Diabetes – A Confusing Disease

Diabetes is a confusing disease. First of all, there are two types: Type 1 and Type 2. Type 1 was previously called Juvenile Onset Diabetes and Type 2 was called Adult Onset Diabetes. Sometimes Juvenile Onset Diabetes was called Insulin Dependent Diabetes. That’s because individuals diagnosed with juvenile diabetes were dependent on daily insulin injections in order to stay well and alive. Now we know that there is seldom a clear line in any disease and it has become simpler (and more clarifying) to just go to Type 1 and Type 2.

 

People with Type 1 diabetes have a pancreas that does not function. The pancreas makes insulin (among other things). Insulin is necessary for your body to use the food you eat for energy, wound healing, thinking and a lot of other ordinary functions we take for granted. Those with Type 2 diabetes make insulin but their bodies can’t use it appropriately. What causes diabetes? Genetics is a big factor. But so is lifestyle. Being overweight and not exercising are the culprits here. By the way, eating a lot of sugar does not cause diabetes – unless it causes you to become overweight. But once diagnosed with either type of diabetes, diet becomes a very important factor in controlling it.

 

The incidence of Type 2 diabetes has increased phenomenally over the last several decades. What is most disturbing is that the average age of onset of Type 2 diabetes has decreased. It used to be a disease of old or middle age. Now children in grammar school are being diagnosed with diabetes.

 

So, what’s so bad about Type 2 diabetes? You generally don’t have to take daily injections (at least, not at first). What’s bad is that diabetes, both Types 1 and 2, put you at very increased risk for disease of the heart and the vascular system. That means heart attack and stroke. Men with Type 2 have twice the risk of heart disease than men without diabetes. Women with Type 2 have four times the risk.

 

The research on risk is quite clear. However, the research on diet is not.  

 

This past week the American Diabetes Association, the American Heart Association and the American College of Cardiology issued a joint statement. Most people with diabetes should stick with a goal of a low blood sugar count (glycemic control [A1C] of 7 or less) in order to reduce the risk of diabetes-related complication. This contradicts a study recently published in The New England Journal of Medicine.

 

So, what is a person with diabetes to do? Well, both studies suggest that the management of diabetes needs to be individualized. What does this mean for you? Follow your doctor’s recommendations. But first, see my blog of December 19.

 

 

 

 

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Mary Lou Bernardo, PhD, MSN

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