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If you or someone you know suffers from Diabetes, this is possibly the most important thing you will ever read! Click here for free preview....
Diabetes. It is a serious disorder that can lead to blindness, amputation, kidney failure, stroke and heart attacks. Most often caused by the inability of the body to make or properly use insulin, diabetes affects the way your body uses sugars (fruits and vegetables), starches (breads and cereals), and how other foods are broken down into energy.
There are 2 major types of diabetes.
7 Was known as Insulin Dependent Diabetes (IDDM) or Juvenile Onset.
7 Accounts for less than 10% of all diagnosed cases of diabetes.
7 Causes the body to produce little or no insulin. The person with type 1 diabetes must use insulin daily to remain healthy.
7 Is usually diagnosed in people under the age of 20, but it can occur at any age.
7 Does not usually run in families.
7 Usually occurs in thin to normal weight individuals.
7 Increases the risk of ketosis.
7 Was known as Non-insulin Dependent Diabetes (NIDDM) or Adult Onset.
7 Accounts for over 90% of all diagnosed cases of diabetes.
7 In many cases, people will have high levels of insulin at diagnosis, but it can occur in people with normal or low levels of insulin.
7 Is usually diagnosed in people over 30 years of age, but is being found more frequently in children, adolescents and young adults.
7 Tends to run in families.
7 Usually occurs in overweight individuals.
7 Increases risk for high blood pressure and high cholesterol.
1. Overweight - = 120% of ideal body weight or a body mass index (BMI) = 27 kg/m2
2. Family history of Diabetes Mellitus (DM)
3. Hispanic, African American or Native American origin
4. Over 30 years of age
5. Prior history of large babies or diabetes during pregnancy (gestational diabetes)
6. Sedentary lifestyle
1. Excessive thirst or hunger
2. Frequent urination
3. Extreme weakness or fatigue
4. Cuts or sores that are slow to heal
5. Blurred vision
6. Tingling or numbness of the feet or hands
7. Frequent urinary or vaginal infections in women
8. Impotence
9. Acanthosis Nigricans - a darkened pigmentation of the skin folds, i.e., neck, elbows, behind the knees, or the groin areas
1. You should be tested if two or more risk factors are present.
2. Try to be more active.
a. Find things you enjoy doing, such as walking, dancing, gardening, or bicycling.
b. Make time to do something active and fun.
c. Activity should be done regularly, for at least 30 minutes four times a week.
3. Develop healthy eating habits.
a. Reduce fats, such as lard and shortening.
b. Cook with vegetable oils.
c. Use low-fat cooking methods such as broiling and steaming.
d. Trim fat and skin from meats.
e. Eat smaller portions.
f. Choose foods high in fiber, such as fruits, raw vegetables, beans, peas, and whole grains.
g. Eat well balanced meals about the same time each day.
4. Be alert for signs and symptoms of diabetes. Notify the doctor
if they occur.
A. Type 1 - Previously called IDDM or Juvenile Diabetes
1. Accounts for approximately 10% of diabetes.
2. Must take injected insulin to live.
3. Pancreas produces little or no insulin. Absolute insulin deficiency
4. Usually develops in individuals before the age of 20.
5. Typically onset in children is acute and dramatic with frequent urination, thirst, extreme hunger and fatigue, rapid weight loss, and profoundly elevated glucose levels. Onset of symptoms in adults is more gradual, often being mistaken for type 2 diabetes.
6. If untreated, can progress to ketoacidosis and coma.
7. Risk Factors
a. Autoimmune disease. Islet Cell Antibodies (ICA) destroy the beta cells of the pancreas and are often present at time of diagnosis.
b. Genetic predisposition. Over 90% of Caucasians with type 1 are haplotype DR3 and/or DR4 positive on genetic testing.
c. Environmental factors, i.e., viruses and unidentified factors.
B. Type 2 - Previously called NIDDM or Adult Onset
1. Accounts for approximately 90% of people with diabetes.
2. Treatment is highly individualized, requiring dietary modification, exercise, lifestyle changes, medication, or a combination of all these items.
3. Usually has gradual onset.
4. Occurs more frequently after the age of 30.
5. 80 to 90% of individuals are overweight.
6. Individual may present with few or no symptoms.
7. May range from predominately insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance.
8. Coexistence of three major metabolic abnormalities
a. Peripheral insulin resistance
b. Increased basal hepatic glucose production
c. Impaired insulin secretion
a. Overweight - = 120% of ideal body weight or a Body Mass Index (BMI) = 27 kg/m2
b. Family history of DM
c. Hispanic, African American or Native American origin
d. Over 30 years of age
e. Prior history of large babies or diabetes during pregnancy (gestational diabetes)
f. Sedentary lifestyle
g. High blood pressure
h. High Density Lipoprotein Cholesterol (HDL) cholesterol = 35 mg/dl and/or triglycerides = 250 mg/dl.
1. Develops in 2 to 5% of all pregnancies.
2. Usually goes away immediately after delivery of the baby.
3. Associated with an increased risk of type 2 diabetes later in life. (Some studies say up to 50% incidence.)
a. African American, Hispanic/Latino American, and American Indian origin.
b. Family history of diabetes
c. Obesity
1. Results from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses.
2. Accounts for 1 to 2% of all diagnosed cases of diabetes.
Fasting glucose = 110 mg/dl but = 126 mg/dl.
1. Oral glucose tolerance test value of = 140 mg/dl but = 200 mg/dl.
1. Condition in which blood glucose levels are still within normal ranges, but insulin levels may be 2-3 times higher than normal.
2. Currently thought to progress to type 2 diabetes and increase cardiovascular risk.
3. Conditions in which insulin resistance occurs
a. Type 2 diabetes
b. Obesity
c. Late pregnancy
d. Stress
major trauma
surgery
critical illness
e. Diabetic ketoacidosis
f. Generalized acanthosis nigricans
Diabetes is a chronic disease.
People with diabetes are:
1. 17 times more prone to kidney disease;
2. 25 times more prone to eye disease;
3. 15-20 times more prone to lower limb amputation;
3. 2-6 times more prone to heart disease or stroke.
1. Age 65 or older - 18.4 % of all people in this age group have diabetes.
2. Age 20 or older - 8.2 % of all people in this age group have diabetes.
3. Under age 20 - 0.16 % of all people in this age group have diabetes.
Prevalence of diabetes by race/ethnicity in people 20 years or
older (1995 statistics)
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