Diabetes and Cardiovascular Disease
What is diabetes?
¨ It is a disease that affects the ability of your body to use the food you eat.
¨ Diabetes occurs when the body cannot make insulin, or cannot make enough insulin. In type 2 diabetes, the body cannot use the insulin it is making correctly. This is called insulin resistance.
¨ Diabetes is a lifelong disease.
¨ People who have diabetes can live a long, healthy, and productive life by learning how to care for their diabetes. More is being learned about diabetes and its treatment everyday. Keeping up with the latest information is important.
YOU are in charge! Your health care team can assist you.
Types of Diabetes
• Type 1 (previously called insulin dependent, or juvenile diabetes) effects about 10% of the diabetic population. People with type 1 diabetes have to take insulin because their bodies make little or no insulin . Type 1 more commonly begins before age 20, but can occur at any time.
• Type 2 (previously called non-insulin dependent or adult onset) effects about 90% of the diabetic population. It more commonly occurs in older persons, but can occur at any time. Persons at higher risk are those persons who:
• are over 40
• are overweight
• have high triglycerides
• have a family history
• had diabetes during pregnancy
• gave birth to a baby weighing over 9 pounds
• are Native American, Hispanic American, or African American
When you eat, the following should happen
• Foods that contain carbohydrate breaks down into a form of sugar called glucose. This is the body’s main source of fuel.
• The sugar then enters the blood stream and the level of glucose in your body begins to rise.
• The body sends a signal to the pancreas to make insulin.
• Insulin lowers the level of blood glucose by letting sugar leave the bloodstream and enter the cells.
• The level of blood glucose in the bloodstream falls when the glucose goes into the body cells.
• The body cells use the glucose for fuel and stores what we don’t use right away as fat. The body can turn this fat back into simple sugar when we have no food intake for over longer periods of time, when we are under stress, periods of prolonged physical exertion, or when the body is not have enough insulin available.
What are the warning signs?
When there is a balance of insulin and blood glucose, we have the energy for a full and active life. When there is not enough insulin available to help the glucose enter the body’s cells, several things happen:
• The blood glucose rises.
• The kidneys try to remove excess blood glucose, so you have to urinate more.
• You become thirsty.
• You feel tired, because the body can not use the food you are eating to give you energy.
• You have increased hunger because your body is not able to use the food you are eating.
• You may lose weight.
• You may have blurred vision because the high blood glucose causes the lens of the eye to swell and distort the vision.
• You may have more infections because high blood glucose decreases your body’s ability to fight infections.
• Your sexual drive may be less because of the decrease in you energy level.
The pancreas produces insulin.
With diabetes, the body does not have enough insulin to use or can’t use insulin properly. When the body does not have enough insulin present, the body is not able to use the food you eat. The body then turns to the fat that has been stored by the body for another source of energy.
The liver stores glucose and also helps the body turn free fatty acids back into glucose.
The liver plays a major role in glucose storage and in helping the body respond to stressful events by releasing stored glucose. The liver helps the body process fat for a source of fuel when there is not enough insulin available. When the body burns the fat, it forms waste products called ketones. Because ketones are more acidic than healthy body tissues, high levels of ketones may lead to a serious condition called ketoacidosis and to diabetic coma.
Diabetes is diagnosed by testing the blood glucose. The following is a list of some of the ways blood sugar is tested and the results that will confirm that you have diabetes.
• Fasting (no food for at least 8 hours) blood glucose over 126 mg/dl on two occasions
• Non-fasting blood glucose of 200 mg/dl or above along with symptoms of diabetes
• An oral glucose tolerance test (OGTT) using 75 grams of anhydrous glucose with a blood glucose reading is 200 mg/dl or more
Pre-diabetes (Impaired Glucose Tolerance)
• Fasting glucose of over 110 mg/dl but below 126 mg/dl
Normal Glucose Values
• Fasting glucose of 109 mg/dl and below
The results of large studies show that keeping blood glucose in good control greatly reduces the risks of long term complications from diabetes. The person with diabetes and their families must take an active role in acquiring knowledge and obtaining treatment to manage their diabetes. Despite advances in the science of treating diabetes, blood glucose levels for many individuals are still above the goal range.
There are approximately 16 million persons with diabetes in the
· Nearly 2.3 million
· Diabetes is the leading cause of blindness, amputations, and kidney failure
· People with diabetes are twice as likely to have a heart attack or stroke.
· Diabetes is the leading cause of blindness in adults ages 25 to 74.
· Diabetes is the most common cause of amputations not caused by injury.
· $1 out of every $7
spent on health care is spent on diabetes. In the
People with metabolic syndrome are at increased risk for developing diabetes and cardiovascular disease as well as increased mortality from cardiovascular disease. Metabolic syndrome is defined as having three or more of the following conditions:
· Waist circumference greater than 40 inches in men and 35 inches in women
· Serum triglyceride level of 150mg/dL or higher
· High-density lipoprotein (HDL) cholesterol level less than 40mg/dL in men and 50mg/dL in women
· Blood pressure of 130/85 mm Hg or higher
· Fasting glucose level of 110 mg/dL or higher
If you have diabetes, glycemic control alone only modestly lowers the rate of heart disease. Exercise, diet, and appropriate medications to treat blood pressure, high cholesterol, and blood glucose lowering drugs may all be needed to lower the risks of coronary heart disease.
Please check out the following websites for more information about diabetes:
The American Diabetes Association: http://www.diabetes.org/
The Combined Health Information Database: http://chid.nih.gov/
The American Dietetic Association: http://www.eatright.org/
The American Association of Diabetes Educators: http://www.aadenet.org/
The National Diabetes Education Program: http://www.ndep.nih.gov