If you ask any health care professional what the most deadly, destructive and debilitating disease that they have ever dealt with, the chances are pretty good most would put diabetes at or near the top of their list.
I am not claiming to be an expert on diabetes but when you deal with something for 34 years you come to understand it. Type I diabetes is a disease that is usually diagnosed in childhood and always requires an insulin injection to be controlled.
Type II diabetes is generally diagnosed in adults, although that is changing as a result of the childhood epidemic of obesity. It can be controlled with diet, exercise and oral medication. If it progresses, insulin is needed. Those are the basic facts.
Diabetes has the potential to be a horrific disease. In order for it to reach the most devastating levels, one simply has to ignore the disease for a number of years. People who have Type II diabetes, or people who are allowing all of the bad elements to be in place to cause the disease, need constant reminders that they are playing Russian roulette with their lives.
Too many people don't really understand how deadly this disease is. People with diabetes do have to work hard at controlling their blood sugar. It is a constant struggle.
There are some symptoms that occur when blood sugar is too low or too high but, for the most part, people with Type II diabetes usually have few symptoms. When they do start to
Here's what happens when a person's blood sugar stays too high for too long. We are not talking weeks or months, but years and decades. Red blood cells end up carrying what might best be described as some sort material that causes blood vessels to become inflamed. The longer that a person's blood sugar is elevated, the more that red blood cells promote the inflammatory process in blood vessels such as veins and arteries. This inflammation eventually causes small blood vessels to clog and blood flow stops.
In some diabetics this blockage occurs in blood vessels that feed the eyes or the kidneys. In others it blocks vessels going to the legs. Blood vessels that feed nerves can also be choked off causing the horrific pain and complications of diabetic neuropathy.
People who suffer from diabetic neuropathy have bouts of very nasty pain as well as periods of complete loss of feeling in certain parts of their body. One of the common stories of diabetics with neuropathy is how they got into a car accident because they thought they were pressing the brake. They were forced to accept the fact that they had been in denial for months about their inability to feel the brake pedal.
If you want to feel a loss of control of your life, then having to give up driving because of diabetic neuropathy will do it. As things progress, people lose the ability to control their legs and they may have to use walkers and then they eventually become dependent on others for all mobility because they can no longer trust their legs.
Then there are the diabetics who develop leg wounds as a result of bad circulation. These wounds can take months to heal, requiring constant visits to doctors and nurses and loss of the ability to have any semblance of a normal life.
Many of these wounds become so bad, especially in people who have had poor control of their blood sugar, that amputation becomes the only option. Once this happens it is not unusual for a person to first lose a toe or a foot and eventually have to have a leg amputated below or above the knee.
When long-standing elevated blood sugar effects the kidneys, those organs eventually fail. There may be years of bothersome leg swelling before the kidneys become so bad that the only options are death or dialysis. Dialysis usually requires a person to give up three days a week to a machine to filter their blood. If they are lucky, the other four days might be OK.
Blindness is another horrible complication. It happens gradually and, although changes can be monitored, the best treatment is to keep blood sugar within normal range. It is a sad thing to watch someone lose their precious eyesight when you know they could have done something to prevent it.
All of the major studies about blood sugar control in diabetics indicate that if a person keeps strict control of their blood sugar they have an excellent chance of preventing and minimizing complications. Since Type II Diabetes is a mostly preventable disease, if we can slow the current obesity epidemic, then we can spare people the prospect of a life whose primary focus is disease management.
Richard Davis is a registered nurse and executive director of Vermont Citizens Campaign for Health. He writes from Guilford and welcomes comments at firstname.lastname@example.org.