Vol. 15, No. 3, Spring 2002

Medical Focus: Diabetes

Ruth Dubin

What is diabetes? If you have diabetes, your body cannot control the sugar level in your bloodstream. If you are overweight and have diabetes, your blood sugar is likely to be too high most of the time.

Why do I have to watch what I eat? All foods are broken down into sugar, but proteins, for instance, are broken down more slowly and do not raise your blood sugar as much as sugar or fats do. Proteins (meats, nuts, beans, low-fat dairy) and vegetables are therefore better to eat than high-sugar foods like soda, sweets, juice, and high-fat fast foods.

What does it mean if my blood sugar is over 200? And what does the doctor mean by "A1c?" Over 200 means that your level of blood sugar is high! Eventually this extra sugar attaches itself to molecules in your body. You might compare this to dust coating the smallest objects in a room that has not been cleaned in a long time. A1c is a protein in the bloodstream that has been changed by the attachment of sugar; if your A1c is high, this means your blood sugar has been high for a long time. Sugar also attaches itself to molecules that form the lining of your blood vessels. The end result: the inside of small blood vessels starts to become less flexible; eventually, the smallest blood vessels close off or bleed. When this happens in your leg, you may lose sensation, rub your feet the wrong way, and end up with sores. This is why foot care is important for diabetics. In your eyes, damage to small blood vessels makes your eyesight blurry. If you are diabetic, you should get your eyes checked routinely. Damage to small vessels in your kidneys makes you lose sugar and protein in your urine, and, eventually, if your kidneys are damaged too much, you need to go on dialysis.

What is high cholesterol? This means that you have high lipids, or fats, in your blood stream. High blood lipids, high blood sugar, and high blood pressure increase your risk of having a heart attack.

When should I get tested for diabetes? While diabetes used to affect only older people, younger people are now being diagnosed, especially among Native Americans. The Healthy Traditions Diabetes Program will test any person in their teens or early twenties who has a Body Mass Index of 20 to 30 percent more than average (a measure of being overweight) and who has one or more family members with the disease.