabetes affects less than 10 percent of the overall U.S. population, but more than one fourth of all Americans over the age of 65.
Diabetes can develop at any age, but because the risks increase as we get older, and because many people live for years without realizing they have the disease, type 2 diabetes in particular is often not diagnosed until people are middle-aged or older.
With nearly 70,000 reported fatalities in 2010, diabetes ranks as the United States’ seventh-leading cause of death. The ADA believes the number of diabetes deaths may be significantly under-reported. But even with the current numbers, it concludes that diabetes causes more deaths each year than breast cancer and AIDS combined.
Although the exact causes of diabetes are still not completely understood, researchers suspect that type 1 diabetes is linked to both genetic and environmental factors, such as viruses, which could be triggering the disease. Although it’s unclear what starts the process, something causes the immune systems of type 1 diabetics to attack and kill the insulin-producing cells in their own body’s pancreas.
Type 2 diabetes, on the other hand, appears to be caused by a combination of physical inactivity and excessive body weight (though not all type 2 patients are overweight), as well as inherited genetic factors and insulin resistance, in which the body is unable to effectively use insulin.
While the causes and mechanisms vary, all diabetes types result in elevated glucose levels in the blood. If left untreated, this can lead to an assortment of symptoms, including:
Increased thirst and hunger
Fatigue and irritability
Numb or tingling feet or hands
Infected gums or skin
Another important diabetes symptom to be aware of is elevated levels of chemicals called ketones, which can be detected in urine tests. Ketones are produced when the body lacks enough insulin to process glucose and instead begins to break down muscle and fat for fuel. High ketone levels are a warning sign of diabetic ketoacidosis, a life-threatening condition that, if untreated, can lead to kidney failure, heart attack and even death.
For people with type 1 diabetes, the onset of symptoms tends to occur quickly, often in a matter of weeks. Type 2 diabetes symptoms, on the other hand, can take years to appear, while some people with type 2 have no symptoms at all.
People with diabetes symptoms should see a health professional to get tested, especially if they are overweight, over 45 or have other diabetes risk factors such as high blood pressure or a family history of diabetes, heart disease or strokes. The sooner diabetes is confirmed, the sooner patients and their healthcare professionals can begin developing an appropriate treatment plan to stabilize their condition and avoid or minimize life-threatening complications.
Because people with type 1 diabetes can no longer make their own insulin, their treatment requires regular doses of insulin throughout the day, which can be administered either through injections, an inhaler oran insulin pump.
Insulin comes in several varieties and strengths, some of which begin working faster or slower, and others that last for different periods of time. Another recent variation is powdered insulin, which can be ingested through an inhaler.
Although people with type 2 diabetes often require insulin therapy, many people in early stages of diabetes begin treatment with oral medications that either stimulate the pancreas to produce more insulin or reduce the need for insulin by inhibiting the liver’s production of glucose. Other frequently prescribed diabetes drugs include medications to control cholesterol and high blood pressure, or low-dose aspirin to reduce the likelihood of heart disease and stroke.
Pancreas transplants may be an option for some people, although there are significant risks – including infection and organ rejection –as well as a long list of recipients awaiting donors. Almost all pancreas transplants are performed for patients with type 1 diabetes, and inmost cases a replacement kidney is transplanted at the same time.
Most people with diabetes – especially those taking insulin – need to check and record their blood glucose levels frequently, ranging from several times weekly to as often as several times a day. A blood glucose meter typically is used to test small blood samples obtained by pricking a finger or other body area.
People with diabetes may be able to delay the need for insulin, or use less insulin, by exercising, losing weight and eating healthy meals. Exercise also can increase energy and blood circulation, relieve stress, strengthen the heart, muscles and bones and even improve sleep. It also can help to lower blood pressure and cholesterol, as well as the risk of heart disease and stroke.
Almost any sort of regular physical activity can be beneficial, although those with type 1 diabetes have a higher risk of experiencing hypoglycemia (low blood sugar) during or after exercise, which may lead to fainting or falling. To minimize those risks, they may need to adjust their insulin or food intake, as directed by their healthcare providers.
Most experts suggest at least 30 minutes of moderate exercise five days a week, while longer periods of activity may be needed to lose weight. But whatever their exercise regimen, it’s important for people with diabetes to balance physical activity with what, when and how
much they eat and drink.
Health professionals recommend eating a balance of non-starchy vegetables, fruit, whole grains, low- or non-fat dairy, healthy fats, and lean meats. Most diabetes patients also need to keep track of how much carbohydrates – including sugars, starches, and fiber – they eat, since carbohydrates are the foods most likely to affect their blood glucose levels. A doctor or dietitian can help people to develop healthy meal plans, and provide information about counting and managing their carbohydrate intake.
Carlton Senior Living offers a complete care program for seniors with type 1 or 2 diabetes. Designed to help residents with diabetes live their lives better with customized day-to-day support from licensed vocational nurses, our award-winning diabetes management program includes:
Blood Glucose Checks – We monitor your glucose levels as directed by your physician.
Medicine Management – We provide daily help with administering insulin, and in managing additional medications.
Discount Pharmacy – We write prescriptions as needed, and offer competitive pricing.
Nutrition – We provide evaluation and support to ensure residents get the daily nutrients and healthy meals they need to meet their desired weight and blood-glucose goals.
Activities – We offer planned exercise sessions in a group setting.
Education – We also offer monthly diabetes education forums that address issues such as healthy eating and exercise.