Diabetes Health Care: Diabetes

Overview

In the United States, an estimated 18.8 million people have been diagnosed with diabetes, and another 7 million have it but have not received a diagnosis. The condition affects 8.3% of the population, and is the leading cause of blindness, kidney failure, and lower limb amputations. It is also a major cause of heart disease and stroke.

Signs and Symptoms

Although symptoms can vary from one individual to another, they often include the following:

• Frequent urination
• Increasing thirst
• Extreme hunger
• Unexplained weight loss
• Extreme fatigue and irritability
• Blurry vision
• Frequent infections
• Tingling in extremities
• Wounds that don’t heal quickly
• Recurrent gum, skin, or bladder infections

Causes/Common Triggers

Diabetes occurs when the body cannot properly regulate sugar, which leads to a buildup of glucose in the cells that prevents them from correctly functioning. Type 1 diabetes is caused when the pancreas does not produce insulin and glucose regulation is impaired. In type 2 diabetes, either the pancreas produces very little insulin, or the body is unable to recognize the insulin. Some common risk factors for type 2 diabetes are as follows:

• Obesity
• Low level of physical activity
• Genetics
• Age
• High-fat diet
• High alcohol intake
• Ethnicity
• Hypertension

Tests and Diagnosis

A number of tests are used to diagnose diabetes, including an oral glucose tolerance test (OGTT) and a fasting plasma glucose (FPG) test. For the OGTT, which measures the body’s ability to use glucose, patients are advised not to eat, drink, or exercise strenuously for 8 hours prior. A blood sample is collected to provide a baseline for comparing glucose levels.

For the FPG test, which measures the blood sugar level and can expose problems with insulin functioning, patients must fast overnight and then have their FPG level taken. When individuals without diabetes are tested, glucose levels rise but then fall rapidly. For those who have diabetes, the levels rise higher than normal and fail to rapidly decrease. Individuals with glucose levels between normal and diabetic are categorized as having impaired glucose tolerance. Other tests that physicians may order to monitor and diagnose diabetes include:

• Blood glucose test
• Glycated hemoglobin (A1C) test
• Urine tests for kidney disease

Prevention

Several lifestyle modifications can be implemented to prevent diabetes, including:

• Increased physical activity
• Weight loss
• Increased fiber intake
• Maintaining a healthy diet

Management

Proper management of diabetes can slow the progression of the disease and prevent further complications, including kidney disease, eye disorders, heart disease, and stroke. Recommendations for effective management of diabetes are as follows:

• Keep a healthy diet
• Get at least 30 minutes of physical
• Maintain a healthy weight
• Quit smoking
• Learn how to manage stress
• Maintain appropriate foot hygiene (including washing, moisturizing, and examining for cuts and scrapes every day)
• Brush and floss teeth every day
• Test glucose as often as recommended by a physician
• Stay adherent to medication regimens

Treatment and Care

Patients who feel dizzy, sweaty, or have symptoms such as blurry vision may be experiencing hypoglycemia and should immediately ingest a source of glucose. It is critical that close family members and friends know what steps to take in the event that a patient becomes unconscious because of abnormally high or low glucose levels. Patients should also regularly visit their ophthalmologist, podiatrist, and dentist to help monitor their eyes, feet, and mouth.

Homeopathic and Alternative Remedies

Some patients with diabetes prefer to try alternative forms of medications; it is important to discuss any of these medications and therapies with a physician before trying them. Alternative therapies include:

• Vitamin supplements
• Herbal supplements
• Special diets

Self-Care

When individuals with diabetes seek OTC treatment for other conditions, it is critical to speak to a pharmacist about which medications can help treat the condition without worsening the diabetes.

Resources for Patients

These organizations offer support services for patients with diabetes:

• American Diabetes Association
• National Diabetes Education Program
• National Institute of Diabetes and Digestive and Kidney Diseases
• CDC Diabetes Public Health Resource

Resources for Pharmacists

• National Diabetes Education Program
• Joslin Diabetes Center Care Resources
• CDC Diabetes Public Health Resource for Health Care Professionals