Thursday, November 7, 2013

It's Diabetes Awareness Month!

I've been working hard on some educational tips for my co-workers to post everyday during the month of November (at least on the working days).  Since that took away from some blogging time, I figured that I should combine both!  Obviously I am starting on this blog about 7 days late, but I will try to make up for it!!  (And I will get to expand beyond the "tip" format that I am e-mailing co-workers).  So here we go.....

Day 1

What is diabetes?

Diabetes, or diabetes mellitus, is the name given to a group of diseases in which athe main symptom that a person has is high blood glucose (blood sugar).  The blood glucose becomes high either because the body does not make enough of the hormone insulin, or because the body’s cells do not respond properly to insulin, or both in some cases.   There are three types of diabetes:

Type 1:  In this form of diabetes the body does not produce insulin at all and people must take insulin to control the blood sugar and follow a carbohydrate-controlled diet.  People will Type 1 are usually diagnosed before their 40th year and usually present with the symptoms of weight loss, frequent urination, increased thirst, and increased hunger (Those last three are called polyuria, polydipsia, and polyphagia, for those of you who are interested).  This form of diabetes used to be called “insulin dependent diabetes,” “juvenile diabetes,” “or early-onset diabetes.”  These terms were discontinued because they are too confusing and not accurate, particularly since some people are diagnosed "as adults."  Type 1 diabetes only makes up about 5-10% of the cases of diabetes.
Type 2:   This is the most common form of diabetes (about 90% of cases) in the United States and this also makes up the bulk of SkepticRD's case load.   In this form of diabetes the cells in the body do not react to insulin (insulin resistance) or the body does not produce enough insulin, or some combination of both.    If caught early enough this form of diabetes can be treated with a carbohydrate controlled diet and exercise alone.  For those who are diagnosed “later” or who are unable to follow a carbohydrate controlled plan (for whatever reason), they may need to be treated with medications that help sensitize the body to insulin or help the body make more insulin.   Type 2 diabetes is progressive and many people do wind up having to take insulin to control blood glucose levels.
Gestational: This form of diabetes is used to describe elevated blood glucose levels in pregnancy when the woman’s body becomes resistant to insulin.  Some women are able to control this with a carbohydrate controlled diet alone and others may require insulin during that time.  This usually resolves after giving birth, but some women are more at risk for Type 2 diabetes in the future.
Other thoughts:
1) I have had a lot of people with Type 2 over the years tell me that they didn't think they had the "bad kind" of diabetes, particularly if they had not progressed to the point of taking insulin.  I had to follow up with a very frank discussion about how they are just as much at risk for complications (more about that in another post) as someone with Type 1.  And I had to restrain myself from giving a smart aleck answer about how I don't consider any chronic illnesses to be "good."
2) In future blog posts I will also talk more about what a carbohydrate controlled diet plan actually looks like.  I have to keep you all reading don't I?
3) I have worked with an older adult population for my 16 year career, so I don't have a lot of experience in this area, but do have a skeptic related story.  One of my pregnant co-workers was actually told how to "cheat" on her gestational diabetes screening test by someone at her OB/GYN office.  Basically this person told her to follow a carbohydrate controlled plan for two weeks before her test, then if the results were "fine" she could go ahead and start eating her desserts, etc again.  She was at least able to ask me about this and I was able to gently remind her that if she is eating in such a way to control her blood glucose levels BEFORE the test that she should continue to eat in such a way AFTER the test so that her developing fetus would be as less risk for excessive birth weight, pre-term birth, respiratory distress syndrome, etc.  She just delivered a third healthy child so we could all breathe a sigh of relief for now.
See you tomorrow for the next educational tip!

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