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Diabetes (more information)
According to the Centers for
Disease Control and Prevention, diabetes is the 6th leading cause
of death in America. Diabetes is a chronic disease in which the
body is unable to effectively turn consumed sugar into energy
that the body can use to function. Sugar in your diet comes not
only from sweets, but also starches such as bread, pasta and
other foods. Sugar is an essential source of energy for your
body, but in order for sugar to be converted into energy there
has to be enough insulin present in your blood. Insulin is a
hormone that is produced by a gland called the pancreas, which
sits just behind your stomach. Insulin allows sugar to be converted
into energy that your body can use. If you have diabetes your
body cannot process sugar into energy because it doesn't have
enough insulin or does not respond to the insulin you do have
to turn the sugar into energy. Therefore a person with diabetes
has a buildup of sugar in their blood, which can cause serious
health complications such as kidney failure, blindness, heart
disease, stroke and impotency. In addition, people with sedentary
lifestyles who over eat are at higher risk of developing diabetes.
TYPES OF DIABETES
Type 1 Diabetes (formerly called insulin-dependent diabetes
mellitus (IDDM) or juvenile-onset diabetes)
Of all people with diabetes only
5-10% have Type 1 diabetes. Individuals with Type 1 diabetes
do not produce insulin at all and must be injected with insulin
to maintain a healthy lifestyle. There is little information
on what causes Type 1 diabetes although it may be hereditary
or due to environmental factors. For more information about living
and coping with Type 1 diabetes take a look at: http://www.diabetics.org/main/application/commercewf?origin=*jsp&event=link[D]
Type 2 Diabetes (formerly called non-insulin-dependent
diabetes mellitus (NIDDM) or adult-onset diabetes)
Type 2 diabetes affects 90-95%
of people with diabetes. In Type 2 diabetes the body doesn't
respond to the insulin that is produced or not enough insulin
is produced to turn sugar into energy. Risk factors for Type
2 are older age, family history of diabetes, obesity, lack of
physical activity and impaired glucose tolerance which means
that blood sugar levels are higher than normal but not high enough
to be diagnosed as diabetes. African Americans, Latino Americans,
American Indians and Pacific Islanders are especially at risk
for Type 2 diabetes. For more information about Type 2 diabetes
take a look at: http://www.diabetics.org/main/application/commercewf?origin=*jsp&event=link[C]
How Diabetes Affects the Body
People with diabetes have high
blood sugar levels which damages blood vessels all over the body.
High blood sugar levels make the walls of blood vessels thicker
and less elastic so blood has a harder time passing through.
In addition, people with diabetes tend to have higher fat levels
in their blood because they have higher blood sugar. These fats
or lipids clog and narrow the blood vessels creating a problem
called atherosclerosis.
Vascular System
EYES: The high blood sugar levels
caused by diabetes can damage blood vessels in your eyes and
lead to vision loss, which doctor's call retinopathy. Men with
diabetes are more likely to have retinopathy than women with
diabetes.
HEART: High blood sugar levels
in your circulation system, which pumps blood through your body,
can lead to heart disease, stroke, and angina (heart pain). People
with diabetes are more likely to have a heart disease as compared
to people who don't have diabetes.
KIDNEYS: Kidneys maintain the
right amount of water in the body and help to filter out wastes,
but diabetes can damage your kidney, which may lead to bladder
problems, kidney infection, diabetic kidney disease and eventually
kidney failure.
LOWER LIMBS: High blood sugar
levels from diabetes can cause nerve damage and poor circulation
in the feet and lower limbs. Because of the nerve damage people
with diabetes often loose sensation in their lower limbs and
may not feel any blisters or cuts they may have in those areas.
Because there is limited blood flow to the lower limbs due to
the poor circulation it makes infections and cuts in these areas
difficult to heal and may ultimately lead to amputation. Men
are more likely to have amputations due to diabetes than women.
Nervous System
Your nerves can also be damaged
and therefore impair your ability to feel properly, this may
lead to numbness and tingling in various parts of your body.
The nerve damage caused by diabetes can also damage the nerves
and arteries in the genital area, disrupting the blood flow necessary
for an erection causing impotence in men. This is more common
in older men who have had diabetes for a long time.
Risk Factors
You cannot catch diabetes from
someone. Diabetes is a disease whose cause in unknown, but genetics
and environmental factors are thought to play a role. Approximately
7.8 million men or 8.3% of all American men over 20 have diabetes
but one-third of them do not know it. People who are at high
risk are:
- Anyone that is 45 and older
should be tested for diabetes, especially if you are overweight
(To find out if you are considered overweight please consult
this table http://www.niddk.nih.gov/health/diabetes/pubs/risk/bmi_tbl.pdf).
- African American, Latino American,
American Indian and Pacific Islander men are at higher risk for
diabetes, especially for Type 2 diabetes.
- African Americans and Latino
Americans are twice as likely as whites to have diabetes. About
2.8 million or 13% of all African Americans have diabetes, but
approximately 1/3 of them do not know it.
- African Americans who have diabetes
experience higher rates of cardiovascular disease, blindness,
kidney failure and amputation of the lower limbs.
- People who are relatively inactive
and have high blood pressure are also at risk.
SYMPTOMS
The only way to know for sure
if you have diabetes is to visit your doctor and ask for a blood
sugar test. However some common symptoms of diabetes are:
- frequent urination
- often thirsty
- unexplained weight loss
- irritability
- nausea
- vomiting
- stomach pains
- extreme hunger
- difficulty seeing
- frequent skin, bladder or gum
infections
- dry skin
- sores that heal slowly
- more infections than usual
- numbness or tingling in hands
or feet
- feeling very tired
COMPLICATIONS
KIDNEY FAILURE: Diabetes is the
most common cause of kidney failure, which can be a fatal illness.
Treatment for kidney failure includes dialysis or kidney transplant.
Dialysis is a procedure that cleans and filters your blood. It
gets rid of harmful wastes and extra salt and fluids in your
body. It also controls blood pressure and helps your body keep
the proper balance of chemicals. Some symptoms of kidney failure
include:
- Bloating
- Bleeding, often in the stomach
or small intestines
- Confusion
- Seizures
- Coma
NEUROPATHY: Diabetic neuropathies
are a group of nerve disorders which result from long term damage
to nerves by high blood sugar levels. Neuropathies can lead to
numbness, pain and weakness in the hands, feet, arms and legs.
Neuropathies may also cause problems in any organ system. People
with diabetes can develop a neuropathy at any time however those
who have had diabetes for longer are at higher risk. The symptoms
for neuropathy include:
- Numbness, pain, or tingling
in hands, feet, arms, and legs
- Diarrhea or constipation
- Weakening of muscles in the
feet and hands
- Indigestion, nausea or vomiting
- Problems with urinating
- Impotence (inability to have
an erection)
- Dizziness or faintness
- Weight loss
- depression
PREVENTION/PLANNING AHEAD
- Maintain a healthy diet that
is low in fats and sugars.
- Control your blood pressure,
which reduces cardiovascular disease (stroke and heart disease)
and kidney disease.
- Decrease your cholesterol and
fat intake, which can reduce cardio vascular disease.
- Get your vision checked to diagnose
retinopathy.
- Exercise at least 30 minutes
on most days of the week. Walking is a good start!
TREATMENT
Treatment for diabetes is directed
at lowering the amount of sugar in your blood to normal levels.
The large majority of treatment for diabetes depends on the attitude
of the patient. Most treatment plans consist of measuring your
blood sugar levels, taking diabetes pills or shots of insulin,
losing weight, exercising and maintaining a balanced diet. The
regulation of diet and blood sugar levels require a personal
change in lifestyle, which can be mediated through supportive
family, friends and physician.
Treatment for Type 1 Diabetes (formerly called insulin-dependent diabetes
mellitus (IDDM) or juvenile-onset diabetes)
INSULIN: For people with Type
1 diabetes insulin can be used in treatment. Insulin is a drug
that is made to work exactly like the insulin your body would
naturally produce. Insulin is injected under your skin through
a syringe, insulin pin or through pump therapy. Insulin cannot
be taken through a pill. There are over 20 different types of
insulin available through prescription and it is up to you and
your doctor to decide which one is best for you. For more detailed
information about insulin consult this website: http://www.diabetes.org/main/type1/medical/insulin/about_insulin.jsp.
MONITORING YOUR BLOOD SUGAR:
According to the American Diabetes Association you should check
your blood sugar regularly if you are taking insulin or diabetes
pills, or if you have a hard time controlling your blood sugar.
To test your blood sugar you prick your finger or other fleshy
area on your hand, arm or thigh to get a droplet of blood for
testing. From there you test the droplet with a blood glucose
meter (a small machine, like a calculator), which tells you the
amount of glucose or sugar in your blood. This information allows
you to see how close to normal your blood sugar is. For more
information on the procedure, the different blood glucose meters
available and when you should test your blood sugar please see
this website: http://www.diabetes.org/main/type2/medical/blood_sugar/default2.jsp.
Treatment for Type 2 Diabetes (formerly called non-insulin-dependent
diabetes mellitus (NIDDM) or adult-onset diabetes)
People with Type 2 diabetes can
usually maintain normal blood sugar levels through maintaining
a healthy diet, losing weight and exercising. Although the main
treatment is based on altering personal habits you still need
to see your doctor regularly. In order to properly control diabetes
you need the help of your physician who can keep help you monitor
your progress in maintaining healthy blood sugar levels. However,
for some individuals good diet and exercise aren't enough to
maintain normal blood sugar levels. The next step is to take
either diabetes pills or insulin shots.
DIABETES PILLS: Diabetes pills
do not contain insulin. There are three classes of diabetes pills
which all lower blood sugar, but in different ways. The first
class helps your body to make more insulin so that your body
can use the sugar in your blood. The second class allows the
insulin that you already have in your blood to be more effective
at using the sugar in your blood. The third class helps to lower
blood sugar by breaking down starches (pasta, bread) and sugar.
Your doctor may also recommend that you take some of these pills
together. Consult this page for more information on diabetes
pills: http://www.diabetes.org/main/application/commercewf?origin=*.jsp&event=link(D4_3).
INSULIN: For people with Type
2 diabetes insulin can be used in treatment. Insulin is a drug
that is made to work exactly like the insulin your body would
naturally produce. Insulin is injected into the blood stream
through a syringe, insulin pin or through pump therapy. Insulin
cannot be taken through a pill. There are over 20 different types
of insulin available through prescription and it is up to you
and your doctor to decide which one is best for you. For more
detailed information about insulin consult this website: http://www.diabetes.org/main/type1/medical/insulin/about_insulin.jsp.
MONITORING YOUR BLOOD SUGAR:
According to the American Diabetes Association you should check
your blood sugar regularly if you are taking insulin or diabetes
pills, especially if you have a hard time controlling your blood
sugar. To test your blood sugar you prick your finger or other
fleshy area on your hand, arm or thigh to get a droplet of blood
for testing. From there you test the droplet with a blood glucose
meter (a small machine, like a calculator), which tells you the
amount of glucose or sugar in your blood. This information allows
you to see how close to normal your blood sugar is. For more
information on the procedure, the different blood glucose meters
available and when you should test your blood sugar please see
this website: http://www.diabetes.org/main/type2/medical/blood_sugar/default2.jsp.
Complications of Treatment
HYPOGLYCEMIA: Hypoglycemia is
a condition caused by low blood sugar. This is a common complication
of diabetes that can occur even when you are doing your best
to control your blood sugar. Its symptoms include:
- Low blood sugar
- Dizziness
- Shaking
- Sweating
- Hunger
- Headache
- Pale skin
- Sudden moodiness or behavior
changes
- Clumsy or jerky movements
- Seizure
- Difficulty paying attention
or confusions
- Tingling sensation around the
mouth
Please take a look at this website
for more information on hypoglycemia: http://www.diabetes.org/main/application/commercewf?origin=*.jsp&event=link(C4_5).
HYPERGLYCEMIA: Hyperglycemia
is a conditioned caused by high blood sugar. If you have high
blood sugar when the body doesn't have enough insulin or does
not respond to the insulin you have to process the sugar, there
is an excess of sugar in your blood. This is a serious condition
if it is not treated. Its symptoms include:
- High levels of sugar in urine
- High blood sugar level
- Frequent urination
- Increased thirst
- Fatigue
If hyperglycemia is not controlled
it can lead to ketoacidosis. Ketoacidosis is when your body is
dangerously low on insulin and therefore cannot process the large
amount of sugar in your blood to use as fuel. So, your body breaks
down your fat stores to use for fuel. When your body breaks down
fat ketones are produced. Because your body doesn't like to have
a lot of ketones it urinates a lot to try to get rid of them.
This condition is life threatening and you must see a doctor
to control it. Its symptoms include:
- Shortness of breath
- Breath that smells fruity (ketones
give it the fruity smell)
- Nausea and vomiting
- Very dry mouth
Please look at this website for
more information on hyperglycemia and ketoacidosis: http://www.diabetes.org/main/application/commercewf?origin=*.jsp&event=link(C4_6).
ALTERNATIVE MEDICINE
There are alternative therapies
available for the treatment of diabetes such as acupuncture,
biofeedback, vitamin and mineral supplementation and guided imagery.
Consult this website from the National Diabetes Information Clearinghouse
for more information http://www.niddk.nih.gov/health/diabetes/summary/altmed/altmed.htm.
HELPFUL LINKS
REFERENCES
American Diabetes Association
http://www.diabetes.org
Centers for Disease Control and
Prevention
http://www.cdc.gov/diabetes
National Institute of Diabetes
and Digestive and Kidney Diseases
http://www.niddk.nih.gov/
Joslin Diabetes Center
http://www.joslin.harvard.edu/education/library/prevent_itg.shtml
http://www.joslin.harvard.edu/education/library/index.shtml
http://onlineclasses.joslin.org/
http://www.diabetes.org/main/info/facts/facts_men.jsp
http://diabetes.niddk.nih.gov/
http://www.niddk.nih.gov/welcome/releases/11-00.htm
http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/index.htm
http://www.mayoclinic.com/invoke.cfm?objectid=9E510C36-F9F7-4E3B-A7054C1D1F942043§ion=2
GLOSSARY
Artery- A muscular tube that
carries blood away from the heart to the other parts of the body
Chronic disease- A disease that
lasts for a long period of time. Diabetes is a chronic disease
because it is a life long condition. Although diabetes may develop
at any age, once it has developed you will have it for the rest
of your life.
Glucose- The chemical name for
the sugar our bodies require to make energy.
Impotence- Inability to have
an erection or to maintain an erection until ejaculation
Nerves- Bundles of fibers that
send and receive information from all over your body.
Retinopathy- a disorder of the
retina (membrane lining the inner eyeball) of the eye, which
causes blindness.
Sedentary lifestyle- A lifestyle
in which you are used to sitting and do not do much exercise
or other physical activity
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