According to the 2017 National Diabetes Statistics Report, an estimated 30.3 million people in the U.S. have diabetes. Of those, 23.1 million have been diagnosed and 7.2 million don’t even know they have it. That’s a lot of people walking around with a potentially life threatening, undiagnosed disease. After all, the complications of diabetes can be very severe. In the U.S.:
- The number one cause of death from diabetes is heart attack.
- The number one cause of blindness
Some other interesting facts from the report:
- More men have diabetes than women at 15.3 million and 14.9 million respectively.
- More men are undiagnosed than women at 4.0 million and 3.1 million respectively.
- More women are diagnosed than men at 11.7 million and 11.3 million respectively.
But before we get to the disease, let’s take an anatomy review. Your pancreas is a large organ that sits behind the stomach and it has two functions. The first function is to secrete digestive enzymes that help break down our food and is done by about 95% of the pancreas. The second function is to make and secrete insulin. Insulin is made in the beta cells of the pancreas and is a very important hormone. Insulin acts like a little key that opens up your cells and allows glucose to move from the bloodstream into the cells where it is burned for heat and energy. Glucose is our body’s fuel and it comes from the carbohydrates in our food. Without insulin, our cells would starve.
So what is diabetes? For the purposes of this article we will talk about 4 types of the disease; type 1, type 2, gestational diabetes, and type 1 ½ or Latent Autoimmune Diabetes of Adults (LADA).
Type 1 diabetes is considered an autoimmune disease. It occurs when the body makes antibodies that attack the beta cells and kill them off. Once they are all gone, the body can no longer produce insulin. Once diagnosed, type 1 diabetics have to inject insulin for the rest of their life sometimes giving 3 to 7 injections daily. Type 1 accounts for 5-10% of diabetes cases and usually begins in younger children but can develop at any age.Type 2 diabetes is the most common form of the disease. It accounts for around 90-95% of diabetics. Type 2 typically starts with insulin resistance, a condition where the little insulin “key” becomes less effective at opening up the cells. When this happens the pancreas tries to compensate by making more insulin.
Type 2 diabetes is the most common form of the disease. It accounts for around 90-95% of diabetics. Type 2 typically starts with insulin resistance, a condition where the little insulin “key” becomes less effective at opening up the cells. When this happens the pancreas tries to compensate by making more insulin. Unfortunately, in type 2, this usually causes more and more insulin resistance. Eventually, the pancreas can no longer keep up with the demand and the beta cells start to lose their function. Type 2 is considered a progressive disease and tends to get worse over time, however, it can be controlled with a lifestyle change (diet and exercise), oral medication, injected medication including insulin, or any combination of these. Diet, including portion control and carb counting and exercise are always included in the diabetes prescription. Type 2 tends to happen in older adults but with the obesity problem in the United States, we are seeing younger and younger people with the disease.
Gestational diabetes is a disorder where the hormones produced in pregnancy work against insulin making it less effective. It occurs in about 9% of pregnancies. It usually resolves itself after giving birth but does put the mother and baby at increased risk for developing type 2 diabetes later in life.
Type 1 ½ diabetes, or LADA, starts out like type 2 and is controlled with medication at first. At some point, sometimes after years, the beta cells are destroyed and the person is on insulin like type 1. It occurs in adulthood. Some agencies don’t recognize the term and simply refer to it as slow developing type 1.
Next time I will discuss the technology involved in treatment and care of diabetes.
This article was contributed by John White, a registered nurse and Certified Diabetes Educator (CDE) at Cameron Hospital.