What you need to know about diabetes

By Vince Faust

When most people think about diabetes, they think about going blind, losing limbs and dying at an early age. The good news about diabetes is that if you keep your blood sugar levels under control, you can stay healthy and even prevent diabetes and any health problems from happening later.

If you have diabetes, you have a disease in which the body cannot produce or use insulin properly. Insulin is a hormone that affects how our body uses glucose, a sugar that the body needs for your daily life. Like a flashlight needs a battery, your body needs glucose to keep running. When you eat fruits, vegetables and grains they are all converted to the sugar glucose. The glucose is released into your bloodstream. Your pancreas then produces a hormone called insulin. It helps to release the glucose into every cell in your body. Without this release, the glucose stays in your blood vessels.
 The cause of diabetes is still unknown. Genetics and environmental factors such as obesity and lack of exercise play a big role in developing diabetes. There is no cure for diabetes.
Diabetes is listed as the fifth-deadliest disease in the United States. The total annual economic impact of diabetes in 2002 was estimated at $132 billion. That is one out of every 10 health care dollars spent in the United States.
There are about 18.2 million people in the United States, or 6.3 percent of the population, who have diabetes. An estimated 13 million have been diagnosed with diabetes, but 5.2 million people don’t know that they have the disease. Approximately 2.7 million or 11.4 percent of all African Americans age 20 years or older have diabetes. 25 percent of African Americans between the ages of 65 and 74 have diabetes.
One in four African-American women over 55 years of age has diabetes. One-third of all African Americans don’t know it. Some of the most life-threatening consequences of diabetes are heart disease and stroke, which strike people with diabetes more than twice as often as they do others. Adults with diabetes have heart disease death rates two to four times higher than those without diabetes. African Americans with diabetes have an increased risk for heart disease, stroke and other macrovascular complications. Complications of diabetes can also include blindness, kidney disease and amputations.
To diagnose pre-diabetes or diabetes, your doctor might conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it’s easier, faster and not as expensive.

When using the FPG test, a fasting blood glucose level between 100 and 125 mg/dl you have pre-diabetes. When you have a fasting blood glucose level of 126 mg/dl or higher you have diabetes.
When using the OGTT test, your blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. When your two-hour blood glucose level is between 140 and 199 mg/dl, you have pre-diabetes. When your two-hour blood glucose level is 200 mg/dl or higher, you have diabetes.
In type 1 diabetes your body fails to produce insulin. In type 2 diabetes your body is insulin resistant, which is a condition in which the body fails to use insulin properly. Most Americans who are diagnosed with diabetes have type 2 diabetes. Gestational diabetes will affect about 4 percent of all pregnant women in the United States each year. With pre-diabetes, your body’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. Forty-one million Americans have pre-diabetes.
While there is no cure for diabetes, it can be controlled. Most type 2 diabetes can not only be controlled, it can be prevented and reversed. There are a number of areas that are under your control. These control factors include nutrition, fitness, sleep, stress, medical care, smoking and your environment. Educating yourself about diabetes and your control factors are necessary to better control your diabetes.
Smokers should stop smoking. Twelve hundred Americans died yesterday and another 1,200 will die today from smoking-related illnesses. You’ve seen the ad on TV: “There are no safe levels for cigarettes.”
Limit your exposure to secondhand smoke. ETS (environmental tobacco smoke) contains over 4,000 chemical compounds. More than 60 of these are known to cause cancer. Some of the toxins or irritants in secondhand smoke include carbon monoxide, nicotine, hydrogen cyanide, ammonia, formaldehyde and sulfur dioxide. Carcinogens in ETS include benzene, aromatic amines (especially carcinogens such as 2-naphthylamine and 4-aminobiphenyl), vinyl chloride, arsenic, nitrosamines and cadmium. The greater your exposure to ETS, the greater your level of these harmful compounds in your body. Secondhand smoke is the third-leading preventable cause of death nationally.
Overweight people should exercise. You need to exercise 30 minutes or more every day. Most people don’t exercise enough and when they do, they don’t exercise hard enough. You need to challenge yourself every day.
Get eight hours of sleep every night. If you get the right amount of sleep you will get the most out of your fitness program. If you don’t get enough sleep, your muscles will work less efficiently and you’ll stop making progress in your fitness program. Get less sleep than what you need and you’ll find yourself stressed more often and you’ll get sick more often. If you train you may need more than eight hours. To find out what you need keep a diary of your sleeping habits. Record the time you go to bed, the time you wake up, the total hours you sleep, your mental and physical state during the day; any naps and what you ate or drank before bed. After a few weeks, review your diary. You should be able to get good idea of what helps or hinders you from getting the sleep you need.
Reduce stress and develop good coping skills. Other ways of dealing with stress include changing or improving personal character traits. These can include behavior changes such as assertiveness training, self-esteem enhancement, being flexible, improving organizational skills and time management.
Remember, there are many things that we can’t control. But, we must maintain control over how we handle things. If you need to cry, scream, count to 10, smile or simply sigh, do it. Take things in stride and work through it. Sometimes you just have to go with the flow.
The symptoms of stress are common for many illnesses, so consult your doctor to rule out other health problems. If you feel you need help to cope with stress, don’t hesitate to seek professional help!
Plan your meals. Developing healthy eating habits takes meal planning. You cannot change your eating habits if you leave your diet to chance. To do this you must shop wisely. Always have a list of the foods you need when you shop and never shop on an empty stomach. You also have to learn to differentiate between hunger and appetite. Hunger is the actual physical need for food. Appetite is a desire for food, usually triggered by factors such as stress, habit, boredom, smell, depression, food availability or the thought of food itself. Sticking to a regular meal plan will help control hunger and appetite.
Reduce your exposure to harmful chemicals. They are called hormone disruptors and they can change the structure of your body’s cells. Eliminate chemicals you don’t need. These can include hair sprays, cleaning agents, deodorants, moisture creams, pesticides and air fresher.
Pick a good, qualified doctor to handle your diabetes. In the stressed and compressed time frame of a doctor’s appointment, it’s very common for communication to be impaired. A recent survey of how much patients recalled following a general exam revealed that most could not remember more than half of the medical problems their doctor diagnosed! Some patients visiting the ER for treatment could not remember the doctor’s name. Would you consult your banker, tax preparer or clergyman and leave the meeting without making sure you understood what was discussed or not know to whom you spoke? While many doctors are aware of the need to restate treatment plans or medication adjustments, others may not. Time restrictions decrease the amount of verbal reinforcement the doctor can offer. Ask for a brief written summary to make sure all points are covered and necessary prescriptions filled out. Ask what kind of follow-up is needed. Be prepared to take notes.

Questions you should ask before you leave your doctor:
1. What is the problem likely to be, among the possibilities?
2. Are further diagnostic evaluations necessary?
3. What can I expect from the natural course of this problem?
4. Is there treatment available to modify the course?
5. How long before I should see the effects of the medication?
6. Are there any side effects of the medications?
7. Under what circumstances should I notify the doctor?
Your doctor’s appointment is your opportunity to discuss medical problems and concerns. By preparing for the appointment you will be less likely to waste the opportunity, and more likely to gain a higher degree of satisfaction from the visit. Your preparation may even save your life.
Remember, diabetes has no cure but it can be controlled and in some cases prevented.

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