ARLINGTON, Va. -- “Reverse Diabetes with Five Easy Recipes,” the magazine headline glared from the grocery store check-out lane. I tried to distract my 9-year-old daughter so she wouldn’t see it, but it was too late.
“Mom?” she said slowly, staring at the cover. She looked at me to see if I would again deliver the bad news she had learned to expect.
“No, I’m sorry,” I answered. “That’s for people with Type 2 diabetes -- not Type 1.”
“Why do they call them both diabetes if they’re so different?” she exclaimed in frustration.
Diabetes mellitus is the name given to disorders in which the body has trouble regulating blood glucose, or blood-sugar, levels – both Type 1 and Type 2. A more rare and unrelated form of diabetes, diabetes insipidus, is characterized by extreme thirst due to a hormonal problem.
Type 1 diabetes is an autoimmune disease in which the pancreas stops producing insulin, a hormone that enables people to get energy from food. Also known as juvenile diabetes, the disease most often strikes children and young adults, and it is not curable. Treatment involves a complex daily routine of monitoring blood sugar, measuring carbohydrate intake and administering insulin through shots or an insulin pump. Calculations need to be exact. If people get too much insulin, they can lose consciousness. If they get too little, their blood sugar becomes dangerously high as acids build up in the body, decreasing the pH level of the blood. Sustained acid build up, or ketoacidosis, can be fatal.
Type 2 diabetes is a metabolic disorder in which a person’s body produces insulin, but is unable to use it effectively, also known as insulin resistance. Type 2 used to be known as “adult onset” diabetes, but has increasingly been found in teenagers as obesity rises among Americans. Type 2 diabetes can be controlled through diet, exercise, medications and insulin.
While the media attention about “reversing” Type 2 diabetes can be frustrating to people with Type 1, it is understandable. The number of Americans diagnosed with Type 2 has skyrocketed in recent decades, but the disease may be preventable, according to Dr. Warren Lockette, an endocrinologist and deputy assistant secretary of defense for health services policy. Many people have a genetic predisposition to Type 2, and diet and exercise are the means of prevention or, at least delaying the development of the disease, he said.
Meanwhile, the prevalence of Americans under age 20 with Type 1 rose 23 percent between 2001 and 2009, according to the Juvenile Diabetes Research Foundation. But unlike Type 2, there is no way to predict or prevent it.
November is recognized as National Diabetes Awareness Month, as well as Military Family Month. Figuring out how many military families are impacted by diabetes is difficult. Having the disease disqualifies people from joining the military, although TRICARE officials report nearly 1 million beneficiaries have diabetes.
Nationwide, nearly 26 million people – about 8 percent of Americans -- have diabetes, according to the American Diabetes Association. Diabetes is the nation’s No. 1 cause of kidney failure, the leading cause of blindness in adults, and accounts for more than 60 percent of non-traumatic lower-limb amputations, the association has reported. It is the seventh leading cause of death in the United States and one of the costliest chronic diseases, accounting for about $245 billion annually in medical care and lost worker productivity, it said.
While Type 1 accounts for only about 5 percent of diabetes cases, according to the association, there is much people can learn from those with Type 1 to help prevent or control Type 2. The daily regimen of diet, exercise and glucose monitoring that can seem daunting to newly diagnosed adults, is routine for those who have done it since childhood. Many resources for counting carbohydrates and sugars are available in print, on the Internet, or in apps. Those resources and a small, portable kitchen scale may seem like a nuisance initially, but even young children can memorize nutritional information over time.
That’s not to say that managing diabetes is easy. People with diabetes must be constantly aware of their blood glucose levels. It takes careful planning not to run out of supplies and to pack the right ones when you leave home. A diabetic has to plan for contingencies: Will that exercise make my blood sugar go too low? Will my insulin kick in too soon before a meal – or too late? Will the meal at that special occasion be at the wrong time so I can’t eat? What if my insulin is in the heat too long?
The best approach is to do everything possible to prevent Type 2. As my daughter tells her older relatives about staying healthy to ward off diabetes, “You don’t want this.”
Lisa Daniel is a writer with the Military Health System. Her daughter was diagnosed with Type 1 diabetes at age 7.
For more information on diabetes:
Walter Reed National Military Medical Center Diabetes Institute
American Diabetes Association