Copyright 2002 by Nikicj5/and Medical Madness Newsletter@

Diabetes mellitus is a disease of the pancreas (an organ behind your stomach). Normally, the pancreas releases a hormone called insulin that helps your body store and use the sugar and fat from the food you eat.

Diabetes occurs:

When the pancreas does not produce any insulin, or
The pancreas produces very little insulin, or
When the body does not respond appropriately to insulin, a condition called "insulin resistance."
Diabetes is a lifelong disease. Approximately 17 million Americans have diabetes, that's 6.2% of the U.S. population. While a third are aware that they have the disease, one third or 5.4 million are unaware that they have diabetes. An additional 26 million people have pre-diabetes. As yet, there is no cure. People with diabetes need to manage their disease to stay healthy.



The Role of Insulin in Diabetes

To understand why insulin is important, it helps to know more about how the body uses food for energy. Your body is made up of millions of cells. To make energy, these cells need food in a very simple form. When you eat or drink, much of your food is broken down into a simple sugar called glucose. Then, glucose is transported through the bloodstream to the cells of your body where it can be used to provide some of the energy your body needs for daily activities.

The amount of glucose in your bloodstream is tightly regulated by a hormone called insulin. Insulin is always being released in small amounts by the pancreas. When the amount of glucose in your blood rises to a certain level, your pancreas releases more insulin to push more glucose into the cells. This causes the glucose levels in your blood (blood glucose levels) to drop.

To keep your blood glucose levels from getting too low (hypoglycemia or low blood sugar), your body signals you to eat to increase glucose levels and releases some glucose from the stores kept in the liver.

People with diabetes either don't make insulin or their body's cells no longer are able to recognize insulin, leading to high blood sugars. By definition, diabetes is having a blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an overnight fast (not eating anything).

What Are the Types of Diabetes?

Type 1 diabetes occurs because the insulin-producing cells of the pancreas (called beta cells) are destroyed by the immune system. People with type 1 diabetes produceno insulin. People with type 1 diabetes must use insulin injections to control their blood glucose.


The damage to the insulin-producing cells in type 1 diabetes occurs over a variable period of time. However, the symptoms of type 1 diabetes may occur over a period of days to weeks. Type 1 diabetes most commonly starts in people under the age of 20, but may occur at any age.

Type 2 diabetes....Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin. However, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly.When there isn't enough insulin or the insulin is not used as it should be, glucose can't get into the body's cells.



Type 2 diabetes is the most common form of diabetes mellitus, affecting almost 16 million Americans. While over 91% of these cases can be prevented, it remains for adults the leading cause of related complications such as blindness, non-traumatic amputations and chronic kidney failure requiring dialysis. Type 2 diabetes usually starts in people over age 40 who are overweight; but can occur in people who are not overweight. Sometimes referred to as "adult-onset diabetes," type 2 diabetes has started to appear in children because of the rise in obesity in young people.

Some people can manage their type 2 diabetes by controlling their weight, watching their diet, and exercise regularly. Others may also need to take a pill that helps their body use insulin better, or take insulin injections.
Often, doctors are able to detect the likelihood of type 2 diabetes before the condition actually occurs. Commonly referred to as pre-diabetes, this condition occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. It is estimated that 16 million Americans have pre-diabetes.

Gestational Diabetes. is triggered by pregnancy. The condition occurs in 4-7% of all pregnancies. Hormone changes during pregnancy can affect insulin's ability to work properly.

Pregnant women who have an increased risk of developing gestational diabetes are those who are over 25 years old, are above their normal body weight before pregnancy, have a family history of diabetes or are Hispanic, black, Native American, or Asian.

Screening for gestational diabetes is important and is performed during pregnancy. Left untreated, gestational diabetes increases the risk of complications to both the mother and her unborn child.

Usually, blood glucose levels return to normal within six weeks of childbirth. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.

What Are the Symptoms of Diabetes?

The symptoms of type 1 diabetes often occur suddenly and can be severe. They include:


*Increased thirst

*Increased hunger (especially after eating)

*Dry mouth

*Frequent urination

*Unexplained weight loss (even though you are eating and feel hungry)

*Fatigue (weak, tired feeling)

*Blurred vision

*Labored, heavy breathing (Kussmaul respirations)

*Loss of consciousness (rare)

The symptoms of type 2 diabetes may be the same as those listed above. Most often, there are no symptoms or a very gradual development of the above symptoms. Other symptoms may include:


*Slow-healing sores or cuts

*Itching of the skin (usually in the vaginal or groin area)

*Yeast infections

*Recent weight gain

*Numbness or tingling of the hands and feet

*Low blood glucose levels

*Impotence or erectile dysfunction

How Is Diabetes Managed?

At the present time, diabetes can't be cured, but it can be treated and controlled.

The goals of managing diabetes are to:

*Keep your blood glucose levels as near to normal as possible by balancing food intake with medication and activity.

*Maintain your blood cholesterol and triglyceride (lipid) levels as near their normal ranges as possible by decreasing the total amount of fat to 30% or less of your total daily calories and by reducing saturated fat and cholesterol.

*Control your blood pressure. Your blood pressure should not go over 130/80.

Slow or possibly prevent the development of diabetes-related health problems.

You hold the keys to managing your diabetes by:

*Planning what you eat and following a balanced meal plan.
*Exercising regularly.

*Taking medicine, if prescribed, and closely following the guidelines on how and when to take it.

*Monitoring your blood glucose and blood pressure levels at home.

*Keeping your appointments with your healthcare providers and having laboratory tests as ordered by your doctor.

What you do at home every day affects your blood glucose more than what your doctor can do every few months during your checkups.

Risk factors

Although the causes of diabetes are unknown, the following risk factors may increase your chance of developing diabetes.

*A family history: If a parent or sibling in your family has diabetes, your risk of developing diabetes increases.

*Race or ethnic background: The risk of diabetes is greater in Hispanics, blacks, Native Americans, and Asians.

*Being overweight: If you are 20% or more over your optimal body weight, you increase your risk of developing diabetes. (this we have control over so please if your weight is over, work hard to lose it and get your diabetes under control)

*Hypertension: High blood pressure increases the risk of developing diabetes.

*Abnormal cholesterol levels: HDL, or "good" cholesterol, levels under 45 mg/dL for men and 55 mg/dL for women, and/or a triglyceride level over 150 mg/dL increases your risk.

*Age: Your risk of developing diabetes increases progressively as you get older.

*Use of certain drugs: Blood pressure medicines, such as thiazides; Steroid medicines, such as prednisone or Decadron; Hydantoin medicines, such as Dilantin; Medicines for transplant recipients, such as cyclosporine, can increase the risk of diabetes.

*Alcohol Use: Years of heavy alcohol intake increases your risk of developing diabetes.

*Smoking: According to one study, smoking from 16 to 25 cigarettes a day increases your risk for type 2 diabetes to three times that of a non-smoker.

*History of gestantional diabetes(developing diabetes during pregnancy) or of delivering a baby over nine pounds can increase your risk.

*Autoimmune disease: Autoimmune disease can cause your body's defense system (immune system) to attack healthy insulin-producing beta cells in your pancreas increasing your risk of diabetes.

*Viruses: Some viruses are thought to play a part in diabetes development.
 

Reviewed by the Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic.

Edited by Brunilda Nazario, MD, October 2003.

Portions of this page © The Cleveland Clinic 2000-2003.

The information provided by The Cleveland Clinic is not intended to replace the medical advice of your doctor or health-care provider. Please consult your health-care provider for advice about a specific medical condition.
 

Other things you might want to know (thats if you don't know them already..lol)

Ginseng May Help Treat DiabetesPopular Herb Normalizes Blood Sugar Levels

By  Charlene Laino
WebMD Medical News
 

Red Ginseng

June 16, 2003 (New Orleans) -- The herb red ginseng may help normalize blood sugar levels in people with diabetes, two new studies suggest. But before you rush to health-food stores to stock up on the popular herb, be aware that there is no way to know if the product you buy will be as effective as the preparation used in the studies, researchers caution. University of Toronto investigators presented both studies here this weekend at the American Diabetes Association's 63rd Scientific Sessions. Since normalizing blood sugar levels is a critical goal of diabetes treatment, ginseng could someday be an important strategy in managing patients, says Fran Kaufman, MD, president of the American Diabetes Association.

Better Blood Sugar

In one study, people with type 2 diabetes who consumed ginseng and a highly viscous fiber similar to pectin had a notable reduction in blood sugar levels, reports Alexandra Jenkins, a PhD candidate at the University of Surrey, U.K. The study enrolled 30 people with diabetes in whom medication helped to control -- but did not normalize -- blood sugar levels. The participants received either capsules containing ground, North American-grown ginseng and a highly viscous fiber, or dummy capsules, three times a day for 12 weeks. After a four-week break, the participants switched to the alternate regimen; those who had received the ginseng capsules then took placebo and vice versa. Blood samples taken before and after each 12-week period showed that hemoglobin A1C -- a standard measure of blood sugar levels -- dropped into the normal range when participants were taking the ginseng capsules, but not when they were taking placebo, the study showed. The herbal preparation appeared to be safe, with no adverse effects. Moreover, ginseng appears to have an effect beyond medication, the American Diabetes Association's Kaufman says, suggesting the two approaches are complementary in treating diabetes. The Chinese, who use ginseng root to treat a variety of ailments, have been in medicine for 5,000 years, she says. "Just as acupuncture has been proven to have a role in Western medicine, so, too, will ginseng. We need to think globally." Improved Insulin Performance In the second study, Korean red ginseng improved insulin sensitivity when compared with placebo, says John L. Sievenpiper, a PhD candidate at the University of Toronto. One of the key abnormalities behind type 2 diabetes is that the body's tissues are not responsive enough to insulin so they don't process it properly. Ginseng, he says, appears to help the patients process better the insulin they have. "There is no doubt that natural products such as ginseng have a role in controlling the body's defective response to insulin," says Kaufman, who is also head of the Center for Diabetes at Children's Hospital in Los Angeles. According to the American Diabetes Association, poor control of blood sugar can lead to severely debilitating and even fatal complications including heart disease, stroke, blindness, and kidney disease.

Not Standard Treatment -- Yet
But exactly how best to incorporate ginseng into diabetes treatment still needs to be determined, Kaufman says, noting that both trails were small. Sievenpiper agrees. "These are preliminary, short-term studies that indicate a need for more research. They are not a reason to take ginseng," he said. And because of poor regulation, standardization, and labeling in the herbal industry, there is no way to know if one product will work as well as another, Sievenpiper says. Most importantly, he says, people with diabetes should be sure to tell their doctor if they are taking ginseng because lowering blood sugar too much can be dangerous.

**Always ASK your Doctor before ever taking any over the counter or any medication**
 

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