You Could Have Diabetes And Not Even Know It

You Could Have Diabetes And Not Even Know It

According to the CDC about 29 million Americans have diabetes. Over 8 million of them don't even know it. Diabetes is directly responsible for approximately 230000 deaths annually and over 300000 cases of disability. The total cost of diabetes in the US approaches $250 billion annually. Alarmingly 37% of Americans may be classified as having “pre-diabetes” which means that if they continue down their current path in all likelihood they will become diabetic in the coming years.

In simple terms diabetes refers to a state where your body no longer has the capacity to regulate blood sugar. Normally your blood sugar is tightly controlled by two hormones glucagon and insulin. Insulin is like a key which “unlocks” your cells opening the door for glucose (sugar) to enter where it can be used or stored in the form of glycogen or fat. When this happens blood sugar goes down (it is in the cells and no longer in the blood). Glucagon liberates these stored calories from your liver and other cells to push blood sugar levels up. Generally your blood sugar stays in a range of 80-120 depending on many factors such as when you last ate a meal or how much exercise you've had.

In Diabetes Type 1 your body is simply unable to produce insulin because the insulin-secreting cells in the pancreas have been destroyed. This usually occurs in childhood and is thought to be due to immune system malfunction. We are still learning precisely how this occurs so we can intervene and perhaps prevent this from occurring. Until then people with Type 1 Diabetes must monitor their food intake and activity levels carefully and use injectable insulin to try to keep their blood sugar levels close to normal range.

95% of diabetics in America have what is called Type 2 Diabetes. In this type your pancreas may be making significant amounts of insulin but blood sugar levels are high anyway. Why? Often it is because the cells in your body are at capacity and can no longer store any more glucose. The normal amount of insulin can no longer “open the door” so your body brings in “big insulin” (higher insulin levels) to help force the sugar into the cells. Fat cells grow and expand to store all this extra energy. Blood sugar levels drift up. “Pre-diabetes” is the pathologic state where the blood sugar level is not yet at point where it is labeled “diabetes” but the process of expanding fat cells and higher insulin levels has begun.

The bad news is that this pathologic state of high insulin and high blood sugar levels is a systemic problem that greatly increases risk of death and disability from multiple causes (heart disease stroke kidney disease amputations blindness etc). The good news is that most of the time Type 2 Diabetes is very responsive to changes in diet and lifestyle.

In 1982 10 middle-aged Australian full-blood Aboriginal diabetics were eating the standard western industrial diet of white flour carbonated beverages beer desserts and other processed food. They agreed to return to their native people who lived off the land and ate a traditional hunter-gatherer type diet (which was about 12% fat) for 7 weeks. When they returned to civilization they had lost almost 20 lbs with remarkable improvements in their cholesterol and blood sugar levels. They had essentially become non-diabetic.

I have seen patients undergo similar transformations. It is often possible for Type 2 diabetics to reduce or eliminate the need for medication with increased exercise and change in diet. These same lifestyle changes also result in weight loss lower cholesterol and reduction in heart disease and cancer risk.

Common symptoms of diabetes include frequent urination excessive thirst increased hunger weight loss tiredness lack of interest and concentration a tingling sensation pain or numbness in the hands or feet and blurred vision. If you are experiencing any of these symptoms see your doctor.

If you are diabetic and you begin to make dietary changes your need for medication will change. I encourage you to take the first step of including more high fiber plant-based whole foods in your diet.

Dr. Dennis Lipton a board-certified internist at Vail Valley Medical Center's Internal Medicine clinics. Learn more at vvmc.com/internalmed or by calling (970) 477-3090.