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

Prevention

Modest 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 Diagnosis

Diabetes 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 Exercise

Follow 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 Statistics – Reliable Numbers

The International Diabetes Federation (IDF) is an umbrella organization of over 200 national diabetes associations in over 160 countries. Besides promoting diabetes care and prevention, the IDF tracks statistics on diabetes and diabetics on a worldwide basis.

The Federation publishes the Diabetes Atlas, a collection of statistics and comments on diabetes which is issued from time-to-time. The Atlas is based on data supplied by its members. As these are national associations, the facts and figures published by the IDF are considered quite reliable.

According to the 6th edition of the IDF Diabetes Atlas, which was published in 2013, the total population of the world is 7.2 billion. This is expected to have risen to 8.7 billion by 2035, ie in 22 years time.

This total population includes 4.6 billion adults and these has been projected to reach 5.9 billion by 2035. The IDF defines an adult as a person aged 20-79 years, the most likely age range for the development of type 2 diabetes.

According to the Diabetes Atlas, 382 million people around the world or 8.3% of all 4.6 million adults (20-79 years) are estimated to be suffering from diabetes. Almost half of all adults with diabetes are aged 40-59 years, the age range during which people are at their most productive phase in life.

The number of people with type 2 diabetes is increasing in every country. If current trends continue, the IDF expects that there will be more than 592 million diabetics by 2035, a rise of 55%, when one adult in ten will be diabetic.

Undiagnosed diabetes

Type 2 diabetes may be undiagnosed for several reasons. There are few symptoms in the early years of the disease. In addition, the complications vary so widely that, even when symptoms do exist, diabetes may not be recognised as the cause.

The IDF figure for 382 million diabetics in 2013 includes 175 million who are undiagnosed. I must admit I was astounded when I first read that 46% of diabetics are undiagnosed. How can you count something if you don’t know it exists?

Estimating the number of undiagnosed diabetics, I discovered, is relatively easy. All the IDF had to do was to arrange tests for a sample of people living in a particular area. The tests, which are carried out by the IDF’s national associates, identify both known and unknown cases of diabetes, and it is a simple mathematical exercise to extrapolate to the population as a whole with a high degree of accuracy.

Many (but not all) persons who know they have the disease will be making some attempts to beat their diabetes. The problem with undiagnosed diabetes is that these diabetics will not be managing their blood glucose levels and may be developing complications, such as kidney disease, heart failure, retinopathy and neuropathy, unbeknownst to themselves.

Regional differences

The Diabetes Atlas provides statistics for 219 countries which the IDF have grouped into seven regions: Africa, Europe, the Middle East & North Africa, North America & the Caribbean, South & Central America, South-east Asia, and the Western Pacific.

The IDF estimates that 80% of diabetics live in low- and middle-income countries where the disease is increasing very fast and posing a threat to development. The prevalence of diabetes, however, varies widely from region to region and country to country. It also varies widely within regions… to an extent that suggests that the grouping of countries into regions by the IDF needs revising.

While about 8% of adults (aged 20-79) in the Western Pacific have diabetes, in certain countries in that region the proportion of adult diabetics is much higher. In Tokelau, for example, 37.5% of adults are diabetic. The figure for the Federated States of Micronesia is 35%.

In the Middle East and North Africa, nearly 11% of adults have diabetes. However this is an average for the entire region and the figures for the Arabian Gulf states are much higher, more than double the average, with 24% of adults in Saudi Arabia, 23.1% in Kuwait and 22.9% in Qatar being diabetic.

Undiagnosed diabetes also varies from region to region. In some countries in sub-Saharan Africa up to 90% of diabetics are undiagnosed, mainly due to a lack of resources and priorities. By contrast, in high-income countries about one-third of the people with diabetes have not been diagnosed.

In most countries diabetes is increasing in tandem with rapid economic development, which is leading to changes in diets, ageing populations, increasing urbanisation, reduced physical activity and unhealthy behaviour. Many governments, however, seem to be unaware of the growing crisis and the likelihood of serious consequences that could stifle their countries’ development.

Impaired glucose tolerance (IGT)

The IDF estimates that about 316 million people or 6.9% of adults (20-79) have impaired glucose tolerance (IGT). By 2035 this number is expected to have risen to 471 million (8.0% of the world’s adult population).

This is serious, as people with IGT or pre-diabetes have a greatly increased risk of developing type 2 diabetes. IGT is also linked with the development of cardiovascular disease.

The majority of adults with IGT (about 3.5% of the world’s total adult population) are under the age of 50 and are thus at a high risk of becoming type 2 diabetics later in life. Even more worry-some is the fact that nearly 1/3 of all those who have IGT are aged 20 to 39 years. Unless they overhaul their life-styles these people are virtually guaranteed to become diabetic later in life.

Adding the number of diabetics worldwide (382 million) to the number of people with IGT (316 million) gives a total of 698 million. In other words, nearly 10% of the total population of the world or over 15% of all adults (20-79) have either diabetes or pre-diabetes.

By comparison, only 33.4 million people on this planet are living with HIV/AIDS… about 1/20th of all diabetics and pre-diabetics. It’s glaringly obvious that diabetes and pre-diabetes represent a massive crisis that is threatening to overwhelm global health systems.

Deaths

Received opinion is that the medical complications caused by diabetes, such as heart failure and kidney disease, are major causes of death in most countries.

However, it is very difficult to accurately estimate the number of deaths because (a) more than a third of countries do not maintain data on death due to diabetes and (b) routine health statistics under-record these deaths, because the death certificates on which these statistics are based often omit diabetes as a cause of death.

To overcome these problems, the IDF uses a modelling approach to estimate the number of deaths attributable to diabetes, and appears to have come up with some reasonable estimates.

Diabetes is expected to be the cause of about 5.1 million deaths in adults aged between 20 and 79 in 2013 and nearly half (48%) of these will be people under the age of 60. Diabetes ranks as a leading cause of premature death.

These deaths represent about 8.4% of all deaths of adults (20-79). Deaths due to diabetes are increasing. The estimated overall number of deaths in 2013 represents an 11% increase over the estimates for 2011. Death from diabetes is on a rising trend.

Health costs

There is no cure for diabetes. For this reason, diabetics have to look after their health assiduously. Where they are unable to control their diabetes through diet and exercise, they have to resort to regular medication. This can be expensive both for health systems and for diabetics and their families.

The IDF has estimated global health spending on diabetes to be at least USD 548 billion dollars in 2013… 11% of the total spent on adult health. This is expected to exceed USD 627 billion by 2035.

Where diabetes is undiagnosed, the benefits of early diagnosis and treatment are lost. Thus, the costs relating to undiagnosed diabetes must be considerable. One study found that undiagnosed diabetes in the USA was responsible for an additional USD 18 billion in healthcare costs in one year.

There are large disparities in spending between regions and countries. Only 20% of global health expenditure on diabetes was made in the low- and middle-income countries where 80% of diabetics live. On average, the estimate spend in 2013 is USD 5,621 per diabetic in high-income countries but only USD 356 in low- and middle-income countries.

However, when individual countries are compared, the disparities are extremely stark. Norway spends an average of USD 10,368 on diabetes healthcare per diabetic, while countries such as Somalia and Eritrea spend less than USD 30.

The costs associated with diabetes, however, are much wider that just the costs of providing the appropriate health services. The overall costs include losses in productivity, social costs such as disability payments, and losses of income. Without a doubt, diabetes imposes a heavy economic burden on countries, families and individuals.