About Diabetes

Alice Saracho asked:


It can send a chill up anyone’s spine being informed by your physician that you have borderline diabetes. This is a disease that can literally alter your life. But, each year, hundreds of thousands of Americans are being told just that as the number of diabetes cases continually rises. Currently, there are over 18 million known case of diabetes in the U.S. that have diabetes. It’s estimated that there’s approximately 6 million more people that have diabetes and don’t know it. And it remains a serious health problem costing patients billions of dollars in health care every year.

What exactly is borderline diabetes? Sometimes called pre-diabetes, it’s a condition where a person has glucose levels between normal levels and levels that would identify them as diabetic. The reason that many people don’t know they have the condition is that it’s relatively free of symptoms. In a person without diabetes, the body will produce insulin to help the cells break down food into energy. In diabetics and pre-diabetics, however, either the body is unable to create insulin or it is unable to utilize the insulin. This is one reason why people with borderline diabetes tend to be tired much of the time. They are eating, but their body is unable to break down the food into usable energy.

Many doctors have stopped using the term borderline diabetes to describe this condition as, in their minds, a person who exhibits the symptoms of pre-diabetes is, in truth diabetic. and they see no real medical reason to obfuscate the diagnosis. They also feel that telling a person that he or she has borderline diabetes will cause the person to not take the diagnosis seriously - since it is only borderline. Others feel that the condition of these patients is more accurately described as insulin resistant or impaired glucose tolerance. Other doctors, however, still use the term and find it useful to keep the distinction between pre-diabetes and diabetes.

For medical care physicians that continue to use the term, borderline diabetes is diagnosed when a person’s glucose level, as determined by glucose tests, fall between 100 to 125 milligrams per deciliter.

Unfortunately, in most cases, a person who has borderline diabetes will see the disease progress to diabetes. In some cases, however, with a change of eating habits and other healthy lifestyle changes, the disease will be reversed.

Many health experts believe that pre-diabetes is a preventable disease. Studies have shown a distinct correlation between the increase in the amount of fast foods that we eat and the new incidences of type II diabetes. Likewise, there is a correlation between our increasingly sedentary lifestyles with increases in the number of people diagnosed with diabetics. Making the defeat of diabetes even more urgent is that a person with pre-diabetes or diabetes is at greater risk for a host of other diseases including heart disease, stroke, liver disease, and more.

Luckily, researchers have begun to identify and catalog the many risk factors that predispose one towards developing diabetes. Hopefully, in the near future, diabetes will be looked upon as a long forgotten disease of the past.



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Master Copy asked:


Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in diabetes treatment.

Today, healthy eating, physical activity, and taking insulin are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose checking. People with diabetes also monitor blood glucose levels several times a year with a laboratory test called the A1C. Results of the A1C test reflect average blood glucose over a 2- to 3-month period.

Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.

Adults with diabetes are at high risk for cardiovascular disease (CVD). In fact, at least 65 percent of those with diabetes die from heart disease or stroke. Managing diabetes is more than keeping blood glucose levels under control–it is also important to manage blood pressure and cholesterol levels through healthy eating, physical activity, and use of medications (if needed). By doing so, those with diabetes can lower their risk. Aspirin therapy, if recommended by the health care team, and smoking cessation can also help lower risk.

People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too low or too high. When blood glucose levels drop too low–a condition known as hypoglycemia–a person can become nervous, shaky, and confused. Judgment can be impaired, and if blood glucose falls too low, fainting can occur.

A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia.

People with diabetes should see a health care provider who will help them learn to manage their diabetes and who will monitor their diabetes control. Most people with diabetes get care from primary care physicians–internists, family practice doctors, or pediatricians. Often, having a team of providers can improve diabetes care. A team can include:



a primary care provider such as an internist, a family practice doctor, or a pediatrician



an endocrinologist (a specialist in diabetes care)



a dietitian, a nurse, and other health care providers who are certified diabetes educators–experts in providing information about managing diabetes



a podiatrist (for foot care)



an ophthalmologist or an optometrist (for eye care)



and other health care providers, such as cardiologists and other specialists. In addition, the team for a pregnant woman with type 1, type 2, or gestational diabetes should include an obstetrician who specializes in caring for women with diabetes. The team can also include a pediatrician or a neonatologist with experience taking care of babies born to women with diabetes.

The goal of diabetes management is to keep levels of blood glucose, blood pressure, and cholesterol as close to the normal range as safely possible. A major study, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood glucose levels close to normal reduces the risk of developing major complications of type 1 diabetes.

This 10-year study, completed in 1993, included 1,441 people with type 1 diabetes. The study compared the effect of two treatment approaches–intensive management and standard management–on the development and progression of eye, kidney, nerve, and cardiovascular complications of diabetes. Intensive treatment aimed to keep A1C levels as close to normal (6 percent) as possible. Researchers found that study participants who maintained lower levels of blood glucose through intensive management had significantly lower rates of these complications. More recently, a follow-up study of DCCT participants showed that the ability of intensive control to lower the complications of diabetes has persisted more than 10 years after the trial ended.

The United Kingdom Prospective Diabetes Study, a European study completed in 1998, showed that intensive control of blood glucose and blood pressure reduced the risk of blindness, kidney disease, stroke, and heart attack in people with type 2 diabetes.



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