Type ll Diabetes
Vietnam Veterans of America North Dakota
WHAT IS DIABETES?
Diabetes is a metabolic disease in which the
body does not produce or properly use insulin, a hormone that is
needed to convert sugar, starches, and other food into energy needed
for daily life. Diabetes is characterized by high levels of blood
VA presumes that Type 2 Diabetes in veterans
who were exposed to Agent Orange was caused by their military
These veterans may be eligible for disability
compensation and health care benefits for Type 2 Diabetes.
What are the Different Types of Diabetes?
There are three main types
· Type 1 diabetes
· Type 2 diabetes
· Gestational diabetes
Type 1 diabetes, formerly
called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset
diabetes, is an autoimmune disease that results when the body’s
immune system attacks and destroys its own insulin-producing beta
cells in the pancreas. People with type 1 diabetes need daily
injections of insulin to live. Type 1 diabetes develops most often
in children or young adults and accounts for about 5 to 10 percent
of diagnosed diabetes in the United States. Although risk factors
are not well defined for type 1 diabetes, autoimmune, genetic and
environmental factors are involved in its development.
Type 2 diabetes, formerly called non insulin-dependent
diabetes mellitus (NIDDM) or adult-onset diabetes, is a disease that
occurs when the body makes enough insulin but cannot use it
effectively. This form of diabetes usually develops in adults over
the age of 40. About 90 to 95 percent of people with diabetes have
type 2; about 80 percent are overweight. Type 2 diabetes is more
common among people who are older; obese; have a family history of
diabetes; have had gestational diabetes; and are of African
American, Hispanic American, Asian American, Pacific Islander, and
Native American ethnicities.
Gestational diabetes develops or is discovered
during pregnancy. This type usually disappears when the pregnancy is
over, but women who have had gestational diabetes have a greater
risk of developing type 2 diabetes later in their lives.
WHAT IS THE SCOPE AND IMPACT OF DIABETES?
Diabetes is widely recognized as one of the
leading causes of death and disability in the United States. It was
the seventh leading cause of death listed on U.S. death certificates
in 1995 and contributed to 187,800 deaths that same year.
Both type 1 and type 2 diabetes are associated with
long-term complications that threaten life and the quality of life.
Diabetes is the leading cause of adult blindness, end-stage renal
disease, and nontraumatic lower-extremity amputations (as a result
of nerve disease). People with diabetes are 2 to 4 times more likely
to have coronary heart disease and stroke than people without
diabetes. In addition, poorly controlled diabetes can complicate
pregnancy, and birth defects are more common in babies born to women
Diabetes costs the United States $98.2 billion each year. Medical
costs for diabetes care -- including hospitalizations, medical care
and treatment supplies -- total $44.1 billion. Indirect costs --
including disability payments, time lost from work and premature
death -- total $54.1 billion.
HOW IS DIABETES DIAGNOSED?
Symptoms of type 1 diabetes
usually develop over a short period of time, although beta cell
destruction can begin months, even years, earlier. Symptoms include
increased thirst and urination, constant hunger, weight loss,
blurred vision, and extreme fatigue. If not diagnosed and treated
with insulin, a person can lapse into a life-threatening coma.
The symptoms of type 2 diabetes develop gradually and are not as
noticeable as in type 1 diabetes. Symptoms include feeling tired or
ill, frequent urination (especially at night), unusual thirst,
weight loss, blurred vision, frequent infections, and slow-healing
wounds and sores.
In 1997 the Expert Committee on the Diagnosis and Classification of
Diabetes published new guidelines for the diagnosis of diabetes. The
guidelines lowered the blood sugar values for diagnosis and
recommended use of the fasting plasma glucose test to diagnose
diabetes, a simpler and faster test than the commonly used oral
glucose tolerance test. Glucose levels greater than or equal to
126mg/dl with the fasting plasma glucose test, or greater than or
equal to 200 mg/dl with the oral glucose tolerance test indicate a
diagnosis of diabetes.1
HOW IS DIABETES MANAGED?
Diabetes is a self-managed disease because people
with diabetes must take responsibility for their day-to-day care.
Much of the daily care involves keeping blood glucose near normal
levels at all times.
Management of type 1 diabetes: People with type 1 diabetes need
daily injections of insulin because their bodies no longer produce
insulin. Treatment requires a strict regimen that typically includes
a carefully calculated diet, planned physical activity, self-testing
of blood glucose, and multiple daily insulin injections.
Management of type 2 diabetes: Treatment for people with type 2
diabetes typically includes diet management, exercise, self-testing
of blood glucose, and, in some cases, oral medication and/or
insulin. Approximately 40 percent of people with type 2 diabetes
require insulin injections.
The goal of diabetes management is to keep blood glucose levels as
close to a normal range as safely possible, while avoiding blood
glucose levels that are too high (hyperglycemia) or too low (hypoglycemia).
A 1993 study called the Diabetes Control and Complications Trial
(DCCT), conclusively showed that intensive glucose control delayed
the onset and progression of eye disease, kidney disease and nerve
disease by “a range of 35 to more than 70 percent.” In fact, it
demonstrated that any sustained lowering of blood glucose helps,
even if the person has a history of poor control. This study was
conducted by the National Institute of Diabetes and Digestive and
Kidney Diseases of the National Institutes of Health.2
(The above diabetes information acquired from the VA)
For the VA's Diabetes Program,
Visit The United States Department of Veterans