By Houghton Smith
This coming year, the Centers for Disease Control is raising awareness about Type 2 Diabetes in hopes of primary prevention of the disease in much the same way similar approaches have led to lower incidences of certain types of cancer, heart disease and other conditions.
About 26 million people in the United States have Type 2 Diabetes, and it is estimated that another 79 million people are at risk for becoming pre-diabetic. The disease was originally called Adult Onset Diabetes back when it was first recognized. Now the disease is called Type 2 because we can now diagnose it in childhood.
Type 2 Diabetes is associated with weight, diet choices, and activity level. Age, family history and ethnicity can also be a factor. Right now, all non-white cultural groups seem to be at greater risk for Type 2 Diabetes in America. Even though we see a culturally diverse patient population at BMH, the majority of the patients in the diabetes clinic are of European ancestry.
The good news is that when the disease is detected at the pre-diabetes stage it can actually be cured or the onset of Type 2 delayed. Once it becomes Type 2 diabetes, however, it is a lifelong condition that can lead to medical problems, including blindness, kidney failure, cardiovascular disease and circulation problems. Even though improved treatments have reduced the occurrence of these complications, there is concern that a spike in heart disease will take place 20 or 30 years from now as the younger, pre-diabetic population gets older. As such, the CDC is focusing on determining the pre-diabetic risk of people of all ages.
Detection of pre-diabetes begins with regular visits to a primary care provider. All providers have tools for measuring weight and body mass index (BMI), and they can collect information about your family history, your diet and exercise regimen. This data helps the provider to assess a person’s risk. In addition, basic lab work is done during a routine physical that checks a person’s glucose level. If something is abnormal the healthcare practitioner can order additional tests that will diagnose the condition.
Once pre-diabetes has been diagnosed, the treatment plan is well established. We meet with the patient to set up a diet and exercise plan and coach them through it. This same approach can result in remission of Type 2 Diabetes in patients whose conditions have advanced from the pre-diabetes stage. In those cases, however, we would continue to monitor that patient for recurrence of the disease throughout the rest of his or her life.
Vermont has set a goal of reducing prevalence of diabetes in its population to three percent. Currently, the statewide rate is six percent and here in Windham County it is five percent — one of the highest in Vermont. The state’s Blueprint for Health model is also a cause for optimism. Type 2 Diabetes has been identified as one of the health issues community health teams can have a positive impact on. People who are at risk are identified in the different service areas and are directed toward individual or group interventions with dietitians, diabetes educators and counselors who can guide them toward prevention of Type 2 Diabetes.
It all begins with you taking that small step of making sure you and your loved ones are getting regular checkups.
Houghton Smith, RN, CDE, is the coordinator of the Diabetes Education & Counseling program at Brattleboro Memorial Hospital. He can be reached at 802-251-8429.