Q. What is diabetes?

A. Diabetes occurs when the body is not able to properly process blood sugar. There are number of reasons this can happen. For those with type 1 diabetes, previously called "juvenile onset diabetes," the pancreas ceases to provide insulin, which is a key regulator of blood sugar. This form of diabetes usually occurs at an early age and requires the injection of insulin to make up for the failure of the pancreas.

Type 2 diabetes, previously called “adult onset diabetes”, which is the most common type of diabetes, can result from a number of causes. It is often associated with obesity. With type 2 diabetes, the pancreas may be producing insulin but the body is not utilizing it properly. The result is swings in blood sugar levels which affect daily life as well as long term health. If not properly managed, diabetes leads to much suffering and serious health consequences. Diabetes is a major cause of heart disease, kidney failure, adult blindness and non-traumatic amputations.

Q. How many people have diabetes?

A. It is estimated that more than 16 million individuals in the U.S. have diabetes, and over half are undiagnosed. For reasons that are not yet understood, the disease attacks minority populations disproportionately. Hispanics, Native Americans and African Americans experience a higher rate of diabetes.

Q. How many people have diabetes in Santa Barbara?

A. Roughly 5% of Santa Barbara County’s population, or approximately 15,000 people, have been diagnosed with diabetes. Experts believe another 5% have some state of the disease but do not know it.

Q. Is there a cure for diabetes?

A. In addition to insulin, there are a number of drugs and dietary programs that can contribute to management of diabetes so that its health effects are minimal. No cure has been found to eliminate or prevent the disease.

Q. What are the early warning signs of diabetes?

A. For type 1 diabetes, early warning signs include: frequent urination, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue, and irritability. For type 2 diabetes, the early warning signs are: any of the type 1 symptoms, frequent infections, blurred vision, cuts/bruises that are slow to heal, tingling/numbness in hands or feet, and recurring infections. Some people with type 2 diabetes, however, experience none of these symptoms.

Q. Who is at risk for type 1 diabetes?

A. Of the 16 million Americans who have diabetes, approximately 5 percent - as many as 1 million people - have type 1 diabetes. Immediate relatives of people with type 1 diabetes have about a 10 to 20 times greater risk of developing this type of diabetes compared with the general population. Most symptoms of type 1 diabetes do not begin until almost all insulin-producing cells are destroyed by the immune system's attack. By the time a person is diagnosed, damage to these cells is nearly complete.

Type 1 diabetes is a condition that often begins in childhood where the pancreas stops releasing the insulin the body needs to be able to burn sugar for energy. It requires patients to replace the insulin their pancreas stopped making, usually by injection. About five percent of people with diabetes have type 1. Previously known as juvenile onset or insulin-dependent diabetes, type 1 diabetes usually strikes children and young adults. To survive, they need several insulin injections a day or infusion by an insulin pump. Insulin treatment, however, is not a cure. Nor can it always prevent the long-term complications of diabetes.

Q. What is type 2 diabetes?

The most common form of diabetes is type 2 diabetes, where either the body does not produce enough insulin or the cells do not properly utilize the insulin. Insulin is necessary for the body to convert sugar to energy. When sugar builds up in the blood, instead of going into the cells as fuel, it causes two problems: 1) cells become starved for energy and 2) over time, high blood sugar levels hurt one's eyes, kidneys, nerves and heart.

While type 2 diabetes is not curable, with medications, proper nutrition, exercise, and weight loss blood sugar levels may return to normal. Controlling blood sugar is the key to averting complications such as blindness, kidney failure, nerve damage, heart disease, and stroke. Unfortunately, the number of people with type 2 diabetes is soaring, and doctors are becoming increasingly alarmed about a rise in the pre-diabetic condition called impaired glucose tolerance. Although studies indicate it can be reversed with diet, weight loss, and exercise, if unchecked it eventually progresses to type 2 diabetes.

Q. What is gestational diabetes?

A. Gestational diabetes is when a woman is diagnosed with diabetes during pregnancy. In some cases, the diabetes only lasts during the pregnancy, but 40 percent of mothers with gestational diabetes develop type 2 diabetes later in life.

Q. What are other types of diabetes?

A. Surgery, drugs, malnutrition, infection or illness may trigger other "specific types" of diabetes. For example, steroid treatment of conditions such as asthma, lupus of arthritis may lead to diabetes.

Q. How does diabetes affect metabolism of food?

A. Diabetes is a chronic disease in which the body's glucose (sugar) levels are abnormally high. Diabetes occurs when your pancreas stops making enough insulin, which is necessary for the proper metabolism of digested foods. Diabetes doesn't interfere with digestion, but it does prevent the body from using an important product of digestion: glucose for energy.

When we eat, foods containing proteins, fats, and carbohydrates are broken down into simpler, easily absorbed chemicals. One of these is a form of simple sugar called glucose. Glucose circulates in the blood stream where it is available for body cells to use as "fuel". In a non-diabetic person, the blood carries the glucose or sugar throughout the body, causing blood glucose levels to rise. In response, a large gland called the pancreas (found just behind the stomach) makes insulin and releases it into the bloodstream. Insulin signals the body tissues to metabolize or burn the glucose for fuel, causing blood glucose levels to return to normal.

Q. What can I do to prevent the complications of diabetes?

1. Practice tight diabetes control. The American Diabetes Association recommends maintaining as close to normal glucose levels as possible. This means between 70 and 120 mg/dl before meals and 180 mg/dl after meals, with glycated hemoglobin level less that 7 percent. Studies show people with diabetes who do so have 75% fewer eye diseases, 50 % reduced risk of kidney disease, and 66% fewer nerve disease. Check with your physician about your individual goals.
2. Have glycohemoglobin blood glucose test (A1c) two to four times annually. This test indicates how well your treatment plan is controlling your glucose levels.
3. Check your feet daily and attend periodic foot exams. Nerve damage can leave you unable to feel small injuries that can lead to infection.
4. Have a kidney test each year. This test can identify kidney disease by detecting protein in the urine.
5. Schedule annual dilated retinal eye exams. This can detect abnormalities among small vessels in the retina. Left unchecked, these abnormalities can lead to blindness.