Sugar Kills

Federal statistics estimate that 18.2 million children and adults in the United States ? 6.3 percent of the population ? have diabetes. While an estimated 13 million of these have been diagnosed with diabetes, 5.2 million are estimated to have type 2 diabetes and not know it. Most people with diabetes have type 2; an estimated 800,000 have type 1. About 1 million people age 20 or older will be diagnosed with diabetes this year. Diabetes is more prevalent among Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders. An estimated 20 million people in the U.S have pre-diabetes, a condition that occurs when one has higher than normal blood glucose levels, but not high enough to be diagnosed as having type 2 diabetes. (Research shows that if action is taken to control glucose levels, those with pre-diabetes can prevent or delay the onset of diabetes.)

The most consistent symptom of diabetes mellitus (Type I and II) is elevated blood sugar levels. In Type I (insulin dependent / early onset) diabetes, this is caused by the body not producing enough insulin to properly regulate blood sugar. In Type II (non insulin dependent/adult onset) diabetes, it is caused by the body developing resistance to insulin, so it cannot properly use what it produces.

However, high blood sugar is not something you can see in the mirror at home, so it is useful to know the side-effects of high blood sugar, which are commonly recognized as the noticeable symptoms of diabetes.

If you find yourself experiencing many of these diabetes symptoms on a consistent, long term basis, you should visit a doctor to be tested for diabetes. Ignoring (or not recognizing) the symptoms of diabetes can lead to long-term serious health risks and complications from untreated diabetes. Some of the common 'early warning' signs of diabetes are:

* The first symptom of diabetes is often excessive thirst (unrelated to exercise, hot weather, or short-term illness)

* Excessive hunger (you know you've eaten "enough" but are still hungry all the time)

* Frequent urination (often noticed because you must wake up repeatedly during the night)

* Tiredness and fatigue (possibly severe enough to make you fall asleep unexpectedly after meals), one of the most common symptoms of diabetes.

* Rapid and/or sudden weight loss (any dramatic change in weight is a sign to visit a doctor)

While many of the signs and symptoms of diabetes can also be related to other causes, testing for diabetes is very easy, and the constant/regular presence of one or more of these symptoms over an extended period of time should be cause for a visit to the doctor.

If diabetes is suspected, tested for, and diagnosed when those symptoms first start appearing, other more serious symptoms of advanced diabetes can often be prevented or have their onset significantly delayed through diet, exercise and proper blood sugar management.

However, often the 'minor' symptoms of diabetes go unrecognized, and physical and neurological problems may arise, resulting in some
of the following symptoms:

* Blurred vision (diabetes can lead to macular degeneration and eventual blindness)

* Numbness and/or tingling in the hands and feet (peripheral neuropathy, a symptom of diabetes, causes nerve damage in the extremities)

* Slow healing of minor scratches and wounds (diabetes often leads to impaired immune system function)

* Recurrent or hard-to-treat yeast infections in women (another sign of impaired immune function)

* Dry or itchy skin (peripheral neuropathy also affects circulation and proper sweat gland function)

If you are experiencing any of these symptoms on a regular basis, or you recognize these symptoms in a child or relative, they may be signs of untreated diabetes. A doctor's appointment should be made as soon as possible, so the individual experiencing the symptoms can -- if diabetes is diagnosed -- take the steps needed to prevent more serious health problems.

Diabetes mellitus occurs when the pancreas doesn't make enough or any of the hormone insulin, or when the insulin produced doesn't work effectively. In diabetes, this causes the level of glucose in the blood to be too high.

In Type 1 diabetes the cells in the pancreas that make insulin are destroyed, causing a severe lack of insulin. This is thought to be the result of the body attacking and destroying its own cells in the pancreas - known as an autoimmune reaction.

It's not clear why this happens, but a number of explanations and possible triggers of this reaction have been proposed. These include:

* infection with a specific virus or bacteria;

* exposure to food-borne chemical toxins; and

* exposure as a very young infant to cow's milk, where an as yet unidentified component of this triggers the autoimmune reaction in the body.

However, these are only hypotheses and are by no means proven causes.

Type 2 diabetes is believed to develop when:

* the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it - this is known as insulin resistance. In response to this more insulin may be produced, and this over-production exhausts the insulin-manufacturing cells in the pancreas;

* there is simply insufficient insulin available; and

* the insulin that is available may be abnormal and therefore doesn't work properly.

The following risk factors increase the chances of someone developing Type 2 diabetes:

* Increasing age;
* obesity; and
* physical inactivity.

Rarer causes of diabetes include:

* Certain medicines;
* pregnancy (gestational diabetes); and
* any illness or disease that damages the pancreas and affects its ability to produce insulin e.g. pancreatitis.

What doesn't cause diabetes

It's important to also be aware of the different myths that over the years have arisen about the causes of diabetes.

Eating sweets or the wrong kind of food does not cause diabetes. However, it may cause obesity and this is associated with people developing Type 2 diabetes.

Stress does not cause diabetes, although it may be a trigger for the body turning on itself as in the case of Type 1 diabetes. It does, however, make the symptoms worse for those who already have diabetes.

Diabetes is not contagious. Someone with diabetes cannot pass it on to anyone else.

Drugs such as steroids, Dilantin, and others may elevate the blood sugar through a variety of mechanisms. Certain other drugs, such as alloxan, streptozocin, and thiazide diuretics, are toxic to the beta cells of the pancreas and can cause diabetes. Certain syndromes (for example, Prader-Willi, Down's, Progeria, and Turner's) may result in a hyperglycemic state; if this state is prolonged, the result can be permanent diabetes.

Diabetes resulting in an insulin-dependent state is classified as Type 1 diabetes. While Type 1 diabetes affects only between 5 to10 percent of the diabetic population, its effects on the body can be worse than other forms of diabetes. In the past, Type 1 has been known as juvenile or juvenile-onset diabetes (because it is usually diagnosed in those under thirty), brittle diabetes, unstable diabetes, and ketosis-prone diabetes. People in this classification more frequently exhibit the classic symptoms, usually with ketones present in blood and urine. A blood-sugar level of 800 mg/dl (44 mmol) or more, especially if ketones are not present, indicates a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (a state in which the body is extremely dry (dehydrated), the chemicals in the body are concentrated, and the blood sugar is high).

As stated before, diabetes is a syndrome or group of diseases (rather than one disease), leading to the prolonged hyperglycemic state. Type 1 is most associated with the killing of the beta cells, most likely by the body's own immune system. Either the immune system cannot kill an infecting agent, which then kills the beta cells, or the immune system itself goes "wild," attacking the body's own tissue and destroying the beta cells. The cells of the islets of Langerhans are inflamed, resulting from an infectious-disease process (for example, mumps) or, more commonly, from an autoimmune (allergic to self) response.

The autoimmune process results in the circulation of antibodies that may either cause or be caused by beta-cell death. If it is found that the antibodies cause beta-cell destruction (the body fighting what it now considers foreign to itself), the body's response to the Type 1 diabetes is much less severe (i.e., easier to control) with treatment. Until then, the outcome is a lack of available insulin. While the onset is said to be sudden, changes resulting in decreased insulin availability may have occurred over a longer period of time. In short, insulin-dependent diabetes mellitus is an inherited defect of the body's immune system, resulting in destruction of the insulin-producing beta cells of the pancreas.

Heredity is a major cause of diabetes. If both parents have Type 2 diabetes, there is a chance that nearly all of their children will have diabetes. If both parents have Type 1 diabetes, fewer than 20 percent of their children will develop Type 1 diabetes. In identical twins, if one twin develops Type 2 diabetes, the chance is nearly 100 percent that the other twin will also develop it. In Type 1 diabetes, however, only 40 to 50 percent of the second twins will develop the disease, indicating that while inheritance is important, environmental factors (for example, too much food, too much stress, viral infection, and so forth) are also involved in the development of Type 1 diabetes.

Type 1 Diabetes, (sometimes called Juvenile Diabetes) is usually found in young children and teenagers, but can also occur later in life.

In Type 1 Diabetes, your body is not producing insulin, a hormone needed to convert blood sugar into energy. Normally this hormone is produced by cells in your pancreas, but for some reason this is not happening as it should.

As the glucose in your blood can't be converted into energy and absorbed by your cells, it builds up causing high blood sugar.

Left untreated, high blood sugar can cause serious long-term health problems.

The normal treatment for people with type 1 diabetes is daily injections of insulin which keeps the blood sugar level within normal ranges.

Finding out you have diabetes can be upsetting, but it should not prevent you from living a long and happy life.

If you think this condition will prevent you leading an active life, consider Sir Steve Redgrave, one of the World's greatest Olympic athletes.

Sir Steve battled type 1 diabetes to win his record-breaking fifth Olympic Gold medal at the Sydney games in the coxless fours rowing event!

Type 2 diabetes (sometimes called mature onset diabetes) is the most common form of diabetes.

As with Type 1 Diabetes, the problem is related to insulin, a hormone needed to convert sugar into energy.

With Type 2 diabetes your body might be producing too little insulin, or it might not be reacting to the insulin correctly. Either way, the end result is that glucose builds up in the bloodstream instead of going into the cells. Left untreated, high blood sugar can cause serious long-term health problems.

Type 2 diabetes usually appears later in life, often between the ages of 35-45 years. As it often develops slowly, many people may not recognise the symptoms, and may have diabetes without knowing it.

If you have recently been diagnosed with type 2 diabetes, you are one of the lucky ones. Many people have diabetes without knowing it, and are at much greater risk of long term medical complications.

Finding out you have diabetes can be upsetting, but it should not prevent you from living a long and happy life. You may need to make a few changes in your lifestyle, but these changes are also good advice for non-diabetics, so probably a good idea anyway.

Gestational diabetes is a type of diabetes, that is only suffered by pregnant women.

In Gestational diabetes, a woman's blood sugar is higher than normal because of the other hormones pridcued during preganancy interfere with the insulin that is produced naturally.

Gestational diabetes usually becomes apparent during the 24th to 28th weeks of pregnancy, and, in most cases, disappears of its own accord once the baby is born.

Women with gestational diabetes usually do NOT have an increased risk of having a baby with birth defects.

Generally, sufferers of gestational diabetes have normal blood sugar levels during the critical first stages of the preganancy.
Whilst there can be complications caused by gestational diabetes, these can usually be managed by careful attention to nutrition and blood sugar levels.

Approximately 3 to 5 percent of all pregnant women in the developed world suffer from gestational diabetes.

Diabetic retinopathy is a complication of diabetes that results from damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). At first, diabetic retinopathy may cause no symptoms or only mild vision problems. Eventually, however, diabetic retinopathy can result in blindness. In the United States, diabetic retinopathy is a leading cause of blindness in adults.

Diabetic retinopathy can happen to anyone who has type 1 diabetes or type 2 diabetes. In fact, up to 45 percent of adults diagnosed with diabetes in the United States have some degree of diabetic retinopathy, according to the National Eye Institute. And the longer you have diabetes, the more likely you are to develop diabetic retinopathy.

To protect your vision, take prevention seriously. Start by controlling your blood sugar level and scheduling yearly eye exams.

Symptoms
You can have diabetic retinopathy and not know it. In fact, symptoms are unusual in the early stages of diabetic retinopathy.

As the condition progresses, diabetic retinopathy symptoms may include:

Spots floating in your vision
Blurred vision
Dark streaks or a red film that blocks your vision
Poor night vision
Vision loss
Diabetic retinopathy usually affects both eyes.

When you have diabetes, your body doesn't use sugar (glucose) properly. If your blood sugar level is too high, your natural lens may swell - which can blur your vision. Eventually, too much sugar in your blood can damage the tiny blood vessels (capillaries) that nourish the retina. This can result in diabetic retinopathy.

Diabetic retinopathy is usually classified as early or advanced.

Causes
Early diabetic retinopathy. Nonproliferative diabetic retinopathy (NPDR) is the most common type of diabetic retinopathy. It can be described as mild, moderate or severe. When you have NPDR, the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. These bulges are called microaneurysms. As the condition progresses, the smaller vessels may close entirely and the larger retinal veins may begin to dilate and become irregular in diameter. Nerve fibers in the retina may begin to swell. Sometimes the central part of the retina (macula) begins to swell, too. This is known as macular edema.
Advanced diabetic retinopathy. Proliferative diabetic retinopathy (PDR) is the most severe type of diabetic retinopathy. When you have PDR, abnormal blood vessels grow in the retina. Sometimes the new blood vessels grow or leak into the clear, jelly-like substance that fills the center of your eye (vitreous). Eventually, scar tissue stimulated by the growth of new blood vessels may cause the retina to detach from the back of your eye. If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure may build up in the eyeball. This can damage the nerve that carries images from your eye to your brain (optic nerve).

Diabetic ketoacidosis (DKA) is a life-threatening blood chemical (electrolyte) imbalance that develops in a person with diabetes when the cells do not get the sugar (glucose) they need for energy. As a result, the body breaks down fat instead of glucose and produces and releases substances called ketones into the bloodstream.

People with type 1 diabetes and some people with type 2 diabetes are at risk for DKA if they do not take enough insulin, have a severe infection or other illness, or become severely dehydrated.

Symptoms of diabetic ketoacidosis include:

Flushed, hot, dry skin.
A strong, fruity breath odor (similar to nail polish remover or acetone).
Restlessness, drowsiness or difficulty waking up. Young children may lack interest in their normal activities.
Rapid, deep breathing.
Loss of appetite, abdominal pain, and vomiting.
Confusion.
Severe diabetic ketoacidosis can cause difficulty breathing, brain swelling (cerebral edema), coma, or death.

Treatment involves giving insulin and fluids through a vein and closely monitoring and replacing electrolytes.

Proper diabetes management is critical in preventing serious long-term complications arising from high blood sugar. Unmanaged (or
poorly managed) diabetes can lead to medical complications as serious as blindness, emergency amputations, or permanent damage to
internal organs. Obviously, diabetes management is something every diabetic must take very seriously.

The cornerstone of diabetes management is keeping your blood sugar as regular, and within healthy levels, as possible. All of the other
effects of diabetes stem from the effects of high blood sugar. Luckily, today's diabetic has a wide variety of home equipment
available for regularly monitoring blood sugar levels. By keeping close track of your blood sugar throughout the day, you can learn
your 'normal' responses to your medications, different foods and eating schedules, track the effects of a regular exercise program,
and discuss these patterns with your doctor, to adapt the management of your diabetes even more effectively.

The basis of blood sugar management is usually a combination of medication and diet. Type I diabetics must take insulin because their
body does not produce it properly. Management of Type I diabetes needs to be very precise, so the diabetic's need for insulin matches
the dose they are taking, preventing both high blood sugar and dangerous drops in blood sugar as well (hypoglycemia).

In Type II diabetes the body gradually becomes resistant to insulin over a span of many years. Although insulin is still produced, the
body cannot use it effectively. Type II diabetics may take pills to help their body become more receptive to insulin.

In either case becoming familiar with the Glycemic Index, which shows which foods cause blood sugar levels to rise faster than others,
is an important part of proper dietary management of diabetes. Foods with a high Glycemic Index will make blood sugar rise very
rapidly, and should be avoided. Sugars and refined carbohydrates ('white' pasta, white bread, etc.) are among the things at the top of
the list, while whole grains (complex carbohydrates) are lower on the index, and proteins are near the bottom. Becoming familiar with
the Glycemic Index, and finding which foods you like are safest for management of your blood sugar can make overall management of your diabetes much easier.

Regular exercise is an important part of long term management of diabetes. Since peripheral neuropathy often has serious effects on
muscle mass and control in the arms and legs, muscle-building exercises can be an important way of managing some of the physical
effects of diabetes. Developing an effective weight training routine you can do easily in your own home may make this part of your
diabetes management easier than committing to going to a gym regularly.

The onset of Type II diabetes is strongly correlated with overweight. In some cases, if Type II diabetes is diagnosed early enough,
and it is a mild enough case, proper diet combined with regular exercise may lead to the disappearance of diabetic symptoms. While
there is a very strong chance the diabetes will return later in life, adding a few more years of good health will certainly help
minimize side effects later in life, and will be good 'training' for proper diabetes management when it becomes necessary again. While
While exercise can never 'cure' Type I diabetes, the different metabolic characteristics of fat versus muscle cells still make
exercise in important part of managing even Type I diabetes.

Diabetes management can be a complex process, but understanding the basics of your medication, healthy dietary choices and appropriate
and regular exercise will provide a strong foundation for successful management of your diabetes throughout your life.