Diabetes and The Facts - Let's Talk

Let’s talk. Have a seat, grab a cup of coffee and let’s have a frank, little conversation for a moment.

Most people may be unaware that tomorrow, March 23, is National Diabetes Alert Day. This is something that is dear and close to me, because as you might or might not be aware, I am a Type 1 diabetic and my dad was also a Type 1 diabetic. My dad took three insulin injections a day, I take five. My maternal grandmother was a Type 2 diabetic. My brother is pre-diabetic, I have a brother-in-law who was also diagnosed as pre-diabetic and now a sister’s significant other has been diagnosed as type 2.

You may ask, what is the difference between a Type 1 and a Type 2 diabetic. In simple terms, it was always termed that a Type 1 was “childhood” diabetes and Type II was “adult-onset.” A Type 1 is insulin dependent whereas a Type II may or may not need insulin, and/or can sometimes control their diabetes through diet, exercise and pills. Sometimes a Type 2 diabetic can reverse the disease whereas a Type 1 cannot.

Facts: Look around you. One in five Americans is at risk for type 2 diabetes. Nearly 6 million more have diabetes and don't know it. In the next 24 hours, 4,384 cases of diabetes will be diagnosed in America.

Chances are that diabetes has touched you or someone you love. Already there are 57 million Americans at risk for type 2 diabetes. So, this is a wake-up call. March 23, 2010 is the 22nd annual American Diabetes Association Alert Day. It's the day we want to know "What will you do to Stop Diabetes? Know your risk." It's the day we want you to learn your risk for type 2 diabetes by taking the simple Diabetes Risk Test online. It's the day to ask if your loved ones could be a part of the 57 million Americans at risk for type 2 diabetes - and it's the day to share the Diabetes Risk Test with them. It's the day to stop diabetes by taking steps toward prevention.

You can take the test by going on-line, copy the following into your browser and then proceed to take the simple test to see if you are at risk:

http://stopdiabetes.diabetes.org/site/PageServer?pagename=SD_alert_main&utm_source=ENewsletter&utm_medium=Email&utm_campaign=ALERTNSDU032010

Now, let’s talk for a moment about the big differences between Type 1 and 2 diabetes and then I will share with you my story.

Type 2 diabetes is the most common form of diabetes. Millions of Americans have been diagnosed with type 2 diabetes, and many more are unaware they are at high risk. Some groups have a higher risk for developing type 2 diabetes than others. Type 2 diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans, Native Hawaiians and other Pacific Islanders, as well as the aged population.

In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications.

You're probably wondering how you get diabetes or you may worry that your children will get it. Unlike some traits, diabetes does not seem to be inherited in a simple pattern. Yet clearly, some people are born more likely to get diabetes than others.

What Leads To Diabetes?

Type 1 and type 2 diabetes have different causes. Yet two factors are important in both. First, you must inherit a predisposition to the disease. Second, something in your environment must trigger diabetes.

Genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease at most only half the time. When one twin has type 2 diabetes, the other's risk is at most 3 in 4.

Type 1 Diabetes

In most cases of type 1 diabetes, people need to inherit risk factors from both parents. Studies show that they think these factors must be more common in whites because whites have the highest rate of type 1 diabetes. Because most people who are at risk do not get diabetes, researchers want to find out what the environmental triggers are.

One trigger might be related to cold weather. Type 1 diabetes develops more often in winter than summer and is more common in places with cold climates. Another trigger might be viruses. Perhaps a virus that has only mild effects on most people triggers type 1 diabetes in others.

Early diet may also play a role. Type 1 diabetes is less common in people who were breastfed and in those who first ate solid foods at later ages.

In some people, although rare, the development of type 1 diabetes seems to take many years. In experiments that followed relatives of people with type 1 diabetes, researchers found that most of those who later got diabetes had certain autoantibodies in their blood for years before. (Antibodies are proteins that destroy bacteria or viruses. Autoantibodies are antibodies 'gone bad,' which attack the body's own tissues.)

Type 2 Diabetes

Type 2 diabetes has a stronger genetic basis than type 1, yet it also depends more on environmental factors. Sound confusing? What happens is that a family history of type 2 diabetes is one of the strongest risk factors for getting the disease but it only seems to matter in people living a Western lifestyle.

Americans and Europeans eat too much fat and too little carbohydrate and fiber, and they get too little exercise. Type 2 diabetes is common in people with these habits. The ethnic groups in the United States with the highest risk are African Americans, Mexican Americans, and Pima Indians.

In contrast, people who live in areas that have not become Westernized tend not to get type 2 diabetes, no matter how high their genetic risk.

Obesity is a strong risk factor for type 2 diabetes. Obesity is most risky for young people and for people who have been obese for a long time.

Gestational diabetes is more of a puzzle. Women who get diabetes while they are pregnant are more likely to have a family history of diabetes, especially on their mothers' side. But as in other forms of diabetes, nongenetic factors play a role. Older mothers and overweight women are more likely to get gestational diabetes.

Type 1 Diabetes: Your Child's Risk

In general, if you are a man with type 1 diabetes, the odds of your child getting diabetes are 1 in 17. If you are a woman with type 1 diabetes and your child was born before you were 25, your child's risk is 1 in 25; if your child was born after you turned 25, your child's risk is 1 in 100.

Your child's risk is doubled if you developed diabetes before age 11. If both you and your partner have type 1 diabetes, the risk is between 1 in 10 and 1 in 4.

There is an exception to these numbers. About 1 in every 7 people with type 1 diabetes has a condition called type 2 polyglandular autoimmune syndrome.

In addition to having diabetes, these people also have thyroid disease and a poorly working adrenal gland. Some also have other immune system disorders. If you have this syndrome, your child's risk of getting the syndrome including type 1 diabetes is 1 in 2.

Researchers are learning how to predict a person's odds of getting diabetes. For example, most whites with type 1 diabetes have genes called HLA-DR3 or HLA-DR4.

If you and your child are white and share these genes, your child's risk is higher. (Suspect genes in other ethnic groups are less well studied. The HLA-DR7 gene may put African Americans at risk, and the HLA-DR9 gene may put Japanese at risk.)

Other tests can also make your child's risk clearer. A special test that tells how the body responds to glucose can tell which school-aged children are most at risk.

Another more expensive test can be done for children who have siblings with type 1 diabetes. This test measures antibodies to insulin, to islet cells in the pancreas, or to an enzyme called glutamic acid decarboxylase. High levels can indicate that a child has a higher risk of developing type 1 diabetes.

Type 2 Diabetes: Your Child's Risk

Type 2 diabetes runs in families. In part, this tendency is due to children learning bad habits eating a poor diet, not exercising--from their parents. But there is also a genetic basis.

In general, if you have type 2 diabetes, the risk of your child getting diabetes is 1in 7 if you were diagnosed before age 50 and 1 in 13 if you were diagnosed after age 50.

Some scientists believe that a child's risk is greater when the parent with type 2 diabetes is the mother. If both you and your partner have type 2 diabetes, your child's risk is about 1 in 2.

People with certain rare types of type 2 diabetes have different risks. If you have the rare form called maturity-onset diabetes of the young (MODY), your child has almost a 1-in-2 chance of getting it, too.

Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

The most common symptoms for Type 1 Diabetes: frequent urination, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue and irritability. Common symptoms for Type 2 diabetes: any of the type 1 symptoms, frequent infections, blurred vision, cuts/bruises that are slow to heal, tingling/numbness in the hands/feet, and recurring skin, gum, or bladder infections. But, often people with type 2 diabetes have no symptoms.

As I told you, I'm a Type 1 diabetic. My symptoms didn't start until a couple days before I was diagnosed. A1C blood tests can determine only as far back as three months prior to the test how long you have been diabetic. My tests determined that I was diabetic at least three months prior. Because my dad was a type 1 diabetic, I have always had my blood tested every year when I have my annual physical. Nothing has showed up prior to this. My cholesterol is excellent, my blood pressure before this was fine, my weight was fine. What happened to me was shortly after I was diagnosed (which at first I was misdiagnosed as a type 2), I crashed. Literally and figuratively, I crashed and burned. It was like the race car hitting the wall and exploding into flames, but having the driver emerged from the wreck shaken up and with a few small cuts and bruises here and there. Scared at first, but after going through it, you want to know what happened and why. That how I feel after having gone through this. I wanted to know why and what caused it. So I wanted to share this with you, so that you, too, can be aware of some of the most important aspects of this disease. I have seen the devastating effects it had on my dad, a type I diabetic, who developed the disease in his childhood and after three heart attacks in his 30's, the fourth finally took him in his 50's. I saw what it did to a client, type 2 diabetic, who wasn't given a replacement to allow him the time to attend to doctor appointments. During the course of his litigation, he lost his first leg and after taking it as far as the Seventh Circuit Court, who still denied he was disabled, he lost his second leg. Three years later, he was finally diagnosed as being disabled. A little too late, but he is still alive, if that is any concilation.

Now that I have given you the facts, let me tell you my story. My story follows in the next post entitled "Diabetes - Crash and Burn (My Story)."

Before you go to the next post, do me one small favor. Take the Diabetes Risk Test. If not for yourself, do it for me, do it for those that you love, because they are the ones that need to know just as much as you do. It takes just a moment to do and you will be taking one step toward possibly correcting something that you never knew was wrong with you. And if you pass with flying colors, it is all more the reason to feel even better about yourself today.