Diabetes — Is it preventable?

By: Dr. Nancy Yoon, Springfield-Greene County Health

Diabetes is just one of several health conditions impacting the Springfield community right now, but its prevalence in our community exceeds state, regional, and national percentages. At 11%, diabetes is a public health concern in our community. Approximately 37 million U.S. adults currently have diabetes. It is estimated that 8.5 million people, or 23% of adults with diabetes are undiagnosed.

But what exactly is diabetes?

Diabetes, which is the seventh leading cause of death in the United States, is a chronic health condition that affects how your body turns food into energy. When we eat food containing carbohydrates, our body breaks it down into sugar (glucose) which is then released into the bloodstream (in blood vessels). The pancreas (an organ in the abdomen) responds by releasing insulin, and blood sugar levels remain within a normal range.

Insulin is a vital hormone that regulates blood sugar levels in the body. It can be thought of as a “key” that unlocks the cell’s glucose channels. This allows blood sugar to enter the body’s cells for use as energy. Insulin also signals the liver to store blood sugar for later use. If a person’s body doesn’t make enough insulin, or if the body is resistant to the effects of insulin, blood sugar does not enter the body’s cells properly. This leads to high glucose levels in the bloodstream (hyperglycemia). This can lead to serious health problems over time like heart disease, vision loss, nerve damage, kidney disease and premature death.

Symptoms of high blood sugars include feeling very thirsty, needing to urinate often, losing weight without trying, having blurry vision, slow healing of wounds and sores, and having more infections than usual. Some of these may mimic symptoms of other health conditions. If you are wondering if your blood sugar may be high, or have a family history of diabetes, talk to your healthcare provider about getting your blood sugar tested. This can be done with a simple blood test. According to the American Diabetes Association, all patients should be screened for diabetes at three-year intervals beginning at age 45, especially in people who are overweight or obese.

There are three main types of diabetes: Type 1, type 2, and gestational diabetes (diabetes while pregnant).

Type 1:

In type 1 diabetes, your pancreas does not make insulin. This causes blood sugar levels to increase to abnormally high levels. Only about 5–10% of people have type 1 diabetes. Type 1 typically develops in children, teens, and young adults and was once called juvenile diabetes. However, people of all ages can develop type 1 diabetes.

This is because type 1 diabetes is thought to be caused by an autoimmune reaction, meaning the body attacks itself and destroys the beta cells in the pancreas, which make insulin. Other triggers to developing type 1 diabetes include certain genes (traits passed on from parent to child) that may make someone more likely to develop it. Sometimes environmental triggers, like a virus, may also lead to developing type 1 diabetes. Diet and lifestyle habits do not cause type 1 diabetes. There is currently no cure for type 1 diabetes and there are no known ways to prevent it. People with type 1 diabetes manage their blood sugars with daily insulin injections, or they can also use an insulin pump.

Type 2:

About 90–95% of people living with diabetes have type 2 diabetes. Unlike type 1, type 2 typically develops in people ages 45 and up, but younger people are starting to develop it including children and teens.

In type 2 diabetes, the cells in your body become resistant to the effects of the body’s insulin. Eventually the pancreas is not able to make enough insulin, which leads to high blood sugars.

In prediabetes, your blood sugar is above normal levels but isn’t quite high enough to be diagnosed as type 2 diabetes. There are more Americans living with prediabetes than actual diabetes — approximately 96 million, according to the CDC. What is even more staggering is that about 80% of those living with the condition don’t even know they have it.

While there may not be any symptoms when a person has prediabetes, here are a few factors that may increase your risk for type 2 diabetes:

· Being overweight or obese

· Having a parent, brother, or sister with type 2 diabetes

· Ever having gestational diabetes or given birth to a baby who weighed over 9 pounds

· Engaging in physical activity less than 3 times a week

· Being over the age of 45

· Having polycystic ovary syndrome

· Some African-American, Hispanic or Latino, American Indian, Alaska Native, Pacific Islanders and Asian Americans are also at higher risk

Type 2 diabetes, unlike type 1 diabetes, can be prevented or delayed. Additionally, while it cannot be cured, a person’s glucose levels can return to a non-diabetes range (complete remission) or pre-diabetes glucose level (partial remission). This can happen with steps such as losing weight, eating healthier food, and being physically active. If these are not enough to regulate your blood sugars, your healthcare provider may prescribe oral or injectable diabetes medications to help you manage your blood sugars.

Gestational Diabetes

Gestational Diabetes is not talked about as often as type 1 and type 2 diabetes, but it impacts more people than you think. The CDC estimates that about 2–10% of pregnancies in the United States are affected by gestational diabetes.

Gestational diabetes is when a pregnant individual develops high blood sugars, putting themselves and their baby at risk for health problems during the pregnancy and delivery. There are often no symptoms of gestational diabetes, or they may overlap with symptoms from the pregnancy itself (e.g. fatigue, frequent urination, or feeling thirsty). All pregnant individuals should be tested for gestational diabetes between 24–28 weeks of pregnancy. Once gestational diabetes is diagnosed, it can often be managed by checking blood sugars and following a diabetic diet.

Gestational diabetes can put you and your baby at a higher risk of developing type 2 diabetes. About 50% of women who have gestational diabetes develop type 2 diabetes after giving birth. Before you get pregnant, you may be able to prevent gestational diabetes with lifestyle changes. These include losing weight if you’re overweight, eating a healthy diet, and getting regular physical activity.

All types of diabetes can be successfully treated by checking your blood sugars regularly, taking medications, getting regular health checkups, and following your healthcare providers’ recommendations for living a healthy lifestyle. Regulating blood sugars in people with diabetes is very important to reduce the risk of complications such as vision loss, heart disease, and kidney disease. Speaking with diabetes educators and other people living with diabetes is also helpful for getting support.

It’s time to put a greater focus on diabetes prevalence in the Springfield community. When people are aware that they have prediabetes or diabetes, they can take positive steps to manage their condition, and live long, healthy and fulfilling lives. Please continue to check in with Springfield-Greene County Health to learn more about diabetes in our community.

To learn more about diabetes, visit https://www.cdc.gov/diabetes/prevent-type-2/guide-prevent-type2-diabetes.html.

To learn more about diabetes in Spanish, please click here. https://www.cdc.gov/diabetes/spanish/index.html

The American Diabetes Association (www.diabetes.org) has additional information and resources for patients.

Sources

CDC.gov

www.joslin.org

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