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Recognizing that diabetes has become a common, life-threatening, and costly disease, the Vermont Department of Health began a diabetes control program in October 1996, with funding from the Centers for Disease Control & Prevention.
In September 1997, the Health Department called together about 70 health care professionals, advocates, health officials and people with diabetes to form the first statewide coalition on diabetes (now called the Diabetes Awareness Wellness Network, or DAWN), and to begin work on a diabetes control plan for the state. Diabetes is a disease that contributes significantly to death and disability among Vermonters.
An estimated 28,000 Vermonters suffer from diabetes, about one-third of whom have not yet been diagnosed. Diabetes mellitus is a group of diseases characterized by high levels of blood glucose ("sugar") resulting from defects in insulin secretion, insulin action or both. Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes.
Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Gestational diabetes develops in 2 to 5 percent of all pregnancies, but disappears when the pregnancy is over.
Other specific types of diabetes result from specific genetic syndromes, surgery, medications, malnutrition, infections and other illnesses. Adults with diabetes have heart disease death rates about two to four times as high as those of adults without diabetes. Diabetes is the leading cause of end-stage kidney disease, accounting for about 40 percent of new cases. About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. Periodontal disease (a type of gum disease that can lead to tooth loss) occurs with greater frequency and severity among people with diabetes.
Between 3 to 5 percent of pregnancies among women with diabetes result in death of the newborn. Much of the health and economic burden of diabetes-related complications can be averted through known prevention and treatment measures. Training the person with diabetes in self-care management is integral to the treatment of diabetes. Treatment of Type 1 requires a strict regimen that typically includes diet control, exercise, home blood glucose testing several times a day, and multiple daily insulin injections. A national survey shows that only 8 percent of Americans consider diabetes a serious disease. Raise public awareness about the risk factors for diabetes and the need for regular preventive health care visits (including screening when appropriate).
Raise public awareness about the complications of diabetes and the role that a healthy lifestyle, screening and diagnosis, education, treatment and support services play in controlling the disease.
Objective: Develop a "model" structure for support groups, including a checklist of needed informational materials, supplies, etc. Objective:Increase the availability and the number of resources and activities for people with diabetes, their families and other interested parties. Ensure that families, friends and community members have the information they need to support and assist people with diabetes in achieving their self-care management goals. Objective: Gather and assess current information, materials and resources that are available.
Ensure full implementation of the Americans with Disabilities Act and other such legislation or policy in Vermont which affects people with diabetes in various settings (school, employment, health care, etc.). Objective: Promote a better understanding of the various laws and policies and how they relate to people with diabetes. Recent state legislation (8 VSA §4089c) improved health insurance coverage for equipment, supplies, outpatient education and self-management training.
Ensure that all Vermonters with diabetes have access to quality services, equipment and supplies.
Objective: Publish and distribute a resource directory, which includes resources appropriate for diverse cultures and languages. Provide training and technical assistance for health care professionals to ensure that appropriate care is available to all Vermonters with diabetes. Objective: Identify current training programs that are available to health care professionals, including physicians, nurses, diabetes educators, dietitians, pharmacists, optometrists, podiatrists, etc. Objective: Develop innovative, alternative methods of providing training to a wider range of health professionals. Consider the development of policies that maximize access to comprehensive services, equipment and supplies. Objective: Establish a policy group (including representation from minority and special populations) to examine existing policies or practices and identify barriers to access.

Patient education can translate to improved self-care management skills (self-monitoring of blood glucose, diet control, etc.) and a reduction in the occurrence and progression of diabetic complications.
Enhance the availability of standardized and current patient information, materials and programs. Objective: Identify the special patient education needs of people with Type1 and Type 2 diabetes. Objective: Develop and distribute culturally appropriate information and strategies to meet the identified needs. Objective: Identify and assess existing support groups throughout the state and develop recommendations for patient self-care management. Objective: Develop a Vermont diabetes web site and encourage and support the development of information resource centers at medical facilities and local Health Department offices. Objective: Monitor and assess provider acceptance and adherence to practice and screening guidelines.
Objective: Refine methods and types of clinical interventions to promote patient compliance with their treatment plan. Reliable data on prevalence, morbidity and mortality, health behaviors and preventive practices, etc. Compile and issue periodic reports concerning diabetes that can be used for program planning, monitoring and evaluation.
Objective: Define the prevalence of diabetes, diabetes-related complications and health care utilization in Vermont. Objective: Define the prevalence of diabetes self-care management behaviors, and behavioral risk factors associated with the development and the progression of complications and disabilities. Objective: Define the levels of health care provider adherence to recommended diabetes practice guidelines.
Funding for this project was provided by a grant from the Centers for Disease Control & Prevention.
The first recognisable reports of type 1 diabetes – a condition presenting in children or young adults and terminating in fatal ketoacidosis – appeared towards the end of the 19th century. OPatientPlus articles are written by UK doctors and are based on research evidence, UK and European Guidelines. Assigning a type of diabetes to an individual often depends on the circumstances present at the time of diagnosis, and many diabetic individuals do not easily fit into a single class. Type 2 diabetes, once called non-insulin-dependent diabetes, is the most common form of diabetes, affecting 90% to 95% of the 26 million Americans with diabetes. Insulin resistance, largely caused by obesity and physical inactivity, both precedes and predicts type 2 diabetes. Type 2 is also known as non-insulin dependent diabetes, which is a lifelong disease occurred by high levels of sugar in the blood. When you have suffered from type 2 diabetes, the body does not respond correctly to insulin, which is called insulin resistance, means that fat, liver, and muscle cells do not respond normally to insulin.
Many people with type 2 diabetes have no symptoms, and regularly exposed accidently after routine medical check-ups or following screening tests for other conditions.
Diabetes mellitus is one of the leading causes of disability and death in the United States.
In Los Angeles County, diabetes is the seventh leading cause of death (12.9 deaths per 100,000 population in 1997). In order to reduce the risk of developing diabetes, public health efforts should focus on preventing obesity by promoting regular physical activity and diets low in fat and high in complex carbohydrates and fiber. Since these findings are based on self-reports, the prevalence estimates do not include those who have diabetes and remain undiagnosed. Funding for the survey was provided by the Los Angeles County Department of Health Services, the California Department of Health Services, the Los Angeles County Medicaid Demonstration Project, and the Los Angeles County Department of Public Social Services. This fact sheet is published by the Health Assessment Unit, Office of Health Assessment and Epidemiology, Los Angeles County Department of Health Servicesa€“Public Health. Most of the goals and objectives are designed specifically to reduce the burden of diabetes for the estimated 18,500 Vermonters who are already diagnosed. The national Healthy People Year 2000 objective is to reduce diabetes-related deaths to no more than 34 per 100,000 people. Diabetes is a statewide public health problem; in nearly every county, the diabetes-related death rate is worse than the Year 2000 goal.
In 1992, Vermont spent an estimated $223 million on direct and indirect costs related to diabetes, according to estimates by the Centers for Disease Control and Prevention. Insulin is a hormone that regulates carbohydrate metabolism by controlling blood glucose levels. Gestational diabetes occurs more frequently in women from high risk racial and ethnic groups and those with a family history of diabetes.

This often includes impaired sensation of pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome and other nerve problems. Periodontal disease has been reported to occur among 30 percent of people aged 19 years or older with Type 1 diabetes. For example, they are more likely to die of pneumonia or influenza than people who do not have diabetes.
A major goal of diabetes treatment is to keep blood glucose near normal levels at all times. Although some risk factors for diabetes cannot be modified (such as genetic factors, age, race, ethnicity, or family history of diabetes), there are other risk factors that individuals can modify (such as obesity or physical activity). Not only is diabetes serious, it is becoming even more prevalent as the population ages and at-risk minority populations increase. Still, many Vermonters report that they do not have adequate access to services for a variety of reasons: gaps in insurance coverage, lack of health professionals specially trained in diabetes control, services not available locally, cultural, linguistic or literacy barriers, etc.
Yet many people with diabetes either do not know about self-care measures or don’t practice them.
National Institutes of Health-National Institute of Diabetes and Digestive and Kidney Diseases, NIH Publication No. It is caused by either a decreased production of insulin or decreased functioning of the insulin. Although the specific causes of diabetes remain elusive, both genetics and environmental factors appear to be important. Among persons with diabetes, access to health care is critically important to ensure optimal treatment and prevention of complications. Adults with diabetes are more likely to be sedentary (61%) than adults who do not have diabetes (40%). Among those with diabetes who are uninsured, 51% are not currently under a doctora€™s care for their diabetes. For the other 9,500 Vermonters who have diabetes and do not yet know it, the plan includes recommendations for informing the public and health care providers about risk factors and screening. It is also a major contributor to high blood pressure, heart disease, stroke and infection. Autoimmune, genetic and environmental factors appear to be involved in the development of this type of diabetes. Severe forms of diabetic nerve disease are a major contributing cause of lower extremity amputations.
The national trend toward obesity and decreasing physical activity is also likely to increase prevalence.
Department of Health and Human Services, Public Health Service, Office of Disease Prevention and Health Promotion, 1994.
A severe, chronic form of diabetes caused by insufficient production of insulin and resulting in abnormal metabolism of carbohydrates, fats, and proteins. The Type 2 diabetes symptoms can develop very quickly in children or adolescents who had previously been exhibiting signs of health. You may have increased some (causing diabetes) or lost some as a result of high blood glucose levels. The Centers for Disease Control and Prevention report that approximately 16 million people in the United States have diabetes and one third of them remain undiagnosed.
Type I diabetes (insulin-dependent) accounts for 5a€“10% of those with diabetes and most often occurs during childhood or adolescence.
There are many symptoms of type 2 diabetes including Blurred vision, Fatigue, Frequent or slow-healing infections, increased appetite, increased thirst, and increased urination. In severe cases, diabetes can lead to debilitating complications including blindness, kidney failure, cardiovascular disease, mobility problems and lower extremity amputation. Type II diabetes (non-insulin dependent) is the more common type, affecting 90%a€“95% of those with diabetes and usually occurs in adulthood, although a recent increase has been seen among adolescents. In some studies, nearly 40 percent of women with a history of gestational diabetes developed diabetes later. High level of blood sugar regularly activates the pancreas to create more and more insulin, but it not enough to keep up with the body's demand. Mostly fatty people are suffer from diabetes that does not mean, the thin people are not suffers from diabetes, type 2 diabetes can also develop in those who are thin, especially the elderly.

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