Diabetes Mellitus

Like arthritis, diabetes mellitus is a series of diseases with a common thread. The disease results from the body’s inability to properly use glucose, one of the principal sources of cellular energy. When the body converts the food we eat into glucose, insulin (made by the pancreas) helps deliver the glucose to cells and stores any excess for later use. However, whenever insulin is either insufficient or altogether absent, glucose builds up within the bloodstream and cells are unable to get the energy source needed to continue their functions.

There are two major types of diabetes, Type 1 and Type 2. Type 1 diabetes, previously called insulin-dependant diabetes mellitus (IDDM) or juvenile onset diabetes, affects approximately 16 million Americans, according to the National Center for Biotechnology Information (n.d.).

Type 1 diabetics are usually less than 40 years of age and experience a very sudden onset of symptoms. Their bodies produce no insulin and they must use insulin injections or, more recently, internal insulin pumps, to provide the insulin necessary to control blood glucose. Symptoms of Type 1 diabetes include excessive thirst, constant hunger, excessive urination, sudden weight loss for no reason, rapid or difficult breathing, sudden vision changes or blurry vision, weakness, drowsiness, exhaustion, or a fruity odor on the breath (JDF, 2004).

Type 2 diabetes, previously callednon0insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes, accounts for 90 to 95 percent of cases Most often, Type 2 diabetes appears gradually after the age of 40. Symptoms include hard-to-heal skin, gum or urinary tract infections, drowsiness, tingling of hands and feet, excessive urination, excessive hunger and thirst, and itching of skin and genitals (ADA, 2002; JDF, 2004). Nearly 11 percent of Americans ages 65 to 74 have Type 2 diabetes (ADA, 1996).

Individuals with Type 2 diabetes produce insulin but either do not make it in sufficient quantities or have cells that resist its actions. The genetic link-or tendency to run in families-is even greater in Type 2 diabetes than in Type 1. For example, an identical twin of a Type 1 diabetic has a 25 to 50 percent chances of having diabetes, while the identical twin of a Type 2 diabetic has a 60 to 75 percent chance of developing the disease (ADA, 1996). Research indicates the most important non-genetic factor in Type 2 diabetes are or have been overweight (ADA, 1996). Age is also a factor, as over half of all new cases of Type 2 diabetes occur in people over age 55 (ADA, 1996). One of the most significant concerns is that Type 2 diabetes often goes undiagnosed for many years. Fortunately, a simple blood test that measures blood glucose provides the basis for making a diagnoses.

Pre-diabetesis a condition that raises a person’s risk of developing Type 2 diabetes, heart disease, and stroke. About 41 million persons-40 percent of all adults in the United States-have pre-diabetes (CDC, 2004). A person with pre-diabetes has a blood glucose level higher than normal but not yet at diabetic levels. Many pre-diabetics develop Type 2 diabetes within 10 years. It is important to identify pre-diabetes early because steps can be taken to prevent or delay the progression to Type 2 diabetes. These steps include losing weight, becoming physically active, an eating a health diet. If the number of persons with diabetes continue to grow, our health care system risks being overwhelmed with the health and economic consequences of the disease.

Seniors And Diabetes

More seniors have diabetes than any other age group, making finger pricks and careful blood sugar monitoring a daily occurrence for many. Approximately half of all diabetes cases occur in people older than 55 years of age. According to the ADA, seven million seniors had diabetes in 2003. People with diabetes represent 18 percent of all nursing home residents and tend to be younger than residents who do not have diabetes.

Diabetes: Our Most Costly Chronic Illness

Because diabetics are at higher risk for heart disease, blindness, kidney failure, extremity amputations, and other chronic conditions, diabetes is the costliest of all medical conditions. Estimated direct and indirect medical expenditures attributable to diabetes in 2002 were in $ 132 billion (ADA, 2002).

Treatment Of Diabetes

Without regard to the type of diabetes, the primary goal of treatment is to achieve a balance between the amount of food ingested and the body’s ability to manage glucose. Keeping blood glucose levels within a controlled range is critical to preventing damage to other areas such as the retina, kidneys, and circulatory system. Components of the treatment plan include a controlled diet, exercise, weight reduction, self-monitoring of blood glucose (SMBG), and medications to either supplement insulin or enhance the effectiveness of the body’s own insulin supply. Approximately 30 to 40 percent of Type 2 diabetics require insulin, often in addition to oral medications (ADA, 1996).

Complications Of Diabetes

Complications of diabetes can be severe, life threatening, and substantially damaging throughout the body before a diagnosis is made. In order to minimize the occurrence of complications, regular screening for blood sugar levels, especially in the presence of a family history of diabetes, is extremely important in assuring the earliest possible response to abnormal blood sugar levels. Currently, it is thought that damage to body tissues from abnormal blood sugars begins early and continues to some degree, even concurrent with external measures for controlling blood sugar. What this tells us is that even today’s medical technology and pharmaceuticals are no match for the body’s inherent controls. However, maintaining one’s blood glucose levels within an established range can usually slow the progression of complications.

Many people first become aware that they have diabetes when they develop one of its life-threatening complications. The more common complications of diabetes, according to the ADA (2002), are described below.

  • Heart disease. Heart disease is the leading cause of diabetes-related deaths. Adults with diabetes have heart disease death rates about two to four times higher than do adults without diabetes.
  • Stroke. The risk for stroke is two to four times higher among people with diabetes.
  • High blood pressure. About 73 percent of adults with diabetes have blood pressure greater than or equal to 130/80 or use prescription medications for hypertension.
  • Blindness.Diabetes is the leading cause of new cases of blindness among adults 20 to 74 years old. Diabetic retinopathy causes from 12,000 to 24,000 new cases of blindness each year.
  • Kidney disease. Diabetes is the leading cause of treated end-stage renal disease, accounting for 43 percent of new cases. In 1999, 38, 160 people with diabetes began treatment for end-stage renal disease. In 1999, a total of 114,478 people with diabetes underwent dialysis or kidney transplantation.
  • Nervous system disease.About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, and other nerve problems. Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.
  • Amputations. More than 60 percent of non-traumatic lower-limb amputations in the United States occur among people with diabetes. From 1997 to 1999, about 82,000 non-traumatic lower-limb amputations were performed each year among people with diabetes.
  • Dental disease. Periodontal (gum) diseases are more common among people with diabetes than among people without diabetes. Young adults with diabetes are often at twice the risk of those without diabetes. Almost one-third of people with diabetes have severe periodontal disease.
  • Other complications. Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening events. People with diabetes are more susceptible to many other illnesses, and once they acquire these illnesses they often have a worse prognosis than people without diabetes. For example, they are more likely to die with pneumonia or influenza than people who do not have diabetes.

The information above is reprinted from Working with Seniors: Health, Financial and Social Issues with permission from Society of Certified Senior Advisors® . Copyright © 2009. All rights reserved. www.csa.us

 Get involved to help stop diabetes

(ARA) - This fall, thousands of people nationwide will join the movement to Stop Diabetes as they walk in the American Diabetes Association's Step Out: Walk to Fight Diabetes. Rain or shine, walkers will join together to change the future of this growing epidemic that is taking a devastating physical, emotional and financial toll on our country.

Step Out: Walk to Fight Diabetes is the Association's signature fundraising walk event. With strong support from the business community including sponsorship and corporate teams, this event raises more than $18 million to support the Association's mission: to prevent and cure diabetes and to improve the lives of all people affected by diabetes.

People with diabetes can choose to walk as a Red Strider. A Red Strider is someone who has diabetes - type 1, type 2 or gestational - who can proudly walk as an individual or create a team and walk with friends, family and co-workers. The purpose of the Red Strider program is to support everyone who lives with diabetes and showcase the courage it takes to live with this serious disease.

Christine Schaeberle is one of the many walkers who will join the movement to Stop Diabetes and step out as a Red Strider this year. Red Striders are distinguished at Step Out events by wearing a red hat. "On the day of Step Out, it is very important to recognize all the people with diabetes," says Schaeberle. "By wearing the red hats, we are able to do that."

Schaeberle is the founder of the Red Strider program and launched the first Red Strider program in Colorado. The program has since gone national.

"The Red Strider program opened our eyes to how many people have diabetes. It also made us realize how important it is for us to recognize them and how we need to raise money to cure this disease," says Schaeberle. "On walk day, I felt particularly supported as I was able to recognize other people with diabetes. All the walkers encouraged us to keep fighting this challenging disease."

Reasons why you should Step Out and walk to stop diabetes:
  • By walking in a Step Out event in your area, you are joining the American Diabetes Association's movement to Stop Diabetes and helping to change the future of diabetes. 
  • You are showing support for the nearly 24 million children and adults in the U.S with diabetes and the millions more at risk. Most people are either affected by diabetes or know someone who is affected.
  • There is no fundraising minimum, although it is strongly encouraged to raise funds and awareness to support the American Diabetes Association and its mission. As a reward, incentives are given to walkers for varying levels of fundraising.
  • Routes are for everyone regardless of age or athletic ability. They range from two to six miles.
  • The day of the event is a party to celebrate the accomplishments of all the teams and individual participants as well as an opportunity to promote awareness about diabetes and the American Diabetes Association.
  • For more information or to register for a Step Out event in your community, visit www.diabetes.org/stepout or call (888) DIABETES (888-342-2383).

    Courtesy of ARAcontent