In the United States, November is associated with Thanksgiving and the inevitable feast.  November is also National Diabetes Month, however, and the 14.6 million Americans who have been diagnosed with this serious disease often approach the upcoming holiday with some anxiety since their bodies cannot properly process sugar from food, causing sugar levels in their blood and urine to rise. The discomfort most people associate with overeating at Thanksgiving pales in comparison to the peril a person with diabetes can face.

The seventh leading cause of death in the United States, diabetes is often called a “silent killer” because many people remain unaware that they have diabetes until they develop one of its life-threatening complications: blindness, kidney disease, heart disease, stroke and nerve disease requiring amputation.  It also has been reported that men over age 50 with diabetes have impotence rates as high as 50 to 60 percent.  In addition to the14.6 million people who have been diagnosed with diabetes, there are an estimated additional 6.2 million people who are unaware they have the disease, according to the American Diabetes Association.

Fortunately, diabetes can be treated.  Many complications can be prevented or their progression can be slowed down successfully if people seek care in time.   The main goal of diabetes treatment is to bring blood sugar levels down as close to normal as possible. 

In Type 1 diabetes, which most often occurs in children or young adults, the pancreas stops making insulin, a hormone produced by an organ called the pancreas that converts the sugar “glucose” into energy.  People with Type 1 diabetes depend on insulin injections to control their glucose levels.

Type 2 diabetes, which represents approximately 90 percent of people with diabetes, occurs most often in susceptible adults over age 40, especially if they are obese and have sedentary lifestyles.  Although this is the most common population, Type 2 diabetes is being diagnosed more frequently in teenagers and young adults, which was not the case even 10 years ago.  In this type of diabetes, the pancreas produces some insulin, but it is not used effectively.  The best treatment for Type 2 diabetes generally consists of weight loss and exercise, although oral medications -- or even insulin -- are often required for optimal blood sugar control.

Other less common types of diabetes include “gestational” diabetes that first occurs during pregnancy and often disappears after the baby’s birth, and “secondary” diabetes caused by damage to the pancreas by chemicals, certain medicines or diseases such as cancer.  “Impaired glucose tolerance” used to be called “borderline” diabetes, but the blood sugar level actually falls between normal and diabetic levels.  People with impaired glucose tolerance are at an increased risk of developing diabetes.  This is also known as pre-diabetes. 

Type 2 diabetes may develop slowly and without any associated symptoms over many years.  When symptoms do develop, they may include excessive thirst, frequent urination and extreme hunger, especially for sugary foods.  Many people also feel edgy, tired or sick to their stomach.  Some people may actually lose weight, even though they have an increased appetite.  Other symptoms can include repeated or difficult-to-heal infections of the skin, gums, vagina or bladder; burred vision; tingling or loss of feeling in the hands or feet; and dry, itchy skin.

The causes of diabetes are not fully understood, but researchers believe there is a genetic component since diabetes frequently runs in families.  Diabetes is more common in Hispanics, Native Americans, African Americans and Southeast Asians than in other ethnic groups.  Other people who are at greater risk for developing Type 2 diabetes include:

• People over age 45, especially those who are overweight
• People with abnormal or high triglycerides
• Women who have had gestational diabetes or who have had a baby weighing 9 pounds or more at birth.

In people who are prone to Type 2 diabetes, obesity and a sedentary lifestyle can contribute to the onset of diabetes.  Anyone with these characteristics should be screened periodically for diabetes.

The St. Luke’s Diabetes Center, which celebrated its 10^th anniversary in October, offers complete outpatient services for adults and children with all types of diabetes.  These services include screenings, individual care instructions, diet and meal planning, and resources for supplies and services.  In addition, the Diabetes Center staff provides training for individuals and families, teaching them how to manage their diabetes and prevent the serious and often life-threatening complications of the disease.  Training can include:

• Blood sugar monitoring
• Meal planning, basic nutrition and weight management
• Medication management
• Proper foot care
• Managing complications

The Diabetes Center’s professional staff of certified diabetes educators works closely with your primary care physician to help you manage your symptoms.  They also assist with referrals to specialists, including podiatrists, endocrinologists and ophthalmologists.  Staff members speak English and Spanish and can provide translators for other languages.

For more information about the Diabetes Center at St. Luke’s Hospital, please call (415) 641-6826, or click here.

Back to top