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Category : Medical Devices - Diabetes - Blood glucose monitor

Manufacturer : Roche Diagnostics
Item: Accu-check Advantage Diabetes Monitoring Kit 860

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Category Medical Books and Guides - Diabetes Care- Meal Planning

Category : CookBooks - Diabetes Care

Title:
"The Diabetes Menu Cookbook"
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Scott-Goldman, Doner, Pilossof

Category :Medical Books and Guides Diabetes Care

Title:
"Diabetes A to Z"
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The American Diabetes Association

Category : Medical Books and Guides Diabetes Care

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ADA's Complete Guide to Diabetes
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The American Diabetes Association

Category : Medical Devices - Diabetes - Blood glucose monitor

Manufacturer : Lifescan
Item: One Touch Ultra 2 Glucose Meter Value Pack

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Category : Medical Books and Guides Diabetes Care - Nutrition and Food

American Medical Association Guide to Living with Diabetes: Preventing and Treating Type 2 Diabetes - Essential Information You and Your Family Need to Know By American Medical Association, Boyd E. Metzger MD

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Category : Cooking Software - Health Improvement - Recipes Management - Meal Planning

Title:
Diabetes Meal Planning Made Easy
Authors: Warshaw
The American Diabetes Association

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Contents of Article

   >> 1 - The Symptoms of Diabetes

   >> 2 - The Reasons, the physiology

   >> 3 - What is Type 1 Diabetes?

   >> 4 - What is Type 2 Diabetes?

   >> 5 - What is Insulin Resistance?

   >> 6 -What is IFG"

   >> 7 - The Use of Insulin

   >> 8 - Other Diabetes Medication

   >> 10 - NUTRITION and Diabetes

   >> 9 - What are the Complications

... on Page 2

   >> 11 - References

What is Diabetes?
An Overview of the Basics.

ABSTRACT of the article.
 
Caring for diabetes is a constant preoccupation for those who have been diagnosed with one form of the disease. However, the results they achieve can sometimes vary wildly. One morning, blood glucose measures at 115 mg/dL (6.4 mmol/L), and the next morning it is at 203 mg/dL (11.3 mmol/L) ! This can be very frustrating to either old-time or newly diagnosed diabetics. Some very famous professional athletes have achieved great success despite the fact that they are diabetics. They, of course, have mastered their condition. In order to do so, they have come to know the very nature of their ailment. They have a good knowledge of just what is diabetes. Having figured out how diabetes works (its physiology), they can now master it with great success. Actually, their performance is superior to that of the general population. A good knowledge of the basics of diabetes will go a long way in improving a diabetic's ability to manage the disease.

1- THE SYMPTOMS OF DIABETES.

Note that an individual may, even in the initial stages of development of diabetes, exhibit one or more symptoms. These may vary from one person to another. The following list mentions the symptoms covering types 1 and 2 diabetes. A person exhibiting symptoms of diabetes may experience the following:

• Frequent, unusual or excessive URINATION
• Unusual, excessive, unexplained THIRST
• Unusual, excessive or abnormal HUNGER
• Unexplained or unusual WEIGHT LOSS or change in weight
• Extreme and unusual FATIGUE or lack of energy
• Unusually BLURRED VISION
• Increased and unexplained IRRITABILITY
• Unusual frequency of INFECTIONS
• Wounds, cuts or bruises that are SLOW TO HEAL
• Strange NUMBNESS or TINGLING in the hands or feet
• Episodes of IMPOTENCE.

A person exhibiting one, two or more of these symptoms should see a physician. Your Doctor will have some diagnostic tests performed in order to determine if you have diabetes or not. He/she may order either a Fasting Blood Glucose Test (in the morning, after you have been fasting overnight) or a Casual Blood Glucose Test. In most instances the morning fasting blood glucose test is preferred. For FBG, a value above 7.0 mmol/L or ( 125 mg/dL) is considered indicative of diabetes. For the casual BG, a value above 11.0 mmol/L ( 200 mg/dL) with the presence of one or more symptoms will be considered as indicative of diabetes.

2- THE REASONS, WHAT IS THE PHYSIOLOGY RELEVANT TO DIABETES ?

Here is a basic overview of how our body handles the sugar in our blood. We will concentrate on the most important terms and concepts to remember. Basically, the cells that make up our body use one form of sugar, GLUCOSE, as their primary source of energy. Glucose comes mostly from carbohydrate: the sugars, starches that we ingest through diet. The longer molecules are broken down to smaller ones that reach our liver. Immediately after a meal, the level of glucose in the blood increases sharply. When glucose is not immediately required for producing energy, the extra glucose will be converted into GLYCOGEN or fat and will be stored in that form, for use at a later time. This conversion of glucose into glycogen can happen in the liver or in the cells. Conversely, a long time after a meal, the glucose level in the blood has decreased considerably. The GLYCOGEN will now be converted back to glucose to be used by the cells to produce energy.

How do the cells and the liver know what to do and when it is time to either store or release glucose? There are cells in our pancreas that will secrete two very special hormones to induce one process or the other, depending on what is needed at that particular moment. When blood glucose is rising too high, the pancreas will secrete a hormone, a protein known as INSULIN. Insulin, by acting at the cell membrane level, will induce glucose transport across the cellular membrane and allow the cells to absorb the glucose. It will also favor the conversion of glucose to glycogen for storage. On the other hand, when blood glucose levels are getting too low, the pancreas will turn off the secretion of insulin and will secrete another type of hormone or protein: GLUCAGON. Glucagon has the opposite effect; it will instead promote the conversion of glycogen to glucose. The glucose is then released in the blood stream or made available in the cellular fluid. This balancing act can be summed up like this:

• High blood sugar (HYPERGLYCEMIA) >> Increased Secretion of INSULIN >> Cells Absorb Glucose, liver and cells produce GLYCOGEN as storage medium.
• Low blood sugar (HYPOGLYCEMIA) >> Increased Secretion of GLUCAGON >> Glycogen is converted into glucose.

Inside our cells are microscopic structures called mitochondria; they are the power plants of the cells. When needed, glucose is converted into a substance called pyruvate (from the ancient Greek word "pyros" which refers to fire and/or heat). Pyruvate enters the mitochondria and is converted into energy. The process yields by-products such as lactic acid and carbon dioxyde. This is the main source of the CO2 we breathe out.

The above section is a simplified representation; it does not take into account all of the biochemical reactions involved in the processes described. This would require a very thick book, which is not necessary for the purpose of the present. The basics as explained above will now be helpful in explaining what is diabetes.

3 -WHAT IS TYPE-1 DIABETES ?

Under some circumstances, the cells of the pancreas that are responsible for the secretion of insulin may be destroyed or may fail completely to produce any insulin at all. From the paragraph above, you will recall that it was the insulin that was responsible for allowing the transport of glucose through the cell membrane. Without insulin, the cells are deprived of their primary source of fuel for producing energy. The glucose accumulates in the blood stream, producing a very unhealthy state of HYPERGLYCEMIA. This state of hyperglycemia is harmful to tissues such as the endothelium of the arteries and to other tissues as well. Your body will attempt to rid of the excess sugar through the urine (GLYCOSURIA). The high sugar concentration in the urine of diabetics was the reason for calling the disease "diabetes mellitus" (sweet water passing).

For your body, things aren't so sweet. It will resort to metabolising fats and proteins as sources of energy. The end products of metabolising fats and proteins can cause unwanted states of keto-acidosis or damage the kidneys. Fortunately, today, insulin is available. So, we can supply it to one's needy organism.

Type-1 Diabetes is that form of the disease which is said to be insulin-dependent, meaning that insulin must be supplied to the patient because his/her ability to produce insulin is non-existent. The onset of Type-1 Diabetes is frequently related to genetics. Type-1 Diabetes normally develops in the first two decades of a person's life. This is why it was often called "juvenile" diabetes. If there are members of your family who are diabetics, your chances of developing the disease are much greater. Other factors may cause its appearance.

4- WHAT IS TYPE-2 DIABETES ?

Type 2 Diabetes normally appears later in life, as opposed to type1. As we age, there are functions that are affected. The production of insulin by the pancreas may not be as adequate as in our teen years; especially if we have abused our pancreas with the excesses of our sometimes unhealthy western diet. When the amount of insulin secreted by the pancreas is just insufficient for the task, glucose starts to accumulate in the blood stream. The cells are also ill supplied with glucose. The process starts to remind one of the patterns of type-1 diabetes. Only this time, it is partial. Generally, spreading the intake of food through time and proper nutrition will help in managing glycemia. Resorting to insulin is generally not necessary, unless the condition has been neglected or has worsened considerably

Type-2 Diabetes is that form of the disease said to be non insulin-dependent, meaning that, in general, insulin does not have to be supplied to the patient. Type-2 Diabetes is due to an inadequate secretion of insulin by the pancreas. It may also be caused by the failure of the cells to use insulin correctly; this is called insulin resistance. In some instances, medication may be prescribed, when necessary, to help the pancreas produce more insulin. Type-2 Diabetes tends to appear in the second half of a person's life, such as in the mid forties.

5- WHAT IS INSULIN RESISTANCE ?

 The terms "Insulin Resistance" describe a situation where both glucose and insulin are present in the blood stream but a situation where the cell membrane cannot respond properly by absorbing the glucose. The cells are said to be resistant to the action of the hormone. For the cells, the net result is the same as if there were no insulin. The cells are in need of glucose. The culprit in this case is tought to be some inhibiting interference with insulin-mediated glucose transport; searchers suspect it may be related to or caused by fatty acids. When this occurs, glucose also accumulates in the blood stream, prompting the pancreas to produce even more insulin. Glucose remains too high. Some cells in the overworked pancreas may be lost. If unchecked, this may develop into full-blown type 2 diabetes .

A persistent touch of hyperglycemia in a fasting person may be indicative of insulin resistance. While not as well known as "diabetes" in the public, insulin resistance is highly prevalent in North America.

6- WHAT IS IFG OR IMPAIRED FASTING GLUCOSE ? (Prediabetes)

Impaired Fasting Glucose (IFG) is also called Impaired Glucose Tolerance (IGT) and increasingly called just plain PREDIABETES. All those terms refer to condition where a person's glycemia is chronically higher than normal, but not quite high enough for this person to be diagnosed as a diabetic. If you are told that you show signs of Impaired Fating Glucose or Prediabetes, you should try to give your pancreas a bit of a break. Your risk of developing type 2 diabetes is high and very real. Large sugar-laden doughnuts at the fast-food joint and oversized sugar-rich bottles of cola may not be for you. The American Heart Association estimates that over 56 million people in the United States suffer from some degree of prediabetes.

Talk to your doctor about the dietary changes you should make or, if need be, consult a registered dietitian (dietician to our friends in the UK). It may well be worth it. We were all born with only one pancreas, it is the only one we will ever have. Can't buy a replacement pancreas in any store. Consider healthy alternatives to Mac' Doughnuts-style nutrition !

7- THE USE OF INSULIN

When pancreatic production of insulin has totally stopped, there is no choice but to use an external source of insulin and inject it. Let us first mention that it cannot be taken orally...sorry! Insulin is a protein, if it were swallowed, the enzymes in the digestive tract would break it down to amino acids which would be used to build other types of protein. Insulin would not make it into the bloodstream. Fortunately, today's devices for delivering insulin are virtually painless.

There are jet injectors that force a fine insulin solution jet through the skin; pressure is the principle behind it. There are the usual syringes that have become smaller than ever so as to generate virtually no pain. Finally there are insulin pumps that require a catheter to be installed. Your doctor will guide you as to what is the best solution for your needs.

Originally, there was only one type of insulin, the short-acting type, which had to be injected 4 times a day, on average. With time, other types have appeared. The types available are:

• Rapid Acting : Normally taken immediately before a meal,
• Short Acting : Taken 30 minutes before a meal,
• Intermediate Acting: Taken twice a day or at bedtime,
• Extended- long Acting: Once (or twice) daily,
• Premixed: Variable mixes of the above, use depends on the type of mix.

The dosage and timing of your insulin dose need to be customized to your particular needs. Again your doctor will help you as to how you should use your insulin. A good understanding of what is diabetes will be of great help to you when it comes to using insulin.

"What is Diabetes ?" continues >>

Category : Cooking Software - Diabetes Care - Heart Health

"Cook'n for Diabetes"
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Author:
The American Diabetes Association

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