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It is important that research on the treatment of diabetes is progressing at a rapid pace. According to the American Diabetes Association, over 18 million people in the United States (or 6.3 percent of the population and probably many more) have diabetes, but at least one-third of them are unaware they have the disease. Diabetes is a leading cause of death in the United States and also a major factor in a range of other disabling conditions.

Christine McLaughlin, M.D., specialist in endocrinology at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, says, “Diabetes is a disease that is worthwhile detecting early and controlling aggressively to help prevent its many complications.”

There are two major types of diabetes, a disease characterized by high levels of blood sugar because of problems with insulin production and resistance to insulin. Insulin regulates the body’s processing of blood sugars or glucose. Type 1 Diabetes generally occurs in young people under the age of 30 and involves the immune system actually attacking the cells that make insulin. Eventually the cells are destroyed and unable to make insulin, which results in an abrupt onset of high blood sugars and its associated symptoms.

Type 2 Diabetes develops more gradually and is a result of resistance to insulin, as well as a decrease in the production of insulin. It usually occurs in people over 40 years old, but Dr. McLaughlin points out that it is now sometimes occurring in much younger age groups mainly because of the epidemic of obesity in younger people today. With Type 2 Diabetes, insulin may be initially overproduced; however, with time this chronic stress on the insulin-producing cells results in decreased production of insulin. Both types of diabetes have similar symptoms, including excessive thirst, excessive urination, weight loss, fatigue, and blurred vision, although in its early stages, there may be no symptoms at all.

Many people with Type 2 Diabetes have a genetic predisposition to it, although obesity is also a major risk factor. Other risk factors include women who have had diabetes during pregnancy, who have had large babies over nine pounds, or who have polycystic ovary syndrome. Certain ethnic groups, including Asians, African Americans, Hispanics. Native Americans, Asian Americans and Pacific Islanders are also at greater risk for developing diabetes. Doctors don’t usually screen patients for diabetes before the age of 45, unless they belong to a high risk group or are pregnant over the age of 35.

Dr. McLaughlin says, “Diabetes is a major concern because of the chronic complications associated with the disease.” Diabetes can accelerate the development of cardiovascular disease, and can increase the risk of strokes. Diabetes is also the leading cause of kidney failure and blindness, and frequently leads to lower-limb amputations because of diabetic nerve disease. Many diabetics die prematurely, often from cardiovascular disease.

“Lifestyle changes are the cornerstone of treatment for diabetes and can have a major effect on slowing the progress of the disease, as well as preventing complications,” says Dr. McLaughlin. Getting your weight down, even modestly, and establishing a regular exercise program can make a difference and can also reduce the risk of cardiovascular disease. Many patients will also require oral medications and insulin to maintain good control of blood sugars. The oral medications used to treat diabetes as well as newer insulins are becoming more sophisticated. There are many exciting therapeutic developments on the forefront, including the recent FDA approval of inhaled insulin.

Diabetes is a progressive disease and, while lifestyle changes and medications can significantly slow its progress, it is still likely to progress with time as a person ages. Dr. McLaughlin emphasizes, “Diabetes used to be a disease of old age. Unfortunately, it is appearing at younger ages in our country because of our sedentary lifestyles and the increase in obesity.”

Dr. McLaughlin continues, “The good news about diabetes, however, is that there is much research being done in the field, which has opened doors to our understanding of the link between heart disease, diabetes, and obesity. I believe that in the next ten or twenty years, we will have much more effective treatments and possibly a cure. Today there is every reason to be hopeful because there is so much that can be done to delay the onset and prevent the complications of diabetes.”

For a free Mount Auburn Hospital 2005 physician directory, please call us at 617-499-5094.