Diabetes information books. Diabetic information from a diabetic.

DIABETES SYMPTOMS: diabetes type 1, diabetes type 2 Type 1 diabetes mellitus.

Type 1 diabetes is most commonly diagnosed in children and adolescents, but can occur in adults as well. It is an autoimmune disorder, in which the body's own immune system attacks the beta cells in the Islets of Langerhans of the pancreas, destroying them or damaging them sufficiently to reduce insulin production. The autoimmune attack may be triggered by reaction to an infection, for example by one of the viruses of the Coxsackie virus family. A subtype of type 1 (identifiable by the presence of antibodies against beta cells) develops slowly and so is often confused with Type 2. In addition, a small proportion of type 1 cases has the hereditary condition maturity onset diabetes of the young (MODY).

Some poisons (e.g. certain rat poisons) work by selectively destroying certain types of cells, including pancreatic beta cells, thus producing "artificial" type 1 diabetes. Other pancreatic problems including trauma, pancreatitis or tumors (either malignant or benign) can also lead to loss of insulin production.

Currently, type 1 is treated with insulin injections, lifestyle adjustments, and careful monitoring of blood glucose levels using blood test kits. The treatment must be continued indefinitely. Experimental replacement of beta cells (by transplant) is being investigated in several research programs and may become clinically available in future.

About 5-10% of all North American cases of diabetes are Type 1 diabetics. The fraction of type 1 diabetics in other parts of the world differs; this is likely due to both differences in the rate of type 1 and differences in the rate of other types, most prominently type 2. Most of this difference is not currently understood.

Formerly, type 1 diabetes was called "childhood" or "juvenile" diabetes or "insulin dependent" diabetes. Each term is a misnomer, especially since the obesity epidemic in recent years has led to increased incidence of type 2 diabetes in children and adolescents in the USA, and insulin is used in some type 2 cases.

Symptoms often come on suddenly and include:

Increased thirst

Increased urination

Constant hunger

Weight loss

Blurred vision

Fatigue, or a feeling of being tired

Type 2 diabetes mellitus
Type 2 diabetes is characterized by "insulin resistance" as body cells do not respond appropriately when insulin is present. This is a more complex problem than type 1, but is sometimes easier to treat, since insulin is still produced, especially in the initial years. Type 2 may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder (no ketoacidosis) and can be sporadic. However, severe complications can result from unnoticed type 2 diabetes, including renal failure, and coronary artery disease.

Type 2 diabetes was formerly known by a variety of partially misleading names, including "adult-onset diabetes", "obesity-related diabetes", "insulin-resistant diabetes", or "non-insulin-dependent diabetes" (NIDDM). It may be caused by a number of diseases, such as hemochromatosis and polycystic ovary syndrome, and can also be caused by certain types of medications (e.g. long-term steroid use). About 90-95% of all North American cases of diabetes are type 2, and about 20% of the population over the age of 65 is a type 2 diabetic. The fraction of type 2 diabetics in other parts of the world varies substantially, almost certainly for environmental and lifestyle reasons. There is also a strong inheritable genetic connection in type 2 diabetes: having relatives (especially first degree) with type 2 is a considerable risk factor for developing type 2 diabetes. The majority of patients with type 2 diabetes mellitus are obese - chronic obesity leads to increased insulin resistance that can develop into diabetes, most likely because adipose tissue is a (recently identified) source of chemical signals (hormones and cytokines).

Type 2 is initially treated by changes in diet and through weight loss. This can restore insulin sensitivity, even when the weight lost is modest e.g. around 5 kg (10 to 15 lb). The next step, if necessary, is treatment with oral antidiabetic drugs: the sulphonylureas, metformin, or (if these are insufficient) thiazolidinediones. When these have failed, insulin therapy may be necessary to maintain normal glucose levels.

Symptoms of Type 2 diabetes may include:

Frequent infections

Very slow healing of wounds or sores

Nausea

Fatigue, or a feeling of being tired

Increased urination

Increased thirst

Weight loss

Blurred vision

ARE YOU A "HIDDEN DIABETIC"?
(Almost 1 person in 40 is!)

Are you over 40?
Are there any diabetics in your family?
Are you overweight?
Any sudden weight loss?
Are you constantly thirsty?
Do you eat excessively?
Do you urinate frequently?
Do you tire easily?
Any change in your vision?
Does your skin itch frequently?
Do your wounds heal slowly?
Have you had a baby that weighs over 9 pounds at birth?
Are you often drowsy?
Any pain in your fingers and toes?
Every "Yes" you answer to these questions increases the possibility that you MAY be a "hidden diabetic". Did you know that one out of 20 people have diabetes and only half of these know they have the disease?

When people KNOW they have diabetes, they can follow their doctor's orders and lead normal, happy lives. Complications can be avoided. The "hidden diabetics" are the reason that diabetes is one of the leading causes of blindness, limb loss, and death in the United States. Let's locate our undiagnosed diabetics and urge them to seek proper medical care.

See your doctor today! Find out for sure if you are a "hidden diabetic". Your good health is the most important thing - DO IT NOW

Q. What is Diabetes?

A.Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone, produced by the pancreas, that is needed to convert food, such as sugar, starches and other food components, into energy needed for daily life. When insulin does not work properly, blood glucose levels rise.

Q. What is the difference between type 2 diabetes & type 1 diabetes?

A.Type 2 diabetes is the most common form of the disease, affecting 90-95% of those with diabetes. In type 2 diabetes, the body does not create enough insulin or cells are resistant to the action of the insulin the body does make. Diet and exercise are an important part of treating type 2 diabetes, and with the advice of a health care provider, medications may also be needed for blood glucose control.

Type 1 diabetes is usually diagnosed in children and young adults, but can be diagnosed through the early adult years. Only 5-10% of people with diabetes have type 1 diabetes. In type 1 diabetes, the body does not produce insulin. People with type 1 diabetes require insulin shots.

Q. Why is blood glucose so important?

A.Glucose is the basic fuel for the cells in the body, and insulin takes the glucose from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can cause problems:

The cells of your body become starved for energy.

High blood glucose levels may hurt your eyes, kidneys, nerves or heart over a period of time.

Q. What causes type 2 diabetes?

A.The cause of diabetes is unknown. However, there are several factors that can increase the risk of developing type 2 diabetes, such as: being overweight, a lack of exercise, and genetics.

Q. What is "high blood sugar?"

A.Blood sugar, more accurately called blood glucose is the main source of energy for our bodies and the body makes it from the food we eat. "High Blood Sugar" is the condition in which glucose builds up in the bloodstream. The medical term for this is hyperglycemia and it is the main factor used to diagnose diabetes. Hyperglycemia can only be determined by a blood test. However, hyperglycemia can have some serious side effects. Prolonged hyperglycemia may contribute to changes in vision or damage to the eye, kidney problems, heart disease or stroke.

Q. What is insulin?

A.Insulin is a hormone produced by our bodies, specifically our pancreas. Among it's many functions, insulin also helps with the movement of glucose from the blood into body cells where glucose is used as a source of energy or stored as a future fuel source. Without insulin, body cells can "starve", even though there may be plenty of glucose in the bloodstream.

Q. What is hypglycemia (low blood sugar)?

A.Hypoglycemia can occur when there is an imbalance between insulin and glucagon (Glucagon is a hormone produced by our bodies that raises the level of glucose in the blood, and is an important factor in hypoglycemia.). To keep diabetes in control it is important to test blood glucose often. Ask your health care provider how often you should test and what your blood glucose levels should be, and what to do when they are low. Good diabetes control, including an appropriate diet, is the best way to prevent hypoglycemia.

Q. What can I do to help treat type 2 diabetes?

A.The most important thing is to work on a plan with your healthcare provider. In general, most people with type 2 diabetes need to change their lifestyle to control diet, exercise and weight loss, especially if you have just been diagnosed.

If you are overweight, try to lose some weight. Even a small reduction is body weight can have a major effect in controlling blood glucose.

Be sure to eat regularly throughout the day. Eat lots of foods that are a good source of fiber, such as oats and beans and try to include vegetables in each meal.
Help protect your heart by lowering your fat intake.

If you do not currently have one, find a dietitian. They can help you choose a diet that will work for your specific needs. Your physician may also prescribe medication and/or insulin depending on your blood glucose levels, your health, how long you've had type 2 diabetes and other issues.

Q. How will my diet change?

A.Controlling your diet is an important aspect of your treatment plan. Your health care provider will make specific recommendations, perhaps by sending you to consult a dietitian. You will learn to eat a well-balanced diet-like everyone should-and you'll need to learn about foods and how blood glucose levels respond to them. A registered dietitian can help you develop a plan that fits your lifestyle, habits and health goals. The good news is that almost any food can fit into your meal plan. You will learn to keep track of what you eat so you stay in control of your blood glucose.

Q. How will my diet change?

A.Controlling your diet is an important aspect of your treatment plan. Your health care provider will make specific recommendations, perhaps by sending you to consult a dietitian. You will learn to eat a well-balanced diet-like everyone should-and you'll need to learn about foods and how blood glucose levels respond to them. A registered dietitian can help you develop a plan that fits your lifestyle, habits and health goals. The good news is that almost any food can fit into your meal plan. You will learn to keep track of what you eat so you stay in control of your blood glucose.

Q. Now that I have been diagnosed with diabetes, do I have to give up all the foods I love?

A.While you may have to adjust your serving size and how often you eat them, most foods can fit into your eating plan. The key for a healthy diet is moderation, which everyone, diabetic or not, should follow. Consult your healthcare provider to help you develop your meal plan.

Q. Do i have to completely eliminate sugar from my diet?

A.People with diabetes can fit sweets into their meal plan by substituting for other carbohydrate foods, according to the American Diabetes Association (ADA). It's the total amount of food and type of food consumed that really matters. Consult your health care provider or dietitian to find out what is the right amount for you.

Q. Should I try to eat at the same time everyday?

A.It is helpful to have a regular eating schedule. This will help your blood glucose level to stay better balanced. Also, don't miss out on breakfast. Q. Why should I consult a dietitian?A.Registered dietitians have special training and knowledge on how the body handles food. Dietitians who understand diabetes can show you how the foods you consume affect your blood glucose level. Understanding this helps to coordinate your needed medications and eating habits. Your dietitian will help you create a healthy diet that incorporates your favorite foods.

You've probably wondered how you got diabetes. You may worry that your children will get it too.

Unlike some traits, diabetes does not seem to be inherited in a simple pattern. Yet clearly, some people are born more likely to get diabetes than others.

What leads to diabetes?
Type 1 and type 2 diabetes have different causes. Yet two factors are important in both. First, you must inherit a predisposition to the disease. Second, something in your environment must trigger diabetes.

Genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease at most only half the time. When one twin has type 2 diabetes, the other's risk is at most 3 in 4.

Type 1 diabetes
In most cases of type 1 diabetes, people need to inherit risk factors from both parents. We think these factors must be more common in whites because whites have the highest rate of type 1 diabetes. Because most people who are at risk do not get diabetes, researchers want to find out what the environmental triggers are.

One trigger might be related to cold weather. Type 1 diabetes develops more often in winter than summer and is more common in places with cold climates. Another trigger might be viruses. Perhaps a virus that has only mild effects on most people triggers type 1 diabetes in others.

Early diet may also play a role. Type 1 diabetes is less common in people who were breastfed and in those who first ate solid foods at later ages.

In many people, the development of type 1 diabetes seems to take many years. In experiments that followed relatives of people with type 1 diabetes, researchers found that most of those who later got diabetes had certain autoantibodies in their blood for years before.

(Antibodies are proteins that destroy bacteria or viruses. Autoantibodies are antibodies 'gone bad,' which attack the body's own tissues.)

Type 2 diabetes

Type 2 diabetes has a stronger genetic basis than type 1, yet it also depends more on environmental factors. Sound confusing? What happens is that a family history of type 2 diabetes is one of the strongest risk factors for getting the disease but it only seems to matter in people living a Western lifestyle.

Americans and Europeans eat too much fat and too little carbohydrate and fiber, and they get too little exercise. Type 2 diabetes is common in people with these habits. The ethnic groups in the United States with the highest risk are African Americans, Mexican Americans, and Pima Indians.

In contrast, people who live in areas that have not become Westernized tend not to get type 2 diabetes, no matter how high their genetic risk.

Obesity is a strong risk factor for type 2 diabetes. Obesity is most risky for young people and for people who have been obese for a long time.

Gestational diabetes is more of a puzzle. Women who get diabetes while they are pregnant are more likely to have a family history of diabetes, especially on their mothers' side. But as in other forms of diabetes, nongenetic factors play a role. Older mothers and overweight women are more likely to get gestational diabetes.

Type 1 diabetes: your child's risk

In general, if you are a man with type 1 diabetes, the odds of your child getting diabetes are 1 in 17. If you are a woman with type 1 diabetes and your child was born before you were 25, your child's risk is 1 in 25; if your child was born after you turned 25, your child's risk is 1 in 100.

Your child's risk is doubled if you developed diabetes before age 11. If both you and your partner have type 1 diabetes, the risk is between 1 in 10 and 1 in 4.

There is an exception to these numbers. About 1 in every 7 people with type 1 diabetes has a condition called type 2 polyglandular autoimmune syndrome.

In addition to having diabetes, these people also have thyroid disease and a poorly working adrenal gland. Some also have other immune system disorders. If you have this syndrome, your child's risk of getting the syndrome including type 1 diabetes is 1 in 2.

Researchers are learning how to predict a person's odds of getting diabetes. For example, most whites with type 1 diabetes have genes called HLA-DR3 or HLA-DR4.

If you and your child are white and share these genes, your child's risk is higher. (Suspect genes in other ethnic groups are less well studied. The HLA-DR7 gene may put African Americans at risk, and the HLA-DR9 gene may put Japanese at risk.)

Other tests can also make your child's risk clearer. A special test that tells how the body responds to glucose can tell which school-aged children are most at risk.

Another more expensive test can be done for children who have siblings with type 1 diabetes. This test measures antibodies to insulin, to islet cells in the pancreas, or to an enzyme called glutamic acid decarboxylase. High levels can indicate that a child has a higher risk of developing type 1 diabetes.

Type 2 diabetes: your child's risk

Type 2 diabetes runs in families. In part, this tendency is due to children learning bad habits eating a poor diet, not exercising--from their parents. But there is also a genetic basis.

In general, if you have type 2 diabetes, the risk of your child getting diabetes is 1 in 7 if you were diagnosed before age 50 and 1 in 13 if you were diagnosed after age 50.

Some scientists believe that a child's risk is greater when the parent with type 2 diabetes is the mother. If both you and your partner have type 2 diabetes, your child's risk is about 1 in 2.

People with certain rare types of type 2 diabetes have different risks. If you have the rare form called maturity-onset diabetes of the young (MODY), your child has almost a 1-in-2 chance of getting it, too.