• Printer Friendly Version

Defeating Diabetes

Risks, Reality and Resources

Diabetes is a serious condition and it is important people receive the right care and support to prevent and manage it. If you have diabetes, you’re twice as likely to have heart disease or a stroke as people who do not.

Diabetes can also cause kidney failure, permanent vision loss and has contributed to a rise in amputations, according to the Centers for Disease Control and Prevention (CDC). “People are losing their limbs and part of that is because their diabetes is not well controlled,” said board-certified endocrinologist Dr. Julie O’Keefe.

The statistics show as high as 80% of nontraumatic lower limb amputations happen due to diabetic complications. This is of particular concern locally because the most recent Community Health Needs Assessment once again revealed diabetes to be a priority.

The good news is – it’s not too late to get your blood sugar levels back down. Even people at high risk can cut their risk in half by eating healthy, exercising regularly, getting to a healthy weight, reducing stress and stopping smoking.

Recently, we sat down with Dr. O’Keefe to learn more about diabetes, the life-threatening complications it can cause, if not controlled, who should be screened and why eating right and moving more can significantly lower your risk.

Q: What is diabetes?

It is a group of diseases in which the body’s ability to respond to the hormone insulin is impaired. It results in abnormal metabolism or breakdown of carbohydrates, which increases the levels of glucose or blood sugar in the blood or the urine. There are different forms of diabetes and what causes them are different. The most common type is type 2, which has risen dramatically with the epidemic of obesity.

Q: What causes it?

Genetics plays a role; so does being overweight and people’s lifestyles – not getting enough exercise and eating poorly. But the only risk factor you need is age. As you become older, you become more resistant to insulin.

Q: How serious is diabetes?

Diabetes and heart disease go hand in hand. There is at least a 10-fold greater risk of a serious coronary event. Whether it’s a heart attack, congestive heart failure or stroke – the risk is significantly greater.

Microvascular complications (affecting the small blood vessels) are vision loss, loss of kidney function that can lead to dialysis and neuropathy, where the disease affects the nerves. Once you have neuropathy, especially in the lower extremities, you are at increased risk of severe infection or amputation.

Patients who have neuropathy can avoid amputations if they make it a practice to look at their feet daily. If it is difficult for you to see your feet, place a mirror on the floor or ask someone to look at your feet. Any abnormalities (swelling, redness, lesions) should be evaluated by a medical provider.

Macrovascular complications of type 2 diabetes include coronary heart disease where there is a narrowing or blockage of the coronary arteries usually caused by atherosclerosis (buildup of plaque inside the coronary arteries). Diabetes also increases the risk of the heart muscle not working and congestive heart failure.

Q: What’s the relationship between diabetes and dementia?

A number of studies have shown that diabetes is associated with a 1.5- to 2-fold increase in the risk of developing cognitive decline and dementia later in life. This increased risk is present for vascular dementia and Alzheimer’s disease but the magnitude of risk is higher for vascular dementia. Vascular dementia is due to the atherosclerotic changes that occur in the blood vessels in the brain. Dementia may also occur after repeated hypoglycemic (low blood glucose) events.

Q: How do you know you have it?

That’s part of the problem. With type 2, there are some people who have symptoms that are so mild they often go unnoticed. That is why it is critical to have your blood sugar tested – early screening may help people avoid the more serious complications of the disease.

Q: Who should be screened?

Per the American Diabetes Association (ADA), any adult over 45 OR any adult who is overweight (BMI over 25) and has one additional risk factor such as:

  • Hypertension
  • High cholesterol
  • Smoking
  • First-degree relative with diabetes
  • History of gestational diabetes

We know certain populations such as African-American, Hispanic, Asian-American, Pacific Islander and Native American are at a much higher risk. If you are screened and it’s negative, you should get screened every three years. If you are someone who was told you are prediabetic, you should be screened yearly.

Q: Can type 2 diabetes be prevented?

Yes, it can. First of all, what is important is to know your risk – talk to your doctor if you don’t know. And make sure you’re getting screened. Because in truth, as we age our body becomes more resistant to insulin. That is just reality. But keeping your weight in check, being active, and eating a healthy diet can help prevent most cases of type 2 diabetes.

In general, it’s a good idea to load up on vegetables, especially the less starchy kind such as spinach and other leafy greens, broccoli, carrots and green beans. Add more high fiber foods and enjoy fruit in moderation (1-3 servings per day), choose whole grain foods and avoid bad fats like bacon, luncheon meats, chips, ice cream and fried foods.

Q: Why is regular physical activity so important?

Becoming more active is one of the best things you can do to make type 2 diabetes less likely. In fact, inactivity is a risk factor for developing the disease. Aim for 30 minutes of aerobic activity five days a week. Find what is going to keep you engaged and keep doing it. It’s OK to split it into three 10-minute intervals.

Strength/resistance training should be done at least twice a week. Muscles are what allows the body to take the glucose in your bloodstream and use it as energy. The other thing it does is lower your resistance to insulin. That’s why your exercise routine needs a strength/ resistance training component. Before beginning any exercise program or regimen, you should get clearance from your doctor.

back to top button