Your Health: Diabetes, Part II

In my November column on diabetes, I discussed the definition, symptoms, causes, risks and complications of this common disease (“Diabetes a common peril,” Page 20, Nov. 23). Today, I would like to discuss the diagnostic tests and treatments for diabetes, prevention and the impact of the disease on our society.
Before I do so, though, a reader who has a child with Type 1 diabetes has asked me to clarify a few points. Type 1 (childhood) diabetes is not caused by eating too much sugar; it is caused by the body not having enough insulin, which causes increased blood sugar. Also, a child will not “grow out of it.” Type 1 diabetes is a lifetime health issue.
Now, on to today’s topics:
Blood tests are used to diagnose diabetes. The fasting blood sugar test is the one most commonly used. It tests the amount of sugar in the bloodstream after a period of fasting. A more reliable blood test is called the A1C test and measures a person’s average blood sugar over several months.
Specific treatment for Type 1 diabetes involves the use of insulin, frequent monitoring of one’s blood sugar level and counting carbohydrates. Treatment of Type 2 diabetes involves oral diabetes medications, possible use of insulin, blood sugar monitoring, maintaining a proper diet and routine exercise.
Type 1 diabetes can’t be prevented and can only be treated with insulin. However, Type 2 diabetes can be prevented by the same lifestyle choices that also treat the condition, including:
– Eating healthy foods.
– Getting plenty of physical activity.
– Losing extra pounds, if overweight.
About 26 million Americans have diabetes, and the numbers are growing yearly. About 2 million of these diabetics have Type 1 diabetes, and the remaining 24 million have the more preventable Type 2 diabetes. Twenty-six percent of all hospital costs are related to the treatment of diabetes and its complications, costing $175 billion to $200 billion per year.
In summary, we know that Type 1 diabetes usually begins in childhood, is most often caused by genetic or other unknown factors, is not caused by a poor diet and can be treated with insulin injections. It is incurable.
Type 2 diabetes affects mostly adults and is treated and often cured by diet, exercise and preventing obesity.
About 25 million Americans have prediabetes, a precursor to Type 2 diabetes. I would advise patients to talk with their physicians at their next routine visit about being screened for this common disease.
Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, http://valleydoctor.wordpress.com, or email him at

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. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.