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Understanding Type 2 Diabetes

Monday, November 21, 2016

With November being National Diabetes month, we will look at the type of diabetes that impacts the greatest number of individuals.  Type 2 diabetes affects about 90-95% of the 29.1 million Americans who have diabetes. This form of diabetes used to be called Adult Onset Diabetes but no more.  Type 2 diabetes represents anywhere from 8% to 45% of all the diabetes diagnosed in children and adolescents.  According to the Centers for Disease Control (CDC), the greatest percentage of type 2 diabetes is in the over 65 years age group.

Type 2 diabetes has an insidious onset.  The usual signs of excessive thirst, excessive urination and hunger may not be present. In their place may be a general fatigue, a dry mouth or slow wound healing.  This is one reason that the condition can go undiagnosed for a while which makes regular check-ups important even when you feel fine.  Type 2 diabetes is chronic and progressive.  The beta cells in the pancreas are secreting less and less insulin.  Partner this with increased resistance on the part of the body’s cells, usually the muscle cells, to use the insulin the body is producing, and the result is a high blood sugar.  Type 2 diabetes can be diagnosed with two fasting blood sugars on different days, equal to or above 126mg or a hemoglobin A1c of 6.5 or greater. If the individual has some of the classic symptoms, a casual blood sugar over 200mg can confirm the diagnosis.

The main contributing factors for type 2 diabetes in adults, adolescents and children are obesity and a sedentary lifestyle.  Other risk factors include a family history of diabetes, ones ethnicity which can increase risk if the individual is African American, Hispanic, or Native American.  

Education, weight loss and increased activity are the places to start when treating type 2 diabetes.  The goal with any diabetes diagnosis is to lower blood sugar (glucose) through self-management.  Working with your health care provider (HCP) and learning about the condition with a certified diabetes educator starts one down this important path.  For some patients, weight loss and increased activity aren’t enough to lower the blood sugar so your HCP may start oral medications, one of the non-insulin injection medications or insulin.  Good self-management of diabetes also includes daily self-glucose monitoring and with the wide selection of glucometers these days, it is easy to find one to match the individual and important that their insurance favors the meter as well as this will help with co-pays for test strips.  Self–management also includes taking medications as prescribed, keeping appointments with your HCP and getting blood work as ordered.  One blood test, the HbA1c (mentioned above) is usually ordered every 3 or 6 months.  This test lets you and your HCP know what your average blood sugar has been over the last three months as it is the weighted average of the amount of glucose glycated or “stuck” to the red blood cells.  The American Diabetes Association recommends a HgA1c of less than 7% as a first step.

Self-management also includes regular foot checks, regular dental checks and eye exams that include the visualization of the retina.  It also includes regular blood work to monitor cholesterol levels and kidney function.  

My message this week is the same as last week, if you have diabetes, get educated and get involved with the self-management of your diabetes.  Make sure you have the most current information and tools to keep your blood sugar in a normal range. To find the certified diabetes educator and recognized diabetes program closest to you, go to the American Association of Diabetes Educators website.  

The Diabetes Self  Management Program at Noyes Health is recognized by the American Association of Diabetes Educators and is staffed with an RN CDE and RN Health Educator. The program is available in Geneseo, Dansville, Hornell and four area Health Care Provider offices.  Call 335-4355 for additional information.  

Nancy M. Johnsen RN, CDE is a Certified Diabetes Educator and Community Health Education Coordinator and Coordinator of the Diabetes Education Program at Noyes Health.

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