Boomers Especially at Risk for Type 2 Diabetes

Type 2 Diabetes, which affects older people, is on the rise.

By Jayne MacAulay

Is Type 2 Diabetes in your future? Is it already in your present? A 17th-century English physician called diabetes “the pissing evil.” (People with the disorder have a frequent need to urinate.) Thomas Willis even deduced that patients with diabetes had a “sweetness” in the blood before it reached their urine. Nearly four centuries later, the Canadian Diabetes Association (CDA) reports that more than three million Canadians have the disease, 90 per cent of them mostly adults with Type 2 diabetes. (Type 1 usually strikes people under 30; they don’t produce enough insulin.)

Type 2 is characterized by insulin resistance — the body partially or totally can’t use the hormone insulin to regulate the amount of sugar (glucose) in the blood. Uncontrolled diabetes can harm nerves and blood vessels, causing complications such as blindness, kidney disease and dental problems and may result in limb amputation. Heart attacks and strokes eventually kill 80 per cent of people with diabetes.

Risk factors for Type 2 diabetes include:
> Age of 40 or older
> Ethnicity (Aboriginal, Hispanic, Caribbean, Asian, African, South Asian)
> Family history of the disease
> Obesity (abdominal fat increases risk of Type 2 diabetes)
> High cholesterol or blood pressure
> Sedentary lifestyle
> Sleep apnea
> Pregnancy-related diabetes or delivery of a baby weighing more than nine pounds

HOW DOES IT FEEL?
Symptoms include fatigue, thirst, excessive urination, weight loss/gain, unusual hunger, slow-healing cuts, yeast infections and erectile dysfunction. There’s no cure for Type 2 diabetes but lifestyle adjustments (diet, weight loss, exercise and quitting smoking) as well as oral medication and perhaps insulin can help fend off complications.

GET TESTED
The CDA suggests a fasting blood glucose test at age 40, then once every three years. If you have Type 2 diabetes, your physician will recommend a blood glucose range.

An A1C blood test every three to six months measures glycated hemoglobin. It indicates how well you’ve been controlling your diabetes. A persistent result of seven per cent or higher means you’re on the road to developing complications. You’ll also need tests for protein in your urine, regular eye exams and your feet checked for sores or abrasions.

If you’re prediabetic (glucose levels higher than normal but not at Type 2 diabetes levels of 7.0 mmol/l or higher) you might delay or even prevent onset of Type 2 diabetes by exercising and controlling your diet.

MEDS AND MONITORS
The pharmaceutical arsenal includes drugs that decrease glucose production in the liver, increase muscle use of blood glucose, slow intestinal absorption of glucose or increase insulin production. (Bonus: a study by the National Cancer Institute reports metformin, prescribed for the overproduction of insulin in some Type 2 diabetic patients, appears to fight colon and lung cancers.)

Home testing for blood glucose involves drawing a drop of blood from a finger prick onto a paper strip to be read by a small meter. (In development is an implantable device that will wirelessly transmit glucose measurements.) If needed, insulin can be injected with a syringe or injection pen. Small pumps programmed to deliver insulin through a small catheter offer insulin-dependent diabetics more reliable control of blood glucose.

For more information on Type 2 diabetes, go to the Canadian Diabetes website at www.diabetes.ca.