Practical Practitioner
By: Pamela Egan, FNP-C CDE
Diabetes remains a serious, growing health threat
In honor of National Diabetes Month, I thought it appropriate to address the growing number of newly diagnosed diabetics in our country.
New data from the U.S. Department of Health and Human Services shows that the number of Americans with diabetes continues to escalate.
Clearly, diabetes remains a serious and growing health threat. We are fighting this terrible disease by promoting better lifestyle choices and increasing awareness among all Americans.
An estimated 13 million Americans have been diagnosed with this disease, and about 5.2 million additional Americans have the disease but have not been diagnosed.
Diabetes is classified into two types. In Type 1 diabetes, formerly called insulin-dependent diabetes mellitus and juvenile-onset diabetes, the body does not produce insulin or produces it only in very small quantities. Symptoms usually appear suddenly, typically in individuals under 20 years of age.
Most cases occur around puberty. In the United States, Type 1 diabetes accounts for 5 to 10 percent of all diabetes cases.
Type 1 diabetes is considered an autoimmune disease because the immune system attacks and destroys insulin-producing cells, known as beta cells, in the pancreas.
In Type 2 Diabetes, formerly known as non-insulin dependent diabetes mellitus and adult-onset diabetes, the body’s delicate balance between insulin production and the ability of cells to use insulin goes amiss. Of the nearly 18.2 million people in the United States with diabetes, 90 to 95 percent have Type 2 Diabetes.
The onset of Type 2 Diabetes usually occurs after the age of 45, although the incidence of the disease in younger people is growing rapidly.
Because symptoms develop slowly, individuals with the disease may not immediately recognize that they are sick. A number of genes work together to cause Type 2 Diabetes. In addition, scientists believe that there is a strong relationship between obesity and Type 2 diabetes. About 80 percent of diabetics with this form of the disease are significantly overweight.
If left untreated, diabetes mellitus may cause life-threatening complications. Type 1 diabetes can result in diabetic coma (a state of unconsciousness caused by extremely high levels of glucose in the blood) or death. In both Type 1 and Type 2 diabetes, complications may include blindness, kidney failure and heart disease.
Diabetes can cause tiny blood vessels to become blocked. When this occurs in blood vessels of the eye, it can result in retinopathy (the breakdown of the lining at the back of the eye), causing blindness. When diabetes affects the kidney it is called nephropathy (the inability of the kidney to properly filter body toxins). About 40 percent of new cases of end-stage renal disease (kidney failure) are caused by diabetes mellitus. Blockages of large blood vessels in diabetics can lead to many cardiovascular problems, including high blood pressure, heart attack, and stroke.
Diabetes mellitus may also cause loss of feeling, particularly in the lower legs.
This numbness may prevent a person from feeling the pain or irritation of a break in the skin or of foot infection until after complications have developed, possibly necessitating amputation of the foot or leg.
Burning pain, sensitivity to touch, and coldness of the foot, conditions collectively known as neuropathy, can also occur.
Other complications include higher-risk pregnancies in diabetic women and a greater occurrence of dental disease.
This article was originally published December 1, 2003 in The St. Tammany News.
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