Articles

Diabetes

What is it and what are the risk factors commonly associated with it?

Diabetes results from the body’s inability to utilize glucose in its cells. This may either result from an inadequate supply of insulin, which facilitates the utilization of glucose, or the body develops a resistance to the function of insulin. In either case the glucose stays in the blood stream where it can cause a wide variety of problems. Type1 diabetes, which typically afflicts people before they are 30 years old, is caused by the body not producing sufficient insulin. Type 2 diabetes usually begins in people older than 30 and becomes more common with age. The risk factors for both types of diabetes include genes but for type 2 diabetes the most important risk factor is obesity.

Societal Impact

Over 20% of people over 65 have diabetes and those with diabetes represent 18% of all nursing home residents, who also tend to be younger than those without diabetes. Diabetes is the costliest of all medical conditions, in part because those with diabetes are at higher risk for heart disease, blindness, kidney failure, extremity amputations and other chronic conditions.

Symptoms

Excess glucose spills into the urine, which causes the kidneys to excrete additional water to dilute the sugar, which, in turn, results in large volumes of urine. This then causes abnormal thirst and, because a lot of calories are lost in the urine, a loss of weight. To compensate, one feels excessively hungry and thirsty. Other symptoms can include drowsiness, hard to heal skin wounds, blurred vision, tingling of hands and feet, gum or urinary tract infections and itchy skin.

Treatment

The objective of treatment is to achieve a balance between the food ingested and the body’s ability to manage glucose, thereby keeping blood sugar levels within the normal range as far as possible. This is critical if damage to other organs such as kidneys, the cardiovascular system and retinas is to be avoided. Treatment typically involves diet, exercise, education and for most people, drugs, either to supplement the insulin supply or to enhance the body’s utilization of insulin.

Complications

Heart disease, including strokes and high blood pressure, is the leading cause of diabetes related deaths (2 to 4 times higher death rates than those without diabetes). The excess sugar contributes to blocked arteries and blood clots.

Diabetes is the leading cause of blindness among adults and also accounts for 43% of new end-stage kidney disease cases.

About 60-70% of people with diabetes develop mild to severe forms of nervous system damage and these account for more than 60% of non-traumatic lower limb amputations.

Periodontal and gum diseases are more common among people with diabetes than those without.