DIABETES

Diabetes is a condition in which the pancreas produces little or no insulin, or improperly uses insulin, which is needed to process glucose (sugar) in the blood from the food we eat, allowing it to enter the cells of the body and produce energy.

The exact cause of diabetes is not known, however, it is thought to be hereditary and immune-system related. Diabetes is a serious condition that if not controlled can cause damage to the nerves, eyes, kidneys, heart, and other organs.

Diabetes releases large amounts of free radicals into your blood stream, explaining why diabetics are prone to die of cardiovascular disease.

Types of Diabetes

In Type 1 Diabetes, little or no insulin is produced by the pancreas. Type 1 affects less than 10 percent of persons with this condition. Onset of this type of diabetes is acute, usually occurs in people under the age of 40 and, since it usually begins in childhood, is also referred to as juvenile diabetes .

Symptoms of Type 1 can include frequent urination, increased thirst and appetite, fatigue, and rapid weight loss.

In Type 2 Diabetes, some insulin is produced but the amount is insufficient, or the body is unable to properly utilize the insulin it produces which is referred to as insulin resistance.

Type 2 is the most common type of diabetes and usually occurs in people over the age of 40, often in those who are overweight.

In some cases, symptoms of type 2 may be slow to develop or are non-existent, however, when they do occur, in addition to the symptoms of type 1, symptoms can also include blurred vision, slow healing of cuts, and tingling and/or numbness in the hands and/or feet.

Latent Autoimmune Diabetes is a form of type 1 diabetes, however, onset occurs in individuals who are older when they are diagnosed and are often thought to have type 2 diabetes.

They initially respond to type 2 treatment (diet and, if necessary, oral medication), but eventually lose the ability to produce insulin, and become insulin dependant as in type 1.

Gestational Diabetes is a form of type 2 diabetes, which develops in some women only during pregnancy. It is important that this is controlled to avoid complications to both the mother and the baby.

After delivery, the blood sugar level returns to normal, however, there is a possibility that gestational diabetes will occur in future pregnancies, or that type 2 diabetes will develop later in life.

Complications of Diabetes

Hypoglycemia can occur if blood sugar levels drop too low. This can occur rapidly and can be caused by too much insulin in the body due to delaying or missing a meal, over-exercising or consumption of too much alcohol.

Symptoms can include profuse perspiration, fatigue, feeling weak, shaky, confused, irritable, and developing a headache.

If any of these symptoms occur, blood sugar levels should be checked. If the level is below 70, steps should be immediately taken to raise the level by either eating a piece or fruit, a few pieces of hard candy, taking a few glucose tablets, or drinking a small glass of regular (not diet) soda or fruit juice.

The blood sugar level should be checked again after 15 minutes. If still below 70, it should be checked again after another 15 minutes.

If, after checking once again at another 15-minute interval the level has not risen, it is important to have someone drive you to the emergency room for treatment. An ambulance should be called if necessary. You should not attempt to drive yourself.

If the blood sugar level drops too low, it can cause seizures or loss of consciousness and possibly death.

Diabetic Neuropathy is the term used for nerve damage caused by chronically high, uncontrolled blood sugar levels. There are several types of diabetic neuropathy:

Peripheral neuropathy is the most common, affecting the hands, arms, feet and legs. It causes pain and numbness in these areas, most commonly in the feet and legs and can include loss of balance, sensitivity to touch and a burning or tingling sensation. These symptoms are often more frequent at night.

Autonomic neuropathy affects the digestive system, the heart and blood vessels, the urinary tract and the sex organs. It can cause dizziness due to a drop in blood pressure when rising, diarrhea, constipation and impotence.

Proximal Neuropathy affects the buttocks, hips and thighs, causing weakness in the legs and difficulty going from a sitting to standing position without assistance.

Focal Neuropathy, although not as common as the other neuropathies, can affect the eyes, muscles of the face, chest, back and pelvis areas, the thighs, and the abdominal area.

Retinal Neuropathy is damage caused to the blood vessels of the retina. When the blood vessels become damaged, they can weaken and rupture. As new blood vessels grow, the possibility of blurred vision or blindness, either temporary or permanent, may result.

The likelihood of developing retinal neuropathy increases the longer a person is affected with diabetes.

Kidney disease can result from uncontrolled blood sugar and blood pressure levels. They cause stress on the kidneys, forcing them to overwork and adversely affecting their filtering process. They begin to leak, releasing protein (albumin) into the urine.

If diagnosed early, damage can be prevented from progressing, however, if detected in its later stages or left untreated, it can lead to kidney failure. Once the kidneys fail, the only options available are continued kidney dialysis or transplant.

Hypertension (high blood pressure). People with diabetes are also twice as likely to have high blood pressure. The combination of these two diseases increases the risks of developing heart disease, stroke, retinopathy and kidney disease.

Hearing Loss. Most of us, as we age, develop some degree of hearing loss, however, because of nerve damage or impaired blood flow, in some instances, this can occur earlier in people with diabetes.

Smoking and Diabetes

Smoking raises the levels of blood sugar, making diabetes more difficult to control and also, because it constricts blood vessels, this can lead to foot ulcers, blood vessel disease, and leg and foot infections.

Alcoholic Beverages and Diabetes

Diabetics should avoid consumption of alcoholic beverages if they have difficulty controlling their blood sugar levels or have any other related complications such as diabetic neuropathy.

It is in the best interest of the patient to discuss alcohol consumption with their physician so he/she can determine the types and amounts, if any, which can be safely consumed.

Treatment

Type 1 diabetes requires daily insulin injections, a managed diet and exercise. There is also an insulin pump available that is worn outside the body and supplies continuous amounts of insulin, making daily insulin injections unnecessary.

Type 2 diabetes, in many instances, can be managed with diet and exercise alone, however, oral medication or insulin injections may also be necessary.

Treatment of diabetic neuropathy includes keeping the blood sugar levels within normal limits to prevent progression and reduce symptoms.

Oral medications such as amitriptyline, gabapentin, and carbamazepine, among others, can be used to control pain. Your physician will determine the best treatment plan, depending on the type of neuropathy and intensity of symptoms.

Foot Care is very important in people with diabetes. Diabetics should not go barefoot or wear any type of open-toed shoes. Feet should be protected by wearing close-toed, comfortable, well-fitting shoes, as well as soft absorbent socks without seams.

On a daily basis, feet should be washed with warm water, thoroughly dried, and inspected for any type of injury. If the skin is dry or cracked, a moisturizing lotion should be applied, however, it should never be applied between the toes to avoid development of infection.

Because of circulatory problems that can develop, common foot problems such as cuts, bruises and blisters are slow to heal and can become infected.

If foot or leg injuries go unnoticed or untreated for too long, the infected area can develop into gangrene, which, in many instances, requires amputation. Therefore, It is extremely important to contact your physician immediately if any type of foot or leg injury is incurred.

Summary

Currently, there is no cure for diabetes. Once it is discovered, treatment is necessary for the rest of your life.

Living with this disease can be a challenge and requires adapting to a new lifestyle with a goal of keeping blood sugar levels within normal limits to prevent complications.

It requires continual medical care, and since you, as the patient, are responsible for most of the treatment such as monitoring blood sugar levels, proper diet, exercise, and taking insulin as prescribed if necessary, the effectiveness of treatment will depend mainly on you.