Type 1 diabetes occurs when the body no longer manufactures its own insulin when the immune system has been compromised, and the cells that manufacture it no longer work. A combination of genetic and environmental factors are believed to be responsible. Patients with this affliction must take insulin every day because diabetes is incurable, but it can be controlled.
Type 2 diabetes, the most common form, occurs as people age and sometimes is called adult-onset diabetes. Like Type 1, Type 2 sufferers begin to lose the ability to make insulin or have a body that doesn’t manufacture it as efficiently as it used to. Although the cause of the disease is unknown, diet and lifestyle are believed to be strong influences, particularly when the patient is obese and largely inactive. Type 2 diabetics can’t be cured, although the disease can be managed with an improved diet, weight loss and exercise.
The American Association of Diabetes Educators, a trade organization focused on the disease, reports that nearly 10 percent of the United States population has diabetes, and about 86 million are in a pre-diabetic state. About 14 percent of all health-care spending is devoted to combatting this disease.
The Non-Compliant
But having the disease and complying with its treatment are two different things. Doctors will advise patients to take their medicine as directed, keep track of blood glucose, lose weight and get some exercise. But apparently, according to the American Association of Diabetes Educators, that sound advice is largely ignored.
Only 77 percent of diabetic patients take their insulin as prescribed, with 85 percent taking other medication as prescribed. The rest are non-compliant and take their medications sporadically or not at all. Fewer than half of patients who were surveyed monitor blood glucose as instructed, and 45 percent are non-compliant. As for weight loss and exercise, only 24 percent to 27 percent follow doctors’ orders and actually do something about their conditions.
What that adds up to is a lot of people with a serious disease who don't take their treatment seriously. Worse, a good deal of them continue the bad habits that led to the onset of the disease in many cases. This self-sabotage isn’t done to thwart anyone in particular. These are just bad habits developed over a lifetime that the patient struggles to stop but often cannot.
FIVE BAD HABITS
Here are five habits that can become a problem for diabetes management, but people do anyway.
1) Food: Trying to control blood sugar means strict attention to diet and meal planning so that you’re not forced to eat whatever’s available. Many diabetics wind up grabbing something rich in carbohydrates, which have the biggest impact on blood sugar, and then skyrocket out of control. Because fruits, vegetables and whole grains require a shopping trip and spoil quickly, many diabetics wind up scouring the kitchen for something unhealthy. Portion control is key – too little food may send blood sugar plummeting (a condition known as hypoglycemia), while too much spikes it (hyperglycemia). Some diabetics also can’t stay away from sugar-sweetened, high-fructose beverages, which doesn’t help.
2) Lack of Exercise – When you undertake physical activity, your muscles burn glucose for energy. Regular activity also helps the body with its insulin management. This doesn’t mean you need to train like an Olympic athlete -- even walking, housekeeping or gardening can burn off some energy. But working people, particularly those in office jobs, find it hard to muster the get-up-and-go that will allow them to get up and go.
3) Alcohol Consumption – Drinking monopolizes the liver, which has to release stored sugar to counteract falling blood sugar levels. If it’s too busy metabolizing alcohol, it can’t get around to handling the sugar. Thus, drinking can lower the blood sugar for as many as 24 hours after consumption. Alcohol also can wreak havoc with nerves and eyes, both key attack points for diabetes. Moderate consumption under a doctor’s supervision is usually OK, but binge drinking more than the recommended one drink per day for women and two for men will throw off an entire diabetes management plan. It’s also important to stick to sugar-free mixers.
4) Menstruation Management – As hormones change during the week before and while menstruating, so the plans for diabetes management have to adapt. Otherwise, blood sugar maintenance will be in flux, complicating diabetes management. Track blood sugar changes during these crucial times and vary your diet and exercise levels or medications to deal with the changes.
5) Smoking – Even for healthy people, smoking causes all kinds of health issues. But for diabetics, thealth problems can be compounded with things like heart disease, raising your risk of heart problems even further. Smokers generally have poorer blood flow in the legs and feet, which can lead to foot sores and ulcers.
Other issues that can cause problems for diabetics include excessive stress, skipping meals, late-night snacking or so-called yo-yo dieting, where weight is repeatedly lost and regained.
All of the above in combination can produce even more problems for diabetics, throwing blood sugar levels into chaos and making management that much harder. While everyone slips occasionally and doesn’t comply with strict medical advice, diabetics have a choice – they can live longer and healthier by managing their disease or continue bad habits that provide a slippery slope to worsen the condition.