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Odds are high in South Carolina that, at this very moment, one of your friends or family members is living with a serious disease – and doesn’t even know it.
At last count, nearly 560,000 people (or 13.5 percent of the Palmetto State’s adult population) had been diagnosed with diabetes. Another 34.9 percent of South Carolina’s adult population had been diagnosed with pre-diabetes.
As high as those figures are, the key word in each sentence is “diagnosed” – meaning these are just the cases we know about. The actual number is likely much higher, with another 120,000 adult South Carolinians estimated to be living with the disease and yet “unaware” of it, according to Diabetes Free SC.
“Diabetes is often an asymptomatic disease until it becomes pretty severe; people can go years without knowing they have it,” said Anthony Schwab, MD, an internal medicine physician with the Columbia Medical Group. “It doesn’t really have a lot of significant symptoms like some other diseases do.”
Dr. Schwab sees the impact of this hidden killer every day at his practice – which is part of the care network at Lexington Medical Center, an award-winning Midlands-area hospital system.
“It may be something where people just have to go pee a little bit more than normal – or are a little bit more thirsty than normal,” Dr. Schwab said. “People will usually chalk that up to the heat or they’ll say ‘I’ve just been drinking more water, so I’m peeing more.’ It can be very subtle. So the actual number is probably higher.”
November is Diabetes Awareness Month, making this the ideal time to take a closer look at this serious disease.
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The numbers associated with this epidemic are truly staggering. Diabetes is the seventh-leading cause of death in South Carolina, and it disproportionately impacts black patients - who are 2.3 times more likely to die from it than whites. One in every ten emergency room visits in our state is diabetes related. While cost estimates are dated, as of 2017 total direct medical expenses related to diabetes topped $4.3 billion annually. Another $1.6 billion in losses were attributed to missed work, according to data (.pdf) from the American Diabetes Association (ADA).
Regardless of which measurement you use - loss of life, physical suffering or financial impact - diabetes is wreaking havoc across our state.
Here’s the saddest part of this story: In many cases, these pernicious impacts are either preventable or treatable. First, though, let’s start with the basics. Let’s consider what’s happening inside the body when diabetes goes undiagnosed.
“Two different processes are going on most of the time,” said Dr. Schwab. “First, your body is usually just not able to produce enough of a hormone called insulin, which helps regulate your blood sugar. And then your body just doesn't respond as well to the insulin anymore, either. That’s because you've probably had high sugar levels in your blood for so long. It's almost desensitized to it.”
As diabetes slowly worsens, the damage it causes within the body increases.
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"Over time, diabetes damages the blood vessels - and you see that come up in the form of heart disease, kidney disease and other serious conditions," Dr. Schwab said. "Diabetes is the leading cause of kidney failure along with contributions from hypertension. It can also cause issues with blood pressure because of the damage to the blood vessels. It puts you at risk for strokes as well as blindness because it also affects your eyes."
While these symptoms are noticeable once they hit, the key to effective treatment is noticing them before they hit - before they can cause irreversible damage or death.
"Diabetes does a lot of damage silently, which is why people need to get screened early," Dr. Schwab added. "The earlier we catch it, the better we can prevent these problems from occurring down the line.”
Age and obesity can also factor into someone developing diabetes - and heredity plays an extremely important role, too.
“If you have a strong family history of it, even if you have a very healthy lifestyle you're still at an increased risk of developing it later in life," Dr. Schwab warned. "It’s a process that happens over time, where your body is just not able to produce enough insulin and then it develops that resistance. So that happens at different rates for different people. And that often has to do with genetic predisposition, but it's also pretty heavily tied to lifestyle as well.”
For those with diabetes, the combination of newer medications - and healthier choices - can work wonders.
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“I've seen people prevent the development of diabetes with lifestyle changes as well,” Dr. Schwab said. “Everybody associates diabetes with eating ice cream or candy or sodas or sweet teas. But a lot of times, it involves eating things that you don't think about - like bread, rice, pasta, and very carb-heavy foods that aren’t sweet."
Being prescribed the proper medication is also critical to tackling the disease.
“An oral medication, like metformin, is very helpful in treatment," Dr. Schwab said. "It’s probably the most common one. It's just a pill you take once or twice a day and it helps with the insulin resistance part and helps control those blood sugars."
While medicines are helpful, Dr. Schwab emphasized the biggest thing people can do is make those lifestyle changes - including increasing their daily physical activity.
"Being active - even if it's just walking for 20 to 30 minutes a day - starting small helps," he said. "And then making those dietary changes where you don't have to get rid of everything, but you do have to cut back. It's kind of that 'everything-in-moderation' approach. Those are all things that can help prevent diabetes.”
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ABOUT THE AUTHOR ...
J. Mark Powell is an award-winning former TV journalist, government communications veteran, and a political consultant. He is also an author and an avid Civil War enthusiast. Got a tip or a story idea for Mark? Email him at mark@fitsnews.com.
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3 comments
If you’re a fatass, you either have it or about to get it. Start putting odds on which toes go first.
This is an important story, so it’s too bad there’s no distinction made between Type 1 Diabetes and Tyoe 2 Diabetes. I’ve been a Type 1 diabetic for more than 50 years. Everything in the story applies to Type 2, sometimes nicknamed “lifestyle diabetes.” Importantly, you can’t prevent Type 1 and you can’t make it go away with lifestyle changes. Here’s an AI generated comparison of the two types, to set the record straight.
Type 1 diabetes and Type 2 diabetes are two distinct forms of diabetes that differ in their causes, symptoms, treatment, and management. Here’s a comparison of the two:
### Type 1 Diabetes:
– **Nature**: An autoimmune condition.
– **Onset**: Typically diagnosed in children and young adults, though it can occur at any age.
– **Cause**: The immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas.
– **Insulin Production**: Little to no insulin is produced.
– **Symptoms**: Rapid onset of symptoms such as excessive thirst, frequent urination, weight loss, fatigue, and blurred vision.
– **Management**: Requires lifelong insulin therapy (injections or an insulin pump), along with blood sugar monitoring, diet, and exercise management.
– **Prevention**: Currently, there is no known preventive measure for Type 1 diabetes.
### Type 2 Diabetes:
– **Nature**: A metabolic disorder.
– **Onset**: More commonly diagnosed in adults, but increasingly seen in children and adolescents due to rising obesity rates.
– **Cause**: The body becomes resistant to insulin or the pancreas does not produce enough insulin.
– **Insulin Production**: Insulin is produced, but not effectively utilized by the body’s cells.
– **Symptoms**: Symptoms develop gradually and may include increased thirst, frequent urination, hunger, fatigue, and blurred vision.
– **Management**: Often managed through lifestyle changes (diet, exercise), oral medications, and sometimes insulin therapy.
– **Prevention**: Can often be prevented or delayed through lifestyle changes such as maintaining a healthy weight, regular physical activity, and a balanced diet.
### Summary:
While both types of diabetes involve issues with insulin and blood sugar regulation, their underlying causes, demographics, and management strategies differ significantly. Understanding these differences is crucial for effective treatment and management of the disease.
You make the argument and points that so few seem to make. I can say from your statement that you have taken a clear and meticulous course for your life with type 1. I have a friend with type 1 they told him as a kid he probably would only live to 25. He is 70 and has taken extremely good care of his body but when he gets sick he typically ends up in the hospital. Type1 is your life dependent on insulin shots, etc. Type 2 can be controlled and managed or even eliminated by your lifestyle and diet choices. Mass media and others wont say what you have stated so clearly. I have another friend that passed at age 36 from heart failure because she did not take care of her type 1 the way she should have. I watched a forum the other day with Senator Mia Mcloud. It seemed they want govt to take over and help people with type 2. I understand there are in certain cases things that can’t be helped. But basic choices like food and exercise and good healthy decisions are always on the individual for type 2. I wish people would understand that.