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Thursday, December 27, 2007

For Context: Diabetic Basics

In order for the remaining post or two on corporate diabetes issues to make sense, we need to cover some fundamentals to provide context for non-diabetics or those newly diagnosed .

Diabetes is a condition whereby the body fails to process blood sugar properly, resulting either in abnormally high (hyperglycemia) or low (hypoglycemia) blood sugar levels in the body. The World Health Organization categorizes all diabetes into three types: Type 1, Type 2, and Gestational. You might best remember Type 1 as genetically caused and most commonly associated with people who have required insulin since childhood. Gestational diabetes is typically temporary, associated with pregnancies in some women, and generally resolves itself after delivery. For purposes of our discussion we'll be concentrating on Type 2, also commonly known as Adult Onset Diabetes.

Depending upon which health organization's data you believe, there are between 18 -21 million Type 2 Diabetics in the U.S. I am one of those. For years this disease was also referred to as Obesity Diabetes as those with it are typically overweight. More recent studies indicate that the disease itself my cause obesity, so this label is now more rare. Type 2 diabetes is usually diagnosed in adults from early middle age or older, and is defined by a fasting blood sugar >126 mg/dl and two-hour post-meal blood sugar of >200 mg/dl.

In Type 2 diabetics, the receptors in the pancreas that accept and process sugar from the blood stream fail to open or otherwise reject the sugars. Since sugar enters the blood stream during digestion, and most foods contain some amount of sugar, the level of sugar in the blood increases to an unhealthy level. Imagine leaves in a swimming pool when the skimmer stops working; after a time, you don't want to swim there. Its the same principle.

An overabundance of sugar in the blood stream has both immediate and long-term negative impacts on the body. In the short term, high blood sugar causes various symptoms such as headache, blurred vision, loss of cohesion, etc... The real damage, however, is in the longer term. The cardiovascular system, especially the smallest blood vessels, are damaged over time from high levels of blood glucose. The ultimate fate of untreated or uncontrolled diabetes include permanent vision loss from blood vessel damage in the back of the eye, loss of extremities such as feet and legs from poor circulation, heart disease, stroke, and from some combination of these, death. While that all sounds like really morbid, the good news is that this disease is imminently controllable and can even be reversed up to a certain stage.

So how do you control it? Aside from medication, exercise causes the receptors in the pancreas to open and thus process blood glucose. It is also critical to control how much sugar you take in, through limiting sweet foods, breads, pastas, rice, potatoes, or any other type of starchy food. This is a vital point for anyone planning corporate meals or breaks; starches metabolize into sugar when they are digested. Any lunch or break that includes all breads, fruits, cereals, pasta salads, etc... leaves nothing we can eat that doesn't raise blood sugar.

So the good news is that the three-pronged approach of medication, diet, and exercise slows or stops the progression of the disease. Starting next time we'll examine how work requirements such as schedules (and people who won't respect yours), meeting planning, corporate meal planning, and work-life balance can help or totally inhibit controlling your glucose.

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