Duration Of Suboptimally Controlled Diabetes

Evaluating Risk Factors: Suboptimally Controlled Diabetes

Evaluating your likely current (and near future) state of health means taking into account the risk factors — such as duration of suboptimally controlled diabetes — that affect you.   Our medical diagnosis tool, The Analyst™, identifies major risk factors by asking the right questions.

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If you indicate having diabetes, The Analyst™ will ask further questions including this one:
Suboptimally controlled Diabetes. In total, for approximately how long have your fasting blood-sugar levels remained generally moderately elevated? This would be in the 120-180mg range.
Possible responses:
→ Not applicable / never / don't know
→ Under 4 years
→ 4 to 6 years
→ 7 to 9 years
→ Over 9 years

The Diagnostic Process

Based on your response to this question, which may indicate reasonably controlled diabetes, The Analyst™ will use differential diagnosis to consider possibilities such as:
Alzheimer's Disease

According to a study in Neurology, diabetes mellitus may not only damage the function of the eyes, limbs, kidneys, and heart – it may also impair the function of the brain and hasten the process of senile dementia.

Researchers have found that diabetes mellitus nearly doubles the risk of developing both vascular dementia and Alzheimer's disease, according to a Rotterdam Study that tracked dysglycemia and dementia in over 6,000 individuals over age 55.  Diagnosis of diabetes was based on World Health Organization criteria using a glucose tolerance test.

A related editorial called Alzheimer's a possible "brain-type diabetes." Besides damaging important blood vessel networks and increasing the risk of small "silent" strokes deep inside the brain, dysglycemia may be directly involved in the development of the neurofibrillary tangles, the clumping of nerves and fiber tissue inside the brain characteristic of Alzheimer's.

The researchers noted that advanced glycation endproducts (AGE), proteins damaged by chronically high blood sugar levels, are commonly found inside these tangles.  "In brains of AD patients the receptor for AGE appears overexpressed," they noted.  "Activation of this receptor leads to increased oxidative stress that may result in cellular damage."

Diabetes also disrupts insulin-signaling to other cells in the body.  This altered signaling may increase the activity of a neuronal enzyme that stimulates phosphorylated tau proteins to build up, a key trigger mechanism cited as one of the earliest signs of Alzheimer's.

NOTE: This study strongly suggests the important potential role of glycation products and insulin response, not just glucose levels, as being causes of degenerative disease.

Chronic Renal Insufficiency

Diabetes mellitus is a major cause of chronic renal failure.  In Singapore, statistics have shown that out of the 500 newly diagnosed kidney failure patients each year, 50% were caused by diabetes and 9% were caused by hypertension.  When sugar levels rise enough to spill into the urine, as in diabetes, blood vessels in the kidneys are damaged.  This condition is known as diabetic nephropathy.  Symptoms related to kidney failure usually occur only in late stages of the disease, when kidney function has diminished to less than 25% of normal capacity.  For many years before that point, kidney disease of diabetes exists as a silent process.

Gallbladder Disease

Gallstones may progress more rapidly in patients with diabetes, who tend to suffer worse infections.

Retinopathy

Uncontrolled diabetes can cause retinopathy, a progressive disease that can lead to complete blindness.  The most effective course of prevention and treatment is to control the underlying disease.  If you have diabetes, see your ophthalmologist annually and maintain good control of your blood sugar.

Senile Dementia

Hypertension, diabetes and heart disease are risk factors for reduced circulation in the brain, sometimes called ischemic vascular dementia (IVD).

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