MICHAEL TOWARNICKY: Diabetes, a treatable epidemic

It is well known that diabetes has reached epidemic proportions in the United States and its commonality in Eastern North Carolina is no different. It has been estimated that one out of two adults in Eastern North Carolina may be affected by diabetes or glucose intolerance in their lifetime.

The main manifestation of diabetes is high blood sugar (normal 80-115 in a fasting state) and is usually associated with obesity, high carbohydrate diets, and an inactive lifestyle. It is important to understand that although diabetes is a disorder of sugar metabolism, it is also a disease that profoundly affects large and small blood vessels. Imagine high blood sugar as little shards of glass, ever circulating through your system, nicking and cutting your blood vessels causing damage to the blood vessels in your eyes, kidneys, brain, heart, nerves and fingers, toes and virtually ever blood vessel in your body. Blindness, kidney failure, stroke, heart attacks, peripheral neuropathy, limb amputations and impotence are common end results of diabetes.

What causes diabetes? At the most basic level, it is the body’s inability to properly metabolize sugar due to inadequate amounts of insulin being produced by islet cells in the pancreas or inability of the insulin being produced to work properly at the cellular level (resistance). Sedentary lifestyles, genetic predisposition, obesity and diets too high in refined sugar all play roles in the development of diabetes. It is important to distinguish that some people develop diabetes in childhood and produce no or little insulin and are called Type I diabetics but the majority of diabetes is Type II, which largely occurs in adulthood and is considered acquired because of obesity, poor dietary and exercise habits.

Research into diabetes has come a long way from the initial discovery of insulin by Banting and Best in the 1950s. We live in an age of molecular biology and tremendous research and discoveries are being made to better understand the disease. This has resulted in many improved therapies and treatments for diabetes. From the early days of beef and pork insulin we now live in a day of α-­‐Glucosidase inhibitors, DPP4 inhibitors, GLP-­‐1 Incretin mimetics, MET, Sulfonylureas, and TZD’s. Additionally, insulins are now synthetically derived and closely resemble human insulin. We have insulin pumps and 5-­‐Day Continuous Glucose Monitors. It has gotten complicated, but it’s all to the benefit of the patient.

The treatment of diabetes has many options short of taking insulin injections. More than ever it becomes important to see your physician to properly make the diagnosis and to understand how diabetes is affecting you and to tailor your therapy on an individual basis. CarolinaEast Internal Medicine (CIM) has highly trained internal medicine specialists who do exactly that. Additionally, CIM offers the latest in testing techniques, the ability to handle simple and complex diabetes, insulin pumps, and classes with Certified Diabetic Educators. Referral to an Endocrinologist for highly complex diabetes can easily be made.

More than ever, and because of its prevalence, it becomes important to identify the diabetic patient and get proper treatment. The prevention of serious illness, quality of life and longevity is at stake. Treatments do not need to be invasive or cumbersome and can be tailored to lifestyles. They do need to be interactive with the patient, doctor, and diabetic support personnel for best outcomes. CarolinaEast Internal Medicine, its physicians and staff are prepared and dedicated to provide these best diabetic outcome services to the patients of Eastern North Carolina.