February 27, 2002

Diabetics at Increased Risk for Heart Disease and Stroke

The Associated Press has just recently published the results of a poll commissioned by the American Diabetes Association. Conducted between August and October of 2001, 2,008 diabetics were surveyed about their condition in relation to heart disease and stroke. Even though heart disease ranks first as the cause of death in Americans, and diabetics are especially at risk, two out of three diabetics did not consider cardiovascular disease a serious threat.

In fact, heart disease and stroke are the leading cause of death in diabetics. Yet, 52% of those surveyed reported their physicians had never discussed the importance of lowering their blood pressure, and doctors never addressed the topic of lowering cholesterol with 45% of the participants. Clearly, the latest poll illustrates the need to educate people with diabetes about their increased risk for cardiovascular disease and practices that can reduce that risk.

Diabetes is a disease caused by a deficiency of the hormone insulin. All bodies convert the food that is eaten into a form of sugar (glucose) that serves as the fuel for the body to function. This sugar travels through the body in the bloodstream to the cells where it has to be absorbed. There are “sugar entrances” in each cell that must be opened for the sugar to enter. Insulin acts like a key to open the entrances in the cells. When insulin is unavailable or not being used as it should, the cells fail to absorb the sugar, and the level of blood sugar remains high.

Diabetes is the 7^th leading cause of death in the United States, and is believed to cost $98 billion each year ($44 billion in direct medical costs, and $54 billion in indirect costs such as disability, work loss, and premature mortality.) Nearly 16 million Americans have diabetes. Most of these can be classified as either Type 1 or Type 2.

Type I accounts for 5 –10% of the people with diabetes, occurring most often in children and young adults. In this form of diabetes, the body produces little or no insulin, so people with this type of diabetes need to take insulin shots. In type II diabetes, the body usually still produces insulin, but either the amount is insufficient or the body is unable to use what is produced. About 90-95% of diabetes cases are type II. It usually occurs after age 45, and is closely related to obesity and sedentary lifestyles. Normally, insulin injections are not required with this type of diabetes.

The new poll reveals that diabetics are more aware of and worried about other complications of the disease, such as blindness, foot problems, amputation, and kidney disease. However, most were not aware that their high blood sugar levels cause damage to the blood vessels and often result in cardiovascular disease. The survey points out the need to educate people with diabetes about the importance of regularly testing blood sugar levels, blood pressure, and cholesterol levels. Frequent monitoring can reveal a problem before it is difficult to treat so steps can be taken sooner to minimize additional risk. This is especially true for the majority of diabetics, who have the Type 2 form of the disease; this type often can be managed by losing weight, exercising regularly, and maintaining a nutritious diet.

Unfortunately, there is no cure for diabetes. It is a lifelong disease. The only way to treat diabetes is to maintain the blood glucose level in the normal range at all times. This requires constant vigilance and educating people with this disease. But with proper treatment and education, it can be controlled. Understanding the nature of diabetes makes management of this condition a little easier.

To obtain further information about diabetes, contact the health district at 721-2822.