Diabetes is a disease that affects the way your body uses food—particularly glucose, a simple sugar which is an end product of the digestion of more complex carbohydrates. Normally, your pancreas produces insulin, a hormone which enables the body to use glucose, and automatically adjusts insulin output to keep your blood sugar in the normal range. If you are diabetic, your disease interferes with the way insulin helps your body’s cells to use glucose. Diabetes cannot yet be cured, but it can be controlled.
Three primary types of diabetes
These are Type 1, Type 2 and Gestational Diabetes.
Insulin-Dependent Diabetes Mellitus (IDDM):
IDDM, also known as Type 1 or juvenile diabetes, most often develops in children and young adults. In Type 1 diabetes, the pancreas produces too little insulin or none at all. Most Type 1 diabetics must take insulin, delivered by injection or pump. Researchers are investigating the use of pancreas transplants to cure Type 1 diabetes.
Gestational diabetes occurs in some women during pregnancy and usually ends after the baby is delivered. However, women with gestational diabetes may develop Type 2 diabetes later in life. Gestational diabetes may result from the body’s resistance to insulin caused by hormones produced by the placenta during pregnancy. It is usually treated with diet. If this is insufficient, the pregnant woman must use insulin, as oral diabetic medications could harm her unborn baby.
Non-Insulin-Dependent Diabetes Mellitus (NIDDM):
NIDDM is the focus of this resource guide. It is also known as Type 2 or adult-onset diabetes. NIDDM is the most common form of the disease, affecting about 90% of Americans diagnosed with diabetes. It most commonly develops in people over the age of 40 who are overweight. In NIDDM, some insulin is produced by the pancreas, but either the amount is not sufficient or the cells cannot use it efficiently because they are resistant to insulin. While some Type 2 diabetics inject insulin, most are treated through weight control with diet and exercise, and with oral medications.
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Symptoms of Type 2 Diabetes
The onset of Type 2 diabetes is usually sudden and dramatic, and most obstetricians today routinely test their pregnant patients for gestational diabetes. But the onset of Type 2 diabetes may be so gradual that the diabetic does not notice the symptoms, and is shocked when the condition is diagnosed during a routine physical exam.
The word diabetes comes from one of its more distressing symptoms. From the Greek dia-, meaning across, and bainein, to straddle, it refers to the discharge of excessive amounts of urine. Symptoms of diabetes include excessive thirst and frequent urination, irritability, fatigue and nausea. Someone suffering from diabetes may also sometimes experience weight loss despite an increased appetite.
Other symptoms are repeated or slow-healing infections of the skin, gums, vagina or bladder; blurred vision; tingling or loss of feeling in the hands or feet; and dry, itchy skin. Factors that increase your risk of developing diabetes include obesity, a family history of diabetes, physiological or emotional stress, pregnancy and certain medications. Persons over forty years old are also more susceptible to Type 2 diabetes. The disease is more common among Native Americans, African-Americans, and Hispanics.
Care and Treatment
While a cure for diabetes has not yet been found, there is hope as research continues. Meanwhile, there are many approaches available for reducing the impact Type 2 diabetes has on your life and well being.
Eating a carefully balanced diet, pursuing a regular exercise regimen and not smoking are beneficial habits for everyone, but essential for the diabetic.
Some diabetics are treated with insulin, delivered by injection one or more times a day or by a pump, and others are treated with oral medications. Alternative healing approaches may also prove helpful.
The ability to carry out daily tasks with vigor and alertness, without undue fatigue, and with ample reserve energy to enjoy leisure pursuits; the ability to respond to physical and emotional stress without excessive increase in heart rate and blood pressure—all of this can still be accomplished by a person with diabetes.
Blood Glucose Monitoring
Recent studies have shown that the key to slowing or preventing the development of diabetic complications is maintaining blood sugar levels as close to normal as possible. It is important to know how close you are to achieving this goal, so that your diet, exercise and medications can be adjusted. Your health control practitioner will outline a monitoring schedule suited to your needs and show you how to monitor and record your blood sugar level by drawing a drop of blood from your finger and analyzing it on a hand-held meter.
Following a diet plan is an essential part of the treatment of diabetes. Your nutritionist can help you to develop a diet plan consistent with your lifestyle and food preferences.
In recent years, two main approaches to diabetic diet planning have been the exchange system and, more recently, carbohydrate counting. Other approaches to diabetic diet planning include the glycemic index and the high-carbohydrate, high-plant fiber (HCF) diet. The HCF diet is based in part on the observation that diabetes begins to rise in non-Western cultures when people abandon traditional foods for a Western diet of refined and processed foods.
Losing weight can also reduce your risk of developing Type 2 diabetes, or can improve your condition if you are already diabetic. In some cases, weight loss may also reduce the amount of medicine you need to take, or even allow you to control your diabetes with diet and exercise alone.
Oral medications are frequently used to treat Type 2 diabetes. These medications fall into one of several drug groups:
Sulfonylurea drugs, which help the body increase insulin production and lower the glucose level. First generation sulfonylureas (marketed before 1984) include Dymelor (acetohexamide), tolbutamide and tolazamide. Second generation sulfonylureas (marketed since 1984) include Amaryl (glimepiride), diabinese, Orinase, Tolinase, chlorpropamide, tolbutamide, tolazamide, Glucotrol and Glucotrol XL (glipizide), Diabeta (glyburide), Glynase (glyburide), and Micronase (glyburide);
Biguanide drugs, which make the insulin the body produces work harder. This includes Glucophage (metformin);
Alpha-glucosidase inhibitor drugs, which delay the digestion of sugars and starches. This includes Precose (acarbose);
Thiazolidinedione drugs, which make the insulin the body produces work better. This includes Rezulin (troglitazone);
Meglitinide drugs, which stimulate insulin secretion from the beta cells of the pancreas. This includes Prandin (repaglinide).
Alternative Treatment Approaches
Alternative treatment approaches generally place more emphasis on the body as a whole and integrated unit, rather than on a particular disease, except as that disease is symptomatic of, or related to larger, underlying issues, such as toxicity, dehydration or deficiencies.
As more Americans discover the benefit of alternative therapies, more allopathic physicians are supporting their use or incorporating them into their own practices. Alternative therapies include but are not be limited to Ayurvedic medicine, biomagnetic therapies, herbal medicine, nutritional therapies, homeopathy, chiropractic, acupuncture, holistic medicine and naturopathy. As much as possible, we have listed resources that are affiliated with medical doctors, or where the listed resource has a multi-year history of service to its patients.
Stress is a risk factor in developing or aggravating diabetes. Alternative treatments that reduce your stress level, such as biofeedback, meditation, guided imagery, hypnotherapy and other relaxation techniques may help improve your diabetic control, and can assist in pain management.
Diabetic peripheral neuropathy (DPN) is a complication characterized by numbness, tingling or burning in the extremities, which may in time become so painful as to be debilitating. Alternative methods of pain relief, such as biofeedback and acupuncture, have been used to alleviate the pain of DPN. Magnetic footpads may help relieve foot pain caused by DPN. Another alternative treatment of DPN is the use of capsaicin cream, derived from capsicum, a substance found in plants of the hot pepper family.
Vitamin and Mineral Supplements
The value of vitamin and mineral supplements in the treatment of diabetes has not yet been conclusively established, but certain substances are thought to be of value in the treatment of diabetes. These include bilberry, biotin, chromium picolinate, copper, CoQ10, cystime, inositol (a B-complex vitamin), magnesium, manganese, quercetin, taurine, vanadium, zinc and Vitamins B6, B12, C and E.