Basics Of Diabetes

[Denise]

What is diabetes? 

It's a disease that is the 7th leading cause of death in the United States.

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia).

Diabetes is the condition in which the body does not properly process food eaten for use as energy.  Most of the food we eat is turned into glucose (sugar) for our bodies to use for energy. The pancreas, an organ that lies near the stomach (upper right quadrant of abdomin, above the gall bladder).  The pancreas makes a hormone called insulin to help glucose get into the cells of our bodies.  When a person has diabetes, the body either doesn't make enough (or any) insulin or the body can't use its own insulin as effectively as it should.  This causes sugars to build up in the blood as ingested food is converted into glucose and it enters the body's blood. 

Once developed, diabetes is a chronic (lifelong) disease that requires constant treatment and medical monitoring to manage potential serious damage to the body.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower extremity amputations.  Most of diabetic complications occur from the damage diabetes does to the circulatory system  Diabetes harms the circulatory system  by causing damage to blood vessels in different parts of the body. Many diabetics develop a painful condition called diabetic neuropathy which is damage to the nerves in the body that occurs due to high blood sugar levels from the diabetes. The nerves are damaged by insufficient blood flow due to damaged blood vessels.  The circulation to the lower extremities (legs) is often damaged by diabetes to the point that the tissue dies and requires amputation or death can occur from infection in the 'dead' tissue of the legs. Worst of all is when diabetes damages the blood vessels that 'feed' the heart, causing heart disease and death.

When blood vessels feeding organs are damaged, this can affect the functioning of the organ.  For example, when blood vessels to the kidney are damaged it affects the ability of the kidneys to filter the blood, and if enough damage occurs kidney failure results.  When blood vessels to the eyes are damaged by diabetes, blindness occurs. 

 

 

[Denise]

There are three types of diabetes:  Type 1 (IDDM or early onset), Type 2 (NIDDM or adult/late onset), and Gestational Diabetes (Pregnancy Diabetes).

Type 1 and Type 2 are chronic (lifelong) diseases once developed; Gestational diabetes usually resolves after the pregnancy ends.

TYPE 1 DIABETES

Type 1 diabetes, previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, may account for 5-10% of all diagnosed cases of diabetes, thus is the less common chronic form of the disease. It is usually devoped before the age of 40 (often during early adulthood or teenage years)

Risk factors are less well-defined for Type 1 diabetes than for Type 2 diabetes but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes.

The body does not produce any insulin. Some people call this juvenile diabetes, early onset diabetes or insulin-dependent diabetes.  People with Type 1 diabetes will need to take insulin injections for the rest of their life.  They must also ensure proper blood glucose levels by regularly testing their blood sugar levels and following a special diet that does not contain any concentrated sugar.

Between 2001 and 2009, the prevalence of Type 1 diabetes among those under 20 yrs of age in the USA rose by 23% according to:  SEARCH for Diabetes in Youth data issued by the CDC (Centers for Disease Control and Prevention)

TYPE 2 DIABETES  

The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance).

The most common type of diabetes.  Type 2 diabetes was previously called non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes.  Type 2 diabetes accounts for about 90-95% of all diagnosed cases of diabetes.  Risk factors for Type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/enthnicity.  African-Americans, Hispanic/Latino Americans, Native Americans, some Asian Americans and Pacific Islanders are at particularly high risk for developing Type 2 diabetes.

Overweight and obese people have a much higher risk of developing type 2 diabetes compared to those with a healthy body weight. People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk. Being overweight/obese causes the body to release chemicals that can destabilize the body's cardiovascular and metabolic systems.

Being overweight, physically inactive and eating the wrong foods all contribute to our risk of developing type 2 diabetes. Drinking just one can of (non-diet) soda per day can raise our risk of developing type 2 diabetes by 22%, researchers from Imperial College London reported in the journal Diabetologia. The scientists believe that the impact of sugary soft drinks on diabetes risk may be a direct one, rather than simply an influence on body weight.

The risk of developing type 2 diabetes is also greater as we get older. Experts are not completely sure why, but say that as we age we tend to put on weight and become less physically active. Those with a close relative who had/had type 2 diabetes, people of Middle Eastern, African, or South Asian descent also have a higher risk of developing the disease.

Men whose testosterone levels are low have been found to have a higher risk of developing type 2 diabetes. Researchers from the University of Edinburgh, Scotland, say that low testosterone levels are linked to insulin resistance.

GESTATIONAL DIABETES

Gestational diabetes develops in 2-5% of all pregnancies but usually disappears when the pregnancy is over.  Gestational diabetes occurs more frequently in African-Americans, Hispanic/Latino Americans, Native Americans, and people with a family history of  diabetes than in other groups of people.  Obesity is also associated with higher risk.  Women who have had gestational diabetes have an increased risk for developing Type 2 diabetes later in life. In some studies, nearly 40 percent of women with a history of gestational diabetes developed diabetes in the future.

The majority of gestational diabetes patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth. The baby may be bigger than he/she should be.

Scientists from the National Institutes of Health and Harvard University found that women whose diets before becoming pregnant were high in animal fat and cholesterol had a higher risk for gestational diabetes, compared to their counterparts whose diets were low in cholesterol and animal fats

Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1-2% of all diagnosed cases of diabetes.

 
More to come about diabetes, diagnosis, symptoms, treatment, etc.

 

[Denise]

HOW PREVALENT IS DIABETES AMONG BLACKS?​

 ​

***  Blacks are 1.7 times more likely to develop diabetes as whites

***  The prevalence of diabetes among blacks has quadrupled during the past 30 years.

***  Among blacks 20 yrs of age and older, about 2.3 million have diabetes, which is 10.8 percent of that age group.

***  Blacks with diabetes are more likely than non-Hispanic whites to develop diabetes and to experience greater disability from diabetes-related complications such as amputations, adult blindness, kidney failure, increased risk of heart disease and increased risk of stroke.

***  Death rates for blacks with diabetes are 27% higher than for whites. 

 

[Denise]

Why Is It Called Diabetes Mellitus?

Diabetes comes from Greek, and it means a "siphon". Aretus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) - like a siphon. The word became "diabetes" from the English adoption of the Medieval Latin diabetes.

In 1675, Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means "honey"; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean "siphoning off sweet water".

In ancient China people observed that ants would be attracted to some people's urine, because it was sweet. The term "Sweet Urine Disease" was coined.

 

[Denise]

What is metabolic syndrome?

Metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to overweight and obesity that puts people at risk for both CVD and type 2 diabetes. 

There is more information about Insuline Resistance Syndrome located in this thread under "Diabetes is a Metabolism Disease".

Metabolic syndrome is defined* as the presence of any three of the following:

• large waist size—waist measurement of 40 inches or more for men and 35 inches or more for women
• high triglycerides in the blood—triglyceride level of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride level
• abnormal levels of cholesterol in the blood—HDL, or good, cholesterol level below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL
• high blood pressure—blood pressure level of 130/85 or above, or taking medication for elevated blood pressure
• higher than normal blood glucose levels—fasting blood glucose level of 100 mg/dL or above, or taking medication for elevated blood glucose2
  

In addition to type 2 diabetes, metabolic syndrome has been linked to the following health disorders:

• obesity
• CVD (Cardio-Vascular Disease)
• PCOS (Polycystic Ovarian Syndrome)
• nonalcoholic fatty liver disease
• chronic kidney disease

However, not everyone with these disorders has insulin resistance, and some people may have insulin resistance without getting these disorders.

People who are obese or who have metabolic syndrome, insulin resistance, type 2 diabetes, or prediabetes often also have low-level inflammation throughout the body and blood clotting defects that increase the risk of developing blood clots in the arteries. These conditions contribute to increased risk for CVD

 

[Smokeyjoe]

This is great info Denise, I hope others here look it over too.

I always carried 10 or 15 extra pounds and ate like most, fast food a lot and snapper and clearly Canadian sugar water drinks but was active and never even thought I would have any blood sugar issues. I had to have my appendix removed and it was discovered I was in the pre diabetic stages. I lost the weight , changed my eating, excersize a lot more now and it helped lowere it a bit and it's holding so far.

Point is, I never felt bad or had any issues and was and still am shocked that too much sugar for years could do this to me.

I hear work colleagues say how they get sleepy after lunch, they should get their blood sugar checked as this is a sign of issues as you mention.

 

[Packrat]

@Denise,

IMO outstanding summary of one of the US's most damaging chronic conditions; one that is growing in its presence in our society.  

I was diagnosed pre-diabetic about eight years ago and have controlled it with diet and exercise.  I lost over 50 lbs and changed my lifestyle, spent time learning about nutrition (the more I learned the more I realized I knew very little).  I test blood glucose and blood pressure daily as I always fear that the condition will progress.   I also have an annual physical including A1C and fasting BG test (among other tests).   So far, so good.

My mom was not open about her medical conditions and she passed at 90 - I hope I'm still breathing then.  My grandma was diagnosed Type 2 in her 90's, tho.  One of the risk factors is hereditary so I frequently wonder if my mom was also T2 but I'll never know.  This shows how important it is to have good family medical records.

Anyway, when we discussed grandma, mom always said Diabetes is "completely controllable" with the proper understanding of the condition, nutrition, and a willingness to change.  I'll always remember that.

I want to say that those who are close to me tell me that I appear healthier to them now than eight years ago.  I know I certainly feel healthier.   For some a dx of DM may bring depression and hopelessness and it's important to get past that because if you control this chronic condition you may have a better quality of life than if you were never diagnosed in the first place.  I know this may sound strange to some people but with the growth of this condition in the US being epidemic in proportions every bit of hope is important.

Thanks again for posting this important thread and I hope there are many responses with healthy productive discussion.

Warm regards,

PR

 

[jthompson27566]

Back in June of last year I was diagnosed with type II diabetes. Like most folks read the material and have to admit was down in the dumps for while. Not to mention my family doctor didn't seem too concerned and just placed me on metformin. After about 6 months of worrying and not really feeling like I was doing the right thing, made an appointment with an endocrinologist. Best decision I ever made. My first meeting with him alleviated a lot of my fears as he said I had caught it at a good time and could make tremendous improvement with the right diet and exercise. He put me with his nutritionist she guided me to a 60 carb per meal diet, balanced, and then I picked up my level of exercise. My A1c at this time was 6.9. I just had a follow up appointment in late September, I had lost 20 lbs over the least year and my a1c was 6.0. A major improvement. I've put about 5 lbs back on recently and need to gauge my level of eating and exercise. Feel better than I have felt in years.

 

[Smokeyjoe]

Back in June of last year I was diagnosed with type II diabetes. Like most folks read the material and have to admit was down in the dumps for while. Not to mention my family doctor didn't seem too concerned and just placed me on metformin. After about 6 months of worrying and not really feeling like I was doing the right thing, made an appointment with an endocrinologist. Best decision I ever made. My first meeting with him alleviated a lot of my fears as he said I had caught it at a good time and could make tremendous improvement with the right diet and exercise. He put me with his nutritionist she guided me to a 60 carb per meal diet, balanced, and then I picked up my level of exercise. My A1c at this time was 6.9. I just had a follow up appointment in late September, I had lost 20 lbs over the least year and my a1c was 6.0. A major improvement. I've put about 5 lbs back on recently and need to gauge my level of eating and exercise. Feel better than I have felt in years.

Right on and great job on the improvements you made.

Keep up the excersize and don't think of the new way of eating as a diet, it's a new more healthy bunch of foods you eat. I too feel better when I really eat right, constant energy thru the day rather then peaks and valleys. Now when I eat candy bars or sugared things with no other foods I can totally feel the low energy 20 mins later.

Keep up the good work.

Don't eat too may of those tasty sugar free (sugar alcohol) but fat loaded treats unless you like the runs.