Diabetes: November 2014

Wednesday, 26 November 2014

Tuesday, 25 November 2014

PREVENTION

Tip 1: Get more physical activity

30 minutes moderate intensity regularly most days. There are many benefits to regular physical activity. Exercise can help you:

· Decreased insulin requirements

· Weight reduction

· Lipid control

· Blood pressure control

· Lose weight

· Lower your blood sugar

· Boost your sensitivity to insulin — which helps keep your blood sugar within a normal range.

Research shows that both aerobic exercise and resistance training can help control diabetes, but the greater benefit comes from a fitness program that includes both.

Tip 2: Get plenty of fiber

It's rough, it's tough and it may help you:

· Reduce your risk of diabetes by improving your blood sugar control

· Lower your risk of heart disease

· Promote weight loss by helping you feel full

Foods high in fiber include fruits, vegetables, beans, whole grains, nuts and seeds.

Tip 3: Go for whole grains

Although it's not clear why, whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains. Many foods made from whole grains come ready to eat, including various breads, pasta products and many cereals. Look for the word "whole" on the package and among the first few items in the ingredient list.

Tip 4: Lose extra weight

If you are overweight, diabetes prevention may hinge on weight loss. Every pound you lose can improve your health, and you may be surprised by how much. Participants in one large study who lost a modest amount of weight around 7% of initial body weight and exercised regularly reduced the risk of developing diabetes by almost 60%.

Tip 5: Skip fad diets and just make healthier choices

Low-carb diets, the glycemic index diet or other fad diets may help you lose weight at first, but their effectiveness at preventing diabetes is not known nor are their long-term effects. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients. Instead, think variety and portion control as part of an overall healthy-eating plan.

Tip 6: When to see your doctor

If you're older than age 45 and your weight is normal, ask your doctor if diabetes testing is appropriate for you. The American Diabetes Association recommends blood glucose screening if:

· You're age 45 or older and overweight

· You're younger than age 45 and overweight with one or more additional risk factors for type 2 diabetes — such as a sedentary lifestyle or a family history of diabetes

Share your concerns about diabetes prevention with your doctor. He or she will applaud your efforts to keep diabetes at bay, and perhaps offer additional suggestions based on your medical history or other factors.

Tip 7: Stop Smoking

A well-established risk factor for many chronic diseases, including diabetes and its complications. As well as other harmful effects, smoking increases abdominal fat accumulation and insulin resistance. All smokers should be encouraged to quit smoking. However, weight gain is common when quitting smoking and therefore dietary advice on avoiding weight gain should also be given (e.g. managing cravings and withdrawal symptoms by using short bouts of physical activity as a stress-relief activity, rather than eating snacks).

Tip 8: Stabilize your sleeping patterns

Both short (<6h) and long (>9h) sleep durations may be associated with a higher risk of developing type 2 diabetes. Sleep deprivation may impair the balance of hormones regulating food intake and energy balance. Long sleep durations may be a sign of sleep-disordered breathing or depression and should be treated appropriately. There is also a close association between obesity and obstructive sleep apnoea syndrome (OSA), the most common form of sleep disordered breathing.

TREATMENT

TYPE 1

Treatment for type 1 diabetes involves taking insulin, which needs to be injected through the skin into the fatty tissue below. The methods of injecting insulin include:

• Syringes

- Insulin pens that use pre-filled cartridges and a fine needle- Jet injectors that use high pressure air to send a spray of insulin
through the skin

- Insulin pumps that dispense insulin through flexible tubing to a
catheter under the skin of the abdomen

• A1C blood test

A periodic test called the A1C blood test estimates glucose levels in your blood over the previous three months. It's used to help identify overall glucose level control and the risk of complications from diabetes, including organ damage.

• Having type 1 diabetes does require significant lifestyle changes that include:

- Frequent testing of your blood sugar levels

- Careful meal planning

- Daily exercise

- Taking insulin and other medication as needed

TYPE 2

There is no cure for diabetes. Type 2 diabetes can, however, be controlled with weight management, nutrition, and exercise. Unfortunately, type 2 diabetes tends to progress, and diabetes medications are often needed.

An A1C test is a blood test that estimates average glucose levels in your blood over the previous three months. Periodic A1C testing may be advised to see how well diet, exercise, and medications are working to control blood sugar and prevent organ damage. The A1C test is typically done a few times a year.

Regular check-up

Dressing procedure for diabetic patient with gangrene

DIAGNOSIS

Blood tests are used to diagnosis diabetes and prediabetes because early in the disease type 2 diabetes may have no symptoms. All diabetes blood tests involve drawing blood at a health care provider’s office or commercial facility and sending the sample to a lab for analysis. Lab analysis of blood is needed to ensure test results are accurate.

**Glucose measuring devices used in a health care provider’s office, such as finger-stick devices, are not accurate enough for diagnosis but may be used as a quick indicator of high blood glucose.

**Testing enables health care providers to find and treat diabetes before complications occur and to find and treat prediabetes, which can delay or prevent type 2 diabetes from developing.

Any one of the following tests can be used for diagnosis:

an A1C test, also called the hemoglobin A1c, HbA1c, or glycohemoglobin test
a fasting plasma glucose (FPG) test
an oral glucose tolerance test (OGTT)

*Not all tests are recommended for diagnosing all types of diabetes. See the individual test descriptions for details.

Another blood test, the random plasma glucose (RPG) test, is sometimes used to diagnose diabetes during a regular health checkup. If the RPG measures 200 micrograms per deciliter or above, and the individual also shows symptoms of diabetes, then a health care provider may diagnose diabetes.

Real life scenario

RPG Test Procedures

Monday, 24 November 2014

CAUSES OF DIABETES

CAUSES

TYPE 1

Type 1 diabetes occurs when the body is unable to produce insulin. Insulin is a hormone that's needed to control the amount of sugar (glucose) in your blood.

The role of insulin

Once a significant number of islet cells are destroyed, you'll produce little or no insulin. Insulin is a hormone that comes from the pancreas, a gland situated behind and below the stomach.

· The pancreas secretes insulin into the bloodstream.

· Insulin circulates, enabling sugar to enter your cells.

· Insulin lowers the amount of sugar in your bloodstream.

· As your blood sugar level drops, so does the secretion of insulin from your pancreas.

The role of glucose

Glucose — a sugar — is a main source of energy for the cells that make up muscles and other tissues.

· Glucose comes from two major sources: food and your liver.

· Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.

· Your liver stores glucose as glycogen.

· When your glucose levels are low, such as when you haven't eaten in a while, the liver converts stored glycogen into glucose to keep your glucose level within a normal range.

In type 1 diabetes, there's no insulin to let glucose into the cells, so sugar builds up in your bloodstream, where it can cause life-threatening complications.

The cause of type 1 diabetes is different from the cause of themore familiar type 2 diabetes. In type 2 diabetes, the islet cells are still functioning, but the body becomes resistant to insulin or the pancreas doesn't produce enough insulin or both.

Type 2

Type 2 diabetes is caused by a combination of factors, including insulin resistance, a condition in which the body’s muscle, fat, and liver cells do not use insulin effectively. This diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin.

Genetic Susceptibility
Obesity and Physical Inactivity
Sleep Habits
Insulin Resistance
Abnormal Glucose Production by the Liver
Metabolic Syndrome
Beta Cell Dysfunction

Risk factors

People who develop type 2 diabetes are more likely to have the following characteristics:

·         age 45 or older

·         overweight or obese

·         physically inactive

·         parent or sibling with diabetes

·         family background that is African American, Alaska Native, American Indian,
Asian American, Hispanic/Latino, or Pacific Islander American

·         history of giving birth to a baby weighing more than 9 pounds

·         history of gestational diabetes

·         high blood pressure—140/90 or above—or being treated for high blood pressure

·         high-density lipoprotein (HDL), or good, cholesterol below 35 milligrams per deciliter (mg/dL), or a triglyceride level above 250 mg/dL

·         polycystic ovary syndrome, also called PCOS

·         prediabetes

·         history of CVD

SIGNS & SYMPTOMS

Signs & symptoms
Individuals can experience different signs and symptoms of diabetes, and sometimes there may be no signs. Some of the signs commonly experienced include: