The Silent Killer

New research and guidelines detect Type 2 diabetes
in a much larger population.

Diabetic
Retinopathy

Diabetes can affect vision by caus-
ing cataracts, glaucoma and dam-
age to blood vessels inside the eye.
Diabetic retinopathy is a com-
plication of diabetes caused by
changes in the blood vessels of the
eye. The retina is a nerve layer at
the back of the eye that senses
light and helps send images to the
brain. When blood vessels in the
retina are damaged, they may leak
fluid or blood and grow fragile,
brushlike branches and scar tissue.
This can blur or distort the images
that the retina sends to the brain.
Diabetic retinopathy is the lead-
ing cause of new blindness among
adults. People with untreated dia-
betes are 25 times more at risk
than the general population. The
longer a person has diabetes, the
more the risk of developing diabet
is retinopathy increases.

Jack Adelman's ears are checked by Dr. Solomon Rosenblatt during a routine exam.

RUTHAN BRODSKY

Special to The Jewish News

S

ixteen million Americans suf-
fer from diabetes and half of
them don't know it. Indeed,
next to hypertension, diabetes
is the disease family physicians are
most likely to encounter in patients
over age 40.
Jack Adelman of Farmington Hills
never felt sick when he was diagnosed
as having diabetic mellitus.
"I was close to my 60th birthday
and found myself craving sweets and
running to the bathroom frequently.
My internist reported that my blood

sugar was high and I started to watch
what I was eating. About seven years
ago, when diet alone couldn't control
the elevated blood sugar, I started tak-
ing oral medication and today I'm
working with a combination of med-
ications. I've eliminated desserts and
sweets and I exercise regularly. As a
result I lost 20-plus pounds, which is
saying a lot because I was the world's
biggest nosher. I've become very disci-
plined about my diet and exercise
because, no matter the medication,
that's a major factor keeping my dia-
betes under control."
Last July, the new guidelines for the
diagnosis and classification of diabetes

mellitus were published and, among
other things, they included more fre-
quent testing. Blood sugar levels previ-
ously considered normal now call for a
diagnosis of diabetes.
As a result, another two million
cases will be detected of this country's
leading cause for blindness, kidney
failure, and foot and leg amputation.
Diabetes also was connected with
close to 200,000 deaths in 1997.
Diabetic symptoms develop gradu-
ally and in the beginning are difficult
to identify. Early diagnosis is impor-
tant because the longer diabetes goes
untreated, the greater the risk of com-
plications.

Until six months ago, the threshold
for a diabetic diagnosis was 140 mil-
ligrams of sugar (per deciliter of
blood) after an eight-hour fast. Now
the American Diabetes Association
says a fasting blood sugar or glucose
level of 140 may mean that a lot of
damage has already been done — even
if the person doesn't show any out-
ward signs. The new, lower threshold
is 126.
"Type 2 diabetes mellitus, the more
common form of the disease, is often
called the silent killer because many
with high blood glucose levels don't
have major symptoms and the condi-
tion goes unrecognized," says Dr.

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