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The Details on Diabetes

Preventing or delaying the onset of this chronic condition
Author: Sarah M. Aldridge, MS

Super-sized sodas, mega meals and sitting for hours at the computer mean fewer folks will dodge the diabetes dart. In an August 2014 study published in The Lancet Diabetes & Endocrinology, researchers at the US Centers for Disease Control and Prevention (CDC) found the lifetime risk of developing type 2 diabetes is now 40%, or 4 out of every 10 American adults over age 20.

Chances are, in the future you may develop diabetes or live with someone who does. That’s why it’s important to get the details on diabetes, and do what you can now to prevent or manage it.

Types of diabetes

Diabetes mellitus, or diabetes, results when the body can’t manufacture enough insulin or use it effectively. Insulin is a hormone secreted by the pancreas that helps the body metabolize, or break down, carbohydrates and fats.

There are two types of diabetes: type 1 and type 2. Type 1 is usually diagnosed in childhood, when the effects of the body’s inability to manufacture insulin become noticeable. In contrast, type 2 diabetes typically occurs in adults who are overweight, sedentary or have a family history of the disease. Women who develop gestational diabetes are prone to develop type 2 diabetes later. African Americans, Asian Americans/Pacific Islanders, Latinos and Native Americans have higher risks of developing type 2 diabetes. The CDC estimates that 90% to 95% of all cases of diabetes are type 2. This article explains the risks of type 2 diabetes.

Sugar, sugar

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When you munch on a muffin, carbohydrates are broken down into other components, including glucose, a type of sugar. In the small intestine, glucose is absorbed into the blood. The pancreas then produces the hormone insulin to move the glucose out of the bloodstream and into cells, where it provides energy to the body.

However, if you have type 2 diabetes, your body doesn’t use insulin properly, and glucose builds up in the bloodstream. This is called insulin resistance. Excess sugar in the blood may not sound serious, but it can affect a variety of organs. Prolonged, elevated blood glucose levels can cause heart disease and strokes, kidney failure and blindness. Circulation complications in the legs and feet can lead to amputation. The CDC lists diabetes as the 7th leading cause of death in the US.

Diabetes and viral infections

Long-term viral infections in people with hemophilia from HIV and/or hepatitis C (HCV), a result of contaminated factor products prior to safe screening, can contribute to diabetes. Note that people with HIV may have an increased risk of developing diabetes, either from HIV medications or on­going inflammation from the virus itself. A 2014 study in the Journal of Acquired Immune Deficiency Syndrome showed that people taking antiretroviral medications without interleukin had a significantly higher risk of developing type 2 diabetes. This group had a higher body mass index, was older, was co-infected with hepatitis B or C, and used lipid-lowering medications. Further, studies have shown that HCV disrupts the body’s ability to regulate blood sugar ­levels, leading to insulin resistance.

Although the incidence of diabetes in the bleeding disorders community is not documented, there is a correlation between it and hypertension, or high blood pressure. A 2013 study in Hypertension evaluated high blood pressure in 458 adult men with hemophilia from two hemophilia treatment centers (HTCs) in California and one in Louisiana. Men with hemophilia and hypertension had a significantly higher rate of diabetes than their nonhemophilic peers—13.8% vs. 1.7%.

If you have a family history of diabetes or hypertension, your primary care physician should not only be monitoring your blood pressure but also your blood sugar. Symptoms of diabetes include severe thirst; frequent urination; extreme fatigue; and tingling, pain and numbness in the hands and feet. Cuts, bruises and sores that are slow to heal also can be a tip-off. But symptoms can also be subtle. Dry, itchy skin and blurred vision could be chalked up to other conditions.

Testing for diabetes

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The A1C blood test is a simple procedure that measures the average blood glucose for the past three months. It’s also called the glycated or glycosylated hemoglobin test because it shows the percentage of hemoglobin (a protein in your red blood cells that carries oxygen) that is coated with sugar, or glycated. High A1C levels indicate that your blood sugar control is abnormal, which increases your risk of complications.

According to the American Diabetes Association (ADA), A1C levels of less than 5.7% are normal, levels between 5.7% and 6.4% are considered prediabetic, and levels greater than or equal to 6.5% are diabetic. Be aware that you can receive abnormal results if you have anemia, take vitamin C and E supplements, or have kidney or liver disease.

Prediabetes and diabetes

If test results show you are prediabetic, you can still take steps to delay or prevent the onset of diabetes. The National Institutes of Health (NIH) Diabetes Prevention Program found that losing 5% to 7% of your body weight (15 pounds for a 200-pound person), exercising moderately for 30 minutes five days each week and eating a lower fat, lower calorie diet helped restore normal blood glucose levels in some people.

A diagnosis of diabetes requires diligently managing  your blood sugar with medication (oral or insulin injections), devising meal and exercise plans, and controlling blood pressure and cholesterol. The CDC recommends a team of healthcare providers oversee your care: an endocrinologist, a primary care physician, a dietitian, an ophthalmologist and a podiatrist.

Dealing with diabetes is doable. So get moving, count your carbs, monitor your blood sugar level and communicate with your healthcare team. You can live a healthy life with diabetes.