Diabetes- Getting Down to the Basics

What is diabetes?

Diabetes is a disease where your blood glucose (sugar) levels are above normal. It results from the inability of the glucose to get into your cells. As a result your cells are starving for their food (glucose). It would be like a starving person surrounded by tables of wonderful food but their mouth has been sewn closed and they can't eat.

About 17 million Americans are believed to have diabetes and one-third of those patients don't even know they have it. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the 6th leading cause of death in the US. And most diabetics develop heart disease. In fact, just having diabetes carries the same risk of having a heart attack as someone who has already had such an event. Therefore it is very important for patients that have diabetes to also have a physician that closely monitors and treats their cholesterol levels as well as their blood pressure. Additionally, any use of tobacco products multiplies the risks and should be stopped.

Are there different kinds of diabetes?

Certainly. But the basic features of the disease are same. In any form of diabetes there is some underlying reason why your body is not able to utilize glucose (sugar) for energy, and that causes the levels of glucose (sugar) in your blood build up above normal. There are three areas that are important for you to understand in diabetes. First, the cells in your body which use the glucose are important as they must be able to remove sugar from the blood and put it inside the cell as a fuel. Secondly, the insulin which is made by your pancreas (an organ near your stomach) is important to allow the sugar to enter the cell (the key to unlock the door to enter), and lastly, glucose which is broken down from your food or from muscle and liver from a storage form of glucose called glycogen. Now if you think of the disease diabetes as involving a locking gas cap on your car, it will be easier to understand.

If you understand how a locking gas cap works, then you can understand how diabetes works. All of the cells in your body have a locking gas cap on them. Insulin is the key to the locking gas cap, and glucose would be the fuel for the car. In one form of diabetes, the body totally quits making insulin (keys) so you can't get glucose (fuel) into your cells. In other forms of diabetes, your body makes some insulin (keys) but not much as your body needs. Therefore, only a few of the cells can be unlocked and opened to put the glucose (fuel) inside. Another thing that happens is that some of the locks on the cells become rusty and won't work properly. So even if you have insulin (keys) you can't get the cells to open. This is called insulin resistance. If the cells won't open, you can't get glucose (fuel) inside the cell for energy. The result of all of this is excess glucose in your blood.

Types Of Diabetes.

Type 1 diabetes is usually diagnosed in children and young adults and only accounts for 5-10% of diabetes patients. In type 1 diabetes the pancreas doesn't make any insulin (keys) at all.

Type 2 diabetes is the most common form of the disease. It accounts for 90-95% of all the cases of diabetes. In type 2 diabetes, either your body doesn't make enough insulin (keys), or the cells in your body ignore the insulin (the lock is rusty and doesn't work) so they can't utilize glucose like they are supposed to. When your cells ignore the insulin, as mentioned above, it is often referred to as insulin resistance.

Other types of diabetes which only account for a small number of the cases of diabetes include gestational diabetes, which is a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies and usually disappears when the pregnancy is over. Other types of diabetes resulting from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses may account for 1% to 2% of all cases of diabetes.

How do you get diabetes?

There are risk factors that increase your chance of developing diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in developing this type of diabetes.

What are the symptoms of diabetes?

People who think they might have diabetes must visit a physician for a diagnosis. They might have SOME or NONE of the following symptoms: frequent urination, excessive thirst, unexplained weight loss, extreme hunger, sudden vision changes, tingling or numbness in hands or feet, feeling very tired much of the time, very dry skin, sores that are slow to heal, more infections than usual. Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of type 1 diabetes.

Glucose is sugar! So all I have to do is avoid sweets, right?

It is not that simple. The truth is, most food, and all of the carbohydrates you eat, are broken down into its simplest structure, glucose. As food arrives in your stomach, the acid starts to break the food down immediately. Proteins are broken down for their amino acids, and carbohydrates for their glucose. Once your gastrointestinal system breaks your food down into something your body can utilize, the blood picks it up and carries it to your cells to for energy. In healthy people, the blood picks up the glucose absorbed from the GI tract, and sends a signal to your pancreas (an organ near your stomach) to make and release insulin. Remember, in Type 2 diabetes your body doesn't make enough insulin (keys), or some of your cells ignoring the insulin that is there. (The locks are rusty and won't work) In both situations, your cells don't get the glucose they need for energy and they are starving while all the extra glucose is just floating around in your blood and can't be used. The worst part is, when all that extra glucose is floating around in your blood, it is causing damage to your blood vessels and organs and that damage increase your risk of heart disease. That is why it is very important to keep your blood glucose levels as close to normal as possible. When the glucose levels get really high, the glucose starts to leak out into your urine.

How do you treat diabetes?

There are several things you need to do to help control your diabetes. For type 1 diabetes, Healthy eating, physical activity, and insulin injections are the basic therapies. The amount of insulin taken must be balanced with food intake and daily activities. For patients with type 1 diabetes, blood glucose levels must be closely monitored through frequent blood glucose testing.

For type 2 diabetes, healthy eating, physical activity, and blood glucose testing are the basic therapies. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels. Some of the oral medications work by stimulating your pancreas to make more insulin (keys). Other oral medicines work to make the rusty locks start working again. In a sense they are kind of like WD-40 for the rusty locks on the cells. It fixes the lock on the cells so the insulin (keys) can open the cell to allow the glucose (fuel) inside. Once the glucose (fuel) is allowed inside the cells, your blood sugar levels will drop back down to normal.

What medicine am I going to have to take for my diabetes?

There are many different types of medications that your doctor may prescribe for diabetes; however these prescriptions can cause certain nutritional deficiencies that may increase your risk for chronic degenerative diseases. NutraMD Diabetes Essential Nutrients® supplement was designed to work with your diabetic medications by replacing lost nutrients reducing the risk of dangerous side effects, and promote better health

The main classes of diabetic medications include sulfonylureas, biguanides, and thiazolidinediones.

Sulfonylureas include the following medications:

Orinase ,Tolinase, Diabinese, Glipizide, Glyburide, Amaryl, Prandin, Strarlix
The main function of sulfonylureas is to increase insulin production in the beta cells of the pancreas. Sulfonylureas can interfere with the body's normal metabolism of Coenzyme Q10. Because CoQ10 is necessary to make energy in all tissues of the body, this effect may decrease your body's natural ability to utilize or "burn up" sugars, and may even reduce the ability of the pancreas to produce insulin over time.

Biguanides include the following medications:

Glucophage (Metformin)

Glucovance (metformin + glyburide)

The main functions of biguanides are to lower the production of glucose by the liver thereby reducing blood glucose levels. Your doctor may prescribe this type of medicine in combination with sulfonylureas insulin, or a class of drugs known as thiazolidinediones. Unfortunately, biguanides have been shown to deplete vitamin B-12, folic acid and Coenzyme Q10 (CoQ10). A few of the problems which may arise from deficiencies of folate and vitamin B-12 include the following: Heart disease, stroke, anemia, arthritis, joint pain, muscle pain, and neuropathies (nerve damage). Because diabetes increases your risk for heart disease, stroke, and neuropathy, it is especially important to prevent nutritional deficiencies which may add to these risk factors. Therefore to reduce potential side effects of nutrient deficiencies you should take NutraMD Diabetes Essential Nutrients® supplement as long as you are on your diabetic medication.

Because both medication types listed above can deplete CoQ10, it is important to understand some of the symptoms of a deficiency. CoQ10 deficiency has been linked to the following diseases and symptoms: Congestive heart failure, high blood pressure, rhabdomyolysis (muscle break down), muscle and joint pain, and fatigue. Therefore to achieve maximum benefit from the diabetes medications and minimize potential side effects of nutrient deficiencies, you should compliment your prescription medication by taking NutraMD Diabetes Essential Nutrients® supplement. By doing this, you will balance the risk/benefit ratio further in your favor.

In summary, diabetic medications prescribed by your doctor are necessary to treat your condition; however, you should also be aware that the long term potential nutritional side effects may be just as big a risk factor for your health as the disease you set out to treat in the first place. Put the odds in your favor and maintain your health with NutraMD Diabetes Essential Nutrients® supplement

How do I know I am keeping my blood sugar under control?
Frequent blood tests are used to monitor your blood sugar. Most patients with diabetes should have a home blood monitoring kit. Some doctors ask their patients to check their blood sugar as frequently at 6 times a day, though this is an extreme. The more information you have about your blood sugar levels, the easier it will be for you to control it. People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high.

When your blood sugar is too high, your doctor refers to it as hyperglycemia. When your blood sugar is too high, you may not experience any symptoms, but the high levels of glucose in your blood is causing damage to your blood vessels and organs. That is why it is important to have your body utilize the sugar properly and get it out of your bloodstream.

When your blood sugar is too low, your doctor refers to it as hypoglycemia. Having low blood sugar can be very dangerous and patients taking medication for diabetes should watch for symptoms of low blood sugar. It is also important that your monitor your blood sugar regularly to avoid both low as well as high blood sugar. It is important that you keep your blood sugar as close to normal as possible at all times.

How does my doctor know if I am keeping my blood sugar under control?
Some patients are may not follow the proper diet and exercise except for the days leading up to a blood test in the doctor's office. They want to look like they are doing a good job controlling their blood sugar. This way their fasting blood glucose test results will be good for the doctor. But, there is a test that will show your doctor the real picture over the past 3 months or so. It is called the hemoglobin A1C (HbA1C) test. Hemoglobin is the part of your blood, or red cells, that carries oxygen to your cells. Glucose sticks to the hemoglobin in your red cells of the blood as they emerge from the bone marrow where they are made.

The amount of sugar on the red cell is proportionate to the blood sugar level at the moment the red cell goes into circulation, and remains at that level for the life of the red cell. So if there has been a lot of extra glucose in your blood, there will be a lot of glucose stuck all over your hemoglobin. Since the average lifespan of the hemoglobin in your blood is 90-100 days, a HbA1C test shows a doctor how well you have been controlling your blood sugar over the last 3 months. This test is a check on the overall sugar control, not just the fasting blood sugar. So it is important to control your blood sugar at all times, and not just before visiting the doctor. The most important reason to control your blood sugar is so that you can live a longer, healthier life without complications that can be caused by not controlling your diabetes.

What happens if I do not control my diabetes?
The complications of diabetes can be devastating. Both forms of diabetes ultimately lead to high blood sugar levels, a condition called hyperglycemia. The damage that hyperglycemia causes to your body is extensive and includes:

Damage to the retina from diabetes (diabetic retinopathy) is a leading cause of blindness.

Diabetes predisposes people to high blood pressure and high cholesterol and triglyceride levels. These independently and together with hyperglycemia increase the risk of heart disease, kidney disease, and other blood vessel complications.

Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis), chronic diarrhea, and an inability to control heart rate and blood pressure with posture changes.

Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of kidney failure.

Damage to the nerves from diabetes (diabetic neuropathy) is a leading cause of lack of normal sensation in the foot, which can lead to wounds and ulcers, and all too frequently to foot and leg amputations.

Diabetes accelerates atherosclerosis or "hardening of the arteries", and the formation of fatty plaques inside the arteries, which can lead to blockages or a clot (thrombus), which can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).

Hypoglycemia, or low blood sugar, occurs from time to time in most people with diabetes. It results from taking too much diabetes medication or insulin, missing a meal, doing more exercise than usual, drinking too much alcohol, or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times. Headache, feeling dizzy, poor concentration, tremors of hands, and sweating are common symptoms of hypoglycemia. You can faint or have a seizure if blood sugar level gets too low.

Diabetic ketoacidosis is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or a relative deficiency of insulin) over time creates a buildup in the blood of acidic waste products called ketones. High levels of ketones can be very harmful. This typically happens to people with type 1 diabetes who do not have good blood glucose control. Diabetic ketoacidosis can be precipitated by infection, stress, trauma, missing medications like insulin, or medical emergencies like stroke and heart attack.

Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly and often leads to dehydration so severe that it can cause seizures, coma, even death. This syndrome typically occurs in people with type 2 diabetes who are not controlling their blood sugar levels or have become dehydrated or have stress, injury, stroke, or medications like steroids.

My doctor says I have pre-diabetes? What is that?
Pre-diabetes is a common condition related to diabetes. In people with pre-diabetes, the blood sugar level is higher than normal but not high enough to be considered diabetes. Pre-diabetes increases your risk of getting type 2 diabetes and of having heart disease or a stroke. Pre-diabetes can be reversed without insulin or medication by losing a modest amount of weight and increasing your physical activity. This can prevent, or at least delay, onset of type 2 diabetes. When associated with certain other abnormalities, it is also called the metabolic syndrome.

What are normal blood glucose levels? The amount of glucose (sugar) in your blood changes throughout the day and night. Your levels will vary depending upon when, what and how much you have eaten, and whether or not you have exercised. The American Diabetes Association categories for normal blood sugar levels are the following, based on how your glucose levels are tested:

A fasting blood glucose test: This test is performed after you have fasted (no food or liquids other than water) for eight hours. A normal fasting blood glucose level is less than 100 mg/dl. A diagnosis of diabetes is made if your blood glucose reading is 126 mg/dl or higher. (In 1997, the American Diabetes Association lowered the level at which diabetes is diagnosed to 126 mg/dl from 140 mg/dl.)

A "random" blood glucose test can be taken at any time. A normal blood glucose range is in the low to mid 100s. A diagnosis of diabetes is made if your blood glucose reading is 200 mg/dl or higher and you have symptoms of disease such as fatigue, excessive urination, excessive thirst or unplanned weight loss.

Another test called the oral glucose tolerance test may be performed instead. For this test, you will be asked, after fasting overnight, to drink a sugar-water solution. Your blood glucose levels will then be tested over several hours. In a person without diabetes, glucose levels rise and then fall quickly after drinking the solution. In a person with diabetes, blood glucose levels rise higher than normal and do not fall as quickly.

A normal blood glucose reading two hours after drinking the solution is less than 140 mg/dl, and all readings between the start of the test until two hours after the start are less than 200 mg/dl. Diabetes is diagnosed if your blood glucose levels are 200 mg/dl or higher.

What else do I need to do if I have diabetes?
People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.

Diabetes, and its precursor, the metabolic syndrome, can lead to a multitude of problems if not adequately controlled. These include vascular diseases that result in heart attack and stroke, kidney damage leading to kidney failure, damage to nerves (neuropathy), retinal damage leading to blindness, high blood pressure, and various metabolic defects such as high triglycerides or high cholesterol. It is therefore crucial to control the diabetes as well as all the other risk factors for artery diseases that cause heart attack and stroke.

To do this, your doctor will insist on a good diet and regular exercise. Medications are added to lower the blood sugar, and if these are inadequate, insulin or other injectable medication will be required. The medications that treat diabetes may cause depletion of folic acid, which in turn can cause a high homocysteine, which is a risk factor for artery disease that underlies heart attack and stroke. You can shift the risks in your favor by taking NutraMD Diabetes Essential Nutrients along with your doctor prescribed medications.

[http://www.essential-nutrients.net]

Donald Ford, MD, Diplomate of the American Board Internal Medicine. Dr. Ford has practiced general internal medicine for the past 22 years. He is a native Texan and trained at Baylor University, the University of Texas Medical School at Houston, and Scott and White in Temple. He is a Clinical Assistant professor at Baylor College of Medicine. In addition to general Internal Medicine, his practice includes travel medicine, vascular disease prevention, and Integrative Medicine with nutrients. He has been interested in the body’s ability to heal itself since medical school, and has used nutrients throughout his career to help patients use less prescription medication, or avoid it altogether.While he sees the tremendous value prescription medications can provide, he is also aware of the value and place for nutrients.

Diabetes in Senior Citizens

Your body obtains glucose from the food you take in, the liver and muscles also supply your body with glucose. Blood transports the glucose to cells throughout the body. Insulin, a chemical hormone, helps the body's cells to take in the glucose. Insulin is made by the beta cells of the pancreas and then released into the bloodstream.

If the body does not make enough insulin or the insulin does not work the way it should glucose is not able to enter the body's cells. Instead the glucose must remain in the blood causing an increase in blood glucose level. This high blood glucose level causes pre-diabetes or diabetes.

Pre-diabetes means that blood glucose level is higher than average but not high enough for a diabetes diagnosis. Having pre-diabetic glucose levels increases risk for developing type 2 diabetes as well as heart disease and stroke. Still, if you have pre-diabetes there are many ways to reduce your risk of getting type 2 diabetes. Moderate physical activity and a healthy diet accompanied by modest weight loss can prevent type 2 diabetes and help a person with pre-diabetes to return to normal blood glucose levels.

Symptoms of diabetes include excessive thirst, frequent urination, being very hungry, feeling tired, weight loss without trying, the appearance of sores that slowly heal, having dry and itchy skin, loss of feeling or tingling in feet, and blurry eyesight. Still, some people with diabetes do not experience any of these symptoms.

Diabetes can be developed at any age. There are three main types of diabetes: type 1, type 2, and gestational diabetes.

Type 1 diabetes is also referred to as juvenile diabetes or insulin-dependent diabetes. It is usually diagnosed in children, teens, or young adults. In this type of diabetes, the beta cells of the pancreas are no longer able to produce insulin because they have been destroyed by the body's immune system.

Type 2 diabetes is also referred to as adult-onset diabetes or non insulin-dependent diabetes. It may be developed at any age, including childhood. In this type of diabetes is the result of insulin resistance, a condition in which the body's cells do not interact properly with insulin. At first, the pancreas is able to produce more insulin to keep up with the increased demand for insulin. However, it loses the ability to make up for the body's cells inability to interact properly with insulin with time. The insulin is unable to help the cells take in glucose, this results in high blood glucose levels. Type 2 diabetes is the most common form of diabetes. An unhealthy weight contributed by a high calorie diet and lack of physical activity increases the risk for developing this form of diabetes.

African Americans, Hispanic Americans, American Indians, Alaska Natives, and Asian and Pacific Islanders are at especially high risk for developin Type 2 diabetes.

Gestational diabetes refers to the development of diabetes in the late stages of pregnancy. It is caused by hormones associated with pregnancy and a shortage of insulin. This form of diabetes goes away after the baby is born, but puts both the mother and child at a greater risk for developing type 2 diabetes in later life.

Diabetes is a serious disease and when it is not well controlled, it damages the eyes, kidneys, nerves, heart, gums, and teeth. Having diabetes makes one more than twice as likely as someone without diabetes to have heart disease or stroke.

It is important to keep blood glucose, blood pressure, and cholesterol under control to avoid the serious complications associated with diabetes. Taking steps to control diabetes can make a large impact in the one's health.

Risk Factors and Prevention

Diabetes is a serious disease with no cure. Controlling blood glucose levels, blood pressure, and cholesterol can help prevent or delay complications associated with diabetes such as heart disease and stroke. Much research is being done to find ways to treat diabetes.

Risk Factors

Type 1 diabetes is classified as an autoimmune disease. An autoimmune disease is the result of the body's own immune system, which fights infections, turning against part of the body.

Currently, it is unclear what exactly causes the body's immune system to turn on itself attacking and destroying the insulin producing cells of the pancreas. There are genetic and environmental factors, such as viruses, involved in the development of type 1 diabetes. Researchers are working to identify these factors and prevent type 1 diabetes in those at risk.

Type 2 diabetes is associated with being overweight, high blood presure, and abnormal cholestorol levels. Being overweight can contribute to one's body using insulin correctly.

Other risk factors include:

• Having a family history of diabetes, perhaps in a parent, brother, or sister.


• Being of African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino descent.


• Having a history of heart disease.


• Having a history of gestational diabetes.


• An inactive lifestyle

PreventionModest changes in lifestyle can help prevent the development of type 2 diabetes in those at risk. Here are some helpful tips.

• Maintain a healthy body weight. Being overweight has many negative effects on one's health and can prevent the body from properly using insulin. It also can contribute to high blood pressure. Research shows that even a modest amount of weight loss can reduce one's risk of developing type 2 diabetes.


• Make healthy food choices. What we put into our bodies has big consequences in our health and how our body functions. Eating healthy helps control body weight, blood pressure, and cholesterol levels.


• Be active. Find a physical activity you enjoy and that gets your heart pumping, perhaps walking briskly, dancing, or yard work. Try to be physically active for at least 30 minutes a day 5 days a week - research shows that this helps to reduce the risk for type 2 diabetes.

Symptoms and DiagnosisDiabetes is sometimes referred to as a "silent" disease because people may not show any signs or symptoms. Symptoms of diabetes include: excessive thirst frequent urination, being very hungry, feeling tired, weight loss without trying, the appearance of sores that slowly heal, having dry and itchy skin, loss of feeling or tingling in feet, and blurry eyesight. Still, some people with diabetes do not experience any of these symptoms.

Symptoms for type 2 diabetes develop gradually, while type 1 diabetes develops more quickly.

Doctors use different tests to diagnose diabetes. Tests to diagnose diabetes and pre-diabetes include the fasting plasma glucose (FPG) test and the oral glucose tolerance test (OGTT). A random plasma glucose test allows doctors to diagnose only diabetes.

If any of these tests show that you might have diabetes, your doctor will need to repeat the fasting plasma glucose test or the oral glucose tolerance test on a different day to confirm the diagnosis.

Because type 2 diabetes is more common in older people, especially in people who are overweight, doctors recommend that anyone 45 years of age or older be tested for diabetes. If you are 45 or older and overweight, getting tested is strongly recommended.

Older adults are at higher risk for developing Type 2 diabetes, particularly if they are overweight. Doctors recommend that those over 45 years of age be tested for diabetes especially if they are overweight.

Diabetes is a serious disease that can lead to pain, disability, and death. Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick.

Despite the risk of diabetes due to age and weight status, people often delay having a checkup because they do not feel any symptoms. Sometimes, people experience symptoms do not realize that it may be diabetes. Still, diabetes is a serious disease which, if left untreated, may lead to hazardous complications and even death.

Often times, people are not diagnosed with diabetes until they experience one of its complications, such as heart trouble or difficulty seeing. Early detection can prevent or delay such complications, making checkups all the more important.

Treatment

There is no cure for diabetes, but with careful control of blood glucose level, as well as cholesterol levels and blood pressure, it can be managed.

People with type 1 diabetes use insulin injections, by shots or an insulin pump, to control their blood glucose levels. People with type 2 diabetes use oral medications, insulin, or both to control their blood glucose levels. In some cases of type 2 diabetes, a person can use diet and exercise alone to maintain appropriate blood glucose levels.

Managing your blood glucose includes several lifestyle changes. These include:

• Follow a meal plan that makes sense for you and how your body responds to the different foods that you eat.


• Incorporate physical activity into your daily life.


• Take the appropriate diabetes medicine and check your blood glucose levels in a manner that is consistent with your doctors recommendations is also key.

Treatment and Research - Diet and ExerciseFollow a Meal Plan

To keep your blood glucose level in the correct range, it is very important to make healthy choices when it comes to what foods you eat. People with diabetes should have their own meal plan that makes sense with how their body responds to the different type so of food that they eat. If you ask, doctors can give you the contact information of a dietitian or diabetes educator who can help you to construct an appropriate meal plan.

When you develop your meal plan, several things should be considered such as your weight, daily physical activity, blood glucose levels, and medications. A meal plan will help you to achieve a healthy weight for those who are overweight in addition to helping control blood glucose levels. A dietitian can help clarify misconceptions about healthy eating as well as ease you and your family into a plan that fits your goals and lifestyle.

It is not necessary for people with diabetes to only eat particular foods, rather food that are good for everyone are also good for diabetics. Such food includes those that are low in fat, salt, and sugar. Foods that are high in fiber, such as whole grains, beans, fruits, and vegetables are also great choices. Making healthy choices in your diet will help you to achieve and maintain a healthy weight, control your blood glucose levels, and prevent heart disease.

Get Regular Physical Activity

Staying active is very important for people diagnosed with diabetes. Research has shown better blood glucose levels in older adults and senior citizens who take part in a regular fitness program. Exercise offers many health benefits that are especially important for people with diabetes. It helps you to reach and maintain a healthy weight, promotes insulin functioning to lower blood glucose, strengthens the heart and lungs, and increases energy.

If exercise is new to you, talk with your doctor before you begin. Some exercises, for example weightlifting, may not be safe for people with eye problems or high blood pressure. Ask your doctor to check your heart and feet to make sure you do not have any special problems associated with diabetes. Moreover, ask you doctor to help you find exercises that are safe for you.

Make physical activity a part of your daily life. Go on walks, ride a bike, or garden. Try dancing or swimming, or simply stay active by doing work around the house. Try different activities and look for ways to increase physical activity in your everyday life. Try to get some sort of exercise every day for at least 30 minutes. If you are new to exercising, start slowly and gradually increase the amount and intensity of your exercise.

Medication

Insulin

People with type 1 diabetes and some people with type 2 diabetes use Insulin to lower blood glucose levels. People must take insulin when their body does not take enough of it. Insulin is a liquid hormone that must be injected with shots or an insulin pump.

Diabetes Pills

In many cases of type 2 diabetes, the body makes enough insulin but is not properly used by the body. Diabetes pills are used to correct this problem. Some are taken once daily while others must be taken more often. It is important to ask your doctor or pharmacist how to take your pills. Also, be sure to talk with your doctor if you are experiencing side effects or your pills make you sick. Finally, remember that diabetes pills should be used in addition to a healthy diet and exercise.

Other cases of type 2 diabetes do not require insulin or diabetes pills, rather a healthy diet and regular physical activity will treat their diabetes.

Self-Monitoring

It is important to keep track of your blood glucose levels regularly by using a blood glucose monitor. Logging these levels in a diary may also be helpful to get a better idea of how your treatment is going. Some people must check their blood glucose levels several times a day while others check it once daily. Ask your doctor how often you should test your blood.

Monitoring your glucose levels will help you detect "highs" and "lows." A condition referred to as hypoglycemia results when glucose levels fall too low. When this happens a person may become shaky and confused. If blood glucose levels decrease too much, a person may faint. Following the treatment plan recommended by your doctor as well as monitoring your blood glucose levels can help you avoid "lows." If you check your glucose level and it is too low, you can increase it by taking in sugary foods or drinks like fruit juice.

A condition referred to as hyperglycemia results when glucose levels are too high. If blood glucose is too high, it can cause a person to go into a coma. If you experience persistent "highs," talk with your doctor, you may need to adjust your treatment plan.

ABCs of Monitoring Diabetes

People with diabetes are at especially high risk for developing heart disease and stroke. Because of this, it is very important to monitor your diabetes using your "ABCs."

A. A1C or average blood glucose
B. Blood pressure
C. Cholesterol

The A1C (A-one-C) test is a good measure of what your blood glucose level is most of the time. A test result lower than 7 is positive sign that your diabetes is under control. A test result that is greater than 7 means that blood glucose levels are too high. If your A1C is too high, take action. Talk with your doctor about changing your treatment plan and lifestyle to reach your goal. Lowering your A1C to a healthy level, will help you avoid the complications associated with diabetes such as heart disease and kidney damage.

High blood pressure can lead to stroke, kidney disease, and other complications. Generally people with diabetes want to keep their blood pressure less than 130/80. Have your blood pressure checked at every doctor visit. If it is too high, talk with your doctor about how you can lower it.

Cholesterol, particularly LDL cholesterol, is a fat like substance that builds up in your arteries. If your cholesterol levels are too high it causes your arteries narrow. This can lead to heart disease or a heart attack. People with diabetes should try to keep their cholesterol less than 100. Have your doctor check your cholesterol, and if it is too high talk with him or her about how to reach your cholesterol goal.

Foot and Skin Care

High glucose levels and decreased blood supply to the limbs can cause severe nerve damage and loss of feeling. Unnoticed injuries can contribute to ulcers, which may lead to amputation. Because of this, foot care is very important for people with diabetes. Check your feet every day for cuts, ret spots, sores, infected toenails, and swelling. Report any issues to your doctor, and be sure to have your feet checked at every doctor visit. People with diabetes are more likely to experience skin injuries and infections; for this reason, taking care of your skin is also important.

Diabetes And The Long Term Dangers

Diabetes has hidden dangers that begin before diagnosis and continue to worsen if certain steps are not taken to prevent the complications that are the true, "killers" in terms of diabetes.

Statistics show that there are around 18 million diabetics in America, both Type 1 and Type 2. It is amazing how many people, diabetics included, who have no idea what dangers a diabetic faces over their lifetime. A diabetic, all things being equal, lives almost 10 years less than their non-diabetic counterpart on average.

Why do diabetics life shorter life spans than non-diabetics? The answer is both simple and complicated. Simple in explaining in general terms, complicated in the medical sense. Without traveling the complicated route in this article, I will try to give a simple, straight forward answer to the above question. Diabetics live shorter lives than non-diabetics because of diabetic complications.

What Are Diabetic Complications?

Diabetic complications are chronic medical conditions that begin to affect the body of the diabetic. These complications are brought about mostly by a condition the medical community had named, "Advanced Glycation End products" which is simply, "excess sugar" saturating the inside of the cells of the body. This condition also called AGE for short includes coronary artery disease, vascular disease, blindness, kidney disease, retinopathy (blindness) and loss of feeling in the hands and the feet (peripheral neuropathy) among others.

Diabetes in the early stages does not produce symptoms. Unless found during a routine medical exam, it is possible for a diabetic to remain undiagnosed for years. It is during these years that the beginnings of diabetic complications can gain a foothold due excess sugar in the cells (AGE). The statistics show there is the possibility of as many as over 5 million people going about their normal lives while having undiagnosed diabetes.

Are Diabetic Complications A Certainty?

While the current consensus is that the formula for diabetic complications Diabetes + Time = Complications. What this means is there is a much higher potential of a diabetic becoming diagnosed with one or more diabetic complications over time. This is partly due to how well the individual monitors and controls his/her blood sugar.

Drastic rises and falls of blood sugar can be hard on the body and the excess sugar present in the cells create havoc on the different nerves within the body as well as the capillaries, veins, and arteries. The evidence to date show that excellent control of blood sugar and an active lifestyle goes a very long way in preventing and/or slowing down the onset of diabetic complications.

The Different Types Of Diabetes

There are two types of diabetes - Type One and Type Two. Type One attacks children and young adults and is characterized by the pancreas failing to produce insulin which is a hormone that breaks down sugars and starches while converting them into energy. Type Two occurs usually later in an adult's life and is characterized by the pancreas being unable to produce enough insulin due to several factors, obesity being one of them.

Around 10 percent of diabetics are Type One while the other 90 percent are Type Two. The major difference between the two being that Type One diabetics are completely dependent on insulin and take daily injections while the Type Two's have both those who require insulin shots while others can rely on oral medication and/or changes in diet and exercise.

The Risk Factors Surrounding Diabetes

There are several risk factors that can push a pre-diabetic into full blown diabetes.

1) being overweight.

2) family history of diabetes,

3) lack of adequate exercise.

4) history of gestational diabetes (occurs during pregnancy and usually disappears after delivery).

5) certain ethnic groups

People over 45 years of age and has one or several of the risk factors mentioned above should be screened for diabetes each year, preferably during an annual medical exam. It has been shown that people with these risk factors comprise the majority of diagnosed cases of diabetes each year.

What Tests Help Diagnose Diabetes Cases?

There are two, main tests used for determining whether or not a person has a glucose intolerance:

1) Fasting Plasma Glucose Test

2) Oral Glucose Tolerance Test

Both of these tests can determine glucose intolerance which is where blood sugar is higher than what is considered normal. This is not always an indication of diabetes however.

Can The Onset Of Diabetes Be Prevented?

People with the above risk factors can go a long way toward preventing the development of full-blown diabetes by making significant lifestyle change. What are lifestyle changes? Changing unhealthy diets to more blood sugar friendly ones, doing enough exercise to help offset increased blood sugar levels and keep the body healthy and losing weight especially if considered obese by the medical community.

If you are pre-diabetic you need to stay on a strict diabetic diet. Ask your healthcare professional for a diet that meets that criteria and limit cakes, candy, cookies, and other things made of simple sugars. Eat small, nutritious meals and eat 5 times a day instead of only three.

If you are already diagnosed with full-blown diabetes, you should follow the same diet while under the meticulous care of your healthcare professional. Keep your cholesterol, blood pressure and blood sugar within proper limits and have your eyes checked every year.

Diabetes can contribute to blindness, kidney disease and heart disease. Complications caused nearly 70,000 deaths in 2000.

What Can The Diabetic Look Forward To?

Diabetic complications can be prevented or lessened for a longer time period by paying serious attention to lifestyle. A diabetic who eats right, keeps his blood sugar in control and within accepted limits, exercises and gets proper rest can expect to have a quality of life that is much higher in terms of the pain and suffering that diabetic complications brings into the lives of diabetics who do nothing to change their lifestyle.

What begins to occur in the diabetic who starts to develop complications because of uncontrolled blood sugars over time is a life filled with the possibility of becoming an invalid, either blind, an amputee, or suffering renal failure or a heart attack.

The above paints a rather grim picture if lifestyle changes are not adhered to. Research has shown that the diabetic that keeps their blood sugar within acceptable limits and follows a healthy, diabetic lifestyle that has been shown to be effective against diabetic complications stands a much better chance of not developing many of the complications their less than dedicated counterparts do.

There is a new derivative of thiamine (Vitamin B1) available now that is showing great promise in greatly reducing the excess sugar in the cells of the diabetic, the process known as Advanced Glycation Endproducts (AGE).

Is Benfotiamine Effective Against Diabetic Complications?

Benfotiamine is a lipid soluble derivative of thiamine. Japanese researchers developed benfotiamine in the 1950's and later patented it in the United States in 1962. No one in the US medical community paid much attention to it at the time. For the past 12 years in Europe it has been used for neuropathy, retinopathy and other uses.

The chemical name and formula for benfotiamine is: S-benzoylthiamine-O-monophosphate (C19H23N4O6PS). It wasn't until a group of researchers in New York at the Albert Einstein College of Medicine of Yeshiva University released the results of their research in 2003 in Nature Medicine Magazine did the rest of the world begin to take a look at this substance.

Benfotiamine is unique and was reported by Michael Brownlee, M.D., as showing much promise in preventing nerve and blood-vessel damage in diabetics. Every diagnosed diabetic has been told by his/her healthcare provider that diabetic complications are the true killers in terms of diabetes.

If you are a diabetic or know a diabetic, you may find additional information about benfotiamine and view research that has been recently conducted showing the benefits of preventing diabetic complications by following the link to the website below.

Zach Malott is CEO of Brentwood Health International, a nutritional supplement company involved in distribution and supplying wholesale, retail and end users.

Diabetes: African Americans Deadly Foe

Diabetes is having a devastating effect on the African American community. Diabetes is the fifth leading cause of death in African Americans and their death rates are twenty seven percent higher than whites.

Over 2.8 million African Americans have diabetes and one third of them don't know they have the disease. In addition, twenty five percent of African Americans between the ages of 65 - 74 have diabetes and one in four African American women, over the age of 55, have been diagnosed with the disease

The cause of diabetes is a mystery, but researchers believe that both genetics and environmental factors play roles in who will develop the disease.

Heredity

Researchers believe that African Americans and African Immigrants are predisposed to developing diabetes. Research suggests that African Americans and recent African immigrants have inherited a "thrifty gene" from their African ancestors.

This gene may have enabled Africans to use food energy more efficiently during cycles of feast and famine. Now, with fewer cycles of feast and famine, this gene may make weight control more difficult for African Americans and African Immigrants.

This genetic predisposition, coupled with impaired glucose tolerance, is often associated with the genetic tendency toward high blood pressure. People with impaired glucose tolerance have higher than normal blood glucose levels and are at a higher risk for developing diabetes.

What is Diabetes?

Diabetes, commonly know as "sugar diabetes", is a condition that occurs when the body is unable to properly produce or use insulin. Insulin is needed by the body to process sugar, starches and other foods into energy. Diabetes is a chronic condition for which there is no known cure; diabetes is a serious disease and should not be ignored.

Diabetics often suffer from low glucose levels (sugar) in their blood. Low blood sugar levels can make you disorientated, dizzy, sweaty, hungry, have headaches, have sudden mood swings, have difficulty paying attention, or have tingling sensations around the mouth.

Types of Diabetes

Pre-diabetes is a condition that occurs when a person's blood glucose levels is higher than normal but not high enough for a diagnosis of type II diabetes. Pre-diabetes can cause damage to the heart and circulatory system, but pre-diabetes can often be controlled by controlling blood glucose levels. By controlling pre-diabetes you can often prevent or delay the onset of Type II diabetes.

Type I or juvenile-onset diabetes usually strikes people under the age of 20, but can strike at any age. Five to ten percent of African Americans who are diagnosed with diabetes are diagnosed with this type of the disease. Type I diabetes is an autoimmune disease where the body produces little or no insulin and this type of diabetes must be treated with daily insulin injections.

Type II or adult onset diabetes is responsible for ninety to ninety-five percent of diagnosed diabetes cases in African Americans. Type II results from a condition where the body fails to properly use insulin. According to the American Diabetes Association, "Type II is usually found in people over 45, who have diabetes in their family, who are overweight, who don't exercise and who have cholesterol problems." In the early stages it can often be controlled with lifestyle changes, but in the later stages diabetic pills or insulin injections are often needed.

Pregnancy related diabetes or gestational diabetes can occur in pregnant women. Gestational diabetes is often associated with high glucose blood levels or hyperglycemia. Gestational diabetes affects about four percent of all pregnant women. The disease usually goes away after delivery, but women who suffer from gestational diabetes are at a higher risk for developing diabetes later in life.

Symptoms of Diabetes

The most common symptoms of diabetes include:

excessive urination including frequent trips to the bathroom

increased thirst

increased appetite

blurred vision

unusual weight loss

increased fatigue

irritability

Complications from Diabetes

Diabetes can lead to many disabling and life threatening complications. Strokes, blindness, kidney failure, heart disease, and amputations are common complications that effect African Americans who have diabetes

Kidney Disease

"Diabetes is the second leading cause of end stage kidney disease in African Americans, accounting for about thirty percent of the new cases each year," says the National Kidney Foundation of Illinois. Up to twenty-one percent of people who develop diabetes will develop kidney disease.

Amputations

Diabetes is the leading cause of non-traumatic lower-limb amputations in the United States. More than sixty percent of non-traumatic lower-limb amputations in America occur among people with diabetes and African Americans are almost three times more likely to have a lower limb amputated due to diabetes than whites. According to Center for Disease Control (CDC), about 82,000 non-traumatic lower-limb amputations were performed among people with diabetes in 2001.

Blindness

African Americans are twice as likely to suffer from diabetes related blindness. Diabetics can develop a condition called "Diabetic Retinopathy", a disease affecting the blood vessels of the eye, which can lead to impaired vision and blindness. Diabetes is the leading cause of new cases of blindness in people from 20 - 74 years of age and up to 24,000 people loose their sight each year because of diabetes.

Heart Disease

People with diabetes are up to four times more likely to develop heart disease as people who don't have diabetes. Atherosclerosis (hardening of the arteries) is more common in diabetics and can lead to increased risk of heart attacks, stroke, and poor circulation throughout the body.

Diabetes Risk Factors

What You Need To Know About Diabetes

INTRODUCTION

According to the World Health Organization, a few decades back diabetes was an uncommon disease, in both developed and developing countries. Today, the story is different. It is currently estimated that over 143million people worldwide are affected by the disease. This figure is ever increasing, by 2020 over 220million people are expected to be living with diabetes, if the current trend continues.

In the United States alone, there are 18.2 million people (6.3% of the population) living with diabetes. While another 13million people have been diagnosed with diabetes. Unfortunately, 5.2milion (or nearly one third) are unaware that they have the disease.

The figure for Nigeria is not readily available, but it is estimated that over 1.5million people have diabetes in Nigeria.

In developed countries, most patients of diabetes are over sixty, but in developing countries, diabetes is found to affect people in their prime.

WHAT IS DIABETES?

Diabetes Mellitus (or simply diabetes) is derived from the Greek word 'Diabeinein', meaning 'To pass through' describing copious urination, and Mellitus from the Latin word meaning 'Sweetened with honey'. These two words signify sweetened urine or sugar in urine.

Diabetes is a disease in which the body does not produce or properly use Insulin. Insulin is a hormone that is needed, in the body, to control the rate at which sugar, starch and other food are converted into glucose required as energy for daily life. The hormone is produced and released
into the blood by an organ called 'Pancreas'. This insulin help to maintain the blood glucose level within a normal range. The World Health Organization (WHO) puts this normal range between
60 - 100mg/dl (Before taking any food for the day, hence this value is called Fasting Blood Glucose). In health, despite several demands for glucose in different situations, the blood glucose rarely exceeds this value.

After a meal the liver stores the glucose from the meal as glycogen and releases it into the blood in between meals. The role of insulin is the control of this storage and release of glucose. It ensures that the amount of glucose in the blood at every particular time does not go beyond or below the normal range.

TYPES OF DIABETES.

According to the World Health Organization (WHO), five classes of diabetes are recognized, these are; Insulin Dependent Diabetes Mellitus (IDDM) or Type I Diabetes, Non Insulin Dependent Diabetes Mellitus (NIDDM) or Type II Diabetes, Gestational Diabetes, Diabetes Insipidus and Bronze Diabetes.

INSULIN DEPENDENT/TYPE I DIABETES: This type of diabetes was initially called Juvenile onset diabetes because it affects adolescents and young adults. It is caused by a sudden failure of the pancreas to produce Insulin. It is, therefore, an acute disease, presenting with thirst, polyuria (passing large amount of urine), diuresis and weight loss. Type I diabetes is not common, it accounts for less than 10% of all diabetes cases.

NON-INSULIN DEPENDENT/ TYPE II DIABETES: This is the most prevalent type of diabetes, accounting for more than 80% of all diabetic cases. It is found in adults and the elderly. This type of diabetes develops gradually over a long period of time (unnoticed) and is characterized by insufficient insulin, deficient insulin in the blood or the inability of the body to utilize the insulin resent (Insulin resistance). Because of its slow and gradual occurrence, it is mostly undetected until one or more of its long-term complications appear.

Unlike in Type I Diabetes, the Insulin in the blood of a Type II diabetic may be normal or even high, but lacks the desired effect, due to insulin resistance, and this is prevalent among obese people.

GESTATIONAL DIABETES: This type of diabetes occurs during pregnancy and disappears after delivery, within 3weeks. An estimated 3% of all pregnancies are accompanied by gestational diabetes and almost half of these patients are prone to developing permanent diabetes later in life.
WHAT CAUSES DIABETES.

As with hypertension and other non communicable diseases, no clear cut cause(s) can be attributed to the most prevalent type of diabetes (Type II Diabetes, Type I diabetes being secondary to failure of the pancreas). However, some factors are known to increase one's chances of becoming diabetic and these are called risk factors. For example, indolent and well-fed populations are 2 - 20times more likely to develop type II diabetes than active and lean population of the same race. Some other factors known to increase one chances of getting diabetes include:

OBESITY: It is estimated that three quarter (¾) of all Type II diabetes patient are obese. Indolent and affluent lifestyles tend to contribute to this. It is believed that a 10kg loss of weight can reduce fasting blood sugar level by almost 50md/dl. An active lifestyle with frequent exercise is also known to increase Insulin sensitivity.

The International standard for measuring overweight and obesity is based on a value called BODY MASS INDEX (BMI). This value is derived by dividing the body weight (in Kilograms) by the square of height (in metres).

i.e. BMI = Body weight (Kg) / Height2 (Metres).

Note: 1ft = 0.305metres.

For adults, a BMI less than 25kg/m2 is preferred.

25 - 29kg/m2 is considered overweight and above 30kg/m2 is Obesity.

FAMILY HISTORY: A family history of diabetes increases one's chances of getting the disease. In such a situation, leading a healthy lifestyle and constant monitoring of one's blood sugar level becomes very important.
AGE AND RACE: Most Type II diabetes patient are over 40yrs at presentation of the disease. However, the proportion of increase in the incidence of this disease with age is higher for those with a family history of diabetes, obese and probably those leading sedentary lifestyles. Moreover, diabetes tends to be more prevalent among Africans, African Americans, Latinos, Native Americans and Asian Americans. Belonging to any of the races is a risk factor in itself.

HISTORY OF GESTATIONAL DIABETES: in a woman also increases her chances/possibility of developing permanent diabetes later in life.

YOU CAN PREVENT/DELAY DIABETES!
Diabetes have no permanent cure once it develops, it is managed al through life. But you can prevent ever falling into this life long pain. Before diabetes present in people, it is almost always preceded by a situation called PRE DIABETES. A situation where the blood glucose is higher than normal, but not yet enough to be diagnosed as diabetes. Saddening, however, you cannot know when you fall into this category, if you have not being monitoring your blood glucose regularly.

Pre Diabetes is itself a serious medical situation, though can still be reversed by making changes in diet pattern and increasing physical activity. To determine one's blood sugar a test called Fasting Blood Glucose has to be conducted. This test measures the amount of glucose (sugar) in one's blood before taking any meal for the day. It is measured in milligrams per deciliter (mg/dl).

A value below 100mg/dl is generally accepted to be normal, while a value greater than 100mg/dl but less than 120mg/dl is not full diabetes yet, so it is regarded as Pre diabetes. An individual with a pre diabetes blood glucose level need to take urgent steps to reduce his blood glucose or risk life long diabetes.

It should be emphasized, however, that the racial and genetic factors predisposing to diabetes are still beyond human comprehension and control. It makes common sense, therefore, to reduce all human controllable factors to the barest minimum. Most of these factors have to do with social occupational and diet habits.

The following tips can help reduce your diabetes risk:

* Reduce weight. Obesity seems to be the single most significant factor in diabetes. Reducing body weight and fat and maintaining an average body weight is very essential. To this end a body mass index (BMI) less than 25kg/m2 for males and less than 24kg/m2 for females is recommended.

* Increase Physical Activity. It is an established fact that diabetes is more common among people that lead a sedentary affluent lifestyle. Simple dynamic exercises like brisk walking for 30-50mins daily or 3-5times weekly has been shown to be very helpful. Exercise reduces bodyweight and fat, increases functionality of the heart, reduces the chances of diabetes and also boosts emotions and healthy living.

* Cut down or cut out alcohol. Alcoholic intake of more than 2units per day has been shown to adversely affect the body. Alcohol being an addictive drug makes it very difficult to maintain a definite amount of intake for a long time. It is better therefore to strive to cut out alcohol completely.

* Avoid Smoking. Cigarette smoke has been shown to contain several poisonous substances. Cigarette smoking and alcohol have been related to several disease. Stopping smoking will definitely reduce the chances of several other ailments apart from diabetes.

* Lean good eating habits, such as;

* Cut down on fatty food and junks

* Eat more of fish and poultry (without the skin is better).

* Garlic reduces blood pressure cholesterol; add it to your meal plan once in a while.

* Cut the number of eggs you take to 3- 4 weekly (better boiled than fried).

* Reduce salt intake to less than 5.8grams daily.

* Eat more of vegetables and fibre rich food, especially fruits.

* Finally, constantly monitor your fasting blood glucose, as this is the only way to know when you are getting into trouble.

CONCLUSION

Diabetes and Hypertension being so interlinked requires a comprehensive plan of care, and this revolves round one's dietary habits, social and environmental factors. Several lifestyle changes like regular exercise, maintaining a moderate body weight, reduction of fat intake and high fibre diet all help to live a normal healthy life. These measures are known to increase insulin sensitivity and also reduce blood pressure.

Conclusively, it is very important to create a more health conscious individuals in the populace. A people who practically believe that it is better and cheaper to prevent an illness than to treat it, when it has become stronger. Moreover, preventive health cannot be divorced from regular medical checks, as this two go hand in hand. There is no way to detect several non-communicable diseases without undergoing regular medical checks. The importance of these checks cannot be over emphasized.
Be alive to your health. Know your Blood glucose values and live a healthier life free from the pains of diabetes.

Type 1 and Type 2 Diabetes

Diabetes affects the manner in which the body handles digested carbohydrates. If neglected, diabetes can cause serious health complications, ranging from blindness to kidney failure.

Approximately 8% of the population in the United States has diabetes. This means that approximately 16 million people have been diagnosed with the disease, based only on national statistics. The American Diabetes Association estimates that diabetes accounts for 178,000 deaths, 54,000 amputees, and 12,000-24,000 cases of blindness annually. Blindness is 25 times more common among diabetic patients compared to nondiabetics. It is proposed that by the year 2010, diabetes will exceed both heart disease and cancer as the leading cause of death through its many complications.

Diabetics have a high level of blood glucose. The blood sugar level is regulated by insulin, a hormone produced by the pancreas, which releases it in response to food consumption. Insulin causes the cells of the body to take in glucose from the blood. The glucose is used as fuel for cellular functions.

Diagnostic standards for diabetes have been fasting plasma glucose levels greater than 140 mg/dL on two occasions and plasma glucose greater than 200 mg/dL following a 75-gram glucose load. More recently, the American Diabetes Association lowered the criteria for a diabetes diagnosis to fasting plasma glucose levels equal to or greater than 126 mg/dL. Fasting plasma levels outside the normal limit require additional tests, usually by repeating the fasting plasma glucose test and (if indicated) giving the patient an oral glucose tolerance test.

The symptoms of diabetes include excessive urination, excessive thirst and hunger, sudden weight loss, blurred vision, delay in healing of wounds, dry and itchy skin, repeated infections, fatigue and headache. These symptoms, while suggestive of diabetes, may be due to other reasons also.

There are two different types of diabetes.

Type I Diabetes (juvenile diabetes or insulin-dependent diabetes): The cause of type I diabetes is caused by pancreatic inability to produce insulin. It is responsible for 5-10% of cases of diabetes. The pancreatic Islet of Langerhans cells, which secrete the hormone, are destroyed by the body's own immune system, probably because it mistakes them for a virus. Viral infections are thought to be the trigger that sets off this auto-immune disease. It is more common in caucasians and runs in families.

If untreated, death occurs within a few months of the onset of juvenile diabetes, as the cells of the body starve because they no longer receive the hormonal prompt to take in glucose. While most Type I diabetics are young (hence the term Juvenile Diabetes), the condition can develop at any age. Autoimmune diabetes can be definitely diagnosed by a blood test which shows the presence of anti-insulin/anti-islet-cell antibodies.

Type II Diabetes (non insulin dependent diabetes or adult onset diabetes): This diabetes is a result of body tissues becoming resistant to insulin. It accounts for 90-95% of cases. Often the pancreas is producing more than average amounts of insulin, but the cells of the body have become unresponsive to its effect due to the chronically high level of the hormone. Eventually the pancreas may exhaust its over-active secretion of the hormone, and insulin levels fall to below normal.

A tendency towards Type II diabetes is hereditary, but it is unlikely to develop in normal-weight individuals eating a low- or moderate-carbohydrate diet. Obese, sedentary individuals who eat poor-quality diets based on refined starch, which constantly activates pancreatic insulin secretion, are prone to develop insulin resistance. Native peoples such as North American Indians whose traditional diets did not include refined starch until its recent introduction by Europeans have extremely high rates of diabetes, up to 5 times the rate of caucasians. Blacks and hispanics are also at higher risk. Though Type II diabetes is not fatal within a matter of months, it can lead to health complications over several years and cause severe disability and premature death. As with Type I diabetes, the condition is found primarily in one age group, in this case people over 40 (which is why it is often termed Adult Onset); however, with the rise in childhood and teenage obesity, it is appearing in children as well.

If neglected, diabetes can lead to life-threatening complications such as kidney damage (nephropathy), heart disease, nerve damage (neuropathy), retinal damage and blindness(retinopathy), and hypoglycemia (drastic reduction in glucose levels). Diabetes damages blood vessels, especially smaller end-arteries, leading to severe and premature atherosclerosis. Diabetics are prone to foot problems because neuropathy, which affects approximately 10% of patients, causes their feet to lose sensation. Foot injuries, common in day-to-day living, go unnoticed, and these injuries do not heal because of poor circulation through the small arteries in the foot. Gangrene and subsequent amputation of toes or feet is the consequence for many elderly patients with poorly-controlled diabetes. Usually these sequelae appear earlier in Type I than Type II diabetes, because Type II patients have some of their own insulin production left to buffer changes in blood sugar levels.

Type I diabetes is a serious disease and there is no permanent cure for it. However, the symptoms can be controlled by strict dietary monitering and insulin injections. Implanted pumps which release insulin immediately in response to changes in blood glucose are in the testing stages.

In theory, since it caused by diet, Type II diabetes should be preventable and manageable by dietary changes alone, but in practice many diabetics (and many obese people without diabetes) find it personally impossible to lose weight or adhere to a healthy diet. Therefore they are frequently treated with drugs which restore the body's response to insulin, and in some cases injections of insulin.

Please note that this article is not a subsitute for medical advice. If you suspect you have diabetes or are in a high risk group, please see your doctor.

Diabetes and Depression: Can Hypnosis Help?

Discussed in this article:

1) The Quiet Crisis Within Diabetes.

2) A Hidden Danger of Diabetes.

3) Are Physicians Aware Of This Danger?

4) Does Depression Cause Diabetes?

5) The Formation of Depression Post-Hypnotic Suggestions.

6) Summary

5) Next Issue Highlights.

The Quiet Crisis Within Diabetes

Depression is a 'quiet crisis' facing diabetics, their families and their health care providers. Financially and emotionally this crisis is exacting a terrible cost.

The purpose of this and following articles is to share important information about depression and how a hypnotist can responsibly and effectively help a diabetic with depression. This assistance will help to improve a diabetic's life by (a) reducing the suffering from this painful state of mind and being and (b) thus enhance their diabetes management skills which will therefore result in a state of enhanced health.

Bear in mind the importance of your contribution as a hypnotist. You can make an incredible difference because even a small reduction in a diabetic's long term blood sugar levels can result in a marked decrease in the likelihood of diabetic complications.

A Hidden Danger of Diabetes

A largely unknown hence, hidden danger of diabetes is that diabetics have twice the risk of non-diabetics for becoming depressed. Dr. Richard Surwit of Duke University states that: "Diabetes more than doubles the odds of suffering from depression at some point. One third of people with diabetes have been diagnosed with significant depression and 11 percent with major depression--twice the rate in the non-diabetic population (1)."

What is obvious and yet, not really obvious about the preceding statement is that being diagnosed with a major disease is traumatic. This, in and of itself, can lead to depression--never mind all the other contributing factors that are related to diabetes and depression.

For example, a contributing factor to depression in a diabetic can be their physiological state. As noted by Dr. Surwit, there is research indicating that high blood sugars cause biochemical changes in the brain that can lead to depression. (2)

Are Physician's Aware Of This Danger?

Physicians by and large, are extremely busy and the demands on them are greater than most can imagine. It is no wonder that many of them are simply not aware that their diabetic clients are two times more likely to suffer from depression. If they knew this, they would probably be more likely to refer their diabetic clients with poor blood sugar control to someone who could help.

When appropriate, a hypnotist can help in key ways because a hypnotist is trained to be a motivational coach and stress management consultant. One way a trained hypnotist can help a depressed person with diabetes will be explained later in this article. But first, let's look at an important question.

Does Depression Cause Diabetes?

This is an important question for many reasons. Probably one of the more compelling reasons to deeply consider this idea is because, if true to some degree, then it begs this question: Wouldn't the validity of this concept make the majority of treatment efforts inappropriate and/or ineffective to some degree? Consider the plight of many frustrated nurses and doctors who will attest that no matter what they do for their patients, nothing seems to work.

This statement is not meant to denigrate in any way the efforts of so many. It is meant to highlight the importance of timely consideration of the depression-diabetes connection before the cost for all concerned becomes not only debilitating, but also tragically unnecessary.

Consider this: Evidence, that will be discussed shortly, shows there is a strong connection between depression and diabetes. This is important because, unless diabetes treatment programs are sculpted to target a largely unaddressed cause and exacerbating feature of diabetes, many of those at risk will only become worse. Those at risk include person's with pre-diabetes as well as those with diabetes.

This pragmatic approach also prompts one to think about the idea that perhaps with re-targeted treatment methods, many of those with diabetes may actually experience a remission of symptoms. And, dwell on the idea of how many may be able to avoid developing diabetes.

Bear with me a moment while I explain. Untreated depression in those with diabetes is a personal tragedy for all family members but most especially children. I state this because children have no coping skills to handle the emotional burden of a depressed and diabetic parent.

Imagine being a child helplessly watching your mother (as in my case) being slowly, inexorably, taken apart emotionally and physically by the deadly combination of poorly controlled diabetes and untreated depression.

It is because of this searing pain that I am driven to reach whomever I can with my Diabetes Motivational Coaching TM training so that perhaps some little boy somewhere doesn't have to watch his mother go blind emotionally and physically.

I realize this may sound disingenuous or dramatic to some and I understand but I make no apologies because it is true. In fact, my feelings go far deeper than what I have communicated here. You see, the apple doesn't fall far from the tree and now that hypnosis has helped me to put my life on a previously undreamed of healthy course, my motivation is intensified because I think so many times: "What if my mother had been able to have access to these methods? How much better would her life be now?"

Now, to tie all this in to my point that perhaps an innovative approach can actually prevent diabetes: The challenge with current diabetic treatments is that no amount of chemical management (including anti-depressants as well as insulin, etc.) will ever ameliorate this significant cause of diabetes. (Depression) This is because these treatments do not address the root of the problem. Furthermore, no amount of medication given to one individual will ever prevent another from developing diabetes.

The last point seems odd until you consider a landmark Swedish study (3) in which it was discovered that there is a disturbingly high correlation between traumatic childhood life events (4) and diabetes-related auto-immune activity. This study involved 17,000 children born between 1997 and 1999. One of many conclusions in this study is that: "Experiences of serious life events (e.g., parental separation, serious illness, or death in the family) has been suggested to trigger type 1 diabetes(5) or the auto-immune process behind the disease.(6)"

An additional interesting point to take away from the preceding considerations is that current treatment programs treat one person. Limited efficacy and high cost. However, if a patient were to receive Diabetes Motivational Coaching TM then more than one person can receive the positive benefits because a healthier, non-depressed diabetic parent is less likely to have a precipitating influence on their child. Two for the price of one. A win-win situation from so many angles. Obviously more study is required but the premise is intriguing and the evidence it is based on is reasonably sound.

Another win-win benefit of appropriate, innovative treatment is that the exacerbating (and ultimately very costly) effects of depression on those with diabetes can likely be reduced or eliminated.

So, what can a properly trained hypnotist do? One key way a properly trained hypnotist can help is to reduce or eliminate depression in an individual (diabetic or not) by helping them to eliminate depression activating post-hypnotic suggestions.

The Formation of Depression Activating Post-Hypnotic Suggestions
A post-hypnotic response is a cause-effect belief program that powerfully dictates behavior. Another way to look at this is that when a specific stimulus becomes uniquely associated with a strong internal state, you have a post-hypnotic suggestion and effect. (stimulus/response)

For example, the physical lethargy and mental apathy that accompanies very high (or low) blood sugars can be a contributing factor to inappropriate cause-effect belief formation. To illustrate, let me share with this case: Shortly before I was diagnosed with diabetes, my cognitive functions were significantly reduced and my affect was severely depressed.

In layman's terms this means I felt like garbage due primarily to out of control blood sugar levels that were causing me to lose my vision as well as feel awful. (What is interesting to note is that diabetes and its attendant emotional/physical affects can go undiagnosed or misdiagnosed for years.)

Now, when a person has a strong emotional feeling, that affect state can then become associated with whatever situation and/or thoughts they are currently experiencing. I.E., uncontrolled diabetic consequences coupling with a relationship break-up, a job loss or any other stressful situation. These are common events but note that even a small, insignificant incident can also be implicated. This confluence of events is called an I.S.E. or Initial Sensitizing Event. (Please note that, as in the case of many phobias, some initial sensitizing events can have a profound post-hypnotic impact after only one learning event.)

The next stage in deepening the power of this erroneous belief programming occurs when a person is next exposed to the same stimuli that were initially associated with a powerful, negative state of mind.

The result? Generally, with enough repetition and enough time, feelings can become facts cognitively and physically. And then, a pseudo-depression cycle is perpetuated.

As a quick illustration imagine a large spider near your foot. Now, if you are a person who becomes upset when big, hairy spiders with lots of eyes and big fangs are near you, then your body will respond to some degree.

Now, imagine being unconsciously reminded (triggered or post-hypnotically influenced) to thinking and therefore feeling, many times a day that there is a nasty spider about to crawl up your leg. Ultimately, this could become a panic disorder that can even attach itself to unrelated objects and/or events. In fact, this is not uncommon.

Hopefully, this example will help to illustrate why I call it pseudo-depression. I do this because the belief syllogism is: "I feel depressed (like garbage) therefore there must be reasons."

And, when feelings happen, a person must make sense out of their world. So, they justify this unconscious, powerful, emotional experience with a conscious understanding that usually takes the form of inappropriate cause-effect associations. I.E., "I am feeling depressed because of my job--spouse--life--" or whatever seemingly reasonable explanation is available.

In other words, one's feelings of depression can be in part or whole, built on erroneous beliefs or, post-hypnotic suggestions. Therefore, all a depressed person may need are the tools and coaching in order to be able to disable erroneous cause-effect belief programs.

To finalize this point, please consider a quote from Breaking The Patterns of Depression, by Michael D. Yapko, Ph.D.:
"For most people, depression is the product of a hurtful way of interpreting and responding to life experiences."

Summary

In this article I have attempted to share information that will raise awareness on a number of different levels. If you are a person with diabetes and you are hitting a 'wall', consult with your physician to discover whether or not you have depression.

If you are a nurse or physician and you have patients who don't seem to want to take care of themselves, then perhaps there are hidden forces at work. And, there are alternatives that you may not have been aware of before now.

If you are a hypnotist and you wish to help those with diabetes, please remember four things:

1) You must always obtain a fully informed referral from your client's doctor. If you suspect your client is depressed, never diagnose. In fact, if you think they are depressed, it is incumbent upon you that you suggest they see their physician for an official assessment before you can help them further. Be sure to obtain an additional referral so that you can help them appropriately with their depression if your help is suitable. If you feel you cannot help, don't.

2) Should a physician or nurse, have time to chat with you, please remind them that if you are only allowed one approach to helping their patient, stress management alone can produce incredible blood sugar lowering benefits over time. This is attested to by an article in a January, 2002 issue of Diabetes Care in which a study done by Dr. Surwit shows that: "stress management techniques, when added to standard care, helped reduce glucose levels". Surwit notes also that: "The change is nearly as large as you would expect to see from some diabetes-control drugs".

3) By acting in a responsible manner as part of your client's health care team, you can in your way, make a big difference, even if only by reducing stress. Please note that stress is a contributing factor to depression. Therefore, as your client is reducing their stress levels they may also experience a reduction in depression. This will in turn create a need for your client to reduce their diabetic medication needs . This is because there is evidence that a reduction in depressive symptoms correlates with a reduction in blood sugar. This was demonstrated in a study conducted by Patrick Lustman, a psychologist at Washington State University School of Medicine in St. Louis.

4) Finally, before helping a person with diabetes or depression, you really need to know a great deal about both subjects.

In the next article, we will discuss several things:

1) More Ways A Hypnotist Can Responsibly Help.

2) When A Hypnotist Should Never Help.

3) The Depression-Diabetes-Pain Connection.

4) Additional Interesting Ideas and Studies.

Type 1 Diabetes Mellitus and Possible Causes of It

Type 1 diabetes, or Insulin Dependent Diabetes Mellitus (IDDM), is a disease characterized by "auto-destruction" of the pancreatic beta cells that produce insulin. Overtime, your body silently destroys these cells creating an insulin deficiency. IDDM appears to stem from an inherited defect in the immune system, triggered by some environmental stimuli. The exact cause of the disease is still unknown; however, scientists have isolated a few factors that may be related to development of the disease. The purpose of this review is to provide insight on where research is headed and what we already know about the progression of IDDM.

Genetics
Recent mapping of the human genome has opened many areas to explore in the field of diabetes research. Animal models and large population studies have led to some possible genetic links. The major histocompatibility complex (MHC) on chromosome 6 is a regulator of immune response because it recognizes "self" and "not-self" things in the body. If something is seen as foreign, the MHC will stimulate antibody production. Genes encoded on the MHC are associated with IDDM, particularly the human leukocyte antigen (HLA) class II alleles, DQ and DR (1). Although the HLA-DQ locus appears to be the best single marker for susceptibility among Caucasians, at least 40% of family-related diabetes cases have combinations of both DQ and DR alleles (2,3). DQ and DR alleles are almost always found together on a chromosome and the risk is associated with them not being in equilibrium. Many combinations have been documented, some showing both increased and decreased susceptibility, however it has been difficult to determine the contribution of HLA-DQ independent of DR. The insulin gene region at chromosome 11 is also associated with IDDM risk.

Studies conducted in the 1970's established an HLA association and contribution of IDDM while comparing siblings with the disease (4,5,6). When comparing the relationship between family members, results are inconsistent. Current estimates suggest that HLA is 40-50% related to genes passed down by family members (7,5). The risk of developing IDDM for a twin of someone who already has the disease is about 70%, and this rises depending on the specific HLA alleles that the twins share (8). When comparing the risk of developing the disease for first-degree relatives vs. the US population, the risk is 1/20 and 1/300, respectively (1). Research in the area of HLA has been extremely difficult. Definitive answers cannot be drawn because not everyone holding these "susceptible" genes develops IDDM. Actually, less than 10% of genetically susceptible individuals progress to diabetes, implying that other factors are responsible for progression of the disease. Researchers have explored these other factors, particularly environmental factors such as early introduction of cow's milk, dysregulation of the gut immune system, viral infections, drinking water and a number of others.

Cow's Milk
Several population studies have found a link between exposure to cow's milk and increased risk for IDDM in genetically susceptible individuals. A few studies have also shown an increased risk for infants exposed to cow's milk or cow's milk based formulas within the first 3 months, and also later in life. It has been found that infants fed cow's milk had increased levels of bovine insulin anti-bodies compared to those that were breast-fed (9,10,11). Bovine insulin is found in the milk of cows. The antibodies binding to bovine insulin appear to cross-react with human insulin (9,10). Bovine insulin is considered immunogenic because it differs from human insulin by 3 amino acids.

Insulin-specific antibodies (ISA), those specific for IDDM, and increased T cell levels from exposure to cow's milk have been found in those carrying diabetes associated HLA risk alleles. Of all the studies to date however, levels of insulin binding antibodies seem to decrease as the child approaches 9-18 months. This suggests that the infant is building a tolerance to dietary antigens (12). However, Vaarala et al. discovered that infants who developed ISA's, also had increased levels of bovine insulin antibodies, suggesting that insulin specific immune responses in children prone to develop autoimmunity cannot be prevented (12). Other studies have found bovine insulin antibody levels to decrease when human insulin was presented in the body.

Early weaning (2-3 months) from breast milk has been shown to increase the risk for IDDM. Maternal milk contains colostrum, a light fluid that contains a variety of protective factors for the infant. Infants have an immature and easily penetrable gut system allowing food, in this case cow's milk, to easily cross into the bloodstream. The gut system works in one of two ways: it will either accept (build tolerance to) or reject (develop immunity to) food and its dietary components (13). Several cow's milk proteins have been shown to be related to IDDM such as bovine albumin, beta-lactoglobulin, and beta casein (14,15,16)

A study by Karjalainen et al. in 1992 was conducted to assess whether bovine serum albumin (BSA) was a trigger for IDDM (14). Researchers measured the levels of anti-BSA and anti-ABBOS (specific part of the albumin protein) antibodies in the serum of children with newly diagnosed IDDM, children without IDDM, and blood donors' (14). Antibodies that react to the ABBOS also react with a beta cell surface protein that may represent a target for autoimmune attack (14). All children in the study with IDDM had the highest amount of both antibodies, especially ABBOS, compared to the children without IDDM and blood donors' (14). Antibody levels declined after one or two years of exposure to cow's milk (14). This suggests that albumin has a section that is capable of reacting with "beta-cell specific surface proteins", which could contribute to islet cell dysfunction because of molecular mimicry (14). What is molecular mimicry?

When an antigen is present in the body, T cells latch onto a short segment, consisting of about 10 amino acids. T cells then present the antigen to macrophages that engulf it and break it down into smaller protein fragments. The macrophages bring the fragments to the cell surface where capable T cells can bind to it. This activates the T cells, leading to stimulation in other areas to attack all proteins with similar amino acid segments. Bovine serum albumin has a short amino acid sequence similar to a beta cell surface receptor ICA69 (17) and beta casein shares a similar sequence with a glucose transporter. If molecular mimicry occurs here, then presentation of BSA or beta casein in the body would lead to autoimmune destruction.

Contrary to Karjalainen et al.'s study, Vaarala et al. found no association with BSA, but did find an increased risk for newly diagnosed IDDM with beta-lactoglobulin, another cow's milk protein (15). A study conducted by Cavallo et al. found an association with increased risk of newly diagnosed IDDM with beta casein, another milk protein (16). However, no differences were noted with BSA and other proteins assessed (16). Despite these conflicting results, it does appear that some form of "cross-reactivity" may occur with cow's milk proteins and islet-cell antigens, leading to "auto-attack" of the beta cells.

The role of cow's milk related to IDDM is not clear. The hypothesis of molecular mimicry has been questioned. Few studies have found a link between cellular immunity to BSA and IDDM. A recent study found that reactivities to beta casein were similar between newly diagnosed individuals with IDDM, their immediate relatives without the disease, and non-related healthy subjects. One confounding factor of the previous study was the lack of appropriately matched subjects, because researchers failed to use HLA matched relatives. Also, when comparing breast-feeding vs. cow milk formula, it is unclear at what point there is an increased risk, as well as the actual amount needed to induce an immune response. Despite all of the evidence presented here, exposure to cow's milk and risk for IDDM is only suggestive because the exact cause is unknown (18).

Viral Infections
Viral infections have been considered to be "more" responsible for diabetes development, than milk proteins. Identifying the exact virus responsible has been extremely daunting for several reasons. Individuals are exposed to many viral infections within their lifetime. Although IDDM is primarily a juvenile disease, by the time the disease is diagnosed, children have been exposed to many viruses. Thus, pinpointing the exact one would be every difficult, if not impossible to link. Another problem is that immunological damage often occurs after the virus is gone, leaving no trace of the virus responsible. However, large population studies, as well as human and mice studies, have led to some possible viruses responsible.

Coxsackie B Virus
Coxsackie B virus is an enterovirus, a virus part of a group of picornaviruses, related to those that cause polio. Several studies have found that after or with exposure to Coxsackie B that individuals developed IDDM. Also, large population studies have found antibodies against the virus in children with newly diagnosed IDDM. Coxsackie B viruses have been isolated from the pancreas in children who have developed IDDM very rapidly. Plus, inducing certain mouse strains with the virus has caused these mice to develop the disease.

Molecular mimicry has been postulated in the case of Coxsackie B virus. The virus increases the expression of an enzyme GAD in the pancreas. GAD is a highly potent autoantigen of the autoimmune response in humans and mice models. Coxsackie B and GAD share a similar sequence that may lead to cross reactivity.

Other, but not limited to, factors that may be responsible for Coxsackie B and IDDM are altered immune system regulation because of viral infection, altered memory of the T cells causing them to forget which are "self" and "not self" in the presence of viral infection, and persistent infection of the beta cells because of viral antigens expressed within them.

Although this all sounds promising, several other studies have not found conflicting results such as no difference in Coxsackie B antibodies between those with IDDM and those without it, along with no differences in prevalence and amount of antibodies responsible.

Rubella Virus
About 12-20% of fetal infected individuals with rubella will develop diabetes within 5-20 years (19,20). In some adults, development of diabetes has occurred after infection with rubella. Although this poses a threat to genetically susceptible individuals, vaccination programs have decreased the amount of rubella cases.

Cytomegalovirus (CMV)
There have been individual case reports of children developing IDDM after exposure to CMV. There have been recent studies done showing that newly diagnosed individuals with IDDM were recently exposed to CMV. It has been suggested that molecular mimicry may be partly responsible because CMV proteins share a resemblance with a protein in the islet cells of the pancreas. Pak et al. discovered that about 20% of individuals with IDDM have CMV DNA in the islet cells (21). Despite all this evidence however, a large Swedish study found no correlation between CMV infection and risk for IDDM (22). Besides all of this, vaccinations against the virus have lowered the prevalence of CMV infections.

Epstein-Barr Virus (EBV)
Individual cases have been noted where those infected with EBV develop diabetes. However, IDDM development as a result of EBV infection is probably not responsible for the disease in the majority of subjects. Little research and single cases are not enough to consider this a major cause.

Other Viruses
There have been reports of individuals developing IDDM after exposure to influenza, hepatitis A, varicella zoster, mumps, measles, rotavirus, polio, and Coxsackie A virus.

Other Environmental Factors
Recent studies have found a positive association between zinc levels in drinking water and protection against diabetes. Magnesium levels in tap water have been shown to be related to diabetes protection as well, however conflicting evidence resides with this. The protections that zinc may provide is unclear. Despite possible relationships with heavy metals and diabetes, more research must be done to ascertain the actual relationship.

Of all the evidence presented here, researchers have been unable to find the exact cause for development of IDDM. What we do know is that genetically susceptible individuals have an increased risk for diabetes. As displayed here, researchers have located genes that seem to predispose individuals to diabetes. Genes are not enough however, because not everyone who has these genes develops diabetes. Environmental factors are another part of the picture. Whether it is milk proteins, viral infections, or impaired gut function, those with genetic susceptibility tend to develop the disease after exposure to these. Identifying which factor is responsible has been difficult because exact mechanisms of the body are still unclear and tests to determine these things may not be specific or have not yet been developed. Plus, isolating one factor is not reasonable because there are a lot of overlaps in immune functions and genetics. All in all, research is headed in the right direction, but for now there is still no known cause for IDDM.

What Are 3 Common Types Of Diabetes

Diabetes Mellitus is now considered as an epidemic disease in most of countries. This article is about risk causes management of 3 most common types of diabetes mellitus

what are types of Diabetes Mellitus. Diabetes is classified into 3 types.

1-Type 1 Diabetes

2-Type 2 Diabetes

3-Gestational Diabetes

Here we will discuss one by one all three types of diabetes.

Type 1 Diabetes:

Type 1 diabetes is also called Juvenile Diabetes, Insulin dependent diabetes or Autoimmune Diabetes. Person with type 1 diabetes has immune response against his own beta cells of pancreas, so pancreas is unable to produce insulin at-all.That is why it is called as autoimmune diabetes. Juvenile diabetes usually occurs in children but can appear at any age. To live normal life patient has to take insulin and take regular exercise and has proper diet plan. The main cause of this type 1 diabetes are environmental factors like virus, diet or chemicals in people genetically predisposed. In USA 10-15% diagnosed cases of diabetes mellitus comprises of type 1 diabetes. Symptoms of type 1 diabetes are increase urination, increase thirst, increase hunger and weight loss. Eyes may also be affected as blurred vision. The person with type 1 diabetes should be diagnosed earlier, otherwise it can lead to a medical emergency situation like diabetic Coma with kitoacidosis.

Type 2 Diabetes:

Type 2 Diabetes is also called as Non Insulin dependent diabetes Mellitus or Adult-onset diabetes.This is most common type of diabetes affecting nearly 80% of all cases of diabetes. It is usually seen in adults. There are two mechanisms of type 2 diabetes. Either there is deficiency of insulin, or there is increase resistance of insulin. Insulin resistance means that body is unable to use available insulin.The main cause of this type of diabetes is genetic however other factors like overweight, obesity, high blood pressure, lack of exercise, overeating habits may also affect.About 80% of people with type 2 diabetes are overweight. Symptoms of type 2 diabetes in-contrast to type 1 develop very slowly. There may be fatigue, weight loss, increase urination, blurred vision or delay wound healing.This type of diabetes is treated with exercise, diet control, tablets. However later, you may need insulin injections as well.

Gestational Diabetes:

Some women who develop diabetes during later stages of pregnancy is called as Gestational diabetes. Though their glucose levels returns to normal but even then they have greater chances of developing diabetes mellitus within next 5 to 10 years. Women with gestational diabetes may have no symptoms at all. The cause of gestational diabetes is hormonal imbalance during pregnancy or insufficient Insulin. Child of women who develops gestational diabetes is also at high risk of developing diabetes in later life. Maintaining normal body weight and being physically active may help prevent development of type 2 diabetes mellitus in a patient of gestational diabetes.