Q: What is diabetes?
A: Diabetes mellitus is a chronic condition that affects approximately 16 million Americans. It is characterized by high blood sugar, which occurs when the body is unable to produce or to properly use the hormone insulin to convert sugars, starches and other foods into energy. The major types of diabetes are:
- Type 1 Diabetes, which was previously called insulin-dependent diabetes, affects about 10% of people with diabetes and most often occurs in children and young adults. Individuals with type 1 diabetes make little or no insulin and must take daily injections to live.
- Type 2 Diabetes, which used to be referred to as non-insulin dependent or maturity onset diabetes is the most common form of the disease, and affects about 90% of individuals with diabetes. It used to occur only in adults 45 years old or older, but, in recent years, type 2 diabetes is also being diagnosed in children as young as 8 years old. People with this type of diabetes make some insulin, but they are unable to use it properly to produce energy. Management of type 2 diabetes includes proper nutrition and physical activity. Treatment also involves oral diabetes medications and, in some cases, insulin injections.
- Gestational Diabetes (GDM) is a type of diabetes that is discovered or diagnosed during pregnancy, most commonly around the 24th to 28th week of gestation. It can be treated with nutrition therapy only or with the addition of insulin injections if needed to control the blood sugar level. GDM usually resolves after delivery. However, women with gestational diabetes are at risk to develop type 2 diabetes and should be tested after delivery and periodically thereafter.
Q: Who gets diabetes?
A: The causes of diabetes are not well known, but both heredity and environment appear to play a role in its development. The American Diabetes Association recommends that testing be done in individuals who:
- Are 45 years of age or older
- Are overweight
- Have diabetes in their family
- Are members of high risk ethnic population (Native American, Hispanic, African American, Asian)
- Had gestational diabetes or had a baby weighing more than 9 pounds at birth
- Have high blood pressure
- Have abnormal blood fat (cholesterol, triglyceride)
- Have a history of abnormal glucose test: impaired glucose tolerance, or impaired fasting glucose (previously called borderline diabetes)
Early detection and prevention of is recommended for individuals at risks for type 2 diabetes. Prevention may be achieved with proper nutrition and exercise.
Q: What are the goals of diabetes management?
A: Diabetes management is a partnership between the health care team and the individual with the condition. Management goals should be set individually, based on each person’s health status and motivation to participate in his/her self-care. The general goals of diabetes management are to:
- Achieve and maintain the best possible blood sugar control
- Prevent acute complications
- Prevent/delay chronic complications
- Achieve/maintain the best possible quality of life
Q: What type of diabetes care should be expected?
A: According to the standard of care developed by the American Diabetes Association the following key monitoring should be done regularly:
- Glycohemoglobin (HbA1c) (average blood sugar over a 3 month period) quarterly or at least twice a year if meeting goals
- Dilated eye exam at least yearly
- Foot exam at regular diabetes related visits
- Lipid (blood fat) exam yearly
- Microalbumin test (to check kidney function) yearly
- Blood pressure at each regular diabetes visits
- Weight monitoring