Diabetes is on the rise around the world. Current global statistics reveal that 1 in 11 persons had diabetes in 2015. This is about 415,000 million people. A recently published study by JAMA found that almost 50% of Americans have pre-diabetes or diabetes. About one-third of these patients were unaware they had either condition, and were already showing signs of diabetes. National cost was almost $300 billion in 2012. International cost in 2015 was $673 billion which is 12% of global health expenditure.
Pre-diabetes and diabetes are often discovered during the routine physical, or in the emergency room with severe hyperglycemia or complications secondary to the disease. Patients may present without any symptoms or the classic triad of polyuria (increased urination), polydipsia (increased thirst), polyphagia (increased hunger). Blood tests that confirm diabetic disease include: FBS (fasting blood sugar) / FPS (fasting plasma glucose) over 126 mg/dl; two hour plasma glucose over 200 mg/dl HgbA1c over 6.5. Weight loss and dehydration may be apparent clinically as the heavy glucose molecule depletes the body's water volume.
Comorbidities associated with diabetes include hypertension, heart disease, stroke, kidney disease, and general vascular disease. These are all chronic disease states as is the eye disease (diabetic retinopathy) which may lead to total blindness. Diabetic neuropathy involves nerves especially those to the extremities causing numbness, tingling, and decreased sensation. If vascular disease is present, this may lead to poor circulation. As a result diabetic foot ulcers may emerge. Due to lack of sensitivity these may go unnoticed until an infection occurs which left untreated may lead to amputation.
Treatment includes diet, exercise, and medication. Surgery is also a consideration. It is of utmost importance that the proper diet is followed. Counseling with a dietician provides necessary nutritional information to keep and help keep blood sugar in normal range. Weight maintenance at a healthy level is beneficial as overweight states have been correlated with an increased risk of diabetes. Excess weight can make diabetes more difficult to control. Adherence to diet leads to better control overall even if on medication. Along with routine exercise this helps maintain a healthy weight. If you are losing weight and eating the right foods, diabetes may come into control without medication. It is important to check your blood sugar often when lifestyle changes are being made. Keeping your blood sugar within normal limits will help defend against secondary complications. Most important, you will feel better. Best health!
