Diabetes

Diabetes (diabetes mellitus) is a disease that negatively impacts how the body processes glucose (sugar) from foods that are rich in carbohydrates such as fruits, dairy products, grains and highly refined items like soda, candy and sweets. People who have diabetes are either unable to produce the glucose-regulating hormone insulin (secreted by the pancreas) or their cells are unable to use that insulin efficiently, leading to excess sugars in the blood.

According to the National Diabetes Information Clearinghouse (NDIC), as of 2011 approximately 25.8 million people in the United States had diabetes, representing 8.3% of the total population. Diabetes among people aged 65 and older is common; in 2010, approximately 1 in 4 American were diagnosed with type 2 diabetes, “the leading cause of kidney failure, non-traumatic lower-limb amputations, and new cases of blindness among adults” as well as cardiovascular and liver disease.

Diabetes is diagnosed using simple blood tests which measures both your fasting blood sugar level and your blood sugar level after ingesting a sugary drink (known as an impaired glucose tolerance test). While there is currently no known cure for diabetes, with lifestyle modifications, medications and regular blood glucose testing, most diabetics can either prevent the onset of type 2 diabetes and/or manage their symptoms to avoid further complications from this disease.

Types of Diabetes

There are three major types of diabetes: type 1, type 2 and Gestational, as well as the precursor condition, pre-diabetes.

Type 1 diabetes (also referred to as insulin-dependent or juvenile diabetes) is an autoimmune disorder which occurs when the body’s own immune system blocks natural insulin production. This type of diabetes is usually diagnosed among children and young adults; approximately 10% of all diabetics have this chronic form of the disease. Managing type 1 diabetes involves adherence to a strict diet and frequent injections of insulin throughout the day.

Type 2 diabetes (also known as adult-onset or “sugar” diabetes) is the most common form of this disease; the Centers for Disease Control and Prevention estimates that about 90% of all people with diabetes (excluding Gestational) have this form of the disease. This form of diabetes can develop at any age; it occurs when the body is either unable to produce enough insulin or insulin resistance has developed, causing a buildup of glucose in the blood.

Gestational Diabetes

Gestational diabetes affects between 5-10% of all pregnant women during their pregnancy; this temporary form of diabetes often occurs among women who are at a higher risk of developing type-2 diabetes. Gestational diabetes is treated with dietary and lifestyle modifications; the symptoms usually disappear shortly after giving birth.

Pre-Diabetes

Pre-diabetes is the precursor condition to type 2 diabetes; at this stage people often experience signs of diabetes although their clinical test results do not yet fall into the diagnostic range for type 2 diabetes.

Symptoms of Diabetes

Diabetes is often referred to as a “silent” disease since many people who have diabetes never notice any symptoms at all, or the symptoms they do experience seem  either harmless or too common to alert them to seek medical attention.
Here are the most common symptoms of type 1 diabetes:

  • Excessive, insatiable thirst
  • Frequent (more than 6-8 times daily) urination
  • Uncontrollable hunger and constant cravings for carbohydrate-rich foods
  • Extreme mood swings (related to mealtimes and food intake) combined with fatigue
  • Unexplained weight loss.

Type 2 diabetes symptoms may include any of the symptoms of type 1 diabetes plus the following:

  • Problems with vision, such as blurry vision or deteriorating night vision
  • Slow-healing wounds, frequent skin outbreaks, rashes and bruising
  • Poor recovery from infections combined with an overall malaise (gets sick easily)
  • “Pins and needles” sensation throughout the feet and hands or loss of feeling in the feet.

Pre-diabetics may also experience the same symptoms as those who have either type 1 or type 2 diabetes.

Diabetes Risk Factors and Causes

Diabetes Risk Factors and CausesWhile type 1 diabetes is usually caused by genetic factors, most of the risk factors for type 2 diabetes are related to both ethnicity and lifestyle factors. Adult-onset diabetes is more common among “African Americans, Latinos, Native Americans and Asian Americans, Native Hawaiians and other Pacific Islanders,” while being over the age of 65 also increases the risk of developing this disease.
Here are the most common variable risk factors for type 2 diabetes:

  • A family history of type 2 diabetes
  • Having a body mass index of 30 or greater (overweight or obese)
  • Low physical activity levels
  • Elevated blood pressure levels
  • Chronic stress leading to elevated levels of the hormone cortisol
  • A history of gestational diabetes
  • Eating a diet that is high in carbohydrates, particularly refined sugars
  • Polycystic ovary syndrome (among women)
  • Having a waist circumference over 35 inches (women) or 40 inches (men)
  • Depression (including chronic, seasonal and bi-polar)
  • Poor sleep habits (sleeping less than 6 hours or more than 9 hours nightly)
  • High triglyceride (blood fat) levels.

Side Effects of Diabetes

Because diabetes affects the body’s ability to process fuel (glucose from carbohydrates), it causes fluctuations in blood glucose levels which in turn impacts many systems throughout the body, such as the circulatory, reproductive and nervous systems. Diabetes also impacts eye health, mental wellness and the digestive system.
People with both type 1 and type 2 diabetes are at an increased risk of developing vision problems since fluctuating blood glucose levels can damage the tiny vessels in the eye, leading to retinal damage.

Diabetes also impacts the nervous system, leading to a condition known as diabetic neuropathy which impacts the nerves of the feet and hands as well as those which help to control the bladder, bowel and sexual functions. According to the University of Maryland Medical Center, it “affects nearly half of people with type 1 or type 2 diabetes after 25 years” and can lead to ulcers, severe pain and loss of sensitivity.
People with diabetes often suffer from more frequent and severe bacterial and viral infections, yeast infections, urinary incontinence and severe mood swings related to fluctuations in blood sugar levels.

Diabetes Prevention and TreatmentDiabetes Prevention and Treatment

Adults who have been diagnosed with either pre-diabetes or type 2 diabetes are usually advised to reduce their risk factors for diabetic complications through lifestyle modifications:

  • Eliminating refined sugars and foods that are high in sodium and fat.
  • Eating a diet that is rich in green leafy vegetables, lean proteins, whole grains and high-fiber foods.
  • Increasing physical activity levels through low-impact exercises such as walking.
  • Improving sleep habits.
  • Taking steps to achieve a healthy body mass index (below 30).
  • Regular monitoring and management of blood glucose levels through diet and medication.

Often adults who have developed type 2 diabetes can successfully manage their disease through lifestyle and dietary modifications alone. Researchers at the University of Alabama at Birmingham recently conducted a study which concluded that type 2 diabetes remission is possible, particularly among adults who both lose weight and adopt regular exercise habits.

Because type 1 diabetes is caused by a complete lack of insulin in the body, treating this form of the disease always involves the use of insulin injections combined with careful monitoring of blood glucose levels throughout the day.

Diabetes Among Older Adults

While diabetes can have devastating consequences for adults of all ages, people who are over the age of 65 are at particularly high risk from diabetic complications due to the presence of age-related conditions such as vision loss, decreased mobility and sleep disturbances. Seniors’ diets often consist mainly of prepared meals and packaged foods that are often high in refined sugars and sodium, placing them at increased risk of both diabetes and heart disease.

People over the age of 65 who have diabetes also face an increased risk of both physical impairment and cognitive decline, making prevention and detection of diabetes among older adults vital to their health and well-being. Seniors and their caregivers should discuss their diabetes risk factors, prevention strategies and treatment options with their doctor or medical care team.

Diabetes Resources for Seniors

Diabetes among older adults is often referred to as an “emerging epidemic,” however, in many cases this disease can either be successfully managed and/or completely prevented. Here is a list of online diabetic resources on the detection, prevention and treatment of diabetes among seniors:

Diabetes in Older Adults

This research paper on diabetes among adults aged 65 and older discusses the current prevalence of this disease along with various prevention and treatment options for both patients and their medical providers.

Diabetes Care Guidelines for Older Adults

This plain-language article is based on the diabetes care guidelines from the American Geriatrics Society; it explains what test results mean, steps seniors and their caregivers can take to minimize the side effects of diabetes and possible drug reactions that diabetic seniors may experience.

National Diabetes Prevention Program

Information about the Center for Disease Control’s National Diabetes Program, including links to nationwide lifestyle classes, publications and educational resources for caregivers and patients.

8 Weeks to Maximizing Diabetes Control
This publication from the American Diabetes Association is available for purchase as either a downloadable e-book or a printed book; it provides a comprehensive 8-week diet and lifestyle plan for adults with type 2 diabetes including advice on blood glucose monitoring, meal planning and fitness.

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