Baltimore Sun, May 2004
As one grows older, there are a host of common side effects as your body ages. Many mature adults experience fatigue, frequent urination, hunger, dehydration, sexual dysfunction and vision issues. Since these conditions are commonplace with your peers, it’s easy to dismiss them and say, “I guess I’m just getting older and slowing down a bit.” However, ignoring these conditions — as most Americans do — can be harmful because for some adults, these conditions are not just another downfall of aging; they may be symptoms of a common, yet serious disease — Type 2 diabetes.
“One third of the population who has diabetes doesn’t know that they have it,” says Paula Yutzy, RN, BSPA, CDE, director of diabetes education at The Diabetes Center at Mercy Medical Center. “There are few symptoms with this type of diabetes, and many are easy to dismiss by middle-age adults because they are common signs of aging. Men, for example, tend to experience frequent urination at night due to prostate issues; however, that could be a sign of diabetes.
Yutzy, whose son has Type 1 diabetes, says that the national average for Type 2 diabetes is rising, and Maryland ranks above the national average. According to a 2002 study by the American Diabetes Association (ADA), 18.2 million Americans have diabetes, representing over 6 percent of the total population. Yutzy says that including the perceived undiagnosed Marylanders with diabetes, the state’s rate is closer to 12 percent.
Through the digestive process, carbohydrates we consume are broken down into a simple sugar called glucose. In order for glucose to be used for energy, the pancreas produces a hormone called insulin. In diabetes, however, the pancreas produces insufficient insulin, and in Type 2 diabetes, the body experiences insulin resistance. Approximately 90 to 95 percent of all diabetes cases in the United States are Type 2 diabetes, and a growing number of children are being diagnosed with Type 2 diabetes, instead of Type 1, which traditionally has affected most children with diabetes.
Since the risk of developing diabetes increases with age, the ADA recommends that all adults have routine diabetes screening beginning at age 45, or younger if they are in a high-risk category. Yutzy says that a simple blood test performed by you family doctor can detect diabetes. She says that results can be found in 15 minutes if your doctor has the necessary equipment. If not, samples can be sent to a lab and usually results are found within 24 hours. Yutzy notes that if the doctor performs a fasting plasma glucose test (FPG), a fasting blood glucose level between 100 and 125 milligrams per deciliter (mg/dl) signals pre-diabetes, while levels above 126 mg/dl signals diabetes.
If a patient is diagnosed with Type 2 diabetes, he or she is typically sent to a certified diabetes educator to learn more about the disease. A certified diabetes education dietician is utilized to develop a diet plan based on individual likes and dislikes. “Lifestyle changes are the hardest ones to make,” says Yutzy. “You cannot make a complete change in eating habits overnight; you have to learn how to make better choices.”
“Eating less and exercising more may sound simple, but it’s especially important to those with diabetes,” says Sinai Hospital’s Naomi Walpert, RN, MS, CDE. Walpert, who has spent more than 35 years at Sinai and the last 19 years in the field of endocrinology, says that exercise does not have to entail going to a gym and lifting weights. “A 30-minute walk each day will help tremendously.”
In addition to lifestyle changes, those diagnosed with diabetes must monitor their blood glucose levels, and many will need pharmacological help. Oral medications, with or without insulin injections, are methods to fight Type 2 diabetes. Of course, those with diabetes should have regular checkups with a doctor experienced in treating Type 2 diabetes.
Properly managing diabetes is especially important due to its link to other serious diseases. According to the National Diabetes Education Program, a joint program of the National Institutes of Health and the Centers for Disease and Prevention, cardiovascular disease is a major complication and the leading cause of premature death among people with diabetes — at least 65 percent of people with diabetes die from heart disease or stroke. Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes. Of course, not smoking, eating a low-fat diet, exercising regularly and maintaining proper blood pressure and cholesterol levels helps, too.
Other complications linked to diabetes include eye disorders, nervous system disorders and kidney disorders.
Unfortunately, some risk factors for diabetes cannot be controlled. Some ethnic groups — including African-Americans, Latin-Americans, American Indians, Asian-Americans and Pacific Islanders are particularly at risk for diabetes.
“African-Americans are more prone to develop Type 2 diabetes than whites, and American Indians have a very high rate, especially the Pima Indians, a group with a 50 percent rate of having diabetes,” says Walpert. Walpert says that many experts subscribe to the “thrifty gene” theory, which suggests that a change in lifestyle to a more sedentary one is a cause for the high rate of American Indians with diabetes.
“African-Americans and American Indians have a high insulin resistance tendency,” adds Yutzy. “Type 2 diabetes is a genetic disease, which can be compounded by lifestyle choices.”
The National Diabetes Education Program suggests that for those in a high-risk ethnic group, those with diabetes in their family or those who need to lose weight should aim to increase activity by 150 minutes per week and decrease body weight by 7 percent. These acts could decrease your risk of diabetes by 50 percent.
For more information on diabetes, including prevention methods, symptoms and treatment options, check out www.diabetes.org and www.ndep.nih.gov.