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Diabetes 101: how diabetes affects the health of adults and children

Greeley Tribune - 2/20/2021

Feb. 20—Carrying extra weight can cause a lot of health issues and put people at higher risk for certain diseases.

In addition to joint problems, high cholesterol and heart disease, being overweight can cause diabetes.

According to a 2020 report from the Centers for Disease Control and Prevention, CDC, 34.2 million adults and children in the United States have some form of diabetes. In 2018, 1.5 million new cases of diabetes were diagnosed, with that number continuing to rise.

The percentage of adults with pre-diabetes doubled between 2005 and 2016, with many adults remaining unaware of their risk for the disease.

Some of the risk factors for developing diabetes include smoking, obesity, lack of exercise, high blood pressure and high cholesterol.

How food affects sugar levels

Before delving into what diabetes is and how it can affect a person, here's a quick biology lesson on the body.

Food is made of three different types of building blocks — proteins, fats and carbohydrates, explained Dr. Richard Millstein, an endocrinologist with UCHealth.

Proteins are comprised of things like meat, dairy and eggs, fats are butter and oil, and things like bread, rice, potatoes, cakes, and fruit all fall into the carbohydrate arena.

Whenever you eat a carb, it breaks down the sugar in the stomach, or glucose, and is then absorbed into the blood stream, raising the blood sugar.

"The pancreas makes insulin, which comes along to open a door essentially to let the sugar leave the bloodstream to be used by the body's cells for energy, lowering the blood sugar," Millstein said. "That is a perfect world when everything works."

People with diabetes either don't produce enough insulin or their body is resistant to insulin, which can cause a variety of health issues.

Types of diabetes

There are three different types of diabetes — Type 1 diabetes, Type 2 diabetes and gestational diabetes.

Type 1 diabetes is often associated with children and teens and is caused by an autoimmune reaction that causes the body to stop making insulin. Around 5 to 10% of people who have the disease have Type 1 diabetes. Older people can develop Type 1 diabetes.

"There's a lot of research going into Type 1 diabetes and working with a lot of different immune drugs to try to initiate early on in the process to prevent it from happening," Millstein said. "If it's there, it's going to be there; it is not reversible."

Symptoms for Type 1 diabetes come on quickly and there is no way to prevent the disease. People diagnosed with it must take insulin shots daily to survive.

Increased thirst, frequent urination, fatigue, blurred vision, increased hunger and an elevated heart rates are a few of the symptoms people can experience with Type 1 diabetes.

Type 2 diabetes is the more known form of the disease and can be seen in adults, teens and children.

Type 2 diabetes takes longer to develop than Type 1 and this form of the disease can be prevented. With Type 2 diabetes, the body either doesn't produce enough insulin or is insulin resistant.

"Initially, you make even more insulin trying to overcome that resistance to be able to open the door to get the sugar out of the blood," Millstein said. "After a while, the insulin gets to be at such a level that your own pancreas can't make enough insulin to deal with the resistance level, and the blood sugars start to rise."

People with Type 2 diabetes can take non-insulin medication or insulin shots, depending on the severity of the disease.

Some of the symptoms associated with Type 2 diabetes include excessive hunger, weight gain or loss, poor wound healing and increased thirst.

If you've ever been pregnant, there's a good chance you were tested for gestational diabetes.

Gestational diabetes can develop in women despite them never being diagnosed with the disease. Gestational diabetes not only puts pregnant women at risk for getting Type 2 diabetes later on down the line, but their baby as well. Babies born to mothers with the disease tend to have obesity as a child and are more likely to develop Type 2 diabetes later in life.

Typically there are no symptoms of gestational diabetes so doctors rely on a blood sugar test to determine if a mother and baby are at risk. However, some women wit the disease can experience frequent urination or yeast infections.

While those are the three main forms of diabetes, there is also something called pre-diabetes. According to the CDC, 88 million adults — or 1 in 3— have pre-diabetes.

Pre-diabetes is where a person's blood sugar levels are higher than normal, but not high enough to be considered actual diabetes. Pre-diabetes can raise a person's risk for Type 2 diabetes as well as heart disease and stroke.

Unlike Type 1 and 2 diabetes, the condition does not have any symptoms and many people do not even realize they are pre-diabetic.

Turning a diabetes diagnosis around

Fortunately for people who are diagnosed with pre-diabetes and Type 2 diabetes, they can reverse negative effects associated with the disease by making a few lifestyle changes.

Diabetes and pre-diabetes can be diagnosed through blood tests such as a fasting blood sugar test or an A1C test that measures the average of the past three months of blood sugar.

A fasting blood sugar count of 100 or higher signals pre-diabetes, Millstein explained. For Type 2 diabetes, a person's blood sugar would have to be 126 or higher.

For A1C test results, anything below 5.7 is normal, 5.7 to 6.4 is pre-diabetes and 6.5 or higher is diabetes.

Maintaining a healthy weight for your height and body type is one way to effectively reverse or prevent Type 2 diabetes.

"Whether or not you have diabetes, if there is extra weight on board or adipose or fat tissue, there's insulin resistance and it'll be more than someone that doesn't have the extra weight," Millstein explained. "There are a lot of foods out there that human beings were never meant to eat, but eat them because they are tasty and cheaper."

Even just losing 10% of your body weight can make a big impact on a person's risk for being diagnosed with Type 2 diabetes.

"Metformin, which is used for Type 2 diabetes, can decrease the progression by around 37%," Millstein said. "While the medicine works great, lifestyle changes did a boatload better."

Staying away from fast food, soda and other unhealthy foods and eating in moderation will help burn calories and promote weight loss.

"This isn't the kind of diet that says you can never have bread again. It's a lot about portion sizes," Millstein said. In general, diets higher in vegetables are going to help you no matter what. Processed or simple carbohydrates tend to hurt you."

Millstein suggests opting for whole wheat breads and eating fruit rather than drinking fruit juice, which is often high in sugar.

Getting in regular exercise, even if it is only 15-30 minutes a day, can make a huge difference in your health.

Like many diseases, genetics play a large role in a person's risk level.

"If your mom or dad has diabetes then there's a higher risk of you getting it," Millstein said. "Although with the data that we have, weight plays a bigger role than genetics do."

The risk of diabetes in children and teens

Children and teens are just as susceptible to getting diabetes as adults.

With the advancements of technology and rise in popularity of social media and video games, combined with not being able to do group activities and sports, physicians are seeing an increase in obesity rates of children and teens.

In 2018, 210,000 children and teens had been diagnosed with Type 1 or Type 2 diabetes, according to the CDC.

As with adults, managing weight and getting in exercise are key factors in helping kids and teens avoid the Type 2 diabetes trap.

"Unless they're aware of diabetes or have a family member with diabetes it's usually a surprise to the parents," Dr. Amy Driscoll, a pediatrician with UCHealth said. "But most of the time they will come in because they think their child has a urinary tract infection because they are going to the bathroom frequently or their child is having stomach aches."

Before drugs like insulin, children diagnosed with diabetes "slowly withered away" and the diagnosis was a "death sentence."

The disease is hard on both parents and children.

Parents with young children who are diabetic will have to keep track of what they eat and how much as well as help their youngsters test their blood sugar levels.

Teens that have had the disease for a long time may feel "tired" of having to deal with watching what they eat and checking blood sugar levels.

"They're tired of having a chronic illness and just don't want to take their medications or refuse to take them at times. Then they end up with hospitalizations," Driscoll explained. "It's a big toll on the family; the whole mental thing of it."

Children and teens diagnosed with diabetes can still have a normal and fulfilling life.

"As long as their diabetes is well controlled, they can do any of the sports and all the activities," Driscoll said. "They might have to just make sure they have a snack before they play any sports so that they don't get too low with their blood sugar."

Driscoll is also seeing more young patients who are pre-diabetic.

"The kiddos will come in and they will have a significant weight gain since we last saw them," she said.

Promoting healthy eating habits and keeping kids busy are two ways to help lower youngsters' risk of getting pre-diabetes or Type 2 diabetes.

"Bored kids will eat and snack. We've seen a big increase over the past year just for the fact that those kids have been sitting at home and not at school," Driscoll said. "When they are home, they have access to the kitchen all day long."

Driscoll also advises abstaining from buying junk food — if it's not in the house, the kids can't eat it.

"Trying to find sports or exercise that kids can be involved in is important," she said. "And limiting the sedentary and screen time to no more than 2 hours per day."

The American Diabetes Association has lots of information on how to maintain or prevent diabetes in adults, teens and children. For more information, go to www.diabetes.org.

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