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FIT FOR DUTY. . .FIT FOR LIFE! |
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NOVEMBER
WAS AMERICAN DIABETES MONTH
Submitted by CDR April Shaw, USPHS
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| I Don’t Have Diabetes, Do I Need to
Read this Article? |
| Absolutely! Diabetes is the
fifth deadliest disease in the United States. It affects nearly 21 million children and
adults and has no cure.
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| There are several types of diabetes and
researchers continue to search for the cause. Current thinking is that both
genetics and environmental factors such as obesity and lack of exercise play
important roles. Let’s focus on the two most prevalent types: Type 1 Diabetes
Mellitus (Type 1 DM) and Type 2 Diabetes Mellitus (Type 2 DM).
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| What is Type 1 Diabetes? |
| Type 1 DM is more closely associated with
onset before the age of 30, but can be diagnosed at any age. Normally, when you
eat a meal or snack, your body sends signals to the beta cells of your pancreas
to release the hormone, insulin. Insulin is needed to convert sugar, starches,
and other food into energy needed for daily life. The more food you eat, the
higher the demand for insulin. People with Type 1 DM produce no insulin in
their pancreas and must rely on taking insulin from an outside source. Without
insulin, individuals affected with Type 1 DM would accumulate high amounts of
sugar (glucose) in their blood and, without treatment, could lead to coma and
death.
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| What is Type 2 Diabetes?
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| Approximately 90 percent of patients in
the United States with diabetes have Type 2 DM and it may be undiagnosed in as
many as 30 percent of those affected. In fact, on average, it may be present
for 6.5 years before it is diagnosed. In Type 2 DM, there may be several
defects that play a role in high blood glucose levels, including:
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inadequate insulin produced by the pancreas to control blood glucose levels;
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resistance by the body to the insulin
produced; or
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insulin receptor abnormalities.
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| These
defects and others (refer to the Web site of the American Diabetes Association
for more information at www.diabetes.org) result in high blood glucose levels.
To control blood glucose levels in Type 2 DM, an individual may be required to
administer insulin, take oral medication, or both. A cornerstone to all
treatment plans are lifestyle changes such as diet and exercise.
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| Who’s at Risk for Developing
Diabetes?
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| In Type 1 DM, people with another family
member with Type 1 DM are at more risk of developing the disease. The risk in
the general population is 0.10 percent - 0.25 percent. The risk is increased to
2 percent - 5 percent in children of parents with diabetes.
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| In Type 2 DM, heredity plays a major role.
Although it occurs more often after the age of 30 years, it is becoming more
common in adolescents and children. Children of individuals with Type 2 DM have
a 15 percent chance of developing the disease and a 30 percent chance of
developing impaired glucose tolerance (blood glucose levels that are higher
than normal, but not yet high enough to be diagnosed as diabetes). In African
American and Hispanic children, Type 2 DM now accounts for 30 percent - 50
percent of childhood onset diabetes.
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| Certain ethnic groups are at a higher risk
for developing Type 2 DM. Native Americans, Hispanics/Latinos, African
Americans, Asian Americans, and Pacific Islanders are all at a higher risk for
developing Type 2 DM. Other risk factors are individuals who are overweight or
obese; those who have increased central obesity which is deposited around
abdominal organs; and older adults. In adults with Type 2 DM, approximately 50
percent of men and 70 percent of women are obese at the time of diagnosis.
Women with a diagnosis of gestational diabetes (diabetes that was first
diagnosed in pregnancy) have about a 50 percent chance of developing Type 2 DM
in the years to follow.
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| Preventing the Complications of
Diabetes |
| Diabetes can affect many parts of the body
and can lead to serious complications such as heart disease, high blood
pressure, blindness, kidney damage, and lower-limb amputations. Before
developing Type 2 DM, many people have ‘pre-diabetes’ (higher than normal
fasting or post-meal blood glucose levels, but not yet high enough to be
diagnosed as diabetes). There are 54 million people in the United States who
have pre-diabetes. Recent research has shown that over time, some long-term
damage to the body, especially the heart and circulatory system, may occur
during pre-diabetes.
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| People working together with their health
care providers can reduce the occurrence of these and other diabetes
complications by controlling blood glucose levels, blood pressure, and blood
lipids, and by receiving other preventive care.
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| Healthy Lifestyle
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| Following a healthy lifestyle may prevent
or delay the development of Type 2 DM. Increased physical activity, weight
loss, and healthy dietary choices all play a role in a healthy lifestyle. A few
tips to try:
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Eat five servings of fruits and vegetables a day;
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Choose nonfat or low fat dairy products;
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Choose high fiber foods;
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Eat smaller portions;
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Park your car further from your destination and walk;
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Take the stairs when possible; and
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Enroll
in the President’s Fitness Challenge at http://www.presidentschallenge.org
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| For more information on healthy eating and
weight loss, check out the suggestions at the American Dietetic Association (http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition.html)
and the American Diabetes Association (http://www.diabetes.org/nutrition-and-recipes/nutrition/overview.jsp).
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| Take the Quiz
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| Take the quiz at the American Diabetes
Association Web site to check your risk for developing diabetes.
(http://www.diabetes.org/risk-test.jsp) Share your quiz results with your
healthcare provider. If you feel that you may be at risk for developing
diabetes, see your healthcare provider at least annually (or more often if
recommended) for diabetes screening.
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| The series “Fit For Duty…Fit for Life!” is
a lifestyle-based column provided by the USPHS Dietitian/Nutritionist
Professional Advisory Committee (D/N-PAC). If you have related topics of
interest that you would like to learn more about in future articles, contact
CAPT Jean Makie, USPHS, at jean.makie@fda.hhs.gov.
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