Doctor offers healthy ways to combat type 2 diabetes

With a grow­ing obesity epi­dem­ic in the United States, type 2 dia­betes mel­litus has be­come one of the largest health con­cerns that primary care phys­i­cians en­counter. An es­tim­ated 23 mil­lion Amer­ic­ans live with dia­betes. Type 2 dia­betes is a dis­order of meta­bol­ism. When we eat, our food is broken down to gluc­ose. The cells of our body util­ize this gluc­ose for growth and en­ergy. In­sulin, which is made by the pan­creas or­gan, is ne­ces­sary to carry the gluc­ose in­to the cells to provide this en­ergy source.

In type 2 dia­betes, the fat cells of the body, par­tic­u­larly those around the waist and mid­sec­tion, be­come dif­fer­ent from nor­mal cells. These cells be­come res­ist­ant to in­sulin. That is, they do not al­low in­sulin to do its nor­mal func­tion. When this oc­curs, the gluc­ose sug­ar has no op­tion oth­er than to re­main in the blood­stream. It can­not re­main there forever, though, and it even­tu­ally gets de­pos­ited in dif­fer­ent body parts. Dia­bet­ics are at high risk for dam­age to many of these or­gans. Sug­ars de­pos­ited in the kid­neys can lead to dia­bet­ic neph­ro­pathy and kid­ney fail­ure. Sug­ars in the ret­ina of the eye can lead to ret­ino­pathy and vis­ion loss. When it dam­ages the nerves, it can cause pain­ful neuro­pathy of the hands and feet. This can also lead to dia­bet­ic foot ul­cers than can lead to am­pu­ta­tion. Dia­bet­ic dam­age to the blood ves­sels can cause heart at­tacks and strokes, or even erectile dys­func­tion in men.

Of­ten times, people with type 2 dia­betes do not show any signs or symp­toms and it is dis­covered with routine blood tests. However, some of the most com­mon symp­toms in­clude ex­cess­ive thirst or ap­pet­ite, fre­quent ur­in­a­tion, un­usu­al changes in weight or fa­tigue. Some­times, people will get naus­ea, dry mouth or blurry vis­ion. Fre­quent skin in­fec­tions, yeast in­fec­tions in wo­men or poorly heal­ing wounds can be clues lead­ing to­ward dia­betes.

To dia­gnose dia­betes, your primary care phys­i­cian can use dif­fer­ent tests, in­clud­ing fast­ing blood gluc­ose, hemo­globin A1c val­ues or two-hour gluc­ose tol­er­ance test­ing. Speak with your doc­tor if you have any of the symp­toms above. You may be at a high­er risk for type 2 dia­betes if you are over­weight, have a fam­ily his­tory of dia­betes or are a fe­male who had gest­a­tion­al dia­betes when you were preg­nant.

The treat­ment of dia­betes is two-fold. The part you can do for your­self is live a health­i­er life­style. You need to mon­it­or your diet, de­crease the total num­ber of cal­or­ies you con­sume each day and par­tic­u­larly min­im­ize foods high in fats, car­bo­hydrates and sug­ars. You need to ex­er­cise more and burn more cal­or­ies. 

The part your doc­tor can do is to put you on the right medi­cine, which usu­ally starts with met­form­in, be­fore oth­er medi­cines can be ad­ded, in­clud­ing pills or in­sulin in­jec­tions. 

It is also im­port­ant for dia­bet­ics to see an eye and foot spe­cial­ist each year for prop­er com­plic­a­tion sur­veil­lance. With the right diet, amount of ex­er­cise, phys­i­cian mon­it­or­ing and med­ic­a­tion, you can avoid the dev­ast­at­ing com­plic­a­tion of this dan­ger­ous dis­ease. ••

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