One of the most common chronic health conditions affecting adults in the United States is Type 2 diabetes mellitus. Risk factors for diabetes include family history of the condition, increased weight, lack of physical activity and an unhealthy diet.
Type 2 diabetes mellitus is a condition in which the body becomes resistant to the effects of insulin, resulting in an elevated blood sugar level. Normally, the blood sugar level should never rise above 140, regardless of eating or exercise. However, in people with diabetes, blood sugar rises above this level in a way that can be toxic to certain tissues in the body.
Abnormally elevated blood sugar can affect blood vessels, leading to premature hardening of the arteries known as atherosclerosis. This can increase the risk for heart disease, stroke and peripheral vascular disease. EKG testing is commonly performed to test for heart abnormalities among patients with diabetes.
Elevated blood sugar can also lead to eye damage. The elevated blood sugar risks lens damage in the eye, producing a premature cataract. It also promotes proliferation of blood vessels in the portion of the eye responsible for vision, called the retina. Without recognition and treatment, this can progress to vision loss. Regular yearly diabetic eye screens help to detect these conditions at an early stage, when treatment can prevent vision loss.
Blood sugar elevations can also produce damage to the kidneys. The earliest effects of this can be detected as abnormal protein in the urine because of filter damage. Later stages of diabetic kidney disease include a loss of kidney function that can cause swelling, anemia, bone problems and abnormal blood levels of certain toxins. Regular yearly screening of the urine and blood for early evidence of kidney problems permits interventions to delay or prevent progression of this complication.
Diabetes also increases the risk of damage to the peripheral nervous system. The peripheral nervous system is responsible for sensation in the hands and feet and diabetic damage can produce a burning-type pain or even numbness in these locations. Combined with poor circulation caused by diabetic peripheral vascular disease, skin breakdown and infections in the foot can lead to serious problems, such as bone infection or gangrene. Complete foot examination should be performed at least yearly to screen for these conditions. This often permits identification of problems early and prevention of more serious problems.
While Type 2 diabetes mellitus is common and can lead to complications, effective control of blood sugar through lifestyle efforts and medication combined with regular screening can reduce the risk of complications.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
