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Got a Minute?: Understanding Type 2 diabetes

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By NANCY M. JOHNSEN

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November is National Diabetes month and the “Got a Minute?” column continues its look at the disorder and ways to live with it.

Type 2 diabetes affects the greatest number of individuals. Type 2 diabetes affects about 90 percent to 95 percent of the 30.3 million Americans who have diabetes.

Previously, Type 2 diabetes was called Adult Onset Diabetes but onset can happen at any age – 8 percent to 45 percent of all Type 2 diagnosed diabetics are children and adolescents. According to the U.S. Centers for Disease Control and Prevention, the greatest percentage of Type 2 diabetes is in the older than 65 years old age group.

Type 2 diabetes has an insidious onset. The usual signs of excessive thirst, excessive urination and hunger may not be present. In their place may be a general fatigue, a dry mouth or slow wound healing.

The condition can go undiagnosed for a significant period of time, which makes regular check-ups, and blood work critical even if you feel fine.

Type 2 diabetes is chronic and progressive. The beta cells in the pancreas are secreting less and less insulin. Partner this with increased resistance on the part of the body’s cells, usually the muscle cells, to use the insulin the body is producing, and the result is a high blood sugar. Type 2 diabetes can be diagnosed with two fasting blood sugars on different days, equal to or above 126mg or a hemoglobin A1c of 6.5 or greater. If the individual has some of the classic symptoms, a casual blood sugar of more than 200mg can confirm the diagnosis.

The main contributing factors for Type 2 diabetes in adults, adolescents, and children are obesity and a sedentary lifestyle. Other risk factors include a family history of diabetes and being African American, Hispanic, or Native American.

Education, weight loss, and increased activity are the places to start when treating type 2 diabetes.

The goal with any diabetes diagnosis is to lower blood sugar (glucose) through self-management. Working with your health care provider and learning about the condition with a certified diabetes educator starts one down this important path.

For some patients, weight loss and increased activity are not enough to lower the blood sugar so oral medications, non-insulin injection medications, or insulin may be necessary.

Good self-management of diabetes also includes daily self-glucose monitoring. With the availability of a wide selection of glucometers, it is easy to find one to match the individual. Co-pays for test strips are often linked to insurance coverage. It is therefore, important to determine insurance coverage when choosing a glucometer.

Self-management also includes taking medications as prescribed, keeping appointments with your health care provider, and getting blood work as ordered. One blood test, the HbA1c is typically ordered every 3 or 6 months. This test lets you and your health care provider know your average blood sugar during the last three months as it is the weighted average of the amount of glucose glycated or “stuck” to the red blood cells. The American Diabetes Association recommends a HbA1c of less than 7 percent as a first step.

Self-management includes regular foot checks, regular dental checks, and eye exams that include the visualization of the retina. It also includes regular blood work to monitor cholesterol levels and kidney function.

If you have diabetes, get educated and get involved with the self-management of your diabetes. Make sure you have the most current information and tools to keep your blood sugar in a normal range. To find the certified diabetes educator and recognized diabetes program closest to you, go to the American Association of Diabetes Educators at https://www.diabeteseducator.org/.

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Previous columns can be found online at www.thelcn.com.

Local resource

Recognized by the American Association of Diabetes Educators, the diabetes self-management program at UR Medicine Noyes Health is staffed with a RN certified diabetes educator and a RN diabetes educator. The program is available close to home in Geneseo, Dansville, Hornell, and three area health care provider offices. For more information, call (585) 335-4355.

Join me during the month of November as I explain the types of diabetes, new advances in treatment options, and management tools.

Nancy M. Johnsen, RN, is a certified diabetes educator and coordinator of the Diabetes Education Program and Wellness at UR Medicine Noyes Health in Dansville. Johnsen is guest writing the “Got a Minute?” column for Lorraine Wichtowski, a community health educator at Noyes Health, during November. For more information about diabetes, she can be reached at (585) 335-4355.

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