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What is diabetes? Diabetes is a chronic disease that impairs the body's ability to use food properly. Normally, glucose, a form of sugar produced when starches and sugars are digested, is burned as fuel to supply the body with energy. This process--turning food into energy--is called metabolism. But in order to metabolize glucose properly, the body requires another substance: Insulin. Insulin is a hormone produced by the pancreas, a gland located just beneath the stomach; its job is to regulate the body's use of glucose. Insulin is essential to the metobolic process. Trying to burn glucose without insulin is like trying to set fire to a pile of logs without a match. It can't be done. And that's the problem for people with diabetes: They either don't produce enough insulin to properly metabolize glucose, or the insulin they have works inefficiently. Without insulin to turn glucose into energy, the glucose piles up in the bloodstream and spills into the urine showing as "sugar in the urine." Excessively high levels of sugar in the blood and the urine are the hallmarks of untreated diabetes. While there is no cure for diabetes as yet, it can be controlled. The main goal of diabetes treatment is to control blood sugar levels and keep them in the normal range. The specific kind of treatment used to control blood sugars depends on the type of diabetes that a person has. Types of Diabetes Type I (Insulin-Dependent or Juvenile) Diabetes In this form of diabetes, a person's pancreas produces little or no insulin. Although the causes for this are not entirely known, scientists believe that the body's own defense system (the immune system) attacks and destroys the insulin-producing cells in the pancreas. Because insulin is necessary for life, people with Type I diabetes must take one or more injections of insulin every day in order to metabolize their food. Before the discovery of insulin in 1921, people with Type I diabetes would fall into a diabetic coma and die, usually within a few weeks of onset. This form of diabetes if often referred to as "juvenile diabetes" because it usually starts in children or young adults. Type II (Non-insulin-Dependent or Adult-Onset) Diabetes In this form of diabetes, the pancreas still produces insulin, but for some reason the body is not able to use it effectively. So in spite of the presence of adequate amounts of insulin, blood glucose levels are not normal. Fortunately, Type II diabetes can be treated in a variety of ways, including weight loss (many Type II's are overweight), proper diet, reduced sugar intake and exercise. More severe cases may be treated with oral drugs or insulin injections. Type II, which is also known as "adult-onset diabetes," occures most often in people over 40. Other less common forms of diabetes include: Gestational diabetes: Diabetes can suddenly appear in pregnant women who have never exhibited any signs of high blood glucose--this is called gestational diabetes. The hormonal changes of pregnancy stress the mother's system and, in some cases, the pancreas is unable to produce sufficient insulin. Treatment for gestational diabetes ranges from diet management to insulin therapy. While this type of diabetes usually disappears after the birth of the baby, 30 to 40 percent of these women develop diabetes within five to ten years. Glucose Intolerance: This condition used to be called latent or borderline diabetes, but it is no longer considered a form of diabetes. People with glucose intolerance have an abnormal response when large amounts of carbohydrates are consumed. They are unable to metabolize it normally. Such people are at increased risk of developing diabetes, but most do not. Symptoms of Diabetes If you notice one or more or the following symptoms on a recurring basis, you should see a doctor. He or she can find out, through a simple series of tests, if you have diabetes. Type I These symptoms may occur suddenly:
These symptoms usually occur gradually:
Nearly one in every 20 North Americans has diabetes. Out of about seven million diagnosed with diabetes, approximately one million are Type I and six million are Type II. Another seven million are Type II and have not yet been diagnosed. High-risk categories include the following:
Treatment of diabetes aims to do what a normal body does naturally--maintain a proper balance of insulin and glucose. How Diabetes Is Controlled Diabetes "control" means keeping the level of sugar (glucose) in the blood as close to normal as possible. The three elements of diabetes "control" are: Food ~ Exercise ~ Insulin The rule of thumb is: Food makes the glucose rise; exercise and insulin make the glucose level fall. Diabetes control is a constant balancing act of these three factors. If the balance is thrown off, there is the danger of either of two diabetic emergencies: Hypoglycemia (low blood sugar--insulin reaction) or hyperglycemia (high blood sugar). Hyperglycemia will be encountered much less frequently as a problem than hypoglycemia. Low Blood Sugar (Hypoglycemia, Insulin Reaction) Sometimes called "insulin shock," this happens suddenly if a person using insulin eats too little food, doesn't eat soon enough, takes too much insulin, or exercises too much. This condition must be treated quickly with sugar or sugary foods because hypoglycemia can lead to unconsciousness. If a person becomes unconscious, honey or syrup should be rubbed inside the person's cheek, where it can be absorbed without risk of choking. If the person still does not respond in 10 to 15 minutes, glucagon, a hormone that raises blood sugar, may need to be injected. Symptoms appear rapidly: One or more of these symptoms may suddenly occur. Each person has a particular set of personal symptoms and you will come to recognize them. (Note: Some patients show no preliminary symptoms and therefore need to monitor their blood sugar levels more frequently.) Inappropriate responses: Confusion and inattention, Drowsiness Pale complexion, Perspiration, Headache Ketoacidosis
Blood sugar levels can be measured at home with a blood glucose monitoring system. It involves placing a drop of blood on a chemically treated strip which is then put into a meter for a blood sugar reading. Another method relies on a visual comparison of the strip with a color coded chart. It has been determined that with more precise monitoring and better "control," the complications of diabetes can be reduced, even reversed. Urine Tests Although a urine test using tablets or strips will indicate if sugar has spilled into the urine at some point, this method does not measure the actual level of blood sugar. Urine tests are useful, however, for monitoing ketones, whose presence are a warning sign of ketoacidosis, which can lead to diabetic coma. Frequency of Testing 1. Education with physicians and certified diabetes educators. A certified diabetes educator can help the person with diabetes to learn how to balance the factors that effect blood glucose levels to have adequate control. 2. Blood tests - Prescribe by M.D. especially hemoglobin - A.C. every 3 months. 3. Following the advice of both M.D. and C.D.E. with all other tests.
Excercise Exercise is important both because it helps control weight and because it burns food, reducing demand on the pancreas to product insulin. Check with your physician before starting an exercise program to determine what activities will be best for you. Scheduling Maintain a regular pattern of eating, exercising and resting. Changes of schedule require adapting the diet or insulin dosages appropriately. For instance, if you have Type II diabetes and you're going to a very late dinner, you should work in a little snack at your normal dinner hour. Employment People with diabetes can work and work well. The discipline demanded in order to control the diabetes often makes for a better employee. They must eat at regular times, but other than that, they can do even a very physically demanding job. People with diabetes work in nearly every walk of life. Hiring people with diabetes usually does NOT affect a firm's insurance rates. Employees are often covered automatically under most group plans upon completion of a short waiting period after hiring. A Word About Complications As time goes on, diabetes can cause complications in organs and systems throughout the body.
Hope for the Future There is increasing hope that diabetes and its problems can be cured. Significant progress has been made, and JDF funding has been involved in all of these areas.
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