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Controlling a too often fatal disease
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One in three Americans born in 2000 will develop diabetes in their lifetime and there are presently more than 20 million people in the United States (7 percent of the population) who have diabetes today.
Although 14.6 million of them have been diagnosed with the disease, another 6.2 million are unaware they have the disease so are at increased risk for other diseases.
In addition to the 20.8 million people with diabetes, it is estimated that an additional 41 million Americans have “pre-diabetes.” This is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. Many people first become aware they have diabetes when they develop one of its life-threatening complications: heart disease and stroke, high blood pressure, blindness, kidney disease, nervous system damage, amputations, dental disease, pregnancy complications, sexual dysfunction.
The cause of diabetes is a mystery, although genetics and environmental factors such as obesity and lack of exercise appear to play roles. There is no known cure, but the management of blood glucose (sugar) is the cornerstone of diabetes care.
There are several different types of diabetes:
Type 1 — this type of diabetes accounts for 5-10 percent of all diagnosed cases and requires insulin be taken to control it. Risk factors are less well defined than for type 2 diabetes, but autoimmune, genetic and environmental factors are believed to be involved.
Type 2 — This diabetes may account for 90-95 percent (17 million people) of cases. This type can often be controlled by diet and regular activity although some people may also need to take pills or insulin. Risk factors include age, obesity, family history, prior gestational diabetes, impaired glucose tolerance, inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians and some Asian Americans and Pacific Islanders are at particularly high risk.
Gestational diabetes — This affects about 4 percent of pregnant women and usually disappears when a pregnancy is over. Some studies have reported that approximately 40 percent of women with a history of gestational diabetes eventually developed type 2 diabetes.
Other types of diabetes have been known to result from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illnesses.
You are at risk of developing diabetes if you:
1. Are older than 45.
2. Are overweight.
3. Have a close relative who has or had diabetes.
4. Have had diabetes when you were pregnant.
5. Are African American, Hispanic/Latino, Asian American or Pacific Islander or Native American.
Symptoms may include: frequent urination, excessive thirst, unexplained weight loss, extreme hunger, sudden vision changes, tingling or numbness in hands or feet, feeling very tired much of the time, very dry skin, sores that heal slowly, more infections than usual.
While heart disease is the leading cause of death for diabetics, millions of them fail to make the connection between these two life-threatening conditions. Most diabetics consider kidney complications, blindness and amputations to be their greatest risks, but an alarming two out of three diabetics will die from heart attack or stroke.
Diabetics are more likely to also have other health problems such as high blood pressure and high cholesterol that contribute to an increased risk for heart attacks and stroke.
People with diabetes are also more susceptible to many other illnesses and, once they acquire these illnesses, often have worse prognoses than people without diabetes. Diabetics are more likely to die with pneumonia or influenza than people who do not have the disease. Periodontal or gum diseases are more common among people with diabetes than among people without diabetes and approximately one-third of people with diabetes have severe periodontal diseases.
Your risk for diabetes may be significantly reduced by:
• Keeping your weight in control;
• Eating low fat meals that are high in fruits, vegetables and whole grain foods;
• Staying active most days of the week.
If you are at risk and have one or more symptoms, please see your healthcare provider. Irreversible complications may result from lack of or improper treatment. Careful monitoring and treatment will prevent cardiovascular and kidney disease and save your sight. For more information about diabetes, contact your healthcare provider or local health department.

Ratcliffe works with the Coastal Health District.
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