The hallmark of diabetes is an elevated blood glucose level, commonly referred to as “I found out I had diabetes during a routine physical with a family …
THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle
The hallmark of diabetes is an elevated blood glucose level, commonly referred to as high blood sugar Although the body requires glucose for energy, people who lack insulin or become insensitive to it are unable to use glucose as an energy source The bodys cells starve while glucose accumulates in the bloodstream Im Dr Nathaniel Clark, of the American Diabetes Association Diabetes has reached epidemic proportions Our program, Diabetes: Achieving A Healthier Lifestyle talks about the new treatments that help people with diabetes lead healthier lives Romain Deffes Jr Patient I found out I had diabetes during a routine physical with a family physician about 12 to 15 years ago The problem was, during the early stages, nobody told me I had to change my lifestyle, and as the years went by it just got progressively worse Narrator Diabetes is basically the bodys inability to use the energy normally released from the digestion of food Its a disorder of carbohydrate metabolism that develops when the body cannot effectively control the level of sugar in the blood Symptoms of diabetes include: thirst, frequent urination,
hunger, fatigue, irritability, possibly blurred vision, tingling or numbness in hands or feet, itching, slow to heal cuts and sores There are two types of diabetes: 1 and 2 Both result from the same basic problem the inability to properly control blood sugar Only about 10 percent of cases are type 1 diabetes, which was formerly known as juvenile diabetes, although it can occur at any age In type 1, the body destroys insulin producing beta cells in the pancreas, and is no longer able to produce this natural hormone These patients are always dependent upon insulin injections to replace what they are not making or utilizing naturally Everyone else with diabetes has type 2, which is usually adult onset, although the number of children and adolescents is increasing These patients are not, as a group, dependent on insulin therapy Blood and urine tests are used to screen for and diagnose diabetes, which is serious, common and costly Diabetes is on the rise, and is reaching almost epidemic proportions Sixteen million people in the United States alone are affected, and the number of people diagnosed with diabetes is projected to increase dramatically in the coming decades
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THE PATIENT
CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle
Vivian Fonseca, MD, Tulane University, New Orleans Diabetes is a silent killer, a really, really serious disease It is the leading cause of blindness for people below the age of 65 It is the leading cause of kidney failure requiring dialysis It is responsible for most amputations It contributes very greatly to heart attacks and strokes, so it is a very serious disease Narrator The US Centers for Disease Control and Prevention CDC does have some good news A recent study indicates there may be a way to prevent the onset of diabetes and its complications The CDC suggests that people who are at risk for diabetes make lifestyle changes, such as developing better eating habits and maintaining a regular exercise program Most people with type 2 diabetes are over 45 and significantly overweight Other risk factors are: family history, lack of exercise, high blood pressure, high levels of fats in the blood; gestational diabetes during pregnancy; and ethnic background Dr Fonseca There are certain people who are at greater risk for getting diabetes and should be screened at a younger age These include certain ethnic groups that are at
an increased risk, like Native Americans, African-Americans, Hispanics, women who have large babies who had diabetes during pregnancy; anybody who is overweight who has diabetes in the family is at greater risk and should be screened earlier Narrator In some people with type 2 diabetes, the pancreas does not produce enough insulin, the hormone that helps the sugar in your blood enter the cells of your body, where it is used for energy For others, the cells develop a condition called insulin resistance While the beta cells in the pancreas are still producing insulin, the body cannot use it correctly, and the glucose sugar remains in the blood Eventually, blood sugar levels rise, and type 2 diabetes results Today, medications can work to overcome insulin resistance an underlying cause of type 2 - by making the bodys cells more sensitive to this hormone Narrator The discovery of insulin was one of the major medical breakthroughs of the 20th century, and has saved millions of lives Find out about this amazing discovery when The Cutting Edge Medical Report returns
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THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle
Narrator Before the 1920s, people with
diabetes generally died shortly after diagnosis Diabetes was known to the ancient Egyptian, Hindu, Chinese and Greek cultures In fact, diabetes mellitus translates as honey urine disease in Greek, referring to the high amounts of sugar in the urine of an untreated patient In 1899, Oskar Minkowski and Joseph Von Mering produced diabetes in dogs by removing the pancreas, demonstrating the link to that gland But decades of failure in finding an anti-diabetic substance followed In the summer of 1921, Canadian researchers Frederick Grant Banting and his assistant Charles Herbert Best successfully isolated insulin, a feat for which they shared the Nobel Prize One of the 20th centurys greatest advancements in medical science, the discovery of insulin signified new hope for diabetes patients worldwide However, Dr Banting knew that this life saving substance was only a control, not a cure In front of the Banting House National Historic Site in London, Ontario where he came up with his idea for finding insulin, a flame burns from a cairn placed there by the Canadian Diabetes Association Its called the Flame of Hope, and it was kindled in 1989 by Englands Her Majesty Queen Elizabeth The Queen
Mother When a true cure is finally found for diabetes, the Flame of Hope will be extinguished Narrator Experts say diet and exercise are the primary ways today to manage type 2 diabetes, and many can control their condition through these factors alone Patients must learn to take an active part in their own treatment through a team care approach They will become part of the team of medical professionals who are involved in the treatment plan Other team members include a doctor, nurse, and dietitian At least one team member should be a certified diabetes educator, as theres a lot to learn about managing this condition In New Orleans, where the rich food, obesity and high percentage of ethnic minorities all contribute to the high diabetes rate, classes on managing diabetes are offered at Tulane University Hospital and Clinic and at Charity Hospital Dr Fonseca I think that patients who are educated about the disease do extremely well So we have a very strong emphasis on patient education in our program We teach patients the consequences of the disease, we teach them how to control it, what the goals are, and we like them to think that its nice they are a part of the team Narrator Diet
is the primary method of controlling type 2 diabetes, and patients need to know what they can and should not eat
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THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle Donald King, Patient I used to just eat anything I wanted without any thoughts whatsoever because I love to eat But now I check everything, my wife checks everything even better so Im thankful for her, but the lifestyle has changed dramatically as far as when I eat and how I eat, because we try to do it normally Any American knows normalcy is not 24 hours a day, but we make do Willa Hsueh, MD UCLA Medical School The obesity and physical inactivity that we continually subject ourselves to in our society sets the stage, not just for altering the metabolism which is high glucose levels, but certainly ultimately contributes to heart disease and stroke, which is the major killer in America and worldwide Narrator Exercise is also very important It can help keep blood sugar under control Philip Raskin, MD University of Texas Southwestern Medical Center at Dallas It turns out that exercise and insulin sensitivity are linked because one of the ways to reduce insulin resistance is exercise There are a lot
of studies showing that a rigorous exercise program can improve an individuals insulin sensitivity Romain Deffes, Patient Hey, you dont have to work up a big sweat All you have to do is get out there, take a natural walk, one or two miles if youre able to walk that and your limbs will let you do it Itll make a tremendous difference in the outcome I live a lot better, I sleep better, and Im able to enjoy life a little bit more Narrator Over 80 percent of patients with type 2 diabetes are on oral medications, which are not oral forms of insulin Instead, oral medications work by increasing the levels of insulin produced by the body or by decreasing its resistance to insulin They work best for those who are near normal weight, and have less severe cases of type 2 diabetes Pills have the advantages of being easier for the patients to take than insulin injections, and they require less blood glucose monitoring Because there are many kinds of oral medications available to treat the various problems of diabetes, many different medical combinations are possible Dr Fonseca If you use combinations of medications that work in different ways, at different times of the day as well, at different
times in relation to meals, you may be able to get better control of the blood sugar overall over a longer period of time And in fact that is whats been shown in clinical trials
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THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle
Narrator While they can work very well, usually more than one medication is needed over a patient lifetime Newer insulin sensitizers called TZDs are available that work in the s muscle and fat tissues as well as the liver Metformin, another drug for type 2 diabetes that works mainly in the liver, can be combined with TZDs The use of more than one treatment multiple medications or both medication and insulin together is called combination therapy Dr Hsueh The goal of therapy is to nearly normalize the blood glucose level in patients with diabetes This sometimes requires only diet and exercise in some mildly diabetic patients However, patients who have more severe disease often need multiple medications, or what we call combination therapy, to control their blood glucose to nearly normal levels Narrator Some patients with type 2 diabetes do need insulin shots, especially before diet and exercise can bring their blood levels under
control Researchers are looking for better ways to administer insulin if its needed One method is the insulin pump, a device thats now no larger than a pager and is worn on the body While relatively expensive, the insulin pump has some advantages over injections Dr Raskin I believe that its a much better way to deliver insulin It is a better insulin delivery system than injections, because it is like getting a tiny little shot every 20 minutes of insulin So you give less insulin more often The patient is less likely to get hypoglycemic and you have a little better control over it Dr Raskin How do you like your pump? Kenneth Stierwalt, Patient Oh, I love it Narrator A diabetic emergency can be truly life threatening How can you tell if someone is having one? And what should you do? Find out the answer when The Cutting Edge Medical Report returns Narrator Heres the situation: Someone who you know has diabetes becomes irritable, pale, sweaty, weak, has a rapid heartbeat, is extremely hungry, and is uncoordinated and confused He may be having an insulin reaction
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THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle Are you okay? Whats going on?? Mom, Mom Dads in
trouble Narrator Because his blood sugar level has fallen dangerously low, this can be life threatening Insulin reactions require immediate attention The most important thing for a patient to do during an insulin reaction is to quickly eat or drink something to counteract the low blood sugar Juice, candy or glucose tablets should always be on hand If the reaction is not quickly treated, the person may become unconscious In that case, call 9-1-1 immediately Since the confusion and lack of coordination of a person having an insulin reaction could be mistaken for intoxication, its a good idea for people with diabetes to wear a medical ID tag and carry a wallet card that identifies their condition Maxine Henry, RN , Patient No, it doesnt need to be kept a secret, because your coworkers need to know that bit of information in case you have an episode — your blood sugar is low and you pass out Theyll know they wont have an idea what could be possibly wrong with you I let everyone know Im a diabetic, even when I go on trips Your symptoms might be geared to, they might think its something else, and youre in deep trouble cause no one would know until they got you to the hospital Narrator
People with diabetes and their families should know the warning signs of an insulin reaction and what to do if one occurs Preventing reactions is very important By monitoring their blood sugar levels several times a day, patients can make sure that it doesnt go into the danger zone Severe, out of control diabetes is also extremely dangerous While not a 9-1-1 emergency, its a major cause of death due to its serious complications if left uncontrolled Diabetes is the leading cause of blindness, and can cause kidney failure, heart disease and stroke Its also the main cause of non-injury amputations due to gangrene and nerve damage Dr Fonseca Its very important to detect the diabetes early while you dont have complications and then take whatever means are necessary to prevent the diabetes complications from occurring by good control of blood sugar, good control of the blood fats and cholesterol, and high blood pressure, etc Narrator With proper care, most of the complications of diabetes can be kept to a minimum or avoided altogether
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THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle Dr Fonseca Well, at present we do not have a cure for diabetes, but we can
control it So if you control your blood sugars and the other risk factors for complications very well, you do not have to get those serious complications, and diabetes no longer becomes a serious killer Narrator Diabetes can destroy vision, as tiny blood vessels run through the retina, which can weaken and leak blood Patients need careful monitoring by eye specialists; laser photocoagulation can prevent loss of vision Narrator Many people with diabetes have problems with high blood pressure, blood cholesterol and fat levels, leading to angiopathy, or disease of the blood vessels Diabetes can weaken and damage blood vessels, causing small ones to leak and larger ones to clog Clogged blood vessels can lead to heart attacks if circulation to the heart is interrupted, or stroke if a clot breaks loose and travels to the brain Poor circulation to the feet can be worsened by neuropathy, nerve damage caused by diabetes If circulation is cut off for long, gangrene can result and lead to amputation Dr Hsueh A major complication of diabetes is also accelerated cardiovascular disease This translates to the fact that patients with diabetes have about three to four times the incidence of heart
attack and stroke compared with patients who do not have diabetes Therefore we have to be very cognizant that the major killer of patients with diabetes will be atherosclerosis, or heart disease Narrator Some oral medications may reduce blood vessel damage and can lower the risk of cardiovascular disease Dr Hsueh We know that some of the pills that are used to treat diabetes not only improve the blood glucose level but may have direct impact themselves on the cardiovascular status Narrator The link between diabetes and cardiovascular disease is so strong that in the past decade, the old definition of diabetes as simply a disorder of high blood sugar has expanded Dr Hsueh Diabetes is a disease of blood vessels Narrator How are people controlling their type 2 diabetes? Find out when The Cutting Edge Medical Report returns
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THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle
Narrator Setting up a management plan based on lifestyle, habits, cultural background and family medical history can control type 2 diabetes If you have it or are at risk, see a physician and set up a plan thats right for you Clifton Thomassie, Patient Get the screening Take your doctors
advice If they tell you youre a borderline diabetic, listen to them Lose the weight; get on a diet; get on a routine; start working out Because, you know, I thought I knew it all and I could handle itIm a big, strong, tough guy and I couldnt do it It beat me Diabetes will beat anybody if you let it But if you dont let it, you can master it You can get off the insulin, you can do anything you want, but diabetes is a killer Narrator People with type 2 diabetes should make a commitment to control it: See the doctor regularly: two to four times a year Perform careful and continual monitoring of blood sugar levels Cultivate family support dieting is easier if the family understands your needs Learn what to do in case of a low blood sugar reaction Understand that half of adults with type 2 can control their condition with diet alone Learn to limit fat, cholesterol and salt as well as sugar intake Learn the difference between simple and complex carbs and when the body needs them Know that alcohol can lower blood sugar levels Stop smoking Smoking worsens circulation that is already impaired by the diabetes Get regular exercise It helps improve the bodys response to insulin Take
oral medications to lower glucose if the doctor prescribes them Reemphasize team care: Become an active participant in your own treatment decisions Get educated, set behavior goals, and actively manage your diabetes and quality of life Narrator Type 2 diabetes is controllable, and its enormous human and economic toll can be reduced with aggressive and early intervention Researchers are continually learning more about how to reduce the complications of diabetes And promising news is that type 2 diabetes may be prevented altogether
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THE PATIENT CHANNEL PRESENTS Diabetes: Achieving a Healthier Lifestyle
Dr Hsueh The diabetes prevention program has clearly demonstrated that exercise and weight loss can prevent diabetes The question is will that also prevent cardiovascular disease? Those are some of the areas that were also investigating Narrator You can learn to manage type 2 diabetes if you make a commitment to yourself and your family Dr Fonseca My main take-home message is, control the diabetes It is controllable; you could prevent those serious long-term consequences, and if you have got diabetes in your family, take some steps to prevent it Narrator Type 2 diabetes can be
controlled, and millions have learned that the more actively they manage their condition, the more they can enjoy their lives While prevention of type 2 may now be possible, many people are still hopeful for a true cure for their type 2 diabetes On that day, at Dr Bantings House, the Flame of Hope will be extinguished
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Source:phlaunt.com
