Type 2 diabetes mellitus is among the leading causes of chronic adult illness in the United States. Along with high blood pressure, high cholesterol and smoking, it is a leading contributor to cardiovascular disease, which is responsible for more U.S. deaths than any other cause.
Though the rate of diagnosed diabetes is very high, many diabetics are unaware of their illness. This lack of recognition can delay essential treatments that have been proven to prevent complications from the disease.
Type 2 diabetes results from an impairment in the body's sensitivity to insulin. Normally, insulin produced by the pancreas in response to rising blood-sugar levels serves as a vehicle to carry sugar into the body's cells for use as fuel. Insulin resistance caused by Type 2 diabetes blocks this transport, producing the parallel problems of rising blood-sugar levels and lack of fuel for the body's tissues.
The symptoms of diabetes result from these problems. With inadequate fuel levels in the tissues, many patients experience fatigue and weight loss despite increasing hunger levels. As sugar levels rise in the blood, they in turn spill over into the urine. Sugar in the urine increases urination, which can produce dehydration. Resulting symptoms include excessive urination, nighttime urination and excessive thirst. Also, because of excess sugar levels and the associated impaired immune function, frequent infections such as yeast infections and boils often are experienced.
The diagnosis of diabetes is quite simple. It involves a test of blood sugar in the setting of appropriate symptoms. Elevated fasting sugar levels on two occasions are adequate to establish the diagnosis and prompt treatment.
A simpler method for the diagnosis of diabetes is on the horizon. This test, which is known as a hemoglobin A1c and already is used to monitor sugar levels in diabetics, does not require fasting or repeat testing to establish the diagnosis. Moreover, it can be accomplished with a simple finger stick. Experts still are working out the details of this newer diagnostic method, which should be available in the coming year.
Treatment of Type 2 diabetes involves dietary changes to reduce the consumption of sugary foods. Exercise and weight management also are essential lifestyle changes that can produce improved blood-sugar control.
Medication for Type 2 diabetes often involves treatment with pills that target either insulin production or insulin resistance.
In addition to correcting the underlying problems produced by diabetes, the goals of treatment are to reduce the risk of complications, most of which result form long-term elevations in blood sugar.
Sugar can act as a toxin to certain tissues in the cardiovascular system, eye, kidney and nervous system.
Diabetes is a leading cause of heart attack, stroke, blindness and kidney failure.
Fortunately, early diagnosis and treatment of diabetes has been shown to effectively reduce the risk of complications from this common disease.
Dr. Matthew A. Clark is a
board-certified physician in internal medicine and pediatrics practicing at the Southern Ute Health Center in Ignacio.