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What Is Diabetes
Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States. 2. What are the symptoms of diabetes? People who think they might have
diabetes must visit a physician for diagnosis. They might have SOME or
NONE of the following symptoms: Frequent urination Excessive thirst
Unexplained weight loss Extreme hunger Sudden vision changes Tingling or
numbness in hands or feet Feeling very tired much of the time Very dry
skin Sores that are slow to heal More infections than usual. Nausea,
vomiting, or stomach pains may accompany some of these symptoms in the
abrupt onset of insulin-dependent diabetes, now called type 1 diabetes. 3. What are the types and risk factors of diabetes? The following types of diabetes and some of their risk factors are quoted from the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US Department of Health and Human Services, 1997): Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes. Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes. Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly 40% of women with a history of gestational diabetes developed diabetes in the future. Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of diabetes. 4. What is the treatment for diabetes? Management strategies should be planned along with a qualified health care team. The following information on treatments for diabetes is from the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US Department of Health and Human Services, 1997): Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues. Treatment of type 1 diabetes: Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to control. Treatment requires a strict regimen that typically includes a carefully calculated diet, planned physical activity, home blood glucose testing several times a day, and multiple daily insulin injections. Treatment of type 2 diabetes: Treatment typically includes diet control, exercise, home blood glucose testing, and in some cases, oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require insulin injections. 5. What causes type 1 diabetes? The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for development of both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people. 6. Can diabetes be prevented? A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. It also appears to be associated with obesity. Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes, but prevention, as well as a cure, remains elusive. 7. Is there a cure for diabetes? In response to the growing health burden of diabetes mellitus (diabetes), the diabetes community has three choices: prevent diabetes; cure diabetes; and take better care of people with diabetes to prevent devastating complications. All three approaches are actively being pursued by the US Department of Health and Human Services. Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on being sure that the proven science is put into daily practice for people with diabetes. The basic idea is that if all the important research and science are not made meaningful in the daily lives of people with diabetes, then the research is, in essence, wasted. Several approaches to "cure" diabetes are being pursued: Pancreas transplantation Islet cell transplantation (islet cells produce insulin) Artificial pancreas development Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with type 1 diabetes). Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas 8. What are some other sources for information on diabetes? The following organizations may help in your search for more
information on diabetes: Federal Government Organizations Department
of Veterans Affairs Internet http://www.va.gov/health/diabetes/ Health
Resources and Services Administration Internet
Indian Health Service Diabetes Program 5300 Homestead Road NE,
Albuquerque, NM 87110 505/248-4182 Internet http://www.ihs.gov/IHSMAIN.html
National Diabetes Education Program Internet http://www.cdc.gov/diabetes/projects/ndeps.htm
The NDEP is a new nationwide initiative of the Centers for Disease
Control and Prevention (CDC) and the National Institutes of Health (NIH).
It is an inclusive, partnership-based program involving many diverse
public and private sector partner organizations. The goal of the program
is to reduce the morbidity and mortality of diabetes and its
complications. CDC contact: Faye L. Wong, MPH, RD, Associate Director
for Diabetes Education, 770-488-5037 (phone); 770-488-5966 (fax); flw2@cdc.gov
(e-mail). NIH contact: Joanne Gallivan, MS, RD, Director, Diabetes
Outreach Program, 301- 496-6110 (phone); 301-496-7422 (fax); gallivanj@hq.niddk.nih.gov
(e-mail). National Institute of Diabetes and Digestive and Kidney
Diseases 1 Information Way, Bethesda, MD 20892-3560 800/GET LEVEL
(800/438-5383) or 301/654-3327 Internet http://www.niddk.nih.gov
National Eye Institute (NEI) Bldg. 31, Room 6A32 31 Center Drive,
MSC 2510 Bethesda, MD 20892-2510 301/496-5248 or 800/869-2020 (to order
materials) 301/402-1065 (fax) Internet http://www.nei.nih.gov
Educating People with Diabetes Kit (Sponsored by the National Eye
Institute) 2020 Vision Place, Bethesda, MD 20892 Internet http://www.nei.nih.gov/nehep/diabkit.htm
Office of Minority Health Resource Center US Department of Health
and Human Services P.O. Box 37337, Washington, DC 20013-7337
800/444-MHRC (444-6472) Internet http://www.omhrc.gov/
o Non-Federal Government Organizations Links to non-Federal
organizations are provided solely as a service to our users. These links
do not constitute an endorsement of these organizations or their
programs by CDC or the Federal Government, and none should be inferred.
The CDC is not responsible for the content of the individual
organization Web pages found at these links. American Association of
Diabetes Educators 100 West Monroe, 4th Floor, Chicago, IL 60603-1901
800/338-3633 for names of diabetes educators 312/424-2426 to order
publications Internet http://www.aadenet.org
American Diabetes Association 1660 Duke Street, Alexandria VA 22314
800/232-3472 or 703/549-1500 800/ADA-ORDER to order publications toll
free ADA's D.I.A.L. Program (Diabetes Information and Action Line)
800/342-2383 or 800/DIABETES for diabetes information Internet http://www.diabetes.org
American Dietetic Association National Center for Nutrition and
Dietetics 216 West Jackson Boulevard, Suite 800, Chicago, IL 60606-6995
800-366-1655 Consumer Nutrition Hotline (Spanish speaker available)
800-745-0775 Internet http://www.eatright.org/
American Heart Association National Center 7272 Greenville Avenue,
Dallas, TX 75231 214/373-6300 Internet http://www.americanheart.org/ Internet http://www.diabetesnet.com/idaa.html Juvenile Diabetes Foundation International The Diabetes Research Foundation 120 Wall Street, 19th Floor, New York, NY 10005-4001 800/JDF-CURE or 800/223-1138 212/785-9595 (fax) Internet http://www.jdf.org Medical Eye Care for the Nation's Disadvantaged Senior Citizens The Foundation of the American Academy of Ophthalmology P.O. Box 429098, San Francisco, CA 94142-9098 800/222-EYES (222-3937) National Diabetes Information Clearinghouse 1 Information Way, Bethesda MD 20892-3560 301/654-3327 (phone); 301/907-8906 (fax) ndic@aerie.com (e-mail) Internet http://www.niddk.nih.gov/health/diabetes/ndic.htm Centers for Disease Control and Prevention web site at http://www.cdc.gov/health/diabetes.htm ******************** The
Diabetic and The Feet Foot
problems may slow down and inconvenience everyone at some point in
time, but, for the diabetic patient, foot-related problems are the
number one cause of hospital admissions.
In the United States, diabetes is the most frequent cause of
non-trauma-related lower-limb amputations. Dr.
Charles M. Clark Jr., co-chair of the National Diabetes Education
Program, said, “The real tragedy is that almost half of the
diabetes-related amputations that occur each year could be
prevented.” People
with diabetes face a greater than average odds of losing a toe, foot,
ankle or leg because of two conditions that may result in serious
damage to the feet and legs: Peripheral
vascular disease (PVD). Patients
with PVC have fatty deposits, which have formed over time. These
deposits harden the blood vessels, resulting in lost of blood flow
delivered to the legs and feet. This decreased amount of blood flow
and circulation to the lower limbs makes it difficult for sores or
infections to heal. What
are some of the leg/feet symptoms associated with diabetes? ·
Leg
pain when walking or lying down ·
Sores
that won’t heal ·
Feet
that always feel cold to the touch
Diabetic
neuropathy. This
condition occurs when the nerves in the hands and feet become damaged
and lose feeling sensation or become numb. This damaged condition
increases the risk of infection by simple ailments such as a blister
caused by poorly fitting shoes or a sore that develops from dry skin. Symptom:
A burning sensation in the toes, later progressing to numbness.
What
Diabetic Patients Should Ask Their Health-Care Providers Ask
your health care provider to check each foot at least once a year for
color, temperature, toe-hair and skin texture. One piece of equipment
that may be used for testing is a piece of flexible plastic fiber.
This thin piece of plastic is pressed on several foot spots to see if
its touch can be felt. There is no pain involved in this test.
Respect
Your Feet Proper foot
care is vital for everyone, especially those who have diabetes. The
best way to avoid problems is to monitor and control blood sugar
levels, by exercise, diet and medications. Exercise increases
circulation and stimulates the blood flow to the legs and feet. Be
observant to avoid foot problems by paying close attention to both
legs and feet and they will take you far.
·
Wash feet with warm
(not hot) water and mild soap daily. Test the water temperature with
your wrist before putting feet into the water. Inspect between each
toe and around the each nail for any redness, cuts, cracking, or
peeling. Look at the bottom of each foot for any breaks in the skin,
splinters, sores, blisters, or calluses. At the first sign of redness
or infection, call your health-care providers for help. Dry each foot
gently with a soft towel. ·
Apply a lotion or
moisturizer, like plain petroleum jelly, to only the top and bottom of
each foot to keep the skin soft and prevent cracking and drying. Do
not use lotion or moisturizer between the toes: the extra moisture can
promote infection. For feet that sweat a lot, use a dusting of talcum
powder to keep dry. ·
Wear clean, dry socks
and enclosed shoes that are sturdy and comfortable. Don’t go
barefoot, even indoors. Check the inside of each shoe for any rough
spots or objects that may have fallen inside. The toes should not rub
or be squeezed. Do not wear new shoes for more than 1-2 hours at a
time to avoid blisters. ·
Cut and file toenails
straight across to avoid ingrown toenails. The side corners can be
rounded and smoothed with a nail file so the next toe will not be
scratched. ·
Avoid putting strong
chemicals or acids that can destroy sensitive tissue on your feet,
such as Epsom salts, iodine, and corn removers. Do not do “bathroom
surgery,” such as trimming corns or calluses. ·
Remove your shoes and
socks at each doctor’s visit so your feet are ready to be checked.
·
When sitting, keep
the blood flowing to feet and legs by propping feet up and frequently
moving toes and ankles for a few minutes.
Managing
diabetes and improving foot care can seem overwhelming, especially at
first. GO slow; take small steps to prevent amputations, but START.
To order your
free copy of the “Take Care of Your Feet for a Lifetime” booklet
call the National Diabetes Education Program at 1-800-438-5383 or http://ndep.nih.go **********************8 Here are some Internet sources of information on
diabetes? Veterans Private
Physician's Statement Veterans
Benefit Network
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