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Diabetes

What Is Diabetes?
Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.
What Are The Scope And Impact Of Diabetes?
Diabetes is widely recognized as one of the leading causes of death and disability in the United States. In 2000, it was the sixth leading cause of death. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke. An estimated 18.2 million people (6.3 percent of the population) in the United States have diabetes, a serious, lifelong condition.

Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

In 2002, diabetes cost the United States $132 billion. Indirect costs, including disability payments, time lost from work, and premature death, totaled $40 billion; direct medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $92 billion.
What Are The Types of Diabetes?
The three main types of diabetes are:
   ball1.gif (1653 bytes) type 1 diabetes
   ball1.gif (1653 bytes) type 2 diabetes
   ball1.gif (1653 bytes) gestational diabetes
What Are The Common Symptoms of Diabetes?
Common symptoms of diabetes include:
  ball1.gif (1653 bytes)Excessive thirst and appetite
  ball1.gif (1653 bytes)Increased urination (sometimes as often as every hour)
  ball1.gif (1653 bytes)Unusual weight loss or gain
  ball1.gif (1653 bytes)Fatigue
  ball1.gif (1653 bytes)Nausea, perhaps vomiting
  ball1.gif (1653 bytes)Blurred vision
  ball1.gif (1653 bytes)In women, frequent vaginal infections
  ball1.gif (1653 bytes)In men and women, yeast infections
  ball1.gif (1653 bytes)Dry mouth
  ball1.gif (1653 bytes)Slow-healing sores or cuts
  ball1.gif (1653 bytes)Itching skin, especially in the groin or vaginal area
Diabetic Nerve Pain: A Warning Sign of Diabetes
For people with diabetes, nerve pain can be a serious problem. Would you recognize the symptoms of diabetic nerve pain?

Nearly 21 million Americans have diabetes, and at least six out of 10 of them have some kind of nerve damage, called diabetic neuropathy.

Nerve pain or numbness can happen anywhere in your body - not just in your feet - although that's a common spot if you're over the age of 40.

Nearly one in three people over the age of 40 with diabetes have lost some feeling in their feet. A little numbness sound like a minor problem? Actually, it's major. Amputation, having a toe, foot, or lower leg surgically removed, is 10 times more likely in people with diabetes.

Just as dangerous are symptoms of neuropathy that go unnoticed, dismissed, or simply aren't seen as diabetes-related. A good example is when a person is at rest, perfectly calm and comfortable, and yet the heart's racing. Or people lose sensation - this is probably what we fear the most - and can't tell they're having chest pain.

If you can no longer feel the symptoms of a heart attack or blood sugar drops, it can be a sign that the autonomic nerves that send signals to and from your organs have been damaged by diabetes. Either the signaling is overly disrupted, as with pain, or it goes in the other direction, where you no longer appreciate any pain or sensation whatsoever.

If you have peripheral neuropathy, is it typical to have some autonomic neuropathy, too? You could have one or the other, or you could have both. That's why knowing the range of symptoms of neuropathy is a key step in taking care of yourself and managing your diabetes.

Symptoms of Peripheral Neuropathy In Your Feet and Hands:
If you have diabetes, you may be all-too-familiar with nerve pain and damage in your feet, legs, and hands, called peripheral neuropathy. Your peripheral nerves serve the farthest reaches - the periphery - of your body. The nerves to your feet are the longest in your body, and they're often the first to be affected. (Nerve pain, numbness, and muscle weakness can also appear in your hips, thighs, and buttocks, called proximal neuropathy, making it hard to walk.

Do you have:
  ball1.gif (1653 bytes)Tingling or burning in your toes, feet, legs, fingers, hands, or arms?
  ball1.gif (1653 bytes)A "pins and needles" feeling?
  ball1.gif (1653 bytes)Pain or cramping?
  ball1.gif (1653 bytes)Numbness or loss of sensation?
  ball1.gif (1653 bytes)Insensitivity to heat and cold?
  ball1.gif (1653 bytes)Extreme sensitivity to even the lightest touch?
  ball1.gif (1653 bytes)Muscle weakness in your hands or feet?
  ball1.gif (1653 bytes)Loss of coordination or balance that makes it harder to walk?

Symptoms of Autonomic Neuropathy Throughout Your Body:
Autonomic nerves play a key role in controlling a wide range of basic body functions, most of them involuntary: your heart rate, blood pressure, sexual response, bowels, bladder, sweating, and your ability to sense the signs of high blood sugar or a heart attack.

Most people feel weak or shaky when their blood sugar levels drop below 70 mg/dL, but people with this kind of neuropathy have a hard time feeling these sensations. A vicious cycle can result, since being unaware that your blood sugar's too high (hyperglycemia) or too low (hypoglycemia) makes it harder to keep your blood sugar leveled out throughout the day.

Your social life can be affected, too. If nerves in your urinary tract are damaged, you may not be able to feel or control your bladder and may have incontinence. If nerves in your digestive system are damaged, you may have chronic constipation or a stomach that empties too slowly, resulting in bloating, nausea, even vomiting. If nerves leading to sex organs are damaged, men may have difficulty maintaining an erection, called erectile dysfunction or ED, while women may no longer enjoy their usual sexual response. For both men and women, orgasm may be out of reach.

Do you have:
   ball1.gif (1653 bytes)Trouble feeling when your blood sugar is low?
   ball1.gif (1653 bytes)Chronic constipation or diarrhea?
   ball1.gif (1653 bytes)Frequent indigestion, nausea, or vomiting?
   ball1.gif (1653 bytes)Problems with urination?
   ball1.gif (1653 bytes)Problems with sex or orgasm?
   ball1.gif (1653 bytes)Faintness or dizziness when you stand up?
   ball1.gif (1653 bytes)Trouble seeing well enough to drive at night?
   ball1.gif (1653 bytes)Changes in sweating, either much more or less than usual?
   ball1.gif (1653 bytes)Other Kinds of Neuropathy:
     ball1.gif (1653 bytes)Slow stomach emptying. Other common neuropathies can be caused by diabetes, such as the inability to empty the stomach, called gastroparesis. People may notice fluctuations in blood sugar that don't seem to correspond to anything related to food, medication dosing, or activity. They often report feeling very full, having just a few bites of food. And it's not unusual, when they get up in the morning, to feel full before they've eaten. They can actually throw up, and it's last night's dinner.
     ball1.gif (1653 bytes)Diabetic diarrhea. Another common problem is diabetic diarrhea which is diarrhea that can come at any time. Socially, it's a major concern. You can't predict it. It's a rapid transit problem that can occur where there are abnormalities in how fast food is absorbed or how well it's absorbed, so it can cause chaos with blood sugars.
     ball1.gif (1653 bytes)Cardiovascular nerve damage. If nerves in your circulatory system are damaged, your body may lose its natural ability to adjust heart rate and blood pressure. You may frequently feel light-headed or dizzy when you stand up after sitting for awhile, or your blood pressure may stay high too long after exercise, rather than dropping to normal levels after resting.
     ball1.gif (1653 bytes)Focal neuropathy. You can think of this type of nerve pain and damage as suddenly "focusing" in one part of your body with sudden, severe pain or weakness. It can show up as sudden pain in your feet, or sharp pain in one eye, double vision, or trouble focusing one eye. Or you may suddenly be unable to move the muscles on one side of your face.

Why Does Diabetes Cause Nerve Pain?
What's the current theory of why glucose damages nerves? It all boils down to two main theories. Both target the protective covering of nerves, called the myelin sheath.

One theory is that it's either glucose directly, or a byproduct of the metabolism of glucose - something that chemically irritates the nerve sheath. When this sheath is destroyed, a bare nerve is exposed - just as you'd expose an electrical wire if you stripped off its plastic coating. The bare nerve is very painful, and then over time, the sensation is completely lost.

The other camp thinks the problem lies in the vascular system and a cutting-off of the blood supply to the nerves. If the tiny blood vessels that feed the nerve are destroyed, then you see a "starvation" of the nerve sheath. There's some evidence for one or the other theory, and there's some evidence that both may be going on, too. It's a question that has not yet been resolved.

So while modern medicine doesn't yet know for sure what causes nerve pain, one thing is certain: Keeping your blood sugars at your target level is the first step in protecting the health of your nerves. And be open and talk with your doctor at the first sign of unusual nerve pain, numbness, or sensation -- no matter where they may happen in your body.

Source: WebMD
Who Gets Diabetes?
Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase the risk of developing diabetes.
Type 1 diabetes occurs equally among males and females, but is more common in whites than in non-whites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown.

Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanic Americans. On average, non-Hispanic African Americans are 1.6 times as likely to have diabetes as non-Hispanic whites of the same age. Hispanic Americans are 1.5 times as likely to have diabetes as non-Hispanic whites of similar age. American Indians have one of the highest rates of diabetes in the world. On average, American Indians and Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites of similar age. Although prevalence data for diabetes among Asian Americans and Pacific Islanders are limited, some groups, such as Native Hawaiians, Japanese and Filipino residents of Hawaii aged 20 or older, are about twice as likely to have diabetes as white residents of Hawaii of similar age.
You are more likely to develop type 2 diabetes if:
   ball1.gif (1653 bytes) you are overweight
   ball1.gif (1653 bytes) you are 45 years old or older
   ball1.gif (1653 bytes) you have a parent, brother, or sister with diabetes
   ball1.gif (1653 bytes) your family background is African American, American Indian, Asian American, Hispanic American/Latino, or Pacific Islander
   ball1.gif (1653 bytes) you have had gestational diabetes or gave birth to at least one baby weighing more than 9 pounds
   ball1.gif (1653 bytes) your blood pressure is 140/90 or higher, or you have been told that you have high blood pressure
   ball1.gif (1653 bytes) your HDL cholesterol is 35 or lower, or your triglyceride level is 250 or higher
   ball1.gif (1653 bytes) you are fairly inactive, or you exercise fewer than three times a week

The prevalence of diabetes in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanic Americans and other minority groups make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates, the prevalence of diabetes in the United States is predicted to reach 8.9 percent of the population by 2025.
More Than 50 Ways To Prevent Diabetes
Many Americans are at a high risk of developing type 2 diabetes, and being overweight increases that risk. Losing a small amount of weight, by getting 30 minutes of physical activity 5 days a week and eating healthy, will help prevent diabetes. To get started, use this guide for ideas on moving more, eating healthier, and tracking your progress.
Small Steps For Big Rewards:
   ball1.gif (1653 bytes) Less on your plate.
   ball1.gif (1653 bytes) Keep meat, poultry and fish servings to about 3 ounces.
   ball1.gif (1653 bytes) Make less food look like more by serving your meal on a salad or breakfast plate.
   ball1.gif (1653 bytes) Try not to snack while cooking or cleaning the kitchen.
   ball1.gif (1653 bytes) Try to eat sensible meals and snacks at regular times throughout the day.
   ball1.gif (1653 bytes) Make sure you eat breakfast every day.
   ball1.gif (1653 bytes) Use broth and cured meats (smoked turkey and turkey bacon) in small amounts. They are high in sodium. Low sodium broths are available in cans and powder.
   ball1.gif (1653 bytes) Share your desserts.
   ball1.gif (1653 bytes) When eating out, have a big vegetable salad, then split an entree with a friend or have the other half wrapped to go.
   ball1.gif (1653 bytes) Stir fry, broil or bake with non-stick spray or low sodium broth and try to cook with less oil and butter.
   ball1.gif (1653 bytes) Drink a glass of water or other "no-calorie" beverage 10 minutes before your meal to take the edge off your appetite.
   ball1.gif (1653 bytes) Select the healthier choice at fast food restaurants. Try grilled chicken instead of the cheeseburger. Skip the french fries or replace the fries with a salad.
   ball1.gif (1653 bytes) Listen to music while you eat instead of watching TV (people tend to eat more while watching TV).
   ball1.gif (1653 bytes) It takes 20 minutes for your stomach to send a signal to your brain that you're full. Eat slowly.
   ball1.gif (1653 bytes) Eat a small meal.
   ball1.gif (1653 bytes) Teaspoons, salad forks, or child-size utensils may help you take smaller bites and eat less.
   ball1.gif (1653 bytes) You don't have to cut out the foods you love to eat. Just cut down on your portion size and eat it less often.
Add more physical activity to your daily routine:
   ball1.gif (1653 bytes) Dance it away.
   ball1.gif (1653 bytes) Show your kids the dances you used to do when you were their age.
   ball1.gif (1653 bytes) Turn up the music and jam while doing household chores.
   ball1.gif (1653 bytes) Deliver a message in person to a co-worker instead of e-mailing.
   ball1.gif (1653 bytes) Take the stairs to your office. Or take the stairs as far as you feel comfortable, and then take the elevator.
   ball1.gif (1653 bytes) Make a few less phone calls. Catch up with friends during a regularly scheduled walk.
   ball1.gif (1653 bytes) March in place while you watch TV.
   ball1.gif (1653 bytes) Park as far away as possible from your favorite store at the mall.
   ball1.gif (1653 bytes) Select an exercise video from the store or library.
   ball1.gif (1653 bytes) Get off the bus one stop earlier and walk the rest of the way home or to work at least two days a week.
Make healthy food choices:
   ball1.gif (1653 bytes) Snack on a veggie.
   ball1.gif (1653 bytes) Try getting at least one new fruit or vegetable every time you grocery shop.
   ball1.gif (1653 bytes) Macaroni and low-fat cheese can be a main dish. Serve it with your favorite vegetable dish and a salad.
   ball1.gif (1653 bytes) Try eating foods from other countries. Many international dishes feature more vegetables, whole grains and beans and less meat.
   ball1.gif (1653 bytes) Cook with a variety of spices instead of salt.
   ball1.gif (1653 bytes) Find a water bottle you really like (church or club event souvenir, favorite sports team, etc.) and drink water from it wherever and whenever you can.
   ball1.gif (1653 bytes) Always keep a healthy snack with you.
   ball1.gif (1653 bytes) Choose veggie toppings like spinach, broccoli and peppers for your pizza.
   ball1.gif (1653 bytes) Try different recipes for baking or broiling meat, chicken, and fish.
   ball1.gif (1653 bytes) Try to choose foods with little or no added sugar.
   ball1.gif (1653 bytes) Gradually work your way down from whole milk to 2% milk to 1% milk until you're drinking and cooking with fat free (skim) milk.
   ball1.gif (1653 bytes) Try keeping a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.
   ball1.gif (1653 bytes) Eat foods made from a variety of whole grains-such as whole wheat bread, brown rice, oats, and whole grain corn-every day. Use whole grain bread for toast and sandwiches; substitute brown rice for white rice for home-cooked meals and when dining out.
   ball1.gif (1653 bytes) Don't grocery shop on an empty stomach and make a list before you go.
   ball1.gif (1653 bytes) Read food labels. Choose foods with lower fat, saturated fat, calories, and salt.
   ball1.gif (1653 bytes) Fruits are colorful and make a welcoming centerpiece for any table. Have a nice chat while sharing a bowl of fruit with family and friends.
   ball1.gif (1653 bytes) Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a slice of cake. Peel and eat an orange instead of drinking orange juice.
Nurture your mind, body, and soul:
   ball1.gif (1653 bytes) You can exhale, Gail.
   ball1.gif (1653 bytes) Don't try to change your entire way of eating and exercising all at once. Try one new activity or food a week.
   ball1.gif (1653 bytes) Find mellow ways to relax--try deep breathing, take an easy paced walk, or enjoy your favorite easy listening music.
   ball1.gif (1653 bytes) Give yourself daily "pampering time" and honor this time like any other appointment you make... whether it's spending time reading a book, taking a long bath, or meditating.
   ball1.gif (1653 bytes) Try not to eat out of boredom or frustration. If you're not hungry, do something else.
   ball1.gif (1653 bytes) Honor your health as your most precious gift.

There are many more ways to prevent type 2 diabetes with healthy eating and physical activity. Discover your own and share it with your family, friends and neighbors.

Take the first step today. If you're overweight, you may be at high risk for developing type 2 diabetes. Talk to your health care provider today.

Source: WebMD Health
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