Are you at risk of diabetes?

THE US National Diabetes Fact Sheet released Jan. 26, 2011 showed that  25.8 million children and adults in the United States, or 8.3 percent of the population, have diabetes. There are 18.8 million who are diagnosed and about 7 million undiagnosed. Seventy- nine million are pre-diabetics. All these figures may even be conservative. In 2010 alone, 1.9 million new cases were diagnosed among children 20 years and older. About one in every 400 children and adolescents has diabetes.

In the Philippines, the incidence is rising. We have one of the highest, if not the top, in Asia, most blaming it on our culture of eating a lot of white rice and bread, carbohydrates in general, including soft drinks. In 2008, one out of every five (20 percent) Filipinos had diabetes. Ten years before this, it was only 3.9 percent, a jump of over five times. Extrapolated, the actual incidence today might be around 20 million, and diabetes is among the top causes of mortality, with more than 20,000 deaths annually.

Worldwide, the incidence in 30 years jumped from 30 million to the estimate of 366 million in 2011, and this is expected to catapult to 552 million in 2030, 17 years from now. Data from the International Diabetic Foundation: China, 90 million, Europe, 50 million, Japan, 11 million. It is indeed most concerning and frustrating, since diabetes is, to a great extent, preventable, as we pointed out and discussed in great details in the coffee-table book at www. Let’sStopKillingOurChildren.com (Central Books Store, National Book Stores, amazon.com, BN.com, with eBook versions)

Here are some questions emailed to me by our readers over the past years:

Am I at risk of diabetes?

The major risk factors for type 2 diabetes are: age (the older, the more prone to diabetes, but young children could have it too), family history of diabetes, excess weight or obesity, sedentary life-style, those who consume red meats and a lot of carbohydrates (rice, bread, sweets), those with hypertension, impaired glucose tolerance, insulin resistant cells, disease of the pancreas, infection or illness, polycystic ovary syndrome, history of gestational diabetes.

Should everyone get a blood glucose test?

Since diabetes could be a treacherous disease, causing complications that ravage the body when discovered late, it is a good idea to have a baseline blood glucose level tested, even without symptoms, after age 20, and earlier for those with a family history of diabetes. Detecting the disease early and treating it promptly will prevent complications and allow one to live practically normally.

Would simple urinalysis do the same job?

While urinalysis could detect glucose level, a blood test for sugar is the more sensitive and more accurate way to detect abnormal level, especially for a baseline level for future reference among those non-diabetics.

For diabetics, why is daily blood glucose level needed?

As prescribed by the attending physician, blood sugar level test (by home glucometer using a drop of blood from a finger stick) may be done once or twice or more times daily. The very tiny needle prick is so mild it is well-tolerated. The regular blood glucose test provides essential information for the diabetics as far as adjustments in food intake, activity and

medications are concerned. The information helps in

maximizing the effectiveness of the treatment and in preventing complication. Glucometers and test strips are available in most pharmacies.

How else could blood sugar level be monitored?

The use of the home glucometer as we alluded to is one way. The less convenient and more expensive way is to go to a clinic for actual blood test, especially for those who need daily glucose monitoring. All the information from this will help in the day to day decisions for care. The other way is to get a Hemoglobin A1C

level at least every six months, which data will reveal the average daily blood sugar the past two to three months, like a panoramic picture of the blood sugar level of the past 60 to 90 days. This will show how

effective the management is, or how brittle (uncontrolled) or severe the diabetes is, while being treated. This will enable the physician to modify his treatment plan. A1C level of 6 percent means the average blood sugar the past 2-3 months was about 126 mg/dl, 6.5 percent indicates an average of 140 mg/dl, etc.

What makes blood sugar level go up or down?

Our blood sugar level rises when we eat more than what we need, inactivity, insufficient medication, side effects of other drugs, hormonal changes (menstrual cycle), infection or illness, and stress. Glucose level falls when we miss a meal or eat less carbohydrates, drink alcoholic beverage, especially on an empty stomach, extra physical activity too much diabetic medications, side effects of other medications. Of course, make sure that the glucometer strips being used are not expired, the Code is correct, and test

solutions are showing accurate reading standard.

What are the target levels?

The targets recommended by the American

Diabetic Association are: 70 to 130 mg/dl, for test done immediately after waking up, before a meal. This is the Fasting Blood Glucose level. For the two-hour Post-prandial level, which is very accurate, the target level is 180 mg/dl or lower.

When is the best time to test?

Besides the Fasting and Post-prandial levels mentioned above, blood glucose could also be done when symptoms (weakness, dizziness, confusion, etc) occur, when ill and unable to eat, before, during or

after a physical activity, before driving a car or a

machine, before going to sleep, or when in  doubt. Your physician can customize the schedule for you.

How often should the test be done?

This depends on what your physician has

prescribed for you. If you are taking insulin and using the glucose level to decide on how much insulin

to take, then you should check it several times a day, according to your insulin shot schedule. If your level is on target and your level does not fluctuant too much, you could do the test less. If you are changing your diet, medication or are pregnant, you do the test more often. Confirm this with your attending physician.

Is type 2 diabetes preventable?

Yes, this type of diabetes and all the miseries it brings are preventable through early healthy lifestyle—abstinence from tobacco, disciplined use of alcohol, low-fat, low-cholesterol diet of fish, vegetables, nuts and grains and minimal red meat, daily physical exercise, relaxation and stress management. There are a significant number of diabetics who were able to stop taking their medications for diabetes by simply modifying their diet and doing daily exercises. And the same for people with high blood pressure, who were able to discard their pills and control their pressure by diet and exercise.

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