Dangers of Diabetes

with Andrew Brayer, M.D., Family Practice Physician, Columbia St. Mary’s

Posted: June 1, 2004

Eating whatever you want whenever you get a craving for it is something most of us take for granted. But that’s not an option for the 18 million Americans living with Type 1 and Type 2 diabetes.

“People don’t realize how serious of a health condition diabetes can be,” said Dr. Andrew Brayer, a family practice physician with Columbia St. Mary’s. “In general, if you compare the population of non-diabetics to diabetics, the average life span is 10 years less.”

Dr. Andrew Brayer, Family Practice Physician, Columbia St. Mary's "It's thought that there are as many as 5.2 million people walking around with undiagnosed diabetes."

The reason for that, he said, is that there are a lot of complications that occur with diabetes. They can include coronary artery disease, peripheral vascular disease, blindness, kidney problems and loss of sensation in the hands and feet.

“It’s thought that there are as many as 5.2 million people walking around with undiagnosed diabetes,” Dr. Brayer said. Early diabetes can have no symptoms. People who are not tested for diabetes may not know they have it.

There is good news, though.

“If you do have diabetes,” Dr. Brayer said, “there has been a lot of evidence to show that very good control of the disease significantly reduces the risk of developing complications associated with diabetes.”

Type 1 and Type 2 diabetes
There are two types of diabetes. In Type 1 diabetes, the pancreas fails to produce insulin, a hormone necessary to convert food, particularly sugars and starches, into energy. Type 2 diabetes occurs when the pancreas is unable to keep up with the demand to produce insulin; or the body becomes unable to use the insulin it produces.

Only about 10 percent of people with the disease are Type 1 diabetics. These people are completely insulin-dependent, requiring daily injections of the hormone. Of the other 90 percent, some rely on insulin shots, but others require no more than dietary modifications and/or oral medications.

Who is at risk
Risk factors for diabetes include being overweight, a sedentary lifestyle, a family history of diabetes, a history of gestational diabetes (which occurs during pregnancy and goes away after the birth of the child), and being from a particular ethnic group. African Americans, Native Americans, Hispanic Americans, Asian Americans and Pacific Islanders also have an increased risk of developing diabetes during their lifetimes.

Dr. Brayer recommended early screening for people with particular risk factors; anyone 45 and older should also be routinely screened for diabetes during their annual physical examinations.

Testing for diabetes is done using one of two tests. Both involve a blood draw, and both require that the person fast prior to coming in for the test. The Fasting Plasma Glucose Test (FPG) and the Oral Glucose Tolerance Test (OGTT) can both accurately indicate diabetes or glucose intolerance, a condition in which the blood sugar is higher than the normal range, but isn’t categorized as full-blown diabetes.

Lifestyle changes important
“People at risk for diabetes can possibly prevent diabetes from ever developing by making lifestyle changes,” Dr. Brayer said. These changes include modifying their diets, increasing their exercise levels and losing weight if they are overweight.

“Pre-diabetics should follow a diabetic diet,” he said. “They want to limit simple sugars – cakes, candy, cookies, ice cream and other sweets – and it’s better to eat several smaller meals throughout the day than eating one or two really large meals.”

Those who are already diabetic can prevent complications by doing the same, and by carefully monitoring their health. Diabetics need to be particularly mindful of keeping their blood pressure and cholesterol within normal levels, and should have their vision checked annually. Also, regular visits with their family doctor are important. Dr. Brayer recommended that diabetic patients see their doctor every three months; those with glucose intolerance, should see their doctor every six months.

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