By Rebecca Martin, FNP, School-Based Health Center, part of Finger Lakes Community Health, a non-profit organization with nine health centers and a Mobile Health Unit.
According to the CDC, more than 37 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it.
Some of the risk factors that could lead to type 2 diabetes are unexplained weight loss, increased thirst, increased urination, and if a parent, brother, or sister has type 2 diabetes. If that is the case, please see your medical provider.
Type 2 diabetes occurs when the body becomes “resistant to insulin.” Over time due to poor dietary habits, and lack of exercise the body has had to produce more and more insulin to keep up with the demand to lower sugar and it gets tired. Eventually, the body can no longer keep up with the demand for insulin, in turn, sugars rise and will require medical management to keep those sugars where they belong. Insulin is a hormone that the body makes inside the pancreas. Insulin helps the body use or store blood glucose from each meal.
Many type 2 diabetics can be treated with oral medications and in the past few years, there have been many excellent new drugs available. There are instances where type 2 diabetics require insulin.
Managing your diabetes is important because uncontrolled glucose is hard on all your body systems. Here is a review of commonly affected body parts and annual screening recommendations to prevent or provide early detection of damage:
What is the effect of Type 2 Diabetes if left untreated?
YOUR EYES: Over time having elevated blood sugars can lead to damaging your retina. Elevated blood
sugars are hard on all blood vessels throughout the body, and especially the small arteries in your eye. Diabetic Retinopathy is a condition that found in those with diabetes that can cause blindness. Often patients do not have signs initially but later notice that their vision is changing.
RECOMMENDED SCREENING: As a result, it is recommended that Diabetic patients have an annual Diabetic Retinopathy Screening done every year, where the back of the eye is examined. Your eye specialist can do this, or in some cases like at our health centers, we have special cameras in our office that take pictures of the retina and are sent to an Ophthalmologist for review. If Diabetic Retinopathy is present, we can refer to an eye specialist for further evaluation and treatment.
YOUR FEET: How many times have you heard that someone had diabetes and lost his foot? As we said, uncontrolled blood sugars are hard on blood vessels, however high blood sugar can also damage nerve endings too. Diabetic neuropathy is nerve damage that commonly occurs in the feet and lower extremities. This neuropathy can cause pain and numbness in the extremities. Why is this important? If you cannot feel your feet and you cut yourself and do not realize it, you may not take care of it right away. Then the wound is likely to take a longer time to heal because your sugar is elevated putting you at a greater risk for infection.
RECOMMENDED SCREENING: Diabetics should have an annual foot exam either by their primary care provider or a podiatrist. This exam should consist of a visual inspection of the feet top and bottom and between toes. Your circulation and sensations should also be reviewed and you can expect to be poked with a nylon fiber in multiple areas of your foot to test vibratory sensation and palpation of your pulses in your foot.
YOUR KIDNEYS: Remember elevated blood sugar is hard on the blood vessels, and there are many in the kidneys. When the kidneys start showing a decline in function, it often cannot be reversed, resulting in patients on dialysis.
RECOMMENDED SCREENING: at least once a year your provider should obtain a urine sample from you to test for a protein called, Microalbumin. This test will often show evidence of kidney issues earlier than your blood work. Elevated microalbumin is a great early indicator that we need to work diligently to get your blood sugar under control.
Arming yourself with knowledge about type 2 diabetes and how it affects your body will help you and your provider create a plan to manage your diabetes. It will take teamwork to get the best outcomes. If you have uncontrolled Type 2 diabetes and you have not seen your provider in the past three months, it may be time to give them a call.
