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Diabetes: How Do I Know if I Have it?
What is diabetes? Diabetes is a disease that occurs when your body doesn't make enough of a hormone called insulin, or if your body doesn't use insulin the right way. If left untreated, it may result in blindness, heart attacks, strokes, kidney failure and amputations. Only half of the people who have diabetes are diagnosed because in the early stages of diabetes, there are few symptoms, or the symptoms may be the same as in other health conditions. What are the symptoms of diabetes? Early symptoms of diabetes may include:
If you have any of these symptoms, call your family doctor right away. Who is at risk for diabetes? The early stages of diabetes have few symptoms, so at first you may not know you have the disease. Damage may already be happening to your eyes, kidneys and cardiovascular system before you notice symptoms. You have more risk of having diabetes if:
If you have one or more of these risk factors, your doctor may want you to be tested for diabetes. You might also be tested at a younger age and more often if you have these risk factors. Talk to your doctor about your risk of getting diabetes and about a plan for regular testing. How will I be tested for diabetes? Testing, which is also called "screening," is usually done with a fasting blood test. You will be tested in the morning, so you shouldn't eat anything after dinner the night before. A normal blood sugar test result is lower than 110 mg per dL. A test result higher than 125 mg per dL suggests diabetes, but you should have two tests that are higher than 125 mg per dL, on two different days, before a diagnosis of diabetes is made. Test results from 110 mg per dL to 125 mg per dL suggest that you have a higher risk of getting diabetes. Why is it important for diabetes to be diagnosed early? Many people have diabetes for about five years before they show the symptoms of diabetes. By that time, some people already have eye, kidney, gum or nerve damage. There is no cure for diabetes, but there are ways to stay healthy and reduce the risk of complications. If you get more exercise, watch your diet, control your weight and take any medicine your doctor prescribes, you can make a big difference in reducing or preventing the damage that diabetes can do. The earlier you know you have diabetes, the sooner you can make these important lifestyle changes. Where can I get more information about diabetes? Your doctor can give you advice about diet and exercise, and how often to be tested for diabetes. How to Best Test for Undiagnosed Diabetes A simple test that measures long-term blood sugar may help identify millions of people with undiagnosed type 2 diabetes. The test, known as hemoglobin A1c (HbA1c), provides information on a person's average blood sugar (glucose) over the past 2 to 3 months and does not require fasting. Although the fasting plasma glucose test is still considered the most accurate measure, HbA1c may be more pragmatic because it does not require patients to fast for several hours beforehand. More than 5 million Americans have undiagnosed diabetes. If not controlled, the disease can lead to serious medical complications such as heart disease, blindness, kidney damage and amputations resulting from damage to nerves. Currently, however, there is no clear evidence to support widespread screening at the doctor's office. While the new findings do not show that the HbA1c test is a cost-effective way to do routine screening, they do suggest that more cases of diabetes can be caught. The test was particularly effective at detecting new cases of diabetes in obese individuals, those with high blood pressure and individuals with a family history of the disease. An estimated 16 million Americans have been diagnosed with type 2 diabetes, but medical experts say the figure is actually higher.Journal of General Internal Medicine January 2002;17:1-7 The Diabetes Conundrum: What Physicians are Teaching You may be Killing You Fact: Very little relationship exists between what a patient knows about diabetes and his or her control of its related cardiovascular risk factors and whether or not he or she ultimately succeeds or fails, indicated a study by Duke Clinical Research Institute. Research found that improved disease knowledge alone does not lead to improved blood sugar control, cholesterol levels, weight management and mortality rates. And, while education may be part of the puzzle, researchers noted there are likely other pressing health care delivery issues that must be addressed if a diabetic patient hopes to reduce their risks of dying from heart disease -- the main culprit of death among diabetic patients. The Minute Role of Knowledge Diabetic patients are twice as likely to suffer from acute coronary syndrome (ACS) than the general population; ACS can eventually lead to chest pain and possibly heart attack. Considering the facts, researchers measured the progress of 200 diabetic patients who were treated for ACS. At enrollment, each patient took a 14-question standardized test that measured his or her knowledge on diabetes. Patients were then divided into two groups: high- or low-scoring. Six months later, researchers linked how each of the groups scored with clinical measurements such as glycemic control, cholesterol levels, body mass index (BMI) and death. Data showed:
In light of the findings, researchers recognized the need to determine how to best assign scarce health care resources to reduce cardiovascular risk factors faced by diabetics. American Journal of Cardiology June 1, 2005;95(11):1290-1294 Duke University Medical Center June 2, 2005 Lifestyle Changes Better Than Drugs for Diabetes Men and women at high risk of developing type 2 diabetes can reduce this risk by losing weight and exercising, study findings show. The diabetes drug Glucophage can also cut diabetes risk if given preemptively, but not as dramatically. About 8% of US adults have type 2 diabetes, in which the body loses the ability to respond properly to the blood sugar-regulating hormone insulin. There are well-known risk factors for the disease, including high blood sugar levels after fasting, being overweight, and living a sedentary lifestyle. To determine whether targeting lifestyle factors with weight loss and exercise, or giving at-risk patients Glucophage, which helps the body respond better to insulin, would cut diabetes risk, the researchers compared these two approaches with an inactive placebo in more than 3,200 nondiabetic men and women. The average age of study participants was 51, and all had high blood glucose levels. Their average body mass index (BMI) was 34. BMI is a measure of weight in relation to height, and a person with a BMI of 30 or higher is considered obese. Study participants were randomly assigned to a placebo, 850 milligrams of Glucophage twice daily, or a lifestyle change program intended to help them lose at least 7% of their weight and engage in 150 minutes of physical activity per week. During the follow-up period, which lasted nearly 3 years, the investigators found that patients in the lifestyle intervention group saw the greatest reduction in their diabetes risk. They had a 58% lower risk of developing type 2 diabetes than people in the placebo group. Those given Glucophage cut their diabetes risk by 31%. The lifestyle program was significantly more effective than Glucophage therapy in all age groups. This study shows that type 2 diabetes is not inevitable. It is not necessary to wait until a person has type 2 diabetes to begin doing something about it. The New England Journal of Medicine February 7, 2002;346:393-403 Vinegar Can Fight Diabetes and Promote Weight Loss Eating vinegar before a meal, perhaps as part of an oil-and-vinegar salad dressing, could be greatly beneficial to people with diabetes or those at high risk of developing the disease. According to the results of a study, two tablespoons of vinegar taken prior to eating dramatically reduced insulin and glucose spikes in the blood that occur after meals. In people with type 2 diabetes, these spikes can cause major complications, including heart disease. Vinegar's effects were comparable to those from antidiabetes drugs like metformin, researchers said. In the study, which involved 29 people, one-third had been diagnosed with type 2 diabetes, one-third had signs that they could develop diabetes and one-third were healthy. Each individual was given either a vinegar dose or a placebo prior to eating a high-carbohydrate breakfast, and one week later were given the opposite drink and the same breakfast. Results indicated that:
A follow-up study geared at testing vinegar's long-term effects also found that taking vinegar yielded a pleasant side effect: moderate weight loss. In the four-week study, half of participants took a two-tablespoon dose of vinegar prior to each of two meals daily, while the other half were told to avoid vinegar. Participants taking the vinegar lost an average of two pounds over the four-week period, while weight remained constant in the non-vinegar group. And some participants taking vinegar lost up to four pounds. The downside? Participants weren't fond of drinking vinegar, even flavored apple cider vinegar. In response, researchers are now developing an encapsulated form of vinegar and testing its effectiveness. However, don't rush out to buy any of the vinegar dietary supplements currently on the market. According to the researchers, they don't contain acetic acid, which they suspect is the antidiabetic component in the vinegar. Science News January 1, 2005;167(1)
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