The vast majority of people with diabetes have type 2 diabetes, a condition in which the body becomes resistant to insulin, the hormone that helps glucose, your body's primary source of energy, make its way inside cells. But 1 out of every 4 of these people aren't aware they have the disease, according to the US Centers for Disease Control. That's nearly 7 million Americans, an astounding number by any measure, living with dangerously high blood sugar levels.
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The symptoms of diabetes are all related to this increase in blood sugar, too. Here's what to look out for:
It's important to note that most of these symptoms are progressive in nature: they get worse if you aren't quick to begin appropriate treatments. Notice potential symptoms of diabetes? Visit your doctor as soon as possible for a blood test. Your physician will be able to check your blood glucose levels to see if they're normal. Multiple tests are required to conclusively diagnose the condition.
While researchers are still unsure what causes type 2 diabetes, we do know a fair amount about who's more likely to develop the disease.
Being overweight is probably the most reliable risk factor, especially if you tend to carry extra fat around your abdomen. Physical activity is another primary indicator. People who exercise less, or live more sedentary lives in general, are at an increased risk. As with all conditions, genetics seems to play a role as well. People who have family members with type 2 diabetes, particularly parents or siblings, are more likely to develop the condition themselves. Age is another factor, since the likelihood of developing type 2 diabetes seems to increase the older we get.
To learn more about diabetes risk factors, check out the International Diabetes Foundation.
Those risk factors may prove a handy guide, but the truth is that anyone can develop diabetes, no matter their age, weight or genetic history. Even more problematic is that type 2 diabetes doesn't present itself suddenly. Usually, the disease progresses very slowly, without any symptoms in its early stages. That makes it even more important to be aware of the signs.
In people with type 2 diabetes, around 27.9 million Americans, the hormone insulin doesn't work properly. Insulin is like a key, unlocking almost every cell in your body and allowing glucose, a blood sugar, to get inside. Once glucose is inside, tiny structures called mitochondria are able to convert it into a form of energy. It's what keeps your cells, and thus your body, running.
But in people with type 2 diabetes, glucose can't get inside the cells - specifically, the cells of the liver, muscles and fat. Instead, it starts to build up in the blood stream. In response to this buildup, your pancreas, a gland buried deep in the abdomen, starts to produce more insulin. But the pancreas eventually tires out, and the specific beta cells that make insulin get damaged.
In type 1 diabetes, more commonly diagnosed in kids and young adults, the body's immune system actually attacks those beta cells, knocking out the pancreas' ability to produce insulin from the start.
In either case, elevated blood sugar levels can damage numerous organ systems, wearing away at the walls of capillaries and veins and impairing blood flow throughout the body. Treating diabetes is all about controlling these blood sugar levels to reduce the risk of damage.
Diabetes appears to be more common now than ever before. Between 1980 and 2008, a span of only 28 years, the number of people with diabetes worldwide more than doubled, from 153 million to 347 million, according to research published in the preeminent British medical journal The Lancet.
Why? The world population is aging; people are living longer, and with age comes increased risks for developing diabetes. Our diets are changing, too, for the worse, with rising levels of obesity and declining rates of physical activity. Add those trends together and you have a veritable health crisis. It's what led one epidemiologist from Harvard, who spoke to the Washington Post in 2011, to call diabetes a "global epidemic [with the] potential to overwhelm the health systems of many countries, especially developing countries."
Nope. There's no cure for either type 1 or type 2 diabetes, and you should generally be wary of diets or natural supplements that advertise themselves as "solutions" for diabetes.
Diabetes is a life-long medical condition that needs to be managed. People with diabetes have to develop individual eating plans and exercise regularly, all in an effort to control their blood glucose levels. Physical activity helps lower blood sugar, and sticking to foods with a low glycemic index, ones that don't cause sharp increases in blood sugar after they're eaten, helps, too.
For some people, diet and exercise will be enough to adequately control their blood sugar. But many people with type 2 diabetes require medications in addition to nutritional and activity changes, and some will have to routinely monitor their blood sugar levels.
While insulin therapy is more common for patients with type 1 diabetes, who can't produce their own insulin, some people with type 2 diabetes go on insulin therapy after other treatment methods have failed.
When people do need medication, they're usually put on metformin first. Metformin does two things:
Together, these two effects might not be enough to control blood sugar, but along with diet and exercise, metformin has been an effective addition to the treatment regimen of many people with type 2 diabetes for over 50 years. Other medications, like glipizide (Glucotrol) and repaglinide (Prandin), act in a different way, increasing the amount of insulin produced by the pancreas. In fact, the vast majority of diabetes drugs work in one of these two ways, either making your cells more sensitive to insulin or amping up your body's production of the hormone.
There's a new kid on the block, however. SGLT2 inhibitors have an insulin-independent mechanism of action; they don't have any effect on how well your body uses insulin, or how much it creates. Instead, these drugs work directly on the kidneys, the organs responsible for secreting wasting materials in your urine. Usually, the kidneys filter glucose from urine and return it to the body. But after you've taken an SGLT2 inhibitor, your kidneys will start expelling all of that extra glucose when you pee.
Although we're still learning how SGLT2 inhibitors, like Invokana, affect the body, and many physicians have heralded the drugs as a "revolution" in diabetes management, there have been some troubling early warning signs. We mentioned diabetic ketoacidosis before, a condition caused by increased levels of blood acids, usually when the body relies on fat for its energy production. But fat only becomes a major fuel source when your insulin levels are really low, so people with type 2 diabetes don't usually get ketoacidosis. That's good since the condition can be fatal.
People on Invokana, though, who have type 2 diabetes, have been suffering severe episodes of ketoacidosis. It's so odd that the US Food & Drug Administration has made a point of warning patients taking SGLT2 inhibitors of the risk, even adding new warnings to the drugs' labeling. The FDA is also looking into severe urinary tract infections, which may be more likely to spread, and become life-threatening, in patients taking Invokana or other SGLT2 inhibitors.
Every drug comes with risks, along with any benefits it may present for patients. But many public health advocates are beginning to question whether SGLT2 inhibitors are really the best choice for people with type 2 diabetes.
Continue Reading: FDA Links Invokana To Acute Kidney Injury
Thanks to our friends at Sahn Law, Charleston SC, personal injury lawyers, for their contributions to this post.