Is Diabetes a Concern For You?

Over 25 million or 8.3% of Americans have diabetes.  Approximately, another 80 million are at the pre-diabetic stage, which means that about a quarter of the population is at risk for developing diabetes.  Diabetes accounts for 1 out of every 10 healthcare dollars spent.  It is the leading cause of new cases of blindness, kidney failure, amputations of feet and legs, as well as the seventh leading cause of death in the United States. 

What is diabetes?

Our body attains the energy to perform daily functions from the foods that we consume.  The starches and sugars we eat are broken down into glucose which is the main fuel source for the cells of the body.  Insulin, a hormone released by the pancreas is very important in enabling cells to attain and use glucose.  Type 1diabetes occurs when the body is unable to produce insulin. Type 2 diabetes happens when the pancreas does not make enough insulin, or the cells cannot recognize and use the insulin produced.  As a result, glucose builds up in the blood and causes symptoms like frequent urination, extreme hunger or thirst, unusual weight loss, fatigue and irritability, blurred vision, slow healing of cuts and bruises, and tingling or numbness in the hands and feet.  Type 1 diabetes affects only 5% of the patients, while type 2 diabetes is more common, affecting 90 to 95% of cases. Gestational diabetes specifically affects pregnant women and usually disappears after childbirth with proper treatment.  When diabetes is not controlled, damage is done to many organs of the body and complications arise such as high blood pressure, heart disease, eye problems and blindness, kidney failure, nerve disease and foot problems.

Risk factors

·      Family history

·      Obesity

·      Hispanics, African-Americans, Native Americans and Asians are at higher risk than Caucasians

·      Physical inactivity

·      History of gestational diabetes

·      Hypertension

·      Low high-density lipoprotein (HDL) cholesterol

·      Polycystic ovary syndrome

Treatment
As diabetes is a chronic illness, treatment options are focused on:

·      controlling blood glucose levels

·      slowing progression of the disease  

·      reducing the risk of complications

The first line of treatment for Type 2 diabetes is proper diet and exercise.
An appropriate diet and exercise regimen, as recommended by the American Diabetes Association (ADA), should:

·      be heavy in whole grains and fiber

·      contain a variety of fruits and vegetables

·      be low in sugars and fats, especially saturated fats

·      include at least 150 minutes of moderate intensity exercise or 90 minutes of vigorous exercise per week;  resistance training is recommended 3 times per week

If diet and exercise are not enough, there are many medications available to help control blood sugar levels. These include:

·      drugs that sensitize cells to insulin such as metformin

·      drugs that stimulate insulin secretion such as glyburide

·      drugs that slow the absorption of glucose such as acarbose

·      Insulin can also be given directly to patients by injection

A healthcare provider should discuss the specific treatment regimen to be provided, ensure proper implementation, and patient understanding of expected results and possible side effects. In addition, proper monitoring of blood glucose levels at home should be demonstrated.  To help reduce complications, it is recommended to get routine eye, foot, dental, and physical exams in addition to monitoring cholesterol levels and kidney function.

Ways to get involved
November is American Diabetes Month and there are many opportunities for people to help in the fight against diabetes.  The ADA is holding many Step Out events, which are fundraising walks held all around the country to raise awareness and money for diabetes research.  You can choose to walk, donate money, or volunteer.  More information can be found at http://stepout.diabetes.org.

In addition, you can donate money directly to the ADA (http://www.diabetes.org) or other organizations that fund diabetes research, such as the Juvenile Diabetes Research Foundation (http://www.jdrf.org).  You can also contact your elected representatives to increase diabetes research funding and increase access to proper health care for patients with diabetes.

There are also local events provided by the Operation Diabetes group of the UIC chapter of American Pharmacists Association Academy of Student Pharmacists (APhA-ASP).  They hosted a Diabetes Day Clinic at the Community Health Clinic (located at 2611 West Chicago Avenue) on Nov. 12 as well as participated in an ADA diabetes conference at the Cicero Community Center on the same day.



If you need more information, stop into UIC Pharmacy and talk to a UIC Pharmacist.

References
American Diabetes Association. Diabetes basics. Available at: http://www.diabetes.org/diabetes-basics/?loc=GlobalNavDB. Accessed October 26, 2011.
Centers for Disease Control and Prevention. Diabetes public health resource. Available at:  http://www.cdc.gov/diabetes/index.htm.  Accessed October 25, 2011.

 Laffel L, Svoren B.  Epidemiology, presentation, and diagnosis of type 2 diabetes in children and adolescents. UpToDate Database. Waltham, MA: Wolters Kluwer Health; 2011. http://www.uptodate.com/contents/epidemiology-presentation-and-diagnosis-of-type-2-diabetes-mellitus-in-children-and  adolescents?source=search_result&search=diabetes%2C+risks&selectedTitle=4%7E150. Accessed October 25, 2011.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).  What I need to know about diabetes medicines. Available at: http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.aspx.  Accessed October 26, 2011.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). What I need to know about eating and diabetes. Available at: http://diabetes.niddk.nih.gov/dm/pubs/eating_ez/index.aspx. Accessed October 25, 2011.

By: Ed Kazyanskaya & Viola Bockenfeld, PharmD Candidates, 2015