Diabetes

Diabetes is the inability to transfer sugars in blood into the sugar-storage sites of your body, the muscles and liver. Sugars, called carbohydrates, are found mainly in cereals, rice, bread, pastas, potatoes, milk products, fruits, fruit juices and sweets. When we consume these foods, they pass from the stomach into the intestines and get broken down to the most basic sugar form, glucose. Glucose (sugar) normally moves into the blood via a web of blood vessels that are connected to the intestines. When the movement of glucose into the blood stream raises its average level above 100 points (mg/dl), it triggers the secretion of a hormone called insulin from the pancreas. When insulin is secreted into the blood, it causes the excess glucose (sugar) to be stored in muscles and liver cells. It is stored in a form called glycogen, which may be used at a later time as an immediate source of energy.

This energy is used for activities of up to three minutes: lifting or throwing an object, running away from danger, sprinting, stop-and-go actions such as a short walk, or any sports activity. Some people have impairment in their insulin production or in the functioning of their insulin. This insulin impairment causes the level of glucose to rapidly rise above the 100-point mark, and that is the condition we call diabetes. High sugar levels, left untreated, can gradually cause damage to vital tissues, such as blood vessels, the nervous system, kidneys, heart and arteries. This can cause debilitating strokes, heart disease, erectile dysfunction, loss of sensation or pain in the feet and hands, leading to leg amputations, kidney failure and blindness.

Type 1 Diabetes

Type 1 Diabetes is when someone can produce little or no insulin, due mainly to immune and genetic (inherited) defects in the pancreas. People with Type 1 Diabetes create approximately only 10% of all of people diagnosed with diabetes. Type 1 can occur at a relatively young age, especially during childhood. At the time of diagnosis, people are usually of average weight, experiencing weight loss; frequent urination, blurred vision and dry mouth and their blood fasting sugar are way above 125 points (mg/dl). Type 1 diabetics have to depend on insulin use for the rest of their lives, in order to survive and making good lifestyle choices is integral to diabetes control. Oral Diabetes medications that are Sensitizers (see detailed discussion of this group of drugs in Action Step 2 right after the Insulin section) can be prescribed along with Insulin for people with Type 1 which can help reduce the amount of daily insulin used. Also leading and maintaining an active Lifestyle and making favorable food choices and raising your fiber intake can all help bring Diabetes under control and reduce the amount of total daily insulin dose (decisions about insulin dosing can ONLY be made by your doctor). Refer to Action Step 4 for a detailed discussion on how to start and maintain an active Lifestyle and make favorable food choices.

Impaired Glucose Tolerance or Pre-diabetes

This is a condition where glucose levels are higher than normal but not enough to be diagnosed as diabetes namely at a range from 100 to 125 mg/dl on a fasting state (first thing in the morning before eating). Typically, the more than 54 million people in this category are overweight or obese. They are people who consume large amounts of “junk food” (nutrient-deficient foods and drinks such as soft drinks and all other sugar containing juices and drinks. Foods that are loaded with sugars and unfavorable sources of fat such as animal fat, butter, margarine and Trans Fatty Acids that are found in the majority of packaged processed sweet and or salty snacks) and lead totally sedentary lifestyles; they also have high cholesterol and triglycerides and have low HDL (the good cholesterol). Studies show that these people will eventually develop diabetes and other preventable chronic ailments, such as: high cholesterol, high blood pressure and heart disease, “unless” they are identified early and they start making favorable lifestyle choices.

Gestational Diabetes

Gestational diabetes affects some women during pregnancy and is characterized by consistently higher than 95 points (mg/dl) on a fasting state first thing in the morning, and over 120 points 2 hours after a meal. Most women who suffer from Gestational Diabetes will return to having normal blood glucose levels after delivery. Up to 45% of women who develop diabetes during pregnancy may progress to having full-blown diabetes later in life unless they make favorable lifestyle choices and change their eating and activity habits. The main predisposing factors for gestational diabetes are family history of diabetes, obesity and sedentary lifestyles . It is crucial that women at risk be identified, since high blood sugar causes fetal harm.

Who Should Test?

All women, early on in their pregnancy, who have the following criteria must be tested for high blood sugar; women who are: overweight, over the age of 25, who have family history of diabetes, those who belong to ethnic groups other than Caucasian, those who have previously had gestational diabetes, or who have previously delivered large babies over 9 pounds.

Treatment

Gestational diabetes is initially treated with Lifestyle interventions such as making balanced food choices and increasing activity as described in Action Step 4. If fasting (first thing in the morning before eating) blood sugar is not brought to 95 points (mg/dl) or to 120 points 2 hours after lunch or dinner then Insulin is the ideal drug that is used. Your doctor will decide which insulin product and dose is appropriate for you. (See the discussion about insulin in Action Step 2).

Type 2 Diabetes

Type 2 diabetes, on the other hand, usually affects people later on in life, after the age of 25 or 30. However, Type 2 Diabetes has alarmingly been plaguing children at a much younger age than ever witnessed. Kids as young as 15 and 17 who are obese and leading sedentary lifestyles and commonly seen in grocery stores shopping while riding electric shopping scooters, are now diagnosed with Type 2 Diabetes. About 90% of people with diabetes have Type 2. People with Type 2 Diabetes produce insulin from their pancreas, but due to lifestyle factors such as obesity and inactivity the insulin is not able to perform and move the extra sugar from the blood into the muscle and liver cells, resulting in the buildup of sugar levels in the blood. This defect is referred to technically as insulin resistance. The diagnosis for Type 2 Diabetes is when people have a fasting (before eating in the morning) blood sugar level of 126 points (mg/dl) and over on 2 separate readings.

Type 2 Diabetes can be of hereditary origin. Non-Caucasians are more predisposed to getting it. But the vast majority of people get it due to inadequate lifestyles such obesity, overeating and sedentary lifestyles. A staggering 75% of people with diabetes are obese and inactive . This lends to the worsening of their conditions. I witness this trend every single day in my pharmacy practice. People drop off several prescriptions for diabetes, cholesterol and blood pressure, and they sit the entire time in the pharmacy waiting area. When I counsel them about their medications and suggest they might increase the amount of daily walking, their invariable answer is, “I don't have time.” Sometimes, they drop off their prescriptions and go food shopping; they bring back a cart full of bacon, cookies and other packaged snacks such as popcorn, jugs of soft drinks, pretzels, butter, white bread, and let's not forget the cigarettes!

People with Type 2 Diabetes may be treated with: medications, either taken by mouth and/or through insulin injections, and by making favorable lifestyle choices . Medications alone without an active lifestyle will never be an efficient way to control diabetes and/or other chronic lifestyle-related diseases. Your doctor has many medication options from which to choose. What is important is to get diabetes under control in order to avoid deadly complications ! Your health is your responsibility, and staying in close contact with your doctor and pharmacist is the only way to avoid diabetes complications and hugely important in keeping your diabetes under control.

The message that I bring you is that, “You are not doomed.” Certainly, you can control diabetes, but you have to be aware of some simple facts and act on them . Inaction will cause these deadly ailments to creep up on you and systematically destroy your internal organs and claim your life prematurely. You can become involved, seriously and consistently, in your health; take the lead and the primary responsibility for managing your health and disease! It is simpler than you think.

If you take charge of this responsibility, you reap the benefits of living your lifespan to the fullest, enjoying the best quality of life. It is very simple. You just have to take charge by starting to apply the reliable, simple, and practical recommendations in LIFESTYLE MAKEOVER FOR DIABETICS AND PRE-DIABETICS

By: George Tohme

Labels: 1 diabetes type, diabetes, diabetes 1, diabetes 2, diabetes mellitus, diabetes symptoms, diabetes type 2, gestational diabetes, type diabetes

Type 1 diabetes mellitus - diabetes, for short. This chemical disorder disrupts the body's ability to utilize certain nutrients, primarily a blood sugar called glucose.
Treatment for diabetes is made more difficult because a person can have the disease a long time before it is diagnosed. "Because the early symptoms are relatively mild," notes Asiaweek magazine, "diabetes often goes unrecognized." Hence, diabetes has been dubbed the silent killer.

Why Serious

Diabetes has been called "a disorder of the very engine of life," and for good reason. When the body cannot metabolize glucose, a number of vital mechanisms can break down, sometimes with life-threatening consequences. "People don't die directly from diabetes," says Dr. Harvey Katzeff, "they die from complications. We do a good job of preventing complications, but a poor job of treating [them] once they occur."

Diet and Exercise

Although Type 1 diabetes cannot be prevented, scientists are studying the genetic risk factors and are trying to find ways to suppress an immune attack. "With type 2, the picture is much brighter," says the book Diabetes - Caring for Your Emotions as Well as Your Health. "Many of those who might be genetically susceptible avoid showing any sign of this disease simply by eating a balanced diet and exercising regularly, thereby staying physically fit and keeping their weight within normal limits."

Underscoring the value of exercise, the Journal of the American Medical Association reported on a large study involving women. The study found that "a single bout of physical activity increases insulin-mediated glucose uptake [by the body's cells] for more than 24 hours." Hence, the report concludes that "both walking and vigorous activity are associated with substantial reductions in risk of type 2 diabetes in women." The researchers recommend at least 30 minutes of moderate physical activity on most if not all days of the week. This can include something as simple as walking, which, says the American Diabetes Association Complete Guide to Diabetes, "is probably the best, safest, and least expensive form of exercise."

However, exercise by people with diabetes should be professionally supervised. One reason is that diabetes can damage the vascular system and nerves, thus affecting blood circulation and feeling. Hence, a simple scratch on the foot may go unnoticed, get infected, and turn into an ulcer - a serious condition that may lead to amputation if not treated immediately.

Insulin Therapy

Many with diabetes must supplement their diet and exercise program with daily testing of glucose levels along with multiple insulin injections. As a result of improved health through diet and a good routine of exercise, some with Type 2 diabetes have been able, at least for a time, to discontinue insulin therapy. Karen, who has Type 1 diabetes, found that exercise increases the efficiency of the insulin she injects. As a result, she has been able to cut her daily insulin requirements by 20 percent.

If insulin is needed, however, there is no reason for the sufferer to feel discouraged. "Going on insulin does not imply failure on your part," says Mary Ann, a registered nurse who cares for a number of diabetes patients. "Whatever form of diabetes you have, if you carefully control your blood sugar, you will minimize other health problems later." In fact, a recent study revealed that people with Type 1 who kept strict control of their blood-sugar levels "had drastic reductions in the occurrence of diabetic eye, kidney, and nerve diseases." The risk of eye disease (retinopathy), for instance, was cut by 76 percent! Those with Type 2 who keep tight control of their blood-sugar levels enjoy similar benefits.

To make insulin therapy easier and less traumatic, syringes and insulin pens - the most common tools used - have microfine needles that give minimal discomfort. "The first shot is usually the worst," says Mary Ann. "After that, most patients say they hardly feel a thing." Other methods of injection include automatic injectors that shoot a needle into the skin painlessly, jet injectors that literally fire insulin through the skin by means of a fine jet blast, and infusers that employ a catheter that stays in place for two or three days. About the size of a pocket pager, the insulin pump has gained popularity in recent years. This programmable device dispenses insulin through a catheter at a steady rate according to the body's daily needs, making insulin administration more precise and convenient.

Keep Learning

All told, there is no blanket therapy for diabetes. When considering treatment, each individual must take into account a number of factors in order to make a personal decision. "Even though you may be under the care of a medical team," says Mary Ann, "you are in the driver's seat." In fact, the journal Diabetes Care states: "Medical treatment of diabetes without systematic self-management education can be regarded as substandard and unethical care."

The more those with diabetes learn about their disease, the better equipped they will be to manage their health and increase their prospects of living a longer, healthier life.

The Role of Glucose

Glucose fuels the body's trillions of cells. To enter the cells, however, it needs a "key" - insulin, a chemical released by the pancreas. With Type 1 diabetes, insulin is simply not available. With Type 2, the body makes insulin but usually not enough. Moreover, the cells are reluctant to let insulin in - a condition called insulin resistance. With both forms of diabetes, the result is the same: hungry cells and dangerous levels of sugar in the blood.

In Type 1 diabetes, a person's immune system attacks the insulin-producing beta cells in the pancreas. Hence, Type 1 diabetes is an autoimmune disease and is sometimes called immune-mediated diabetes. Factors that can trigger an immune reaction include viruses, toxic chemicals, and certain drugs. Genetic makeup may also be implicated, for Type 1 diabetes often runs in families, and it is most common among Caucasians.

With Type 2 diabetes, the genetic factor is even stronger but with a greater occurrence among non-Caucasians. Australian Aborigines and Native Americans are among the most affected, the latter having the highest rate of Type 2 diabetes in the world. Researchers are studying the relationship between genetics and obesity, as well as the way excess fat seems to promote insulin resistance in genetically susceptible people. Unlike Type 1, Type 2 diabetes occurs mainly in those who are over 40 years of age.

About 90 percent of those with diabetes have Type 2. Previously, this was referred to as "non-insulin dependent" or "adult onset" diabetes. However, these terms are imprecise, for up to 40 percent of those with Type 2 diabetes require insulin. Furthermore, an alarming number of young people - some not even in their teens - are being diagnosed with Type 2 diabetes.

The Role of the Pancreas

About the size of a banana, the pancreas lies just behind the stomach. According to the book The Unofficial Guide to Living With Diabetes, "the healthy pancreas performs a continuous and exquisite balancing act, managing to sustain smooth, stable blood-sugar levels by releasing just the right amount of insulin as glucose levels wax and wane throughout the day." Beta cells within the pancreas are the source of the hormone insulin.

When beta cells fail to produce enough insulin, glucose builds up in the blood, causing hyperglycemia. The opposite - low blood sugar - is called hypoglycemia. In concert with the pancreas, the liver helps manage blood-sugar levels by storing excess glucose in a form called glycogen. When commanded by the pancreas, the liver converts glycogen back into glucose for use by the body

The Role of Sugar

It is a common misconception that eating a lot of sugar causes diabetes. Medical evidence shows that getting fat - regardless of sugar intake - increases the risk among genetically susceptible individuals. Still, eating too much sugar is unhealthy, since it provides poor nutrition and contributes to obesity.

Another misconception is that people with diabetes have an abnormal craving for sugar. In reality, though, they have the same desire for sweets as most others. When it is not controlled, diabetes can lead to hunger - but not necessarily for sugar. People with diabetes can eat sweets, but they must factor their sugar intake into their overall diet plan.

By: Ken McClendon

Labels: diabete, diabetes, diabetes 2, diabetes mellitus, diabetes symptoms, diabetes type 2, mellitus diabetes, type 2 diabetes, type diabetes

The Causes of diabetes are still not fully understood. Neither are medical scientists able to explain why some people develop diabetes and others don't. Certain factors have, however, been clearly identified which contribute to the development of diabetes.

Is Diabetes Inherited?

Heredity is a major factor. That diabetes can be inherited has been known for centuries. However, the pattern of inheritance is not fully understood. Statistic indicates that those with a family history of the disease have a higher risk of developing diabetes than those without such a background. The risk factor is 25 to 33 percent more.

Children are most likely to develop diabetes if either or both parents are diabetes, or if the expectant mother became diabetic, or if the mother was a confirmed diabetic prior to conception. This may not always be true. It is possible for parents who were, or are diabetic and the other remains free from the disease.

It is, however, essential that the blood sugar level of an expectant mother who is diabetic be maintained within the normal range, so that diabetes is not passed on to her child. It the blood sugar level is kept under control, the infant may not have nay symptoms of inherited diabetes, but a risk factor cannot be ruled out.

One reason why diabetes, especially type-2 diabetes runs in the family is because of the diabetes gene. But even it is caused by genetic factors beyond your control; there is no reason to suffer from it. Diabetes mellitus cannot be cured in full sense of the term, but it can be effectively controlled so that you would not know the difference.

Intensive genetic research is currently underway to identify genes associated with both type-1 and type-2 diabetes. In a study sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases of USA the relatives at risk of type-1 diabetes are being treated with low doses of either insulin or an oral medication to determine if drugs may prevent the disease.

Surveys show that in India diabetes is more prevalent among males than females. In this population, family history of diabetes mellitus was present in 5.5 to 11.6 per cent. Amongst diabetics, 18.3 per cent urban and 6.4 percent of rural population had a direct relative with diabetes. Therefore, genetic predisposition in India is comparable to that observed in other parts of the world.

Diet: A Self Inflicted Causes

Diabetes has been described by most medical scientists as a prosperity' disease, primarily caused by systematic overeating. Not only is eating too much sugar and refined carbohydrates harmful, but proteins and fats, which are transformed into sugar, may also result in diabetes if taken in excess.

Too much food taxes the pancreas and ultimately its normal activity of producing insulin gets paralyzed. It is interesting to note that diabetes is almost unknown in countries where people are poor and cannot afford to overeat.

The incidence of diabetes is directly linked with the consumption of processed foods rich in refined carbohydrates, like biscuits, bread, cakes chocolates, pudding and ice creams. In Britain, during the war when only whole wheat bread was available the incidence of diabetes dropped by 55 percent.

Parents should take great care to develop correct dietary habits in their children. Children should be prevented from becoming addicts to harmful foods like ice cream, cakes, jam, jelly, peppermint, chocolates and other sweets. The amount of food given to children should be such as would allow growth but not obesity. Children should be convinced about the importance of exercise and games and sports should be encouraged. Ideal body weight and a proportionate body is an almost certain guarantee against diabetes.

The Obesity Trigger

Obesity is one of the main causes of diabetes. Studies show that 60 to 85 % of diabetics tend to be overweight. In the United States of America, about 80 percent of type -2 non-insulin dependent diabetics are reported to be overweight. During the Second World War, when there was a decrease in the average weight of the people, the incidence of diabetes came down dramatically. The greater the obesity, the greater is the mortality rate due to complications of diabetes.

Excess fat prevents insulin from working properly. The more fatty tissue in the body, the more resistant the muscle and tissue cells become to body insulin. Insulin allows the sugar in the blood to enter the cells by acting on the receptor sites on the surface of the cells. In obesity, where a person is overweight by 20 percent of the ideal weight or has high uric acid, or some syndromes, receptors are sparse and functionally idle. This is observed in patients developing diabetes around the age of 40 years, and having type-2 non-insulin dependent diabetes. It is estimated that the incidence of diabetes is four times higher in persons of moderate’s obesity and 3 times higher in persons of severe obesity. It has been rightly said; Heredity is like a cannon and obesity pulls and trigger.

Older people often tend to gain weight, and the same time, many of them develop and mild form of diabetes because who are over weight can often improve their blood sugar simply by losing weight. In some cases, it is all that is required to bring blood sugar back into the normal range. Even small weight loss can have beneficial effects, reducing blood sugar levels, or allowing medicines to work better. However, sudden gain in weight may cause diabetes to return. It is therefore important for older people to keep their weight down to normal. Among those detected to be diabetic, almost one third are overweight.

Virus Infections

Pancreatic infections with Coxsackie's B virus can result in beta cell damage, development of autoantibodies and, consequently, type-1 insulin dependent diabetes mellitus. Some of these can be diagnosed by a viral antibody test and islet cell antibody test. Screening for antibodies can indicate potentially juvenile diabetes in a family on the basis of auto-immunity.

The Lifestyle Risk

A sedentary lifestyle, resulting from lack of physical work and exercise, plays an improvement role in the development of diabetes. The less active a person, the greater the risk of developing diabetes. Modern conveniences have made work easier. Physical activity and exercise helps control weight, uses up a lot of glucose (sugar) present in the blood as energy and makes cells more sensitive to insulin. Consequently, the workload on the pancreas is reduced.

Exercise also adds to the muscles mass. Normally, between 70 percent to 90 percent of the blood sugar is absorbed into the muscles. A reduction in muscle mass-either due to age of physical inactivity - reduces the storage space for blood sugar, and it remains in the blood stream.

Smoking: An Important Risk Factor

Smoking is another important risk factor. Among men who smoke, the risk of developing diabetes is doubled. In women who smoke 25 or more cigarettes a day, the risk of developing diabetes is increased by 40 percent. Smoking also reduces retinal blood flow and increases the risk of developing retinopathy. It also decreases insulin absorption and limits joints mobility. Smoking, in combination with diabetes, greatly enhances the likelihood of premature mortality. It also depends upon the number of cigarettes a day a person smokes and the number of years he has been smoking.

Age

A risk of type-2 diabetes increases, as one grows older, especially above the age of 45 years. Part of the reason is that is people grow older, they tend to become less physically active, lose muscle mass and gain weight. With life styles becoming more sedentary, there has been an increase of diabetes among people in there 30s and 40s.

Stress and Tension

Stress can be emotional or physical, such as a surgery or a serious infection, an accident or an emotional shock. Another very urban trait, the high stress lifestyle, not just amongst the young unwardly mobile, but increasingly in all walks of life, is a relatively new phenomenon in India. Since there is a known connection between stress and diabetes mellitus, those who are under stress and/or lead an irregular lifestyle, need to take adequate precautions and make necessary lifestyle adjustments.

Pancreatic insufficiency caused by stress, can lead to diabetes. Grief, worry and anxiety resulting from examinations, death of a close relative, loss of a joy, business failure and strained marital relationship, all a deep influence on the metabolism and may cause sugar to appear in the urine.

Organic Disorders

Diabetes may be associated with some grave organic disorders like cancer, tuberculosis and cerebral diseases. Diabetes may also be caused by a variety of other factors. These include certain metabolic and genetic disorders, inadequate secretion of insulin by the pancreas, malfunctioning of other endocrine glands like thyroid, pituitary and adrenal, excessive consumption of alcohol and the use of the certain drugs.

Race

Although the reasons are unclear, people of certain races are more likely to develop diabetes than others.

By: Dr John

Labels: diabetes, diabetes 1, diabetes diet, diabetes mellitus, diabetes symptoms, diabetes treatment, diabetes type 1, diabetes type 2, symptoms of diabetes, type diabetes