WHAT IS DIABETES?

Diabetes is one of the biggest disease epidemics sweeping the world. By the year 2020, there will be over 280 million diabetics in the world. China,India and the US are the countries with the highest number of diabetics. Diabetes is a lifestyle disease that is brought on by the excessive intake of calories and a lazy or sedentary lifestyle (a lifestyle without much exercise).

Diabetes occurs when your body is unable to use the glucose that is obtained from your meal, successfully. Insulin is a hormone that is produced in your pancreas (an organ that is located behind your stomach). There are cells in the pancreas called beta cells which produce the insulin. Insulin enables your cells to transport glucose from your blood into your cells. Every cell in your body needs glucose to make energy which is used by the cell to carry out its function.

When your pancreas fails to make enough insulin, or the cells cannot use the insulin effectively (a condition called INSULIN RESISTANCE), glucose cannot be effectively transported into the cells. This sustained high level of blood glucose over weeks and months is what gives the symptoms of diabetes.

Diet, Exercise and Lifestyle play a very important role in managing diabetes.

TYPES OF DIABETES

There are 2 major types of diabetes - each caused by a different mechanism. Type 1 diabetes occurs in childhood or teenage years and is due to failure of the beta cells in the pancreas to make insulin. This type of diabetes requires insulin replacement a few times daily - this is life saving. The person with Type 1 Diabetes must be on insulin for life.

Type 2 Diabetes occurs when there is an overload of glucose coming into the body. This is usually from overeating foods that release glucose into the blood stream rapidly (high glycemic index foods). The type of foods that cause and aggravate diabetes are mainly carbohydrates or starches. Being overweight, not exercising and eating large amounts of starchy or carbohydrate rich foods can cause and aggravate diabetes.

There is a genetic pattern that runs in certain families that predisposes you to developing diabetes. However, it is your life style and selection of foods that brings on the diabetes earlier.

There is a 3rd type of diabetes that is due to the immune system destroying the beta cells of the pancreas. This is an autoimmune type of diabetes and has to be managed with insulin.

DIABETES TREATMENT

The 1st step in managing your diabetes easily is to know which type of diabetes you have. Type 1 diabetes will need insulin if you are to survive. Your doctor will guide you as to how many units of insulin you need to take and how often. Insulin is given as an injection, usually in the abdominal wall or thigh. Diet and exercise are crucial in Type 1 diabetes.

If you have Type 2 diabetes, a low GI (glycaemic index) diet is essential. Two types of medication are available that can be taken orally, if your doctor recommends them. The first class of drug (Metformin) improves the insulin resistance in your cells. Excessive fat accumulated around the organs in your abdomen is one of the biggest causes of insulin resistance and your diabetes not improving.

The second class of drug (Sulphonylureas) helps increase the secretion of insulin from your pancreas. Sometimes both drugs are needed in some diabetics. Your doctor will know when to add this second class of drug.

As you get older, you lose more beta cells in the pancreas (apoptosis or natural cell death with aging). The oral drug treatment may now not be enough and insulin may have to be started. You should not be afraid of starting insulin treatment as it can improve your control of the diabetes.

THE NEED FOR GAINING BETTER CONTROL OVER YOUR BLOOD SUGAR LEVELS

When blood sugar levels are persistently high in diabetes, the excessive blood glucose behaves like a toxin and begins to damage the inner lining (endothelium) of the arterial blood vessels causing plaque formation and a blockage to the oxygen bearing circulation. The tissue in the end organs that these blood vessels supply become deprived of oxygen and degenerate and malfunction. The end organs that are most affected by diabetes through this process are the kidneys, the heart, the eyes, the brain, the nerves of the body and the feet.

When these organs become damaged from the lack of oxygen due to blockage of the small blood vessels as a result of uncontrolled diabetes, serious complications arise. You want to avoid these serious and life threatening complications by learning how to easily control your blood glucose level.

Be aware that intense stress from whatever reason can cause your blood sugar level to go out of control. Infections anywhere in your body can cause your diabetes to rapidly spiral out of control. An often missed infection that may be causing your poor diabetes control could be a tooth or gum infection.

You must be aware that your blood sugar can go very low (hypoglycaemia) - this often happens in Type 1 diabetes, but can occasionally happen in Type 2 diabetes. An out of control diabetes most often means that you blood sugar level is very high (hyperglycaemia).

KNOWING THE FOODS THAT CAUSE YOUR DIABETES TO GO OUT OF CONTROL

Excessive intake of carbohydrates is the main cause of poor control of diabetes. Carbohydrates are starches such as bread, rice, potatoes, pastas, cereals, biscuits, pumpkin, squashes and butternut. Beer is very high in carbohydrates.

Food high in glucose, such as drinks with high amounts of sugar (fizzy drinks), fruit juices, cooked carrots and beetroot can also cause the blood sugar to go up rapidly.

IGNORANCE IS THE BIGGEST REASON WHY DIABETICS FAIL TO CONTROL THEIR BLOOD SUGAR

To gain easy control over your diabetes, you must invest some time in understanding the various aspects of what and why you must do certain things in your lifestyle, diet and exercise. Just knowing what to do in managing your diabetes, with the assistance of your doctor, can easily bring your diabetes under control.

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Diabetes is a disorder that affects the way your body uses digested food to maintain health, growth and energy. Normally, the food you eat is broken down into glucose, which is a type of sugar. It becomes the major source of energy for your body. This glucose is carried in your bloodstream to be used by your cells for growth and energy.

But if your body doesn't have enough of a hormone called insulin, the glucose in your blood can't reach your cells. If you have type 2 diabetes your pancreas may not produce enough insulin. That means your fat, muscle, and liver cells can't use the glucose effectively and it builds up in your blood. The glucose must go somewhere, so it overflows into your urine and passes out of your body.

According to the National Diabetes Information Clearinghouse, more than 20 million people in the United States have diabetes. Ninety to 95 percent of people with diabetes have type 2 diabetes. Diabetes is a very serious illness. In fact, diabetes is the main cause of kidney failure, limb amputation, and blindness in American adults.

People with diabetes are also two to four times more likely than people without diabetes to develop heart disease. Pre-diabetes is also a serious condition. It's also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Having pre-diabetes means your the level of glucose in your blood glucose are higher than normal but not high enough for a diagnosis of diabetes.

But pre-diabetes means you're at a higher risk for developing type 2 diabetes and heart disease. Your doctor can test you to see if you have pre-diabetes or type 2 diabetes.

Prevent Diabetes Problems: Keep Your Diabetes under Control

What are diabetes problems?
Too much glucose (sugar) in the blood for a long time can cause diabetes problems. This high blood glucose (also called blood sugar) can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.

What should my blood glucose numbers be?
Keeping your blood glucose on target will prevent or delay diabetes problems. For most people, target blood glucose levels are:

Before meals > 90 to 130
1 to 2 hours after the start of a meal > Less than 180

Talk with your health care provider about what your blood glucose numbers should be. You and your health care provider will agree on when you need to check your blood glucose using a blood glucose meter. Your health care provider can teach you how to use your meter.

Keep track of your blood glucose checks using the record page. Make copies yourself or ask your health care provider for a blood glucose record book. Your blood glucose check results will help you and your health care provider make a plan for keeping your blood glucose under control. Always bring your record book to your health care appointments so you can talk about reaching your glucose goals.

Ask your health care provider to do an A1C test. This blood test shows the average amount of glucose in your blood during the past 2 to 3 months. If your A1C result is not as good as it should be, your health care provider will do this test more often to see if it is improving as your treatment changes. Your A1C result plus your blood glucose meter results can show whether your blood glucose is under control.

Aim for a result below 7 percent. If your A1C test result is below 7 percent, then your blood glucose is in a desirable range and your diabetes treatment plan is working. The lower your A1C is, the lower your chance of getting eye, nerve, and kidney damage.

If your test result is more than 8 percent, you need a change in your diabetes plan. Your health care team can help you decide what part of your plan to change. You may need to change your meal plan, your diabetes medicines, or your exercise plan.

What should my blood pressure be?
Normal blood pressure will help prevent damage to your eyes, kidneys, heart, and blood vessels. Blood pressure is written with two numbers separated by a slash. If you already have kidney disease, you may want even lower blood pressure to protect your kidneys.

Meal planning, medicines, and exercise can help you reach your blood pressure target. Normal cholesterol levels will help prevent heart disease and stroke, the biggest health problems for people with diabetes. Keeping cholesterol levels under control can also help with blood flow. Have your cholesterol level checked at least once a year. Meal planning, exercise, and medicines can help you reach your cholesterol targets:

Total cholesterol: under 200
LDL cholesterol: under 100
HDL cholesterol: above 40 (men) above 50 (women)
Triglycerides: under 150

Smoking and diabetes are a dangerous combination. Smoking raises your risk for diabetes problems. If you quit smoking, you'll lower your risk for heart attack, stroke, nerve disease, and kidney disease. Your cholesterol and your blood pressure levels may improve. Your blood circulation will also improve. If you smoke, ask your health care provider for help in quitting.