Type 2 diabetes, a chronic disease that develops gradually in adults, is on the rise across the country and in Siouxland.
According to the Center for Disease Control and Prevention, one in 10 U.S. adults has diabetes. Approximately 175,000 Iowans have a form of the disease, which an lead to blindness, kidney disease, amputations and other life-threatening conditions.
Most of the people with Type 2 diabetes are overweight when they are diagnosed, according to Steven Joyce, a physician with Mercy Medical Center Internal Medicine & Pediatrics.
"With the epidemic of obesity, which is clearly the biggest risk factor for Type 2 diabetes, as the rate of obesity increases, so does that of Type 2 diabetes," he said.
Joyce offered more insight into the disease.
What is Type 2 diabetes?
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"Type 2 diabetes is insulin resistance. People make plenty of insulin from their pancreas, their body is just resistant to it."
Who has Type 2 diabetes?
"Obesity is the greatest risk factor. Family history is some risk factor for Type 2 diabetes. Ethnicity with Native Americans and Asian Americans those populations have high rates of Type 2 diabetes. The older you get, the more likely you are to get it if you are obese."
Can children develop Type 2 diabetes?
"It used to be very uncommon in children. It was almost never heard of. Now with pediatric obesity rates raising, now we are starting to see more of that in children. It's less common in children just because you need years of insulin resistance before you develop Type 2 diabetes, but we are now seeing it in children. Typically it is the adult population."
What causes Type 2 diabetes?
"When we eat something, especially with carbohydrates, our digestive system digests it. And part of that digestive system is an organ called the pancreas. The pancreas secrets numerous enzymes to digest food, but it also secrets hormones, not one of them being insulin. Insulins help to control carbohydrate, metabolism and blood sugar levels. When you're obese, you have resistance to your body's own insulin, therefore you make plenty of insulin, yet your blood sugar rises because your body doesn't use that insulin in the way that it should."
What symptoms are associated with Type 2 diabetes?
"Unfortunately, most of the time there are none. If your blood sugar is so high, you will notice increased thirst and urination, but those are very non-specific signs. Those can go with many, many other things. Most of the time there are no symptoms, which is why they need to get checked for it."
Do people go a long time before being diagnosed with Type 2 diabetes?
"The average length of time between the onset of diabetes and the diagnosis of Type 2 diabetes is five years."
What leads to a Type 2 diabetes diagnosis?
"Most of the time, it's routine blood work. Anyone who comes in for an annual physical will typically get some blood work. Checking the blood sugar is the first step in the diagnosis of Type 2 diabetes."
How do you manage Type 2 diabetes?
"There are oral medications to help lessen that resistance to insulin. If you are beyond that stage of treatment, then you simply just need more insulin. Which is why some Type 2 diabetics are on insulin. We usually just think about Type one diabetics needing insulin."
What are the long-term complications associated with Type 2 diabetes?
"There are many. This is typically after years of having it. Diabetic retinopathy, diabetic neuropathy and diabetic nephropathy. Diabetic retinopathy is the effects on the eyes, the retina. Diabetes is the most common cause of blindness in our country. Neuropathy affects the nerves. People get numbness, tingling and burning in their feet. They can eventually get ulcers in their feet, amputations, things like that. Diabetic nephropathy is the kidney. It affects the small blood vessels of the kidney and that's why diabetes is one of the leading factors for those presenting with end stage kidney disease."
Should a person with Type 2 diabetes monitor their blood sugar levels like a Type 1?
"There is much debate whether self-monitoring glucose levels improves diabetic control. If the patients have a propensity to develop hypoglycemia, then I would say the answer should be yes, they should be checking their blood sugars. If they're under good control with their medications and they have routine followup with their physicians, there are many patients who don't check. It certainly is not nearly as important for Type 2s as for Type 1s."
Can a person who is obese lose weight and be cured of Type 2 diabetes?
"I don't know that we ever call someone cured of diabetes, but they can ween themselves of medication or at least get down to lower dosages. So yes, losing weight is a huge benefit. It will allow their treatment to become much simpler - decreasing dosages and sometimes weening off medications all together."
