What Is Diabetes
1. What is diabetes?Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.
2.What are the symptoms of diabetes? People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following symptoms: Frequent urination Excessive thirst Unexplained weight loss Extreme hunger Sudden vision changes Tingling or numbness in hands or feet Feeling very tired much of the time Very dry skin Sores that are slow to heal More infections than usual. Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.
3. What are the types and risk factors of diabetes? The following types
of diabetes and some of their risk factors are quoted from the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US Department of Health and Human Services, 1997): Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes. Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes. Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly 40% of women with a history of gestational diabetes developed diabetes in the future. Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of diabetes.
4. What is the treatment for diabetes? Management strategies should be planned along with a qualified health care team. The following information on treatments for diabetes is from the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US Department of Health and Human Services, 1997): Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues. Treatment of type 1 diabetes: Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to control. Treatment requires a strict regimen that typically includes a carefully calculated diet, planned physical activity, home blood glucose testing several times a day, and multiple daily insulin injections. Treatment of type 2 diabetes: Treatment typically includes diet control, exercise, home blood glucose testing, and in some cases, oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require insulin injections.
5. What causes type 1 diabetes? The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for development of both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.
6. Can diabetes be prevented? A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. It also appears to be associated with obesity. Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes, but prevention, as well as a cure, remains elusive.
7. Is there a cure for diabetes? In response to the growing health burden of diabetes mellitus (diabetes), the diabetes community has three choices: prevent diabetes; cure diabetes; and take better care of people with diabetes to prevent devastating complications. All three approaches are actively being pursued by the US Department of Health and Human Services. Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on being sure that the proven science is put into daily practice for people with diabetes. The basic idea is that if all the important research and science are not made meaningful in the daily lives of people with diabetes, then the research is, in essence, wasted. Several approaches to "cure" diabetes are being pursued: Pancreas transplantation Islet cell transplantation (islet cells produce insulin) Artificial pancreas development Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with type 1 diabetes). Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas
8. What are some other sources for information on
The following organizations may help in your search for more
information on diabetes: Federal Government Organizations
Department of Veterans Affairs Internet Health Resources and
Services Administration Internet Indian Health Service Diabetes
Program 5300 Homestead Road NE, Albuquerque, NM 87110 505/248-4182
Internet National Diabetes Education Program Interne The NDEP is a new nationwide initiative of the Centers for
Disease Control and Prevention (CDC) and the National Institutes of
Health (NIH). It is an inclusive, partnership-based program
involving many diverse public and private sector partner
organizations. The goal of the program is to reduce the morbidity
and mortality of diabetes and its complications. CDC contact: Faye
L. Wong, MPH, RD, Associate Director for Diabetes Education,
770-488-5037 (phone); 770-488-5966 (fax); email@example.com (e-mail). NIH
contact: Joanne Gallivan, MS, RD, Director, Diabetes Outreach
Program, 301- 496-6110 (phone); 301-496-7422 (fax);
firstname.lastname@example.org (e-mail). National Institute of Diabetes
and Digestive and Kidney Diseases 1 Information Way, Bethesda, MD
20892-3560 800/GET LEVEL (800/438-5383) or 301/654-3327 Internet
National Eye Institute (NEI) Bldg. 31, Room 6A32 31 Center
Drive, MSC 2510 Bethesda, MD 20892-2510 301/496-5248 or 800/869-2020
(to order materials) 301/402-1065 (fax) Internethttp://www.nei.nih.gov
Educating People with Diabetes Kit (Sponsored by the National Eye
Institute) 2020 Vision Place, Bethesda, MD 20892 Internet Office of Minority Health Resource Center US Department of
Health and Human Services P.O. Box 37337, Washington, DC 20013-7337
800/444-MHRC (444-6472) Internet Non-Federal Government Organizations Links to non-Federal
organizations are provided solely as a service to our users. These
links do not constitute an endorsement of these organizations or
their programs by CDC or the Federal Government, and none should be
inferred. The CDC is not responsible for the content of the
individual organization Web pages found at these links. American
Association of Diabetes Educators 100 West Monroe, 4th Floor,
Chicago, IL 60603-1901 800/338-3633 for names of diabetes educators
312/424-2426 to order publications Internet
American Diabetes Association 1660 Duke Street, Alexandria VA
22314 800/232-3472 or 703/549-1500 800/ADA-ORDER to order
publications toll free ADA's D.I.A.L. Program (Diabetes Information
and Action Line) 800/342-2383 or 800/DIABETES for diabetes
American Dietetic Association National Center for Nutrition and
Dietetics 216 West Jackson Boulevard, Suite 800, Chicago, IL
60606-6995 800-366-1655 Consumer Nutrition Hotline (Spanish speaker
available) 800-745-0775 Internet
American Heart Association National Center 7272 Greenville Avenue,
Dallas, TX 75231 214/373-6300 Internet
American OptometricAssociation 1505 Prince Street, Alexandria, VA 22314 800/262-3947 or 703/739-9200 Internet http://www.aoanet.org/ International Diabetic Athletes Association 1647-B West Bethany Home Road, Phoenix, AZ 85015 800/898-IDAA or 602/433-2113 602/433-9331 (fax) email@example.com (e-mail) Juvenile Diabetes Foundation International The Diabetes Research Foundation 120 Wall Street, 19th Floor, New York, NY 10005-4001 800/JDF-CURE or 800/223-1138 212/785-9595 (fax) Medical Eye Care for the Nation's Disadvantaged Senior Citizens The Foundation of the American Academy of Ophthalmology P.O. Box 429098, San Francisco, CA 94142-9098 800/222-EYES (222-3937) National Diabetes Information Clearinghouse 1 Information Way, Bethesda MD 20892-3560 301/654-3327 (phone); 301/907-8906 (fax) firstname.lastname@example.org (e-mail) Internet Centers for Disease Control and Prevention web site at http://www.cdc.gov/health/diabetes.htm
The Diabetic and The Feet
People with diabetes face a greater than average odds of losing a toe, foot, ankle or leg because of two conditions that may result in serious damage to the feet and legs.
Foot problems may slow down and inconvenience everyone at some point in time, but, for the diabetic patient, foot-related problems are the number one cause of hospital admissions. In the United States, diabetes is the most frequent cause of non-trauma-related lower-limb amputations.
Dr. Charles M. Clark Jr., co-chair of the National Diabetes Education Program, said, “The real tragedy is that almost half of the diabetes-related amputations that occur each year could be prevented.
People with diabetes face a greater than average odds of losing a toe, foot, ankle or leg because of two conditions that may result in serious damage to the feet and legs: Peripheral vascular disease (PVD).Patients with PVC have fatty deposits, which have formed over time. These deposits harden the blood vessels, resulting in lost of blood flow delivered to the legs and feet. This decreased amount of blood flow and circulation to the lower limbs makes it difficult for sores or infections to heal.
What are some of the leg/feet symptoms associated with diabetes?
Diabetic neuropathy.This condition occurs when the nerves in the hands and feet become damaged and lose feeling sensation or become numb. This damaged condition increases the risk of infection by simple ailments such as a blister caused by poorly fitting shoes or a sore that develops from dry skin.
A burning sensation in the toes, later progressing to numbness.
What Diabetic Patients Should Ask Their Health-Care Provider
Ask your health care provider to check each foot at least once a year for color, temperature, toe-hair and skin texture. One piece of equipment that may be used for testing is a piece of flexible plastic fiber. This thin piece of plastic is pressed on several foot spots to see if its touch can be felt. There is no pain involved in this test.
Respect Your Feet
Proper foot care is vital for everyone, especially those who have diabetes. The best way to avoid problems is to monitor and control blood sugar levels, by exercise, diet and medications. Exercise increases circulation and stimulates the blood flow to the legs and feet. Be observant to avoid foot problems by paying close attention to both legs and feet and they will take you far.
Wash feet with warm (not hot) water and mild soap daily. Test the water temperature with your wrist before putting feet into the water. Inspect between each toe and around the each nail for any redness, cuts, cracking, or peeling. Look at the bottom of each foot for any breaks in the skin, splinters, sores, blisters, or calluses. At the first sign of redness or infection, call your health-care providers for help. Dry each foot gently with a soft towel.
Apply a lotion or moisturizer, like plain petroleum jelly, to only the top and bottom of each foot to keep the skin soft and prevent cracking and drying. Do not use lotion or moisturizer between the toes: the extra moisture can promote infection. For feet that sweat a lot, use a dusting of talcum powder to keep dry.
Wear clean, dry socks and enclosed shoes that are sturdy and comfortable. Don’t go barefoot, even indoors. Check the inside of each shoe for any rough spots or objects that may have fallen inside. The toes should not rub or be squeezed. Do not wear new shoes for more than 1-2 hours at a time to avoid blisters.
Cut and file toenails straight across to avoid ingrown toenails. The side corners can be rounded and smoothed with a nail file so the next toe will not be scratched.
Avoid putting strong chemicals or acids that can destroy sensitive tissue on your feet,such as Epsom salts, iodine, and corn removers. Do not do “bathroom surgery,” such as trimming corns or calluses.
Remove your shoes and socks at each doctor’s visit so your feet are ready to be checked.
When sitting, keep the blood flowing to feet and legs by propping feet up and frequently moving toes and ankles for a few minutes.
Managing diabetes and improving foot care can seem overwhelming, especially at first. GO slow; take small steps to prevent amputations, but START.
To order your free copy of the “Take Care of Your Feet for a Lifetime” booklet call the National Diabetes Education Program at 1-800-438-5383 or http://ndep.nih.gov.
Do you know what causes the most blindness in U.S. adults?
It is an eye problem caused by diabetes, called diabetic retinopathy. Your retina is the light-sensitive tissue at the back of your eye. You need a healthy retina to see clearly.
Diabetic retinopathy happens when diabetes damages the tiny blood vessels inside your retina. You may not notice at first. Symptoms can include
If you have diabetes, you should have a complete eye exam every year. Finding and treating problems early may save your vision. Treatment often includes laser treatment or surgery.
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