1. The Lack Of Diabetic Awareness Sharon Corts English 102, Section 2146 December 5, 2002

2. 2 Introduction In 1999, diabetes was the sixth leading cause of death in the U.S. There were 17 million people who suffered from this disease, yet 5.9 million of those suffered in silence as they were unaware they even had the disease (National). Diabetes can effect any person, at any age. Statistics from the American Diabetes Association national fact sheet state that, in 1999, there were approximately 151,000 people under the age of twenty with the disease. Sufferers over the age of twenty numbered 16.9 million, of which 7 million were aged sixty-five and over. As of date there is no known cure for diabetes. However education, management, awareness and control can lead to a decrease in the approximated 450,000 people who die from diabetes complications each year (National).

3. 3 What Is Diabetes? The technical term for diabetes is diabetes mellitus and is best described as a “chronic metabolic disorder characterized by elevated blood glucose, or sugar, levels”(What). In a person diagnosed as diabetic, there is limited or no insulin being produced, so a build up of sugar occurs in the bloodstream. The glucose will then be expelled from the urine rather than feeding the cells.

4. 4 How Diabetes Occurs In a healthy individual,food that a body has digested is broken down into a type of sugar which is then converted into an energy source. This happens when the sugar enters the bloodstream and increases the amount of sugar in the blood. The body will then be alerted of the rise in sugar and send a signal to the pancreas, which in turn will release the chemical insulin. Insulin works by deceasing the level of sugar and allows the sugar to leave the blood and enter cells, which in turn acts as a fuel ( Lilly 6). Diagram 1:Position of the pancreas, from the diabetes.about.com image gallery.

5. 5 Types of Diabetes Type I. The severest form of diabetes is Type I or insulin-dependant diabetes mellitus. This is caused when beta cells in the pancreas, which make insulin, are destroyed by the immune system. No, or little, insulin means that the sugar from anything eaten cannot be used as fuel energy.Insulin shots must be administered before every meal in order to survive The onset of Type I can be sudden and unexpected. Warning signs are an extreme increase in thirst and/or hunger, the need to urinate often, fatigue and sudden weight loss ( National). Type I affects only 1 in 10 diagnosed diabetics (Lilly 11). Type II. When the body doesn’t make enough insulin, or cannot use the insulin it makes, this is called Type II or non- insulin-dependant diabetes. It is the most common form of the disease accounting for 90 to 95% of diagnosed cases( National). It is linked mostly to obesity, inactivity and people over the age of 40. Sugar has to go through entrances in the cells to produce energy, with Type II there is a problem with these entrances and the sugar builds up in the blood. Type II symptoms can take a while to be noticeable and can include tiredness, dry skin, infections, increased urination, cuts that take a long while to heal and an increase in thirst or hunger ( Lilly 13).

6. 6 Other Types A third type of diabetes is called gestational diabetes. It occurs in women during pregnancy. To avoid any complications occurring to the unborn child, blood glucose levels have to be carefully monitored (National). Diagram 2: Gestational diabetes, from diabetes.about.com image gallery.

7. 7 Coping With Diabetes Whichever type of diabetes that you suffer from, longevity of life can be achieved if five basic regimes are adhered to.

8. 8 Education Almost a third of all diabetics do not know they have the disease until they are at a critical stage. Type I symptoms can be instant and obvious, while the problem with Type II is that the symptoms can take a long while to appear. People who are at risk, such as those who are severely overweight or have a family history of diabetes, should be aware of the signs that coincide with diabetes. Once people know what the warning symptoms are they can prevent or delay the onset of diabetes. Simple adjustments to a persons way of life,like diet and exercise,can make a huge difference. Diabetic awareness,either preventative or after diagnoses care,can be achieved through educational booklets such as those by Eli Lilly and company or the American Diabetes Association.

9. 9 Meal Planning The second is meal planning. Every person, diabetic or not, can benefit from choosing the foods they eat by using the Food Guide Pyramid. The foods at the bottom of the pyramid like bread, cereal, rice and pasta are best for glucose control.Foods at the top of the pyramid that are fatty, oily and sweet should only be consumed in small amounts. Type I diabetics still require the same amount of food and calories than if they did not suffer from the disease. The amount of insulin that is injected has to counter balance the amount of food eaten(Lilly 24). Type II diabetics are generally overweight, thus there is a need to eat smaller portions of low fat and sugar foods. Diagram 3: USDA Food Pyramid, from the diabetes.about.com image gallery

10. 10 Exercise The third regime is to get regular exercise. Exercise helps to burn sugar faster which can promote weight loss and improve blood pressure and flow (Lilly 33-37).

11. 11 Medication The fourth is to take medication. Type I people have no insulin so must inject a prescribed form of the chemical. There are seven different types of insulin, each one having a different reaction time. Type II people may also require insulin shots but most only require an oral medicine that lowers or prevents high blood sugar (Lilly 40). The American Diabetes Association states that, of the diagnosed individuals, about 11% take insulin and oral medicines, 22% take insulin only, 49% take oral medication only and 17% do not take either insulin or oral medicine (National). Lastly there is a need to test the level of blood sugar on a regular basis. The ideal range is between 70 and 140 mg/dl. Ketones are the waste products of fat burning and can lead to a build up in the urine. They are acidic and can lead to ketoacidosis or diabetic coma, thus, regular testing of the urine is required (Lilly 59-67).

12. 12 Short-term Complications Hypoglycemia ( low blood sugar) When blood sugar levels go below 70 mg/dl a diabetic may feel shaky, sweaty, tired, hungry, moody or dizzy.The individual must eat something sugary straight away to rectify the situation Hyperglycemia (very high blood sugar) When a diabetic feels extra thirsty or hungry, urinates often or fatigued they may need to lower their blood sugar level by taking medication or exercising. Ketoacidosis ( Dangerously high blood sugar) When there are high levels of ketones the body becomes acidic. The cells in the body are damaged and can lead to death ( Lilly 74-85).

13. 13 Long Term Complications The American Diabetes Association lists the following as possible complications: Heart disease Stroke Blindness Kidney disease Nervous system disease Amputations Dental disease Diagram 4: Complications of diabetes to the anatomy, from the heart center online web site.

14. 14 The Future of Diabetic Research The National Institute of Health released a report in 2002 that detailed the progress in research achievements, since a Strategic Plan was established by the Diabetes Research Working Group in 1999. Such discoveries are: Identification of those most liable to suffer from Type I before the symptoms arise. Better insulin formulas, which can improve the longevity of life for Type I patients. The identification of genes that trigger diabetes. Clinical trials in diet and exercise prevention. Obesity research. These are discoveries that are still in the research phase and may still take time to be assigned as proven scientific remedies that will benefit those with diabetes (NIH Reports).

15. 15 Conclusion In 1999, the total cost of diabetes was $98 billion. Of that amount, $44 billion accounted for direct medical costs. The other $55 billion was amassed through indirect means such as work loss, disability and premature mortality( National). The map to the left, from the National Center for Chronic Disease Prevention and Health Promotion, indicates how widespread diabetes is across the U.S. The percentage rate of those diagnosed is increasing at an alarming rate, this is due in part to the rise in obesity levels which is a main contributor of Type II diabetes. Map: Diabetes and Gestational Diabetes Trends Among Adults in the U.S.,Behavioral Risk Factor Surveillance System, 1990,1995 and 2000, from the cdc.gov web site

16. 16 Conclusion A lack of diabetic awareness has caused millions to suffer and die unnecessarily. Diabetes can be prevented or delayed by knowing the warning signs, such as being severely overweight, thirsty all the time, urinating often or having a family history of the disease. A person diagnosed with diabetes must deal with the emotional and physical aspects of the complications, both short and long term, that can arise from having the disease. But, with control and management, a diabetic can live a long and uncomplicated life.

17. 17 Works Cited Complications of Diabetes. Diagram 4. 24 Nov. 2002.. Diabetes and Gestational Diabetes Trends Among Adults in The U.S., Behavioral Risk Factor Surveillance System, 1990,1995 and 2000. (2002) Map. National Center for Chronic Disease Prevention and Health Promotion. 1 Dec.2002.. Gestational Diabetes. Diagram 2. 27 Nov.2002.. Lilly, Eli and Company. Managing Your Diabetes. Educational Study Guide. 1997. “National Diabetes Fact Sheet.” American Diabetes Association. (2000).11 Nov. 2002..

18. 18 Works Cited “NIH Reports Progress In Diabetes Research.” 23 Oct. 2002. National Institute Of Diabetes And Digestive And Kidney Diseases. 23 Nov. 2002.. Position Of The Pancreas. Diagram 1. 27 Nov.2002.. USDA Food Pyramid. Diagram 3. 25 Nov.2002.. “What Is Diabetes?” Harvard Health Publications. (Jan 2002):3. MasterFILE Premier. EBSCOhost. Glendale Community College Library Media Center, Glendale, AZ. 20 Nov.2002.