VISTA COMMUNITY CLINIC: Do you know whether or not you have diabetes?

More than 18 million people have diabetes, and more than 5 million don't even know it. Worse, many people with diabetes don't understand their disease or how to manage it.

What is diabetes? In most of us, a hormone called insulin enables glucose to pass from the bloodstream into the cells, where it is used as the body's main form of energy. In a person with diabetes, the body produces either too little insulin, no insulin at all, or the cells are unable to use the insulin that is produced. If that happens, glucose may build up and lead to unhealthy blood sugar levels.

Elevated blood sugar levels can lead to several symptoms, such as frequent urination, unusual thirst, fatigue, unexplained weight loss and blurred vision. Serious complications include heart attack or stroke, permanent damage to the eyes, kidneys, feet, nerves and blood vessels. When the blood becomes increasingly acidic as toxic substances build up in the bloodstream, a potentially fatal condition called ketoacidosis can also develop.

Treatment for diabetes aims to keep the blood glucose levels within the normal range through blood glucose monitoring, diet and exercise, and insulin therapy. Hyperglycemia, or elevated blood sugar levels, can be caused by too much food, too little insulin, illness or stress. The onset is gradual and may progress into a diabetic coma. Symptoms include blood sugar levels above 180mg, hunger, blurred vision, nausea, dry skin, drowsiness, extreme thirst, and frequent urination.

The opposite is also dangerous. Hypoglycemia, or low blood sugar, may be caused by too little food, too much insulin or diabetes medication, or too much physical activity. The onset may be sudden, and can progress to insulin shock. Hypoglycemia can lead to a variety of symptoms, including shaking, rapid heart beat, headache, sweating, impaired vision, anxiety, dizziness, weakness, fatigue, irritability and hunger.

There are two types of diabetes: Type 1 diabetes seems to be caused by a combination of genetic and environmental factors. For unknown reasons, the body's immune system attacks itself, destroying beta cells that are responsible for creating insulin in the pancreas. People with Type 1 diabetes need to take insulin for the rest of their lives or risk slipping into a diabetic coma.

Type 2 diabetes is more common than Type 1. It is closely linked to obesity, and occurs most often in Latinos, Pacific Islanders, blacks, American Indians and Asian Americans. It has also been linked to inactivity, being over 45 years old, and to women who have had gestational diabetes. Gestational diabetes usually disappears after pregnancy; however, women who had gestational diabetes have a 20 to 50 percent chance of later developing Type 2 diabetes.

People with Type 2 diabetes may sometimes require insulin. However diabetes can be managed and controlled with lifestyle modifications, including weight loss, dietary changes, exercise, and oral medications. Exercise plays a critical role in the management of diabetes and heart disease because of the risk for heart attack, stroke and other health conditions brought on by diabetes.

Raquel Aguirre is a diabetes care coordinator at Vista Community Clinic. Call (760) 631-5000 or visit


