Diabetes is the inability to transfer sugars in blood into the sugar-storage sites of your body, the muscles and liver. Sugars, called carbohydrates, are found mainly in cereals, rice, bread, pastas, potatoes, milk products, fruits, fruit juices and sweets. When we consume these foods, they pass from the stomach into the intestines and get broken down to the most basic sugar form, glucose. Glucose (sugar) normally moves into the blood via a web of blood vessels that are connected to the intestines. When the movement of glucose into the blood stream raises its average level above 100 points (mg/dl), it triggers the secretion of a hormone called insulin from the pancreas. When insulin is secreted into the blood, it causes the excess glucose (sugar) to be stored in muscles and liver cells. It is stored in a form called glycogen, which may be used at a later time as an immediate source of energy. This energy is used for activities of up to three minutes: lifting or throwing an object, running away from danger, sprinting, stop-and-go actions such as a short walk, or any sports activity. Some people have impairment in their insulin production or in the functioning of their insulin. This insulin impairment causes the level of glucose to rapidly rise above the 100-point mark, and that is the condition we call diabetes. High sugar levels, left untreated, can gradually cause damage to vital tissues, such as blood vessels, the nervous system, kidneys, heart and arteries. This can cause debilitating strokes, heart disease, erectile dysfunction, loss of sensation or pain in the feet and hands, leading to leg amputations, kidney failure and blindness. Type 1 Diabetes Type 1 Diabetes is when someone can produce little or no insulin, due mainly to immune and genetic (inherited) defects in the pancreas. People with Type 1 Diabetes create approximately only 10% of all of people diagnosed with diabetes. Type 1 can occur at a relatively young age, especially during childhood. At the time of diagnosis, people are usually of average weight, experiencing weight loss; frequent urination, blurred vision and dry mouth and their blood fasting sugar are way above 125 points (mg/dl). Type 1 diabetics have to depend on insulin use for the rest of their lives, in order to survive and making good lifestyle choices is integral to diabetes control.
Oral Diabetes medications that are Sensitizers (see detailed discussion of this group of drugs in Action Step 2 right after the Insulin section) can be prescribed along with Insulin for people with Type 1 which can help reduce the amount of daily insulin used. Also leading and maintaining an active Lifestyle and making favorable food choices and raising your fiber intake can all help bring Diabetes under control and reduce the amount of total daily insulin dose (decisions about insulin dosing can ONLY be made by your doctor). Refer to Action Step 4 for a detailed discussion on how to start and maintain an active Lifestyle and make favorable food choices.
Impaired Glucose Tolerance or Pre-diabetes
This is a condition where glucose levels are higher than normal but not enough to be diagnosed as diabetes namely at a range from 100 to 125 mg/dl on a fasting state (first thing in the morning before eating). Typically, the more than 54 million people in this category are overweight or obese. They are people who consume large amounts of “junk food” (nutrient-deficient foods and drinks such as soft drinks and all other sugar containing juices and drinks. Foods that are loaded with sugars and unfavorable sources of fat such as animal fat, butter, margarine and Trans Fatty Acids that are found in the majority of packaged processed sweet and or salty snacks) and lead totally sedentary lifestyles; they also have high cholesterol and triglycerides and have low HDL (the good cholesterol). Studies show that these people will eventually develop diabetes and other preventable chronic ailments, such as: high cholesterol, high blood pressure and heart disease, “unless” they are identified early and they start making favorable lifestyle choices.
Gestational Diabetes
Gestational diabetes affects some women during pregnancy and is characterized by consistently higher than 95 points (mg/dl) on a fasting state first thing in the morning, and over 120 points 2 hours after a meal. Most women who suffer from Gestational Diabetes will return to having normal blood glucose levels after delivery. Up to 45% of women who develop diabetes during pregnancy may progress to having full-blown diabetes later in life unless they make favorable lifestyle choices and change their eating and activity habits. The main predisposing factors for gestational diabetes are family history of diabetes, obesity and sedentary lifestyles. It is crucial that women at risk be identified, since high blood sugar causes fetal harm.
WHO SHOULD TEST?
All women, early on in their pregnancy, who have the following criteria must be tested for high blood sugar; women who are: overweight, over the age of 25, who have family history of diabetes, those who belong to ethnic groups other than Caucasian, those who have previously had gestational diabetes, or who have previously delivered large babies over 9 pounds.
TREATMENT
Gestational diabetes is initially treated with Lifestyle interventions such as making balanced food choices and increasing activity as described in Action Step 4. If fasting (first thing in the morning before eating) blood sugar is not brought to 95 points (mg/dl) or to 120 points 2 hours after lunch or dinner then Insulin is the ideal drug that is used. Your doctor will decide which insulin product and dose is appropriate for you. (See the discussion about insulin in Action Step 2).
Type 2 Diabetes
Type 2 diabetes, on the other hand, usually affects people later on in life, after the age of 25 or 30. However, Type 2 Diabetes has alarmingly been plaguing children at a much younger age than ever witnessed. Kids as young as 15 and 17 who are obese and leading sedentary lifestyles and commonly seen in grocery stores shopping while riding electric shopping scooters, are now diagnosed with Type 2 Diabetes. About 90% of people with diabetes have Type 2. People with Type 2 Diabetes produce insulin from their pancreas, but due to lifestyle factors such as obesity and inactivity the insulin is not able to perform and move the extra sugar from the blood into the muscle and liver cells, resulting in the buildup of sugar levels in the blood. This defect is referred to technically as insulin resistance. The diagnosis for Type 2 Diabetes is when people have a fasting (before eating in the morning) blood sugar level of 126 points (mg/dl) and over on 2 separate readings.
Type 2 Diabetes can be of hereditary origin. Non-Caucasians are more predisposed to getting it. But the vast majority of people get it due to inadequate lifestyles such obesity, overeating and sedentary lifestyles. A staggering 75% of people with diabetes are obese and inactive. This lends to the worsening of their conditions. I witness this trend every single day in my pharmacy practice. People drop off several prescriptions for diabetes, cholesterol and blood pressure, and they sit the entire time in the pharmacy waiting area. When I counsel them about their medications and suggest they might increase the amount of daily walking, their invariable answer is, “I don’t have time.” Sometimes, they drop off their prescriptions and go food shopping; they bring back a cart full of bacon, cookies and other packaged snacks such as popcorn, jugs of soft drinks, pretzels, butter, white bread, and let’s not forget the cigarettes!
People with Type 2 Diabetes may be treated with: medications, either taken by mouth and/or through insulin injections, and by making favorable lifestyle choices. Medications alone without an active lifestyle will never be an efficient way to control diabetes and/or other chronic lifestyle-related diseases. Your doctor has many medication options from which to choose. What is important is to get diabetes under control in order to avoid deadly complications! Your health is your responsibility, and staying in close contact with your doctor and pharmacist is the only way to avoid diabetes complications and hugely important in keeping your diabetes under control.
The message that I bring you is that, “You are not doomed.” Certainly, you can control diabetes, but you have to be aware of some simple facts and act on them. Inaction will cause these deadly ailments to creep up on you and systematically destroy your internal organs and claim your life prematurely. You can become involved, seriously and consistently, in your health; take the lead and the primary responsibility for managing your health and disease! It is simpler than you think.
If you take charge of this responsibility, you reap the benefits of living your lifespan to the fullest, enjoying the best quality of life. It is very simple. You just have to take charge by starting to apply the reliable, simple, and practical recommendations in LIFESTYLE MAKEOVER FOR DIABETICS AND PRE-DIABETICS
For more detailed information on any of these topics log on to: www.LifestyleMakeoverEbook.com and check out these information packed lifesaving book and e-book volumes: LIFESTYLE MAKEOVER FOR DIABETICS AND PRE-DIABETICS and 4 other e-books: Lifestyle Makeover: Sex, Stress, and Alcohol, Lifestyle Makeover for All Couch Potatoes, Lifestyle Makeover: Defeat High Cholesterol and Blood Pressure, and Lifestyle Makeover for all Tobacco Users. The author of this article is also the author of these volumes
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Copyright © 2008 by George Tohme
All rights reserved. Except where indicated, no part of this article may be reproduced in any form without written permission from the publisher and/or the author.
RESOURCE BOX:
George F. Tohme, pharmacist, graduate of Univ. of Pittsburgh, PA in 1987 and currently practicing in Texas. He is certified in diabetes and cholesterol management, smoking cessation, nutrition guidance, and a certified personal trainer. He is a lifestyle makeover expert and also conquered his own 17-year battle with obesity.
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Your health is the sum of choices you make every day. Take charge and make favorable lifestyle choices so you can enjoy lifelong good health, defeat chronic diseases and enjoy the best quality of life. The lifesaving ebooks I authored will show you the way.
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