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Diabetes mellitus is a common disease in the United States. It is estimated that over 16 million Americans are already caught with diabetes, and 5.4 million diabetics are not aware of the existing disease. Diabetes prevalence has increased steadily in the last half of this century and will continue rising among U.S. population. It is believed to be one of the main criterions for deaths in United States, every year. This diabetes information hub projects on the necessary steps and precautions to control and eradicate diabetes, completely.

Diabetes is a metabolic disorder where in human body does not produce or properly uses insulin, a hormone that is required to convert sugar, starches, and other food into energy. Diabetes mellitus is characterized by constant high levels of blood glucose (sugar). Human body has to maintain the blood glucose level at a very narrow range, which is done with insulin and glucagon. The function of glucagon is causing the liver to release glucose from its cells into the blood, for the production of energy.

There are three main types of diabetes:

  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational diabetes

Type 1 and Type 2 diabetes impede a person’s carefree life. When breakdown of glucose is stopped completely, body uses fat and protein for producing the energy. Due to this mechanism symptoms like polydipsia, polyuria, polyphegia, and excessive weightloss can be observed in a diabetic. Desired blood sugar of human body should be between 70 mg/dl -110 mg/dl at fasting state. If blood sugar is less than 70 mg/dl, it is termed as hypoglycemia and if more than 110 mg /dl, it>’s hyperglycemia.

Diabetes is the primary reason for adult blindness, end-stage renal disease (ESRD), gangrene and amputations. Overweight, lack of exercise, family history and stress increase the likelihood of diabetes. When blood sugar level is constantly high it leads to kidney failure, cardiovascular problems and neuropathy. Patients with diabetes are 4 times more likely to have coronary heart disease and stroke. In addition, Gestational diabetes is more dangerous for pregnant women and their fetus.

Though, Diabetes mellitus is not completely curable but, it is controllable to a great extent. So, you need to have thorough diabetes information to manage this it successfully. The control of diabetes mostly depends on the patient and it is his/her responsibility to take care of their diet, exercise and medication. Advances in diabetes research have led to better ways of controlling diabetes and treating its complications. Hence they include:-

  • New improved Insulin and its therapy, (external and implantable insulin pumps) have advanced well to manage elevated blood sugars without any allergic reactions.
  • Oral hypoglycemic drug, controls diabetes type 2.
  • New improved blood glucose monitor (new device for self blood glucose monitoring), and hemoglobin A1c laboratory test to measure blood glucose control during previous 3 months.
  • Effective availability of the treatments for affected body organs due to diabetes.
  • Better ways to manage mother and its fetus health during the gestational diabetes phase.

Symptoms of Diabetes

In both types of diabetes, signs and symptoms are more likely to be similar as the blood sugar is high, either due to less or no production of insulin, or insulin resistance. In any case, if there is inadequate glucose in the cells, it is identifiable through certain signs and symptoms. These symptoms are quickly relieved once the Diabetes is treated and also reduce the chances of developing serious health problems.

Diabetes Type 1:

In type 1, the pancreas stop producing insulin due to autuimmune response or possibly viral attack on pancreas. In absence of insulin, body cells don>’t get the required glucose for producing ATP (Adenosin Triphosphate) units which results into primary symptom in the form of nausea and vomiting. In later stage, which leads to ketoacidosis, the body starts breaking down the muscle tissue and fat for producing energy hence, causing fast weight loss. Dehydration is also usually observed due to electrolyte disturbance. In advanced stages, coma and death is witnessed.

Diabetes Type 2:

  • Increased fatigue : Due to inefficiency of the cell to metabolize glucose, reserve fat of body is metabolized to gain energy. When fat is broken down in the body, it uses more energy as compared to glucose, hence body goes in negative calorie effect, which results in fatigue.
  • Polydipsia : As the concentration of glucose increases in the blood, brain receives signal for diluting it and, in its counteraction we feel thirsty.
  • Polyuria: Increase in urine production is due to excess glucose present in body. Body gets rid of the extra sugar in the blood by excreting it through urine. This leads to dehydration because along with the sugar, a large amount of water is excreted out of the body.
  • Polyphegia : The hormone insulin is also responsible for stimulating hunger. In order to cope up with high sugar levels in blood, body produces insulin which leads to increased hunger.
  • Weight flactuation : Factors like loss of water (polyuria), glucosuria , metabolism of body fat and protein may lead to weight loss. Few cases may show weight gain due to increased appetite.
  • Blurry vision : Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of the eye, which affects its ability to focus, resulting blurry vision.
  • Irritability : It is a sign of high blood sugar because of the inefficient glucose supply to the brain and other body organs, which makes us feel tired and uneasy.
  • Infections : The body gives few signals whenever there is fluctuation in blood sugar (due to suppression of immune system) by frequent skin infections like fungal or bacterial or UTI (urinary tract infection).
  • Poor wound healing : High blood sugar resists the flourishing of WBC, (white blood cell) which are responsible for body immune system. When these cells do not function accordingly, wound healing is not at good pace. Secondly, long standing diabetes leads to thickening of blood vessels which affect proper circulation of blood in different body parts


The precise Etiology of most cases of diabetes is uncertain, although certain contributing factors are as follows:

Type 1 diabetes

Type 1 Diabetes is autoimmune disease that affects 0.3% on average. It is result of destruction of beta cells due to aggressive nature of cells present in the body. Researchers believe that some of the Etiology and Risk factors which may trigger type 1 diabetes may be genetic, poor diet (malnutrition) and environment (virus affecting pancreas). Secondly, in most of the cases, diabetes occurs because there is abnormal secretion of some hormones in blood which act as antagonists to insulin. Example- Adrenocortical hormone, Adrenaline hormone and Thyroid hormone.

Type 2 diabetes

Type 2 Diabetes is also called non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. It occurs when the body produces enough insulin but cannot utilize it effectively. This type of diabetes usually develops in middle age. A general observation says that about 90-95 % of people suffering with diabetes are type 2; about 80 percent are overweight. It is more common among people who are older; obese; have a family history of diabetes; have had gestational diabetes. There are number of risk factors found to be responsible for type 2 diabetes like, the more the Etiology and Risk factors carried by an individual, the higher the risk for developing diabetes.

Following are the Causes of Diabetes

  • Hereditary or Inherited Traits : It is strongly believed that due to some genes which passes from one generation to another, a person can inherit diabetes. It depends upon closeness of blood relationship as mother is diabetic, the risk is 2 to 3%, father is diabetic, the risk is more than the previous case and if both the parents are diabetic, the child has much greater risk for diabetes.
  • Age : Increased age is a factor which gives more possibility than in younger age. This disease may occur at any age, but 80% of cases occur after 50 year, incidences increase with the age factor.
  • Poor Diet (Malnutrition Related Diabetes) : Improper nutrition, low protein and fiber intake, high intake of refined products are the expected reasons for developing diabetes.
  • Obesity and Fat Distribution : Being overweight means increased insulin resistance, that is if body fat is more than 30%, BMI 25+, waist grith 35 inches in women or 40 inches in males.
  • Sedentary Lifestyle : People with sedentary lifestyle are more prone to diabetes, when compared to those who exercise thrice a week, are at low risk of falling prey to diabetes.
  • Stress : Either physical injury or emotional disturbance is frequently blamed as the initial cause of the disease. Any disturbance in Cortiosteroid or ACTH therapy may lead to clinical signs of the disease.
  • Drug Induced: Clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel) and ziprasidone (Geodon) are known to induce this lethal disease.
  • Infection : Some of the strephylococci is suppose to be responsible factor for infection in pancreas.
  • Sex : Diabetes is commonly seen in elderly especially males but, strongly in women and those females with multiple pregnancy or suffering from (PCOS) Polycystic Ovarian Syndrome.
  • Hypertension : It had been reported in many studies that there is direct relation between high systolic pressure and diabetes.
  • Serum lipids and lipoproteins : High triglyceride and cholesterol level in the blood is related to high blood sugars, in some cases it has been studied that risk is involved even with low HDL levels in circulating blood.

Diabetes Complications

Once we have crossed the reversible stage of prediabetes and enter diabetes stage, certain changes start developing in our body. These changes occur due to high blood sugar level with instability in the hormones as well as blood vessels and nerves. When these changes become permanent in the body it develops into serious Diabetes Complications and body indicates these changes by steady symptoms.

Symptoms of the Diabetes Complications

  • Diabetic retinopathy shows symptoms of pain in the eyes and may even result in loss of vision.
  • Renal (kidney) disease shows symptoms of swelling (edema) in the feet and legs. It then passes over total body and as the disease progresses, blood pressure also increases.
  • Tingling, burning, numbness, tightness, shooting or stabbing pain in the hands, feet or other parts of your body, especially at night. Digestive problems also occur if, the nerves controlling internal organs get damaged (autonomic neuropathy).
  • You may have scanty or profuse sweating, difficulty of sensing when your bladder is full, when there is a low blood sugar, increased sexual problems, weakness, dizziness, and fainting.
  • Chest pain (angina) or shortness of breath dizziness or light headache, shoulder or stomach pain, fast heartbeat. You might not show any symptoms until having a heart attack or stroke.

When alarming symptoms given by the body are ignored and the same status is maintained, it starts damaging body organs, such as heart, kidney, eye, feet, and skin. The physiology for each and every affected organ is explained one by one.

See Other Related Diabetes Complications

Diabetic Retinopathy

Diabetic Neuropathy

Diabetes Skin Care

Diabetic Nephropathy

Heart Disease and Stroke

Diabetes and Eye

Diabetes and Foot

Diabetes and Kidney

Diabetes and Pregnancy

Obesity and Diabetes

Gestational Diabetes

Gestational diabetes is a form of diabetes which affects pregnant women. It is believed that the hormones produced during pregnancy reduce a woman's receptivity to insulin, leading to high blood sugar levels. Gestational diabetes affects about 4% of all pregnant women. It is estimated that about 135,000 cases of gestational diabetes arise in the United States each year.

Hormones involved in development of placenta, which helps the baby to develop also blocks, the action of the mother's insulin in her body. This problem is called insulin resistance. During pregnancy a mother may need up to three times more insulin for glucose to leave the blood and transform to energy. When body is not able to use insulin due to insulin resistance it develops into Gestational Diabetes. Glucose builds up in the blood to high level, it is called hyperglycemia.

Gestational diabetes affects the mother in late pregnancy and the baby too. Insulin does not cross the placenta, as glucose and other nutrients do. Extra blood glucose passes through the placenta that gives the baby a high blood glucose level. It results the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to develop and grow, the extra energy is stored as fat. It can lead to Macrosomia i.e. “Fat” baby. At birth this fat baby develops problem in breathing or may develop hypoglycemia due to over production of insulin.

Why there is a need to take care of gestational diabetes

Gestational diabetes can harm you and your baby, so you need to consider about it seriously and start caring at once. The main aim of gestational diabetes treatment is to keep blood glucose levels equal to those of normal pregnant women. It needs a planned meal and scheduled physical activity, even blood glucose testing and insulin injections if required. If gestational diabetes is taken care off properly, reduces the risk of a cesarean section birth that high weight babies may require.

Types of Gestational Diabetes

There are 2 types of gestational diabetes:

Type A1: Only diet modification is sufficient to maintain normal glucose levels.
Type A2: Insulin or other medications along with diet are required to maintain normal range of blood glucose.

Gestational diabetes is also classified into different forms of diabetes which existed prior to pregnancy:

  • Type B: onset at age 20 or older or with duration of less than 10 years.
  • Type C: onset at age 10-19 or duration of 1-19 years.
  • Type D: onset before age 10 or duration greater than 20 years.
  • Type F: diabetic nephropathy.
  • Type R: diabetic retinopathy.
  • Type H: diabetes with ischemic heart disease.
  • Type T: diabetes requiring kidney transplant.

Symptoms of Gestational Diabetes

Often women with gestational diabetes exhibit no symptoms. Screening glucose challenge test is a preliminary screening test performed between 26-28 weeks. However, symptoms of gestational diabetes are similar as Type II diabetes. It includes increased thirst, increased urination, fatigue, nausea and vomiting, bladder and yeast infection, and blurred vision.

Gestational Diabetes – Risk of diabetes in Future:

Gestational diabetes is only a temporary phase, it disappears after pregnancy. But once you are diagnosed with gestational diabetes, your chances are 2 in 3 that it will return in future. It is hard to tell whether the particular woman has diabetes due to gestational diabetes or type 2 diabetes. There seems to be a link between the tendency to get gestational diabetes and type 2 diabetes. Gestational diabetes and type 2 diabetes both involve insulin resistance.
Risk factors for gestational diabetes include:

  • Strong family history of type 2 diabetes
  • Mother>’s age - a woman is at higher risk if she is aged at the time of pregnancy
  • Obesity
  • Fallen prey to gestational diabetes in previous pregnancy
  • A previous pregnancy that resulted in a child with a birth weight of 9 pounds or more
  • If you are diagnosed with prediabetes, impaired glucose tolerance, or impaired fasting glucose

Gestational Diabetes Test

Depending on risk factors, the doctor will decide when you need to be checked for diabetes. If you are at higher risk, the blood glucose level may be checked at your first prenatal visit. If your test results are normal, you will be checked again sometime between weeks 24 and 28 of your pregnancy.

Depending on the risk and your test results, you may have one or more of the following tests:

Fasting blood glucose or random blood glucose test: When plasma glucose level is >126 mg/dl or when random plasma glucose >200 mg/dl is confirmed on a subsequent day then the woman is at risk to develop GDM. Hence, you will be suggested by your doctor to go for some confirmatory tests.

Screening glucose challenge test: It is a preliminary screening test, which is performed between 26-28 weeks. This test will diagnose whether diabetes exists or not by indicating whether or not the body is using glucose. The Glucose Challenge Screening is now considered to be a standard test performed during the second trimester of pregnancy.

Oral glucose tolerance test (OGTT): Women who are considered at risk for gestational diabetes are being asked to go for this test. The glucose challenge is performed by giving 1.76 oz of glucose drink and then drawing a blood sample an hour later and measuring the level of blood glucose present. Women with a blood sugar level greater than 140 mg/dl may have gestational diabetes, and require a follow up test called a 3-hour oral glucose tolerance test (OGTT).

According to ADA following values are considered to be abnormal for the OGTT:

  • Fasting Blood Glucose Level>=95 mg/dl
  • 1 Hour Blood Glucose Level>=180 mg/dl
  • 2 Hour Blood Glucose Level>=155 mg/dl
  • 3 Hour Blood Glucose Level>=140 mg/dl

Treatment for Gestational Diabetes

Women with gestational diabetes have healthy pregnancies and healthy babies if, they follow a treatment plan from their health care provider. It is required to keep your blood glucose levels in a target range. Each woman should have a specific plan designed just for her needs, so one can follow these general tips to stay healthy with gestational diabetes:

  • Know your blood sugar and keep it under control
  • Eat a healthy diet 
  • Get regular, moderate physical activity
  • Keep a healthy weight

Women with gestational diabetes should note down their blood sugar level, physical activity and everything she eats and drinks, in a daily record book. This can help track how well the treatment is working and what is to be done further to maintain the normal blood sugar level. Some women with gestational diabetes will also need to take insulin, to help manage their diabetes if blood sugar is shooting up, in spite of all this.  The extra insulin can help them lower their blood sugar level.

Juvenile Diabetes

Juvenile diabetes is an autoimmune disorder which can be due to environmental trigger or virus, which hampers the function of beta cell. Once the beta cells are destroyed the body is unable to produce insulin. It is also believed that Type 1 diabetes results from an infectious or toxic insult to a child, whose immune system is predisposed to develop an aggressive autoimmune response either against molecules of the B cell or against altered pancreatic B antigens, resembling a viral protein. A child with diabetic siblings is more prone to develop juvenile diabetes than the child from a totally unaffected family. It is considered to be a more hereditary problem than excess eating or being obese.

Pancreas produces the exact amount of insulin, to breakdown the sugar produced in the body. The juvenile diabetic lack the production of insulin so, sugar builds up high in the blood, overflows into the urine and passes from the body unused.It is estimated that about 10-15% in United States are suffering with juvenile diabetes. Approximately 35 American children are diagnosed with juvenile diabetes every day.

Symptoms of Juvenile Diabetes

Unlike type 2 diabetes the symptoms of juvenile diabetes may occur suddenly and prove to be dangerous, they are

  • Increased urination:- The glucose cannot reach the cells which results into high blood sugar. The kidneys do this by filtering out the extra sugar, which is the reason of frequent urination
  • Increased thirst:- Due to frequent urination there is more loss of water from the body which automatically increases the intake of water.
  • Increased hunger:- The body glucose is not being used due to insufficiency of insulin which results into increased urge of hunger.
  • Weight loss:- When the body glucose is not used for the production of energy since long time, the body starts using fat deposits and proteins which leads to weight loss. Weight loss is too fast as it is a growth period.
  • Fatigue:- Due to deficiency of the required energy in the body, we feel exhausted very fast.
  • Flu like symptoms:- when the body is weak and running out of the calories that it generally requires, there are much chances of falling prey to small infections.
  • Fruity breath odor:- when body fat starts breaking down for the production of glucose it releases acetone and other ketone bodies, which leads to fruity odor from mouth.
  • Bedwetting:- particularly, if the child was previously “dry” at night

Diagnosis of Juvenile Diabetes

There are numerous tests available to diagnose diabetes which can be done with the advice of your physician.

  • Urine test: - A urine sample will help us to detect glucose and ketones (acids that release in the blood and urine when the body uses fat instead of glucose for energy).
  • Blood test: - It is used to measure the amount of glucose present in the bloodstream
  • Glucose-tolerance test: - checks the body's ability to process glucose. Sugar levels in the blood and urine are monitored for 3 hours after drinking a large dose of sugar solution.
  • Fasting blood sugar: - It involves fasting overnight and blood being drawn the next morning.

Message to Parents

The diagnosis will result as a shock to most parents, especially if it is juvenile diabetes, which is often a case in young children. Little ones get terrified with daily insulin injections.

Type 1 diabetes is not a death sentence and parents should not over react in this situation. Encourage the child to continue with normal social activities and stress the similarities rather than the differences between a diabetic and other normal child. A child>’s self esteem and self image can be threatened by diabetes. Be aware of it. Consider counseling, not only for your diabetic child, but for the whole family.

Your child must be discouraged politely if he/she is eating something that is not on their diet sheets or if their blood tests results reveal a high blood sugar level. Remember to describe the result as high/low/normal, not as good and bad.

Meet your diabetic child, play with him and simplify his doubts regarding diabetes very patiently, children have an extraordinary capacity to adapt accordingly with the changes.

You need to control their diets and medication, while promoting self-care. Children with juvenile diabetes and their families should learn about different foods especially carbohydrates such as bread, pasta, and rice can affect blood glucose levels. Another message for parents to be supportive of a child with Type 1 diabetes is by regularly engaging in physical activity, which is essential in lowering blood glucose levels, controlling weight, and reducing stress. It>’s also a good way for the families to spend time together by going for a walk, shooting hoops for taking a bike ride. Parents may need to talk with their children about how to follow their diabetes management plan in special situations while attending parties.

Parents and children can get help by sharing their concerns with physicians, diabetes educators, dieticians and other health-care providers. Local peer groups for children and teens with diabetes can provide positive role models, support and group activities.

Diagnosis of Juvenile Diabetes

There are numerous tests available to diagnose diabetes which can be done with the advice of your physician.

  • Urine test: - A urine sample will help us to detect glucose and ketones (acids that release in the blood and urine when the body uses fat instead of glucose for energy).
  • Blood test: - It is used to measure the amount of glucose present in the bloodstream
  • Glucose-tolerance test: - checks the body's ability to process glucose. Sugar levels in the blood and urine are monitored for 3 hours after drinking a large dose of sugar solution.
  • Fasting blood sugar: - It involves fasting overnight and blood being drawn the next morning.

Diabetes Nutrition

Are you tired of taking insulin pills and injections for maintaining your blood sugar levels? Have you ever thought about the health advantages that can be derived from the consumption of food supplements? If not, think about it! The transition to the diabetic lifestyle will be much easier.

Diabetes is one of the most prevalent chronic diseases in the world. It prevents the body from using glucose in our food for taking care of its energy needs. This glucose gets accumulated in our blood, thereby risking the well-being of our heart, eyes, kidneys and nerves.

Nutritional Supplements for Diabetics

Recent researches carried out by food industries and health experts conclude that herbal supplements such as bitter melon, goat>’s rue, nopal cactus, fenugreek, bilberry, gurmar, onions and garlic are quite effective in lowering the blood glucose level, thereby helping the patients to undergo less treatment distress.

Diabetics must be always cautious about the source of their calorie intake. Non starchy veggies, skimmed milk, lean chicken, high fiber fruits and low glycemic food products are smart choices for an informed diabetic. Oil low in saturated fats content should be preferred. It had been proved that a balanced diabetic diet contains some important nutrients and useful supplements to help control dancing blood sugar. Let>’s see few useful diabetic nutritional supplements we receive from our food, and their action in controlling diabetes.

  • Biotin >– It helps the body in metabolizing carbohydrates, proteins and fats.
  • Vitamin C >– It prevents sugar from getting attached to proteins. Insulin deficiency hinders effective metabolism and transport of Vitamin C, making its increased intake all the more important. Here, ascorbates like EmergenC is more preferred as compared to ascorbic acid.
  • Chromium >– It aids the metabolism of glucose. It is most effective if consumed as niacin.
  • Vitamin E >– It helps in improving insulin sensitivity.
  • Magnesium >– It helps in lowering blood pressure and reducing heart-attack risks by relaxing the muscle tissues.
  • CLA >– It helps in protecting cells from becoming diabetic or getting damaged by atherosclerosis, colon cancer and chronic inflammation.
  • Omega 3 and Alpha Lipoic Acids - They are effective building blocks and anti-oxidants respectively. They reduce the risks associated with nerve damages by aiding balancing of blood sugar.
  • Vitamin B6 >– It helps in preventing neuropathy.
  • Vitamin D >– It helps in reducing insulin resistance and averting the risks of cataract.
  • Zinc >– It helps in improving the action of insulin.

Diabetics have greater needs of nutritional supplements for fulfilling the antioxidant and metabolic requirements of the body. Design your food intake as per the above necessities and living the diabetic lifestyle will be a much easier road to travel upon.

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