NHM Health Focus: American Diabetes Month November 2009

November is American Diabetes Month and a good time to remind ourselves why we should care about diabetes: Nearly 24 million children and adults in the United States, have diabetes. It is the leading cause of kidney disease, blindness, and amputation, yet nearly 25% of people who have diabetes don't even know it. (ADA).

Campaigns like those sponsored by the National Diabetes Education Program and the American Diabetic Association are designed to raise awareness of and support for those with diabetes.

The National Diabetes Education Program reminds us that "about 65 percent of people with diabetes will die from a heart attack or stroke, yet two out of every three people with diabetes are unaware of their increased risk."

The good news: diabetes can be prevented.

"By losing a modest amount of weight, by getting 30 minutes of physical activity 5 days a week and eating healthier, people with pre-diabetes can delay or prevent the onset of the disease. The "Small Steps. Big Rewards. Prevent type 2 Diabetes" campaign, the first-ever national diabetes prevention campaign, spreads this important message of hope to the millions of Americans with pre-diabetes" (NDEP).

"Control Your Diabetes for Life" program provides a foundation of knowledge about diabetes, guidelines for self-managing your diabetes, and resources to help you adopt healthy new lifestyle habits. (NDEP).

"Be Smart About Your Heart: Control the ABCs of Diabetes" makes the connection between diabetes and heart disease as it encourages people with diabetes to control not only their blood glucose (sugar), but also their blood pressure and cholesterol. By keeping all three levels as close to normal as possible, people with diabetes can live long, healthy lives (NDEP).

Increasing awareness about the importance and benefits of diabetes control is the key objective of the "Control Your Diabetes. For Life." and National Diabetes Education Month.

"Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can be associated with serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications" (CDC).

• "Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. 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. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin."

• "Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy" (CDC).

You are at higher risk for diabetes if it runs in your family, or if you are Native American, Hispanic American, African American or Pacific Islander.

"Just 10 years ago, Type 2 diabetes was virtually unknown in children and adolescents. Indeed, the medical community commonly referred to the condition as 'adult onset diabetes.' Today, it accounts for almost 50 percent of new cases of pediatric diabetes in some communities" (HHS).

Am I at Risk for Type 2 Diabetes? (NDIC)

Diabetes Risk Test (also available in Spanish and Chinese)

Symptoms. "People with diabetes may 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" (CDC).

Complications of diabetes can include:
   • Heart disease and stroke
   • High blood pressure
   • Blindness
   • Kidney disease
   • Nervous system disease
   • Amputations
   • Dental disease
   • Complications of pregnancy
   • Sexual disfunction
Complications of uncontrolled diabetes may lead to diabetic ketoacidosis and hyperosmolar (nonketotic) coma. In addition, people with diabetes are more susceptible to many other illnesses and, once they acquire these illnesses, often have worse prognoses (American Diabetes Association).

Prevention of complications:
   • Glucose control reduces the risk of eye, kidney, and nerve disease) by 40%.
   • Preventive care for eyes can reduce severe vision loss by an estimated 50% to 60%.
   • Preventive care for kidneys can reduce the decline in kidney function by 30% to 70%.
   • Preventive care for feet can reduce amputation rates by 45% to 85%.
   • Blood pressure control can reduce heart disease and stroke by 33% to 50%, and eye, kidney, and nerve disease by approximately 33% (CDC).

At this time, Type 1 diabetes cannot be prevented, but can be treated. Type 2 diabetes can be prevented or the risk greatly reduced. In both cases, complications can be prevented by losing weight (if one is over weight), controlling glucose levels, and controlling blood pressure. A healthy diet and regular exercise are significant factors in preventing and reducing complications of diabetes.

Access Excellence @ the National Health Museum has these resources related to diabetes:

• Health Headquarters: Question of the Week - Diabetes
• Health Headquarters: Question of the Week - Remembering Siblings
• Health Headquarters: Question of the Week - School Lunches
• What's News: Science Updates - Childhood Obesity- a Growing Problem
• What's News: Science Updates - Approaches to Preventing Diabetes
• What's News: Science Updates - Diabetes Researchers Find the Grail
• What's News: Science Updates - Immunologists Recognized
  
• Health Headquarters: Health Focus - Minority Donation and Transplantation
• Health Headquarters: Health Focus - Health Disparities
• Health Headquarters: Health Focus - Healthy Vision Month
• Resource Center: Graphics Gallery - Transfer and Cloning of the Insulin Gene
• Resource Center: About Biotech - First Commercial Use Of Genetic Engineering