November is National Diabetes Awareness Month with World Diabetes Day on November 14. Adelante Healthcare is honoring it by providing resources and tips to help you learn preventative measures and how to manage it from both our doctors and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This year, the focus on taking small steps to make a big difference. This means small life goals and changes that could have a great impact and a positive impact on your long-term health goals.

Adelante’s very own Dr. Jeffery Dann, MD, MBA, CPE, CPHQ gives us a brief background of diabetes and says that it is a very common disorder that affects about 11 percent of the US population. The US has the highest rate of Diabetes in the world. Diabetes has a very strong genetic component and is seen more commonly in certain races and ethnic groups especially Native Americans, Pacific Islanders, Blacks, and Hispanics. Diabetes comes in two main flavors: Type I and Type II. In both types of Diabetes, if the blood sugar is not well controlled it causes damage to the microvascular system. This ultimately results in damage to the eyes, kidneys, nervous system, etc.

Type I is an autoimmune disease that usually presents in children or young adults. In Type I Diabetes the body produces antibodies that attack the pancreas and destroy the cells that make insulin. Type I Diabetics must use insulin daily. Without insulin these patients develop a very severe illness called Diabetic ketoacidosis that has a very high mortality rate. This type of Diabetes typically has a rapid onset and patients present very sick. It is very important to get these patients sugar levels under control in a short amount of time after diagnosis. If not, permanent damage occurs after about 5 years.

Type II has a strong genetic component but is driven by obesity. Type II Diabetes develops slowly over several years and many patients have had high sugars for many years before they are diagnosed. As a result, it is very important to screen patients who are at risk for developing Type II Diabetes. This includes patients who are overweight or obese, have a family history of Diabetes, come from a high-risk race or ethnic group, have a history of gestational Diabetes, etc.

The hallmark of Type II Diabetes is insulin resistance. The body can still make insulin and in fact insulin levels are often elevated, but the insulin cannot be used as efficiently by the body. Luckily, there are multiple medications available to treat Type II Diabetes including oral and injectable medications. Some Diabetics can control their blood sugars with diet and weight loss alone. Lifestyle changes that include cutting down on carbohydrates, weight loss, and increasing exercise are a fundamental part of the treatment plan for Type II Diabetes. Cardiovascular disease is the leading cause of death in patients with Diabetes. It is important to monitor these patients for evidence of end organ damage.

This is why these patients need to have annual screening tests to monitor for eye damage (ophthalmology referral), kidney damage (microalbumin), and nerve damage (monofilament).

By Dr. Jeffery Dann, MD

Dr. Jeffrey Dann recommends:

    • • Making calories count with nutritious, fiber-rich foods, fish and “good fats” that include avocados, nuts and whole eggs.

• Prioritizing healthy carbohydrates like fruits, vegetables, whole grains and legumes (beans and peas) and avoiding foods that have added sugar and sodium

• Screening tests to monitor for eye damage (ophthalmology referral), kidney damage (microalbumin), and nerve damage (monofilament).