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Diabetes
Basic Information

Diabetes

Diabetes Mellitus ("diabetes" for short) is a serious disease that occurs when your body has difficulty properly regulating the amount of dissolved sugar (glucose) in your blood stream. It is unrelated to a similarly named disorder "Diabetes Insipidus" which involves kidney-related fluid retention problems.

In order to understand diabetes, it is necessary to first understand the role glucose plays with regard to the body, and what can happen when regulation of glucose fails and blood sugar levels become dangerously low or high.

The tissues and cells that make up the human body are living things, and require food to stay alive. The food cells eat is a type of sugar called glucose. Fixed in place as they are, the body's cells are completely dependent on the blood stream in which they are bathed to bring glucose to them. Without access to adequate glucose, the body's cells have nothing to fuel themselves with and soon die.

Human beings eat food, not glu...

 
Fast Facts: Learn! Fast!

What is diabetes?

  • Diabetes Mellitus (usually called "diabetes" for short) is a serious disease that occurs when your body has difficulty properly regulating the amount of dissolved sugar (glucose) in your blood stream.
  • The tissues and cells that make up the human body are living things that require food to stay alive, and this food is a type of sugar called glucose.
  • The body's cells are dependent on the blood stream to bring glucose to them and without adequate supply, the body's cells will soon die.
  • Human foods get converted into glucose as a part of the normal digestion process.
  • Nearby cells are not able to access glucose without the aid of a chemical hormone called insulin, which acts as a key to open the cells, allowing them to receive and use available glucose.
  • Insulin can be thought of as a bridge for glucose between the blood stream and cells.
  • The concentration of glucose available in the blood stream at any given moment is dependent on the amount and type of foods that people eat.
  • Problems with insulin production or with how insulin is recognized by the cells can cause the body's carefully balanced glucose metabolism system to get out of control.
  • When either of these problems occur, Diabetes develops and the body risks becoming damaged.

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What types of diabetes are there?

  • Diabetes is common, affecting 23.6 million Americans according to a 2007 survey by the American Diabetes Association (CDC, 2008) with roughly 1.6 million more Americans being diagnosed with diabetes every year (CDC, 2008).
  • Diabetes comes in two major forms and a third less common form.
  • Type 1 diabetes is an autoimmune disease where the body's own immune system attacks and destroys the cells within the pancreas that produce insulin, leaving the person unable to produce insulin naturally.
  • Type 1 is also known as juvenile diabetes because it often begins in childhood.
  • It is fairly rare, accounting for only 5% or so of all diabetes cases.
  • Type 2 diabetes begins with a gradual decrease in the body's ability to respond to insulin (a condition known as "Insulin Resistance"), rather than an abrupt stoppage of actual insulin production.
  • Type 2 diabetes, which is linked to obesity and poor lifestyle choices and which often begins in adulthood, is far more common than Type 1 diabetes, and accounts for some 90 to 95% of diabetes cases.
  • Gestational diabetes occurs in women in the latter stages of pregnancy, is relatively rare, and generally subsides with the end of pregnancy.
  • Women who have experienced Gestational diabetes go on to have an increased risk of developing Type 2 diabetes in later life.

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How can diabetes be prevented?

  • At this time there appears to be little or nothing that people can do to avoid risk of getting Type 1 diabetes, but there are clear risk factors for Type 2 Diabetes.
  • While Type 2 diabetes can occur in people of any age, it is much more common in people aged 40 or older. Recent evidence suggests that more and more children are being diagnosed with type 2 diabetes also.
  • African Americans, Native Americans, Hispanic Americans, Pacific Islanders, and Asian Americans are at greater risk for developing the illness than are Caucasians.
  • People who have close blood relatives (siblings or parents) who have diabetes are at increased risk of getting diabetes themselves.
  • Mothers who experienced temporary Gestational diabetes during pregnancy, or who gave birth to a baby that weighed 9 pounds or more, are at increased risk for developing Type 2 diabetes.
  • Pre-diabetes, otherwise known as "impaired glucose tolerance", is a pre-cursor to Type 2 diabetes, and without intervention, many pre-diabetic people go on to develop Type 2 diabetes within a decade.
  • People who lead sedentary, inactive lives (for example, those who work at a desk job and then watch a lot of TV) have a greater risk of developing diabetes than more active people (those who have built regular exercise into their daily routines).
  • Research has demonstrated that modest sustained weight loss (of even 10 lbs), portion control, and lower-fat and refined sugar dietary choices reduce Type 2 diabetes risk.
  • High blood cholesterol and hypertension (high blood pressure) are also risk factors for Type 2 diabetes.

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How is diabetes diagnosed?

  • Your doctor will rely on tests of your blood to diagnose diabetes.
  • A Fasting Plasma Glucose test measures baseline blood sugar concentration by testing blood samples taken after prolonged fasting (not eating for eight or more hours), often first thing in the morning. This is the first and most common screening test a physician will use to diagnose diabetes.
  • An Oral Glucose Tolerance test involves the collection of a fasting blood sample (as in the Fasting Plasma Glucose test), and then having the patient eat a known amount of sugar (75 grams), and collecting a blood sample from them after two hours have passed to provide information about how blood sugar might swing in the short term after food has been eaten.
  • The Hemoglobin A1C measures the relative amount of a particular hemoglobin molecule in a person\'s blood that is related to the amount of glucose their blood contains. This test does not require the patient to fast the night before and gives a good representation of a person's blood glucose control over the past two to three months.
  • A Random Plasma Glucose test involves blood samples being taken without regard for meals and fasting, and the results are compared against charts that indicate when glucose levels are simply too high to be normal.

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How is diabetes monitored?

  • The purpose of this set of tests is to check for complications of diabetes and to learn whether the diabetes is improving or getting worse.
  • A Urinalysis involves the patient giving a sample of their urine in the physician's office. This test is important because it can determine the effect of diabetes on the kidneys.
  • The Hemoglobin A1C measures the relative amount of a particular hemoglobin molecule in a person's blood that is related to the amount of glucose their blood contains. This test does not require the patient to fast the night before and gives a good representation of a person's blood glucose control over the past two to three months.
  • A Blood pressure check should be done at least once a year and many people with diabetes are also encouraged to purchase a home blood pressure unit so that they may check their pressure regularly.
  • An Eye Exam should be done at least once a year as it can help catch diabetic retinopathy early when it may still be treatable.
  • Cholesterol testing should be done at least once a year because diabetes and high cholesterol often go hand in hand and can combine to cause serious heart and vascular problems.

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How is diabetes treated?

  • Blood sugar concentration is monitored with the aid of a personal Glucose Meter, a device that can measure glucose concentration within a small sample of blood.
  • It is a good idea for diabetic patients to carry some form of sugar with them at all times, so that if self-monitoring of blood glucose indicates hypoglycemia (low blood sugar), they can introduce a safe amount of sugar into their bodies as a counter-measure.
  • Insulin therapy is the primary means of treating Type 1 diabetes and is also often used in type 2 diabetes as injecting insulin will have the effect of lowering the patient's blood sugar.
  • Those with Type 1 diabetes will most likely need to take insulin every day, often even multiple times a day and the insulin must be injected directly into the body as any attempt to take it orally would result in the destruction of the insulin by the digestive tract.
  • While some Type 2 diabetics find that diet and exercise alone are sufficient to help them manage their blood sugar, others require one or more medications to help with blood sugar control.
  • Despite best efforts, there are times when diabetic patients are unable to keep their blood sugar under control, and severe hyperglycemia or hypoglycemia states or even unconsciousness (coma) occur and immediate emergency medical treatment is required. At the hospital, doctors can re-balance body systems back towards a normal and healthy state.
  • Some people with diabetes may also require hospitalization when consequences of diabetes (cardiovascular disease, infection, limb and vision problems, etc.) become health crises in their own right.

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What are healthy living choices that those with diabetes can make?

  • With Type 1 diabetes the single most important factor for preserving health is proper glucose and insulin management.
  • People with Type 2 diabetes also need to pay attention to blood sugar management issues, but often can accomplish that management through careful attention to diet and exercise.
  • The best way to combat obesity, and some of the other risk factors for Type 2 Diabetes as well, is to eat a healthy and balanced diet and to commit to a program of regular physical exercise.
  • A healthy and balanced diet involves meals that are balanced combinations of different food groups with cereals, grains, fruits and vegetables representing the bulk of meals, meats, fish, and dairy as a smaller component and fats/sweets consumed in very limited quantities. A healthy diet is also one that contains fresh and relatively unprocessed foods.
  • Regular exercise (a raised heart rate for at minimum 30 minutes a day, three days each week) is a critical part of effective weight loss. Examples of useful exercises include running, jogging, fast walking, swimming, cycling, stair-climbing, Pilates, tennis, soccer and basketball.
  • Sustained weight loss is a difficult thing to achieve, as there are many food and recreational temptations that can undercut your resolve. It is highly useful to seek out social support for your weight loss project.

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