What Is Diabetes? What Causes Diabetes?

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia). There are three types of diabetes: 1) Type 1 Diabetes The body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years. Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10% of all diabetes cases are type 1. Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet. Between 2001 and 2009, the prevalence of type 1 diabetes among the under 20s in the USA rose 23%, according to SEARCH for Diabetes in Youth data issued by the CDC (Centers for Disease Control and Prevention). (Link to article) 2) Type 2 Diabetes The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). Approximately 90% of all cases of diabetes worldwide are of this type. Some people may be able to control their type 2 diabetes symptoms by losing weight, following a healthy diet, doing plenty of exercise, and monitoring their blood glucose levels. However, type 2 diabetes is typically a progressive disease - it gradually gets worse - and the patient will probably end up have to take insulin, usually in tablet form. Overweight and obese people have a much higher risk of developing type 2 diabetes compared to those with a healthy body weight. People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk. Being overweight/obese causes the body to release chemicals that can destabilize the body's cardiovascular and metabolic systems. The risk of developing type 2 diabetes is also greater as we get older. Experts are not completely sure why, but say that as we age we tend to put on weight and become less physically active. Those with a close relative who had/had type 2 diabetes, people of Middle Eastern, African, or South Asian descent also have a higher risk of developing the disease. Men whose testosterone levels are low have been found to have a higher risk of developing type 2 diabetes. Researchers from the University of Edinburgh, Scotland, say that low testosterone levels are linked to insulin resistance. (Link to article)

Measuring the glucose level in blood

3) Gestational Diabetes This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Diagnosis of gestational diabetes is made during pregnancy. The majority of gestational diabetes patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth. The baby may be bigger than he/she should be. Scientists from the National Institutes of Health and Harvard University found that women whose diets before becoming pregnant were high in animal fat and cholesterol had a higher risk for gestational diabetes, compared to their counterparts whose diets were low in cholesterol and animal fats. (Link to article)

What Is Prediabetes?
The vast majority of patients with type 2 diabetes initially had prediabetes. Their blood glucose levels where higher than normal, but not high enough to merit a diabetes diagnosis. The cells in the body are becoming resistant to insulin. Studies have indicated that even at the prediabetes stage, some damage to the circulatory system and the heart may already have occurred.

Diabetes Is A Metabolism Disorder

Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood - it is the principal source of fuel for our bodies. When our food is digested, the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present - insulin makes it possible for our cells to take in the glucose. Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate

quantity of insulin to move the glucose present in our blood into the cells, as soon as glucose enters the cells bloodglucose levels drop. A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

How To Determine Whether You Have Diabetes, Prediabetes or Neither

Doctors can determine whether a patient has a normal metabolism, prediabetes or diabetes in one of three different ways - there are three possible tests:

The A1C test - at least 6.5% means diabetes - between 5.7% and 5.99% means prediabetes - less than 5.7% means normal

The FPG (fasting plasma glucose) test - at least 126 mg/dl means diabetes - between 100 mg/dl and 125.99 mg/dl means prediabetes - less than 100 mg/dl means normal An abnormal reading following the FPG means the patient has impaired fasting glucose (IFG)

The OGTT (oral glucose tolerance test) - at least 200 mg/dl means diabetes - between 140 and 199.9 mg/dl means prediabetes - less than 140 mg/dl means normal An abnormal reading following the OGTT means the patient has impaired glucose tolerance (IGT)

Why Is It Called Diabetes Mellitus?

Diabetes comes from Greek, and it means a "siphon". Aretus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) like a siphon. The word became "diabetes" from the English adoption of the Medieval Latin diabetes. In 1675, Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means "honey"; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean "siphoning off sweet water". In ancient China people observed that ants would be attracted to some people's urine, because it was sweet. The term "Sweet Urine Disease" was coined.

Controlling Diabetes - Treatment Is Effective And Important

All types of diabetes are treatable. Diabetes type 1 lasts a lifetime, there is no known cure. Type 2 usually lasts a lifetime, however, some people have managed, through a lot of exercise, diet and excellent body weight control to get

rid of their symptoms without medication. Researchers from the Mayo Clinic Arizona in Scottsdale showed that gastric bypass surgery can reverse type 2 diabetes in a high proportion of patients. They added that within three to five years the disease recurs in approximately 21% of them. Yessica Ramos, MD., said "The recurrence rate was mainly influenced by a longstanding history of Type 2 diabetes before the surgery. This suggests that early surgical intervention in the obese, diabetic population will improve the durability of remission of Type 2 diabetes." (Link to article) Patients with type 1 are treated with regular insulin injections, as well as a special diet and exercise. Patients with Type 2 diabetes are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required. If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications.

Ads by Google

Diabetic Diet & Meals - Free Diabetic Recipes > Breakfast, Lunch - Snack - Dinner - Dessert. www.diabetesinfocenter.org

Blood Sugar Testers - Upto 60% Off on Digital Glucometer. Free Shipping, Pay COD. Order Now! HealthKart.com/DiabetesGlucometer

type 2 diabetes food list - Manage your diabetes with free tools from DiabetesCare.net! www.diabetescare.net Complications linked to badly controlled 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 Hyperglycemic 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 increases significantly 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

USA - 2011 National Diabetes Fact Sheet

How many Americans have diabetes or pre-diabetes?

8.5% of the US population have diabetes - 25.8 million children and adults. Researchers from the Jefferson School of Population Health (Philadelphia, PA) published a study which estimates that by 2025 there could be 53.1 million people with the disease. (Link to article)

18.8 million people have been diagnosed with diabetes

About 7 million people with diabetes have not been diagnosed. Even though type 2 diabetes rates in the USA have risen sharply, Timothy Lyons, MD, who is presently Director of Research of the Harold Hamm Diabetes Center in Oklahoma City says that the disease is still not being detected promptly. He added that the lag in diagnosis involves both patients and doctors. (Link to article)

About 79 million people have pre-diabetes

1.9 million people aged 20 years or more were newly diagnosed with diabetes in 2010

215,000 (0.26%) people younger than 20 years have diabetes

Approximately 1 in every 400 kids and teenagers has diabetes

11.3% of people aged 20+ years have diabetes; a total of 25.6 million individuals

26.9% of people aged 65+ years have diabetes; a total of 10.9 million people

11.8% of men have diabetes; a total of 13 million people

10.8% of women have diabetes; a total of 12.6 million people

Diabetes In The United Kingdom

In the United Kingdom there are about 3.8 million people with diabetes, according to the National Health Service. Diabetes UK, a charity, believes this number will jump to 6.2 million by 2035, and the National Health Service will be spending as much as 17% of its health care budget on diabetes by then.

Diabetes Spreads In Southeast Asia

Diabetes is rapidly spreading in Southeast Asia as people embrace American fast foods, such as hamburgers, hot dogs, French fries and pizza. More Chinese adults who live in Singapore are dying of heart disease and developing type 2 diabetes than ever before, researchers from the University of Minnesota School of Public Health and the National University of Singapore reported in the journal Circulation. The authors found that Chinese adults in Singapore who eat American-style junk foods twice a week had a 56% greater risk of dying prematurely form heart disease, while their risk of developing type 2 diabetes rose 27%, compared to their counterparts who "never touched the stuff". There was a 80% higher likelihood of dying from coronary heart disease for those eating fast foods four times per week. (Link to article)

Some Facts And Myths Regarding Diabetes

Many presumed "facts" are thrown about in the paper press, magazines and on the internet regarding diabetes; some of them are, in fact, myths. It is important that people with diabetes, pre-diabetes, their loved ones, employers and schools have an accurate picture of the disease. Below are some diabetes myths:

People with diabetes should not exercise - NOT TRUE!! Exercise is important for people with diabetes, as it is for everybody else. Exercise helps manage body weight, improves cardiovascular health, improves mood, helps blood sugar control, and relieves stress. Patients should discuss exercise with their doctor first.

Fat people always develop type 2 diabetes eventually - this is not true. Being overweight or obese raises the risk of becoming diabetic, they are risk factors, but do not mean that an obese person will definitely become diabetic. Many people with type 2 diabetes were never overweight. The majority of overweight people do not develop type 2 diabetes.

Diabetes is a nuisance, but not serious - two thirds of diabetes patients die prematurely from stroke or heart disease. The life expectancy of a person with diabetes is from five to ten years shorter than other people's. Diabetes is a serious disease.

Children can outgrow diabetes - this is not true. Nearly all children with diabetes have type 1; insulin-producing beta cells in the pancreas have been destroyed. These never come back. Children with type 1 diabetes will need to take insulin for the rest of their lives, unless a cure is found one day.

Don't eat too much sugar, you will become diabetic - this is not true. A person with diabetes type 1 developed the disease because their immune system destroyed the insulin-producing beta cells. A diet high in calories, which can make people overweight/obese, raises the risk of developing type 2 diabetes, especially if there is a history of this disease in the family.

I know when my blood sugar levels are high or low - very high or low blood sugar levels may cause some symptoms, such as weakness, fatigue and extreme thirst. However, levels need to be fluctuating a lot for symptoms to be felt. The only way to be sure about your blood sugar levels is to test them regularly. Researchers from the University of Copenhagen, Denmark showed that even very slight rises in blood-glucose levels significantly raise the risk of ischemic heart disease. (Link to article)

Diabetes diets are different from other people's - the diet doctors and specialized nutritionists recommend for diabetes patients are healthy ones; healthy for everybody, including people without the disease. Meals should contain plenty of vegetables, fruit, whole grains, and they should be low in salt and sugar, and saturated or trans fat. Experts say that there is no need to buy special diabetic foods because they offer no special benefit, compared to the healthy things we can buy in most shops.

High blood sugar levels are fine for some, while for others they are a sign of diabetes - high blood-sugar levels are never normal for anybody. Some illnesses, mental stress and steroids can cause temporary hikes in blood sugar levels in people without diabetes. Anybody with higher-than-normal blood sugar levels or sugar in their urine should be checked for diabetes by a health care professional. Diabetics cannot eat bread, potatoes or pasta - people with diabetes can eat starchy foods. However, they must keep an eye on the size of the portions. Whole grain starchy foods are better, as is the case for people without diabetes.

One person can transmit diabetes to another person - NOT TRUE. Just like a broken leg is not infectious or contagious. A parent may pass on, through their genes to their offspring, a higher susceptibility to developing the disease.

Only older people develop type 2 diabetes - things are changing. A growing number of children and teenagers are developing type 2 diabetes. Experts say that this is linked to the explosion in childhood obesity rates, poor diet, and physical inactivity.

I have to go on insulin, this must mean my diabetes is severe - people take insulin when diet alone or diet with oral or non-insulin injectable diabetes drugs do not provide good-enough diabetes control, that's all. Insulin helps diabetes control. It does not usually have anything to do with the severity of the disease.

If you have diabetes you cannot eat chocolates or sweets - people with diabetes can eat chocolates and sweets if they combine them with exercise or eat them as part of a healthy meal.

Diabetes patients are more susceptible to colds and illnesses in general - a person with diabetes with good diabetes control is no more likely to become ill with a cold or something else than other people. However, when a diabetic catches a cold, their diabetes becomes harder to control, so they have a higher risk of complications.

Symptoms of Diabetes
People can often have diabetes and be completely unaware. The main reason for this is that the symptoms, when seen on their own, seem harmless. However, the earlier diabetes is diagnosed the greater the chances are that serious complications, which can result from having diabetes, can be avoided. Here is a list of the most common diabetes symptoms :

Frequent urination Have you been going to the bathroom to urinate more often recently? Do you notice that you spend most of the day going to the toilet? When there is too much glucose (sugar) in your blood you will urinate more often. If your insulin is ineffective, or not there at all, your kidneys cannot filter the glucose back into the blood. The kidneys will take water from your blood in order to dilute the glucose - which in turn fills up your bladder. Disproportionate thirst If you are urinating more than usual, you will need to replace that lost liquid. You will be drinking more than usual. Have you been drinking more than usual lately? Intense hunger As the insulin in your blood is not working properly, or is not there at all, and your cells are not getting their energy, your body may react by trying to find more energy - food. You will become hungry. Weight gain This might be the result of the above symptom (intense hunger). Unusual weight loss This is more common among people with Diabetes Type 1. As your body is not making insulin it will seek out another energy source (the cells aren't getting glucose). Muscle tissue and fat will be broken down for energy. As Type 1 is of a more sudden onset and Type 2 is much more gradual, weight loss is more noticeable with Type 1.

Increased fatigue If your insulin is not working properly, or is not there at all, glucose will not be entering your cells and providing them with energy. This will make you feel tired and listless. Irritability Irritability can be due to your lack of energy. Blurred vision This can be caused by tissue being pulled from your eye lenses. This affects your eyes' ability to focus. With proper treatment this can be treated. There are severe cases where blindness or prolonged vision problems can occur. Cuts and bruises don't heal properly or quickly Do you find cuts and bruises take a much longer time than usual to heal? When there is more sugar (glucose) in your body, its ability to heal can be undermined. More skin and/or yeast infections When there is more sugar in your body, its ability to recover from infections is affected. Women with diabetes find it especially difficult to recover from bladder and vaginal infections. Itchy skin A feeling of itchiness on your skin is sometimes a symptom of diabetes. Gums are red and/or swollen - Gums pull away from teeth If your gums are tender, red and/or swollen this could be a sign of diabetes. Your teeth could become loose as the gums pull away from them. Frequent gum disease/infection As well as the previous gum symptoms, you may experience more frequent gum disease and/or gum infections. Sexual dysfunction among men If you are over 50 and experience frequent or constant sexual dysfunction (erectile dysfunction), it could be a symptom of diabetes. Numbness or tingling, especially in your feet and hands If there is too much sugar in your body your nerves could become damaged, as could the tiny blood vessels that feed those nerves. You may experience tingling and/or numbness in your hands and feet.

Diagnosis of diabetes
Diabetes can often be detected by carrying out a urine test, which finds out whether excess glucose is present. This is normally backed up by a blood test, which measures blood glucose levels and can confirm if the cause of your symptoms is diabetes. If you are worried that you may have some of the above symptoms, you are recommended to talk to your Doctor or a qualified health professional.

What is insulin?
Insulin is a hormone. It makes our body's cells absorb glucose from the blood. The glucose is stored in the liver and muscle as glycogen and stops the body from using fat as a source of energy.

When there is very little insulin in the blood, or none at all, glucose is not taken up by most body cells. When this happens our body uses fat as a source of energy. Insulin is also a control signal to other body systems, such as amino acid uptake by body cells. Insulin is not identical in all animals - their levels of strength vary. Porcine insulin, insulin from a pig, is the most similar to human insulin. Humans can receive animal insulin. However, genetic engineering has allowed us to synthetically produce 'human' insulin.

The pancreas

(1. click for large diagram) - 3d Medical RF

The pancreas is part of the digestive system. It is located high up in your abdomen and lies across your body where the ribs meet at the bottom. It is shaped like a leaf and is about six inches long. The wide end is called the head while the narrower end is called the tail, the mid-part is called the body. The pancreas has two principal functions: 1. 2. It produces pancreatic digestive juices. It produces insulin and other digestive hormones. The endocrine pancreas is the part of the pancreas that produces insulin and other hormones. The exocrine pancreas is the part of the pancreas that produces digestive juices. Insulin is produced in the pancreas. When protein is ingested insulin is released. Insulin is also released when glucose is present in the blood. After eating carbohydrates, blood glucose levels rise. Insulin makes it possible for glucose to enter our body's cells - without glucose in our cells they would not be able to function. Without insulin the glucose cannot enter our cells. Within the pancreas, the Islets of Langerhans contain Beta cells, which synthesize (make) the insulin. Approximately 1 to 3 million Islets of Langerhans make up the endocrine part of the pancreas (mainly the exocrine gland), representing just one fiftieth of the pancreas' total mass.

Etymology (history) of the word pancreas

It is said that the pancreas was described first by Herophilus of Chalcedon in about 300B.C. and the organ was named by Rufus of Ephesus in about 100A.D However, it is an established fact that the word pancreas had been used by Aristotle (384-322B.C.) before Herophilus. In Aristotle's Historia Animalium, there is a line saying "another to the so-called pancreas". It is considered that the words "so-called pancreas" imply that the word pancreas had been popular at the time of Aristotle, but it had not been authorized yet as an anatomical term. However, the word pancreas presumably has been accepted as an anatomical term since Herophilus. The word pancreas comes from the Greek pankreas, meaning sweetbread.

Type 1 diabetes
Type 1 diabetes is an autoimmune disease - the person's body has destroyed his/her own insulin-producing beta cells in the pancreas. People with Diabetes Type 1 are unable to produce insulin. Most patients with Diabetes Type 1 developed the condition before the age of 40. Approximately 15% of all people with diabetes have Type 1. Type 1 diabetes is fatal unless the patient regularly takes exogenous insulin. Some patients have had their beta cells replaced through a pancreas transplant and have managed to produce their own insulin again. Type 1 diabetes is also known as juvenile diabetes or childhood diabetes. Although a large number of diabetes Type 1 patients become so during childhood, it can also develop after the age of 18. Developing Type 1 after the age of 40 is extremely rare. Type 1, unlike Type 2, is not preventable. The majority of people who develop Type 1 are of normal weight and are otherwise healthy during onset. Exercise and diet cannot reverse Type 1. Quite simply, the person has lost his/her insulin-producing beta cells. Several clinical trials have attempted to find ways of preventing or slowing down the progress of Type 1, but so far with no proven success. A C-peptide assay is a lab test that can tell whether somebody has Type 1 or Type 2. As external insulin has no Cpeptide a lack of it would indicate Type 1. The test is only effective when ALL the endogenous insulin has left the body - this can take several months.

Diet for a person with type 1

A person with Type one will have to watch what he/she eats. Foods that are low in fat, salt and have no or very little added sugar are ideal. He/she should consume foods that have complex carbohydrates, rather than fast carbohydrates, as well as fruits and vegetables. A diet that controls the person's blood sugar level as well as his/her blood pressure and cholesterol levels will help achieve the best possible health. Portion size is also important in order to maintain a healthy bodyweight. Meal planning needs to be consistent so that the food and insulin can work together to control blood glucose levels. According to the Mayo Clinic there is no 'diabetes diet'. The Clinic says you do not need to restrict yourself to boring bland foods. Rather you should, as mentioned above, consume plenty of fruits, vegetables and whole grains - foods that are highly nutritious, low in fat, and low in calories. Even sugary foods are acceptable now and again if you include them in your food plan. If you have Type 1 you should seek the help of a registered dietitian. A dietitian can help you create a food plan that suits you. Most dietitians agree that you should aim to consume the same quantity of food, with equal portions of carbs, proteins and fats at the same time each day.

Complications - the bad news and the good news

A person with Type 1 has a two to four times higher risk of developing heart disease, stroke, high blood pressure, blindness, kidney failure, gum disease and nerve damage, compared to a person who does not have any type of diabetes. A person with Type 1 is more likely to have poor blood circulation through his/her legs and feet. If left untreated the problem may become such that a foot has to be amputated. A person with Type 1 will likely go into a coma if untreated. The good news is that treatment is available and it is effective and can help prevent these complications from happening.

How to help prevent complications

Keep your blood pressure under 130/85 mm Hg. Keep your cholesterol level below 200 mg. Check your feet every day for signs of infection. Get your eyes checked once a year. Get your dentist to check your teeth and gums twice a year.

Physical activity helps regulate blood sugar levels

Before starting exercise make sure your doctor tells you it is OK. Try to make physical activity part of your daily life. You should try to do at least 30 minutes of exercise or physical activity each day. Physical activity or exercise means aerobic exercise. If you have not done any exercise for a while, start gently and build up gradually. Physical activity helps lower your blood sugar. Remember that exercise is good for everybody, not just people with Type 1. The benefits are enormous for your physical and mental health. You will become stronger, fitter, your sleep will improve as will your skin tone - and after some time you will look great! Exercise will help your circulation - helping to make sure your lower legs and feet are healthy. Remember to check your blood sugar level more frequently during your first few weeks of exercise so that you may adapt your meal plans and/or insulin doses accordingly. Remember that a person with Type 1 has to manually adjust his/her insulin doses - the body will not respond automatically. "Gary Hall won an Olympic gold medal in swimming. He had Type 1 diabetes."

Possible cure for diabetes type 1 closer with stem cells

Stem cells in the pancreas which can turn into insulin-producing cells have been identified by researchers from the Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia. They published their breakthrough in PLoS One (November 9th, 2012). The authors explain that their finding raises the hope that one day soon patients with diabetes type 1 will be able to produce their own insulin in their own regenerated beta cells in the pancreas. The scientists identified and isolated stem cells from the adult pancreas. They then developed a method for making them become insulin-producing cells that can secrete insulin in response to glucose in the bloodstream.

Type 2 diabetes

A person with diabetes type 2 either:

1. 2.

Does not produce enough insulin. Or Suffers from 'insulin resistance'. This means that the insulin is not working properly. The majority of people with Type 2 have developed the condition because they are overweight. Type 2 generally appears later on in life, compared to Type 1. Type 2 is the most common form of diabetes. In the case of insulin resistance, the body is producing the insulin, but insulin sensitivity is reduced and it does not do the job as well as it should do. The glucose is not entering the body's cells properly, causing two problems:

1. 2.

A build-up of glucose in the blood. The cells are not getting the glucose they need for energy and growth. In the early stages of Type 2 insulin sensitivity is the main abnormality - also there are elevated levels of insulin in the blood. There are medications which can improve insulin sensitivity and reduce glucose production by the liver. As the disease progresses the production of insulin is undermined, and the patient will often need to be given replacement insulin. "Excess abdominal fat is much more likely to bring on Type 2 Diabetes than excess fat under your skin" Many experts say that central obesity - fat concentrated around the waist in relation to abdominal organs - may make individuals more predisposed to develop Type 2 diabetes. Central obesity does not include subcutaneous fat - fat under the skin. The fat around your waist - abdominal fat secretes a group of hormones called adipokines. It is thought that adipokines may impair glucose tolerance. The majority of people who develop diabetes Type 2 were overweight during the onset, while 55% of all Type 2 patients were obese during onset. "Sometimes all the patient needs is to do more exercise, lose weight and eat fewer carbs" It is not uncommon for people to achieve long-term satisfactory glucose control by doing more exercise, bringing down their bodyweight and cutting down on their dietary intake of carbohydrates. However, despite these measures, the tendency towards insulin resistance will continue, so the patient must persist with his/her increased physical activity, monitored diet and bodyweight. If the diabetes mellitus continues the patient will usually be prescribed orally administered anti-diabetic drugs. As a person with Type 2 does produce his/her own insulin, a combination of oral medicines will usually improve insulin production, regulate the release of glucose by the liver, and treat insulin resistance to some extent. If the beta cells become further impaired the patient will eventually need insulin therapy in order to regulate glucose levels.

The risk factors for type 2

Age and ethnicity. The older you are the higher your risk is, especially if you are over 40 (for white people), and over 25 (for black, South Asian and some minority groups). It has been found in the UK that black people and people of South Asian origin have five times the risk of developing Type 2 compared to white people. Diabetes in the family. If you have a relative who has/had diabetes your risk might be greater. The risk increases if the relative is a close one - if your father or mother has/had diabetes your risk might be greater than if your uncle has/had it. Bodyweight (and inactivity combined with bodyweight). Four-fifths of people who have Type 2 became so because they were overweight. The more overweight a person is the higher his/her risk will be. The highest risk is for a person who is overweight and physically inactive. In other words, if you are very overweight and do not do any exercise your risk is greatest. Cardiovascular problems and stroke. A person who has had a stroke runs a higher risk of developing Type 2. This is also the case for people who suffer from hypertension (high blood pressure), or have had a heart attack. Any diagnosis of a problem with circulation indicates a higher risk of developing Type 2. Gestational Diabetes. A woman who became temporarily diabetic during pregnancy - gestational diabetes - runs a higher risk of developing Type 2 later on. Women who give birth to a large baby may run a higher risk, too. Impaired fasting glycaemia (IFG) - Impaired glucose tolerance (IGT). A person who has been diagnosed as having impaired fasting glycaemia or impaired glucose tolerance and does not have diabetes runs a significantly higher risk of eventually developing Type 2. People with IFG or IGT have higher than normal levels of glucose in their blood. In order to prevent diabetes it is crucial that you eat healthily, keep an eye on your weight and do exercise. Severe mental health problems. It has been found that people with severe mental health problems are more likely to develop Type 2.

Diabetes and cardiovascular diseases

People with diabetes type 2 are much more likely to develop cardiovascular diseases, such as coronary heart disease, stroke, hypertension, inflammatory heart disease and other cardiovascular conditions. Treatments tend to be similar to the ones used on patients who do not have diabetes. Stents versus bypass surgery for clogged artery Patients with diabetes who have one clogged artery tend to have better results from heart bypass surgery than drug coated stents, researchers from Saint Luke's Mid-America Heart Institute in Kansas City, Missouri, explained at the American Heart Association's (AHA's) Scientific Sessions 2012 in Los Angeles (4 November, 2012). Although stents may be cheaper and appear initially to be a better option, over the long term, bypass surgery patients in a trial had fewer heard attacks and were less likely to die prematurely, the investigators explained. Senior author, Elizabeth A Magnuson, said "Our results demonstrate that bypass surgery is not only beneficial from a clinical standpoint, but also economically attractive from the perspective of the US healthcare system. The economic data are important because of the large number of people with diabetes who are in need of procedures to unblock clogged arteries." The findings confirm the American Heart Associations recommendations which have been in place since the 1990s that diabetes patients with one clogged heart artery should receive bypass surgery.

How is diabetes managed? Planning your food consumption

Three things will have a major impact on your blood glucose and blood lipids (cholesterol, triglycerides) levels

What you eat How much you eat When you eat By selecting the right types of foods, as well as appropriate quantities you can significantly improve your ability to control your blood glucose and blood lipids.

What does healthy eating mean?

Healthy eating most certainly does not mean you will go hungry and have to spend much of your life desperately trying to resist temptation. You can still consume the food you like. All it means is that you will have to be much more aware of how much carbohydrate, fat and protein you consume each time you eat. You just have to get the balance right.

Carbohydrates
Carbohydrates are most abundantly found in fruit, vegetables, yoghurt, sweets, pasta and bread. Our body needs carbohydrates; we cannot live without them. When consumed, our bodies turn the carbohydrate into blood glucose - glucose is needed by our cells for energy and growth. If you consume the same amount of carbohydrates each time you eat - especially if those times are at the same time each day - you will be well on your way towards controlling your blood glucose. It is important that you do not skip meals, no matter what your blood glucose readings indicate. All you will achieve by skipping meals is a more aggressive fluctuation in your blood glucose levels - something you want to try to avoid. If your consumption of glucose can follow a regular pattern, it will be easier for you to balance food with your medicine(s) and physical activity with optimum blood glucose control.

Variety and moderation

A varied and moderated diet is ideal if you want to enjoy good health. Your carbohydrate intake should consist of a variety of grains, fruits and vegetables. They have plenty of fiber - fiber helps control blood glucose. Remember that brown rice has more fiber than white rice; whole-grain breads have the most fiber. If you are cooking or baking, opt for whole-wheat or whole grain flours. Include pulses, such as beans; they are a great source of fiber. Dark green leafy vegetables and dark yellow ones have a slower release of carbohydrates than most other vegetables.

Carb, protein and fat mix

According to the Mayo Clinic, your daily intake of calories should consist of:

Carbohydrates 45% to 65%

Proteins 15% to 20% Fats 20% to 35% If you adhere to your meal plan for portion sizes and eating times you should eat the same mix of carbohydrates, proteins and fats each day. Your blood sugar control will be ideal, as will your weight. The more you vary from your food plan, the Mayo Clinic informs, the more your blood glucose will fluctuate.

The rewards will be worth it

The ideal eating pattern for a person with diabetes is not really any different from what a non-diabetic person would do if he/she aimed for optimum health and fitness. However, the diabetes patient has the added incentive of trying to prevent complications from developing, such as cardiovascular disease, kidney problems, vision problems and leg and feet sores. Foods on offer for a diabetes patient are extensive and varied. You will be able to plan a wide range of tasty and interesting meals.

The food pyramid

When you talk to your health care professional, diabetes educator or dietician, they will probably mention the Food Pyramid. At the base there are foods rich in carbohydrates, such as grains, then there are fruit and vegetables. Above are meat, fish, milk and cheese; which are rich in protein. At the top are the fatty foods. Almost all diabetes and medical associations say that you should eat more from the groups at the bottom of the pyramid, and less from those at the top. It is vital that you talk to an expert about your eating plan. It needs to be tailored according to your weight, age, which medications you are taking and how physically active you are (and, if so, when during the day you are likely to be the most active).

Glycemic index
Not all carbohydrates are the same. The Glycemic Index (GI) describes what effect certain foods can have on our blood glucose levels. A high GI tends to cause more blood glucose fluctuations than a low one. Ask your dietician. - Information on the Glycemic Index from the Canadian Diabetes Association

Diabetes Diet and Food Tips

Eating to Prevent, Control and Reverse Diabetes

Diabetes is on the rise, yet most cases are preventable with healthy lifestyle changes. Some can even be reversed. Taking steps to prevent and control diabetes doesnt mean living in deprivation. While eating right is important, you dont have to give up sweets entirely or resign yourself to a lifetime of bland health food. With these tips, you can still enjoy your favorite foods and take pleasure from your meals without feeling hungry or deprived.

Taking control of diabetes

Have you recently been diagnosed with diabetes or prediabetes? Or has your doctor warned you that youre at risk? It can be scary to hear that your healths on the line, especially if you feel helpless to do anything about it. Heres a scenario that may sound familiar: your doctors telling you how important it is to lose weight and transform your eating habits, but youre already discouraged. After all, youve tried dieting in the past without success. And counting calories, measuring portion sizes, and following complicated food charts sounds like way too much work.

Small changes equal big results

Whether youre trying to prevent or control diabetes, there is some good news. You can make a big difference with healthy lifestyle changes. The most important thing you can do for your health is to lose weightand you dont have to lose all your extra pounds to reap the benefits. Experts say that losing just 5% to 10% of your total weight can help you lower your blood sugar considerably, as well as lower your bl ood pressure and cholesterol levels. Its not too late to make a positive change, even if youve already developed diabetes. The bottom line is that you have more control over your health than you think.

Not all body fat is created equal

The biggest risk factor for developing diabetes is being overweight, but not all body fat is created equal. Your risk is higher if you tend to carry your weight around your abdomenthe so-called spare tireas opposed to your hips and thighs. So why are apple shaped people more at risk than pears? Pears store most of their fat close below the skin. Apples store their weight around their middle, much of it deep within the belly surrounding their abdominal organs and liver. This type of deep fat is closely linked to insulin resistance and diabetes. In fact, many studies show that waist size is a better predictor of diabetes risk than BMI (body mass index). You are at an increased risk of developing diabetes if you are:

A woman with a waist circumference of 35 inches or more A man with a waist circumference of 40 inches or more

To measure your waist circumference, place a tape measure around your bare abdomen just above your hip bone. Be sure that the tape is snug (but does not compress your skin) and that it is parallel to the floor. Relax, exhale, and measure your waist.

The dangers of "sugar belly"

Calories obtained from fructose (found in sugary beverages such as soda, energy and sports drinks, coffee drinks, and processed foods like doughnuts, muffins, cereal, candy and granola bars) are more likely to turn you into an "apple" by adding weight around your abdomen. Cutting back on sugary foods can mean a slimmer waistline as well as a lower risk of diabetes.

What you need to know about diabetes and diet

Eating right is vital if youre trying to prevent or control diabetes. While exercise is also important, what you eat has the biggest impact when it comes to weight loss. But what does eating right for diabetes mean? You may be surprised to hear that your nutritional needs are virtually the same everyone else: no special foods or complicated diets are necessary. A diabetes diet is simply a healthy eating plan that is high in nutrients, low in fat, and moderate in calories. It is a healthy diet for anyone! The only difference is that you need to pay more attention to some of your food choicesmost notably the carbohydrates you eat.

Myths and facts about diabetes and diet

MYTH: You must avoid sugar at all costs. Fact: The good news is that you can enjoy your favorite treats as long as you plan properly. Dessert doesnt have to be off limits, as long as its a part of a healthy meal plan or combined with exercise. MYTH: A high-protein diet is best. Fact: Studies have shown that eating too much protein, especially animal protein, may actually cause insulin resistance, a key factor in diabetes. A healthy diet includes protein, carbohydrates, and fats. Our bodies need all three to function properly. The key is a balanced diet. MYTH: You have to cut way down on carbs. Fact: Again, the key is to eat a balanced diet. The serving size and the type of carbohydrates you eat are especially important. Focus on whole grain carbs since they are a good source of fiber and they are digested slowly, keeping blood sugar levels more even. MYTH: Youll no longer be able to eat normally. You need special diabetic meals. Fact: The principles of healthy eating are the samewhether or not youre trying to prevent or control diabetes. Expensive diabetic foods generally offer no special benefit. You can easily eat with your family and friends if you eat in moderation.

Diabetes and diet tip 1: Choose high-fiber, slow-release carbs

Carbohydrates have a big impact on your blood sugar levelsmore so than fats and proteinsbut you dont have to avoid them. You just need to be smart about what types of carbs you eat. In general, its best to limit highly refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, and snack foods. Focus instead on high-fiber complex carbohydratesalso known as slow-release carbs. Slow-release carbs help keep blood sugar levels even because they are digested more slowly, thus preventing your body from producing too much insulin. They also provide lasting energy and help you stay full longer.

Choosing carbs that are packed with fiber (and dont spike your blood sugar) Instead of White rice White potatoes (including fries and mashed potatoes) Regular pasta White bread Sugary breakfast cereal Try these high-fiber options Brown rice or wild rice Sweet potatoes, yams, winter squash, cauliflower mash Whole-wheat pasta Whole-wheat or whole-grain bread High-fiber breakfast cereal (Raisin Bran, etc.)

Choosing carbs that are packed with fiber (and dont spike your blood sugar) Instant oatmeal Croissant or pastry Steel-cut oats or rolled oats Bran muffin

Making the glycemic index easy

What foods are slow-release? Several tools have been designed to help answer this question. The glycemic index (GI) tells you how quickly a food turns into sugar in your system. Glycemic load, a newer term, looks at both the glycemic index and the amount of carbohydrate in a food, giving you a more accurate idea of how a food may affect your blood sugar level. High GI foods spike your blood sugar rapidly, while low GI foods have the least effect. You can find glycemic index and glycemic load tables online, but you dont have to rely on food charts in order to make smart choices. Australian chef Michael Moore has come up with an easier way to regulate the carbs you eat. He classifies foods into three broad categories: fire, water, and coal. The harder your body needs to work to break food down, the better.

Fire foods have a high GI, and are low in fiber and protein. They include white foods (white rice, white pasta, white bread, potatoes, most baked goods), sweets, chips, and many processed foods. They should be limited in your diet. Water foods are free foodsmeaning you can eat as many as you like. They include all vegetables and most types of fruit (fruit juice, dried fruit, and canned fruit packed in syrup spike blood sugar quickly and are not considered water foods). Coal foods have a low GI and are high in fiber and protein. They include nuts and seeds, lean meats, seafood, whole grains, and beans. They also include white food replacements such as brown rice, whole -wheat bread, and whole-wheat pasta. Eat a lot of non-starchy vegetables, beans, and fruits such as apples, pears, peaches, and berries. Even tropical fruits like bananas, mangoes, and papayas tend to have a lower glycemic index than typical desserts. Eat grains in the least-processed state possible: unbroken, such as whole-kernel bread, brown rice, and whole barley, millet, and wheat berries; or traditionally processed, such as stone-ground bread, steel-cut oats, and natural granola or muesli breakfast cereals. Limit white potatoes and refined grain products such as white breads and white pasta to small side dishes. Limit concentrated sweetsincluding high-calorie foods with a low glycemic index, such as ice cream to occasional treats. Reduce fruit juice to no more than one cup a day. Completely eliminate sugar-sweetened drinks. Eat a healthful type of protein at most meals, such as beans, fish, or skinless chicken. Choose foods with healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados. Limit saturated fats from dairy and other animal products. Completely eliminate partially hydrogenated fats (trans fats), which are in fast food and many packaged foods. Have three meals and one or two snacks each day, and dont skip breakfast. Eat slowly and stop when full.

8 principles of low-glycemic eating

1. 2.

3. 4. 5. 6.

7. 8.

Adapted from Ending the Food Fight, by David Ludwig with Suzanne Rostler (Houghton Mifflin, 2008).

Diabetes and diet tip 2: Be smart about sweets

Eating for diabetes doesnt mean eliminating sugar. If you have diabetes, you can still enjoy a small serving of your favorite dessert now and then. The key is moderation. But maybe you have a sweet tooth and the thought of cutting back on sweets sounds almost as bad as cutting them out altogether. The good news is that cravings do go away and preferences change. As your eating habits become healthier, foods that you used to love may seem too rich or too sweet, and you may find yourself craving healthier options.

How to include sweets in a diabetes-friendly diet

Hold the bread (or rice or pasta) if you want dessert. Eating sweets at a meal adds extra carbohydrates. Because of this it is best to cut back on the other carb-containing foods at the same meal. Add some healthy fat to your dessert. It may seem counterintuitive to pass over the low-fat or fat-free desserts in favor of their higher-fat counterparts. But fat slows down the digestive process, meaning blood sugar

levels dont spike as quickly. That doesnt mean, however, that you should reach for the donuts. Think healthy fats, such as peanut butter, ricotta cheese, yogurt, or some nuts. Eat sweets with a meal, rather than as a stand-alone snack. When eaten on their own, sweets and desserts cause your blood sugar to spike. But if you eat them along with other healthy foods as part of your meal, your blood sugar wont rise as rapidly. When you eat dessert, truly savor each bite. How many times have you mindlessly eaten your way through a bag of cookies or a huge piece of cake. Can you really say that you enjoyed each bite? Make your indulgence count by eating slowly and paying attention to the flavors and textures. Youll enjoy it more, plus youre less likely to overeat.

Tricks for cutting down on sugar

Reduce how much soft drinks, soda and juice you drink. A recint study found that for each 12 oz. serving of a sugar sweetened beverage you drink a day, your risk for diabetes increases by about 15 percent. If you miss your carbonation kick, try sparkling water with a twist of lemon or lime or a splash of fruit juice. Reduce the amount of creamers and sweeteners you add to tea and coffee drinks. Reduce the amount of sugar in recipes by to . If a recipe calls for 1 cup of sugar, for example, use or cup instead. You can also boost sweetness with cinnamon, nutmeg, or vanilla extract. Find healthy ways to satisfy your sweet tooth. Instead of ice cream, blend up frozen bananas for a creamy, frozen treat. Or enjoy a small chunk of dark chocolate, rather than your usual milk chocolate bar. Start with half of the dessert you normally eat, and replace the other half with fruit.

Proceed with caution when it comes to alcohol

Its easy to underestimate the amount of calories and carbs in alcoholic drinks, including beer and wine. And cocktails mixed with soda and juice can be loaded with sugar. If youre going to drink, do so in moderation (no more than 1 drink per day for women; 2 for men), choose calorie-free drink mixers, and drink only with food. If youre diabetic, always monitor your blood glucose, as alcohol can interfere with diabetes medication and insulin.

Diabetes and your diet tip 3: Choose fats wisely

Fats can be either helpful or harmful in your diet. People with diabetes are at higher risk for heart disease, so it is even more important to be smart about fats. Some fats are unhealthy and others have enormous health benefits. But all fats are high in calories, so you should always watch your portion sizes.

Unhealthy fats The two most damaging fats are saturated fats and trans fats. Saturated fats are found mainly in animal products such as red meat, whole milk dairy products, and eggs. Trans fats, also called partially hydrogenated oils, are created by adding hydrogen to liquid vegetable oils to make them more solid and less likely to spoilwhich is very good for food manufacturers, and very bad for you. Healthy fats The best fats are unsaturated fats, which come from plant and fish sources and are liquid at room temperature. Primary sources include olive oil, canola oil, nuts, and avocados. Also focus on omega-3 fatty acids, which fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flaxseeds. Cook with olive oil instead of butter or vegetable oil. Trim any visible fat off of meat before cooking and remove the skin before cooking chicken and turkey. Instead of chips or crackers, try snacking on nuts or seeds. Add them to your morning cereal or have a little handful for a filling snack. Nut butters are also very satisfying and full of healthy fats. Instead of frying, choose to grill, broil, bake, or stir-fry. Serve fish 2 or 3 times week instead of red meat. Add avocado to your sandwiches instead of cheese. This will keep the creamy texture, but improve the health factor. When baking, use canola oil or applesauce instead of shortening or butter. Rather than using heavy cream, make your soups creamy by adding low-fat milk thickened with flour, pureed potatoes, or reduced-fat sour cream.

Ways to reduce unhealthy fats and add healthy fats:

Diabetes and diet tip 4: Eat regularly and keep a food diary
If youre overweight, you may be encouraged to note that you only have to lose 7% of your body weight to cut your risk of diabetes in half. And you dont have to obsessively count calories or starve yourself to do it. When it comes to successful weight loss, research shows that the two most helpful strategies involve following a regular eating schedule and recording what you eat.

Eat at regularly set times

Your body is better able to regulate blood sugar levelsand your weightwhen you maintain a regular meal schedule. Aim for moderate and consistent portion sizes for each meal or snack.

Dont skip breakfast. Start your day off with a good breakfast. Eating breakfast every day will help you have energy as well as steady blood sugar levels. Eat regular small mealsup to 6 per day. People tend to eat larger portions when they are overly hungry, so eating regularly will help you keep your portions in check. Keep calorie intake the same. Regulating the amount of calories you eat on a day-to-day basis has an impact on the regularity of your blood sugar levels. Try to eat roughly the same amount of calories every day, rather than overeating one day or at one meal, and then skimping on the next.

Keep a food diary

Research shows that people who keep a food diary are more likely to lose weight and keep it off. In fact, a recent study found that people who kept a food diary lost twice as much weight as those who didnt. Why does writing down what you eat and drink help you drop pounds? For one, it helps you identify problem areas such as your afternoon snack or your morning lattewhere youre getting a lot more calories than you realized. It also increases your awareness of what, why, and how much youre eating, which helps you cut back on mindless snacking and emotional eating.

What about exercise?

When it comes to preventing, controlling, or reversing diabetes, you cant afford to overlook exercise.Exercise can help your weight loss efforts, and is especially important in maintaining weight loss. There is also evidence that regular exercise can improve your insulin sensitivity even if you dont lose weight. You dont have to become a gym rat or adopt a grueling fitness regimen. One of the easiest ways is to start walking for 30 minutes five or more times a week. You can also try swimming, biking, or any other moderate-intensity activities meaning you work up a light sweat and start to breathe harder. Even house and yard work counts.

Diabetologist, Dr. Sanjiv Bhambani with Moolchand Medcity suggests "A diabetes diet should be high on fiber, must contain milk without cream, buttermilk, fresh seasonal fruits, green vegetables, etc." But remember to consume these components in moderation. Diabetes diet for Indians should have the ratio of 60:20:20 for carbs, fats and proteins, the doctor explains, "Per day calorie intake should be between 1,500-1,800 calories with a proportion of 60:20:20 between carbohydrates, fats and proteins, respectively." He adds that a diabetes diet should "have at least two seasonal fruits and three vegetables in a diet plan." As for dry fruits, the fructose can spike up your sugar level. The doctor shares his recipe for diabetes diet for Indians: - One teaspoon of methi seeds soaked overnight in 100 ml of water is very effective in controlling diabetes. - Drink tomato juice with salt and pepper ever morning on an empty stomach. - Intake of 6 almonds (soaked overnight) is also helpful in keeping a check on diabetes. We move now to nutritionist Rekha Sharma to look for elaborate answers to diabetes diet for Indians. Rekha Sharma, President and Director of Indian Dietetic Association shares some major diabetes diet pointers that one should follow at home or at a restaurant. Expert speak: Diabetes diet for Indians Whole grains, oats, channa atta, millets and other high fiber foods should be included in the meals. If one feels like consuming pasta or noodles, it should always be accompanied with vegetable /sprouts. Milk is the right combination of carbohydrates and proteins and helps control blood sugar levels. Two servings of milk in a daily diet is a good option. High fiber vegetables such as peas, beans, broccoli and spinach /leafy vegetables should be included in one's diet. Also, pulses with husk and sprouts are a healthy option and should form a part of the diet.

Pulses are important in the diet as their effect on blood glucose is less than that of most other carbohydrate containing foods. Vegetables rich in fiber help lowering down the blood sugar levels and thus are healthy. Good fats such as Omega 3 and MUFA should be consumed as they are good for the body. Natural sources for these are canola oil, flax seed oil, fatty fish and nuts. These are also low in cholesterol and are trans fat free. Fruits high in fiber such as papaya, apple, orange, pear and guava should be consumed. Mangoes, bananas, and grapes contain high sugar; therefore these fruits should be consumed lesser than the others.

Part I: Diabetics, heed these diet tips! Diabetes mellitus is a chronic metabolic disorder in which the body fails to convert sugars, starches and other foods into energy. Many of the foods you eat are normally converted into a type of sugar called glucose during digestion. The bloodstream then carries glucose through the body. The hormone, insulin, then turns glucose into quick energy or is stored for futher use. In diabetic people, the body either does not make enough insulin or it cannot use the insulin correctly. This is why too much glucose builds in the bloodstream. There are two major types of diabetes: 1. Type 1 This is popularly known as Juvenile Onset Diabetes. Here, the body produces little or no insulin. It occurs most often in childhood or in the teens and could be inherited. People with this type of diabetes need daily injections of insulin. They must balance their daily intake of food and activites carefully with their insulin shots to stay alive. 2. Type 2 Also known as Adult Onset Diabetes, this occurs around 35 to 40 years. The more common of the two types, it accounts for about 80 per cent of the diabetics. Here, though the pancreas produce adequate insulin, body cells show reduced sensitivity towards it. Type 2 diabetes is usually triggered by obesity. The best way to fight it is by weight loss, exercise and dietary control. Sometimes, oral medication or insulin injections are also needed. ~ Symptoms of diabetes Here are a few:

Extreme thirst and hunger Frequent urination Sores or bruises that heal slowly Dry, itchy skin

Unexplained weight loss Unusual tiredness or drowsiness Tingling or numbness in the hands or feet

Whether Type 1 or 2, diabetics need a balance of diet and exercise. Here are some foods you can eat, and some foods you must avoid! Foods you must avoid! i. Salt Salt is the greatest culprit for diabetics. You get enough salt from vegetables in inorganic form, so reduce the intake of inorganic salt. ii. Sugar Sucrose, a table sugar, provides nothing but calories and carbohydrates. Also, you need calcium to digest sucrose. Insufficient sucrose intake might lead to calcium being leached off the bones. Substitute sucrose with natural sugar, like honey, jaggery (gur), etc. iii. Fat Excessive fat intake is definitely not a good habit. Try and exclude fried items from your diet totally. But, remember, you must have a small quantity of oil to absorb fat-soluble vitamins, especially vitamin E. iv. For non-vegetarians Try and stop the intake of red meat completely. Try to go in for a vegetarian diet. If you cannot, decrease the consumption of eggs and poultry. You can, however, eat lean fish two to three times a week. v. Whole milk and products Try to switch to low fat milk and its products like yogurt (curd). Replace high fat cheese with low fat cottage cheese. vi. Tea and coffee Do not have than two cups of the conventional tea or decaffeinated coffee every day. Try to switch to herbal teas. vii. White flour and its products Replace these with whole grains, wholewheat or soya breads and unpolished rice.

viii. Foods with a high glycemic index Avoid white rice, potatoes, carrots, breads and banana -- they increase the blood-sugar levels. Special food for diabetics i. Bitter gourd (karela) This vegetable contains a high dosage of 'plant insulin'. It lowers the blood-sugar levels effectively. Have the juice of three to four karelas early morning on an empty stomach. As a vegetable, too, it can be taken on a regular basis. Powder the seeds of karela (measuring 1 teaspoon), mix with water and drink it. ii. Fenugreek (methi) It is the most common food used to control diabetes. Gulp a teaspoonful of these seeds with a glass of water daily. Soak the seeds overnight. Have the water in which the seeds were soaked. You can make a chutney with methi seeds. You can also eat them sprouted, dried and powdered, or mix them in wheat flour to make chapattis. iii. Indian blackberry (jamun) This fruit is very effective in preventing and controlling diabetes. Powder the stone of the fruit and eat it -- it contains glucoside, which prevents the conversion of starch into sugars. iv. Garlic This is used to lower blood-sugar levels. Garlic is rich in potassium and replaces the potassium which gets lost in urine. It also contains zinc and sulphur, which are components of insulin. Take about three to four flakes of freshly crushed garlic daily. v. Onion Because of its diuretic and digestive properties, onion works against diabetes. Raw onion is more useful. vi. Flaxseed This is the richest source of Omega 3 fatty acids.

It helps control diabetes because it maintains the sensitivity of the cell membrane, facilitates insulin, and thereby the uptake of glucose by the cells. vii. Fibre Soluble fibre, found in apples, kidney beans, oatmeal, soyabean, etc, help control diabetes. These aid slow digestion and absorption of nutrients, resulting in a slow and steady release of glucose. They soak up excess bile acids found in the intestinal tract, the same acids that are converted to blood cholesterol. They also help empty the stomach and trigger satiety that can help Type 2 diabetics to achieve weight loss goals. viii. Cinnamon solution Water extracts of cinnamon have been found to promote glucose metabolism and reduce cholesterol. You can boil cinnamon sticks in water and drink this water. ix. Antioxidants Diabetes is often associated with conditions like heart disease, diabetic retinopathy, immune deficiency and kidney disease. Many are caused by free radical damage. Therefore, make sure you include antioxidants, especially vitamin C (lemons), E, selenium, zinc and chromium (Brewer's yeast), in your diet, as they have been shown to control blood sugar levels.

~ Healthy tips for diabetics 1. Eat food at fixed hours. 2. Do not eat immediately after a workout. 3. Do not overeat.

Diet dos and don'ts for diabetics!

4. If you are on insulin, make sure you have three proper meals with light snacks in between. 5. Do not eat fast; masticate and munch your food well before you swallow. 6. Drink a lot of water that will help flush the toxins off your system. 7. Make sure the gaps between your meals are short. 8. Avoid fried foods and sweetmeats.

9. Include fresh vegetable salad in every meal. 10. Have at least 20 to 25 grams of raw onion daily. 11. Add wheat bran to your wheatflour (50% wheatflour + 50% wheat bran). This helps increase fibre in your diet. You can also make diabetic flour by mixing wholegrain cereal, soyabean, blackgram (urad dal), jowar, bajra, Bengal gram (kala chana), wheat bran and barley. You can also add flaxseed and methi seeds into the wheatflour. 12. Include sprouts in the diet. Sprouts are a fountain of nutrients. ~ Now for that X-rated word: Exercise! Exercise is a good way to increase calorie deficit. But it is very important to take certain precautions before you exercise, especially if you lead a sedentary lifestyle. It is very important that you check with your doctor first before starting on an exercise regime. Start an exercise routine that you will enjoy and stick to. Walking is the simplest aerobic activity. Cycling is a good form of exercise, too. If you want to go in for other exercise regimes, please consult your doctor and fitness trainer. Ensure you take the following precautions: 1. Check your blood-glucose levels before and after exercising. 2. Avoid exercising when you have just taken your insulin shot. 3. Avoid hot tubs and saunas immediately after exercise. 4. Always carry a carbohydrate snack, candies /sweets or juice. 5. Drink enough fluids to keep your body well hydrated. 6. Avoid alcohol consumption before and immediately after exercise. 7. Wear appropriate shoes and socks while exercising. 8. Always have an exercise partner.

7 Principles for Good Diabetes Care

These principles, or steps, will help you manage your diabetes and live a long and active life. Every person who has diabetes has different needs. Talk to your health care team about a treatment plan that is best for you. Diabetes affects almost every part of the body and good diabetes care requires a team of health care providers. They include doctors, diabetes educators, nurses, dietitians, pharmacists, mental health workers, eye specialists, foot specialists, dentists, and social workers. Print out and take this information with you when you visit your doctor or other members of your team to talk about your treatment plan. It Is Important to Control Diabetes Taking good care of diabetes can lower the chances of getting: heart disease

stroke eye disease that can lead to a loss of vision or even blindness nerve damage that may cause a loss of feeling or pain in the hands, feet, legs, or other parts of the body and lead to problems such as lower limb amputation or erectile dysfunction kidney failure gum disease and loss of teeth to help you take action to control your diabetes.

As you read through this information, look for things with a

Principle 1: Learn as Much as You Can About Diabetes

The more you know about diabetes, the better you can work with your health care team to manage your disease and reduce your risk for problems. You should know what type of diabetes you have. If you do not know, ask your doctor whether you have type 1 or type 2 diabetes. Type 1 diabetes. People who have this type of diabetes need to takeinsulin every day. This type of diabetes used to be called juvenile diabetes. Type 2 diabetes. Diet and daily physical activity help to control type 2 diabetes. Most people also need to take diabetes pills or insulin. Type 2 diabetes is very common and used to be called adult onset diabetes. Diabetes is always a serious disease. Terms that suggest that diabetes is not serious, such as "a touch of diabetes," "mild diabetes," and "sugar's a little high," are not correct and should no longer be used. Many People Who Have Diabetes Do Not Know It Finding and treating diabetes early can prevent health problems later on. Many people with type 2 diabetes have no symptoms and do not know they have diabetes. Some people are at higher risk for diabetes than others. People at high risk include those who: are older than 45

are overweight have a close family member such as a parent, a brother, or a sister who has or had diabetes had diabetes during pregnancy had a baby that weight more than 9 pounds

are African American, Hispanic or Latino, Asian American or Pacific Islander, or Native American have high blood pressure have high cholesterol or other abnormal blood fats are inactive

Ask your doctor if you have type 1 or type 2 diabetes. If you know someone who has any of the risk factors for diabetes, suggest they talk to their doctor about getting tested.

Principle 2: Get Regular Care for Your Diabetes

If you have diabetes, it is important to:

see your health care team regularly make sure your treatment plan is working. If it is not, ask your health care team to help you change it ask your family, friends, and co-workers for help and support when you need it

Work with your health care team to get the best help to control your diabetes. Ask your health care team how often you need to see them for check-ups. Write down the date and time for your next visit: Date of my next visit is:____________________

Ask your doctor, clinic or office staff, or pharmacist to help you find resources if you have problems paying for food, medicines, and medical supplies. You should be able to get Medicare or other insurance to help you pay for diabetes supplies. Make a list of questions and concerns you want to talk about at your next visit to your health care team.

Principle 3: Learn How to Control Your Diabetes

Diabetes affects many parts of the body. To stay healthy, it is important to know how to eat the right foods, how to be physically active, and how to look after yourself. Using the following checklist will help you learn how to control your diabetes.

How Active Are You in Controlling Your Diabetes? Look at the list below. Check all of the statements that describe you. I talk to my health care team about:

my special needs to help control my diabetes ways to improve my ABC numbers: A1C,* Blood pressure, and Cholesterol aspirin therapy to prevent heart problems getting regular physical activity quitting smoking, if needed

I learn from my doctor, diabetes educator, podiatrist, pharmacist, or dietitian how to

follow a meal plan to control my diabetes check my feet every day take my medicines as prescribed check my blood glucose levels

*A1C (pronounced A-one-C) is a measure of your average blood glucose over the last three months. You should get this test at least twice a year.

I visit my doctor at least twice a year eye doctor each year and report any changes in vision dentist twice a year specialists as my doctor advises

Go over any items you did not check with your health care team. Learning how to control your diabetes can help you stay healthy. Ask your health care team to help you learn more about diabetes and how to control it.

Principle 4: Take Care of Your Diabetes ABC's

A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), Blood pressure, and Cholesterol. You can do this in many ways.

Follow a meal plan that was made for you. Be active every day. Take your medicine as prescribed. Before taking any non-prescription medicines, vitamins, or herbal products, ask your pharmacist how they may affect your diabetes or prescription medicines. Test your blood glucose on a routine basis.

Talk to your health care team about the best ways to control your A1C, blood pressure, and cholesterol and know your target numbers. Get involved in setting goals and making a treatment plan for your diabetes.

Principle 5: Monitor Your Diabetes ABCs

To reduce your risk for diabetes problems such as blindness, kidney disease, losing a foot or leg, and early death from heart attack or stroke, you and your health care team need to monitor the diabetes ABCs: A1C, Blood pressure, and Cholesterol. Talk to your health care team about how to reach your target numbers. Get the A1C Test The A1C test is usually done by your doctor. It measures how well your blood glucose has been controlled over the last three months. This test is very important because it tells how well you are taking care of your diabetes over the long term. It should be done at least twice a year.

The target A1C for most people with diabetes is less than 7.

Ask your health care team what your A1C is and keep a dated record of the results. Discuss your A1C target with your health care team and write it down. Discuss what you need to do to reach your target. Check Your Own Blood Glucose You may need to check your own blood glucose on a regular basis to help control your diabetes. It will tell you what your blood glucose is at the time you test. Keep a record of your results and show it to your health care team. Some meters and test strips report blood glucose results as plasma glucose values which are 10 to 15 percent higher than whole blood glucose values. Ask your doctor or pharmacist whether your meter and strips provide whole blood or plasma results.

The target glucose range for most people using whole blood is 80 to 120 before meals and 100 to 140 at bedtime. The target glucose range for most people using plasma is 90 to 130 before meals and 110 to 150 at bedtime. Talk to your health care team about the best ways to check your own blood glucose.

Ask your health care team what your blood glucose targets are before meals, after meals, and at bedtime and write them down. Ask what to do if your blood glucose is often higher or lower than it should be. Ask how to get the supplies you need to do the tests. Most insurance companies, including Medicare, now pay for diabetes supplies. Know Your Blood Pressure High blood pressure makes your heart work too hard. This leads to strokes and other problems such as kidney disease. Your blood pressure should be checked at every visit. You may need to check it yourself.

The target blood pressure for most people with diabetes is less than 130/80.

Ask your health care team what your blood pressure is and keep a dated record of the results. Discuss your blood pressure target with your health care team and write it down. Discuss what you need to do to reach your target. Ask if you need to test your blood pressure yourself. If so, find out how, when, and what supplies you need. Know Your Cholesterol LDL is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year.

The target LDL cholesterol for most people with diabetes is less than 100.

Discuss your LDL cholesterol target with your health care team and keep a record of the results. Discuss what you need to do to reach your target. Keep a Record of Your Results Keeping a record of your results helps you reach your targets. It helps you know when you and your health care team need to take extra action. Use the record card to keep track of your ABC numbers.

Principle 6: Prevent Long-Term Diabetes Problems

People with diabetes must control their blood glucose, blood pressure, and cholesterol to prevent the problems of diabetes: heart attack, stroke, eye and kidney problems, nerve damage, impotence, foot or leg amputation, gum disease, and loss of teeth. Here are the key self-care activities to help you manage your diabetes and live a long and healthy life.

Daily Follow your diabetes meal plan with the correct portion sizes. Eat a variety of foods that are high in fiber and low in fat and salt.

Be active every day. Take medicines as prescribed. If you have questions, talk to your pharmacist or doctor about your medicines. Look at your feet and wash and dry them well each day. Tell your podiatrist or health care team about any changes with your feet. Check your mouth daily for gum or tooth problems. Call your dentist right away if you have problems with your teeth or gums.

As Needed Test your blood glucose as prescribed by your doctor.

Check your blood pressure as prescribed by your doctor. Reach and stay at a healthy weight. Stop smoking. Make sure your eyeglasses or contact lens prescription is up to date so you can see clearly. Report any changes in your vision to your health care team. Work with your health care team to prevent diabetes problems.

Principle 7: Get Checked for Long-Term Problems and Treat Them

See your health care team regularly to check for problems that diabetes can cause. Regular check-ups help to prevent problems or find them early when they can be treated and managed well. Along with the checks of your A1C, blood pressure, and cholesterol (see Principle 5), here are some tests that you will need:

Triglycerides (a type of blood fat) Dilated eye exam to check for eye problems Foot check Complete foot exam to check for circulation, loss of feeling, sores, or changes in shape Urine test to check for kidney problems Dental exams to prevent gum disease and loss of teeth

Get yearly Get yearly Get every visit Get yearly Get yearly