Diabetes Information

Diabetes During Pregnancy

admin — Wed, 06 Aug 2008 05:00:33 +0000

Diabetes is an age old disease, which is recorded as early as Greek civilization. This disease is characterized by excretion of large amount of very dilute urine. Diabetes can also be explained as a syndrome characterized by disordered metabolism and inappropriate blood sugar level.
On the basis of symptoms diabetes can be classified into two types - a) diabetes mellitus b) diabetes insipid us. While diabetes mellitus is characterized by high blood sugar level, resulting from low insulin (hormone which controls the sugar level in blood) level, the characteristic symptoms are excessive urine production (polyuria), excessive thirst, and increased fluid intake (polydipsia) and blurred vision.
On the other hand, diabetes insipid us is characterized by excretion of large amount of severely diluted urine, which can not be reduced when fluid intake is reduced, leading to severe inability of kidney to concentrate urine. World Health Organization (WHO) recognizes three main forms of diabetes mellitus; one of them is termed as gestational diabetes which occurs during pregnancy. Early diagnosis can cure the disease.
The basic cause of diabetes during pregnancy is that, mother’s body is the sole supplier of glucose (sugar that results from the digestion of food) to the baby. This glucose is delivered to the baby through placenta. in return placenta produces certain hormones which helps the baby to develop, but on other hand these hormones prevents mothers body to use insulin and at later stage placenta increases these anti-insulin hormones which blocks the movement of glucose from the blood stream to the cell of the mother’s body. This condition is termed as insulin resistance which leads to gestational diabetes.
There are several factors which increases the chance of developing diabetes during pregnancy, which includes the parents may have a family history of diabetes, obesity, the mother being over age 25 and the mother have a previous record of giving birth to a stillborn child or to a baby weighing nine pounds. Though there are no obvious symptoms of gestational diabetes, but American diabetes association recommends all women to be screened for gestational diabetes between 24th and 28th week of pregnancy. The following are the names of such screenings a) blood glucose test b) glucose tolerance test.
There can be many cases that the woman may have pre existing diabetes. In that case the mother must be warned against the complicacies that may arise during pregnancy. Careful planning and preconception care can allow the diabetic woman to have a problem free pregnancy.

Diabetes Insipidus with Treatment and Prevention

admin — Wed, 06 Aug 2008 05:00:31 +0000

Diabetes insipidus (DI) are a disorder of which there an abnormal increase of urine output, liquid prerecording is frequently and thirst. It is caused by a deficiency of antidiuretic hormone, also known as vasopressin, or by an insensitivity of the kidneys to that hormone. It can also be induced iatrogenically by the diuretic conivaptan. Antidiuretic hormone is a hormone produced in a region of the brain called the hypothalamus. It is then stored and released from the pituitary gland, a small gland at the base of the brain. Central diabetes insipidus is caused by damage to the hypothalamus or pituitary gland as a result of surgery, infection, tumor, or head injury. Nephrogenic DI may occur as an inherited disorder in which male children receive the abnormal gene that causes the disease on the X chromosome from their mothers. It may also be caused by kidney disease, high levels of calcium in the body, and certain drugs.
Diabetes insipidus can also occur when kidneys are unable to properly respond to the hormone.When diabetes insipidus is caused by failure of the kidneys to respond to antidiuretic hormone, the condition is called nephrogenic diabetes insipidus. Adults with untreated diabetes insipidus may remain healthy for decades as long as enough water is drunk to offset the urinary losses. However, there is a continuous risk of dehydration. Diabetes insipidus and diabetes mellitus are unrelated, although they can have similar signs and symptoms, like excessive thirst and excessive urination. Patients with diabetes insipidus also must take special precautions, such as when traveling, to be prepared to treat vomiting or diarrhea and to avoid dehydration with exertion or hot weather. Diabetes insipidus can be treated by correcting the amount of urine that is produced by the body, although the condition usually requires life-long treatment.
Diabetes insipidus should not confuse with diabetes mellitus, the cause lacks or the resistance to the insulin causes the high blood glucose. Diabetes insipidus is characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced. It denotes inability of the kidney to concentrate urine. Symptoms of diabetes insipidus are quite similar to those of untreated diabetes mellitus, with the distinction that the urine is not sweet as it does not contain glucose and there is no hyperglycemia. Blurred vision is a rarity. In children, diabetes insipidus can interfere with appetite, eating, weight gain, and growth as well. They may present with fever, vomiting, or diarrhea. If the diabetes insipidus is due to renal pathology, desmopressin does not change either urine output or osmolarity.
The cause of the underlying condition should be treated when possible. Habit drinking is the most common imitator of diabetes insipidus at all ages. While many adult cases in the medical literature are associated with mental disorders, most patients with habit polydipsia have no other detectable disease. Central diabetes insipidus may be controlled with vasopressin. Vasopressin is administered as either a nasal spray or tablets. Vasopressin is ineffective for patients with nephrogenic DI. In most cases, if nephrogenic diabetes insipidus is caused by medication, stopping the medication leads to recovery of normal kidney function. Because pituitary DI is sometimes associated with abnormalities in other pituitary hormones, tests and sometimes treatments for these other abnormalities are also needed. Drugs used to treat nephrogenic DI include the anti-inflammatory medication indomethacin and the diuretics hydrochlorothiazide and amiloride.

Classification of Diabetes Mellitus

admin — Tue, 05 Aug 2008 11:51:58 +0000

If you are a health-conscious person, you would have come across the word diabetes mellitus or even heard of it a few times yourself. Thus, with that in mind, I will focus briefly on the aspect of classification and non-pharmacological therapy of DM.

Classification of Diabetes :
Type 1 DM
Type 1 DM is known as insulin-dependent DM as patients have little or unable to synthesize insulin hormone. Hence the name, they will eventually be dependent on insulin injection for their survival. This type of DM is a result of the autoimmune destruction of ²-cells (which produces the insulin hormone) in the pancreas. It mostly occurs in adolescent and children. In general, they are less than 30 years old with a lean body habitus. However in some cases, it could also be found at any age group.

Type 2 DM
On the other hand, Type 2 DM is different from Type 1 in which it is characterized by insulin resistance where in the initial stage, it lacks of insulin secretion. In such a case, although the pancreas retains some ability to produce insulin but it is insufficient to convert the blood glucose to glucagon following the body’s needs resulting in accumulation of blood glucose. Alternatively, the body cells can also become resistant towards the insulin produced by the ²-cells. As a result, blood glucose level is increased and led to hyperglycemia (high blood glucose level).
Most individuals with type 2 DM exhibit abdominal obesity which itself can cause insulin resistance. Furthermore, patient usually has co-existence of other medical disorders such as hypertension, dyslipidemia (high triglyceride levels and low HDL-cholesterol levels), and heart diseases. Clustering of abnormalities is normally referred as “insulin-resistance syndrome” which can also increase the risk of developing macrovascular complications (ischaemic heart disease, cerebrovascular disease and peripheral vascular disease).
Owing to its gradual development in the age of onset and average of more than 30 years old in most patients, Type 2 is also known as maturity-onset DM. This type of DM is highly genetic predisposition regardless to ethnicity.

Gestational DM
GDM is defined as glucose intolerance which is found during pregnancy. It has complicated about 7% of all pregnancies. It is important to have a early clinical detection in pregnant women whereby such therapy will help to reduce the perinatal morbidity and mortality risk.

Non-Pharmacologic Therapy
Regardless of the type of DM, patient should take initiative in preventing the complications of DM. Apart from prescribed medications by doctor; non-pharmacologic therapies should not be neglected as well.

Diet
This is one of the cornerstones in DM management. Success cannot be achieved without a proper diet therapy even though if you comply fully with your given medications. The followings are general recommendations:
1. Obtain counseling from a dietitian on individual nutrition based on your health conditions. This is aim to provide a balanced diet to achieve and maintain a healthy body weight.
2. Restrict intake of high sugar-containing foods such as cakes and ice-cream and other carbohydrates.
3. Reduction of intake of saturated fats in all diabetic patients as it can complicate their abnormal medical conditions.

Physical Activity
Most diabetic patients can benefit from increased physical activity such as walking, aerobic exercise, gardening and cycling. However, the type and intensity should be individualized. For example, an older patient should have a cardiovascular evaluation including a graded exercise test with imaging prior to beginning a moderate to intense exercise regimen.

Diabetes Mellitus - Ayurvedic Herbal Treatment

admin — Tue, 05 Aug 2008 11:44:55 +0000

Diabetes mellitus is a medical condition in which the capacity to produce insulin in the body is marginally or significantly reduced. Because of this condition, glucose uptake by the body cells becomes deficient, and blood sugar levels increase. Type 1 diabetic patients produce little or no insulin, and hence need insulin injections to control their blood sugar. Type 2 diabetic patients can control their blood sugar with a combination of diet, weight management, and exercise and glucose-lowering medications.
Diabetes mellitus is known in Ayurveda as “Madhumeha”. Ayurveda describes the pathology of this disease as resulting from a disturbed “Meda, Kleda and Kapha”. It is believed that all the body tissues lose their vitality because of this condition.

Type 1 diabetic patients who are dependent on insulin injections should monitor their blood sugar and continue the injections regularly. Type 2 diabetic patients may be able to control their blood sugar with Ayurvedic medicines and other measures like diet restrictions and weight control.
Traditional Ayurvedic formulations useful in diabetes are: Arogya Vardhini, Vasant Kusumakar Rasa, Chandraprabha Vati, Prameha Gaja Kesari, Lodhrasava, Khadirarishta, Jambvasava, Trivanga Bhasma, and Suvarna Makshik Bhasma. Herbal medicines useful in this condition are: Haridra (Curcuma longa), Nimba (Azadirachta indica), Karela (Momordica charantia), Saptakapi (Casearia esculenta), Musta (Cyperus rotundus), Daruharidra (Berberis aristata), Arjuna (Terminalia arjuna), Khadeer (Acacia catechu), Lodhra (Symplocos racemosa), Guduchi (Tinospora cordifolia), Patol (Trichosanthe dioica), Vata (Ficus bengalensis), Udumbar (Ficus glomerata), Jamun (Syzygium cumini), Bilwa (Aegle marmelos) , Gudmar (Gymnema sylvestre), Methi (Trigonella foenum-graecum), Asana (Pterocarpus marsupium),Shilajit (Purified Bitumen) and Kumbha (Leucas cephalotes).

Most of the herbal medicines mentioned above reduce blood sugar gradually, and stimulate the body to secrete insulin on its own. These medicines also act on the “Meda” and “Kapha” tissues, reduce “Kleda”, and restore body vitality. Thus they act on the basic pathology of this disease. Taken for long periods, these medicines may help to reverse the disease process in diabetes, and give long lasting relief, or sometimes, even a permanent cure. Unlike modern medicines, medical emergencies like hypoglycemia (a sudden lowering of blood sugar) are not seen with the use of herbal medicines.
Long-term complications of diabetes include diseases related to the eyes, nerves, kidneys, heart, brain, intestines, sexual organs, skin and feet. Ayurvedic medicines are very effective in preventing or significantly reducing symptoms related to these complications, and are useful in both type 1 and type 2 diabetes. Ayurvedic medicines used specially for this are: Tapyadi Loha, Kaishor Guggulu, Agni Tundi Rasa, Vish Tinduk Vati, Kanchnaar Guggulu, Trayodashang Guggulu, Ekanga Veer Rasa, Vaat Gajankush Rasa and Amalaki (Emblica officinalis).
Thus, Ayurvedic medicines are useful both for reducing blood sugar and for treating long-term complications. These medicines can be used independently or as additional therapy to modern medicines. Ayurvedic treatment can significantly reduce the morbidity (severity of disease) and mortality (death rate) associated with diabetes mellitus.

Diabetes Mellitus Pathophysiology

admin — Tue, 05 Aug 2008 11:40:17 +0000

Diabetes Mellitus is divided into two categories, namely type 1 and 2 respectively. In both types of diabetes mellitus pathophysiology they are more likely to be similar as the blood sugar is high. Firstly, it is either due to less production of insulin, or no production which resulted insulin resistance. Either case could result in inadequate glucose in the cells, where it can be identified through certain signs and symptoms or pathophysiology. These diabetes mellitus pathphysiology are quickly relieved once the diabetes is treated and also reduce the chances of developing serious health problems.

Diabetes Type 1:
The main cause of type 1 diabetes is due to dysfunctional pancreas as this resulted in low or no production of insulin. Primary diabetes mellitus pathophysiology includes nausea and vomiting. Subsequently, at latter stage, diabetes type 1 leads to ketoacidosis in which body starts breaking down muscle tissue and fat for energy and resulted in weight loss. Next, individual will undergo dehydration due to electrolyte disturbance. In advance stages, patients may proceed into coma, in some cases death may occur.

Diabetes Mellitus or Type 2 Diabetes:
The pathophysiology for type 2 diabetes and type 1 is somewhat similar, but include more diversified symptoms which include the following:
1. Polydipsia - Individual feel thirsty due to increase glucose concentration in the blood as brain receives signal for diluting concentrated glucose.
2. Polyuria - Increase in urine production is the result seen when excess of glucose is present in body. Body tries to get rid of the extra sugar in the blood by excreting it through the urine. This can also lead to dehydration because excreting the sugar which carries a large amount of water out of the body along with it.
3. Increase fatigue - Due to inefficiency of cell to metabolize glucose, reserve fat of body is metabolized to gain energy. When fat is broken down in the body, it uses more energy as compared to glucose, hence body goes in negative calorie effect, which results in fatigue.
4. Weight fluctuation - Factors like loss of water (polyuria), glucosuria , metabolism of body fat and protein may lead to loss of weight. Few cases may show weight gain due to increased appetite.
5. Blurry vision - Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of eye, which affects the ability of lenses to focus resulting in blurry vision.
6. Irritability - It is one of the sign of high blood sugar because of the inefficient supply of glucose to brain and other body organs, which make us, feel tired and uneasy.
7. Infections - Certain signals from the body is given whenever there is fluctuation of blood sugar (due to suppression of immune system) by frequent infections of fungal or bacterial like skin infection or UTI (urinary tract infection).
8. Poor wounding healing - Wounding is dependent on white blood cells as it contains lymphocytes which aid in attacking foreign particles and blood vessel repair. However, with increase blood glucose level, it resists the flourishing of white blood cells. This in turn resulted in low immune system and may affect proper blood circulation as glucose aid in blood thickening.

All the above are the diabetes mellitus pathophysiology and in order to improve blood sugar level and to reduce the usage of insulin shots, a comprehensive guide by Julia Hanf on diabetes guide provides a better insight on how to defeat diabetes and the secret to cure diabetes patients. This Diabetes Guide has proven to be effective and aid in improving individual health and lifestyle.

Syndrome X, Diabetes and Cardiovascular Disease

admin — Tue, 17 Jun 2008 05:00:34 +0000

Syndrome X is a term used a describe a set of cardiovascular risk factors that includes glucose or insulin disturbances, high blood cholesterol and triglyceride levels, elevated blood pressure, and upper-body obesity. Other terms to describe this syndrome are the metabolic cardiovascular risk syndrome (MCVS), Raven’s syndrome, insulin resistance syndrome, and atherothrombogenic syndrome. While there is a push to abandon the term syndrome X, it has nonetheless persisted.
The underlying metabolic denominator in syndrome X is elevated insulin levels. There is little doubt what contributes to these elevations : an elevated intake of refined carbohydrate. The results from a recent 25-year study add support to the contention that prolonged consumption of refined sugars and the resulting elevations in insulin eventually leads to type II diabetes. This study showed that the development of type II diabetes was preceded by elevations of serum insulin values and insulin insensitivity. Typically, these defects presented themselves decades before the development of diabetes.
Hypoglycemia, increased insulin secretion, syndrome X, and type II diabetes can be viewed as a progression of the same illness : a maladaptation to the “Western diet.” The human body was simply not designed to handle the amount of refined sugar, salt, saturated fats, and other harmful food compounds that many people in Western countries (and increasingly other countries like ours) feed it. The result is that a metabolic syndrome emerges — elevated insulin levels, obesity, elevated blood cholesterol and triglycerides, and high blood pressure. Syndrome X is the label that modern medicine has chosen to ascribe to a condition caused by poor dietary and lifestyle choices. It seems a bit silly for medical researchers to be spending millions of dollars to develop drugs (”magic bullets”) instead of working on ways to better aid people in choosing a healthier diet and lifestyle.

The Role of Insulin in Protein Metabolism

admin — Tue, 17 Jun 2008 05:00:32 +0000

Investigations indicate that insulin stimulates protein synthesis by increasing transport of amino acids into cells and at the same time stimulating nucleic acids, particularly RNA and the messenger RNA, which is especially involved in protein synthesis. Insulin has been shown to stimulate RNA synthesis in many cases. Thus it appears that insulin primarily promotes protein synthesis through its effect upon the RNA synthesis. Moreover the secondary effect of insulin is in increasing carbohydrate metabolism and formation of ATP supply energy for protein synthesis.
In the diabetic patient, glucose can not be fully utilized for the production of energy and the deficiency of glucose is compensated by the utilization of fat and protein. Breakdown of protein serves as a second source of energy. In the diabetic patient, tissue catabolism and increased excretion of nitrogen produce a negative nitrogen balance.
Thus it has been established that the anabolic and catabolic processes of the three essential food constituents (carbohydrate fat and protein) are insulin dependent.
The role of insulin, therefore, appears to be as follows •
1. It facilitates the passage of glucose through cell barriers into the cells.
2. It effects the phosphorylation of glucose.
3. It also plays a role in oxidative phosphorylation and
4. It is essential to lipid and protein catabolism and anabolism.

Effective Treatment of Diabetes

admin — Mon, 16 Jun 2008 05:00:58 +0000

Diabetes can be treated effectively with the co-operation of the patient. If you have a high glucose level in the urine and blood the first and most important thing to do is to control the diet. Cut down sugar completely if you are a clear cut diabetic case. This will bring down the sugar level to some extent, increase physical activity, do walking, jogging, exercises and if sugar is still high then probably you will need some medicine for the time being, but if you supplement the effort with controlled diet and increased exercise you can gradually cut down on medicine and be able to completely stop it in most cases.
In England people used to consume only 18 lbs of sugar per head per year (till 1850). Now the per capita consumption has reached 90 kg per head in UK and 80 kg. in the USA. Figures for other developed and even developing countries show an increasing trend.
Since the time sugar and white bread have been introduced the incidence has increased. These refined carbohydrates are pin-pointed as causing unprecedented increase in diabetes and heart diseases. On the food front — things are slipping from our hands. We have to gear up our energy and try to reverse the process by changing the food habits. The best part of diabetes is that even if you have it, you can have a normal active prolonged life if you keep tabs on your sugar level through regular checkups.
Diabetes can attack the kidneys, heart or any of the vital organs of the body and cause the end of a useful, productive and purposeful life. Since most diabetic are overweight, reduction in weight is advisable. This can be done by reducing the number of calories consumed per day. This will benefit to decrease the sugar level in blood. Exercise will be an added advantage as it increases the use of calories and reduction of weight will be faster.

PRINCIPLES OF DIET THERAPY

admin — Mon, 16 Jun 2008 05:00:27 +0000

Diet therapy is concerned with the modification of the normal diet to meet the requirements of the sick individual. Its purposes are:
1. To maintain good nutritional status.
2. To correct deficiencies.
3. To afford rest to the whole body or the body that is affected.
4. To maintain body’s ability to metabolize the nutrients.
5. To bring about changes in body weight whenever necessary.
Diet therapy in most instances is not a remedy in itself but is a measure which supplements or makes the medical or surgical treatment more effective.
Therapeutic nutrition begins with the normal diet. Advantages of using normal diet as the basis for therapeutic diets are :
1. It emphasizes the similarity of psychologic and social needs of those who are ill and those who are well, even though there is a quantitative and qualitative difference in requirements.
2. Food preparation is simplified when the modified diet is based upon the family pattern and the number of items required in special preparation is reduced to a minimum.
3. The calculated values for the basic plan are useful in finding out the effects of addition or omission of certain foods, for example, if vegetables are restricted vitamin A and C deficiency can occur.

DIABETIC COOKERY

admin — Sun, 15 Jun 2008 05:00:55 +0000

Sugar, jaggery and honey should not be used in cooking. Flour, cheese, groundnut powder and coconut have considerable food value and should not be added as “free foods” (food stuffs of low caloric value and low carbohydrate content).
In order to preserve the fibre, vegetables should be cut into large pieces. The skin, seeds and stalk of the vegetables should not be discarded. Whole wheat flour should be used instead of chickpeas flour.
Butter, ghee, and oil should not be poured while cooking but its exact quantity should be measured in terms of teaspoons. The quantity of cooking fat can be cut down by using non-stick pans. Frying should be avoided. Cooking, baking or grilling are preferred.
Saccharin is available in the form of drops or tablets. The tablet should be crushed and mixed with a little warm water before adding to a foodstuff. Saccharin is decomposed by heat, imparting a bitter taste. It is added after foodstuff is prepared and not during boiling or cooking. Not more than two tablets should be added to one serving. Syrup of sorbitol is prepared by mixing 3 parts of water and 7 parts of sorbitol. A cake made with fructose does not rise like the one made with sugar. Cakes made with sorbitol or fructose may appear paler than those made with sugar. If this appearance is not to one’s liking, a little yellow food color may be added. It is bit difficult to beat air into sorbitol or fructose mixture hence the usual beating or whisking time should be doubled. Fructose browns more easily than sugar; hence foods containing fructose should be cooked in the oven at a slightly lower setting than usual. Aspartame is decomposed at high temperature, so it should not be used in baking cakes. Jams made with sugar substitutes should be stored in small jars because once opened, do not last as long as ordinary jams. Fruits or dates can be used to sweeten a dish. A housewife need not prepare separate foodstuffs for a diabetic. The initial stages of cookery are the same for non-diabetic and diabetic persons. Before the last stage that is addition of sugar, jaggery, groundnut powder or grated dry coconut, the housewife should set aside the serving for the diabetic person and then add these food stuffs for the rest of family members.