|
What
Is It?
Diabetes
is a chronic condition in which the body loses its ability to process
glucose, the raw sugar that serves as the source of energy to your
cells. The formal name for the condition is Diabetes Mellitus from
the Greek "diabetes", meaning "siphon" or "flowing through"
and "mellitus" referring to the sweetness of honey. If untreated,
diabetes causes a buildup of glucose in the bloodstream. As a response,
the body tries to rid itself of the glucose through frequent urination.
This is the reason for the elevated glucose levels in the urine. High
glucose levels can lead to long-term health problems. There are three
types of diabetes: Type 1, Type 2 and Gestational Diabetes.
Type
1 Diabetes
Type 1 diabetes
was once called "juvenile diabetes" because it most often occurred
in children or young adults. With this type, the pancreas, a small organ
near the stomach, stops producing insulin, usually after a bout of some
kind of illness. Insulin is the hormone that cells use to convert glucose
to energy. Without insulin, a person could, in effect, starve to death
on a full stomach.
A person
with Type 1 diabetes will often show the symptoms quickly and some may
even blackout due to a condition called "ketoacidosis". Once
diagnosed, Type 1 diabetes can be treated successfully with injected
insulin (it must be injected because it breaks down in the stomach
if taken in tablet form).
Type
2 Diabetes
By far the
most common form, 90 percent of all people with diabetes have Type 2; this was once called "adult onset" diabetes. In this condition,
the pancreas continues to produce insulin, sometimes at a reduced rate,
but the cells in the body lose their sensitivity, so the insulin fails
to work properly. However, because some insulin is still available,
the symptoms of Type 2 are not always immediately obvious and many
people go for years, risking the dangers of continuing high blood-glucose
levels, without knowing they have the condition.
Roughly 40
percent of people with Type 2 diabetes can manage their condition through
changes in diet and increased exercise, which improves the body's sensitivity
to insulin. The rest must take oral medication or, in some cases, injected
insulin.
Gestational
Diabetes
Four percent
of pregnant women develop Gestational Diabetes Mellitus (GDM); they then
have a 40-percent chance of developing Type 2 diabetes within the next
10 years. Women with gestational diabetes are twice as likely to give
birth to a very large baby and three to four times as likely to give birth
by Cesarean section.
Complications
- Diabetes is the leading cause of new blindness in adults.
- 40 to 50 percent of people with diabetes have nerve damage; it is
the leading cause of amputations in adults.
- The risk of cardiac problems increases by two-fold for men with diabetes,
three-fold for women.
- Hypertension is twice as common among seniors with diabetes.
- 50 to 60 percent of men with diabetes experience erection dysfunction
(impotence).
A
New Epidemic
The World Health Organization estimates that the prevalence of diabetes will jump from the current
1 person in 20 to 1 in 10 over the next 10 years, and the increase will
be worse in the developed world, where the high incidence of obesity
and the aging population increases the risk factors. In Canada, diabetes will affect 1 in 11 adults over the age of 20.
This could
be a public health catastrophe, but if those at risk recognize the warning
signals and act accordingly, the savings will be counted in thousands
of lives and millions of dollars.
Diabetes:
Are you at risk?*
The risk factors are different for Type 1 diabetes and Type 2 diabetes.
If you are of Aboriginal, Hispanic, Asian or African decent, your chances
of developing Type 1 diabetes are higher than those who are not. A family
history of diabetes is another risk factor for Type 1 diabetes. In the
cases of Type 2 diabetes, the risk factors are:
- Age over 45
- Overweight
- Previous problems with glucose tolerance
- Having given birth to a baby over 9 lbs/4 kg
Symptoms*
For Type 1 diabetes, the symptoms
include:
- Excessive appetite
- Excessive thirst
- Excessive urination
- Fatigue
- Weight loss
Those with Type 2 diabetes may also
experience some of the same symptoms as those with Type 1 diabetes. There
are also other symptoms that may be evident in Type 2 diabetes, which include:
- Slow healing
of cuts
- Skin infections
- Bladder
infections
- Blurred
vision
- Numbness
or tingling in the hands and feet
It is also
important to note that Type 2 diabetes, the most common type, can occur
with little or no symptoms. Fully half of the Canadians who have diabetes
don't yet know it. Getting a diagnosis is the first step toward managing
your diabetes. If you are over 45 years
of age, you should be getting your blood sugar levels tested every 3
years. If you have known risk factors, you should be checked every
year.
*Information
has been provided by the Canadian Diabetes Association.
Diabetes
Management
There are a number of steps in managing your condition, each to help you
lead a full and active life. These steps include:
· Educate
yourself. Diabetes education is very important and plays a big role in helping you
manage your condition as well as making lifestyle choices.
· Make
a dietary plan. Work with a dietician to design the best meal plan for you. If you have
Type 1 diabetes, your plan will aim to provide you with a healthy diet
and a steady level of carbohydrates. If you have Type 2 diabetes, your
plan will aim to reduce your blood sugar levels and your weight (if
applicable).
· Exercise
regularly. Exercise and diet work hand in hand. Exercise can help you lose excess
weight, lower your blood sugar level and improve insulin sensitivity3.
You should consult your doctor before beginning any exercise program.
· Monitor
your own blood sugar. You can test your own blood sugar levels at home with a blood glucose
meter. There are a variety of blood glucose monitors on the market, and
your pharmacist can help you pick out the one that's most suited to your
needs. You should keep your own record of your blood sugar levels, because
it can help you determine your need for adjusting your medication, food
or exercise5. When to test and the number of tests vary from person to
person, so you and your doctor will determine the best schedule for you.
Drug
Therapy
Type
1 diabetes
All those
with Type 1 diabetes need to be treated with injected insulin. Insulin
comes in many forms varying in how fast they start working, how long it
takes for them to reach maximum efficiency and how long they last. There
are rapid acting, short acting, intermediate acting, long acting and premixed
combinations of short and intermediate acting insulin on the market4.
Your doctor will work with you to formulate a regimen that is best for
you. For those of you who find using syringes and vials inconvenient,
insulin pens offer a more portable and convenient way of giving your insulin.
Type
2 diabetes
When blood
sugar levels cannot be controlled through diet and exercise, oral medications
can help. These include: sulfonyureas, biguanides, Alpha glucosidase,
thiazolidinediones and meglitinide.
Sulfonylureas
stimulate your pancreas to make more insulin, and may also lower the blood
sugar production in your liver and help your body use insulin better.
Glyburide and Gliclazide are examples of this class.
Biguanides
help your muscle take in more blood sugar and reduce blood sugar production
by your liver. An example is Metformin.
Alpha Glucosidase
inhibitors slow down the absorption of carbohydrates in your small intestines,
hence, lowering your blood sugar. Acarbose is an example of this class
of medication.
Thiazolidinediones
help your muscle and fat tissues take up and use more blood sugar and
lower the amount of blood sugar produced. An example of this class is
Rosiglitazone.
Meglitinide
is a new chemical class of medications that reduce blood glucose by stimulating
the release of insulin from the pancreas. This mechanism is the same as
that of the sulfonylureas. Repaglinide is an example of this class.
A combination
of these pills or a combination of a pill and insulin may be prescribed
if just one medicine doesn't lower the blood sugar levels to an adequate
level.
Crisis Management
Some people
with diabetes could be in danger if their blood-glucose level drops below
a critical point, a condition called hypoglycemia. The symptoms
are sweating, tremors, fatigue, confusion and weakness. Untreated, this
condition can lead to death. If someone you know has diabetes, or if you
come upon someone wearing a diabetes Medic Alert® bracelet while
in this condition, you should immediately call for medical assistance
and then administer sugar in the form of a sweet drink (soft drink containing
sugar or a fruit juice) or a sugar syrup or candy.
Seeking
Information
If you have
any questions about diabetes or about your treatment, talk to your doctor
or Overwaitea Foods pharmacist.
Our pharmacists
can also introduce you to the benefits of the Health computer
kiosk - an easily accessible, user-friendly and authoritative source
of the latest knowledge on health and medicines at the touch of your
fingertips. Health kiosks are located in all of our pharmacies.
And when you have found the information you're looking for, you can print
it and take it with you.
Additional
information on diabetes is available from:
Canadian
Diabetes Association
Alberta & NWT Division
1010-10117 Jasper Avenue NW
Edmonton, Alberta
T5J 1W8
(780) 423-1232 or 1-800-563-0032
Canadian
Diabetes Association
BC & Yukon Division
1385 West 8th Avenue, Suite 360
Vancouver, B.C.
(604) 732-1331 or 1-800-665-6526
www.diabetes.ca
|
