Housecall with host Dr. David Doman, M.D. invites Dr. Paul Sack, M.D. the Chief of Endocrinology at Medstar Union Memorial Hospital in Baltimore, Maryland to discuss the Diabetes Epidemic in the United States.
11.3% of the United States population/37.3 million Americans have Diabetes. Over 8.5 million Americans don’t even know, which is the biggest problem. In Maryland there are 12% of Type 2 Diabetics, including me for the past 24 years. The epidemic of Diabetes directly correlates to the Obesity Epidemic.
There are no symptoms at first. The only way to get diagnosed is typically from blood work. If you are not getting regular checkups, it can be years till people get diagnosed. Complications of high sugars could effect the eyes, kidneys, feet, and is a high risk of heart disease.
Diabetic Neuropathy is one of the most common complications of diabetes that consists of numbness, tingling, and burning of the feet. It usually starts at the toes and slowly works it way up. It is caused by years of high sugars, then add that to someone who may have high blood pressure or high cholesterol. Blockages in the arteries and especially in the large arteries that go to the feet occur, which end up in diabetic foot ulcers when people don’t feel an injury on their foot. Then the ulcer doesn’t heal because they don’t have good blood flow. The combination sometimes leads to amputation.
Diabetic retinopathy is when bleeding in the back of the eyes occurs from high sugar levels from damage to the blood vessels. Treatment is available if bleeding isn’t to bad when you seek help. Poor diabetes management can cause damage blood vessels clusters in the Kidneys too and can lead to kidney damage amongst other things.
Everyone should get an annual checkup even at a young age. Especially people with a family history of diabetes or is obese, have high blood pressure, high cholesterol, or any one with symptoms should get a blood test. If you are healthy then get tested every few years, if you are not healthy then get tested every year.
The different types of test that check you sugars are the Blood Glucose Test, Glucose Tolerance Test (not given much), and Hemoglobin A1C.
Blood Glucose Test
-Get your blood drawn after fasting.
-Below 100 is Normal, 100-125 is Abnormal or Pre-Diabetes, above 125 is Diabetes
-Gives the blood glucose level average of the last 3 months
-This test is a marker of how sugar has effected your red blood cells
-Below 5.7% is Normal, 5.7%-6.4% is Pre-Diabetes, Above 6.4% is Diabetes
Type 1 Diabetes
-Typically in the younger population who are in good health and suddenly get sick
-Sugars are extremely high
-Mostly from Auto Immune Disease, sometimes the bodies immune system gets tricked and destroys the cells that are triggered to make insulin
-Auto Immune Type 1 Diabetes often gets misdiagnosed
-Will be on insulin for the rest of their lives
Type 2 Diabetes
-Typically in older population who are heavier and may have high blood pressure and/0r bad cholesterol
-Sugars slowly go up, much slower progression
-Body produces some insulin, but not enough
-Will be on oral medication or insulin for a portion or the rest of their lives
Short Acting Insulin-Rapid-acting insulin, begins to work about 15 minutes after injection, peaks in about one or two hours after injection, and last between two to four hours.
Long Acting Insulin-It is given once daily to control the blood sugar level.
The liver makes sugar, so we don’t die when we don’t eat. Our bodies are made to resist famine, so we store up energy by over eating because when we don’t have food the body turns that stored up energy into sugar. In someone without diabetes, the Pancreas makes insulin equal to the same amount that the liver outputs sugar.
-Continually monitoring sugars
-Automatically adjusts in background/while sleeping
-Need to enter food data, but pump will give a cushion on the insulin, which all helps make it more manageable
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