Elizabeth S. Reames | 6/30/2005 9:23:00 PM
Two-thirds of Americans with type 2 diabetes are at high risk of diabetes complications because they don't have their blood sugar under control, according to LSU AgCenter nutritionist Dr. Beth Reames.
Compounding the problem, most are unaware they are not controlling their blood sugar effectively, reports the American Association of Clinical Endocrinologists (AACE). Tight control of blood sugar, either through diet and exercise alone or with a variety of medications, can prevent that damage.
Two major kinds of diabetes are called type 1 and type 2. Reames explains that type 2 diabetes is the most common and results from the body’s inability to make enough, or properly use insulin. Insulin is the hormone needed to convert blood sugar (glucose) into energy. If the body doesn’t have insulin or can’t use it properly, glucose can’t get into cells to be used for energy. High blood glucose levels damage blood vessels and nerves, eventually leading to blindness, kidney failure, amputations of feet and legs and heart disease. Diabetes is the nation's sixth-leading killer.
Type 2 accounts for 90 percent to 95 percent of diabetes cases. According to the American Diabetes Association, 18.2 million Americans have diabetes, and experts estimate a third of the people who have it don't know they have it. An additional 41 million have "pre-diabetes," an impaired sugar tolerance that can lead to type 2 diabetes.
Reames says people with type 2 diabetes often have no symptoms. In type 2 diabetes, blood sugar levels rise intermittently or so slowly that a person usually does not have symptoms and may have the disease for many years before diagnosis.
The best measure of diabetes control is the A1C test, which tracks average blood-sugar levels over two or three months. A normal A1C level is 5 percent. The AACE says A1C below 6.5 percent signals good control, but the American Diabetes Association recommends a reading below 7 percent.
The AACE analysis of 157,000 people in 39 states found that 67 percent of people with type 2 diabetes weren’t meeting the AACE goal of 6.5 percent. As many as one-fifth to one-third had A1C levels of 9 percent or higher.
An AACE-commissioned survey found that 84 percent of people with type 2 diabetes believed they were doing a good job controlling their blood sugar, even though 61 percent said they didn't know what the A1C test is.
AACE recently began a campaign for more aggressive diabetes treatment and made two recommendations. First, ask your doctor about your A1C level at every visit. If your scores show you're not making progress, ask what else you can do to lower A1C levels. Diet and physical activity are crucial to glucose control, but many patients also need combinations of medications.
Second, strive for good blood-sugar levels during daily at-home glucose monitoring: no more than 110 before meals and 140 two hours after eating.
A study conducted at 27 research centers in the United States found that by adopting a moderate, consistent diet and exercise program, many people with one or more of the risk factors for type 2 diabetes can stop the disease before it becomes irreversible.
The study found that not only did changes in diet and physical activity prevent or delay the development of diabetes, they actually restored normal glucose levels in many people who had impaired glucose tolerance.
These findings support the recommendations given through the LSU AgCenter’s Diabetes Education Awareness Recommendations (DEAR) Program. For information on related family and consumer topics, click on the Family and Home link on the LSU AgCenter homepage, at www.lsuagcenter.com. For local information and educational programs, contact an extension agent in your parish LSU AgCenter office. ###