Wednesday, November 29, 2000

Diabetes: What to know, head to toe

Sixteen million Americans have diabetes: but one out of three of those persons does not know it.

Diabetes is a serious and silent disease. It is serious because it can lead to major health complications such as blindness, heart attack, stroke, kidney failure, and amputations. It is silent in that early symptoms may be mild, or not recognized as a symptom. By the time the disease is diagnosed, damage to arteries, eyes, nerves, and kidneys may have been occurring for seven to ten years.

Every minute at least one person is diagnosed with diabetes, and this treatable disease kills more than 193,000 Americans each year.

In Georgia, approximately 325,000 (6 percent of the adult population) adults have diabetes, but only 217,000 of them know it. Diabetes is the seventh leading cause of death, resulting in 1,277 deaths in 1997. However, more often, diabetes is a contributing factor in deaths from other causes, i.e. kidney disease, increased susceptibility to infection, heart disease, etc.

In 1997, there were more than 12,000 hospitalizations for diabetes, resulting in more than 60,000 inpatient days and $99 million in hospital charges. Death rates for diabetes have been rising an average of 1 percent per year for nearly two decades. The rates of death from diabetes for black males is twice as high, and for black females is three times as high as that of their white counterparts.

Since the mid 1980s, more Georgians are becoming obese and physically inactive two fundamental risk factors for developing diabetes. We are also seeing a rise in the rate of diabetes in children, some of which is also attributed to inactivity and obesity.

In Fayette County, there were an estimated 1,920 adults (or 3.1 percent of the adult population) with diabetes in 1997.

Diabetes, also known as diabetes mellitus, is a metabolic disorder that adversely effects the ability of the body to use glucose properly. Glucose is unable to get into cells without the help of insulin, a hormone produced in the pancreas. Diabetics do not produce enough insulin, or the cells do not respond to the insulin that is present in their bodies.

There are several types of diabetes:

Type 1 diabetes (insulin-dependent mellitus or juvenile diabetes) occurs when the insulin-producing cells of the pancreas are destroyed by the body's own immune system. In such cases, the pancreas produces little or no insulin, and the individual must take daily insulin injections to live. This type accounts for approximately 5 to 10 percent of diagnosed diabetes in the U.S., and occurs most often (but not exclusively) in children and young adults.

Type 1 symptoms usually develop over a short period of time, and include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme tiredness.

Type 2 diabetes (non-insulin dependent diabetes mellitus) accounts for 90 to 95% of diabetes cases. It most commonly occurs in adults over the age of 55, but can manifest itself at an earlier age. However, recent years have shown an increase in the number of children diagnosed with this type, presumably due to the rising rate of obesity in children under the age of 17.

In type 2 diabetes, the pancreas does produce insulin, but the body is not able to use it effectively. The symptoms of this type develop gradually and may include fatigue, generally not feeling well, frequent urination, weight loss, blurred vision, slow healing of sores and frequent infections.

Gestational diabetes usually develops or is discovered during pregnancy, and disappears once the pregnancy is over. But if undiagnosed, it can have dire consequences for both mother and baby. This is just one of many reasons why early and consistent prenatal care is very important. In addition, women who experience gestational diabetes run a greater risk of developing type 2 diabetes later in life.

What are your chances of developing diabetes? You are at higher risk if:

You are age 45 and older

You are a member of a high-risk ethnic group (e.g., African American, Hispanic/Latino, American Indian, Pacific Islander)

You are over weight

You have high blood pressure (at or above 140/90)

You have a family history of diabetes

You have a history of diabetes during pregnancy or you are a woman who has had a baby weighing more than 9 pounds at birth.

If you find that you fit any of the risk categories, and/or have been experiencing some of the symptoms, call your physician.

If you would like more information on diabetes, visit your local health department. The Fayette County Health Dept. is located at 140 Stonewall Ave West in Fayetteville, in Suite 107 and can provide written information, and simple blood sugar screening. Fasting labwork and other types of testing are also available with a prescription from your physician.