10/27/2006 Diabetes: Practice Your "ABC's" - and Check Your Eyes

Contact: Dennis Tartaglia/Kelly Peterson

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Dr Terry Mahotière

516-326-7767

Diabetes: Practice Your "ABC's" - and Check Your Eyes

By Terry Mahotière, MD, MPH

Got "sugar?" You may call it "sugar" but there is nothing sweet about having diabetes. Diabetes is the sixth deadliest disease in America. If you are African American you are much more likely to get it, to suffer from its complications and to die from it.

But there are important tests to protect your health against the effects of this serious illness. This is American Diabetes Month and it's a good time to a) find out if you're at risk, and b) partner with your doctor to practice the ABC's and Eyes of good diabetes care.

African Americans at Risk

The statistics on diabetes' impact on the African-American community are startling. More than 3 million -- or 13% -- of all African Americans have diabetes, compared to 7% of all Americans. More than one in four African Americans aged 65 and over has the disease. The death rate from diabetes for African Americans is more than double the rate for whites.

Uncontrolled diabetes and cholesterol levels raise the risk of heart attack and stroke. African Americans with diabetes are more at risk for developing disabilities from diabetes-related complications, more likely to get lower limb amputations and far more likely to suffer from kidney and diabetic eye disease compared to whites with diabetes.

Why are African Americans at greater risk? Experts think three factors play a role: genetics, lifestyle and access to care. You may not be able to control your genes, but you stand a chance of doing something about lifestyle and access to diabetes care.

But first you must educate yourself about diabetes.

What is Diabetes?

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that converts sugars, starches, and other food groups into energy. Many people refer to diabetes as "having sugar."

There are three major types of diabetes:

Type 1 diabetes, which results from the body's failure to produce insulin. Some 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. This type used to be known as "juvenile diabetes."
Type 2 diabetes. The vast majority, 90-95% of Americans diagnosed with diabetes, have type 2. This type occurs when the body fails to properly use insulin, combined with relative insulin deficiency. Type 2 used to be known as "adult-onset diabetes."
Gestational diabetes, which affects about 4% of all pregnant women, about 135,000 women in the U.S. each year.

Heredity and lifestyle factors like obesity and lack of exercise appear to contribute to getting type 2 diabetes.

Know the Warning Signs

Diabetes often goes undiagnosed because many of its symptoms are considered harmless. Some symptoms include frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability and blurry vision.

Early detection of diabetes can decrease the chance of developing major health complications. Maintaining a healthy lifestyle can help a person keep diabetes in check, and reduce risk of major health problems by as much as half. Good nutrition, exercise, weight control and stress reduction go a long way toward protecting against the ravages of this disease.

Know Your Diabetes ABC's -- and Get Your Eyes Checked

If you have diabetes, you can reduce your risk of health complications by practicing the ABCs of good diabetes care. Talk with your doctor to make sure you get these tests.

A - for A1c: Get the A1c blood test at least twice a year, so you can control blood sugar (glucose) levels. For every 1% drop in A1c, the risk for developing complications in the small blood arteries decreases by about a third.

B - for blood pressure: Have your blood pressure checked at each doctor visit. Your blood pressure should be below 130/80. Blood pressure control can reduce heart disease and stroke by up to half. It can also reduce small blood artery disease by more than a third.

C - for cholesterol: Have your cholesterol checked at least every year. Improved control of cholesterol and other blood fats (lipids) can reduce heart complications by 20-50%. Ideally your Low Density Lipoprotein (LDL) should be below 100.

Eye exam: Make sure you go to an eye care professional to have your eyes examined at least once a year. An exam by an ophthalmologist or optometrist is necessary, even if you have no problems with your vision. Diabetes is a leading cause of blindness - but you can protect your vision if you have it checked every year.

Also, make sure you get a foot exam and flu shot every year. And don't smoke.

Now is the time to get checked for diabetes or keep your diabetes in check. Even minor steps can have a major impact on your health.

For more information on diabetes, contact the American Diabetes Association at 1-800-DIABETES (1-800-342-2383), or on the Web at www.diabetes.org.

Terry Mahotière, MD, MPH, is Medical Officer at IPRO, an independent health care quality improvement organization based in Lake Success, New York.