Diabetes, a disease which alters the body’s capability to utilize glucose effectively, plays a significant role in the deaths of more than 200,000 Americans each year, six times the number in 1950. Diabetes is the fifth deadliest disease in the United States, and it has no cure. The total annual economic cost of diabetes in 2002 was estimated to be $132 billion, or one out of every 10 health care dollars spent in the United States. Increased risks of stroke and heart disease are associated with diabetes. “These life-threatening consequences strike people with diabetes more than twice as often as they do others” (American Diabetes Association, 2006). Further complications associated with diabetes include kidney disease, blindness, and the threat of amputations. This health concern currently affects about 16 million people in the United States with an estimated five million of those unaware of their condition. These numbers increase every year along with the rising costs associated with health care provisions.
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A primary factor in diabetes is the level of insulin present in the body. Insulin is a chemical the body produces naturally to mange the induction of glucose into the system. When the body produces too little amounts of insulin, greater amounts of glucose are allowed to enter the bloodstream thereby causing the symptoms of the disease called diabetes. Glucose, a simple sugar, enters the body by way of ingested food and into every red blood cell via the bloodstream; the cells then break down the glucose which acts to supply energy throughout the body. Brain cells, as well as other organs, are fueled by glucose alone. In diabetics, the body does not keep a stable amount of glucose in the cells. This means the body has more than the necessary glucose levels immediately after a meal but too little otherwise. To maintain a constant blood-glucose level, the healthy body produces glucagon and insulin, two hormones originating from the pancreas. Typically, there is balance of these hormones in the bloodstream with the insulin acting to prevent the concentration of blood-glucose from increasing disproportionately.
There are generally two types of diabetes that have been identified, differing primarily in the onset and cause and referred to as Type One and Type Two diabetes. Type One Diabetes, or juvenile diabetes, is caused by the body’s inability to produce insulin. Occurring primarily in children, this type is occurs afflicts less than 10 percent of all diabetics. The immune system, the environment and genetics are factors that influence Type One diabetes but the risk factors are more clearly defined for Type Two diabetes. These include obesity, physical inactivity, elderly people, family history of diabetes, a past history of gestational diabetes and those with a weakened tolerance for glucose. Ethnicity is another risk factor. “African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for Type Two diabetes” (American Diabetes Association, 2006).
Diabetics display numerous symptoms including “excessive thirst (polydipsia), frequent urination (polyuria), extreme hunger or constant eating (polyphagia), unexplained weight loss, presence of glucose in the urine (glycosuria), tiredness or fatigue, changes in vision, numbness or tingling in the extremities (hands, feet), slow-healing wounds or sores and abnormally high frequency of infection” (Freudenrich, 2002). These various symptoms are common to both forms of diabetes. However, patients are not necessarily subject to all of the signs mentioned.
A Type One diabetes patient’s diet should include about 16 calories per pound of their individual body weight per day or about 35 calories per kg of body weight. Those diabetics who are overweight when they begin the nutritional program may require more initial calories until their weight drops to a more normal level. The reasoning is that too rapid of a weight loss can be very unhealthy and it takes additional calorie intake to sustain a larger body frame. Gender plays a role in a proper program as males generally possess a greater muscle mass than females and consequently may require a higher intake of calories. Because muscle uses up more calories per hour than does fat, people who are not physically active will have less need for calorie intake, a good reason for everyone, and especially those with diabetes, to exercise regularly and build-up muscle mass. In other words, if you like to eat, supplement it with proportional amounts of exercise. There are different theories regarding the most effective diet but the fact that diet is very important in controlling the symptoms of diabetes is indisputable (American Diabetes Association, 2006). A diabetic’s daily calorie intake, generally speaking, should consist of 40 to 60 percent carbohydrates because the lower the carbohydrate intake, the lower levels of sugar enters the bloodstream. The advantages associated with carbohydrate intake are negated by the patient’s intake of foods that are high in fat. This dilemma can be improved upon by the substitution of polyunsaturated and monounsaturated fats for saturated fats. “Most people with diabetes find that it is quite helpful to sit down with a dietician or nutritionist for a consultation about what is the best diet for them and how many daily calories they need. It is quite important for diabetics to understand the principles of carbohydrate counting and how to help control blood sugar levels through proper diet” (Norman & Politz, 2006).
An A1C test measures the level of glucose in blood cells. The diabetic who has not received treatment may show levels as high as 10 percent while a person not afflicted with the disease tests at close to five percent. As previously discussed, the lack of insulin production allows higher levels of glucose in cells. High levels of blood glucose (or sugar) in the bloodstream leads to various diabetic related health complications if allowed to go unchecked (Becton & Dickinson, 2006). According to the Florida Department of Health, the proper management of glucose in the bloodstream benefits people with both type of diabetes. “For every one point reduction in A1C, the risk for developing micro-vascular complications (eye, kidney and nerve disease) decreases by up to 40 percent. Blood pressure control can reduce cardiovascular disease (heart disease and stroke) by 33 to 50 percent and can reduce micro-vascular disease (eye, kidney and nerve disease) by approximately 33 percent. Improved control of cholesterol and lipids (e.g. HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20 to 50 percent. Detection and treatment of diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50 to 60 percent. Comprehensive foot care programs can reduce amputation rates by 45 to 85 percent.” (“Prevention of Diabetes”, 2003). Proper weight control, increased activity and not smoking should also coincide with regular visits to the doctor in order to better regulate blood pressure, glucose and cholesterol levels. The patient would be best served if they form a team-like relationship with their health care professionals. “Because people with diabetes have a multi-system chronic disease, they are best monitored and managed by highly skilled health care professionals trained with the latest information on diabetes to help ensure early detection and appropriate treatment of the serious complications of the disease” (American Diabetes Association, 2006).
While there is no known cure for the disease, diabetes can be managed effectively with proper treatment. Type One diabetics must examine their blood-glucose levels many times per day and inject insulin accordingly, usually at mealtime so as to help manage the glucose being ingested. The supplementation of insulin assures that blood glucose levels maintain stability. In severe instances, medication may need to be given to control glucose levels. Diabetics are able to significantly decrease the risks of complications due to the disease if they are willing to educate themselves then apply that knowledge to their daily lives.
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- American Diabetes Association. “Diabetes Statistics for African Americans.” All About Diabetes. 2006. American Diabetes Association.
- Becton & Dickinson. “Hemoglobin A1c Testing.” 2006. BD Diabetes.
- Freudenrich, Craig. “How Diabetes Works.” 2006. How Stuff Works. Web.
- Norman, James & Politz, Douglas. “The Diabetes Center.” EndocrineWeb. (2006). Norman Parathyroid Surgery Clinic. Web.
- “Prevention of Diabetes.” Florida Department of Health. (2003). State of Florida.