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Important Information On Diabetes Mellitus


Diabetes mellitus (commonly called diabetes) is a condition found in 16 million Americans. About half of these people do not know they have diabetes and are not under care for the disorder. Diabetes is not a single disease but rather a syndrome of hyperglycaemia and glycosuria, accompanied by varying degrees of ketosis and acidosis, with or without weight loss. It has several causes and mechanisms of inheritance.

As diabetes is a condition characterized by metabolic abnormalities (the most evident is hyperglycaemia, an elevated concentration of glucose in the blood), the treatment of it must also prevent or reduce the risk and severity of other long term complications involving multiple organs, the eyes, kidneys, nerves and blood vessels. These complications result from a deficiency of the hormone insulin or a reduction in the effectiveness of insulin.

The longer the duration of diabetes, and the worse the long-term blood glucose control, the more likely are the complications to occur.

There are two major forms of diabetes: Type 1, insulin-dependent, and Type 2, noninsulin dependent.

Type 1 diabetes is characterized by an absolute deficiency of insulin caused by beta-cell destruction of the Islets of Langerhans in the pancreas. Type I diabetes usually appears before the age 40. Typical symptoms are thirst, fatigue, cramps, excessive urination, increased appetite, and weight loss.

Treatment requires administration of insulin, diet coordinated with insulin dosage schedule, and regular physical exercise. Dietary treatment is primary therapy in Type 2 diabetes and is vital treatment to Type I diabetes. Presently, there is no known method to prevent the development of this form of the disease.

Type 2 diabetes, usually appears in midlife, among people who are overweight or obese. Its onset is gradual, and many people have a long history of mild symptoms, or display no symptoms at all. In type 2 diabetes, the pancreas usually produces insulin, but for some reason, the body cannot use the insulin effectively. The end result is the same as for type 1 diabetes--an unhealthy buildup of glucose in the blood and an inability of the body to make efficient use of its main source of fuel.

Obesity is strongly associated with the onset and severity of Type 2 diabetes. New cases of this condition can be reduced by approximately half by preventing obesity in middle-aged adults. The risk of diabetes increases with the degree of obesity and its duration, as well as the distribution of body fat; upper body fat is more associated with Type 2 diabetes than is lower body fat.

Significant caloric reduction lowers blood glucose levels even before weight loss occurs. Once desirable weight is achieved, control of blood sugar levels can be accomplished by consuming just enough energy to maintain it. As weight falls to desirable levels, improvements in cardiovascular disease risk factors, hypertension and high blood lipid levels, also occur.

Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase one's risk of developing diabetes. People who have family members with diabetes (especially type 2 diabetes ), who are overweight, or who are African American, Hispanic, or Native American are all at greater risk of developing diabetes.

Type 1 diabetes occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most Asian, African, and American Indian populations. On the other hand, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are not known.

People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves trying to keep blood sugar levels from going too low or too high. When blood sugar levels drop too low--a condition known as hypoglycemia--a person can become nervous, shaky, and confused. Judgment can be impaired. Eventually, the person could pass out. The treatment for low blood sugar is to eat or drink something with sugar in it.

On the other hand, a person can become very ill if blood sugar levels rise too high, a condition known as hyperglycemia. Hypoglycemia and hyperglycemia, which can occur in people with type 1 diabetes or type 2 diabetes, are both potentially life-threatening emergencies.

The goal of diabetes management is to keep blood glucose levels as close to the normal (nondiabetic) range as safely possible. A recent Government study, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), proved that keeping blood sugar levels as close to normal as safely possible reduces the risk of developing major complications of diabetes.

Generally diabetics should avoid foods containing sucrose (table sugar) and glucose. However, foods containing fructose (fruit sugar) and lactose are usually safe for diabetics. Very high carbohydrate, high-fiber diets, providing 70 percent of calories as carbohydrate consistently improve glucose tolerance. Fiber slows the rate of absorption of sugar into the bloodstream.

The three principal approaches to diabetes management are diet, exercise, and treatment with oral antidiabetic agents. Overweight persons can be managed by diet and exercise alone.

Because of the secondary conditions (heart disease, hypertension and loss of sight) persons with diabetes need to be very selective with other nutrients besides sugars.

Dietary Recommendations for Persons with Diabetes

Calories

Should be prescribed to achieve and maintain a desirable body weight.

Carbohydrate

Should comprise 60% of calories. Unrefined should replace all refined carbohydrates.

Protein

Should follow the RDA of 0.8 g per kg of body weight for adults. Some reduction in protein intake may prevent or delay the onset of the kidney complications of diabetes.

Fat

Should comprise less than 30% of total calories. Replacement of saturated fats for polyunsaturated fats to reduce the risk of CHD.

Cholesterol

Should be limited to 300 mg or less per day to reduce cardiovascular risk.

Sweeteners

Both nutritive and non-nutritive sweeteners are acceptable in diabetes management.

Sodium (Salt)

Should not exceed 3g per day, to minimize symptoms of hypertension.

Alcohol

Should be moderate and may need to be restricted entirely by persons with diabetes and insulin-induced hypoglycaemia, neuropathy, poor control of blood sugar, blood lipids, or obesity.

Vitamin C

Often deficient in diabetics. May help to control blood cholesterol levels and reduce the chances of other complications.

Selenium

Selenium has been shown to reduce the risk of CHD and hypertension.

Potassium

Potassium regularly produces a decline in blood pressure.

Chromium

Chromium is a constituent part of glucose tolerance factor in the prevention of diabetes.

Magnesium

Lost in urine due to the diuretic effect of high blood sugar. Studies suggest that a deficiency in magnesium may worsen the blood sugar control in Type 2 diabetes. Scientists believe that a deficiency of magnesium interrupts insulin secretion in the pancreas and increases insulin resistance in the body's tissues. Is also used extensively for the treatment of CHD.

Vanadium

A recent study found that when people with diabetes were given vanadium, they developed a modest increase in insulin sensitivity and were able to decrease their insulin requirements. Currently researchers want to understand how vanadium works in the body, discover potential side effects, and establish safe dosages.

In recent years, advances in diabetes research have led to better ways to manage diabetes and treat its complications. Major advances include:

  • New forms of purified insulin, such as human insulin produced through genetic engineering.
  • Better ways for doctors to monitor blood glucose levels and for people with diabetes to test their own blood glucose levels at home.
  • Development of external and implantable insulin pumps that deliver appropriate amounts of insulin, replacing daily injections.
  • Laser treatment for diabetic eye disease, reducing the risk of blindness.
  • Successful transplantation of kidneys in people whose own kidneys fail because of diabetes.
  • Better ways of managing diabetic pregnancies, improving chances of successful outcomes.
  • New drugs to treat type 2 diabetes and better ways to manage this form of diabetes through weight control.
  • Evidence that intensive management of blood glucose reduces and may prevent development of microvascular complications of diabetes.
  • Demonstration that antihypertensive drugs called ACE-inhibitors prevent or delay kidney failure in people with diabetes.

In the future, it may be possible to administer insulin through nasal sprays or in the form of a pill or patch. Devices that can "read" blood glucose levels without having to prick a finger to get a blood sample are also being developed.

Researchers continue to search for the cause or causes of diabetes and ways to prevent and cure the disorder. Scientists are looking for genes that may be involved in type 2 diabetes and type 1 diabetes. Some genetic markers for type 1 diabetes have been identified, and it is now possible to screen relatives of people with type 1 diabetes to see if they are at risk for diabetes.

The nutrients mentioned above reflect the major nutritional supplements that may help the condition. Please do remember however that nutritional supplementation is an adjunct to medical treatment and in no way replaces medical treatment.

  • The Surgeon General's Report on Nutrition & Health, 1988
Discuss It!

1200 calorie diabetic diet ·

It is a disorder of metabolism or can be called the way that body uses the food for energy. The starch, sugar and carbohydrates are broken down into glucose. The hormone insulin helps in absorbing the glucose and utilizes it for energy. Diabetes occurs when the body fails to form the insulin.