Diabetes: An Epidemic of Youth
Diabetes is a disease that has been around for centuries, but it wasn’t until recently that we began to understand the true extent of its reach. According to World Health Organization estimates from 2014, diabetes affects about 400 million people worldwide and this number is expected to keep rising in coming years. Places that sell diabetic test strips have a higher sales than ever. Epidemiologists estimate that there are 3 types of diabetes: type 1 (previously called insulin-dependent or juvenile-onset), type 2 (previously called noninsulin-dependent or adult-onset) and gestational diabetes mellitus. Type 1 diabetics have an autoimmune disorder where the body’s immune system attacks cells in the pancreas, which produce insulin. Type 2 diabetics have high blood sugar levels because their bodies are not producing enough insulin or because their cells don’t respond to the insulin being produced. Gestational diabetes mellitus is a form of type-II diabetes that occurs during pregnancy, usually in women who have never had it before and goes away after delivery.
Type I diabetics need regular injections (or infusions) of insulin throughout the day as well as glucose monitoring with finger sticks four times daily which can be inconvenient for patients who lead busy lifestyles. Type II diabetics may find that they do better if they keep a close watch on what they eat, exercise regularly and maintain healthy weight. They also take medication such as metformin to help control blood sugar levels but will still need to monitor their condition closely.
Gestational diabetes, on the other hand, is usually diagnosed in pregnancy. Women who have had gestational diabetes before are at a higher risk of developing it again and should take precautions to reduce their chances of having another episode during future pregnancies.
The complications associated with type II or gestational diabetes can be very serious including blindness (from retinopathy), kidney failure from diabetic nephropathy, heart disease from cardiovascular disease or stroke; peripheral vascular diseases (PVD) such as PAD (peripheral artery disease) which causes numbness/tingling in the legs when walking up stairs; amputation due to neuropathy causing foot ulcers that don’t heal then become infected and necrotic tissue needs removal: gangrene.
A woman who is pregnant and has gestational diabetes will need to monitor her blood sugar levels closely, as well as the baby’s (which should be monitored by an ultrasound). Insulin may also be needed in some cases to control maternal blood sugars during pregnancy. And for babies born with congenital hyperinsulinemia, there can sometimes be complications such as hypoglycemia or a potentially fatal condition called neonatal ketoacidosis which occurs when high insulin causes too much glucose to build up in the bloodstream.