WASHINGTON — An estimated 5 million people in the United States have diabetes and don`t know it.
This is a milder form of the disease than the type that requires daily insulin injections, but its complications eventually can be just as serious, leading to heart disease, nerve and blood vessel damage, kidney failure and blindness.
Dr. Harold E. Lebovitz of the State University of New York`s Downstate Medical Center says the mild form of diabetes, called type 2, or noninsulin-dependent, diabetes, may go on for years without symptoms or with only mild ones that the individual either ignores or blames on aging.
Diabetes is a complex disorder in which the body is unable to convert sugars and starches in food into energy for everyday activities. The hormone insulin is required for this process, and in someone with diabetes the body either doesn`t produce enough insulin or doesn`t use it properly.
PEOPLE WITH type 2 diabetes usually have enough insulin, but their bodies can`t use it properly to handle the sugars and starches, causing sugar levels in the blood to rise. This sugar, or glucose, overflows into the urine.
Type 1 diabetes usually strikes early in life, and is often called juvenile diabetes. At least 500,000 Americans have this kind of diabetes, and must take insulin injections daily to stay alive.
Much more common is type 2 diabetes. The American Diabetes Association estimates more than 10 million Americans have this kind of diabetes with half unaware of it.
Lebovitz, writing in the medical magazine Drug Therapy, said type 2 diabetes develops in older people, particularly those who are obese.
He calls the milder form of diabetes a disease of civilization, a consequence of changing cultural, social and nutritional patterns.
ACCORDING TO Dr. Saul M. Genuth of the Mt. Sinai Medical Center in Cleveland, a body weight of more than 150 percent the ideal weight has been associated with a two- to six-fold increase in the risk of diabetes. He said one long-term study found that markedly overweight people had a risk 12 times higher than normal of developing the disease.
Lebovitz said the mainstays of treatment for type 2 diabetes are diet and exercise. He said there is no doubt that type 2 diabetes must be treated.
``Restoration of the blood glucose to or toward normal not only relieves any symptoms but also is likely to prevent or greatly retard the development of chronic complications,`` he said.
Doctors John Devlin and Edward Horton of the University of Vermont College of Medicine said in the same magazine that the idea that people with type 2 diabetes should avoid sugars has not been supported by recent studies. ``Thus, it is more important for the obese diabetic to focus his or her efforts on restricting total calories rather than following the mistaken notion that avoiding sugar is therapeutic,`` they said.
THEY SAID several studies have demonstrated that the addition of plant fiber to the diet helps, such as whole grains, fruits and vegetables, especially peas and beans.
Devlin and Horton said exercise also is useful in treating type 2 diabetes because it appears to decrease the body`s resistance to using insulin.
According to the American Diabetes Association, warning signs of type 2 diabetes include:
-- Frequent urination accompanied by unusual thirst and excessive drinking of fluids.
-- Rapid weight loss with easy tiring, weakness, irritability and nausea. -- Extreme hunger.
-- Blurred vision or any change in sight.
-- Tingling or numbness in legs, feet or fingers.
-- Frequent skin infections or itchy skin.
-- Slow healing of cuts and bruises.