According to the American Diabetes Association, 25.8 million children and adults in the United States have diabetes. Approximately $116 billion are spent on direct medical costs, not to mention indirect costs such as disability and premature death. “Diabetes has far-reaching health implications, including heart disease, nerve damage, kidney failure, amputation, blindness and even death due to severe high or low blood glucose levels,” says Charlotte Hayes, MMSc, MS, RD, LD, CDE, senior director of programs and policy development at Open Hand Atlanta and Good Measure Meals.
These statistics may seem overwhelming, however every day specialists are working toward educating the public about this serious disease. The first step toward a healthier America is awareness. November is National Diabetes Month, and it’s important to get the facts about this metabolic disease that affects 8.3 percent of our nation’s population.
Diabetes mellitus (simply called diabetes) is a chronic disease that is associated with high blood glucose levels and the body’s inability to produce and/or make use of insulin. A person with diabetes has difficulty converting glucose (sugar) into energy, and his or her blood sugar levels are consistently higher than normal.
Most of the foods we consume break down into glucose, the body’s primary source of fuel. Once food is digested, the glucose moves into the bloodstream; the cells then use the glucose for energy. For glucose to successfully make its way into the cells, insulin must be present.
Insulin, a hormone produced by the pancreas, controls the glucose levels in the blood. After eating, a sufficient amount of insulin is released to regulate the glucose in the bloodstream. The blood sugar levels of a diabetic are too high because his or her body produces little to no insulin, or becomes resistant to the hormone altogether. While there is a buildup of glucose in the blood, the cells are not obtaining what they need for growth and energy.
There are three types of diabetes: type 1, type 2 and gestational. Type 1, formerly called juvenile onset diabetes, lasts a lifetime. According to the American Diabetes Association, only 5% of people with diabetes have this form of the disease. Type 2 is the most common form of diabetes and usually diagnosed after the age of 35. Gestational usually disappears after childbirth. It is essential to understand the fundamentals of all three forms, as symptoms and treatments may vary.
Type 1 Diabetes
Type 1 diabetes occurs when the body does not produce insulin and the immune system attacks the insulin-producing cells. Due to the absence of the insulin hormone, there is an excessive amount of glucose in the blood. The body’s cells are then deprived of the nutrients they need for energy and must depend on other systems to provide it. “Although onset of type 1 diabetes can occur at any age, it typically occurs before age 30,” Hayes says. The signs and symptoms can show up suddenly and may include: extreme thirst, frequent urination, unusual weight loss, blurred vision, dry mouth, fatigue and abdominal pain.
Factors and Treatment: Genetics and exposure to certain viruses have been attributed to type 1 diabetes; however, the exact cause is unknown. Treatment for type 1 diabetes is a lifelong endeavor. Maintaining a routine makes management of blood sugar levels easier and may include: insulin injections several times a day, the use of an insulin pump, regular exercise, continuous monitoring of blood sugar levels, a healthy diet (includes carbohydrate control), no smoking and abstaining from alcohol.
Type 2 Diabetes
Type 2 diabetes occurs when the body does not produce enough insulin or rejects the insulin completely.
“Insulin resistance occurs as people exceed a healthy body weight, or as people lose muscle mass with age and have more body fat, especially in the abdomen,” says Gay Williams, RN, BSN, CCM, CDE, manager of Saint Joseph’s Center for Diabetes Care.
Millions of Americans are diagnosed with type 2 diabetes every year-it is the most common form and accounts for 90 to 95 percent of cases in the United States. If left untreated, type 2 diabetes can be life threatening.
Unlike type 1 diabetes, which can come on quickly, the signs of type 2 diabetes can develop gradually. Some people have type 2 diabetes years before receiving an actual diagnosis. Consult your physician immediately if you are experiencing any of the following symptoms: extreme thirst, frequent urination, increased hunger, fatigue, high blood pressure, blurred vision, tingling/numbness in the hands and feet, recurring skin, gum or bladder infections, dry skin and slow-healing cuts and bruises.
Factors and Treatment: “Some factors that contribute to type 2 diabetes are an aging population, an ‘obesogenic’ environment that promotes easy access to high-calorie foods, and a lack of physical activity,” Hayes says. According to the Centers for Disease Control and Prevention (CDC), Americans are literally eating their way into a diabetes epidemic.
“When a person is obese or overweight, the body becomes less sensitive to insulin and sugars are not delivered to the cells that convert glucose to energy. Where a person carries the extra pounds is also important, as people who have increased fat around the waistline are at greater risk for obesity-related health problems than those with more weight on their thighs and hips,” says Patrice A. Harris, M.D., director of Fulton County Health Services.
Sarah Piper, a certified diabetes educator at the Diabetes Association of Atlanta, further comments on the association between diabetes and obesity in America: “The rise in type 2 diabetes in this country, and specifically in young people, is directly related to the increase in people being overweight and obese.”
Similar to type 1 diabetes, treatment of type 2 diabetes requires consistency and regular maintenance. Some examples are: meal planning and weight control, routine self-tests of blood sugar levels, regular exercise, thorough foot care (due to potential for infection), medications to regulate blood glucose levels and/or prevent complications.
Gestational diabetes occurs in pregnant women who have never been diagnosed with diabetes in the past, but who exhibit high blood glucose levels during their pregnancy. Testing for gestational diabetes takes place between week 24 and 28 of pregnancy. “Gestational diabetes usually goes away after a woman has given birth. However, a woman who has gestational diabetes is at a higher risk for developing type 2 diabetes in her lifetime,” says Piper.
The signs and symptoms of gestational diabetes are much like those of types 1 and 2 diabetes and may include increased thirst, extreme hunger, frequent urination and blurred vision. Because these symptoms are also common with pregnancy itself, do not be alarmed-a precise diagnosis will be made at the time of testing.
Factors and Treatment: Once again, the exact cause of gestational diabetes is unknown; nevertheless, studies suggest that hormones found in the placenta block the insulin produced in the mother’s body. “While this condition occurs in about four percent of all pregnancies, fasting blood sugar levels usually return to normal within a few weeks after childbirth,” Harris adds.
Treatment of gestational diabetes is similar to types 1 and 2 (i.e. healthy eating, regular physical activity, medications and self-testing), but also include close monitoring of the baby and breastfeeding after giving birth (to help with weight loss).
Pre-Diabetes and Prevention
Pre-diabetes serves as a precursor to type 2 diabetes and is marked by impaired glucose tolerance that has not yet risen to the level of type 2 diabetes. “Fifty-seven million people over age 20 have pre-diabetes in the United States. Complications normally associated with diabetes, such as heart disease, can develop even when a person has pre-diabetes,” Harris says.
As for diabetes prevention, it’s quite simple. Lose those extra pounds, maintain a healthy diet, eat plenty of fiber and whole grains, exercise regularly and go to the doctor for routine physical exams. “Studies have shown that a five percent reduction in body weight can reduce the chances of developing type 2 diabetes by 58 percent,” Harris adds.
There are many local resources and groups that are available to both support people with diabetes and educate people about this disease. “A person with any type of diabetes can live a long healthy life with the disease if it is treated appropriately with medication and lifestyle changes,” Piper says. “It is imperative that people with diabetes access a diabetes education program so that they can learn how to manage their diabetes and prevent or delay the life altering complications.”
The American Diabetes Association is one of the leading sources in the fight to stop diabetes. According to Chrystal Neely, director of the American Diabetes Association, “We are putting new educational programs in place to raise awareness of obesity in Georgia’s children with our Childhood Obesity Initiative. Diet and exercise are paramount in the prevention and management of type 2 diabetes. Our research shows that at the current rate, one in three children born after the year 2000 will be diagnosed with diabetes in his or her lifetime. The American Diabetes Association is working to change this future by taking action to stop diabetes.”
The American Diabetes Association, www.diabetes.org
Diabetes Association of Atlanta, Inc., (404) 527-7150, www.diabetesatlanta.org
Fulton County Health Services, (404) 612-4000, www.fultoncountyga.gov
Good Measure Meals, www.goodmeasuremeals.com
Open Hand Atlanta, (404) 872-6947, www.projectopenhand.org
Saint Joseph’s Center for Diabetes Care, (678) 843-7001, www.stjosephsatlanta.org
Sugar Medical Supply, (888) 522-2545, www.sugarmedicalsupply.com
Colorful Care for Diabetes
Atlanta native Carolyn Jäger was diagnosed with diabetes at the age of 13 and has been a type 1 diabetic for 23 years. Her sister Susan is also a type 1 diabetic and was diagnosed at age six. The idea for Sugar Medical Supply bags began with their mother, who created special diabetic supply bags for the girls to help them feel more stylish. Through the years, Jäger followed her mother’s lead and launched Sugar Medical Supply to bring style into the lives of people living with diabetes.
What was your inspiration behind creating Sugar
My inspiration is twofold. First, we hope to encourage more diabetics to test their blood glucose levels more often (prompting better disease control) by offering supply bags that carry all of their necessary daily supplies in one place. Diabetics have to carry a number of items such as syringes, glucose meters, lancets, testing supplies, log books, insulin, and even a snack with them every day. We wanted to create a bag that could carry everything! Second inspiration was the lack of color and style in the medical field. I felt if you have to carry your diabetic supplies everywhere you go, why not do it in a way that makes you happy and expresses your personality? Diabetics pretty much had one choice for supply bags before Sugar Medical Supply, just basic, boring black bags. We offer color and style. We hope to create a bond between diabetics and their supply bags and erase the negative, sterile bags of the past. The life of a diabetic can be colorful!
What has been some of the best feedback you’ve received?
Our best feedback was from Bernadette M., a type 1 diabetic for 36 years, who wrote to us saying, “I can’t believe no one else has done something so wonderful for diabetes care before this. I actually look forward for the first time in 32 years to pull out my pink supply bag and test each day!” We could not have gotten a better compliment.
What inspires you?
I am inspired by all the diabetics out there who, due to unfortunate circumstances or lack of education, have had to endure severe diabetic complications such as amputations, loss of eye sight, and neuropathy. I want to prevent complications for all diabetics by encouraging diabetics to test their blood glucose levels more frequently. This is the key to good health for a diabetic.
What are you passionate about?
I am passionate about making a difference in a diabetic’s life. If a diabetic now can carry all of their supplies and take better control of themselves, then I have accomplished something great. If providing a pretty pink diabetic supply bag to a newly diagnosed six-year-old little girl makes her feel better about the challenges ahead of her, I have accomplished something great. Diabetes is a tough disease that requires constant care, so if we can create a product that makes their day a bit easier or brighter, we have done something great!