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Diabetes (Mellitus, Type 1 and Type 2) (cont.)

Is It Possible to Prevent Diabetes?

It is not yet known how to prevent type 1 diabetes. Type 2 diabetes, however, can be prevented in some cases.

  • Control weight to normal or near-normal levels by eating a healthy low-fat, high-fiber diet.
  • Regular exercise is essential to prevention of type 2 diabetes.
  • Keep alcohol consumption low.
  • Quit smoking.
  • If a person has high blood fat levels (such as high cholesterol) or high blood pressure, take all medications as directed.
  • Lifestyle modifications and/or certain medications can be used in people with prediabetes to prevent progression to diabetes. Prediabetes can be diagnosed by checking fasting glucose and two hours after ingesting up to 75 grams of glucose (dosing is based on the weight of the patient).

If you or someone you know already has diabetes, focus on preventing complications, which can cause serious disabilities such as blindness, kidney failure requiring dialysis, amputation, or even death.

  • Tight glucose control: The single best thing a person with diabetes can do is to keep their blood sugar level within the suggested range every day. The only way to do this is through a combination of regular blood sugar checks, a balanced diet (low in simple sugars and fat, and high in complex carbohydrates and fiber), a high degree of personal motivation, and appropriate medical treatment. Consult a nutritionist or check with a doctor with questions in regard to diet.
  • Quit smoking.
  • Maintain a healthy weight.
  • Increase physical activity levels. Aim for moderately vigorous physical activity for at least 30 minutes every day.
  • Drink an adequate amount of water and avoid consuming too much salt.
  • Take care of the skin. Keep it supple and hydrated to avoid sores and cracks that can become severely infected.
  • Brush and floss the teeth every day. See a dentist regularly to prevent gum disease.
  • The feet should be washed and examined daily, including the soles, looking for small cuts, sores, or blisters that may cause problems later. The toenails should be filed rather than cut to avoid damaging the surrounding skin. A specialist in foot care (podiatrist) may be necessary to help care for the feet.

What Is the Prognosis of Diabetes?

Diabetes is a leading cause of death in all industrialized nations. Overall, the risk of premature death of people with diabetes is twice that of people who do not have diabetes. Prognosis depends on the type of diabetes, degree of blood sugar control, and development of complications.

Type 1 diabetes

About 15% of people with type 1 diabetes die before age 40 years, which is about 20 times the rate of that age group in the general population.

  • The most common causes of death in type 1 diabetes are diabetic ketoacidosis, kidney failure, and heart disease.
  • The good news is that prognosis can be improved with good blood-sugar control. Maintaining tight blood sugar control has been proven to prevent, slow the progression of, and even improve established complications of type 1 diabetes.

Type 2 diabetes

The life expectancy of people who are diagnosed with type 2 diabetes during their 40s decreases by five to 10 years because of the disease.

  • Heart disease is the leading cause of death for people with type 2 diabetes.
  • Excellent glycemic control, tight blood pressure control, and keeping the "bad" cholesterol (LDL) level at the recommended level below 100 mg/dL (or lower, particularly if other risk factors for cardiovascular disease are present) and the "good" (HDL) cholesterol as high as possible. When indicated, use of aspirin can prevent, slow the progression of, and improve established complications in diabetes.

What Types of Health-Care Providers Treat Diabetes?

Most primary-care providers have experience managing diabetes, including internists, gynecologists, and family practitioners. Specialists in diabetes care are called endocrinologists or diabetologists. You can locate the endocrinologist(s) in your area using the "Find an Endocrinologist" search engine online at the Hormone Health Network (http://www.hormone.org). You can locate a pediatric endocrinologist for diabetic youth using the "Find a Doctor" search engine of the Pediatric Endocrine Society (http://www.pedsendo.org/patients_families/find_a_doctor/index.cfm).

Are There Support Groups and Counseling for People With Diabetes?

You may wish to join a support group with other people to share your experiences. The American Diabetes Association and Hormone Health Network are excellent resources. Your health-care provider will have information about local groups in your area. The following groups also provide support:

American Association of Diabetes Educators
100 W Monroe, Suite 400
Chicago, IL 60603
(800) 338-3633

American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, IL 60606-6995
(800) 877-1600

National Diabetes Education Program
One Diabetes Way
Bethesda, MD 20814-9692
(800) 438-5383
ndep@info.nih.gov

Hormone Health Network
1-800-HORMONE
2055 L Street NW, Suite 600
Washington DC 20036
hormone@endocrine.org

REFERENCE: MedscapeReference.com. Type 2 Diabetes Mellitus.


Medically Reviewed by a Doctor on 3/3/2016

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