| Hope and Help for Controlling Costly, Deadly Diabetes Tri-City Voice,
April 1, 2009 "In 2002, the Centers
for Disease Control and Prevention (CDC)
estimated the direct and indirect costs
of diabetes in the United States at $132
billion," says Washington Hospital
endocrinologist Dr. Prasad Katta. "Just
five years later in 2007 (the latest
year for which data are available), that
figure had risen to $174 billion,
surpassing the CDC's prediction of costs
for 2010. Direct costs of treatment
account for the lion's share of those
costs at $116 billion, yet the indirect
costs associated with premature death,
disability, missed work days and lower
productivity are substantial, too."
But the real cost of diabetes cannot be
tallied in dollars and cents. Diabetes
was the seventh leading cause of death
listed on U.S. death certificates in
2006. The CDC indicates, however, that
diabetes is likely to be underreported
as a contributing cause of death.
Studies have found that only about 35 to
40 percent of people with diabetes had
it listed anywhere on their death
certificates. Overall, the risk for
death among people with diabetes is
about twice that of people without
diabetes of similar age. Despite those
grim statistics, Katta notes, there is
hope - and help - for people with
diabetes. "Diabetes is actually not a
difficult disease to treat," he says.
"The key is to catch it early - even in
the pre-diabetes stage - and then
educate patients to really think about
how they manage the disease. They need
to think about monitoring their blood
sugars. They need to think about the
foods they eat. They need to think about
getting plenty of exercise. And they
need to think about taking their
medications at the proper time and in
the right dosage."
To help people learn more about diabetes
and the latest options for prevention
and treatment, Katta and Vida Reed,
R.N., CDE, Washington Hospital's
Diabetes Education Coordinator, will
conduct a health and wellness seminar on
Tuesday, April 14, from 1 to 3 p.m. The
seminar will be held in the Conrad E.
Anderson, M.D. Auditorium, Rooms A & B,
in the Washington West Building located
at 2500 Mowry Avenue in Fremont. Call
(800) 963-7070 to register. Dr. Katta
explains that there are two main types
of diabetes:
- Type 1 diabetes most often
appears in children or young adults.
In this type, which accounts for
only 5 to 10 percent of all cases of
diabetes, the pancreas stops making
insulin or makes only a tiny amount,
so patients must inject insulin
every day. Risk factors for Type 1
diabetes can include genetic and
autoimmune disorders, as well as
environmental causes.
- Type 2 diabetes, which is far
more common, usually begins as
insulin resistance, with the body's
cells failing to use insulin
effectively. As the need for insulin
rises, the pancreas gradually loses
its ability to produce insulin. In
addition to a family history of
diabetes, other risk factors for
Type 2 include obesity and a
sedentary lifestyle.
"Diabetes is usually diagnosed
when the person's blood glucose
level after fasting is over 126 mg/dL
on at least two different
occasions," Katta says.
"Pre-diabetes, which is also called
'impaired fasting glucose,' is when
the blood sugar level falls between
normal and diabetic levels - 100 to
125 mg/dL. People with impaired
fasting glucose are at an increased
risk of developing diabetes and
heart disease. Women with
'gestational' diabetes that first
occurs during pregnancy and may
disappear after the baby's birth
have a higher lifetime risk of
developing Type 2 diabetes, and
their five-year risk is almost 50
percent."
In the past, the first line of
treatment for diabetes was to
improve the patient's diet and level
of exercise and then re-evaluate the
patient after three months. New
guidelines now recommend adding
medications right away to treat the
condition more aggressively, but
"self-care" measures still play a
vital role.
Diabetes Management
"Washington Hospital's Diabetes
Education Program works with
patients to help them set and
achieve their goals for diabetes
management using the 'AADE7
Self-Care Behaviors' guidelines
developed by the American
Association of Diabetes Educators,"
Reed says. "We provide them with a
'diabetes care schedule' that
outlines how frequently they should
schedule screenings for their blood
pressure, cholesterol levels and
triglycerides, as well as dental,
vision and foot exams. In addition,
we offer a medical nutrition therapy
program for patients with diabetes
and other related health problems
such as high cholesterol, high blood
pressure and difficulty with weight
management."
The AADE7 Self-Care Behaviors
guidelines include:
- Healthy Eating - to control
portion sizes and food choices.
- Being Active - to establish
healthy, consistent exercise
patterns.
- Monitoring - to keep track
of your blood glucose level,
blood pressure, cholesterol and
other factors.
- Healthy Coping - to reduce
stress factors that actually can
raise blood sugar levels.
- Taking Medication - to
ensure you take the proper
dosages at the right time and
discuss any concerns you have
about side effects with your
doctor before stopping
medications.
- Problem Solving - to help
you avoid problem situations
that might arise when you attend
a party, go out to dinner or
face other self-care obstacles.
- Reducing Risks - to create a
schedule of visits to your eye
doctor, podiatrist, dentist and
other health care professionals
who can help you manage your
risks for diabetes
complications.
In addition to these
self-care measures, there are
several classes of medications
available to treat diabetes.
"Type 1 diabetes is caused by
lack of insulin production, so
people with Type 1 diabetes must
take insulin injections every
day," says Katta. "Insulin
injections also can be used for
people with Type 2 diabetes when
they don't respond well to other
medications."
At the upcoming seminar, Dr.
Katta will discuss diabetes
medications and how they can
help manage the condition.
"In many cases, the patient's
physician may prescribe more
than one medication," Katta
says. "I generally try to treat
the problem aggressively using a
combination of medicines. Within
four to six weeks of beginning
treatment, many of my patients
are able to stop taking one or
more of their medications.
Again, the key is to start
treatment early to help avoid
serious complications later on."
Learn More About Diabetes
For information and referral
assistance for the Washington
Hospital Diabetes Education
Program, call (510) 745-6556 or
visit www.whhs.com/services/diabetes.
To register for the Diabetes 1 &
2 seminar on Tuesday, April 14,
please call (800) 963-7070.
For more information about
the 7 Self-Care Behaviors, visit
www.diabeteseduator.org and
click on "Patient Resources"
listed under "About Diabetes
Education." |
