What is diabetes?
Diabetes mellitus is a type of metabolic disease which results in high blood sugar (glucose) levels due to defects in insulin secretion, or its action, or both. Diabetes mellitus, commonly referred to as diabetes was first identified as a disease associated with “sweet urine,” and excessive muscle loss in the ancient world. Extremely high levels of blood glucose (hyperglycaemia) leads to spillage of glucose into the urine, hence the term sweet urine.
Normally, a hormone produced by the pancreas called insulin controls the blood glucose level by lowering the blood glucose level as needed. When the blood glucose elevates (for example, after eating food), the pancreas releases insulin in order to normalize the glucose level in the body by increasing the uptake of glucose into the body’s cells. The absence of or insufficient production of or lack of response to insulin causes hyperglycaemia, which in turn, causes diabetes. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.
The two types of diabetes are referred to as type 1 and type 2. Former names for these conditions were insulin-dependent and non-insulin-dependent diabetes, or juvenile onset and adult onset diabetes.
What is glucose?
The simple sugar found in our food are called glucose. Glucose is an essential nutrient that is essential for the functioning of the body cells as it provides energy. By breaking down carbohydrates in the small intestine, the glucose in the digested food is then absorbed by the intestinal cells into the bloodstream and is carried by the bloodstream to all the cells in the body where it is utilized. However, glucose is unable enter the cells without the aid of insulin. Without insulin, the cells become starved of glucose energy despite the high levels of glucose in the bloodstream. In certain types of diabetes, the cells’ inability to utilize glucose gives rise to the ironic situation of “starvation in the midst of plenty”. The abundant, unutilized glucose is wastefully excreted in the urine.
What is insulin?
Insulin is a hormone that is produced by beta cells, which are found in the pancreas. The pancreas is a deep-seated organ in the abdomen located behind the stomach. In addition to helping glucose enter the cells, insulin also plays the important role of regulating glucose levels in the blood. After a meal, the blood glucose level rises, in response, the pancreas normally releases more insulin into the bloodstream to help glucose enter the cells and lowering the glucose levels in the blood after a meal. When the blood glucose levels are lowered, the amount of insulin release from the pancreas is reduced. It is important to note that even in a fasting state, there is still steady release of insulin which helps to maintain a steady blood sugar level during fasting. In normal individuals, such a regulatory system helps to keep blood glucose levels in a tightly controlled range. As outlined above, in patients with diabetes, the insulin is either absent, relatively insufficient for the body’s needs, or not used properly by the body. All these factors cause elevated levels of blood glucose (hyperglycaemia).
What is type 1 diabetes?
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients’ own body tissues. In the case of type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood.
What is type 2 diabetes
Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult-onset diabetes mellitus (AODM). In type 2 diabetes, the pancreas can still produce insulin but is inadequate for their bodies need. In many cases this means the pancreas produces larger than normal quantities of insulin. A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body, particularly fat and muscle cells.
In addition to the problems caused by the increase the resistance of insulin, the insulin released by the pancreas may also be defective and suboptimal. There is also a chance that the production of insulin by the beta cells may decline over a period of time, which contributes to worsening glucose control. This is plays a major part for many patients with type 2 diabetes who may end up requiring insulin therapy. Finally, the liver in these patients will continue to produce glucose through a process called gluconeogenesis despite the elevated levels of glucose. The control of gluconeogenesis also becomes compromised.
While it is believed that type 2 diabetes occurs mostly to individuals over the age of 30 and the incidence increases with age. In recent years, an alarming number of patients with type 2 diabetes are barely in their teen years. Most of these cases are a direct result of poor eating habits, higher body weight, and lack of exercise.
While genetics do play a large role in developing this form of diabetes, there are other risk factors – the most significant of which is obesity. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes, and this holds true for both children and adults. It is estimated that the chance to develop diabetes doubles for every 20% increase over desirable body weight.
Regarding age, data shows that for each decade after 40 years of age, regardless of weight, there is an increase in the number of incidences of diabetes. The prevalence of diabetes in persons 65 years of age and older is around 25%. Finally, diabetes occurs much more frequently in women with a prior history of diabetes that develops during pregnancy (gestational diabetes).
Diabetes can also occur temporarily during pregnancy, and reports suggest that it occurs in 2% to 10% of all pregnancies. Due to significant hormonal changes during pregnancy, there may be an increase in the blood sugar levels in genetically predisposed individuals. This is called gestational diabetes. Gestational diabetes will usually resolve once the baby is born. However, 35% to 60% of women who had gestational diabetes may eventually develop type 2 diabetes over the next 1 to 2 decades, especially those who require insulin therapy during pregnancy and those who remain overweight after their delivery.
Symptoms of Diabetes
The early symptoms of untreated diabetes are elevated blood sugar levels, and loss of glucose via urination. High amounts of glucose in the urine can cause increased urine output (frequent urination) and may lead to dehydration. The dehydration also causes increased thirst and water consumption.
Insulin deficiency will also eventually lead to weight loss. This occurs despite having an increase in appetite.
Feeling nausea or fatigue and vomiting can also occur if diabetes was left untreated.
Frequent infections in areas such as the bladder, skin, and vaginal areas are also more likely to occur in people with untreated or poorly-controlled diabetes.
Fluctuations in blood glucose levels can lead to blurred vision, extremely elevated glucose levels can lead to lethargy and even coma.
Possible causes of Diabetes
Insufficient production of insulin, production of defective insulin, or the inability of cells to use insulin properly and efficiently leads to hyperglycaemia and diabetes. This latter condition tends to mainly affect muscle cells and fat tissues; thus it is known as insulin resistance. This is the primary problem in type 2 diabetes. In type 2 diabetes, there is also a decline in the production of beta cells which causes the body to be unable to properly control the elevated blood sugar level. Essentially, if someone is resistant to insulin, the body initially can, to some degree, increase production of insulin and overcome the level of resistance. However, after a period of time, due to the steady decrease in the production of insulin, hyperglycaemia develops.
The absolute lack of insulin, usually secondary to a destructive process affecting the insulin-producing beta cells in the pancreas, is the main disorder in type 1 diabetes.
Below is a list of possible complications that could be caused by badly controlled or untreated diabetes:
Eye complications – glaucoma, cataracts, diabetic retinopathy, and some others.
Foot complications – neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated
Skin complications – people with diabetes are more susceptible to skin infections and skin disorders
Heart problems – such as ischemic heart disease, when the blood supply to the heart muscle is diminished
Hypertension – common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stroke
Mental health – uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders
Hearing loss – diabetes patients have a higher risk of developing hearing problems
Gum disease – there is a much higher prevalence of gum disease among diabetes patients
Gastroparesis – the muscles of the stomach stop working properly
Ketoacidosis – a combination of ketosis and acidosis; accumulation of ketone bodies and acidity in the blood.
Neuropathy – diabetic neuropathy is a type of nerve damage which can lead to several different problems.
HHNS (Hyperosmolar Hyperglycaemic Nonketotic Syndrome) – blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition.
Nephropathy – uncontrolled blood pressure can lead to kidney disease
PAD (peripheral arterial disease) – symptoms may include pain in the leg, tingling and sometimes problems walking properly
Stroke – if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke
Erectile dysfunction – male impotence.
Infections – people with badly controlled diabetes are much more susceptible to infections
Healing of wounds – cuts and lesions take much longer to heal
The dos and don’ts to help better manage Diabetes
A healthy Diet
Having diabetes does not require a strict or difficult diet, and while food with high sugar content does affect blood glucose levels, it does not have to be completely removed from the daily diet.
Dietary concerns is dependent on which type of diabetes the person has. For type 1 diabetes, diet is about managing fluctuations in blood glucose levels while for type 2 diabetes, it is about losing weight and restricting calorie intake.
For people with type 1 diabetes, the timing of meals is particularly important in terms of glycaemic control and in relation to the effects of insulin injection.
In general, however, a healthy, balanced diet is all that is needed, and the benefits are not just confined to being able to better control diabetes, it also helps to maintain overall health. A healthy diet typically includes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes and non-tropical vegetable oils.
The following are some general dietary tips for a healthy lifestyle:
- Eat regularly – avoid the effects that skipping meals or having delayed meals has on your on glucose levels due to work or long journeys, take a healthy snack with you
- Eat vegetables and fruits in place of high-calorie foods such as potato chips – a variety of fresh and frozen is good but avoid high-calorie sauces and food containing high amounts of salt or sugar
- Whole grains which are high in fibre are recommended as a healthy source of carbohydrates
- Eat pulses, a low-fat starchy source of protein and fibre, such as beans, lentils, chickpeas and garden peas
- Reduce intake of saturated and trans fats by having poultry and fish without the skin and cooked, for example, under the grill or steamed, rather than fried
- Take a similar approach to cooking red meat while reducing intake and looking for the leanest cuts
- Eat fish twice a week or more, but avoid batters and frying, instead go for steaming or grilling and choose fish that are high in omega-3 such as salmon, mackerel, sardine, trout and herring
- Avoid partially hydrogenated vegetable oils and limit saturated fat and trans-fat – replace them with monounsaturated and polyunsaturated fats
- Dairy awareness helps reduce fat intake – select skim (fat-free) milk and low-fat (1%) dairy products, reduce consumption of cheese and butter and swap out creamy sauces for tomato-based ones
- Cut back on sugar by avoiding added sugars in drinks and foods – have tea and coffee without sugar, avoid fruit that is canned in syrup, avoid sweet or carbonated drinks and pay attention to food labels
- Cut back on salt – prepare food at home with little or no salt and avoid foods with high sodium such as processed foods
- Cut back on portion sizes – be wary of amounts consumed when eating out
- Be wary of “diabetic” foods – they usually are of no particular benefit and can be expensive
- Drink alcohol only in moderation – as a guide, n o more than one drink a day for women and no more than two for men.
Exercising is a proven method in which to help people prevent the onset of diabetes, manage symptoms for those with diabetes and also plays a crucial role in maintaining overall health and prevent complications.
According to a joint position statement by The American College of Sports Medicine and the American Diabetes Association, exercise:
- plays a key role in preventing and controlling blood sugar levels
- can prevent or delay type 2 diabetes
- can prevent diabetes during pregnancy (gestational diabetes)
- Staying physically active also helps prevent diabetes-related health complications and improves overall quality of life.
- Exercise is useful for those with diabetes because it improves insulin sensitivity by helping the cells of the body use available insulin . Physical activity also stimulates a separate mechanism, unrelated to insulin, to allow the cells to use glucose for energy, thereby regulating blood glucose levels.
There are 2 main types of exercise that are recommended
Also known as cardiovascular exercise, aerobic activity helps the body use insulin more effectively. It brings other benefits too, including:
- stress relief
- improved circulation
- reduced risk of heart disease
- lower blood pressure
- improved cholesterol levels
- strong bones
- weight management
- better mood
Examples of aerobic exercises include:
- brisk walking or hiking
- low-impact aerobic exercise classes
- Tai Chi
Strength training, or resistance training, helps lower blood sugar levels and increases insulin sensitivity. In addition, it increases resting metabolism and builds stronger bones and muscles, reducing the risk of osteoporosis
Examples of strength training include:
- lifting free weights
- lifting heavy objects, such as bottles of water or canned food
- weight machines
- resistance bands
- exercises that use body weight such as sit-ups, squats, planks, and push-ups
- strength training classes
It can be useful to consider incidental physical activity – everyday activities that aren’t classed as exercise but involve movement. Some research suggests that such activities can contribute to improved fitness.
Types of incidental physical activities include:
- taking the stairs instead of the elevator
- walking to the bus stop
- moderate intensity gardening
- walking around the shopping mall
- washing the car
Beginning an exercise plan can be daunting. It is important to:
- Set realistic goals – start slowly – with just 5-10 minutes of exercise daily – and gradually increase the frequency and intensity of the activity.
- Include aerobic and strength-based activities – an exercise plan for diabetes management should include both aerobic exercise and strength training – research indicates undertaking both forms of physical activity is more effective than doing just one of the two.
- Take precautions – always keep fast-acting carbohydrates on-hand in case of hypoglycaemia. Consider wearing a medical alert bracelet in case of emergency.
- Choose footwear wisely – many people with diabetes have problems with their feet, due to poor circulation and nerve damage. Wear comfortable and supportive running shoes.
- Be consistent – to reap the benefits of exercise for diabetes, it should be undertaken regularly.
The information provided here should not be used during any medical emergency. Emtech Wellness International does not claim that it can provide a cure for any disease, condition or disorder and should be used for pain relief and health management purposes. Emtech Ultimate works differently for each individual and may produce varying results for each person.
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