Diabetes is a serious disease. It cannot be cured, but careful control of blood sugar can prevent or delay the complications of the disease. If you have diabetes, your body cannot properly convert foods into the energy needed for daily activity. Our bodies change the foods we eat into a form of sugar called glucose. Glucose travels through the bloodstream to "fuel" or feed our cells. Sometimes it is stored in the liver for future use. Insulin is a hormone that is made in the pancreas and helps cells take in the amount of glucose they need. People with diabetes do not make or properly use insulin. As a result, glucose builds up in their blood and causes many symptoms of diabetes such as feeling tired, losing weight, feeling hungry or thirsty, urinating frequently or having vision problems. In time, blood glucose that is not well controlled causes serious damage to the eyes, kidneys, nerves, and heart. A great deal of research is underway to find out exactly what causes diabetes. Diabetes tends to run in families, but other factors add to the risk of getting diabetes. For example, being overweight and under-active triggers diabetes in people who are at risk.
Types of Diabetes
About 5 to 10 percent of people with diabetes have type 1 diabetes. Once known as juvenile onset diabetes or insulin-dependent diabetes, type 1 diabetes usually occurs in children and adults under age 30. It develops when the body's immune system attacks the insulin-producing cells of the pancreas. Along with exercise and controlled diet, lifelong treatment with insulin is required to replace the insulin that the body can no longer produce. About 90 percent of diabetes in the U.S. is type 2 diabetes. It is most common in adults over age 40. Type 2 diabetes occurs when the cells do not use insulin properly and the pancreas is not producing enough insulin. Type 2 diabetes is linked to obesity, inactivity, family history of diabetes, and ethnic heritage. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at very high risk for type 2 diabetes.
Early in the disease, many people with type 2 diabetes can keep their blood glucose levels near normal by controlling their weight, exercising, and following a sensible diet. Often, people with type 2 diabetes must take oral anti-diabetic medications to control their glucose. For some people, insulin may also be needed.
Blood glucose levels that are either very high or very low can lead to serious medical emergencies. Diabetics may go into a coma when their blood sugar levels get very high. Low blood sugar, or hypoglycemia, can also lead to unconsciousness. People who have diabetes must know the warning signs of hypoglycemia and what to do if problems occur. Also, diabetes can cause long-term complications such as stroke, blindness, heart disease, kidney failure, gangrene, and nerve damage. Research has shown that strict blood glucose control helps to delay or prevent these problems.
Some people with diabetes feel "run down" or have symptoms that may go unrecognized. Others have symptoms such as feeling thirsty, urinating frequently, losing weight, feeling tired, having blurred vision, getting skin infections, and having slow healing cuts and bruises. These problems should be reported to a doctor right away.
A doctor may find the first signs of diabetes, such as sugar in the urine or too much sugar in the blood, during a routine exam. Sometimes the problem is found by a glucose tolerance test, which measures the level of glucose in the blood before, and at timed intervals after, drinking a sugary liquid. Research shows some increase in blood glucose levels often occurs with age. This increase results from weight gain, particularly when fat increases around the waist.
Diabetes cannot be cured, but it can be controlled. Good control requires a careful blend of diet, exercise, blood sugar monitoring, and medication. People with type 1 diabetes control their blood sugar with insulin injections and frequent self-monitoring of blood glucose. People with type 2 diabetes generally control their blood sugar with oral medications. In some cases, insulin injections are needed to keep type 2 diabetes under control.
Diet is very important to lowering blood glucose levels. In planning a diet, the doctor considers the patient's weight and daily physical activity. For overweight patients, a weight loss plan is a must for proper blood glucose control. Food exchange lists to help with meal planning are available from your doctor and the American Diabetes Association.
Exercise is very important because it helps the body burn off some of the excess glucose as energy. Taking part in a regular fitness program has been shown to improve blood glucose levels in older people with high levels. A doctor can help plan an exercise program that balances the diet and medication needs and your general health.
Drugs may not be needed for type 2 diabetes if good control can be achieved through diet and exercise. But when these measures fail, oral drugs, insulin, or a combination of the two may be prescribed. A person who normally does well without drugs will need to take medication during acute illnesses.
Foot care is very important for people with diabetes. The disease can lower blood supply to the limbs and reduce feeling in the feet. People with diabetes should check their feet every day and watch for any redness or patches of heat. Sores, blisters, breaks in the skin, infections or buildup of calluses should be reported right away to a podiatrist or family doctor.
Skin care is very important. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean, using skin softeners to treat dryness, and taking care of minor cuts and bruises.
Teeth and gums need special attention to avoid serious infections. People with diabetes should tell their dentist about their condition and schedule regular checkups.
Diabetes is a self-help disease. People who take steps to control their diabetes can make a big difference in their health. If you have diabetes, stick to a diet plan, monitor your blood sugar, exercise regularly, take prescribed medication, and make healthy lifestyle choices. Strict blood glucose control is your best defense against the serious complications of diabetes.
All Medicare beneficiaries with diabetes now receive coverage for supplies such as glucose monitors, test strips, and lancets. For more information about what is covered, call your Durable Medical Equipment Regional Carrier (DMERC).
- DMERC Region A: Connecticut, Delaware, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont 1-800-842-2052
- DMERC Region B: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin, Virginia, West Virginia 1-800-270-2313
- DMERC Region C: Alabama, Arkansas, Colorado, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virgin Islands1-800-213-5452 or 1-800-213-5446
- DMERC Region D: Alaska, American Samoa, Arizona, California, Guam, Hawaii, Iowa, Idaho, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, Wyoming 1-800-899-7095
HCFA Customer Service Center for Beneficiaries: District of Columbia, Maryland 1-800-444-4606
The National Diabetes Education Program (NDEP), a program of the National Institutes of Health and the Centers for Disease Control and Prevention offers information and resources for people with diabetes, health care providers, and organizations conducting diabetes education programs. For more information, visit the website at http://ndep.nih.gov or call 1-800-438-5383.
You can contact the American Diabetes Association for the booklet Seniors: Diabetes and You as well as a list of free or low-cost publications. Write 1701 N. Beauregard Street, Alexandria, Virginia 22311; call (800) DIABETES; or visit their website at www.diabetes.org.
The National Diabetes Information Clearinghouse (a service of the National Institute of Diabetes and Digestive and Kidney Diseases) has information about diabetes for health professionals, patients, and the public. Write NDIC, 1 Information Way, Bethesda, Maryland 20892-2560 or visit their website www.niddk.nih.gov.
The National Institute on Aging offers a variety of information about health and aging. For a list of publications, contact:
National Institute on Aging (NIA)
P.O. Box 8057
Gaithersburg, MD 20898-8057
National Institute on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health
This publication sourced from the National Institute on Aging.