Diabetes: Education key to good outcomes

“The diabetic that knows the most, lives the longest.” This quote from Elliott Joslin, the founder of the first diabetes center in the United States, are as true today as when he first spoke them nearly a century ago. Diabetes is a complex, metabolic disease that requires complicated medical care that the patient must actively perform on a daily basis.

Metabolism is primarily the process by which your body changes what you eat and drink into energy. Metabolism is also how your body uses what you eat to maintain itself – building and repairing the tissues of the body. Diabetes is a disease caused by the body either losing the ability to make insulin (type 1 diabetes) or make enough insulin to meet your body’s needs (type 2 diabetes).

The loss of insulin action leads to abnormal glucose metabolism – how your body uses carbohydrates in your diet for energy. Abnormal glucose metabolism causes glucose to build up in the blood resulting in high blood glucose. In the short-run this causes symptoms like excessive urination and thirst, blurred vision and poor wound healing. In the long-run, high blood glucose levels damage the tissues of the body leading to blindness, kidney failure, limb amputations and nerve damage.

The lack of insulin also disrupts the metabolism of fats in the diet. Persons with diabetes have very significantly more problems with high cholesterol and triglyceride levels, heart attacks strokes and heart failure.

Managing these metabolic disorders requires persons with diabetes to adopt a lifestyle where everything they eat, the medicines they take and their daily activities must all be carefully planned and monitored. Diet, medication and activity each effects glucose and cholesterol levels. They also can cause high or low blood sugars. They also influence the rate at which long-term complications of diabetes develop.

Diet is also referred to as “medical nutrition therapy.” Food is medicine. There is no medication – including insulin – that you cannot “out eat.” Medications are not designed to make up for bad eating habits. Medications provide the most benefit when their effects build on a foundation of proper eating. Diabetes education will train you in what to eat, how much to eat, when to eat and how to lose weight.

Oral and injectable medicines for diabetes have rapidly increased in number in recent years. We have medications than ever to help manage diabetes. We have more forms of insulin with varying duration of activity than ever. We have more sophisticated technology (insulin pumps and glucose sensors) to manage insulin delivery than ever. Diabetes education is key to understanding treatment options and how these options may be mixed and matched to best address your treatment goals.

Finally, diabetes education will help you develop an activity plan to help you control your blood glucose, cholesterol and blood pressure levels. Activity also helps to decrease the risk of heart attacks, strokes and heart failure.

Diabetes education is provided in individual and classroom settings to meet your individual needs. It will add years to your life, and health to your years.

Dr. Samuel Abbate is a physician practicing in Wasilla.