Allen Broome, Pharm.D., the director of health system pharmacy at USA Health, reflects on the Pharmacy Residency Program's first-year achievements.
About Diabetes Care at USA Health
Diabetes affects approximately 30.3 million Americans—about one out of every 10 people in this country. The condition is caused when the pancreas makes little or no insulin or the body becomes resistant to the effects of insulin. Insulin is a hormone that moves glucose out of the blood stream and stops the liver from producing new glucose. With insufficient insulin or insulin resistance, the glucose cannot properly move out of the blood stream and into the cells of the body. This cause’s glucose to build to high levels in the blood stream. Elevated glucose levels in the blood is the defining feature of all types of diabetes.
Over time, these high levels damage the blood vessels and nerves in the body. This damage can lead to complications such as heart attacks, strokes, amputations, kidney disease and vision problems. Diabetes is the leading cause of blindness in the U.S. At USA Health, our goals for treatment are to reduce or avoid the complications of diabetes by controlling blood glucose, blood pressure and cholesterol levels according to an individual treatment plan.
There are three main types of diabetes:
- Type 1 diabetes: This is caused by the body’s immune system turning against itself and destroying the pancreatic beta cells that produce insulin. Scientists don’t know exactly why the immune system attacks these cells in the pancreas, but it may be triggered by a virus. A person with Type 1 diabetes must take insulin every day. Type 1 diabetes can develop at any age but is more commonly diagnosed in children and young adults.
- Type 2 diabetes: The most common type of diabetes, it is typically diagnosed in older adults. However more children and young adults are developing this type as obesity rates rise. Type 2 diabetes occurs when the pancreas does not make enough insulin or there is resistance to insulin, or a combination of the two. Insulin resistance occurs when the pancreas still produces insulin, but the body doesn’t respond properly. When cells are insulin-resistant, it takes more insulin to move glucose out of the blood stream and into the cells. When the pancreas cannot keep up with the insulin demand, it results in diabetes. Weight loss and exercise are good treatments for patients with Type 2 diabetes, but most patients require medication to achieve target glucose values. These medications may include pills, insulin and/or injectable medications that are not insulin.
- Gestational diabetes: Some women develop this type in the last three months of pregnancy when hormones can cause insulin resistance. If the woman’s pancreas cannot supply enough insulin to overcome this resistance, the blood glucose levels rise too high. High blood glucose levels during pregnancy can sometimes result in birth complications.
Prediabetes: More than 1 out of 3 adults has prediabetes. The blood glucose level is above normal but not high enough for the person to be diagnosed with diabetes. Fortunately, people with prediabetes can do something to prevent or delay the onset of Type 2 diabetes. Weight loss, increased physical activity and certain medications have been effective in delaying the progression from prediabetes to Type 2 diabetes. With assistance from our diabetes educator and dietitian, we help patients choose the best nutrition and physical activity plan for them to increase the likelihood of making successful, lasting lifestyle changes.