DIABETES IS NOT ASERIOUS PROBLEM

DIABETES MEANS:-
                                 
Diabetes mellitus is a common disease in the United States. It is estimated that over 16 million Americans are already caught with diabetes, and 5.4 million diabetics are not aware of the existing disease. Diabetes prevalence has increased steadily in the last half of this century and will continue rising among U.S. population. It is believed to be one of the main criterions for deaths in United States, every year. This diabetes information hub projects on the necessary steps and precautions to control and eradicate diabetes, completely.

Diabetes is a metabolic disorder where in human body does not produce or properly uses insulin, a hormone that is required to convert sugar, starches, and other food into energy. Diabetes mellitus is characterized by constant high levels of blood glucose (sugar). Human body has to maintain the blood glucose level at a very narrow range, which is done with insulin and glucagon. The function of glucagon is causing the liver to release glucose from its cells into the blood, for the production of energy.

There are three main types of diabetes:

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes

Type 1 and Type 2 diabetes impede a person’s carefree life. When breakdown of glucose is stopped completely, body uses fat and protein for producing the energy. Due to this mechanism symptoms like polydipsia, polyuria, polyphegia, and excessive weightloss can be observed in a diabetic. Desired blood sugar of human body should be between 70 mg/dl -110 mg/dl at fasting state. If blood sugar is less than 70 mg/dl, it is termed as hypoglycemia and if more than 110 mg /dl, it’s hyperglycemia.

Diabetes is the primary reason for adult blindness, end-stage renal disease (ESRD), gangrene and amputations. Overweight, lack of exercise, family history and stress increase the likelihood of diabetes. When blood sugar level is constantly high it leads to kidney failure, cardiovascular problems and neuropathy. Patients with diabetes are 4 times more likely to have coronary heart disease and stroke. In addition, Gestational diabetes is more dangerous for pregnant women and their fetus.

Though, Diabetes mellitus is not completely curable but, it is controllable to a great extent. So, you need to have thorough diabetes information to manage this it successfully. The control of diabetes mostly depends on the patient and it is his/her responsibility to take care of their diet, exercise and medication. Advances in diabetes research have led to better ways of controlling diabetes and treating its complications. Hence they include:-

• New improved Insulin and its therapy, (external and implantable insulin pumps) have advanced well to manage elevated blood sugars without any allergic reactions.
• Oral hypoglycemic drug, controls diabetes type 2.
• New improved blood glucose monitor (new device for self blood glucose monitoring), and hemoglobin A1c laboratory test to measure blood glucose control during previous 3 months.
• Effective availability of the treatments for affected body organs due to diabetes.
• Better ways to manage mother and its fetus health during the gestational diabetes phase. 
• PREDIABETES:-
•                          Prediabetes is a stage between normal and diabetes stage. It is an alarming sign for upcoming diabetes or a chance to change your future. Universally, numerous terms are given like, Borderline Diabetes, Chemical Diabetes, Touch of Diabetes etc. The term Prediabetic was given by the US Department of Health And Human Services and ADA on 27th march 2002 with an intention to create awareness and convey seriousness of the condition. Also, they motivated people to opt for appropriate treatment and lifestyle modification. According to the ADA statistics 17 million US citizens are diabetic and 16 millions are prediabetic. ADA defines it as a stage before the development of diabetes, with normal glucose tolerance, but with an increased risk of developing diabetes in near future.
    
       Prediabetes is a condition when your blood sugar level triggers higher than normal, but not so high that we can justify it as type 2 diabetes. According to the Centers for Disease Control and Prevention, 41 million U.S. adults aged 40 to 74 have prediabetes. And the same reports from, The American Academy of Pediatrics show that, one of every 10 males and one of every 25 females have prediabetes aged from 12 to 19 years.  
• WHAT CAUSES DIABETES:-   
•                 
  
  The precise Etiology of most cases of diabetes is uncertain, although certain contributing factors are as follows:
  
  Type 1 diabetes
  
  Type 1 Diabetes is autoimmune disease that affects 0.3% on average. It is result of destruction of beta cells due to aggressive nature of cells present in the body. Researchers believe that some of the Etiology and Risk factors which may trigger type 1 diabetes may be genetic, poor diet (malnutrition) and environment (virus affecting pancreas). Secondly, in most of the cases, diabetes occurs because there is abnormal secretion of some hormones in blood which act as antagonists to insulin. Example- Adrenocortical hormone, Adrenaline hormone and Thyroid hormone.
  
  Type 2 diabetes
  
  Type 2 Diabetes is also called non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. It occurs when the body produces enough insulin but cannot utilize it effectively. This type of diabetes usually develops in middle age. A general observation says that about 90-95 % of people suffering with diabetes are type 2; about 80 percent are overweight. It is more common among people who are older; obese; have a family history of diabetes; have had gestational diabetes. There are number of risk factors found to be responsible for type 2 diabetes like, the more the Etiology and Risk factors carried by an individual, the higher the risk for developing diabetes.

  Following are the Causes of Diabetes

  • Hereditary or Inherited Traits : It is strongly believed that due to some genes which passes from one generation to another, a person can inherit diabetes. It depends upon closeness of blood relationship as mother is diabetic, the risk is 2 to 3%, father is diabetic, the risk is more than the previous case and if both the parents are diabetic, the child has much greater risk for diabetes.
  • Age : Increased age is a factor which gives more possibility than in younger age. This disease may occur at any age, but 80% of cases occur after 50 year, incidences increase with the age factor.
  • Poor Diet (Malnutrition Related Diabetes) : Improper nutrition, low protein and fiber intake, high intake of refined products are the expected reasons for developing diabetes.
  • Obesity and Fat Distribution : Being overweight means increased insulin resistance, that is if body fat is more than 30%, BMI 25+, waist grith 35 inches in women or 40 inches in males.
  • Sedentary Lifestyle : People with sedentary lifestyle are more prone to diabetes, when compared to those who exercise thrice a week, are at low risk of falling prey to diabetes.
  • Stress : Either physical injury or emotional disturbance is frequently blamed as the initial cause of the disease. Any disturbance in Cortiosteroid or ACTH therapy may lead to clinical signs of the disease.
  • Drug Induced: Clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel) and ziprasidone (Geodon) are known to induce this lethal disease.
  • Infection : Some of the strephylococci is suppose to be responsible factor for infection in pancreas.
  • Sex : Diabetes is commonly seen in elderly especially males but, strongly in women and those females with multiple pregnancy or suffering from (PCOS) Polycystic Ovarian Syndrome.
  • Hypertension : It had been reported in many studies that there is direct relation between high systolic pressure and diabetes.
  • Serum lipids and lipoproteins : High triglyceride and cholesterol level in the blood is related to high blood sugars, in some cases it has been studied that risk is involved even with low HDL levels in circulating blood.
  DIABETES DIET:-
•         Diet plays a significant role in controlling the diabetes. The diabetic diet may be used alone or else in combination with insulin doses or with oral hypoglycemic drugs. Main objective of diabetic diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood sugar levels in blood. The diet plan for a diabetic is based on height, weight, age, sex, physical activity and nature of diabetes. While planning diet, the dietician has to consider complications such as high blood pressure, high cholesterol levels.
• With respect to the above factors, a dietician will assess calories to be given, like scheming the carbohydrates, proteins, fats, type of carbohydrate, amount of fiber and so on.
• Exchange meal plan is a diet program which balances the amount of carbohydrate that we intake per day. Glucose is a sugar released from carbohydrate so, if we want to control blood sugar we have to limit the consumption of simple carbohydrate. Carbohydrate foods are given as value per portion, known as the exchange. This plan helps us to decide on the type of food to be taken, the amount of food and also the time to eat. You can plan for more flexible meals as you get more knowledge about the diet for a diabetic, may be like the counting carbohydrate meal plan or constant carbohydrate. But there is no common diet that works for everyone. Nor is there any particular diet that works perfectly for any diabetic over a long period. While planning diabetes diet we should adhere to certain important factors, they are as follows:

• Fiber should be at least 1.4 oz / day
• Instead of 3 heavy meals, we should go for 4-5 small mid intervals
• Replace bakery products and fast foods by simple whole cooked cereals, and don't eat carbohydrates 2 hours before bedtime
• Consume fresh fruit and vegetables at least 5 exchange/ day

Diabetics always need to take care of their diet and also about the food they eat. Care has to be taken because all foods contain not only carbohydrate, but also some energy value. Protein and fat available in the food are converted to glucose in the body. This glucose has some effect on the blood sugar level, which has to be taken care of. Furthermore, you needn’t have to eat only the bland boring diet. Instead, you can eat more fruits, vegetables and whole grains. All it means is that you need to select foods that are high in nutrition and low in calories.
Fats (Limit to 1 serving per meal) A serving can be:-

• 10 Peanuts.
• 1 Tbsp Salad Dresssing
• 2 Tbsp light salad dressing or saur cream.
• 1 Tsp margarine, Oil or mayonnaise.
• 1/8 Avocado.

Sweets (Substitute for starch or fruit serving occasionally) A serving can be:-

• 2 Small Cookies.
• 1 Small Cupcake or Muffin
• ½ Cup Ice cream.
• 1/3 Cup Frozen Yoghurt.
• ¼ Cup Sherbet.
• 1 tsp Syrup or Honey.

Milk (2-3 Servings per day) A serving can be:

• 1 cup Milk.
• 1 Cup Low Fat.
• 1 Cup Artificially Sweetened yogurt (No sugar)

Meat / Fish/Chicken (2-3 Serving per day) A serving can be:

• 2 oz Cooked Lean Meat/Poultry/Fish.
• ½ - ¾ Cup Tuna or Cottage Cheese.
• 1 Egg or 4 oz Tofu or 1 oz cheese.
• 2 Tbsp peanut Butter.

Vegetables (3-5 Serving Per day) A Serving can be:

• 1 Cup Raw Vegetables.
• ½ Cup Cooked Vegetables.
• ½ Cup Tomato or Vegetable Juice.

Fruits (3 Serving per Day) A Serving Can be:

• 70 gm small fruit.
• ½ Cup canned fruit.
• ¼ cup Dried Fruit.
• ½ Cup Fruit Juice. (No sugar)

Grains, Starchy Vegetables and Beans. (6 plus Servings Per Day) A Serving Can be:-

• 1 Slice of 1 oz bread or ½ (1 oz) Bagel or 5 Crackers or 1 Granola bar.
• ½ Hamburger or Hot dog Bun or a tortilla of 6 inch or 2 tacos.
• ½ Cup Cooked Cereal, Cooked beans, Lentils, Corn, Peas, S. Potato, Potato or Pasta.
• 1 Cup winter Squash, 1 Cup Soup.
• 1/3 Cup Rice or 3 Cup Plain Popcorn (Fat free)

  DIABETES CARE:-

Diabetes can be a tough disease to handle. There are many reasons for it, firstly, causes of the disease are not clearly known, it is difficult to prevent. Secondly, once you get the disease, it is not possible to cure the same and you need to take care of your health for entire life. This task can be quite daunting; here are a few tips to help you.

Diabetic Care Tips

If you have diabetes, you need to take some precautions, in your day to day life as well and not only at those times, when you feel sick. Here are some precautions that you can take in your everyday life:

• You should monitor your blood glucose level regularly. Depending on the severity of your condition, your doctor would tell you about the intervals, in which you should take the test.
• You should take regular doses of medicine or insulin, as have been prescribed.
• Regular exercise proves to be useful in controlling glucose levels. However, you should avoid few exercises, that are known to cause further complications like cardiovascular diseases, hypoglycemia etc.
• In case your glucose level drops suddenly during or after exercise, you should consume a fruit juice or some similar drink that provides you with sugar.
• Weight reduction is a key of success in managing diabetes; hence take all the measures of carb control, what you can.

In case you are suffering from any ailment like flu, cold or any other disease or infection, some extra precautions need to be taken, to avoid further complications by diabetes:

• Check your blood sugar level more frequently, to ensure that no harm is being caused by diabetes.
• The illness may force some changes in your diet; consult your doctor/endocrinologist about the changes you need to make in your diabetes medicine accordingly.
• You should drink lots of water and other clear liquids.
• Remember not to cut yourself completely from food even if you are not experiencing hunger.
• Consult the doctor, if you feel abnormal in any manner. For example you may be feeling excessively sleepy, giddy, may have trouble with urination etc.

Even though diabetes is a chronic condition, the same does not mean, that you will have to avoid every activity you enjoy, once you contract it. You can have the same amount of fun, provided, that you take certain precautions. Remember, if you have diabetes, you cannot ignore the precautions, nor do you need to get bogged down completely by them.

DIABETES CONTROL:-
Whether your treatment consists of diet alone, diet and tablets or diet and insulin, you need regular blood tests to keep a check on your blood sugar. Urine sugar test is not a reliable indicator of diabetes control.

When blood glucose remains higher than 200mg/dl for 8-10 weeks, the concentration of glycosylated hemoglobin (HbA1c) arises. A (HbA1c) measurement therefore reflects the blood glucose control over a preceding 2-3 months period, while the estimates of blood glucose indicate the glucose value at the time of blood test. HbA1c values between 6-7% indicate very good control on diabetes. You should aim at keeping your blood glucose in the normal range i.e. between 90-130 mg/dl while fasting and less than 180 mg/dl after meals and HbA1c around 7%. Frequent tests for blood glucose are necessary when starting treatment with insulin.

If you are doing capillary blood glucose test using a hand held glucometer, do not squeeze the finger to bring out a sample after you have picked. This invariably gives a low glucose value. Ask your diabetes nurse for a demonstration of capillary blood glucose test.

Urine test for sugar is not reliable indicator of diabetes control. Although spillage of sugar in urine occurs when the blood glucose exceeds 180 mg/dl in the majority of healthy persons, this is not always so in a patient with diabetes. Most patients with diabetes of many years acquire an increase in the renal threshold for glucose (capacity to prevent spillage of glucose into urine). Hence urine test for glucose is not helpful for assessing control of diabetes. In the presence of urinary infections, the bacteria eats up the sugar present in urine, thereby making urine test for sugar unreliable. 

DIABETES PREVENTION:-

Prevention is proven to be one of the most effective and powerful methods to fight diabetes. More than 50% of diabetes is caused due to inappropriate lifestyle. Regulating lifestyle can prove to be advantageous in downfall of probability of contracting diabetes in one’s life. Loss of weight not only helps in fitness but also in control of blood sugar levels. Losing 10% of initial body weight and regular exercise can immensely reduce the risk of diabetes. Physical activities play a key role in reducing the body weight and on the other also the extra blood sugar is broken down. It also helps to uphold the blood sugar in the normal range. You are more liable to diabetes if you are overweight (may also lead to obesity), are having genetic or hierarchal means of predisposition along with proper physical activity.

Food choices: Foodstuffs containing low glycemic carbohydrates, proteins or fats can initially help to lose body weight and maintain dancing blood sugar level. Prefer healthy foods which are low in fats and calories such as lean fish, lean chicken, turkey and fruits and vegetables. Go slow on fast and fried foodstuffs for prevention of diabetes. Avoid processed carbohydrates as much as possible. Try to increase high-protein food in your diet. And reduce eating refined flour i.e. white flour, bleached flour, treated flour and other kind of white flour.

The Fundamentals to prevent diabetes: Diabetes can be prevented by good production of the insulin and keeping the body fat percent low. Insulin and fats helps to maintain body weight and control sugar level. Consumption of meals to a small fraction instead of heavy food also helps to control diabetes. Also avoid eating carbohydrates few hours before you go to sleep. Taking in high-protein breakfast and 5 or 6 small meals a day also helps you to maintain the body weight. This will also help to control excess consumption of fats and carbohydrates.