Diabetes Q & A

[Editor's Note: November is National Diabetes Awareness Month, and the Columbia County Health System is reaching out to Touchet Valley residents to help them understand the disease, and measures available for prevention and treatment.]

What is diabetes?

As many people know, diabetes is a group of disorders that characteristically involves the body either not making enough insulin or not using its own insulin efficiently. As we take in food for energy use in the body, most of it is turned into glucose, or sugar for our later use. Our pancreas is an organ that makes insulin, which is a hormone that gets glucose into our cells for use.

Diabetic patients either don't make insulin or are not able to use insulin properly. The cells cannot get the glucose without the help of insulin, and a resultant abundance of sugar stays in our blood which is dangerous to our body.

Currently 30 million people in the US have diabetes and another 86 million are considered pre-diabetic with risk factors for developing the disease. It is estimated that one in three people will have diabetes by year 2050.

What are the different types of diabetes?

Type 2 diabetes is the most common form of the disease in which the body slowly becomes more and more unable to use its own insulin. At first your body compensates for high sugar levels by making extra insulin, but over time the pancreas will eventually be unable to compensate.

In type 1 diabetes the body does not make its own insulin. Typically type 1 diabetes is diagnosed between early childhood and into young adult years.

Gestational diabetes develops in about 2-5% of all pregnant women and usually goes away after childbirth, however those women who have had gestational diabetes are then at a greater risk for developing type 2 diabetes in their futures.

What does high blood sugar do to the body?

An abundance of sugar in the blood causes damaging changes to our blood vessels, leading to atherosclerosis (hardening of the vessels with buildups of plaque inside them). Atherosclerosis in itself is a huge risk factor for stroke and heart attack due to plaque build ups and restriction of blood flow to the heart and brain.

Diabetes does cause kidney disease and eventually can cause kidney failure, which places the patient in need of dialysis treatments to stay alive. Vision loss and blindness are complications of diabetes, due to blood vessel damage to the eyes. Poor circulation due to blood vessel damage causes poor wound healing, increased skin infections and sometimes amputations to the lower extremities.

Other complications of diabetes include: nerve damage to extremities causing loss of sensation and tingling nerve pain (neuropathy), diminished immune response to illnesses and erectile dysfunction in men.

What are the risk factors for acquiring diabetes?

In type 1 diabetes you would be at greater risk for acquiring the disorder if you had a parent or sibling who had this condition. Genetics is thought to play a role in the development of diabetes.

The farther someone lives from the equator is thought to increase their risk for development of type 1 diabetes. The incidence of type 1 diabetes is 400 times greater in Finland than in Venezuela for example. Type 1 diabetes can appear at any age, really; however, higher rates of diagnosis occur between ages 4-7 and also 10-14 years of age.

Type 2 diabetes risk factors include: advancing age, obesity, family history of diabetes, sedentary or inactive lifestyle, history of gestational diabetes and race. African Americans, Latino or Hispanic Americans and American Indians are at greater risk for this disease.

About 5% of all diabetics are Type 1, and the other 95% are type 2. Of all the risk factors discussed, there are two main modifiable areas, sedentary life- style and obesity. We can greatly lower our chances for becoming diabetic by being more active on a regular basis and not being overweight.

What are the treatments for Diabetes?

The goal of therapy is to control overall blood sugar and prevent complications from diabetes. Management strategies include: diet modification, regular exercise, home blood sugar testing and medications as needed. Type 1 diabetics will require insulin and up to 40% of type 2 diabetics will also. Many patients with type 2, however, can be successfully managed with oral medications and diet alone.

What's being done locally?

November is national diabetes awareness month. Columbia County Health System and its two clinics in Dayton and Waitsburg are participating again with our Dots for Diabetes program. This month each patient with a new or existing diagnosis of diabetes will be "checked off" on our diabetes bingo cards. These cards have bingo squares which each have a diabetic-related health maintenance item on it. Providers and nurses at the clinics will check off the card as each diabetic monitoring parameter is met and when complete the cards go into a drawing for prizes including gift baskets.

Examples of card items include; annual diabetic eye exam, diabetic foot exam annually, cholesterol screening, blood pressure screening, and medication reconciliation with provider. All of these and more of the bingo items are essential for managing diabetes and preventing future diabetic complications. Although providers monitor these things throughout the whole year we put special emphasis on this during the month of November.

Both the Waitsburg Clinic and the Dayton General Hospital are providing free weight loss support groups weekly. They are held each Wednesday evening at the Waitsburg Clinc and Dayton General Hospital starting at 5:15 pm and lasting approximately 30 minutes. There is an optional, but encouraged weigh in at the beginning of the meeting, followed by very casual discussion with group members and leaders. Group walks, hikes and other exercise activities are planned during meetings as optional weekend activities.

Diabetes diet education with a dietician is available at Dayton General Hospital with a simple referral from your primary care provider. This can be essential in providing education on what diet to follow to help manage diabetes.

There are several providers to choose from locally. We have two clinics that are accepting new patients to help you with your healthcare needs.

[For more information on Diabetes and its prevention, or for a list of references used for this column, contact the Columbia Family Clinic or the Waitsburg Clinic.]