Diabetes

• type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease.

• In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives.

• Medication

• A diagnosis of type 1 diabetes means your pancreas is no longer capable of producing insulin. Through multiple daily injections with insulin pens or syringes or an insulin pump, it will be up to you to monitor your blood glucose levels and appropriately administer your insulin. You will need to work closely with your healthcare team to determine which insulin or insulins are best for you and your body.

• Exercise

• Exercise is also a key component of proper diabetes care. Along with all of the other benefits you will receive from being active, your diabetes will also respond in kind with more stable blood glucose levels. We have plenty of information and tips to help get you motivated and keep your exercise routines fresh.

• Nutrition

• Nutrition is one of the most important pieces of the diabetes puzzle. Understanding how different foods affect your blood glucose and learning to develop solid meal plans will be a crucial part of your daily routine.

• Support

• Emotional support, while not often initially considered, plays a key role in diabetes care. Connecting with other people living with diabetes that understand the daily grind of counting carbohydrates, testing blood glucose multiple times each day and dealing with the various highs and lows (both physical and emotional) of life with diabetes can make all the difference.

• Talking with people who "get it" is important, and our Online Community offers a place for people living with and affected by diabetes to find that support. Our Family Link program connects parents of children with type 1 diabetes.

2• Type 2 diabetes is the most common form of diabetes.

• In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells.

• When glucose builds up in the blood instead of going into cells, it can cause two problems:

• Right away, your cells may be starved for energy.• Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart.• Some groups have a higher risk for developing type 2 diabetes than others. Type 2 diabetes is

more common in African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as the aged population.

• Genetics of Diabetes

• You've probably wondered how you developed diabetes. You may worry that your children will develop it too.

• Unlike some traits, diabetes does not seem to be inherited in a simple pattern. Yet clearly, some people are born more likely to develop diabetes than others.

• What Leads to Diabetes?

• Type 1 and type 2 diabetes have different causes. Yet two factors are important in both. You inherit a predisposition to the disease then something in your environment triggers it.

• Genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease at most only half the time.

• When one twin has type 2 diabetes, the other's risk is at most 3 in 4.

• Type 2 Diabetes

• Type 2 diabetes has a stronger link to family history and lineage than type 1, although it too depends on environmental factors.

• Studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes.

• Lifestyle also influences the development of type 2 diabetes. Obesity tends to run in families, and families tend to have similar eating and exercise habits.

• If you have a family history of type 2 diabetes, it may be difficult to figure out whether your diabetes is due to lifestyle factors or genetic susceptibility. Most likely it is due to both. However, don’t lose heart. Studies show that it is possible to delay or prevent type 2 diabetes by exercising and losing weight.

• Myth: Diabetes is not that serious of a disease.

• Fact: If you manage your diabetes properly, you can prevent or delay diabetes complications. However, diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke

• Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.• Fact: Being overweight is a risk factor for developing

this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

• Myth: Eating too much sugar causes diabetes.

• Fact: The answer is not so simple. Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors.

• Being overweight does increase your risk for developing type 2 diabetes, and a diet high in calories from any source contributes to weight gain. Research has shown that drinking sugary drinks is linked to type 2 diabetes.

• The American Diabetes Association recommends that people should avoid intake of sugar-sweetened beverages to help prevent diabetes. Sugar-sweetened beverages include beverages like:

• regular soda• fruit punch• fruit drinks• energy drinks• sports drinks• sweet tea• other sugary drinks.• These will raise blood glucose and can provide several hundred calories in just one serving!

• See for yourself:

• Just one 12-ounce can of regular soda has about 150 calories and 40 grams of carbohydrate. This is the same amount of carbohydrate in 10 teaspoons of sugar!

• One cup of fruit punch and other sugary fruit drinks have about 100 calories (or more) and 30 grams of carbohydrate.

• Myth: People with diabetes should eat special diabetic foods.

• Fact: A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone – low in fat (especially saturated and trans fat), moderate in salt and sugar, with meals based on whole grain foods, vegetables and fruit. Diabetic and "dietetic" foods generally offer no special benefit. Most of them still raise blood glucose levels, are usually more expensive and can also have a laxative effect if they contain sugar alcohols.

• Myth: If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta.

• Fact: Starchy foods can be part of a healthy meal plan, but portion size is key. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. Wondering how much carbohydrate you can have? A place to start is about 45-60 grams of carbohydrate per meal, or 3-4 servings of carbohydrate-containing foods. However, you may need more or less carbohydrate at meals depending on how you manage your diabetes. You and your health care team can figure out the right amount for you. Once you know how much carb to eat at a meal, choose your food and the portion size to match.

• Myth: People with diabetes can't eat sweets or chocolate.

• Fact: If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more "off limits" to people with diabetes than they are to people without diabetes. The key to sweets is to have a very small portion and save them for special occasions so you focus your meal on more healthful foods.

• Myth: You can catch diabetes from someone else.

• Fact: No. Although we don’t know exactly why some people develop diabetes, we know diabetes is not contagious. It can't be caught like a cold or flu. There seems to be some genetic link in diabetes, particularly type 2 diabetes. Lifestyle factors also play a part.

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• Myth: People with diabetes are more likely to get colds and other illnesses.

• Fact: You are no more likely to get a cold or another illness if you have diabetes. However, people with diabetes are advised to get flu shots. This is because any illness can make diabetes more difficult to control, and people with diabetes who do get the flu are more likely than others to go on to develop serious complications.

• Myth: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you're failing to take care of your diabetes properly.

• Fact: For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin, and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.

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• Myth: Fruit is a healthy food. Therefore, it is ok to eat as much of it as you wish.

• Fact: Fruit is a healthy food. It contains fiber and lots of vitamins and minerals. Because fruits contain carbohydrates, they need to be included in your meal plan. Talk to your dietitian about the amount, frequency and types of fruits you should eat.

• Overall Numbers, Diabetes and Prediabetes

• American Population with Diabetes Prevalence: In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes.

• In 2010 the figures were 25.8 million and 8.3%.• Undiagnosed: Of the 29.1 million, 21.0 million were diagnosed, and 8.1 million were undiagnosed.• In 2010 the figures were 18.8 million and 7.0 million.• Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.9%, or 11.8 million seniors

(diagnosed and undiagnosed).• The rate was 26.9% in 2010.• New Cases: The incidence of diabetes in 2012 was 1.7 million new diagnoses/year; in 2010 it was 1.9 million.• Prediabetes: In 2012, 86 million Americans age 20 and older had prediabetes; this is up from 79 million in 2010.• Deaths: Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates

listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death.

• Diabetes in Youth

• Complications/Co-Morbid Conditions

• Hypoglycemia: In 2011, about 282,000 emergency room visits for adults aged 18 years or older had hypoglycemia as the first-listed diagnosis and diabetes as another diagnosis.

• Hypertension: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 71% had blood pressure greater than or equal to 140/90 millimeters of mercury or used prescription medications to lower high blood pressure.

• Dyslipidemia: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 65% had blood LDL cholesterol greater than or equal to 100 mg/dl or used cholesterol-lowering medications.

• CVD Death Rates: In 2003–2006, after adjusting for population age differences, cardiovascular disease death rates were about 1.7 times higher among adults aged 18 years or older with diagnosed diabetes than among adults without diagnosed diabetes.

• Heart Attack Rates: In 2010, after adjusting for population age differences, hospitalization rates for heart attack were 1.8 times higher among adults aged 20 years or older with diagnosed diabetes than among adults without diagnosed diabetes.

• Stroke: In 2010, after adjusting for population age differences, hospitalization rates for stroke were 1.5 times higher among adults with diagnosed diabetes aged 20 years or older compared to those without diagnosed diabetes.

• Blindness and Eye Problems: In 2005–2008, of adults with diabetes aged 40 years or older, 4.2 million (28.5%) people had diabetic retinopathy, damage to the small blood vessels in the retina that may result in loss of vision.

• Kidney Disease: Diabetes was listed as the primary cause of kidney failure in 44% of all new cases in 2011.• In 2011, 49,677 people of all ages began treatment for kidney failure due to diabetes.• In 2011, a total of 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney

transplant.• Amputations: In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older

with diagnosed diabetes.• About 60% of non-traumatic lower-limb amputations among people aged 20 years or older occur in people with diagnosed

diabetes.

• Cost of Diabetes

• Updated March 6, 2013

• $245 billion: Total costs of diagnosed diabetes in the United States in 2012• $176 billion for direct medical costs• $69 billion in reduced productivity• After adjusting for population age and sex differences, average medical

expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.