Some health care professionals say that diabetes has reached epidemic proportions in the United States. A 2017 report released by the Centers for Disease Control and Prevention (CDC) found that more than 100 million U.S. adults are now living with diabetes or prediabetes, when blood glucose levels are too high, but not high enough to be called diabetes. Also referred to as unpaired glucose intolerance, prediabetes is a serious condition that should not be ignored.
At Santa Ana’s South Coast Post Acute, we’re committed to maintaining the health of our senior community. Our caring, committed staff, level of excellence and innovative, compassionate care, have made us Southern California’s post-acute community of choice. We’d like to take a few minutes to delve into the topic of diabetes and ways to treat it.
Let’s start with the basics: what is diabetes? Diabetes is a medical condition in which the body does not properly process the food we ingest for use as energy. Most of the food we put in our bodies is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ near the stomach, produces a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn’t manufacture enough insulin or can’t use its own insulin as well as it should. This causes sugars to build up in your blood (which explains why some people refer to diabetes as “sugar.”) Diabetes is the seventh leading cause of death in the country and can lead to complications such as premature death, heart disease, vision loss, kidney failure, and amputations of legs, toes, and feet.
Here is the list of the country’s top ten causes of death:
- Heart disease
- Chronic lower respiratory disease
- Alzheimer’s disease
- Influenza and pneumonia
- Kidney disease
Here are a few alarming recent statistics on diabetes. Over the last decade, the cases of people living with the disease jumped almost 50 percent, to more than 30 million Americans. That’s
9.4 percent of the U.S. population. Another 84.1 million have prediabetes, a condition that if not treated often leads to Type 2 diabetes within five years. An estimated 1.5 million new cases of diabetes were diagnosed in people ages 18 and older and almost one-in-four adults living with diabetes–7.2 million Americans–didn’t realize they have the condition. In fact, just 11.6 percent of adults with prediabetes knew they had it. The rates of diagnosed diabetes increased with age–among adults ages 18 to 44, four percent had the disease; in the 45 to 64 population, 17 percent of people had diabetes; and among people 65 years and older, a full 25 percent had diabetes. Living with diabetes puts a large emotional, physical and financial burden on entire families–each year, diabetes costs the American public more than $245 billion.
All of these figures show why it’s so important to take diabetes seriously. “Although these findings reveal some progress in diabetes management and prevention, there are still too many Americans with diabetes and prediabetes,” said Brenda Fitzgerald, M.D., Director of the CDC. “More than a third of U.S. adults have prediabetes, and the majority don’t know it. Now, more than ever, we must step up our efforts to reduce the burden of this serious disease,” she added.
There is more than one type of diabetes. We’ve been looking at what is known as Type 2 diabetes, but there are others:
- Type 1. Typically, this type of diabetes begins in childhood, and requires people to begin insulin therapy as soon as they are diagnosed. This form is usually caused by an autoimmune disorder, which is when the body’s immune system mistakenly attacks cells that make insulin. In some people, Type 1 diabetes may occur following a viral infection, such as cytomegalovirus, encephalitis, Epstein-Barr virus, influenza, measles, mumps, polio, or rubella. It’s rare, but the onset of diabetes can be triggered after an injury to the pancreas from trauma or toxins.
- If Type 1 diabetes occurs in adulthood, it’s called Latent Autoimmune Diabetes in Adults (LADA); this is an autoimmune disorder in which the body’s immune system mistakenly attacks cells that make insulin. Compared with adults who have Type 2 diabetes, adults with LADA are often thin, and don’t have a family history of diabetes. People with LADA typically need to begin an insulin regimen within six months after being diagnosed with the condition.
- There are other kinds of diabetes, such as gestational diabetes, which occurs during pregnancy.
What can you do to treat diabetes? Of course, you should consult your physician, but there are some general guidelines for treating diabetes.
- Type 1 diabetes has to be handled with injections of insulin.
- If you have Type 2 diabetes, there are several lifestyle changes you can make, including losing weight by eating a balanced, low-sugar diet, and ditching the sedentary lifestyle with regular exercise. Your doctor may recommend prescription medication to treat Type 2 diabetes, such as Metformin; this is a biguanide, which reduces the production of glucose in the liver, and makes muscle tissue more sensitive to insulin to improve the absorption of glucose. It’s taken in pill form or as a liquid, and works by reducing blood sugar and making insulin more effective. It also helps in losing weight loss, another key to reducing the effects of the disease. It is taken by mouth one to three times a day with meals, and you should drink plenty of liquids when taking Metformin.
- There are other oral medications that can help keep blood glucose in check, including alpha-glucosidase inhibitors, like acarbose and miglitol. These slow the breakdown of starches into glucose after a meal, slowing down the increase in blood sugar levels.
- Bile acid sequestrants (BASs), which reduce cholesterol and blood sugar, and are safe for people who also have liver problems, because they do not enter the bloodstream.
- DPP-4 inhibitors, such as alogliptin, linagliptin, and saxagliptin, which help improve the binding of glucose to the blood without causing low blood sugar.
- Meglitinides, such as nateglinide and repaglinide, which stimulate the release of insulin, but might cause low blood sugar.
- SGLT2 inhibitors, such as canagliflozin and dapagliflozin, which help block the reabsorption of glucose in the kidneys, resulting in sugars leaving the body in the urine.
- Sulfonylureas, including glimepiride, glipizide, and chlorpropamide which stimulate the release of insulin in the pancreas.
- Thiazolidinediones, or TZDs, such as rosiglitazone and pioglitazone, which improve the function of insulin in the fat and muscle and slow glucose production in the liver.
- GLP-1 agonists–including albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, and semaglutide–can help with weight loss and some decrease in cardiovascular events.
A few caveats: Some medications can reduce blood sugar too much or lead to developing hypoglycemia, or low blood sugar, if a person takes them outside of regular mealtimes; if only taking one of these medications at a time is not having the desired effect on blood glucose,
a doctor may prescribe a combination of them; and since they have an impact on different functions in the body, not all of these drugs interact with each other. Also, certain medications, such as GLP-1 receptor agonists–which reduce the glucose output of the liver and increase insulin production–require an injection.
Here are more tips on ways to treat Type 2 diabetes:
Eat Healthier. Eat a diet that is low in sugar, including from fruit, as well as saturated fats. You may want to see a registered dietitian nutritionist (RDN) who is a diabetes educator to help you develop a healthy meal plan that you can stick with. You may not have any pay out-of-pocket cost for this, as Medicare covers annual visits.
Stay Active. You can help you control your glucose level and manage your weight with aerobic exercise, such as walking, swimming, and bicycling. The American Diabetes Association recommends exercising at least five days a week, for 30 minutes, to help to manage your condition. You can split your exercising into 10 minutes of activity three times a day. In addition, you should incorporate strength training, such as free weights, resistance bands, or yoga, into your routine at least twice a week. This will build muscle and help control glucose levels.
Check those glucose levels regularly. Your doctor or other healthcare professional can give you advice on how and when to check your blood glucose level. You should check your levels regularly if you take insulin, have a difficult time controlling blood glucose or have hypoglycemia.
For more than 40 years, South Coast Post Acute has been Southern California’s post-acute community of choice for post-acute rehabilitative, memory and long-term care health services. If you have questions about dealing with your diabetes, contact us today.
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