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Answers to common diabetes questions

Posted on Nov. 5, 2015 ( comments)
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The number of Americans diagnosed with diabetes continues to increase. In the United States, the disease is becoming more common. From 1980 through 2011, the number of Americans with diagnosed diabetes has more than tripled (from 5.6 million to 20.9 million), according to the U.S. Centers for Disease Control and Prevention (CDC).

Much of the tremendous growth can be attributed to poor diet and lack of exercise and subsequent obesity. About 35 percent of the U.S. adult population is obese and more than one-third of Americans are expected to develop diabetes over their lifetime, according to the American Diabetes Association.

Ronald Graf, MD, an endocrinologist with MultiCare Health System, works with diabetic patients daily. Here he answers some questions about the disease.

What are the different types of diabetes?

  • Type 1 diabetes occurs when the pancreas cannot make the hormone insulin. Insulin is necessary for the body’s cells to use glucose for energy. People with type 1 diabetes must take regular insulin injections to help get the sugar into the cells. This has historically been called juvenile diabetes.
  • Type 2 diabetes occurs when the pancreas does not make enough insulin, or the insulin does not work properly, or both. Being overweight greatly increases the risk of developing type 2 diabetes. It can happen in a person of any age and the occurrence in children is increasing dramatically.
  • Gestational diabetes is a form of glucose intolerance that is diagnosed during pregnancy. It requires treatment to bring maternal blood glucose to normal levels and avoid complications of pregnancy and in the infant.

Other types of diabetes result from specific genetic conditions, surgery, medications, infections, pancreatic disease and other illnesses.

Do you see a lot of patients coming to you for help with diabetes?

The vast majority of the patients we see in our practice have diabetes, both type 1 and type 2 diabetes.

Do you see more cases now than a decade ago?

Unfortunately, the incidence of diabetes is growing tremendously. There’s already an enormous number of patients with diabetes in the United States and that number is increasing every year.

How do you know if you have diabetes?

It is estimated that up to one-third of the people with diabetes are undiagnosed. When symptoms occur they include frequency of urination, excess thirst, weight loss, recurrent bladder or yeast infections and blurry vision. Often elevated blood sugar levels are found incidentally on routine blood tests.

What do you do if you think you might have diabetes?

See your doctor. In folks with type 1 diabetes, the condition tends to occur quite abruptly. In those cases it’s important to be seen by your health care provider as soon as possible. In those with type 2 diabetes, there may be no symptoms for many years — maybe 10 to 15 years before diagnosis. Your health care provider should be monitoring your blood sugar periodically, especially if you have risk factors such as obesity, a history of gestational diabetes, or a family history of diabetes.

Can we say definitively that diet plays a role in diabetes?

Your pancreas responds to your food intake. If you overtax it, especially if there’s a genetic predisposition for the pancreas to fail, then the result could be the development of diabetes. Type 2 especially has a strong family connection.

How do the two types of diabetes break down in terms of percentages?

About 80 percent of those with diabetes have type 2, and about 15–20 percent have type 1 diabetes.

How do you get more information about diabetes?

Patient should rely on their health care provider as their primary source of education. Those diagnosed with the condition also should get referral to a diabetes educator. Visit MultiCare's Center for Diabetes Education, which specializes in teaching people with diabetes how to effectively manage their disease.

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Dr. Ronald Graf
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