November 23, 2005

What if someone could predict your future?

By Eduardo Grunvald, M.D.

What if they could give you a heads-up to take a certain action that would prevent you from losing your life savings or your home? Wouldn’t you act?

Sure you would. When it comes to financial security, most people turn on a dime to protect assets.

So why do they ignore their most precious asset.their health?

Sadly, most people do not prioritize their health as they do their finances.

Diabetes, a disease affecting approximately 25 percent of Mexican-Americans above the age of 45, can be detected and treated before it threatens a person’s future health.

To better explain this, one must understand what happens from a simple medical standpoint.

Glucose, or blood sugar, fuels all the cells in the body and keeps them functioning normally. The body must maintain the level of sugar in the blood within a certain range. Normally this happens through a hormone called insulin, which is made by the pancreas. If the blood sugar rises rapidly, for example after eating a large serving of rice, bread, or pasta — high carbohydrate foods that turn into blood sugar in the bloodstream — insulin is sent by the pancreas to push sugar into the tissues and cells, thereby lowering it.  In contrast, if the sugar drops too low, the pancreas turns off insulin, and sugar levels go back up.

Diabetes develops when there is a problem with insulin. If the pancreas cannot make insulin, sugar levels stay up. This is called Type 1 diabetes.

If there is plenty of insulin but the tissues (like muscles, fat cells, and the liver) cannot sense it properly, sugar will also be elevated because it will not be transferred from the blood to the cells. This is known as Type 2 diabetes. That is why people with Type 1 diabetes have to give themselves insulin shots, and people with Type 2 generally treat it with diet and/or medicines that help the insulin work more efficiently.

Type 2 diabetes accounts for approximately 90 percent of all diabetes cases in the United States. This type usually strikes adults and people with a family history of the disease, has a higher incidence in overweight people and is more common in Hispanics.

So why is it dangerous to have high blood sugar?  If the blood sugar goes up too high and too rapidly it can become a serious life-threatening emergency.

But people should be concerned most with what high sugar levels do to the body over time. First of all, it damages small blood vessels, resulting in blindness, kidney failure, nerve damage and ulcers of the feet. In fact, diabetes is the leading cause of kidney failure and new cases of blindness in the United States.

Secondly, there is damage to large blood vessels, raising the risk of heart attacks, strokes and poor circulation.

Thirdly, high blood sugars are bad for the immune system, putting the body at higher risk for infections.

Fortunately, a simple blood test can detect diabetes. Sadly however, not enough people are tested because they do not have symptoms and do not realize they are candidates for the disease.

Usually diabetes does not cause symptoms until it has been present in the body for a long time. It does not happen from one day to the next, and in fact there can be a long period of time of “pre-diabetes,” which can also be detected by blood tests.

Symptoms of diabetes include increased thirst, increased urination, blurry vision, fatigue, weight loss and dizziness.

For all these reasons, it is very important to see a doctor periodically, especially if you have family members with the disease.

But patients often ask, “Why should I see a doctor or take medicine if I feel well?”  The answer is simple: to find a silent killer before its symptoms strike, and to take control of your future by making positive lifestyle changes. Exercising regularly, dropping weight and making healthier food choices can be hard but not impossible.  In fact, once we adopt a healthier life rhythm the results are so positive that it spurs us on.

Your doctor can be a great lifestyle improvement coach, and can refer you to a nutrition specialist, if necessary, for even more recommendations to lower your blood sugar.

If you do not have insurance or do not think you can afford to see a doctor, there are many community clinics in our region that have all the necessary resources to screen, diagnose, and treat diabetes at a very low cost, or even for free.

To find a clinic near you, visit, or call 1-800-640-1662. For more information on diabetes, available in English and Spanish, go to, or call 1-800-DIABETES (1-800-342-2383). The earlier you detect diabetes, or recognize your risk for the disease, the earlier you can take action to protect the length and quality of your life.

Investing today in a healthier you will pay off in many more tomorrows.

Dr. Grunvald, M.D. is Assistant Clinical Professor, Department of Medicine at the Perlman Internal Medicine Group, UCSD Medical Center.

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