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◆ DIABETES MELLITUS - diseaseconditions



◆ DIABETES MELLITUS
o0----------------0o

GENERAL INFO:
---------------

All of us know someone suffering from diabetes. This sums up the prevalence of diabetes. It is, apart from being one of the most prevalent diseases in the world, also a disease that opens up a Pandora's box of many complications. No wonder it is a dreaded disease and people who are diabetic end up getting other medical problems as well. Diabetes is a group of diseases with one thing in common - a problem with insulin. The problem could be that your body doesn't make any insulin, doesn't make enough insulin or doesn't use insulin properly.

The pancreas, which is an organ present in the abdominal cavity of the body, secretes this hormone insulin. This hormone is the key to the way your body processes food because it helps maintain the proper level of a sugar (glucose) in your blood. Glucose is your body's fuel. Cells use glucose to produce energy to grow and function. Glucose is escorted by insulin through your bloodstream and insulin helps in unlocking cells to allow glucose to enter.

In diabetes, lack of insulin or the resistance of your cells to insulin prevents the right amount of glucose from entering your cells. The unused glucose builds up in your blood, a condition called hyperglycemia.


=>TYPES:
---------

THERE R TWO TYPES OF DIABETES:

[A]:Type 1 diabetes:-

This is the type of diabetes that generally affects young people and requires treatment with insulin.

[B]:Type 2 diabetes:-

This type of diabetes generally develops after age 40. Diabetes can develop gradually, often without symptoms, over many years. It may reveal itself too late to prevent damage. In fact, you may first learn you have diabetes when you develop one of its common complications - heart disease, kidney disease or vision problems. Today, better methods of diabetes control, new medications and easier ways to take insulin enable most people who develop type 1 or 2 diabetes to live a long and healthy life.


=>CAUSES OF DIABETES:
----------------------

The various types of diabetes are different disorders with different causes:

[A]:Type 1 Diabetes:-

This type of diabetes is an autoimmune disease. Your immune system turns on itself and destroys the insulin-producing cells in your pancreas. Although type 1 diabetes usually develops in childhood or teen years, it can appear later.

[B]:Type 2 Diabetes:-

In this type, your pancreas makes some insulin, but not enough. Your cells also can become resistant to insulin's effects, keeping insulin from escorting enough glucose into your body's cells. Type 2 diabetes generally develops after age 40. However, doctors are seeing a rise in childhood type 2 diabetes that parallels the rise in obesity among youth. A form of type 2 diabetes, gestational diabetes, develops during 2 percent to 5 percent of pregnancies. In gestational diabetes, your body doesn't effectively use the insulin you produce. The cause may be metabolic changes that occur due to the effects of hormones in pregnancy. Gestational diabetes usually disappears after pregnancy, but more than half of women who experience it eventually develop a permanent type 2 diabetes.


=>SYMPTOMS:
-------------

The symptoms are due to persistent high levels of sugar in the circulating blood. These symptoms are:

->Frequent urination :-
When blood sugar is too high, your kidneys can't absorb the excess glucose. The glucose leaks into urine, pulling water with it.

->Extreme thirst:-
The process of dehydration makes you thirsty.

->Blurry vision :-
High blood sugar may cause new blood vessels to form and may damage old blood vessels on the retina at the back of your eye.

->Weight loss :-
To make up for the lost fuel, your body burns fat reserves, and you may lose weight.

->Fatigue :-
When your cells don't get enough glucose, their primary fuel source, fatigue results.

->Hunger :-
Burning of fat reserves also may make you hungry.


=>DIAGNOSIS:
-------------

If you have a family history of diabetes and also suffer from some of the risk factors mentioned above, then it is always advisable to screen yourself regularly to detect diabetes and avoid the serious complications. As the saying goes " Prevention is better than cure". So it is always advisable to screen yourself for diabetes if you stand the risk of suffering from it. If you're at risk of diabetes or have symptoms, you should take the test at a younger age and more frequently.

A fasting plasma glucose test is a simple, reliable test for diagnosing diabetes. After fasting overnight (or for 8 hours), a sample of your blood is drawn to measure the glucose level. Most people have a level between 70 and 100 milligrams of glucose per deciliter of blood (mg/dL).

A level of 126 mg/dL or higher on two tests confirms a diagnosis of diabetes. Your doctor may diagnose diabetes if you have a single very high fasting blood glucose level or a higher glucose level along with diabetes symptoms.

=>TREATMENT:
--------------

Controlling blood sugar is the single most important thing you can do to prevent long-term complications of diabetes.

->If you have type 1 diabetes, you must take insulin. Before its discovery in 1921, people with type 1 diabetes usually died within a year or two. Today, most people use synthetic insulin, which is chemically identical to human insulin.

->If you have type 2 diabetes, you may be able to control your blood sugar with weight control, diet and exercise. Or, you may need to combine these approaches with medication.

=>DRUGS FOR TYPE 2:
-------------------
IT INCLUDE:

->Sulfonylurea drugs
(glipizide and glyburide)

->Metformin.
->Acarbose.
->Insulin sensitizers.
->Tolbutamide.
->Tolazamide.
->Chlorpropamide.


=>DIABETES & DIET:
-------------------

Insulin is a key regulator of the body's metabolism. It is produced by the “islets of Langerhans” of the pancreas. The beta cells produce insulin. Other hormone produced by pancreas is Glucagon, which has the exact opposite effect as insulin. Insulin is a polypeptide chain.

Within ten minutes after a meal insulin rises to its peak level. Insulin then enables glucose and amino acids to enter cells in the body, particularly muscle and liver cells. Here, insulin and other hormones direct whether these nutrients will be burned for energy or stored for future use.

Note:
The brain and nervous system are not dependent on insulin; they regulate their glucose needs through other mechanisms.

When insulin levels are high, the liver stops producing glucose and stores it in other forms until the body needs it again. As blood glucose levels reach their peak, the pancreas reduces the production of insulin. About two to four hours after a meal both blood glucose and insulin are at low levels, with insulin being slightly higher. The blood glucose levels are then referred to as fasting blood glucose concentrations.


=>GLYCAENIA INDEX:
-------------------

Researchers have created a glycaemic index that ranks foods according to their ability to raise blood sugar. Different foods raise the sugar in blood technically speaking blood glucose to different degrees. The time and ease with which the food gets converted into glucose determines this rate.

Essentially, the glycaemic index is based on how quickly a particular food is digested, metabolized and then released into the bloodstream as glucose. Other factors contribute to variations in blood sugar, but the glycaemic index indicates which foods are likely to cause a rapid increase in blood sugar.

The glycemic index uses a scale of numbers for foods with carbohydrates that have the slowest to highest effects on blood sugar. There are currently two indexes in use. One uses a scale of 1 to 100 with 100 representing a glucose tablet, which has the most rapid effect on blood sugar. This report uses the glucose index. The other common index uses a scale with 100 representing white bread (so some foods will be above 100.)

The higher the glycaemic index, the quicker the rise in blood sugar:

91 --Honey
86 --mashed potato
83 -- Cornflakes
72 --White Bread
64 --Table Sugar
61 --Banana
53 --Oatmeal
50 --Sweet Potato
49 --Pumpernickel Bread
38 --Apple

This way by keeping a watch on the GI an effective diet can be planned.


=>DIEBETES&EXERCISE:
---------------------

Diabetes and Exercise-Overview
Diabetes is one disorder wherein lifestyle modification (physical activity and healthy eating) plays as important a role as medications to control sugar. Regular exercise could bring about a change from "medical management" to "lifestyle management" in patients with Type 2 diabetes.

Exercise is often advised as the only form of therapy in diabetes when the sugar level is between below 200 to 250 mg/dl, provided there are no complications like -

Damage to the blood vessels of the eye or retinopathy

Damage to the nerves and circulation to extremities or, neuropathy

Problems with kidneys or nephropathy

Heart related problems such as - angina

Patients with Type 2 diabetes, who regularly exercise, find that their blood glucose is better controlled,but on a day they miss their physical activity program, the glucose level tends to rise. Exercise is now considered an important tool for the long management of diabetes.

Physical activity of any type (e.g. walking, jogging, swimming, badminton, tennis or similar activity) should be incorporated into the daily routine. Choosing an activity that is enjoyable and is fun helps to sustain it over time.A variety of exercises must be selected and doing it with a partner or friend is helpful in avoiding boredom.

IT HAS FOLLOWING BENFITS:

->Control of blood glucose levels.
->Improved cardiovascular function.
->Lowering the blood pressure.
->Lowering the bad cholesterol (triglyceride)
->Psychological benefit.
->Weight control.

-----o0o-----


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