Diabetes - High Blood Sugar

General Information

Most people are familiar with diabetes as a sugar disorder. The body lacks enough of the hormone insulin to fully use sugar in the diet. However, this is only one aspect of the disease. Diabetes is also a major cause of problems with blood vessels. These blood vessel changes often affect the kidneys. Diabetes is a cause of disease of the nerves as well.

There are several different types of diabetes. Adult-onset diabetes occurs with increased frequency in elderly patients. Many theories exist to explain the occurrence of this form of diabetes, but none is fully satisfactory. Resistance to the effect of insulin develops in the cells of the body, causing the abnormality in the metabolism of sugar. A tendency for the development of diabetes is inheritable.

Patients with adult-onset diabetes (called type 2 diabetes mellitus by physicians) require insulin in their treatment and usually do not suffer the danger of diabetic coma. These patients have elevated blood sugar levels and pass abnormal amounts of sugar in their urine. This causes increased urination and, in turn, necessitates an increase in fluid intake. Patients with diabetes show an increased susceptibility to some kinds of infections as well. With the loss of sugar in the urine, there may be some weight loss. It is not uncommon for adult-onset diabetes to develop in patients who are overweight and for partial normalization of sugar metabolism to occur with weight reduction.

The common reason for diagnosis of diabetes is the finding of an abnormal blood sugar level at the time of a checkup. In a few people, the development of an infection, changes in the blood vessels, or neurologic changes prompt the search for diabetes. It is possible for diabetes to remain silent until a complication occurs.

Important Points in Treatment
Treatment is directed toward the normalization of the blood sugar level. A weight-loss program to reach an ideal weight and careful control of the daily intake of sugar and sugar derivatives are the mainstays of treatment. Weight control and diet precede the need for drugs in many people. A target weight and the diet that is necessary to achieve that weight and maintain it are determined for each patient. Regular daily exercise is a part of the program of weight control.

If weight loss and diet prove ineffective in getting control over blood sugar levels, patients begin treatment with a drug to lower the blood sugar. Many oral agents as well as injected insulin are used. The therapy to be used is determined for each patient. Normal blood sugar levels slow the development of vascular and neurologic complications of diabetes and help restore energy.

Patients with diabetes need to take unusual care to prevent infections and need to undertake vigorous early treatment to prevent complications. Regular checkups of kidney function and vision are important to lessen the impact of complications that involve the kidneys and eyes.

Complications
Overtreatment with drugs can lead to abnormally low blood sugar levels, or hypoglycemia. Hypoglycemia can cause abnormal behavior and fainting. Treatment includes the administration of sugar to restore the blood sugar level quickly. Next, a careful analysis by your physician is necessary to determine what circumstances caused the low blood sugar to develop and whether a change in your treatment regimen is needed.

Notify Our Office If ...

• You have increased thirst, increased urination, and increased appetite. Diabetes in elderly patients may remain unsuspected for long periods. Occasionally, it may come to attention only after the development of a complication.