American Diabetes Month – Questions and Answer with Marci Butcher
Mountain-Pacific Quality Health’s own Marci Butcher recently won the Diabetes Educator of the Year Award from the American Association of Diabetes Educators – a national award. November is American Diabetes Month, so Marci took some time to discuss the importance of diabetes awareness.
Question: What are the primary contributing factors of diabetes?
Marci: Diabetes is actually a group of diseases that have different causes, but all result in high blood glucose (sugar).
Type 1 diabetes used to be called “juvenile” onset diabetes, but we now know that it can occur at any age (although it is more commonly diagnosed in children and young adults). Type 1 diabetes is when the body cannot make insulin. It is caused by an autoimmune response whereby the body’s own immune system attacks the insulin-producing cells of the pancreas. Type 1 diabetes is treated with insulin by taking shots or with an insulin pump. There may be a genetic predisposition to type 1 diabetes and at this time, there is no “cure” for type 1 diabetes.
Type 2 diabetes constitutes the vast majority of cases in the United States (90-95%), and there is often a strong genetic component to type 2 diabetes. Risk factors for diabetes fall into different categories, such as genetic factors, personal health history and lifestyle. Some risk factors cannot be changed, such as a family history of diabetes, age, ethnic background and for women, a history of diabetes during pregnancy or having a baby weighing nine pounds or greater. Other risk factors can be impacted by positive lifestyle changes, such as losing weight, stopping tobacco use, reducing your blood pressure and cholesterol levels, healthy eating and being physically active.
Gestational diabetes occurs in some women during pregnancy due to hormone changes. It is critical that blood glucose control be maintained throughout the pregnancy. After the baby is born, a woman’s blood glucose level usually returns to normal, but the chances of having type 2 diabetes later in life are higher. Recognizing that gestational diabetes increases the risk for type 2 diabetes later in life allows those with the condition to make positive lifestyle changes that will reduce the risk for type 2 diabetes.
Question: What are the warning signs for someone who has diabetes but doesn’t know it?
Marci: The signs and symptoms of type 1 diabetes include being very thirsty, increased urination, increased hunger, being very tired and unexplained weight loss. These symptoms can be extreme and may come on relatively quickly, leading to a serious and potentially dangerous situation. Being aware of the signs and symptoms of type 1 diabetes and acting quickly to see a health care provider may help avoid a tragedy.
The signs and symptoms of type 2 diabetes may include increased thirst and urination, unexplained weight loss and tiredness, but may also include blurred vision, cuts or sores that don’t heal, dry and itchy skin, infections and numbness or tingling in the feet or hands. Sometimes with type 2 diabetes, the signs or symptoms are so subtle that it is easy to miss them completely. About one in four people with diabetes do not know they have the disease.
One of the real problems of type 2 diabetes is that high glucose levels can be causing damage to the body without the person even knowing they have diabetes. Some people may have diabetes for a number of years before being diagnosed, and there may already be signs of the complications of diabetes, such as eye disease, kidney disease, nerve and blood vessel damage. It may be “silent” (no outward signs or symptoms) but that doesn’t mean that everything is OK in the body with undiagnosed diabetes or even pre-diabetes. Getting checked for diabetes, particularly if you have any risk factors, is very important. Talk to your health care team about your risk factors and getting checked for diabetes and pre-diabetes.
Question: Is diabetes genetic, and if someone has a family history should they be more concerned?
Marci: One of the risk factors for type 2 diabetes is having a family history of the disease. Healthy lifestyle behaviors will reduce your risk for diabetes. Talk to your health care provider about the risk for type 2 diabetes, getting screened and what you can do to reduce your risk.
Question: For those who have a family history of diabetes and don’t currently have the condition, what can they do to reduce their risk of getting diabetes?
Marci: For those at high risk for diabetes (those with pre-diabetes, those with a family history of diabetes or with other risk factors), there are positive lifestyle changes that may help reduce your risk. The Diabetes Prevention Program (DPP) is an evidence-based, year-long program that has shown to reduce the risk of diabetes by 58 percent. Check with your provider for a DPP in your area.
Question: What is the number one question people ask you who have diabetes?
Marci: One of the biggest things people with diabetes struggle with is nutrition and how or what to eat. Actually, an overall general healthy eating pattern is the way we all should be eating, including those with diabetes. Seeing a dietitian or a diabetes educator about healthy eating is one of the best things you can do to find an eating pattern that fits into your life.
Question: When checking your blood glucose, are there any tools that may be easier to use and less burdensome?
Marci: Diabetes care is very individualized for each and every person. Checking blood glucose with a glucose meter is one of the tools available to help manage diabetes, but it’s something that you and your health care team need to discuss. There are so many blood glucose meters out there, all with different features that may be better for one situation or another. Diabetes educators are experts in helping you figure out which blood glucose meter is the best option for you. An educator can help you and your provider discover patterns in your blood sugars, which will help determine the best course of diabetes management for you.
Question: For those with diabetes, what the biggest thing you would recommend for folks to manage their condition?
Marci: The biggest thing I would encourage people with diabetes to do is to recognize that positive self-management of your diabetes is very POWERFUL. You can really impact how well you live with diabetes. It is hard sometimes? You bet! But it’s worth it. And you don’t have to do it alone. Your health care team is there to help you, and a diabetes educator can help you find ways to manage your diabetes that really fit into your life. Also, look for support for positive diabetes self-management in your community. There are community-based Diabetes Empowerment Education Program (DEEP)TM classes and other support services that may be available to help you find ways to positively manage diabetes.