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November Is American Diabetes Awareness Month

Diabetes has come into full view in recent years as more and more people—especially children—have been diagnosed with the disease. It is estimated that 10.5 percent of the U.S. population has diabetes. That is more than 34 million people, with 1.5 million Americans being newly diagnosed each year. Around 210,000 American children and youth are estimated to have diabetes, and the numbers are growing, especially for type 2 diabetes. Diabetes takes the lives of about 84,000 Americans annually and is the seventh leading cause of disease.

What Is Diabetes and What Are the Different Types?

Diabetes mellitus is a group of diseases that occurs when a body does not make or use the hormone insulin properly, causing excess glucose, or sugar, to build up in the blood. Glucose is vital to providing energy for the cells that make up muscle and tissues, and it is the brain’s main source of fuel.

The two main types of chronic diabetes mellitus are type 1 and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes (high blood sugar levels that are not high enough to be classified as diabetes but can lead to type 2 diabetes) and gestational diabetes (diabetes during pregnancy).

In type 1 diabetes, the body fails to make insulin due to immune-system abnormalities that destroy the insulin-producing cells in the pancreas. Type 1 diabetes is sometimes referred to as juvenile diabetes because it usually is discovered in children and teens.

Type 2 diabetes occurs when the body does not produce enough insulin or does not use insulin as it should. Type 2 used to be called adult-onset diabetes because it mainly occurred in adults. But with changes in diet in recent decades, with a greater amount of fat and sugar contributing to an increase in the number of overweight and obese children, type 2 is now common in children as well as adults.

Factors that lead to type 2 diabetes are:

  • Weight: Obesity is the single most important risk factor. The more overweight one is, the more the body is resistant to insulin. In turn, low insulin can cause a vicious cycle of an increase in hunger and overeating.
  • Age: People 45 or older are at highest risk for diabetes.
  • Family history: The risk of diabetes is higher if a parent or sibling has diabetes.
  • Polycystic ovary syndrome (PCOS): Women with an imbalance of hormone levels can develop cysts on the ovaries, which can increase the risk of developing type 2 diabetes.

Gestational diabetes mellitus (GDM) occurs during pregnancy and can cause complications to both the mother and child. Complications include:

  • high blood pressure
  • large birth weight babies
  • obstructed labor

GDM tends to go away after pregnancy, but women who experience GDM have an increased chance of developing type 2 diabetes later in life. In fact, half of all mothers with GDM develop type 2 diabetes within 5 to 10 years after delivery. In addition, children exposed to diabetes in the womb are at high risk of becoming overweight or obese, which can lead to type 2 diabetes.

Symptoms of Diabetes

Although symptoms can vary, the early stages of diabetes produce the following symptoms:

  • Extreme thirst
  • Extreme hunger
  • Frequent urination
  • Unexplained weight loss
  • Fatigue or drowsiness
  • Blurry vision
  • Slow-healing wounds, sores, or bruises
  • Dry, itchy skin
  • Tingling or numbness in hands or feet
  • Frequent skin, gum, bladder, or vaginal yeast infections

People with type 2 diabetes may also have insulin resistance, which can cause dark skin around the neck or armpits, high blood pressure, cholesterol abnormalities, and altered menstrual cycles.

Diabetic ketoacidosis (DKA) can occur in people whose blood glucose levels are extremely high and may present as the following:

  • Nausea or vomiting
  • Deeper, faster breathing
  • An “off” breath odor that smells like nail polish remover
  • Weakness, drowsiness, trembling, confusion, or dizziness
  • Uncoordinated muscle movement

Untreated diabetes can lead to high levels of blood glucose and the following symptoms:

  • Shortness of breath
  • Abdominal pain
  • Vomiting
  • Dehydration
  • Coma and death

Managing Diabetes

Managing blood glucose levels as well as blood pressure and cholesterol can prevent many of the health problems associated with diabetes. To manage diabetes, you should know your “ABCs”:

  • A is for A1C test: This test shows your average blood glucose level over the past three months, which should be below 7 percent.
  • B is for blood pressure: Blood pressure should be below 140/90 for most people with diabetes.
  • C is for cholesterol: Too much “bad” cholesterol, or LDL, can build up and clog blood vessels, leading to heart attack or stroke. Having proper “good” cholesterol levels, or HDL, helps remove LDL from blood vessels.
  • s is for stop smoking: Smoking (both tobacco and e-cigarettes) narrows the blood vessels, which makes the heart work harder.

In addition, people with diabetes should follow a meal plan that includes:

  • Fruits and vegetables
  • Beans
  • Whole grains instead of refined grains and other highly processed carbohydrates
  • Chicken or turkey without skin
  • Fish
  • Lean meats, avoiding processed meats
  • Healthy fats, such as polyunsaturated fats found in liquid vegetable oils, nuts, seeds, and avocados
  • Nonfat or low-fat milk and other dairy products or alternative milk products, such as almond milk or oat milk
  • Water instead of sugar-sweetened or artificially sweetened beverages

Light to moderate alcohol consumption (up to one drink a day for women and up to two drinks a day for men) may help lower diabetes risk since moderate amounts of alcohol can increase the efficiency of insulin at moving glucose into cells. Excess drinking, however, can increase the risk.

Exercise to include a goal of 30 minutes of physical activity most days of the week is recommended.

Taking medicine as directed by a physician and self-checking blood glucose levels using a blood glucose monitoring kit are also important.

Monitoring Blood Glucose Levels

Check with your physician on the best monitor for you. There are several types, but the most common entails using a blood glucose meter and a drop of your own blood. Blood is taken by pricking the side of your fingertip with a lancet and placing a drop on the monitor test strip. The monitor will initiate an immediate reading.

Another way to check glucose levels is with a continuous glucose monitoring (CGM) system, which uses a tiny sensor that is inserted under your skin. The sensor measures glucose levels every few minutes, providing an accurate indication of glucose levels throughout the day and night.

Blood glucose targets are:

  • 80–130 mg/dl before a meal
  • Less than 80 mg/dl about two hours after a meal starts

If blood glucose levels drop below where they are intended, hypoglycemia can result. Hypoglycemia is a life-threatening condition and needs immediate medical attention.

If blood glucose levels are too high, hyperglycemia results. Symptoms of hyperglycemia are similar to symptoms indicating a person has diabetes, including:

  • Feeling thirsty
  • Weakness or exhaustion
  • Frequent urination
  • Headaches
  • Blurred vision

Insulin therapy levels in people experiencing hyperglycemia often need to be adjusted to bring the levels within a normal range. Untreated, hyperglycemia can lead to blindness, nerve damage, and kidney damage.

The Importance of Insulin in Treating Diabetes

In a healthy individual, insulin:

  • Regulates blood sugar levels: After eating, carbohydrates break down into glucose, which enters the bloodstream. The pancreas responds by producing insulin to allow glucose to enter the body’s cells in order to provide energy.
  • Stores excess glucose for energy: After eating, insulin levels are high and excess glucose is stored in the liver in the form of glycogen. Between meals, insulin levels are low and the liver releases glycogen into the bloodstream in the form of glucose to keep blood sugar levels within a narrow range.

In a diabetic individual, glucose levels will continue to rise after eating because there is a lack of insulin available to move the glucose into the body’s cells.

To help with insulin distribution, insulin therapy is necessary. Insulin therapy involves self-administering insulin in the following ways:

  • Shots or pens: Insulin is injected in the fat just below the skin using a syringe and needle or a pen-like device containing insulin and a needle.
  • Insulin pump: A pump pushes small, steady doses of rapid-acting insulin into a thin tube that is inserted beneath the skin.
  • Inhaled insulin: Rapid-acting insulin is inhaled at the beginning of a meal.

Talk with your health-care team as to what the best method is to regulate your blood sugar levels and maintain optimum health.

Herrick Library Resources on Diabetes

The following books and DVDs can be reserved and checked out via curbside pickup:

  • Blood Sugar Rising: America’s Hidden Diabetes Epidemic: This PBS documentary puts human faces to diabetes statistics.
  • Diabetes & Keeping Fit for Dummies, by Sheri Colberg: A modern-day guide to keeping fit and healthy while living with prediabetes and type 1 and type 2 diabetes.
  • The Diabetes 2-Month Turnaround, by Laura Hieronymus: Dr. Hieronymus takes a scientific approach to helping the newly diagnosed get their diabetes under control within two months.
  • Diabetes—How to Help: Your Complete Guide to Caring for a Loved One with Diabetes, by Gary Scheiner and Diane Herbert: A guidebook for partners, family members, and friends of diabetics to better understand their role as caregiver.
  • Diabetes Superfoods Cookbook and Meal Planner, by Cassandra Verdi and Stephanie Dunbar: A simple guide to planning nutritional meals for people with diabetes.
  • Don’t Eat This Book: Fast Food and the Supersizing of America, by Morgan Spurlock: Spurlock, who documented the deterioration of his health on a fast-food diet in 2004, investigates the connection among school lunch programs, the marketing of fast food, the decline in Americans’ health, and the rise in such diseases as diabetes and hypertension.
  • Fed Up: Journalist Katie Couric narrates this documentary that takes on the food industry in exposing the link between processed and fast food and childhood obesity and type 2 diabetes. (Read the staff movie review on our blog here .)
  • Indian Cuisine Diabetes Cookbook: Savory Spices and Bold Flavors from South Asia, by May Abraham Fridel: Tasty, exotic but simple Indian recipes for those with diabetes and prediabetes.
  • The Italian Diabetes Cookbook: Delicious and Healthful Dishes from Venice to Sicily and Beyond, by Amy Riolo: How to cook heart-healthy and diabetes-friendly Italian dishes using fresh ingredients like fruits and vegetables, whole grains, seafood, and poultry.
  • Mayo Clinic: The Essential Diabetes Book, by M. Regina Castro, ed.: A thorough guide to diabetes that includes prediabetes warning signs, symptoms and risk factors, and treatments and strategies for managing blood sugar and avoiding complications.
  • My Beloved World, by Sonia Sotomayor: An inspiring memoir by U.S. Supreme Court Justice Sotomayor, who was diagnosed with diabetes as a child living in a housing project in the Bronx, New  York.
  • Prediabetes: A Complete Guide, by Jill Weisenberger: Actions prediabetics can take early on to prevent type 2 diabetes.
  • Tex-Mex Diabetes Cooking: More than 140 Authentic Southwestern Favorites, by Kelley Cleary Coffeen: Recipes with a Southwestern flare that focus on fresh vegetables, fruits, beans, cheeses, and lean meats, fish, and poultry.

For children:

  • Goldilocks and Baby Bear’s Diabetes, by Edward Gale: A picture book on diabetes featuring Goldilocks and the Three Bears.
  • Caillou: Emma’s Extra Snacks: A Story About Type 1 Diabetes, by Anne Paradis: This Caillou series book explains type 1 diabetes through a schoolmate of Caillou’s.
  • Just Ask!: Be Different: Be Brave, Be You, by Sonia Sotomayor: Using her experience as a child with type 1 diabetes, Justice Sotomayor explores the challenges all types of kids face and how the world is more wonderful because of them.
  • Open Your Bag: A Diabetes Picture Book, by Mike Lawson: Featuring animal characters, this picture book explores the routines children must follow to treat their diabetes.

The following e-books can be checked out on the OverDrive  app (click on the e-book’s title):

The following magazines can be read via the Flipster app:

    • Clean Eating
    • Diabetes Self-Management
    • Diabetic Living
    • Eat Well
    • Prevention

 

Sources: American Academy of Family Physicians, Diabetes, https://familydoctor.org/condition/diabetes/?adfree=true; American Diabetes Association, Statistics about Diabetes, https://www.diabetes.org/resources/statistics/statistics-about-diabetes; Cleveland Clinic, Diabetes Mellitus: An Overview, https://my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview; Harvard T.H. Chan School of Public Health, Simple Ways to Preventing Diabetes, https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/#diet; International Diabetes Federation, About Diabetes, https://www.idf.org/aboutdiabetes/what-is-diabetes.html; International Diabetes Foundation, Gestational Diabetes, https://www.idf.org/our-activities/care-prevention/gdm.html; Mayo Clinic, Diabetes, https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444; Mayo Clinic, Diabetes Treatment: Using Insulin to Manage Blood Sugar, https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-treatment/art-20044084; National Institutes of Health: National Institute of Diabetes and Digestive and Kidney Diseases, Managing Diabetes, https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes

Graphics: CDC, https://www.cdc.gov/diabetes/library/socialmedia/infographics.html;  PatientTalk.org, https://patienttalk.org/diabetes-awareness-is-vital-share-our-awareness-graphic/

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