What is the level of blood sugar?
The level of blood sugar is the amount of glucose (sugar) in the blood. Also known as serum glucose level. It is expressed as millimoles per litre (mmol / l).
Normally, blood glucose levels stay within narrow limits throughout the day: 4 to 8mmol / l. But they are higher after a meal and usually lowest in the morning.
In diabetes the level of blood sugar moves outside these limits until treatment. Even with a good control of diabetes, the level of blood sugar is derived sometimes even outside of this normal range.
Why control of the levels of blood sugar?
For reasons that are not well understood, when very high levels of glucose in the blood are present for years, leading to damage to small blood vessels.
This in turn increases the risk of developing late-stage complications of diabetes, such as:
* Retinopathy (eye disease)
* Nephropathy (kidney disease)
* Neuropathy (nerve disease)
* Cardiovascular diseases such as heart attacks, hypertension, heart failure, stroke and problems caused by poor circulation, such as gangrene, in the worst case.
With Type 1 diabetes, these complications can begin to appear 10 to 15 years after diagnosis.
It is often less than 10 years after diagnosis of type 2 diabetes, because this type of diabetes is often present for years before it is recognized.
By keeping the blood sugar stable, significantly reduce their risk of these complications.
How do I measure the levels of blood sugar?
Good advice
Home testing kits come in a variety of shapes and sizes.
A pharmacist or nurse clinic diabetes can recommend the best model.
You can usually get a blood glucose in the metro little or no cost through the clinical diabetes.
Testing strips are available on NHS prescription.
You can learn to measure levels of blood sugar quickly and simply with a home blood glucose test kit. All kits have at least two things: a measuring device and a strip.
To check the level of sugar in his blood, put a small amount of blood on the strip. Now place the band in the product. After about 30 seconds to show the level of glucose in the blood.
The best way to take a sample of blood by pricking the finger with a lancet that strong designed to penetrate the skin only to the extent necessary to extract a drop of blood.
What should be glucose levels?
The ideal values are:
* 4 to 7mmol / L before meals.
* Less than 10mmol / l 90 minutes after a meal
* Around 8mmol / l at bedtime.
How often should blood glucose was measured?
It depends on your lifestyle - the needs of a person with diabetes who is also an instructor of PE are very different from someone who sits at a computer all day.
If you use insulin
In general, people who have type 1 diabetes should measure their blood sugar levels daily before meals. Some days one or two tests can be done, whereas in another four or five might be necessary.
The measurement of the levels of blood sugar in the morning before any meal gives an indication of the amount of insulin needed overnight.
If you have type 2 diabetes being treated with insulin, you should also follow this schedule.
If oral treatments
If diabetes is treated with tablets or a special diet (type 2), should measure their blood glucose levels once or twice a week - either before meals or 90 minutes after a meal.
It must also make a profile of 24 hours once or twice a month. This means the measurement of glucose levels before each meal.
Not everyone with type 2 diabetes has to carry out regular checks of blood glucose.
For the elderly and people with other medical problems, it is often sufficient to control glucose in the urine - usually before breakfast and dinner.
This is because while a good control of diabetes is important, cardiovascular complications (heart attack, stroke, angina pectoris) is the leading cause of severe illness and death in people with this type of diabetes.
Therefore, people with type 2 diabetes will benefit from the fight against the factors contributing to their cardiovascular risk by:
Or controlling blood pressure more rigorously
Or lowering cholesterol levels with medication
Or the beginning or increasing exercise
Or quit.
Levels of blood glucose at bedtime
The level of blood sugar at bedtime should be between 7 and 10 mmol / l.
If the blood glucose is too low or too high at bedtime, you may need to adjust your food intake or insulin dose. Be sure to discuss this with your doctor.
At what other times the levels of blood glucose should be measured?
The blood glucose should be measured at any time of discomfort or think your blood sugar level is too high or low.
If you have type 1 diabetes and have more than 20mmol / l glucose in the blood, you have to use a strip of urine to verify the presence of ketones.
If organs are ketones in the urine is a warning sign of diabetic acidosis. If this is the case, you should consult your doctor immediately.
How is the level of blood sugar control over a period of time?
A test known as the HbA1c test can show the average level of blood sugar during the last six to eight weeks.
The proof is in HbA1c levels in a sample of blood.
Term clock
Hemoglobin
The substance in red blood cells that binds and transports oxygen throughout the bloodstream.
HbA1c is a compound produced by the chemical reaction between hemoglobin and glucose in the blood. HbA1c is also known as glycosylated hemoglobin.
High blood sugar levels to produce more HbA1c. But because the process happens over several weeks, an upturn occasional high blood sugar is not enough to influence the level of HbA1c.
This means that only consistently high levels of glucose in HbA1c due to the height - and why HbA1c used as a measure of diabetes control.
* HbA1c is about 6 percent of total hemoglobin in people without diabetes. This is the aim of targeting with strict blood sugar control - although 7 percent or less is very good.
* HbA1c of 7.5 percent shows just diabetes control.
* HbA1c above 8.5 percent demonstrates the lack of control of diabetes.
Any increase in the level of HbA1c indicates poorer diabetes control.
The United Kingdom Prospective Diabetes Study (UKPDS) Group was 20 years of research long trial in diabetes.
It showed that for every 1 percent increase in HbA1c, a person with type 2 diabetes is 30 percent more likely to develop late-stage complications arising from damage to small blood vessels.
In type 1 diabetes, the same relationship between high levels of HbA1c and strengthening the development of complications was demonstrated by the Diabetes Control and Complications Trial in the United States.
Based on a text by Dr Jan Erik Henriksen, and Dr Henning Bech-Nielsen, professor and consultant
source: netdoctor.co.uk
Blood Sugar Level
http://our-medical-center.blogspot.com/2007/12/diabetes-heart-disease-and-stroke.html
Having diabetes or pre-diabetes puts you at increased risk for heart disease and stroke. You can lower your risk by keeping your blood glucose (also called blood sugar), blood pressure, and blood cholesterol close to the recommended target numbers—the levels suggested by diabetes experts for good health. (For more information about target numbers for people with diabetes, see "How will I know whether I have heart disease?".) Reaching your targets also can help prevent narrowing or blockage of the blood vessels in your legs, a condition called peripheral arterial disease. You can reach your targets by
- choosing foods wisely
- being physically active
- taking medications if needed
What is diabetes?
Diabetes is a disorder of metabolism—the way our bodies use digested food for energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the body’s main source of fuel.
After digestion, glucose enters the bloodstream. Then glucose goes to cells throughout the body where it is used for energy. However, a hormone called insulin must be present to allow glucose to enter the cells. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.
In people who do not have diabetes, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. However, diabetes develops when the pancreas does not make enough insulin, or the cells in the muscles, liver, and fat do not use insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy.
Over time, high blood glucose levels damage nerves and blood vessels, leading to complications such as heart disease and stroke, the leading causes of death among people with diabetes. Uncontrolled diabetes can eventually lead to other health problems as well, such as vision loss, kidney failure, and amputations.
 |
Diabetes can lead to heart and blood vessel disease. |
What is pre-diabetes?
Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Pre-diabetes is also called impaired fasting glucose or impaired glucose tolerance. Many people with pre-diabetes develop type 2 diabetes within 10 years. In addition, they are at risk for heart disease and stroke. With modest weight loss and moderate physical activity, people with pre-diabetes can delay or prevent type 2 diabetes and lower their risk of heart disease and stroke.
What is the connection between diabetes, heart disease, and stroke?
If you have diabetes, you are at least twice as likely as someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or have strokes at an earlier age than other people. If you are middle-aged and have type 2 diabetes, some studies suggest that your chance of having a heart attack is as high as someone without diabetes who has already had one heart attack. Women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of being a woman in her child-bearing years.
People with diabetes who have already had one heart attack run an even greater risk of having a second one. In addition, heart attacks in people with diabetes are more serious and more likely to result in death. High blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis).
What are the risk factors for heart disease and stroke in people with diabetes?
Diabetes itself is a risk factor for heart disease and stroke. Also, many people with diabetes have other conditions that increase their chance of developing heart disease and stroke. These conditions are called risk factors. One risk factor for heart disease and stroke is having a family history of heart disease. If one or more members of your family had a heart attack at an early age (before age 55 for men or 65 for women), you may be at increased risk.
You can’t change whether heart disease runs in your family, but you can take steps to control the other risk factors for heart disease listed here:
- Having central obesity. Central obesity means carrying extra weight around the waist, as opposed to the hips. A waist measurement of more than 40 inches for men and more than 35 inches for women means you have central obesity. Your risk of heart disease is higher because abdominal fat can increase the production of LDL (bad) cholesterol, the type of blood fat that can be deposited on the inside of blood vessel walls.
- Having abnormal blood fat (cholesterol) levels.
– LDL cholesterol can build up inside your blood vessels, leading to narrowing and hardening of your arteries—the blood vessels that carry blood from the heart to the rest of the body. Arteries can then become blocked. Therefore, high levels of LDL cholesterol raise your risk of getting heart disease.
– Triglycerides are another type of blood fat that can raise your risk of heart disease when the levels are high.
– HDL (good) cholesterol removes deposits from inside your blood vessels and takes them to the liver for removal. Low levels of HDL cholesterol increase your risk for heart disease. - Having high blood pressure. If you have high blood pressure, also called hypertension, your heart must work harder to pump blood. High blood pressure can strain the heart, damage blood vessels, and increase your risk of heart attack, stroke, eye problems, and kidney problems.
- Smoking. Smoking doubles your risk of getting heart disease. Stopping smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels. Smoking also increases the risk of other long-term complications, such as eye problems. In addition, smoking can damage the blood vessels in your legs and increase the risk of amputation.
What is metabolic syndrome and how is it linked to heart disease?
Metabolic syndrome is a grouping of traits and medical conditions that puts people at risk for both heart disease and type 2 diabetes. It is defined by the National Cholesterol Education Program as having any three of the following five traits and medical conditions:
| Traits and Medical Conditions | Definition |
| Elevated waist circumference | Waist measurement of |
| Elevated levels of triglycerides | or Taking medication for elevated triglyceride levels |
| Low levels of HDL (good) cholesterol | or Taking medication for low HDL cholesterol levels |
| Elevated blood pressure levels | or Taking medication for elevated blood pressure levels |
| Elevated fasting blood glucose levels | or Taking medication for elevated blood glucose levels |
Source: Grundy SM, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735–2752.
Note: Other definitions of similar conditions have been developed by the American Association of Clinical Endocrinologists, the International Diabetes Federation, and the World Health Organization.
What can I do to prevent or delay heart disease and stroke?
Even if you are at high risk for heart disease and stroke, you can help keep your heart and blood vessels healthy. You can do so by taking the following steps:
- Make sure that your diet is “heart-healthy.” Meet with a registered dietitian to plan a diet that meets these goals:
– Include at least 14 grams of fiber daily for every 1,000 calories consumed. Foods high in fiber may help lower blood cholesterol. Oat bran, oatmeal, whole-grain breads and cereals, dried beans and peas (such as kidney beans, pinto beans, and black-eyed peas), fruits, and vegetables are all good sources of fiber. Increase the amount of fiber in your diet gradually to avoid digestive problems.
– Cut down on saturated fat. It raises your blood cholesterol level. Saturated fat is found in meats, poultry skin, butter, dairy products with fat, shortening, lard, and tropical oils such as palm and coconut oil. Your dietitian can figure out how many grams of saturated fat should be your daily maximum amount.
– Keep the cholesterol in your diet to less than 300 milligrams a day. Cholesterol is found in meat, dairy products, and eggs.
– Keep the amount of trans fat in your diet to a minimum. It’s a type of fat in foods that raises blood cholesterol. Limit your intake of crackers, cookies, snack foods, commercially prepared baked goods, cake mixes, microwave popcorn, fried foods, salad dressings, and other foods made with partially hydrogenated oil. In addition, some kinds of vegetable shortening and margarines have trans fat. Check for trans fat in the Nutrition Facts section on the food package. - Make physical activity part of your routine. Aim for at least 30 minutes of exercise most days of the week. Think of ways to increase physical activity, such as taking the stairs instead of the elevator. If you haven’t been physically active recently, see your doctor for a checkup before you start an exercise program.
- Reach and maintain a healthy body weight. If you are overweight, try to be physically active for at least 30 minutes a day, most days of the week. Consult a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight. Aim for a loss of no more than 1 to 2 pounds a week.
- If you smoke, quit. Your doctor can help you find ways to quit smoking.
- Ask your doctor whether you should take aspirin. Studies have shown that taking a low dose of aspirin every day can help reduce the risk of heart disease and stroke. However, aspirin is not safe for everyone. Your doctor can tell you whether taking aspirin is right for you and exactly how much to take.
- Get prompt treatment for transient ischemic attacks (TIAs). Early treatment for TIAs, sometimes called mini-strokes, may help prevent or delay a future stroke. Signs of a TIA are sudden weakness, loss of balance, numbness, confusion, blindness in one or both eyes, double vision, difficulty speaking, or a severe headache.
How will I know whether my diabetes treatment is working?
You can keep track of the ABCs of diabetes to make sure your treatment is working. Talk with your health care provider about the best targets for you.
A stands for A1C (a test that measures blood glucose control). Have an A1C test at least twice a year. It shows your average blood glucose level over the past 3 months. Talk with your doctor about whether you should check your blood glucose at home and how to do it.
| A1C target |
| Below 7 percent |
| Blood glucose targets | |
| Before meals | 90 to 130 mg/dL |
| 1 to 2 hours after the start of a meal | Less than 180 mg/dL |
B is for blood pressure. Have it checked at every office visit.
| Blood pressure target |
| Below 130/80 mm Hg |
C is for cholesterol. Have it checked at least once a year.
| Blood fat (cholesterol) targets | |
| LDL (bad) cholesterol | Under 100 mg/dL |
| Triglycerides | Under 150 mg/dL |
| HDL (good) cholesterol For men: above 40 mg/dL For women: above 50 mg/dL | |
Control of the ABCs of diabetes can reduce your risk for heart disease and stroke. If your blood glucose, blood pressure, and cholesterol levels aren’t on target, ask your doctor what changes in diet, activity, and medications can help you reach these goals.
What types of heart and blood vessel disease occur in people with diabetes?
Two major types of heart and blood vessel disease, also called cardiovascular disease, are common in people with diabetes: coronary artery disease (CAD) and cerebral vascular disease. People with diabetes are also at risk for heart failure. Narrowing or blockage of the blood vessels in the legs, a condition called peripheral arterial disease, can also occur in people with diabetes.
Coronary Artery Disease
Coronary artery disease, also called ischemic heart disease, is caused by a hardening or thickening of the walls of the blood vessels that go to your heart. Your blood supplies oxygen and other materials your heart needs for normal functioning. If the blood vessels to your heart become narrowed or blocked by fatty deposits, the blood supply is reduced or cut off, resulting in a heart attack.
Cerebral Vascular Disease
Cerebral vascular disease affects blood flow to the brain, leading to strokes and TIAs. It is caused by narrowing, blocking, or hardening of the blood vessels that go to the brain or by high blood pressure.
Stroke
A stroke results when the blood supply to the brain is suddenly cut off, which can occur when a blood vessel in the brain or neck is blocked or bursts. Brain cells are then deprived of oxygen and die. A stroke can result in problems with speech or vision or can cause weakness or paralysis. Most strokes are caused by fatty deposits or blood clots—jelly-like clumps of blood cells—that narrow or block one of the blood vessels in the brain or neck. A blood clot may stay where it formed or can travel within the body. People with diabetes are at increased risk for strokes caused by blood clots.
A stroke may also be caused by a bleeding blood vessel in the brain. Called an aneurysm, a break in a blood vessel can occur as a result of high blood pressure or a weak spot in a blood vessel wall.
TIAs
TIAs are caused by a temporary blockage of a blood vessel to the brain. This blockage leads to a brief, sudden change in brain function, such as temporary numbness or weakness on one side of the body. Sudden changes in brain function also can lead to loss of balance, confusion, blindness in one or both eyes, double vision, difficulty speaking, or a severe headache. However, most symptoms disappear quickly and permanent damage is unlikely. If symptoms do not resolve in a few minutes, rather than a TIA, the event could be a stroke. The occurrence of a TIA means that a person is at risk for a stroke sometime in the future. See page 3 for more information on risk factors for stroke.
Heart Failure
Heart failure is a chronic condition in which the heart cannot pump blood properly—it does not mean that the heart suddenly stops working. Heart failure develops over a period of years, and symptoms can get worse over time. People with diabetes have at least twice the risk of heart failure as other people. One type of heart failure is congestive heart failure, in which fluid builds up inside body tissues. If the buildup is in the lungs, breathing becomes difficult.
Blockage of the blood vessels and high blood glucose levels also can damage heart muscle and cause irregular heart beats. People with damage to heart muscle, a condition called cardiomyopathy, may have no symptoms in the early stages, but later they may experience weakness, shortness of breath, a severe cough, fatigue, and swelling of the legs and feet. Diabetes can also interfere with pain signals normally carried by the nerves, explaining why a person with diabetes may not experience the typical warning signs of a heart attack.
Peripheral Arterial Disease
Another condition related to heart disease and common in people with diabetes is peripheral arterial disease (PAD). With this condition, the blood vessels in the legs are narrowed or blocked by fatty deposits, decreasing blood flow to the legs and feet. PAD increases the chances of a heart attack or stroke occurring. Poor circulation in the legs and feet also raises the risk of amputation. Sometimes people with PAD develop pain in the calf or other parts of the leg when walking, which is relieved by resting for a few minutes.
How will I know whether I have heart disease?
One sign of heart disease is angina, the pain that occurs when a blood vessel to the heart is narrowed and the blood supply is reduced. You may feel pain or discomfort in your chest, shoulders, arms, jaw, or back, especially when you exercise. The pain may go away when you rest or take angina medicine. Angina does not cause permanent damage to the heart muscle, but if you have angina, your chance of having a heart attack increases.
A heart attack occurs when a blood vessel to the heart becomes blocked. With blockage, not enough blood can reach that part of the heart muscle and permanent damage results. During a heart attack, you may have
- chest pain or discomfort
- pain or discomfort in your arms, back, jaw, neck, or stomach
- shortness of breath
- sweating
- nausea
- light-headedness
Symptoms may come and go. However, in some people, particularly those with diabetes, symptoms may be mild or absent due to a condition in which the heart rate stays at the same level during exercise, inactivity, stress, or sleep. Also, nerve damage caused by diabetes may result in lack of pain during a heart attack.
Women may not have chest pain but may be more likely to have shortness of breath, nausea, or back and jaw pain. If you have symptoms of a heart attack, call 911 right away. Treatment is most effective if given within an hour of a heart attack. Early treatment can prevent permanent damage to the heart.
Your doctor should check your risk for heart disease and stroke at least once a year by checking your cholesterol and blood pressure levels and asking whether you smoke or have a family history of premature heart disease. The doctor can also check your urine for protein, another risk factor for heart disease. If you are at high risk or have symptoms of heart disease, you may need to undergo further testing.
What are the treatment options for heart disease?
Treatment for heart disease includes meal planning to ensure a heart-healthy diet and physical activity. In addition, you may need medications to treat heart damage or to lower your blood glucose, blood pressure, and cholesterol. If you are not already taking a low dose of aspirin every day, your doctor may suggest it. You also may need surgery or some other medical procedure.
How will I know whether I have had a stroke?
The following signs may mean that you have had a stroke:
- sudden weakness or numbness of your face, arm, or leg on one side of your body
- sudden confusion, trouble talking, or trouble understanding
- sudden dizziness, loss of balance, or trouble walking
- sudden trouble seeing out of one or both eyes or sudden double vision
- sudden severe headache
If you have any of these symptoms, call 911 right away. You can help prevent permanent damage by getting to a hospital within an hour of a stroke. If your doctor thinks you have had a stroke, you may have tests such as a neurological examination to check your nervous system, special scans, blood tests, ultrasound examinations, or x rays. You also may be given medication that dissolves blood clots.
What are the treatment options for stroke?
At the first sign of a stroke, you should get medical care right away. If blood vessels to your brain are blocked by blood clots, the doctor can give you a “clot-busting” drug. The drug must be given soon after a stroke to be effective. Subsequent treatment for stroke includes medications and physical therapy, as well as surgery to repair the damage. Meal planning and physical activity may be part of your ongoing care. In addition, you may need medications to lower your blood glucose, blood pressure, and cholesterol and to prevent blood clots.
from diabetes.niddk.nih.gov
http://our-medical-center.blogspot.com/2007/12/diabetes-heart-disease-and-stroke.html
http://our-medical-center.blogspot.com/2007/12/diabetes-overview.html
Almost everyone knows someone who has diabetes. An estimated 20.8 million people in the United States—7.0 percent of the population—have diabetes, a serious, lifelong condition. Of those, 14.6 million have been diagnosed, and 6.2 million have not yet been diagnosed. In 2005, about 1.5 million people aged 20 or older were diagnosed with diabetes. For additional statistics, see the National Diabetes Statistics fact sheet online at www.diabetes.niddk.nih.gov/dm/pubs/statistics or call the National Diabetes Information Clearinghouse at 1–800–860–8747 to request a copy.
What is diabetes?
Diabetes is a disorder of metabolism�the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.
After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.
When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.
What are the types of diabetes?
The three main types of diabetes are
- type 1 diabetes
- type 2 diabetes
- gestational diabetes
Type 1 Diabetes
Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body�s system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.
At present, scientists do not know exactly what causes the body�s immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. It develops most often in children and young adults but can appear at any age.
Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms may include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.
Type 2 Diabetes
The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.
Type 2 diabetes is increasingly being diagnosed in children and adolescents. However, nationally representative data on prevalence of type 2 diabetes in youth are not available.
When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes—glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.
The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.
Gestational Diabetes
Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 20 to 50 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.
About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.
How is diabetes diagnosed?
The fasting blood glucose test is the preferred test for diagnosing diabetes in children and nonpregnant adults. It is most reliable when done in the morning. However, a diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day:
- A blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an 8-hour fast. This test is called the fasting blood glucose test.
- A blood glucose level of 200 mg/dL or more 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).
- A random (taken at any time of day) blood glucose level of 200 mg/dL or more, along with the presence of diabetes symptoms.
Gestational diabetes is diagnosed based on blood glucose levels measured during the OGTT. Glucose levels are normally lower during pregnancy, so the cutoff levels for diagnosis of diabetes in pregnancy are lower. Blood glucose levels are measured before a woman drinks a beverage containing glucose. Then levels are checked 1, 2, and 3 hours afterward. If a woman has two blood glucose levels meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting blood glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL.
What is pre-diabetes?
People with pre-diabetes have blood glucose levels that are higher than normal but not high enough for a diagnosis of diabetes. This condition raises the risk of developing type 2 diabetes, heart disease, and stroke.
Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some people have both IFG and IGT.
- IFG is a condition in which the blood glucose level is high (100 to 125 mg/dL) after an overnight fast, but is not high enough to be classified as diabetes. (The former definition of IFG was 110 mg/dL to 125 mg/dL.)
- IGT is a condition in which the blood glucose level is high (140 to 199 mg/dL) after a 2-hour oral glucose tolerance test, but is not high enough to be classified as diabetes.
Pre-diabetes is becoming more common in the United States, according to new estimates provided by the U.S. Department of Health and Human Services. About 40 percent of U.S. adults ages 40 to 74—or 41 million people—had pre-diabetes in 2000. New data suggest that at least 54 million U.S. adults had pre-diabetes in 2002. Many people with pre-diabetes go on to develop type 2 diabetes within 10 years.
The good news is that if you have pre-diabetes, you can do a lot to prevent or delay diabetes. Studies have clearly shown that you can lower your risk of developing diabetes by losing 5 to 7 percent of your body weight through diet and increased physical activity. A major study of more than 3,000 people with IGT, a form of pre-diabetes, found that diet and exercise resulting in a 5 to 7 percent weight loss�about 10 to 14 pounds in a person who weighs 200 pounds�lowered the incidence of type 2 diabetes by nearly 60 percent. Study participants lost weight by cutting fat and calories in their diet and by exercising (most chose walking) at least 30 minutes a day, 5 days a week.
What are the scope and impact of diabetes?
Diabetes is widely recognized as one of the leading causes of death and disability in the United States. In 2002, it was the sixth leading cause of death. However, diabetes is likely to be underreported as the underlying cause of death on death certificates. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke.
Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.
In 2002, diabetes cost the United States $132 billion. Indirect costs, including disability payments, time lost from work, and premature death, totaled $40 billion; direct medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $92 billion.
Who gets diabetes?
Diabetes is not contagious. People cannot “catch” it from each other. However, certain factors can increase the risk of developing diabetes.
Type 1 diabetes occurs equally among males and females but is more common in whites than in non-whites. Data from the World Health Organization�s Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown. Type 1 diabetes develops most often in children but can occur at any age.
Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanics/Latinos. On average, non-Hispanic African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites of the same age. Mexican Americans are 1.7 times as likely to have diabetes as non-Hispanic whites of similar age. (Data are not available for estimation of diabetes rates in other Hispanic/Latino groups.) American Indians have one of the highest rates of diabetes in the world. On average, American Indians and Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites of similar age. Although prevalence data for diabetes among Asian Americans and Pacific Islanders are limited, some groups, such as Native Hawaiians, Asians, and other Pacific Islanders residing in Hawaii (aged 20 or older) are more than twice as likely to have diabetes as white residents of Hawaii of similar age.
Diabetes prevalence in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanics/Latinos and other minority groups at increased risk make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates from the Centers for Disease Control and Prevention (CDC), diabetes will affect one in three people born in 2000 in the United States. The CDC also projects the prevalence of diagnosed diabetes in the United States will increase 165 percent by 2050.
How is diabetes managed?
Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in diabetes treatment.
Today, healthy eating, physical activity, and taking insulin are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose checking. People with diabetes also monitor blood glucose levels several times a year with a laboratory test called the A1C. Results of the A1C test reflect average blood glucose over a 2- to 3-month period.
Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.
Adults with diabetes are at high risk for cardiovascular disease (CVD). In fact, at least 65 percent of those with diabetes die from heart disease or stroke. Managing diabetes is more than keeping blood glucose levels under control�it is also important to manage blood pressure and cholesterol levels through healthy eating, physical activity, and use of medications (if needed). By doing so, those with diabetes can lower their risk. Aspirin therapy, if recommended by the health care team, and smoking cessation can also help lower risk.
People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too low or too high. When blood glucose levels drop too low—a condition known as hypoglycemia—a person can become nervous, shaky, and confused. Judgment can be impaired, and if blood glucose falls too low, fainting can occur.
A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia.
People with diabetes should see a health care provider who will help them learn to manage their diabetes and who will monitor their diabetes control. Most people with diabetes get care from primary care physicians�internists, family practice doctors, or pediatricians. Often, having a team of providers can improve diabetes care. A team can include
- a primary care provider such as an internist, a family practice doctor, or a pediatrician
- an endocrinologist (a specialist in diabetes care)
- a dietitian, a nurse, and other health care providers who are certified diabetes educators—experts in providing information about managing diabetes
- a podiatrist (for foot care)
- an ophthalmologist or an optometrist (for eye care)
and other health care providers, such as cardiologists and other specialists. In addition, the team for a pregnant woman with type 1, type 2, or gestational diabetes should include an obstetrician who specializes in caring for women with diabetes. The team can also include a pediatrician or a neonatologist with experience taking care of babies born to women with diabetes.
The goal of diabetes management is to keep levels of blood glucose, blood pressure, and cholesterol as close to the normal range as safely possible. A major study, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood glucose levels close to normal reduces the risk of developing major complications of type 1 diabetes.
This 10-year study, completed in 1993, included 1,441 people with type 1 diabetes. The study compared the effect of two treatment approaches�intensive management and standard management�on the development and progression of eye, kidney, nerve, and cardiovascular complications of diabetes. Intensive treatment aimed to keep A1C levels as close to normal (6 percent) as possible. Researchers found that study participants who maintained lower levels of blood glucose through intensive management had significantly lower rates of these complications. More recently, a follow-up study of DCCT participants showed that the ability of intensive control to lower the complications of diabetes has persisted more than 10 years after the trial ended.
The United Kingdom Prospective Diabetes Study, a European study completed in 1998, showed that intensive control of blood glucose and blood pressure reduced the risk of blindness, kidney disease, stroke, and heart attack in people with type 2 diabetes.
Hope Through Research
NIDDK conducts research in its own laboratories and supports a great deal of basic and clinical research in medical centers and hospitals throughout the United States. It also gathers and analyzes statistics about diabetes. Other Institutes at the National Institutes of Health (NIH) conduct and support research on diabetes-related eye diseases, heart and vascular complications, autoimmunity, pregnancy, and dental problems.
Other Government agencies that sponsor diabetes programs are the CDC, the Indian Health Service, the Health Resources and Services Administration, the Department of Veterans Affairs, and the Department of Defense.
Many organizations outside the Government support diabetes research and education activities. These organizations include the American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation International (JDRF), and the American Association of Diabetes Educators.
In recent years, advances in diabetes research have led to better ways of managing diabetes and treating its complications. Major advances include
- development of quick-acting, long-acting, and inhaled insulins
- better ways to monitor blood glucose and for people with diabetes to check their own blood glucose levels
- development of external insulin pumps that deliver insulin, replacing daily injections
- laser treatment for diabetic eye disease, reducing the risk of blindness
- successful kidney and pancreas transplantation in people whose kidneys fail because of diabetes
- better ways of managing diabetes in pregnant women, improving their chances of a successful outcome
- new drugs to treat type 1 and type 2 diabetes and better ways to manage this form of diabetes through weight control
- evidence that intensive management of blood glucose reduces and may prevent development of diabetes complications
- demonstration that two types of antihypertensive drugs, ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers), are more effective than other antihypertensive drugs in reducing a decline in kidney function in people with diabetes
- advances in transplantation of islets (clusters of cells that produce insulin and other hormones) for type 1 diabetes
- evidence that people at high risk for type 2 diabetes can lower their chances of developing the disease through diet, weight loss, and physical activity
What will the future bring?
Researchers continue to look for the cause or causes of diabetes and ways to manage, prevent, or cure the disorder. Scientists are searching for genes that may be involved in type 1 or type 2 diabetes. Some genetic markers for type 1 diabetes have been identified, and it is now possible to screen relatives of people with type 1 diabetes to determine whether they are at risk.
Type 1 Diabetes
A number of Federally-funded research studies and clinical trials are under way. Studies focus on the prevention and causes of type 1 diabetes as well as experimental treatments such as islet transplantation.
The Environmental Determinants of Diabetes in the Young Consortium
The main mission of The Environmental Determinants of Diabetes in the Young (TEDDY) consortium, an international group of clinical centers, is to identify infectious agents, dietary factors, or other environmental factors (including psychosocial events) that trigger type 1 diabetes in those who are genetically susceptible. In addition, the consortium aims to
- create a central repository of data and biological samples for use by researchers
- develop novel approaches to finding the causes of type 1 diabetes
- find ways to understand how the disease starts and progresses
- discover new methods to prevent, delay, and reverse type 1 diabetes
TEDDY is funded by the NIDDK, the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Child Health and Human Development (NICHD), the National Institute of Environmental Health Sciences, the CDC, the JDRF, and the ADA. For more information, see www.niddk.nih.gov/patient/TEDDY/TEDDY.htm.
Type 1 Diabetes TrialNet
Type 1 Diabetes TrialNet is a network of experts and facilities dedicated to developing new approaches to the understanding, prevention, and treatment of type 1 diabetes. Clinical centers are located in the United States, Canada, Europe, and Australia.
TrialNet studies are focusing on
- understanding the natural history of type 1 diabetes (to determine its causes and how the disease progresses)
- preventing type 1 diabetes in those at risk
- developing ways to preserve the function of the insulin-producing cells in the pancreas in people recently diagnosed with type 1 diabetes
For more information, see www.DiabetesTrialNet.org or call 1–800–HALT–DM1 (1–800–425–8361).
In many ways, the TrialNet studies build on the advances and insights gained from earlier research in type 1 diabetes. For example, researchers learned a great deal about how to predict type 1 diabetes in at-risk people from the Diabetes Prevention Trial—Type 1 (DPT�1). This study showed that people at risk of developing type 1 diabetes can be identified. The DPT-1 researchers discovered ways to identify two populations at risk of developing type 1 diabetes within 5 years: those at high risk (with at least a 50 percent chance) and those with an intermediate risk (having a 25 to 50 percent risk). Then researchers explored possible ways of preventing type 1 diabetes in both groups. TrialNet will identify people at risk who may be eligible for clinical trials. In addition, TrialNet will conduct trials to save beta cell function in those with new onset type 1 diabetes.
TrialNet is funded by the NIDDK, NICHD, and NIAID. JDRF and ADA also support this effort.
The Immune Tolerance Network
TrialNet works closely with the Immune Tolerance Network, another international, collaborative consortium. Its goal is to find safe and effective ways to induce long-term immune tolerance—prevention of an unwanted immune response by the body. For example, type 1 diabetes might be prevented if scientists could learn how to prevent the immune system from mistakenly attacking the insulin-producing cells in the pancreas. Effective immune tolerance could possibly
- prevent the body�s rejection of organ or tissue transplants
- prevent or treat autoimmune diseases
- prevent or treat allergies and asthma
Islet Transplantation
Researchers are working on a way for people with type 1 diabetes to live without daily insulin injections. In an experimental procedure called islet transplantation, islets are taken from a donor pancreas and transferred into a person with type 1 diabetes. Once implanted, the beta cells in these islets begin to make and release insulin.
Scientists have made many advances in islet transplantation in recent years. Since reporting their findings in the June 2000 issue of the New England Journal of Medicine, researchers at the University of Alberta in Edmonton, Alberta, Canada, have continued to use a procedure called the Edmonton protocol to transplant pancreatic islets into people with type 1 diabetes. Before use of the Edmonton protocol, during the 1990s, less than 10 percent of islet cell transplant recipients were able to control blood glucose levels for more than 1 year without insulin injections.
The Collaborative Islet Transplant Registry (CITR), funded by NIDDK, was created in 2001. CITR�s mission is to expedite progress and promote safety in islet transplantation by collecting, analyzing, and communicating data on islet transplantation. The CITR will study islet transplantation alone as well as islet transplantation following kidney transplant.
The September 2005 CITR annual report noted that with use of the Edmonton protocol, after 1 year, 58 percent of those who had transplants no longer needed to inject insulin. Of those who were still insulin-dependent 1 year after transplantation (33 percent of those followed by the registry), requirements for insulin were decreased. The average reduction in insulin requirements was 69 percent. In summary, a total of 91 percent of those with transplants showed improvement following transplantation. The success of the Edmonton protocol has been confirmed at other study sites, including the NIDDK.
The goal of islet transplantation is to infuse enough islets to control the blood glucose level without insulin injections. For an average-sized person (154 pounds), a typical transplant requires about 1 million islets, extracted from two donor pancreases. Because good control of blood glucose can slow or prevent the progression of complications associated with diabetes, such as nerve or eye damage, a successful transplant may reduce the risk of these complications. However, transplanted islets lose their ability to function over time. Also, a transplant recipient needs to take immunosuppressive drugs to stop the immune system from rejecting the transplanted islets.
These drugs have significant side effects, and their long-term effects are still unknown. Immediate side effects of immunosuppressive drugs may include mouth sores and gastrointestinal problems, such as stomach upset or diarrhea. Patients may also have increased blood cholesterol levels, decreased white blood cell counts, decreased kidney function, and increased susceptibility to bacterial and viral infections. Taking immunosuppressive drugs increases the risk of tumors and cancer as well. Researchers are trying to find safer or less toxic immunosuppressants or new approaches that will allow successful transplantation without the use of immunosuppressive drugs.
The results of the Edmonton protocol are very encouraging, but more research is needed to develop safer and more effective immunosuppression and to enhance islet survival after transplantation.
Another obstacle to widespread use of islet transplantation is the severe shortage of islets. Only about 6,000 pancreases a year become available for transplantation or for harvesting of islets. However, researchers are pursuing alternative sources, such as creating islets from other types of cells. New technologies could then be employed to grow islets in the laboratory.
Type 2 Diabetes
Diabetes Prevention Program
In 1996, NIDDK launched its Diabetes Prevention Program (DPP). The goal of this research effort was to learn how to prevent or delay type 2 diabetes in people with impaired glucose tolerance (IGT), a strong risk factor for type 2 diabetes.
The findings of the DPP, released in August 2001, showed that people at high risk for type 2 diabetes could sharply lower their chances of developing the disorder through diet and exercise. In addition, treatment with the oral diabetes drug metformin also reduced diabetes risk, though less dramatically. Metformin lowers the amount of glucose released by the liver and also fights insulin resistance, a condition in which the body doesn't use insulin properly.
Participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by almost 60 percent. On average, this group maintained their physical activity at 30 minutes per day, usually with walking or other moderate intensity exercise, and lost 5 to 7 percent of their body weight. Participants randomized to treatment with metformin reduced their risk of getting type 2 diabetes by 31 percent.
Of the 3,234 participants enrolled in the DPP, 45 percent were from minority groups that suffer disproportionately from type 2 diabetes: African Americans, Hispanics/Latinos, Asian Americans and Pacific Islanders, and American Indians. The trial also recruited other groups known to be at higher risk for type 2 diabetes, including individuals aged 60 and older, women with a history of gestational diabetes, and people with a first-degree relative with type 2 diabetes. Participants are being followed to check for long-term effects of the interventions, including the effects on risk of CVD.
Type 2 Diabetes in Children and Teens
Two studies focusing on type 2 diabetes in children and teens are under way. The TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) study, a 13-site study sponsored by NIDDK, will compare treatments for type 2 diabetes in children and teens. Participants will undergo one of three treatments:
- taking one diabetes medication (metformin)
- taking two diabetes medications (metformin and rosiglitazone, another medication that fights insulin resistance)
- taking metformin and participating in an intensive lifestyle change program designed to promote weight loss by cutting calories and increasing physical activity
The main goal of the study is to determine how well each type of treatment controls blood glucose levels. The study also will evaluate how long each type of treatment is effective.
The STOPP-T2D (Studies to Treat or Prevent Pediatric Type 2 Diabetes) study, sponsored by NIDDK with support from the ADA, is exploring methods to lower risk factors for type 2 diabetes and CVD in middle-school children (grades 6 through 8) at eight sites. A 3-year program will focus on the benefits of improving nutrition, promoting physical activity, and making changes in behavior.
Preventing and Treating CVD in People with Type 2 Diabetes
CVD is the main killer of people with type 2 diabetes. For this reason, the NIH is studying the best strategies to prevent and treat CVD in people with diabetes in three major studies. These studies are all joint efforts of the NIDDK and the National Heart, Lung, and Blood Institute.
The Look AHEAD (Action for Health in Diabetes) trial is the largest clinical trial to date to examine the long-term health effects of voluntary weight loss. This multi-center, randomized clinical trial is studying the effects of a lifestyle intervention designed to achieve and maintain weight loss over the long term through decreased caloric intake and increased exercise. Look AHEAD will focus on the disorder most associated with being overweight or obese, type 2 diabetes, and on the outcome that causes the greatest morbidity and mortality in people with type 2 diabetes, CVD.
The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, a multi-center, randomized trial, is studying three approaches to preventing major cardiovascular events in individuals with type 2 diabetes. ACCORD is designed to compare current practice guidelines with more intensive glycemic control in 10,000 individuals with type 2 diabetes, including those at especially high risk for CVD events because of age, evidence of subclinical atherosclerosis, or existing clinical CVD. More intensive control of blood pressure than is called for in current guidelines and a medication to reduce triglyceride levels and raise HDL (good) cholesterol levels will also be studied in subgroups of these 10,000 volunteers. Each treatment strategy will be accompanied by standard advice regarding lifestyle choices, including diet, physical activity, and smoking cessation, appropriate for individuals with diabetes.
The primary outcome to be measured is the first occurrence of a major CVD event, specifically heart attack, stroke, or cardiovascular death. In addition, the study will investigate the impact of the treatment strategies on other cardiovascular outcomes; total mortality; limb amputation; eye, kidney, or nerve disease; health-related quality of life; and cost-effectiveness.
The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial, a 5-year, multi-center clinical trial, is comparing medical versus early surgical management of patients with type 2 diabetes who also have coronary artery disease and stable angina or ischemia. At the same time, BARI 2D will study the effect of two different strategies to control blood glucose�providing insulin versus increasing the sensitivity of the body to insulin�on the risk of cardiovascular mortality and morbidity.
A complete listing of clinical trials can be found at www.ClinicalTrials.gov.
Points to Remember
What is diabetes?
- a disorder of metabolism—the way the body uses or converts food for energy and growth
What are the main types of diabetes?
- type 1 diabetes
- type 2 diabetes
- gestational diabetes
What are the impacts of diabetes?
- It affects 20.8 million people—7.0 percent of the U.S. population.
- It is a leading cause of death and disability.
- It costs $132 billion per year.
Who gets diabetes?
- people of any age
- people with a family history of diabetes
- others at high risk for type 2 diabetes: older people, overweight and sedentary people, African Americans, Alaska Natives, American Indians, Asian Americans, Native Hawaiians, some Pacific Islander Americans, and Hispanics/Latinos
http://our-medical-center.blogspot.com/2007/12/diabetes-overview.html
http://our-medical-center.blogspot.com/2007/12/simple-explanation-of-diabetes.html
Diabetes is a disease that if you don't take effective action against, it simply gets worse.
The Real Problem!
Today, most people with blood sugar problems are only treating the symptoms and not getting to the root of the problem. Furthermore, many medications given to people with diabetes are compounding problems instead of getting to the root cause. A lot of these medications increase the likelihood of neuropathy among other problems.
The best way to manage blood sugar problems is to understand and address the actual causes, so let's take a look again at what causes blood sugar problems.
The Simple Explanation.
There are two primary causes of diabetes:
1) a long-term diet that has been high in carbohydrates and
2) nutritional deficiencies.
Let's go over it again.
Your body breaks down carbohydrates into sugar (glucose) which then enters your blood stream. The more carbohydrates consumed, the higher your blood sugar goes. In response, your body produces insulin. Remember, Insulin's job is to push the blood sugar into the cells.
On the surface of each of the cells in your body are insulin receptors, which act like little doors that open and close to regulate the inflow of blood sugar.
After many years of consuming a high-carbohydrate diet, your cells have been bombarded with so much insulin that these doors begin to malfunction and shut down.
With less doors open, your body needs to produce even more insulin to push the glucose into the cells. More insulin causes even more doors to close and as this vicious cycle continues, a condition called "insulin resistance" sets in.
When your body can no longer produce enough insulin to push the blood sugar into the cells, type 2 diabetes results. It is simply an extreme case of insulin resistance.
The key point for you to understand is that your energy, wellness and longevity are primarily dependent on improving the sensitivity of your cells to insulin - how well your cells open and close the doors and clear sugar from the blood.
What's the Bottom line?
Since type 2 diabetes is really a severe case of insulin resistance, the solution to your condition is to find a way through proper nutrition to increase the sensitivity of your cells to insulin and help your body get the sugar out of the blood and into the cells so it can be metabolized and turned into energy. (This inability to metabolize sugar is one of the reasons why many diabetics often feel tired and fatigued.)
The Deadly Effects of Excess Insulin!
Your "metabolism" is the food processing and energy production system of your body. It is made up of extremely fine-tuned internal processes.
Insulin is the master hormone of your metabolism. When it is out of balance and your insulin levels are consistently elevated, a long list of deadly complications are created:
* Heart Disease
* Hardening of the Arteries
* Damage to Artery Walls
* Increased Cholesterol Levels
* Vitamin & Mineral Deficiencies
* Kidney Disease
* Fat Burning Mechanism Turned Off
* Accumulation & Storage of Fat
* Weight Gain
In his best-selling book Protein Power, Dr. Michael Eades wrote,
"When insulin levels become too high... metabolic havoc ensues with elevated blood pressure, elevated cholesterol and triglycerides, diabetes, and obesity all trailing in its wake. These disorders are merely symptoms of a single more basic disturbance in metabolism, excess insulin and insulin resistance."
Nutritional Deficiencies from excess insulin.
Science has shown that excess insulin also causes your body to become deficient in many vitamins, minerals and other nutrients. It's a proven fact that being deficient in these nutrients is directly linked to and a cause of high blood sugar levels.
Chromium
Many studies have shown that chromium is an important nutritional factor to proper metabolism and maintaining safe sugar levels. Excess insulin depletes your body's chromium. In Protein Power, Dr. Eades further states,
"The insulin receptor, the structure on the surfaces of your cells that actually become resistant to insulin, requires chromium to function properly. Deficiency of chromium is rampant - it affects 90% of the American population - because a diet high in starch. carbohydrates and sugar puts a heavy demand on the insulin system to handle the incoming carbohydrate load, and that demand depletes chromium."
Chromium is critical to blood sugar metabolism and as a diabetic you can be pretty sure that you are severely deficient in this nutrient. If you ever wondered where your "sweet tooth" and sugar cravings come from, now you know - chromium deficiency!
Calcium and Magnesium are also depleted by excess insulin, which can cause many problems, as they are critical to over 200 biochemical processes in your body.
Other very important nutrients which excess insulin causes you to be deficient in are Zinc, Selenium, Vitamin E, Vitamin C, Vanadium, B Complex vitamins, essential fatty acids and many more.
Now that you know how and why people develop type 2 diabetes and know some of the consequences of not controlling your blood sugar level, here are your choices:
- You can continue on with what you've been doing, or
- You can use nutrition as a safe and effective way to help you control your blood sugar with absolutely no worries about side effects!
Fortunately, your body has miraculous healing powers, is very resilient and operates in a very intelligent manner. If you give it the right fuel (the right nutrients) the body will have the tools it needs to heal itself and, you will see increased vigor and energy and improved health. Some exercise and the right attitude also help!
The first step is to switch your body from an out-of-control, nutrient-depleting and fat-storing machine into a clean, nutrient-rich, fat-burning machine.
To do this you must must:
- Restrict the carbohydrates in your diet and
- Improve the nutrition of your body! You need the vitamins and minerals in a form that is actually food that your body recognizes, not the man-made chemical "vitamins" found on the shelves of most health food shops and drug stores.
http://our-medical-center.blogspot.com/2007/12/simple-explanation-of-diabetes.html
