March 27 is Diabetes Alert Day. Millions of Americans have diabetes and millions more are at risk of developing the disease.
William Sivitz, MD, interim director of Department of Internal Medicine: Endocrinology - Metabolism at University of Iowa Hospitals and Clinics, talks about diabetes:
What is diabetes?
Diabetes is a condition wherein the blood glucose is over a certain level. We generally define that as a blood sugar of 125 in the fasting state; 125 refers to the units we measure blood sugar in.
Who is at risk for developing diabetes?
A number of risk factors exist; the most common is probably overweight, obesity, and poor diet habits leading to obesity.
Genetics, unfortunately, play a role and that's hard for anyone to control, so if there's a family history, that's a risk factor.
Women who have had large babies or women who have diabetes during pregnancy, gestational diabetes, even though it may go away after the pregnancy, are at risk.
Other individuals that have conditions sometimes associated with diabetes, if they have hypertension or high blood cholesterol, they're at risk.
And then there's a group of people that have high blood sugars, higher than normal, but not quite high enough to immediately call diabetes, we call that pre-diabetes and they are really at risk, also, for developing, we'll say, full-blown diabetes.
How common is diabetes?
Unfortunately, it's very common. It affects seven percent of the U.S. population, and in addition, there's estimated to be 41 million people with the condition I referred to as pre-diabetes.
What are the different types of diabetes?
There's what we refer to as type 1 and type 2. type 1 diabetes is due to an autoimmunity problem. The problem is the pancreas stops making insulin due to what could be considered an allergy to the person's own pancreas. Why that happens is the subject of a lot of research. Type 2 diabetes is different; it's generally due to insulin not having the effect that we'd like it to have, we call it insulin resistance, coupled actually with some decrease in the ability to make enough extra insulin to compensate for that, and that's the form that's generally due to being overweight and associated with the other risk factors, although both forms are clearly associated with genetics.
What are the symptoms of diabetes?
Unfortunately, in at least type 2 diabetes, at the onset there may be no symptoms, so the disorder can go undetected for many years, during which time complications can actually develop. The symptoms when the blood sugar gets high enough will manifest as thirst, excess urination, weight loss, and sometimes blurred vision.
Is there a test or way to find out if you are diabetic or pre-diabetic?
Certainly, and that's more important in people with risk factors. The simplest screen, and what's recommended by the Diabetes Association, is a fasting blood sugar and that value should be 125 or above to have diabetes and it should be reproducible at least once. Blood sugar over 100 is actually considered abnormal, and that's what we call pre-diabetes.
What are the complications of diabetes?
Unfortunately, they can be very severe. They do take a while to develop - several years - and controlling diabetes can prevent these. But the complications include cardiovascular disease, heart disease, strokes, blood vessel disease to the lower extremities, blindness, kidney failure, and neurological deficits.
What are the health concerns of untreated or poorly treated diabetes?
In the more immediate sense, if the blood sugar is high enough, one can be at risk for infections, dehydration for example; but in the long run, it's the long-term complications that are irreversible that can be devastating.
Is University of Iowa Hospitals and Clinics involved in studies with regard to diabetes?
We're doing a lot. There's a lot of work that's done at the basic science level, where we're trying to determine why, for example, genetics lead to the predisposition of diabetes, what goes wrong at the cell level.
And then there's a lot of clinical research, too, which looks at how we can make a more immediate impact in treating this disorder. We're doing a number of studies that involve the sensing of glucose; looking at new ways for patients to measure their blood sugars, even ways that may not even have to involve an invasive procedure such as sticking the finger for blood; and ways to get more blood sugar data more often so that a person with diabetes can be more aware of what their blood sugar is and take corrective measures.
We're also doing a number of studies as to who gets complications and why; and the relation of the control of glucose, blood pressure, and cholesterol, for example, to complications. And the list goes on and on, but these are some of the more salient types of research we do.
Where or who should someone call to learn more about learning more about diabetes and research at UI Hospitals and Clinics?
I would suggest calling Diabetes Clinical Research Programs at 319-356-4879, or the person may know or see a physician here, and can call that physician's office and obtain information, also. |
