What is Diabetes?
Diabetes is an autoimmune disease that afflicts 30 million people in the United States, about 1.25 million of whom have type 1 diabetes. Type 1 diabetes used to be called juvenile diabetes or childhood diabetes, but recent studies have shown that 50% of people who are diagnosed with type 1 diabetes are over the age of 20. Every year, approximately 40,000 people are diagnosed with type 1 diabetes and this number continues to rise.
You have probably heard of insulin and glucose, but how do they work? After a person eats a meal, food is broken down into glucose (sugar) and nutrients, which are absorbed into the blood stream. This causes sugar levels in the blood to rise, which triggers the pancreas to make the hormone insulin and send it into the bloodstream. In people with diabetes, the body either can’t make or can’t respond to insulin properly. This means the sugar stays in the blood stream instead of getting into cells, where the sugar is used for energy.
Because of this, people with type 1 diabetes take artificial insulin throughout the day to counteract high blood sugars. They take the medicine through multiple doses of insulin every day, either through injections or an insulin pump worn on the body. While these measures are certainly helpful for maintaining a steady blood sugar, they are not a perfect science. There are many variables that go into diabetes management, such as diet, exercise, hormones, stress levels, and countless others.
Another concern for diabetics is low blood sugar or hypoglycemia. Symptoms of hypoglycemia include blurred vision, shaking, sweating, slurred speech, irritability, drowsiness, and acting incoherent or spacey. If the blood sugar is severely low, the person may become unconscious or have a seizure. These low blood sugars put a diabetic in immediate danger.
Unfortunately, there is no cure for diabetes. Each child who is diagnosed with type 1 diabetes will have the disease for the rest of their life, unless we can find a cure. The risk of developing diabetes is higher than virtually all other childhood chronic illnesses. It is estimated that one out of every three babies born today will have diabetes in their lifetime. For this reason, the Barbara Davis Center continues to improve diabetes care and search for a cure for diabetes.
Type 1 diabetes appears suddenly, but the start of the illness can usually be detected with blood tests years prior to onset. In type 1 diabetes, the pancreas ceases to manufacture insulin, a hormone essential for our bodies to convert the food we eat into energy. People with type 1 diabetes MUST take multiple daily injections of insulin just to stay alive. But insulin is not a cure.
In type 2 diabetes, the pancreas is still able to manufacture insulin and treatment usually consists of oral medications and a strict diet.
Symptoms of type 1 diabetes include:
- Frequent urination
- Excessive thirst
- Excessive irritability
- Extreme hunger accompanied by weight loss
- Nausea and vomiting
- Weakness and fatigue
Symptoms of type 2 diabetes include any of those listed above and/or:
- Tingling or numbness in hands or feet
- Recurring or hard-to-heal skin, gum or bladder infections
- Blurred vision
- Itching
General
- Approximately 415 million people around the world have diabetes
- Diabetes affects about 30 million Americans, 1.25 million of which have type 1 diabetes
- One in three babies born today will have diabetes in their lifetime
- The rate of diabetes is increasing 3 to 5% annually
- 50% of people diagnosed with type 1 diabetes are over the age of 18 (particularly interesting when you consider that the disease used to be called childhood diabetes)
- Each year, approximately 50,000 Americans are diagnosed with type 1 diabetes. Of those, 25,000 are children. This means 70 children each and every day are diagnosed with diabetes. That is one child every 20 minutes.
Complications
- Adults with diabetes have 2 to 3 times increased risk of heart attack and stroke
- 2.6% of global blindness is attributed to diabetes
- Up to 24,000 Americans lose their sight to diabetes every year
- Over 80,000 amputations are performed each year on people with diabetes.
Barbara Davis Center (BDC) Statistics
- 40% of BDC patients are uninsured or underinsured
- About 70% of BDC patients use an insulin pump
- Research at the BDC costs about $1,000 per hour for expert staff and state-of-the-art equipment
- $75,000 will support a post-doctoral fellow for 1 year for clinical care or research
- $100,000 is needed to establish a new, groundbreaking research project for 1 year
- The Barbara Davis Center has more patients on automated insulin delivery systems (hybrid closed loops) than any other clinic in the US
- Without insurance, diabetes can cost up to $20,000 per year
- When first diagnosed, start-up education and appointment fees total $1,400
- Insulin can cost $300 per month for a child and $600 per month for adults
- A hospital stay for Diabetic Ketoacidosis can cost $10,000 or more
- Getting an insulin pump costs about $6,500, but the monthly supplies for the insulin pump can cost up to $1,200
- A type 1 needs to test their blood sugar 4 to 10 times a day. This requires test strips, which can cost up to $70 per week
- Without insurance, getting the hybrid closed loop system (commonly known as the artificial pancreas) can cost up to $10,000
- Glucagon kits can save a life if a type 1 has extreme low blood sugars. These kits cost $300 and need to be replaced every 12 months
- To get a CGM to get constant blood sugar readings throughout the day, you must get a $700 receiver and $700 worth of start up supplies. After that, $500 covers only 3 months of CGM supplies
Diabetes mercilessly damages almost every major organ in the body. Complications can include blindness, kidney failure, heart disease, stroke, amputation, loss of nerve sensation, early tooth loss, high-risk pregnancies and birth defects.
Retinopathy:
Up to 24,000 Americans lose their sight every year due to diabetes.
Nephropathy:
Each year over 42,000 Americans begin treatment for end-stage renal disease.
Arteriosclerosis:
Diabetes can cause arteriosclerosis, which leads to heart disease, gangrene, and loss of extremities and loss of nerve sensation. Heart disease is the leading cause of death in people with diabetes and the risk of stroke is 2-4 times higher for diabetics.
Neuropathy:
Diabetic neuropathy leads to severe pain or loss of sensation to extremities. Intestinal problems may also occur. Over 80,000 amputations are performed each year on people with diabetes.
The walls of blood vessels are the site of wear and tear from high blood sugars. Because the eye is the only organ where we can see the blood vessels of the body, it is often the first site to show changes from diabetes (diabetic retinopathy). Diabetic retinopathy has been the leading cause of preventable vision loss in the United States for decades and is common after 15-20 years of diabetes.
The mission of the Barbara Davis Center Eye Clinic/Sandy and Elaine Wolf Screening Wing is to prevent vision loss through accurate and timely detection of diabetic retinopathy. An equally important mission of the clinic is to prevent occurrence and progression of this vision-threatening process by way of thorough patient education. We firmly believe that thoroughly educating our patients will provide knowledge that promotes self-empowerment and the will to make sound decisions regarding their diabetes care.
Dr. Brian Bucca has been dedicated to the field of diabetes for over a decade. His research interests include investigation of unique risk factors and biomarkers for diabetic retinopathy. He has directed the BDC Eye Clinic since July 2007 and provides eye care to patients from the Pediatric and Adult clinics. Additional clinic services include evaluations for: glasses prescriptions, double vision, eye irritations, infections and injuries. Walk-in and same-day appointments are welcome. Make an appointment in person or by calling 303-724-6735.
