Houston, We Have a Problem- With Diabetes

Houston has great medical care options. Is diabetes a real problem here?

Houston, Texas is the largest city in the Southern U.S., and the fourth most populous city in the country, so when mayor Annise D. Parker notes that diabetes is a public health concern for the city, she means business. Compared to 8% statewide, 11% of the adult population in Houston has diabetes, and 32% suffer from obesity- a significant risk factor developing type 2 diabetes. 5-10% of the total population suffers from the autoimmune-based type 1 diabetes, most often diagnosed in childhood or young adulthood.

Diabetes mellitus is a group of diseases that affect the body’s insulin needed to metabolize the glucose in dietary carbohydrates. After a meal, sugars are converted to glucose in the body. Glucose can only be used for energy once the cells of the pancreas release a hormone it creates called insulin. This video below from the Mayo Clinic explains how insulin is related to diabetes

Although Houston has the largest medical center in the world, diabetes is a growing problem- one which we need to be prepared to collectively fight tooth-and-nail with education and awareness. Physicians, nutritionists, and specialists can only help when people decide to take control of their health. Becoming familiar with the initial signs is key to combating the disease and the negative hurdles that accompany it.
Do you recognize the various manifestations of diabetes and their common symptoms in anyone you know?

 

Type 1 Diabetes

Once known as juvenile diabetes or insulin-dependent diabetes, type 1 diabetes is a chronic condition when the body produces little to no insulin. Insulin is needed in order to convert sugar into energy for the cells. This condition accounts for only 5% of the diagnoses of the disease. Type 1 diabetes can develop at any age and affects both men and women equally.

Risk factors for type 1 diabetes include autoimmune, genetic, and environmental factors. Those who have family members who have type 1 diabetes have a slightly increased risk of developing the condition. Although this condition can appear at any time, it usually appears between the ages of 4 and 7 years old and 10 and 14 years old. Other risk factors that have been investigated (though not proven) include exposure to certain viruses, such as Coxsackie virus and mumps virus. Low vitamin D levels and early exposure to cow’s milk can also be risk factors for type 1 diabetes.

 

Symptoms

Complications

  • Frequent urination
Increased risk for heart and blood vessel disease, including coronary artery disease
  • Excessive thirst
Nerve damage (neuropathy)
  • Unexplained weight loss
Kidney damage (nephropathy)
  • Extreme hunger
Eye damage, leading to risk of cataracts, glaucoma, and potential blindness
  • Irritability and other mood changes
Foot complications due to poor blood flow or untreated cut and blisters
  • Sudden vision changes (blurred vision)
Skin and mouth conditions, such has bacterial and fungal infections
  • Tingling or numbness in hands or feet
Pregnancy complications (risk of miscarriage, stillbirth, and birth defects increase when diabetes isn’t controlled)
  • Fatigue and weakness
Diabetic ketoacidosis- a serious condition where the body’s insulin levels are too low to use glucose as an energy source so it starts burning fat as an alternative.
  • Nausea
  • Vomiting
  • Stomach pain
  • In females, a vaginal yeast infection
  • Bedwetting in children who previously did not wet the bed at night

 

Treatments:

There is no cure for type 1 diabetes, but it can be managed and controlled. Physical activity, healthy eating, and insulin injections are basic therapies for Type 1 Diabetes. Aim to include 30 minutes of physical activity 3-5 days per week. Carbohydrate counting and following the plate method are also key factors when eating healthy. The amount of insulin that is taken must equal the amount of food and physical activity a person exerts. There are two types of insulin: rapid-acting insulin and long-acting insulin. Usually, a diabetic who takes shots will receive both rapid-acting and long-acting insulin. A diabetic using an insulin pump will use the rapid-acting insulin. Blood sugar levels should be monitored very closely, at least up to four times per day.

 

Pre-diabetes

Think of pre-diabetes as a warning sign from your body that something isn’t quite right. In those with the disorder, blood glucose levels are higher than normal but do not meet the standards at which diabetes is conclusively diagnosed. Tests to determine pre-diabetes are the same that can also detect type 2 diabetes.

 

Type II Diabetes

Unlike type 1 diabetes, type 2 diabetes is not considered insulin-dependent and accounts for most of the diagnoses of the disease (an estimated 90% to 95%). This condition can develop at any age and is marked by either progressive declines of insulin secretion, or the body’s inadequate usage of glucose due to its resistance to insulin.

Certain things can increase the risk of developing type 2 diabetes, the most common of which are often-preventable lifestyle factors such as obesity, untreated sleep disorders, physical inactivity, high blood pressure, high LDL cholesterol and/or triglyceride levels. Other risk factors may be less controllable. For instance, minorities are particularly susceptible to type 2 diabetes and some of its associated risk factors, with increased incidences among Asian Americans and Pacific Islanders, African-Americans, Native Americans, and Latino or Hispanic Americans.

 

Symptoms

Complications

Feeling thirsty Heart disease and stroke risks can double.
Frequent urination Eye problems (including glaucoma and blindness).
Feeling very hungry Hypoglycemia, or when blood sugar is under 70 mg/dL.
Headaches Hyperglycemia, or when blood sugar peaks above
Fatigue, tiredness Nerve damage, decreased circulation
Unexplained weight loss Digestive problems
Blurry vision Recurrent episodes of hypoglycemia can increase the risk for dementia
Infections (like urinary tract infections, yeast infections) Kidney damage leading to dialysis or needing a transplant
Tingling, a pins-and-needles sensation, or loss of feeling in feet Diabetic ketoacidosis- a serious condition where the body’s insulin levels are too low to use glucose as an energy source so it starts burning fat as an alternative.
Itchy, dry skin Painful infections and sores
Sexual dysfunction (in both men and women)
Slow healing of cuts or sores

 

Treatment

There is no cure for type 2 diabetes, but the fact that serious complications and deaths related to the disease have declined sharply while diagnoses have increased shows how very successfully it can be managed.

However, that doesn’t mean you should put off seeing a doctor; diabetes should be treated as soon as possible, and maintaining health on a daily basis is vital at every age since blood sugar control can prevent damage from complications. Stay physically active; work with your physician to determine which medications are ideal for your body and lifestyle and any conditions you may already have.

Nutrition is also extremely important, so if you’re having trouble figuring out what to eat either at home or on the go, we’ve got a great resource that allows you to explore your options without worrying!

 

Gestational Diabetes

Gestational diabetes refers to hormonal changes of pregnancy that affect how insulin works. Women without a previous history of high blood sugar who develop it during pregnancy are considered to have gestational diabetes, and tests are usually conducted between the 24th and 28th week of pregnancy.

Some of the risks for developing gestational diabetes are shared with the risk for type 2 diabetes. The primary risk for gestational diabetes is, obviously, pregnancy- but having already birthed a baby weighing over 9 pounds can also increase the chances of developing the disease. Having gestational diabetes also increases your risk of developing type 2 diabetes later in life as well.

Treatment

Fortunately, gestational diabetes often goes away after pregnancy, but it is still extremely important to manage blood sugar levels as certain risks are posed to the mother and the baby after birth. Physical activity, good nutrition and weight management are some preventative measures women can take prior to and during a pregnancy, especially for those with type 1 or type 2 diabetes.

 

Diabetes Insipidus

Not to be confused with diabetes mellitus, diabetes insipidus is an uncommon disease in which a person urinates an unusual amount- so much that they become dehydrated very quickly. Other adverse effects can also follow, including strong thirst, bedwetting, and sleep disruption due to such frequent urination. Fever, vomiting, diarrhea can be present in children with the disease as well.

Treatment

There are several forms of diabetes insipidus, most of which are treatable with medication. Its symptoms can appear vary similar to type 1 and type 2 diabetes, but it isn’t related to either disease. Diabetes insipidus is often not serious enough to be life-threatening, but can certainly interfere with daily life and possibly cause embarrassment in certain situations.

 

If you suspect diabetes, get tested!

There are a variety of tests to determine if you or someone you know has diabetes. The most commonly used test for diagnosing prediabetes, type 1 or type 2 diabetes is the A1C test. The A1C test, (a.k.a the glycated hemoglobin test) does not require fasting, and is therefore often more convenient to use. For more in-depth information on testing can be found here.

 

A1C Test Types of Diabetes Indicated
≥ 6.5% = Diabetes

5.7 – 6.4% = Pre-diabetes while

< 5.7% = Normal

Pre-diabetes, Type 1, Type 2
Fasting blood sugar tests
Require a blood sample taken after an overnight fast.

< 100 mg/dL= Normal

100 -125 mg/dL = Pre-diabetes

≥ 126 mg/dL on two separate tests= Diabetes

Pre-diabetes, Type 1, Type 2
Oral glucose tolerance test Pre-diabetes, Type 1, Type 2
Overnight fasting is required. After drinking a sugary liquid, glucose levels are tested over the next two hours and the fasting blood glucose level is measured.

< 140 mg/dL = Normal

Between 140 and 199 mg/dL = Pre-diabetes

≥ 200 mg/dL= Diabetes

Initial glucose challenge test Gestational diabetes
After an 8-hour fast and drinking a sugary liquid, your glucose level will be tested after one hour.

< 140 mg/dL = Normal

If your blood sugar level is higher than 140 mg/dL, it indicates a higher risk of gestational diabetes. Your doctor will order a follow-up test to determine if you have gestational diabetes.

Urinalysis Diabetes Insipidus
Examination of the urine can measure the concentration of salt and other wastes- which will be diluted in comparison to the volume of liquid in those with excessive urination.
Fluid deprivation test
Helps doctors better understand the type of diabetes insipidus a person has by determining the cause. It measures fluctuations in one’s weight, urine production and chemical composition of urine when deprived of drinking fluids.

 

What are you waiting for?

Diabetes is no joke, but it can definitely be handled so it doesn’t put limits on life’s pleasures. But it’s easy to ignore the signs and attribute them to something minor, so don’t procrastinate if any of these symptoms give you pause.

If you suspect you or someone close to you may have any of the various types of diabetes, it’s a good idea to contact a doctor and get tested. There are tests, treatment, lifestyle and support resources to help cope with diabetes in all its forms- but knowing is half the battle!

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