Diabetes: Facts, myths and tips

November 21st, 2014

What is diabetes?

On November 14, numerous landmarks and monuments across the globe were lit blue in honor of World Diabetes Day, a disease that affects almost 400 million people worldwide and results in more than five million deaths every year. In past years, well-known buildings such as the Empire State Building, the Alamo, and the London Eye observation wheel were blue for a day for the “Monumental Challenge,” to raise awareness about diabetes, its causes and complications, and to fund more research for better treatments.

In the United States, November marks American Diabetes Month, an effort to focus the nation’s attention on the issues surrounding diabetes and those impacted by the disease. Nearly 30 million children and adults in the United States (nine percent of the overall population) have this disease, and another 86 million Americans have prediabetes, putting them at risk for developing type 2 diabetes. According to the American Diabetes Association, the total cost of this disease in the United States is $245 billion, with one in ten health-care dollars spent treating diabetes and its complications. Diabetes can affect a person of any race or ethnic background; but for those over age 20, it is highest among American Indians, Alaskan Natives, African Americans, and Hispanics, according to the Centers for Disease Control and Prevention.

Diabetes mellitus is the medical term for a group of diseases that affect how your body uses blood sugar, also called glucose. The food we eat is broken down into glucose, which provides energy for the cells that make up our muscles and tissues, as well as the brain’s main source of fuel. People with diabetes have too much glucose in their blood, which can lead to serious health problems.

Normally, after a person eats, the pancreas produces the hormone insulin, the key that allows glucose to leave the blood stream and enter into cells. However in people with diabetes, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. The result is that this fuel source never reaches organs, muscles, and tissues.

Excess glucose can injure blood vessel walls, leading to nerve, kidney, eye, and foot damage. People with diabetes are also more susceptible to heart disease, stroke, and skin conditions. The good news is that more and more people with diabetes are leading long, healthy lives with fewer complications due to medical advances and better management tools.

Types of diabetes include type 1, type 2, gestational, and rarer forms such as surgically induced and chemically induced. Gestational diabetes develops during pregnancy and usually goes away after birth. The most common types are 1 and 2, both of which are chronic health conditions.

Type 1 diabetes

Widely misunderstood and often lumped in with type 2 diabetes, the cause and treatment of type 1 is actually very different from other forms of diabetes. Type 1 (often called T1D) was previously referred to as juvenile diabetes, but it can be diagnosed at any age. Three million Americans have type 1 diabetes. Each year, more than 30,000 people, or 80 a day, are diagnosed with T1D in the United States. About 85 percent of people living with type 1 are adults, and 15 percent are children. However, the prevalence of T1D for those under age 20 rose by 23 percent between 2001 and 2009. Worldwide, the rate of diagnosis for those under age 14 is estimated to increase by three percent every year, further highlighting the need for a cure.

Unlike other types of diabetes, type 1 is an autoimmune disorder and cannot yet be prevented, cured, or reversed. An unknown environmental trigger, possibly a virus, causes the body’s own immune system to mistakenly destroy insulin-producing cells in the pancreas. People with type 1 must inject insulin to survive. While genetic factors do play a role, most people who get T1D have no family history of the disease, which is why being aware of signs and symptoms is critical for an early diagnosis.

The warning signs of type 1 diabetes include extreme thirst, frequent urination, drowsiness or lethargy, sudden vision changes, labored breathing, increased appetite, sudden weight loss, fruity breath odor, and in females, bladder or yeast infections. A day in the life of someone with type 1 means testing blood sugar through finger pricks six or more times. At every meal, the person must estimate their carbohydrate intake and take insulin through a needle injection or pump. People with T1D must also carefully balance what they eat and have a plan for exercise, to try to avoid hypoglycemic (low blood sugar) and hyperglycemic (high blood sugar) reactions, which can be life threatening.

Researchers are actively working on finding a cure for T1D. Research is focused on first stopping the immune system’s attack on these insulin- producing cells (called beta cells) and then regenerating or replacing these beta cells. Medical advancements such as artificial pancreas are also under development. This system would combine continuous glucose monitoring and insulin delivery and automatically deliver the proper amount of insulin in the same way a real pancreas does.

Type 2 diabetes

Type 2 diabetes is the most common form of diabetes, representing 90 percent of diagnosed cases. For people who have type 2 diabetes, their body still produces insulin but does not use it properly (called insulin resistance). The pancreas tries to make extra insulin to make up for the resistance, but over time it isn’t able to keep up and can’t keep blood glucose at normal levels.

The risk for type 2 diabetes increases with age. Currently, 27 percent of adults 65 or older have diabetes. Type 2 diabetes is still fairly rare in children and youth, despite media attention on the growing number of overweight youth. Men have a slightly increased risk of type 2 diabetes compared to women; however, this is more likely due to lifestyle factors and body weight than innate gender differences. There is a stronger link to family history with type 2 than with type 1, but lifestyle plays the largest role in its onset.

Type 2 diabetes is also increasing worldwide. The World Health Organization (WHO) estimates that at least eight of every ten diabetes-related deaths occur in low- and middle-income countries. And in these developing nations, more than half of all diabetes cases go undiagnosed. WHO estimates that worldwide deaths due to diabetes will double by 2030.

Prevention is the key to reducing type 2 diabetes cases, which is why American Diabetes Month is focused on inspiring people to live a more active lifestyle and eat more nutritious foods. Regular exercise and a healthy diet are the most cost-effective methods of preventing or delaying type 2 diabetes and its side effects. In fact, up to 85 percent of complications from type 2 can be effectively addressed through regular doctor visits, monitoring and medication, and a healthy lifestyle.

Signs of type 2 diabetes are usually the same as those of type 1. Some people with type 2 do eventually need to take insulin shots to manage blood glucose levels, and as with type 1, regular blood checks with a glucose meter are important. Access to health care and routine checkups are critical to the detection of prediabetes and preventing full onset of type 2. United Methodist churches and institutions can play a role in this prevention effort by supporting health ministries and wellness programs.

Personal reflections

In 2009, our then 11-year-old daughter was diagnosed with type 1 diabetes. Since we had no family history of the disease and because she had always been very healthy, it came as a shock. If we had had more knowledge about the disease and its symptoms, we might have detected it earlier, another reason why awareness and education are important. Life with diabetes is not devastating, nor is it easy. It does add a thick layer of complication to every aspect of her life, whether it be managing blood sugar highs before a cross-country race or blood sugar lows in the middle of the night.

One aspect of diabetes that most people don’t understand is how emotionally and mentally draining it can be. The constant analyzing of the number that comes up on the blood glucose monitor is like taking a test six times a day, everyday. If you get a 100, you’ve succeeded. A 50 or 220 means you feel you’ve failed in some way, despite your best efforts to maintain control. People of faith can draw on the compassion and discretion Christ showed to the sick and hurting as we minister to those in our lives with chronic illness.

A clergy friend of mine was diagnosed with type 2 diabetes a few years ago. His approach to self-care has become a spiritual practice. A change in diet is an opportunity to be mindful of what he puts in his body. Regular exercise is an opportunity to use that time for meditation and prayer. Most importantly, his change in health resulted in a radical change in his attitude toward life. Every day is now a chance to be grateful, a chance to take care of his temporal body, and a chance to draw strength from our eternal and ever-present Creator.

Myths and tips

Myth: Eating too much sugar causes diabetes. Sugar intake does not cause type 1 diabetes. It’s caused by an unknown environmental trigger. Type 2 diabetes is caused by genetics and lifestyle factors, but limiting sugary drinks can help with the prevention of type 2 diabetes and management of both types.

Myth: If you are overweight or obese, you will develop type 2 diabetes. Being overweight is a risk factor, but family history and age also play a role. Most overweight people never develop type 2 diabetes, and many people are at a normal weight when diagnosed.

Myth: Diabetes is not that serious of a disease. Most people with diabetes live a normal life, participating in sports and other activities. Yet day-to- day management can be frustrating, and diabetes causes more deaths a year than breast cancer and AIDS combined.

Some tips on how you can help: Don’t make jokes about sweets causing diabetes, and don’t ask people with diabetes if they are “allowed” to have that cookie or cake. The occasional dessert as part of a healthy diet is OK. Also, don’t offer to provide a “sugar-free” dessert at gatherings. Most of these offer no benefit, as people with diabetes have to monitor carbohydrate, not sugar intake. However, it is helpful to provide healthy foods such as proteins and vegetables at church and family functions. Comments about weight are never helpful.

Also, avoid using the word diabetic as a noun (someone with cancer is not called a “canceretic”). People with diabetes see this disease as just one aspect of their lives, not their entire identity.

Be sure to check out FaithLink, a weekly downloadable discussion guide for classes and small groups. FaithLink motivates Christians to consider their personal views on important contemporary issues, and it also encourages them to act on their beliefs.

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