November is American Diabetes Month, so let’s discuss this chronic metabolic disease that affects 37.3 million adults in the United States. The Centers for Disease Control and Prevention report that one of five aren’t even aware they have the disease. Yet, it’s the seventh leading cause of death in the country.

When you eat food — particularly carbohydrates such as bread, rice and pasta — your body breaks it down into a simple sugar called glucose, which enters your cells to be used as fuel. But glucose cannot enter your cells without help, which comes from a hormone made by your pancreas called insulin. Insulin serves as the “key” to help glucose get inside your cells.

With diabetes, your body doesn’t make enough or any insulin, or cannot use the insulin it makes efficiently, which is called insulin resistance. As a result, the level of glucose in your bloodstream increases. High blood glucose levels over time can lead to serious health complications, such as cardiovascular disease, nerve damage (neuropathy), kidney damage, eye damage (retinopathy) and even death.

There are three main types of diabetes: Type 1, Type 2 and gestational.

Type 1 diabetes, which accounts for approximately 5 percent of cases, is an autoimmune disorder. With this type, your body’s infection-fighting immune system mistakenly attacks the insulin-producing beta cells in your pancreas. Type 1 can occur at any time but is most often diagnosed in young children, teens and young adults.

Type 2 diabetes is the most common, affecting up to 95 percent of cases. With Type 2, your body becomes resistant to the effects of insulin and glucose builds up in the bloodstream. It typically develops over many years and is most often diagnosed in adults older than 35, although it’s being seen with greater frequency in young children, teens and younger adults.

Gestational diabetes develops in some pregnant women It typically goes away after the pregnancy, but patients are at a higher risk for developing Type 2 diabetes when they are older.

There also is is a condition called prediabetes if blood glucose levels are higher than normal but not enough to be formally diagnosed with Type 2 diabetes.

Symptoms of Type 1 and Type 2 diabetes are similar, but their onset is more rapid with Type 1. Symptoms appear slowly, over time, with Type 2. General symptoms include increased hunger, increased thirst, weight loss, frequent urination, blurry vision, fatigue and sores that are slow to heal.

Most women with gestational diabetes experience no symptoms. Pregnant women are routinely tested for diabetes between the 24th and 28th weeks of pregnancy, so getting regular prenatal care is important to detect and treat this condition before it causes damage to the mother and baby.

There are different causes for each type. Researchers don’t know what causes the immune system to attack beta cells in the pancreas that result in Type 1 diabetes but suspect that genetics plays a role. They also surmise a virus may activate the immune system to attack beta cells.

Type 2 is associated with a combination of genetics and lifestyle factors. The condition runs in families. It is more common in people who are overweight, eat an unhealthy diet and have a sedentary lifestyle. Having high blood pressure, high cholesterol, high triglycerides or prediabetes also puts someone at a higher risk for developing Type 2 diabetes.

Gestational diabetes is caused by hormonal changes during pregnancy. The placenta produces hormones that make cells less sensitive to the effects of insulin, causing high levels of blood glucose in the bloodstream. If a woman is overweight while pregnant or has a family history of Type 2 diabetes, she is at a greater risk for developing gestational diabetes.

Those with Type 1 diabetes must take insulin every day to survive. In many cases, Type 2 diabetes can be managed with a healthy lifestyle, which includes eating a healthy diet, getting regular physical activity, not smoking and maintaining a healthy weight. If that’s not enough, patients must to take oral medication and/or receive insulin injections.

Treatment for gestational diabetes includes special meal plans and scheduled physical activity. In some cases, medication or insulin injections may become necessary to keep blood glucose levels at a healthy level.

Type 1 diabetes cannot be prevented. However, there are some things that can reduce the risk for developing Type 2 and gestational diabetes, including:

• Eat a healthy diet high in fiber and non-starchy vegetables.
• Be physically active. Aim for 30 minutes most days of the week.
• Maintain a healthy weight.
• Quit smoking.
• Get seven to nine hours of sleep per day.
• Lower stress. Try deep breathing, meditation, yoga, tai chi or another relaxation technique.

Patti DiPanfilo

November is American Diabetes Month. Let’s get up to speed on this common disorder.

Diabetes is a chronic metabolic condition that affects how your body uses food for energy. When you eat, your body breaks down the food into a simple sugar called glucose, which enters your body’s cells with the help of insulin, a hormone produced by special beta cells in your pancreas. When the amount of glucose in your blood increases, it signals the pancreas to release insulin.

With diabetes, either your pancreas doesn’t make enough insulin or your body stops responding to the insulin made, a condition called insulin resistance. When this occurs, too much glucose accumulates in your blood, called hyperglycemia. Untreated hyperglycemia can lead to serious health problems, such as heart disease, kidney disease, nerve damage and vision loss.

According to the Centers for Disease Control and Prevention, 34.2 million US adults have diabetes, and one in five don’t know they have it. Diabetes is the seventh leading cause of death in the US and the number one cause of kidney failure, lower limb amputations and adult blindness. The number of adults diagnosed with diabetes has more than doubled in the last 20 years.

There are three main types of diabetes: Type 1, Type 2 and gestational. Type 1 diabetes is an autoimmune disease. It occurs when your immune system mistakenly attacks and destroys the beta cells in your pancreas, so no insulin gets produced. The reason for the attack is not known, but genetics may play a role. It’s also possible that a virus sets off the immune system’s attack.

Type 1 diabetes is most often diagnosed in children and teens but can occur at any age. People with this type of diabetes must take insulin every day to stay alive.

Type 2 diabetes occurs when your body develops insulin resistance and glucose builds up in your blood. It’s the most common type of diabetes, accounting for 90 to 95 percent of diabetes cases. You can develop Type 2 diabetes at any age but it’s most often diagnosed in people ages 45 and older. A combination of genetics and lifestyle factors are believed to cause this type of diabetes.

You are at a greater risk for developing Type 2 diabetes if you are overweight; have a family history of diabetes; have a family history of high blood pressure; have had gestational diabetes or gave birth to a baby weighing more than 9 pounds; are African-American, Native-American, Latin-American or Asian-Pacific Islander or live a sedentary lifestyle.

In many cases, Type 2 diabetes can be managed by controlling your weight, exercising regularly and eating a healthy diet high in whole grains, fruits, vegetables and lean proteins. Sometimes, people with Type 2 diabetes must take medication or inject insulin to control their blood glucose levels.

Gestational diabetes occurs in women who are pregnant and usually resolves after they give birth. It develops when the placenta produces hormones that make your cells less sensitive to the effects of insulin. If you have gestational diabetes, your baby is at a higher risk for health problems, such as excessive birth weight, early (preterm) birth, breathing problems, low blood glucose (hypoglycemia) and even stillbirth.

Further, you and your baby are at a greater risk for developing Type 2 diabetes later in life.

Treatment for gestational diabetes typically includes special meal plans and scheduled physical activity. You may have to inject insulin if you cannot manage your glucose level with diet and exercise alone.

If you have any type of diabetes, it’s important that you check your blood glucose level frequently throughout the day.

Prediabetes is a condition in which your blood glucose level is elevated but not high enough to warrant a diagnosis of Type 2 diabetes. In the US, 88 million adults, more than one in three, have prediabetes, and 84 percent of them don’t know they have it. Having prediabetes raises your risk for developing Type 2 diabetes, heart disease and stroke.

Each type of diabetes has its own symptoms, but there are some general symptoms. These include increased hunger, increased thirst, weight loss, frequent urination, blurry vision, extreme fatigue and sores that don’t heal.

There are certain blood tests your doctor will use to make a diagnosis of prediabetes and diabetes. The fasting plasma glucose test measures your blood glucose after you’ve not eaten anything for eight hours. The A1c test provides a view of your blood glucose levels over the previous three months.

The glucose challenge test checks your blood glucose level an hour after you drink a sugary liquid, and the glucose tolerance test checks your glucose level after you fast overnight and then drink a sugary liquid.

Women who are pregnant are typically tested for gestational diabetes between the 24th and 28th weeks of their pregnancy.

If you eat a healthy diet, control your weight, exercise regularly and follow your doctor’s instructions for taking any medications, if required, you can successfully manage your diabetes and live a full and active life.

The cells in your body need a steady source of energy to function. They get it from a simple sugar called glucose that is released when the food you eat is broken down. But glucose can’t get into your cells on its own. It needs the help of insulin, a hormone produced by the beta cells of your pancreas.

Diabetes is a chronic metabolic disease that develops when your pancreas doesn’t produce insulin or your body can’t use insulin efficiently, a condition called insulin resistance. Without insulin, glucose builds up in your bloodstream and your cells are starved of the energy they need to survive. This can lead to complications with your eyes, heart, kidneys and nerves. In severe cases, it can lead to coma and death.

The National Diabetes Statistics Report 2020, released by the CDC’s Division of Diabetes Translation, revealed that 34.2 million Americans – just over 1 in 10 – have diabetes. Another 88 million – approximately 1 in 3 American adults – have prediabetes, a condition in which your blood glucose level is high but not high enough for a diagnosis of diabetes. More than 84 percent of people with prediabetes don’t know they have it.

There are three main types of diabetes: type 1, type 2 and gestational.

With type 1 diabetes, your pancreas doesn’t produce insulin because your immune system mistakenly attacks and destroys its beta cells. People with this type must take supplemental insulin every day. Type 1 is typically diagnosed in children, adolescents and young adults, but can occur at any age. About 5 to 10 percent of people with diabetes have type 1.

Gestational diabetes develops during pregnancy. It affects up to 10 percent of pregnant women in the US each year. With gestational diabetes, the placenta — which provides oxygen and nutrients for the growing baby – produces hormones that block the action of the mother’s insulin. It can lead to complications for the mother and baby.

In many cases, gestational diabetes can be treated effectively with diet and exercise alone. But in other cases, the mother must take oral diabetes medications or insulin injections to stabilize her blood glucose levels. Gestational diabetes typically resolves after the mother gives birth, but she is at a higher risk for developing type 2 diabetes later in life.

Type 2 diabetes is the most common type, affecting 90 to 95 percent of people with diabetes. It is typically diagnosed in people 45 years old and older and is characterized by insulin resistance. This type is caused by a combination of genetic and environmental factors. You are at a higher risk for type 2 diabetes if you have a family history of diabetes, are overweight or obese, are physically inactive or have prediabetes.

Symptoms of type 2 diabetes include: increased hunger or thirst, frequent urination, weight loss, blurry vision, extreme fatigue and sores that are slow to heal. The diagnosis is generally made using a fasting plasma glucose (FPG) test, A1C test or random plasma glucose (RPG) test. These tests measure the level of glucose in your blood. A consistently high level indicates diabetes.

Treatment for type 2 diabetes begins with lifestyle changes. These include eating a healthy diet full of fruits and vegetables, whole grains and lean protein such as poultry and fish. You should also avoid saturated and trans fats, exercise regularly, maintain a healthy weight and stop smoking. If lifestyle changes aren’t enough to lower your glucose level, you may need to take medication or insulin.

By living a healthy lifestyle – eating properly, exercising regularly, not smoking and taking your medication as needed – you can manage your blood glucose and defeat diabetes!

Diabetes increases the risk for multiple health problems, from cardiovascular disease to kidney damage to skin conditions. Another common – and often preventable – problem linked to diabetes is vision loss. November is Diabetes Eye Disease Month, a time to spotlight the most common eye disorders associated with diabetes and focus on ways to decrease your risk.

According to the Centers for Disease Control and Prevention’s “National Diabetes Statistics Report 2020,” which analyzed health data through 2018, 34.2 million Americans – just over 1 in 10 – have diabetes. In addition, 88 million American adults – approximately 1 in 3 – have prediabetes. Further, 7.3 million adults over 18 were unaware or did not report having diabetes.

Over time, diabetes can damage your eyes and cause poor vision, even blindness. It can lead to
diabetic eye disease, a group of eye problems that includes diabetic retinopathy, diabetic macular edema, cataracts and glaucoma.

The retina is the inner lining of the back of the eye. It senses light entering the eye and turns it into signals that your brain translates into images. Consistently high blood glucose levels associated with diabetes damages the small blood vessels in the eye, which can harm the retina and cause a disease called diabetic retinopathy.

In the early stage of diabetic retinopathy, called nonproliferative diabetic retinopathy, damaged blood vessels can weaken, swell, or leak into the retina. In the more serious stage, called proliferative diabetic retinopathy, some blood vessels close off and new blood vessels grow on the surface of the retina. These blood vessels are abnormal and can cause serious vision problems.

Diabetic macular edema involves fluid build-up on the center part of the retina, called the macula, which is responsible for the detailed, straight-ahead vision necessary for reading, driving and seeing faces. The built-up fluid makes the macula swell, blurring vision and destroying this sharp vision. Diabetic macular edema, which can cause permanent vision loss, typically develops in people who already have other signs of diabetic retinopathy.

The eye’s lens is a clear structure that sits behind the iris (the colored part of the eye) and helps focus light onto the retina. Natural lenses tend to become cloudy from protein deposits as people age. Cloudy lenses are called cataracts. People with diabetes are twice as likely to develop cataracts at a younger age than people without diabetes. That’s because, it is believed, high glucose levels cause protein deposits to build up on the lens.

Glaucoma is a group of diseases that cause damage to your eye’s optic nerve, which can lead to permanent vision loss. Glaucoma occurs when pressure builds up in your eyes. This pressure pinches the blood vessels that carry blood to the retina and optic nerve, causing gradual vision loss. Having diabetes doubles your chances of getting glaucoma.

With open-angle glaucoma, the most common type, pressure builds up inside your eye when fluid can’t drain effectively through the normal drainage channel, called the trabecular meshwork. This type of glaucoma can be treated with medication and eye drops that lower eye pressure, speed up drainage, and reduce the amount of fluid your eyes make

People with diabetes are at risk for a condition called neovascular glaucoma, in which new blood vessels form on the eye’s iris. These blood vessels block the normal flow of fluid and raise eye pressure. Treatment for neovascular glaucoma may include use of a laser to reduce the number of blood vessels or anti-neovascular endothelial growth factor (anti-VEGF) injections to halt the growth of new blood vessels.

There are other eye conditions associated with diabetes including branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). Arteries and veins are blood vessels that carry blood throughout the body. There is one main artery and one main vein supplying the retina.

When this vein becomes blocked, blood and fluid spills out into the retina and the macula can swell, which affects your sharp central vision. Over time, if blood circulation remains cut off, nerve cells in your eye can die and more vision can be lost.

When branches of the retinal vein become blocked, the resulting condition is called branch retinal vein occlusion (BRVO). When the main retinal vein becomes blocked, it is called a central retinal vein occlusion (CRVO).

Here’s the good news: You can help prevent all of these diabetes-related eye disorders by taking steps to manage your diabetes. To do that, you must control your blood glucose, blood pressure and cholesterol levels. Take good care of yourself through healthy eating, exercising regularly and taking medications as prescribed.

In addition, if you smoke, quit. There are many resources online and in the community to help you quit smoking. And don’t forget to get a complete, dilated eye exam once a year, so your eye care professional can detect early signs of diabetic eye disease. Be eye smart: Take steps to protect your vision.

In its “National Diabetes Statistics Report 2020,” the US Centers for Disease Control and Prevention’s Division of Diabetes Translation details the most updated “state of the disease” in America. The CDC aims to use the report’s information to improve diabetes prevention and management strategies available in this country.

According to the report, which analyzed health data through 2018, 34.2 million Americans, or just over one in 10 individuals, have diabetes. Further, 88 million American adults, approximately one in three, have prediabetes. Unfortunately, most people with prediabetes are unaware they have it.

Diabetes is a chronic, or long-lasting, disease that affects how your body turns the food you eat into fuel your body can use for energy. When you eat food, most of it is broken down into a sugar called glucose that is then released into your bloodstream.

When you eat, your glucose level increases, and that signals your pancreas to release a hormone called insulin. Insulin serves as the “key” to unlock your body’s cells and allow glucose to enter. The cells can then use the sugar for energy. Diabetes occurs when there isn’t enough insulin or your body doesn’t use it efficiently, and the glucose in your blood becomes too high.

There are two main types of diabetes: type 1 and type 2.

Approximately 5 to 10 percent of people with diabetes have type 1 diabetes, which is typically diagnosed in children and teens. With type 1 diabetes, your own immune system attacks the specialized insulin-creating cells in the pancreas called islet cells. Normally, islet cells produce the exact amount of insulin necessary to normalize the glucose level in your blood.

With type 2 diabetes, the more common type, you still produce insulin but it’s inadequate for your body’s needs. Generally, the release of insulin from your pancreas is defective and, as a result, the amount is insufficient. Type 2 diabetes occurs most often in people over 30 years old, and its incidence increases with age. It is sometimes referred to as adult-onset diabetes.

Prediabetes is when your blood sugar is higher than it should be but not high enough for your doctor to diagnose diabetes. Almost all people with type 2 diabetes had prediabetes first.

Symptoms of diabetes include: increased thirst, frequent urination, extreme hunger, unexplained weight loss, fatigue, irritability, blurred vision, slow-healing sores and frequent infections,. Abdominal pain, itchy skin and tingling or numbness in the feet or toes may also occur. Symptoms vary depending on the level of glucose in your blood.

The onset of type 2 diabetes is typically slower than that of type 1 diabetes, and the symptoms may be less noticeable. Or you may overlook the symptoms or attribute them to another condition or to simply getting older. But if you notice symptoms, see your health care provider to be tested for prediabetes or diabetes.

Type 1 diabetes is treated using injections of insulin or wearing an insulin pump. The injected insulin performs the same function as the insulin normally made by the islet cells of your pancreas. It serves as the key to allow glucose to enter your cells for use as energy.

Treatment for type 2 diabetes generally begins with lifestyle modification, such as altering your diet, increasing your exercise and losing weight. If your glucose level remains high, you may be instructed to use medications that help your body use insulin more efficiently. It may be necessary to use insulin injections to manage your blood glucose.

If you cannot adequately control the glucose level in your blood, you may develop chronic complications of diabetes. These arise due to blood vessel damage caused by consistently high blood glucose and can affect your eyes, kidneys, nerves and heart. These complications include diabetic retinopathy, diabetic neuropathy, erectile dysfunction and coronary artery disease.

Currently, there is no cure for diabetes, so the aim of treatment is to manage the disease and prevent complications. Management involves controlling your blood glucose, and that requires consistent monitoring. You must test your blood glucose level throughout the day to be sure it is not too high or too low. Both extremes can have serious consequences.

One way to test your glucose level at home is to use a fingerstick to obtain a drop of blood that you place on a meter that calculates your glucose level. There are also monitors that you wear on your body, called continuous glucose monitors (CGMs). CGMs use sensors to measure your glucose level. They provide continuous, dynamic glucose information every five minutes.

If you notice symptoms of diabetes, visit your doctor for testing. If you test positive for diabetes or if you’ve had diabetes for a while, follow your doctor’s recommendations for controlling your blood glucose and managing your condition. And most of all, monitor, monitor, monitor.

America’s Obesity Crisis Intensifies.

The number of people in the United States who are overweight or obese has been climbing for years, and that excess weight has serious and costly health consequences. So, the projections from a highly respected team of scientists about obesity in America’s future are disconcerting at best.

After conducting national surveys and correcting for our tendency to underestimate our weight in surveys, the scientists discovered that in as many as 29 states, the prevalence of obesity will exceed 50 percent by 2030. In addition, they project that no state will have less than 35 percent of its residents who are obese.

The bottom line is that within the next ten years nearly one in two adults in the US will be obese. Further, the team projects that nearly one in four Americans will be severely obese by 2030.

The team’s report, Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity, was published in The New England Journal of Medicine in December and suggests that the prevalence of severe obesity is expected to be higher than one in four in 25 states. Further, severe obesity is projected to be the most common weight category among the nation’s women, non-Hispanic, black and low-income adults.

Obesity will exceed 50 percent by 2030. – The New York Times

This study’s results mirror those of a study presented in the September 2012 “F as in Fat” report. That report, released by the Trust for America’s Health and the Robert Wood Johnson Foundation, also predicted that half of US adults will be obese by 2030.

Obesity is dangerous. It is linked to a substantial number of negative health effects, including high blood pressure, type 2 diabetes, heart disease and stroke, sleep apnea and breathing problems, osteoarthritis, gallbladder disease, mental illnesses such as depression and anxiety and certain cancers, including endometrial, breast, colon, kidney, gallbladder and liver cancer.

The “F as in Fat” report projected that there will be as many as 7.9 million new cases of diabetes a year by 2030, compared with 1.9 million new cases a year in 2012. They suggest there could also be 6.8 million new cases of chronic heart disease and stroke each year, compared with 1.3 million cases in 2012.

Obesity is also expensive. A study conducted in 2013 estimated that the medical cost of obesity totaled $342.2 billion per year. The study also determined that the indirect cost of obesity due to lost productivity came to another $8.65 billion per year. And that was in 2013. Those amounts are likely much higher in 2020.

Obesity is a leading cause of preventable illness, disability and life-years lost in the United States. It is responsible for about one in five deaths, nearly as many as smoking. That makes it an official public health crisis in this country. But what makes us obese?

In general, we’re considered overweight or obese when our weight is higher than a normal weight adjusted for height. Body Mass Index, or BMI, is the tool used for measuring this. BMI, which is related to the amount of fat in our bodies, is defined as weight in kilograms divided by height in meters squared. A BMI of 30 to 39 is considered obese. A BMI of 40 or higher is extremely obese. The higher our BMI, the greater our risk for developing the health problems associated with obesity.

There are several factors that contribute to obesity, but the bottom line is that we become obese when we consistently consume more calories than we burn through normal daily activity. What we eat also plays a role. Foods that are high in fat, sugar and salt cause weight gain. And most of us eat portions that are larger than necessary to satisfy our hunger.

Our genes also play a role. Genetics is a factor in how much body fat we store, where it’s distributed and how efficiently our bodies metabolize the food we eat into energy.

Medical disorders such as Prader-Willi syndrome, a genetic condition, Cushing’s syndrome, a hormone disorder, and arthritis can lead to decreased activity and weight gain. In addition, certain medications including some antidepressants, anti-seizure drugs, steroids and beta-blockers can cause an increase in weight.

Lifestyle and behavioral factors such as a lack of physical activity, smoking, lack of sleep and an unhealthy diet also contribute to the development of obesity. Social and economic factors include not having enough money to buy healthy foods or access to stores that sell healthier food options. Another socioeconomic factor is not having access to a safe place to exercise.

Obesity is a major public health crisis in America that impacts more than 100 million adults and children and is projected to increase dramatically by 2030. Fortunately, obesity and the health and financial consequences associated with it are largely preventable, and that should be our goal.

Steps we can take to help prevent obesity include limiting calorie intake from total fats, shifting away from saturated fats to unsaturated fats. In addition, we can increase our intake of fruits and vegetables, legumes, whole grains and nuts and limit our intake of sugar. We also have to boost the number of calories we burn each day by increasing our physical activity. Health officials recommend at least 30 minutes of regular, moderate-intensity activity on most days.

But it will take more than willpower to change the future. There are already federal and state programs in place to educate about making healthy food and exercise choices and to counter fast food and soda marketing. Additional education and more firepower against the big-money fast-food conglomerates is still needed. Our country’s health, now and in the future, depends on it!

The US Centers for Disease Control and Prevention (CDC) reports that more than 100 million adults in this country are living with diabetes or prediabetes. Of those, 30.3 million – that’s 9.4 percent of the US population – have full-blown diabetes.

Another 84.1 million US adults have prediabetes. That’s a condition that, if left untreated, can lead to type 2 diabetes within five years. More than a third of adult Americans has prediabetes, and most of them don’t know they have it.

Why should we take note of these figures? Because consistently high blood glucose (sugar) levels, the hallmark of uncontrolled diabetes, can cause serious injury to your body’s nerves and blood vessels, impairing circulation and damaging your heart, liver, brain cells and eyes.

Most serious eye diseases related to diabetes begin when high blood glucose damages the eye’s tiny blood vessels. The four main eye diseases that can threaten the vision of a person with diabetes are diabetic retinopathy, diabetic macular edema, glaucoma and cataracts.

Diabetic retinopathy is the most common cause of vision loss for people with diabetes and the leading cause of blindness for all adults in the US. It occurs when high glucose blocks the tiny blood vessels that nourish the retina, the part of your eye that detects light and sends signals to your brain. These damaged blood vessels can begin to swell and leak fluid. This stage is called non-proliferative diabetic retinopathy.

In some cases, non-proliferative diabetic retinopathy progresses into the proliferative stage. That’s when the eye grows new blood vessels to make up for the blocked vessels in a process called neovascularization. But the newly formed blood vessels are highly unstable and leak and bleed easily.

These leaking blood vessels may even hemorrhage into the jelly-like material that fills the center of your eyes, called the vitreous. Blood in the vitreous results in dark spots that can block vision.

Diabetic retinopathy can also cause scar tissue to form in the back of your eye, which may pull the retina away from the back of the eye. This is called a retinal detachment, and it’s a serious complication that can cause loss of vision if not repaired quickly.

As the unstable blood vessels in your retina continue to bleed, they eventually cause the macula, the area of the retina that enables you to read, drive and see faces, to swell. This condition is called diabetic macular edema. Over time, this condition can destroy your sharp vision and lead to partial vision loss and eventually blindness.

The natural lenses of your eyes are clear structures that provide sharp vision. But over time, they can become cloudy, a condition called cataracts. People who have diabetes can develop cataracts at an earlier age than people without the disease, and people with diabetes are two to five times more likely to develop cataracts. It’s believed that high glucose levels cause protein deposits to build up on the lenses, leading to the cataracts.

Sometimes, blood from the leaking vessels blocks the normal drainage channels for fluid in the eyes. As a result, fluid builds up and pressure in the eye increases, which can damage the optic nerve and affect vision. Glaucoma is a group of eye diseases related to increased eye pressure. Having diabetes nearly doubles your risk of developing a type of glaucoma called open-angle glaucoma.

The best way to prevent vision loss from these eye diseases is to control your blood glucose levels and get regular exams by your eye doctor to look for swelling and changes in the blood vessels in your eyes.

To help control your diabetes, eat a healthy and balanced diet, exercise regularly and maintain a healthy body weight. High blood pressure and high cholesterol can affect your blood glucose level, so take all medications your doctor prescribes for these conditions and get them checked regularly. Don’t smoke and drink alcohol in moderation.

Regular eye exams can help find problems early, when they’re easier to treat. Early detection can save your vision. See you eye doctor yearly or as often as your doctor recommends. Call your eye doctor right away if you experience any of the following symptoms:

• Black spots in your vision
• Flashes of light
• “Holes” in your vision
• Blurred vision

 

Time to turn sugar highs into sugar lows.

It’s fitting that the day after the sugar high of Halloween marks the start of National Diabetes Month.

No doubt the folks who came up with the idea for a low-sugar awareness month figured this to be a good time to start keeping it real before the pumpkin pie, chocolate peppermint brownies and sugar cookies start to derail our diets. And well they should.

According to the U.S. Department of Health and Human Services, diabetes is one of the leading causes of disability and death in the United States. One in 10 Americans have diabetes — that’s more than 30 million people. And another 84 million adults in the United States are at high risk of developing type 2 diabetes.

In Florida, it is estimated that more than 2.4 million people have diabetes and more than 5.8 million have prediabetes. Diabetes is the seventh leading cause of death in Florida, according to the Florida Department of Health.

The numbers are expected to get worse as the population continues to age, with 54.9 million Americans diagnosed in 2030, according to a study by the Institute for Alternative Futures, analyzed by PsyD  Programs. That’s an increase of 38 percent from current rates.

The study estimates that 5,393,800 Floridians will have diabetes in 11 years. That’s 19.8 percent of the state’s population and puts Florida as the second-highest state in the nation for diabetes cases. The top state is expected to be West Virginia, with 20.5 percent. The three states with the lowest percentages are Utah, Alaska and Colorado, each with slightly more than 10 percent.

When broken down by metro area, Miami leads the nation with 18.8 percent of the population projected to be diabetic in 2030. The lowest metro is Minneapolis, with 11.7 percent.

“Diabetes is a very serious disease affecting millions of Americans, but it can be managed with a healthy lifestyle,” says Florida Surgeon General and Secretary Dr. Celeste Philip. “This year, I encourage you to know your risk factors for diabetes and act as a support system for those in your life who may be affected by the disease.”

There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). Women with diabetes have more difficulty conceiving and may have poor pregnancy outcomes, so it is especially important for women to be aware of their risk factors for developing diabetes, including having a family history of diabetes as well as age, weight, and physical activity level.

The good news, especially for those with prediabetes, is that it can be prevented. A healthy diet, regular exercise and medical monitoring can go a long way toward ensuring that diabetes never gains a foothold.

That’s important because adults with diabetes are nearly twice as likely to die from heart disease or stroke as people without diabetes. Over time, high blood sugar from diabetes can damage blood vessels and the nerves that control your heart.

This year, the National Institute of Diabetes and Digestive and Kidney Diseases is emphasizing that tie-in to cardiovascular health.  Here are their tips to take control of your health:

• Stop smoking or using other tobacco products.
• Manage your A1C, blood pressure, and cholesterol levels.
• Develop or maintain healthy lifestyle habits – be more physically active and learn ways to manage stress.
• Take medicines as prescribed by your doctor.

Yes, that also includes throwing out that bag of candy corn you bought on clearance.  For more information about diabetes and what you can do to prevent, control it or support a loved one, click here.

 

The image many people form when thinking of medical researchers at work is one of serious men and women using sophisticated technology to investigate treatments and cures for diseases. But in some cases, these professionals use simple, everyday devices to combat people’s disorders and manage their symptoms.

A recent study, published in Nature Biomedical Engineering on August 5, reported on a new wireless device that regulates neural circuits in the brain using a tiny implant controlled by a simple smartphone. The researchers say this device speeds up efforts to uncover various brain disorders including Parkinson’s disease, Alzheimer’s disease, addiction, depression and pain.

The wireless device enables consistent chemical and optical nerve stimulation, which targets specific brain cells. Previous methods to achieve this effect involved the use of rigid metal tubes and optical fibers to deliver the drugs and light. This method limited the subject’s movement due to the physical connections to bulky equipment. It also often led to lesions in the brain’s soft tissue over time, making that method unsuitable for long-term use.

But this new approach uses large, Lego-like replaceable drug cartridges and powerful Bluetooth-enabled low-energy. This method allows for the targeting of specific nerve cells in the brain for prolonged periods without the limits of a physical connection to equipment or the risk of brain lesions.

Controlled by a simple user interface on a smartphone, researchers using this device can easily trigger any specific combination or the precise sequence of light and drug delivery without being inside a laboratory. And because it can be used for long periods, the device may contribute to uncovering the basis of many neuropsychiatric diseases.

Last year, scientists from the Ulsan National Institute of Science and Technology in South Korea reported on advances in technology using wireless communication and portable devices for diabetes monitoring. Their study results were published in the January 2018 issue of Scientific Advances.

The researchers studied a new technology involving a smart soft contact lens capable of monitoring blood glucose levels in tear fluid, as well as other relevant physiological data in real-time. This data can then be used to facilitate disease management.

Previous attempts at using contact lenses for this purpose came under criticism because the material used was too opaque and rigid, and could potentially damage the eyes. The research team in South Korea addressed these concerns by placing the operational components around the edge of the lens away from the pupil.

The new contact lens that was developed is equipped with sensors that can detect blood glucose changes in the tears, as well as other biomarkers typically found in the blood. These biomarkers include cholesterol, sodium ion and potassium ion levels, offering additional disease monitoring possibilities.

The study researchers note that the contact lens collects tears for measuring glucose changes from those created by normal activities such as blinking. As a result, invasive collection methods, such as finger sticks to collect blood for testing, are avoided. The goal of the new technology is to increase patient compliance with regular blood glucose monitoring.

Other noninvasive methods for measuring blood glucose levels in people with diabetes are also being studied. One study is looking at a technology that measures blood glucose by placing a device near the eye. This technique uses a novel biochemical sensor embedded on a small hydrogel disk. The disk is inserted below the patient’s conjunctiva during a simple, painless procedure performed by an ophthalmologist.

The chemical in the disk reacts with blood glucose in the interstitial fluid below the conjunctiva and emits fluorescent light that is quantified by a special photometer device. This device is placed in front of the person’s eve. It can record blood glucose results in less than 20 seconds.

Another noninvasive device uses occlusion spectroscopy measurements to determine blood glucose measurements. It involves placing a ring-shaped probe around the person’s finger and applying gentle pressure. This pressure temporarily stops blood flow, and optical elements in the device’s sensor perform a sensitive measurement of the light transmitted through the finger.

In one study, measurements taken using this device were compared with measurements taken using invasive methods, and this device proved comparable. Tests showed this device to be a painless and accurate alternative to invasive methods such as finger sticks for continuous glucose monitoring in patients with diabetes.

 

Do you have diabetes? If so, you’re certainly not alone. The American Diabetes Association estimates that 30.3 million Americans have diabetes and another 8.1 million have it but haven’t been diagnosed. Another 84.1 million people in the US have prediabetes, and nine out of ten aren’t aware of it. Still, 1.2 million new cases of diabetes are diagnosed in this country every year.

Maintaining healthy glucose (sugar) levels in your blood is a constant concern if you’ve got diabetes. Consistently high blood glucose can damage many parts of the body, such as the heart, kidneys and blood vessels. That includes the tiny blood vessels in the eyes, which can affect the retina, macula, lens and optic nerve.

When high glucose levels negatively affect the blood vessels in the retina, which is an area of light-sensitive tissue located in the back if the eye, it leads to a condition called diabetic retinopathy. There are two main types of retinopathy, nonproliferative and proliferative.

Nonproliferative retinopathy has several stages. It progresses from mild to moderate to severe. It starts as small areas of balloon-like swelling in the tiny blood vessels. These areas may start leaking fluid into the retina. In the moderate stage, the blood vessels that feed the retina may start swelling and distorting, losing their ability to transport blood.

In severe nonproliferative retinopathy, many blood vessels become blocked, which deprives the retina of its nourishing blood supply. Growth factors are also released during this stage. These factors initiate the development of new blood vessels.

In some people, the severe stage progresses into proliferative retinopathy. With that, new blood vessels start growing, but these vessels are very fragile and weak. They can leak blood, which can block vision. Scar tissue can also be created, which can cause the retina to pull away from the back of the eye, a condition called retinal detachment.

Another consequence of retinopathy is macular edema, which is swelling, or the build-up of fluid, in the macula. The macula is the area of the retina responsible for central vision. It’s the macula the enables you to recognize faces, read and drive. Macular edema is the most common cause of vision loss in people who have diabetic retinopathy.

If you maintain good control of your blood glucose levels and your blood pressure, you’ll be less likely to develop diabetic retinopathy or, if you do, you’ll get a milder form of it. Those are risk factors you can control. Risk factors you can’t control are your genes and how long you’ve had diabetes.

Having diabetes puts you at higher risk for other eye conditions as well, including cataracts and glaucoma. Rapidly changing blood glucose levels can affect the eye’s lens and cause it to become cloudy. This can lead to a cataract. Anyone can get cataracts, but people with diabetes tend to get them earlier, and they progress faster.

With glaucoma, pressure builds up inside the eye when fluid can’t be removed through the eye’s drainage system that includes the trabecular meshwork. High blood glucose levels damage the cells of this meshwork, so it can’t function properly. Fluid doesn’t drain and pressure builds up in the eye. If not treated, the pressure can damage the optic nerve, leading to permanent vision loss.

Diabetic retinopathy, macular edema and glaucoma usually have no early symptoms. You may not know you have these diseases until they’ve already done damage to your eyes and affected your vision. That’s why an annual examination by an eye specialist is so important. The specialist can check your eyes for signs of these disorders, so early treatment can be started.

According to the US Centers for Disease Control and Prevention, about 90 percent of diabetes-related vision loss can be prevented. Early detection is one of the ways to reach that goal, and it’s another reason for an annual eye exam. Another way to help prevent vision-stealing eye diseases is by maintaining good blood glucose and blood pressure control.

Following these simple tips can help save your vision. So can knowing these symptoms  that signal an emergency. If you notice any of these symptoms, call your doctor right away:

• Black spots in your vision
• Flashes of light
• “Holes” in your vision
• Blurred vision