Of the 16 million Americans
with diabetes, half don't even know that they have the
condition. Since only one out of three people with diabetes
experience symptoms, the illness may escape diagnosis
until after it has caused serious complications. Fortunately,
lifestyle changes such as maintaining normal weight
and exercising regularly can prevent or even reverse
diabetes.
The Importance of Knowing the Symptoms
Diabetes is a disorder that prevents the body from
turning food into energy. It kills more than 250,000
people in the United States each year. Untreated diabetes
doubles the risk for heart attacks and strokes. It can
also cause kidney failure, blindness and nerve disorders
that lead to amputations.
Some Signs That Diabetes Is There
A person with diabetes cannot turn food into energy
because the hormone insulin, which the body produces,
is not present or because its function is blocked. Because
of this inability to metabolize carbohydrates, some
people with diabetes experience symptoms. Contact your
doctor immediately if you notice any of the following
signs:
extreme tiredness
blurred vision
increased hunger
frequent need to urinate
severe thirst
unexplained weight loss
But remember: Many people who have diabetes experience
no symptoms. The only way to diagnose diabetes and prevent
the problems it can cause is by getting tested.
Diabetes Defined
Diabetes is also called diabetes mellitus (from Greek
and Latin words that mean "siphon" and "honey"), because
people with diabetes typically pass sugar into their
urine. Diabetes mellitus can take one of two forms:
type I or type II.
Type I Diabetes.
Type I diabetes—sometimes called insulin-dependent
diabetes mellitus or IDDM—strikes people under age 35,
typically appearing suddenly between the ages of 10
and 16. In this form of the illness, which affects 10
percent of diabetics, a virus or autoimmune reaction
probably destroys the insulin-producing cells. Insulin
normally enables sugar to pass from the blood into the
body's cells. Since a person with type I diabetes has
completely stopped producing insulin, lifelong treatment
means taking insulin several times daily.
In addition to taking regular insulin injections,
people with diabetes must closely monitor their diet
and blood levels to avoid the dangers of too-high or
too-low blood sugar. More frequent monitoring accompanied
by additional insulin has been found to significantly
decrease some of the long-term risks of diabetes: eye,
kidney and nerve problems.
Type II Diabetes.
In contrast to the rarer type I diabetes, nine out
of 10 people with diabetes have the type II form. Sometimes
called NIDDM or non-insulin-dependent diabetes mellitus,
type II diabetes usually develops slowly and primarily
affects people over 40. In type II diabetes, the body
still produces some insulin, but either the insulin
is not enough or the body does not respond to the hormone.
Experts don't know what causes type II diabetes.
Sixty to 90 percent of the time, however, obesity and
type II diabetes are both present. Even a weight gain
of 15 to 23 pounds after age 30 doubled the risk for
getting diabetes in a group of female nurses who participated
in one long-term study. Nurses who lost as little as
11 pounds, on the other hand, cut their risk of getting
the condition by half.
Type II diabetes also occurs more often with people
over 65, a family history of diabetes and a sedentary
lifestyle. A study of male physicians disclosed that
exercising just once a week significantly reduced the
doctors' risk of getting diabetes.
Keeping Blood Sugar Levels Safe
Lifestyle Changes.
Some people with type II diabetes can lower their
blood sugar to normal levels by achieving and maintaining
a healthy weight, following a low-fat diet and getting
regular exercise.
But many type II diabetics need to supplement these
healthy lifestyle changes with oral medication called
hypoglycemics.
Oral Medications.
These medications lower blood sugar by stimulating
insulin production and by helping the body's insulin
move sugar from the bloodstream into the body's cells.
The decision of which oral medicine to use and how
much a person needs requires teamwork between a recently
diagnosed diabetic and his or her doctor.
Another type of oral medication can be used by some
people with type II diabetes to control blood sugar
by blocking the liver's release of glucose.
New drugs, currently in the testing phase, may soon
become available. Oral medication may not lower a diabetic's
blood sugar enough, or the medication may become less
effective as time passes.
Insulin Injections.
About one in three people with type II diabetes eventually
requires shots of insulin, perhaps for only a limited
time following illness or injury. But taking insulin
does not mean that a person with type II diabetes now
has type I diabetes.
In either type of diabetes, treatment aims to maintain
blood sugar at healthy levels in order to prevent damage
to the eyes, kidneys, heart, blood vessels and nerves.
What Else You Can Do
If you've recently been diagnosed with diabetes,
you need to take an active role in safeguarding and
preserving your health. Here's how:
Get informed about diabetes by reading books, taking
classes and contacting support organizations (see list
on next page).
Eat a healthy diet to reduce or do away with your
need for diabetes medications.
Exercise regularly, even if it's as little as 20
minutes of walking three to five times a week.
Learn how to use a blood glucose meter to monitor
your blood sugar. Notice how body signals such as thirst
and tiredness often accompany a rise or fall in your
blood glucose levels.
Know the signs of too-low blood sugar—sweating, headache,
confusion—and the treatment: eating or drinking something
sweet immediately.
Wear a Medic Alert bracelet that tells people you
have diabetes.
Get help to quit smoking; along with diabetes, this
deadly habit can increase your risk for heart disease
and stroke.
Reduce or don't drink alcohol, which impacts your
blood sugar level.
Take your diabetes medicine according to your doctor's
advice.
See your doctor frequently, including a regular eye
exam, blood and urine tests and a foot exam to check
for sores that can reveal blood flow problems.
Promptly report any other illnesses in order to safely
coordinate medicines.
What Is Your Risk for Diabetes? A Self-Test
African Americans, Hispanic Americans and Native
Americans face the highest risk, but anyone can get
diabetes. To find out your own risk, write the number
of points next to each statement that is true for you.
Put a zero next to any statement that is untrue. Then
add the points to find your total score.
1. My weight exceeds normal weight for my height
by 20 percent or more.
Yes +5
2. I am under 65 years of age, and I get little or
no daily exercise.
Yes +5
3. I am between 45 and 64 years old.
Yes +5
4. I am 65 years old or older.
Yes +9
5. I have given birth to a baby whose birth weight
exceeded nine pounds.
Yes +1
6. have a sister or brother with diabetes.
Yes +1
7. I have a parent with diabetes.
Yes +1
Total
If you scored nine or fewer points, your risk for
developing diabetes is currently low, but note that
risk rises with age. A total of 10 or more points indicates
that you are currently at high risk for having diabetes
or getting diabetes in the future. Be sure to schedule
a simple blood test for diabetes at your next physical
examination.
Adapted from the American Diabetes Association, 1995.
For further information, contact any of these organizations:
