The Dreaded “D-Word” Diabetes: What Is It? How Does One Get It?

Diabetes Series: Part 1 of 2

By Lori S. Brizee, MS, RD, LD, CSP

Diabetes Mellitus is defined by the presence of high blood glucose levels, or “hyperglycemia.” It can be due to decreased insulin production, decreased insulin action or a combination of both. Diabetes is increasing in our population as we become more overweight. Approximately 24 million people in the United States have diabetes—that’s 7.8% of the entire U.S. population. Approximately 25.9% of all adults over 20 years old and >7% of adolescents have pre-diabetes (existing conditions that can easily lead to diabetes). Diabetes is a major cause of heart disease, blindness and kidney failure. Early diagnosis and treatment, especially if it is in the ‘pre-diabetes’ stage, can prevent or decrease many of these problems.  Diabetes is diagnosed when:

• Blood glucose is >200 (any time, fasting or after eating)
• Fasting blood glucose is > 126 mg/dL
• Blood glucose is >200 two hours after glucose is given during an “oral glucose tolerance test.”

Additional tests can be done to determine the ‘type’ of diabetes, if there is any question. What are the types of diabetes, you ask? 

Diabetes Classifications

Prediabetes is diagnosed when blood glucose is between normal and diabetic levels. It is characterized by impaired glucose tolerance—when glucose levels are high after eating, and/or by impaired fasting glucose, or when glucose levels are high after fasting overnight. With lifestyle changes, including increased physical activity and weight loss, pre-diabetes can often be reversed and Type 2 diabetes prevented or delayed.

Type 1 Diabetes is an autoimmune disorder that causes destruction of beta cells (which produce insulin) in the pancreas. This results in an insulin deficiency and requires treatment with insulin. It is typically triggered by a viral infection or some other “stressor;” this type is not caused by obesity or diet. Only 5 to 10 % of people with diabetes have Type 1. It has a genetic component and first degree relatives can be tested to see if they are at risk. Symptoms that might indicate diabetes include the following (a simple blood test can rule out diabetes):

• Polyuria (excessive urine output)
• Polydypsia (excessive thirst)
• Polyphagia (excessive hunger)

Type 2 Diabetes is characterized by insulin resistance—insulin levels are normal or even high, but the body is inefficient in using it. Insulin resistance typically starts long before hyperglycemia occurs; the pancreas just keeps putting out more and more insulin to maintain normal blood glucose levels. Once the pancreas can no longer produce enough insulin to compensate for insulin resistance, blood glucose levels rise, resulting in diabetes. Type 2 diabetes accounts for 90 to 95% of all diabetes in the United States. Type 2 diabetes runs in families; the child of a Type 2 diabetic has a 15% chance of developing diabetes and a 30% chance of developing impaired glucose tolerance. A few of the major risk factors for Type 2 diabetes are:

• Overweight: body mass index >25
• Age: >45 years
• Family history of diabetes (parents, siblings)
• Physical inactivity
• Race/ethnicity (i.e., African-American, Latino, Native American, Asian-American, Pacific Island ethnicities are more prone to diabetes)

Gestational Diabetes is diagnosed when glucose intolerance first occurs during pregnancy. Women with gestational diabetes have a 20% to 50% chance of developing Type 2 Diabetes within the next 5 to 10 years.
Next month we will discuss prevention and treatment of diabetes, till then, learn more about diabetes from the Center for Disease Control.

Information for this article is from; Ross, Diabetes Care and Education Practice Group, Tamia A; Boucher, Jackie L; and O’Connell Belinda S., editors.  American Dietetic Association Guide to Diabetes Medical Nutrition Therapy and Education. American Dietetic Association, 2005 

Diabetes Series: Part 2 >>

Comments

[The Campfire Blog]

The second part of this series, "The Dreaded D-Word," is up!
http://blog.playoutdoors.com/2009/08/dreaded-diabetes-2.html

[The Campfire Blog]

@Armando Thank you for the comment and check back to read the second part of this series within the next few weeks!

[Armando]

Great information. Thanks for sharing it to the community.
Best Regards.