What is Diabetes?

In the past I have written a number of articles on diabetes.  Today I want to bring all this diabetes information together and give the topic an extensive write up.

WHAT IS DIABETES?

Diabetes  mellitus (often abbreviated to simply diabetes) is a disease that develops when your blood glucose levels become extremely high because either:
- Your body is not producing enough insulin.
- Your body is not responding to insulin properly.

In non-diabetic people the pancreas responds to high blood glucose levels by releasing insulin.  Insulin allows your body’s cells to take glucose from the blood and either use it for energy or store it for later use in the form of glycogen or fat.  This causes your overall blood glucose levels to fall.  When they reach a certain level your pancreas stops releasing insulin and starts to release glucagon.  Glucagon causes your liver to convert glycogen stores back into glucose and then release it into the blood.  This causes your overall blood glucose levels to rise.  When they reach a certain level your body stops releasing glucagon, starts releasing insulin and the whole process starts again.

The above process allows your pancreas to regulate blood glucose levels ensuring that they are never too high and never too low.  However, in diabetic people this process goes wrong and their pancreas stops producing enough insulin or their cells stop responding to insulin properly.  This inability to use or produce insulin means that diabetic people’s cells cannot easily take glucose from the blood.  As a result the blood glucose levels in diabetic people become extremely high.  This can cause numerous problems which I will be discussing later on in this article.

WHAT TYPES OF DIABETES ARE THERE?

There are four main types of diabetes:

1) GESTATIONAL DIABETES:- Gestational diabetes (also known as gestational diabetes mellitus or the abbreviated GDM) is a temporary form of diabetes that develops during pregnancy.  It normally occurs during the second half of a woman’s pregnancy and then goes away after the baby is born.  Around 5% of pregnant women are believed to suffer from GDM.

Since GDM is a temporary form of the disease it does not pose an immediate threat to your health.  However, it still needs to be managed properly by making good dietary choices and participating in regular exercise (more on this later in the article).  Failure to manage GDM in this way can lead to pre-eclampsia (a form of high blood pressure) and macrosomia (a new born baby with a high birth weight) which can have a negative impact on your pregnancy and make giving birth more difficult.  Badly managed GDM can also increase your chances of contracting the condition during future pregnancies and makes you more likely to develop type 2 diabetes in later life.

2) PRE-DIABETES:- Pre-diabetes describes people with higher than normal blood glucose levels.  A pre-diabetic’s blood glucose levels are not considered high enough to be classed as type 2 diabetes.  However, pre-diabetes almost always develops into full type 2 diabetes if positive lifestyle changes are not made.  Fortunately, pre-diabetes can be reversed if modify your diet and exercise routine accordingly.

3) TYPE 1 DIABETES:- Type 1 diabetes (also known as juvenile onset diabetes or insulin dependent diabetes) develops when your pancreas can no longer produce insulin.  It is not as common as type 2 diabetes representing between 5% and 10% of diabetes cases.  However, it is a much more serious disease and can be fatal if it is not managed properly.  Type 1 diabetes always needs to be treated with insulin injections although a healthy diet and regular exercise can help you better manage the condition.

If you suffer from type 1 diabetes your body will not be able to produce insulin.  Therefore, it needs to be managed a lot more closely than other types of diabetes.  First, you will need to eat right and exercise regularly.  However, you will also need to monitor your blood glucose levels regularly using a glucometer and supply your body with insulin through daily injections.

4) TYPE 2 DIABETES:- Type 2 diabetes (also known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) develops when your pancreas stops producing enough insulin or your body’s cells become resistant to insulin.  It is much more common than type 1 diabetes representing between 90% and 95% of diabetes cases.  Type 2 diabetes can often be managed through lifestyle changes alone but approximately 40% of sufferers require insulin injections.

In most cases type 2 diabetes can be managed through a good diet and regular exercise routine alone.  You will still need to monitor your blood glucose levels at regular, daily intervals using a glucometer but in 60% of cases no insulin injections are required.

WHAT CAUSES DIABETES?

1) GESTATIONAL DIABETES:- GDM is thought to be caused by hormonal changes that occur during the second and third trimester of pregnancy.  During this time the placenta produces insulin resistant hormones in an effort to make sure the growing baby gets enough glucose.  This can cause a pregnant woman’s insulin requirements to increase by two or three times the normal rate.  If their pancreas cannot supply enough insulin to meet this increased demand GDM develops.

2) TYPE 1 DIABETES:- Type 1 diabetes develops when the pancreas becomes damaged and cannot produce insulin.  In most cases this damage happens when your immune system malfunctions and starts to attack the insulin producing beta cells of the pancreas.  It is not known what causes the body’s immune system to malfunction in this way.  Some believe it is a reaction to certain types of infection.  Others believe it is an inherited genetic weakness.  Another theory is that faulty nerves cause this immune system response.

3) PRE-DIABETES AND TYPE 2 DIABETES:- Pre-diabetes is an early sign of type 2 diabetes and therefore develops in the same way.  Type 2 diabetes develops when your cells start to resist insulin for some unknown reason.  This makes it more difficult for them to use glucose.  Since your cells are not getting enough insulin or glucose your pancreas responds by releasing more insulin and your liver responds by breaking down glycogen and releasing more glucose.  In the long run these responses impair your pancreas’s ability to produce insulin, make your cells more resistant to insulin and raises your blood glucose levels.

The exact reason for your cells becoming insulin resistant is unknown.  Age, ethnicity, having other family members with type 2 diabetes and contracting GDM whilst pregnant are all thought to increase your risk of developing this condition.  However, the biggest risk factors are obesity and a sedentary lifestyle.  Being obese increases the amount of fat cells in your body.  This makes you more resistant to insulin because fat cells have less insulin receptors than muscle cells and also increase the total number of cells that your pancreas has to supply with insulin.  A lack of exercise contributes to obesity and also makes your body less effective at controlling blood glucose levels.

WHAT ARE THE SYMPTOMS OF DIABETES?

1) HYPERGLYCAEMIA:- Hyperglycaemia refers to blood glucose levels that are consistently higher than 126 milligrams per decilitre (mg/dL)  In diabetics it is almost always the result of a low insulin levels.  Hyperglycaemia can be aggravated by eating too many sugars or carbohydrates, not doing enough exercise or becoming stressed.  It has a number of noticeable symptoms which include; blurred vision, hunger, frequent urination and thirst.  Mild hyperglycaemia can be treated with insulin injections but more serious hyperglycaemia requires hospital treatment.

2) HYPOGLYCAEMIA:- Hypoglycaemia refers to blood glucose levels that are consistently lower than 70 mg/dL.  It is normally the result of having too much insulin in your body.  In diabetics, hypoglycaemia is often caused by excessive alcohol consumption, not eating enough before exercising or injecting too much insulin.  It is therefore most common in type 1 diabetics because they have to inject insulin on a regular basis.  The symptoms of hyperglycaemia include; blurred vision, confusion, dizziness, shaking and sweating.  Mild hypoglycaemia can be treated by consuming 10g – 20g of sugar with glucose tablets being a good way to do this.  However, more serious hypoglycaemia leads to unconsciousness and therefore requires medical attention.

3) DIABETIC KETOACIDOSIS (DKA):- DKA refers to a high concentration of ketone bodies in your blood stream.  In diabetics it develops when your body’s cells cannot get the glucose they need because of low insulin levels.  This leads to muscle and fat being broken down for energy instead.  The breakdown of fat causes ketones to be released into your blood stream as a by product.  If your body continues to use fat for energy these ketones build up in the blood which causes your body to enter a state of DKA.  The symptoms of DKA include; abdominal pain, fruity smelling breath, loss of appetite and vomiting.  DKA is a very serious condition and can be fatal if immediate medical treatment is not applied.

4) HYPEROSMOTIC NON-KETOTIC ACIDOSIS (HONK):- HONK (also referred to as nonketotic hyperosmolar coma, nonketotic hyperglycaemia and hyperosmolar hyperglycemic nonketotic coma (HHNKC)) is a diabetic coma.  It develops when low insulin levels lead to your blood glucose levels becoming excessively high.  Your body attempts to remove this excess glucose by passing more urine.  This can then lead to extreme dehydration and eventually HONK.  HONK has multiple symptoms which include; dry skin, a fever and increased thirst.  Like DKA, HONK is a very serious condition and requires immediate medical attention.

5) PERIPHERAL NEUROPATHY:- Peripheral neuropathy refers to the loss of nerve function in your arms or legs.  In diabetics, it is often the result of long term nerve damage that diabetes can cause but it can also be due to alcoholism, disease, infection and vitamin deficiency.  The main symptoms of peripheral neuropathy include; a high sensitivity to being touched, a lack of co-ordination and tingling in your hands and feet which can spread into your arms and legs.  Mild peripheral neuropathy can be managed by eating a healthy, vitamin rich diet but more serious peripheral neuropathy may need to be treated with painkillers.

6) DIABETIC RETINOPATHY:- Diabetic retinopathy refers to damaged blood vessels in the retina.  It is the result of high blood glucose levels causing your eyes to swell and ultimately damaging the capillaries which supply your retina with blood.  Diabetic retinopathy can affect your vision in various ways such as; dark streaks that block your vision, floating spots in your vision and poor night vision.  For mild diabetic retinopathy these symptoms can be reduced by making good nutrition and exercise choices.  However, for sever diabetic retinopathy corrective laser surgery may need to be applied.

WHAT ARE THE TESTS FOR DIABETES?

1) FASTING PLASMA GLUCOSE (FPG) TEST:- The FPG test measures the levels of glucose in a person’s blood following a fast.  It is one of the most popular diabetes tests around but cannot be used to test for GDM.  The test involves fasting for eight hours.  Following this a blood sample is taken and the glucose levels in this sample are measured.  A reading of 99 mg/dL is considered normal whilst a reading between 100 mg/dL and 125 mg/dL suggests that you have pre-diabetes.  A reading of 126 mg/dL or above indicates that you have type 1 or type 2 diabetes which then leads to a re-test to confirm.

2) ORAL GLUCOSE TOLERANCE TEST (OGTT):- The OGTT measures the levels of glucose in a person’s blood following the consumption of a glucose drink.  It can be used to test for all types of diabetes.  The first stage of the OGTT is identical to the FPG test where you fast for eight hours and have a blood sample taken.  For the second stage you are given the glucose drink and then have a blood sample taken at three hourly intervals following consumption.  If the OGTT is being used to test for GDM then only the second stage is performed.  The results of the test are based on the final blood sample with a reading of 139 mg/dL considered normal and a reading between 140 mg/dL and 199 mg/dL indicating pre-diabetes.  Readings of 200 mg/dL and above suggest that you have either type 1, type 2 or gestational diabetes.

3) RANDOM BLOOD GLUCOSE (RBG) TEST:- The RBG test is relatively simple and involves pricking your finger with a lancing device, placing a drop of blood on a test strip then putting this strip into a glucometer.  If the glucometer shows a reading of 200 mg/dL or above this suggests you might have diabetes.  However, since glucometers are designed for home testing they are not accurate enough to be the sole basis of a diabetes diagnosis.  Therefore, if a RBG test indicates that you have diabetes go to your doctor for a second opinion and further testing.

4) KETONE TEST:- This test looks for ketones in your blood stream or urine.  High levels of ketones can indicate that your cells are not using glucose properly.  This may be due to low levels of insulin in your body and therefore can indicate diabetes.  The blood ketone test involves a blood sample being taken and tested by your doctor.  The urine ketone test can be performed at home and involves the use of special test strips.  Whilst the urine test is more convenient the blood test is more accurate.

5) URINE GLUCOSE TEST:- This test looks for glucose in the urine.  It involves urinating in a plastic container which is then passed to your doctor for testing.  Urine does not normally contain glucose.  However, when your blood glucose levels reach 180 mg/dL and above it starts to appear in your urine.  Having glucose in your urine does not mean you definitely have diabetes but it does act as an indicator for the disease.

6) GLYCOSYLATED HAEMOGLOBIN TEST:- This test measures your glycosylated haemoglobin levels through a blood sample.  Unlike the above tests, the glycosylated haemoglobin test is not a test for diabetes but a test to see how well diabetics are managing their condition.  Glycosylated haemoglobin levels of between 4% and 6% are normal for non-diabetics whilst levels of 7% are normal for diabetics who are managing their condition effectively.  Levels of glycosylated haemoglobin above 7% suggest that your diabetes is not being managed effectively.

HOW CAN DIABETES BE TREATED?

All types of diabetes cause one fundamental problem – poor blood glucose control.  Therefore, the key to treating diabetes is keeping your blood glucose levels within a normal range.  Whilst diabetes cannot be 100% cured the treatments below will allow you to keep the condition under control.

1) MONITOR YOUR BLOOD GLUCOSE LEVELS:- Regular blood glucose checks will allow you to see if your diabetes is under control and also how your body is responding to current treatments.  Generally, type 1 diabetics will need to check their blood glucose levels much more frequently than type 2 diabetics.  However, this is not always the case and you should consult your doctor on this.  You can monitor your blood glucose levels by performing a RBG test with a portable glucometer.  Levels between 70 mg/dL and 130 mg/dL before eating, less than 180 mg/dL after eating and around 140 mg/dL before going to bed are all considered normal and suggest that your diabetes is under control.  Readings that are consistently above normal suggest that your current treatment program is not working properly in which case you should go see your doctor immediately.

2) EAT THE RIGHT FOODS:- The food you eat can have a big effect on your blood glucose levels.  Eating more high fibre foods, reducing your alcohol intake, reducing your intake of sugars, eating slow digesting carbohydrates and eating more fruits and vegetables are all dietary changes that can help keep your blood glucose levels under control.

3) INCREASE YOUR ACTIVITY LEVELS:- Exercise can increase your body’s responsiveness to insulin and stimulate the use of glucose in your cells.  In the long term it can also reduce your body fat levels which further improve your body’s responsiveness to insulin.  Although exercise is a very good way to manage diabetes it is important that you check your blood glucose levels regularly whilst exercising, stay hydrated and have a source of glucose and insulin to hand if needed.

4) USE INSULIN IF NEEDED:- As discussed above, all type 1 diabetic require insulin whilst 40% of type 2 diabetics need it.  There are four main types of insulin; rapid acting insulin (which reaches the blood 15 minutes after injecting and can last up to 5 hours), short acting insulin (which reaches the blood 30 minutes after injection and can last up to 8 hours), intermediate acting insulin (which reaches the blood 2 to 6 hours after injection and can last for up to 20 hours) and long acting insulin (which reaches the blood 6 to 14 hours after injection and lasts for up to 24 hours).  To determine the type of insulin you will need you should consult your doctor.  They will be able to tell you which type is most suitable for you.  When taking insulin you need to be sure that you do not overdose and also that it does not interact with any other medications you are taking.

5) ALWAYS HAVE RAPIDLY DIGESTING CARBOHYDRATES TO HAND:- Overdosing on insulin, drinking too much alcohol and not eating enough can all cause your blood glucose to drop below normal levels.  In these situations you need to increase your blood glucose levels relatively quickly.  Rapidly digesting carbohydrates enter your blood stream quickly, increasing your glucose levels and therefore should be carried at all times.  Good sources of rapidly digesting carbohydrates include; sweets and chocolate, fruit and glucose tablets.

6) TRY NATURAL REMEDIES:- There are a number of natural remedies for diabetes.  Whilst they are not a substitute for the above five steps they can be a useful addition to any diabetes treatment program.  Some examples of natural remedies include fish oil supplementation, hydrotherapy and massage.

WHAT DAMAGE CAN UNTREATED DIABETES CAUSE?

1) DAMAGE TO YOUR HEART:- Consistently high blood glucose levels damages your blood vessels which in turn restricts the flow of blood to your heart.  If your heart is not getting enough blood it becomes weak and this increases your risk of heart disease.

2) DAMAGE TO YOUR KIDNEYS:- Poorly controlled diabetes can damage the blood vessels which supply your kidneys.  This damage which is referred to as diabetic nephropathy makes the kidneys function less effectively and in the worst cases can lead to kidney failure.

3) DAMAGE TO YOUR EYES:- Poorly managed diabetes can damage the light sensitive tissues of your retina which leads to the symptom diabetic retinopathy (discussed above).  Diabetes also increases your risk of developing cataracts (clouding of the clear lens that covers your eye) and glaucoma (damage to the optic nerve).

4) DAMAGE TO YOUR NERVES:- Poorly controlled diabetes can lead to a type of nerve damage called diabetic neuropathy.  Diabetic neuropathy can be further broken down into; autonomic neuropathy (nerve disorders affecting the bowel, bladder, digestive system, perspiration and sexual response), focal neuropathy (sudden, specific damage to a nerve or group of nerves), peripheral neuropathy (nerve disorders affecting the feet, toes, lower and upper legs, the hands and the arms) and proximal neuropathy (nerve disorders affecting the hips, buttocks and thighs).

5) DAMAGE TO YOUR FEET:- Diabetes can damage the blood vessels that supply your feet, which restricts their blood supply and ultimately causes long term damage.  Diabetes can also cause peripheral neuropathy which means you lose the feeling in your feet.  This indirectly damages your feet because you fail to notice cuts and sores which makes them more likely to get infected.  To minimise this damage you should inspect your feet on a daily basis and if you notice any cuts, sores or infections that do not disappear after a few days you should go see your doctor.

6) DAMAGE TO YOUR GUMS:- Poorly managed diabetes can weaken your gums and make them more likely to get infected.  High levels of glucose in your mouth fluids can also encourage bacteria to grow which causes further damage to your gums.  To reduce the risk of gum damage you should follow a good oral health routine by brushing your teeth daily, flossing daily and visiting your dentist on a regular basis.

7) DAMAGE TO YOUR SEXUAL ORGANS:- Diabetes can damage the blood vessels which supply the sexual organs and restrict the flow of blood to them.  In men this can lead to erectile dysfunction.  In women it can cause vaginitis (inflammation of the vagina), cystitis (inflammation of the bladder lining) and limited clitoral stimulation during sex (because of the poor blood supply).

I hope this article has given you a full overview of diabetes.  Whilst there is a lot of information here I hope you have learnt something new about this condition.  There are multiple types of diabetes but they all cause the same fundamental problem – poor blood sugar control.  Your ability to keep your blood sugar levels close to normal ultimately dictates how diabetes will affect you.  Whilst medical assistance may be required, leading a healthy lifestyle can go a long way to minimising the impact diabetes has on you.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. Before making any lifestyle changes you should always seek your doctors advice. If you have any concerns regarding any form of diabetes then you should speak to your doctor right away.

The link between Diabetes and Fitness

A lot of my recent blog posts have been focussing on diabetes. Since this is a fitness blog I hope you have made the link between diabetes and fitness. For those of you who have not, I will be outlining the link between the two in this article.

1) THE CAUSES OF DIABETES:- As I discussed in my article on the causes of diabetes it is currently unknown what causes the various types of diabetes. However, type 2 diabetes is associated with a number of risk factors including inactivity and obesity. Both of these risk factors can be eliminated by doing more exercise and eating more healthily. In other words you can reduce your risk of developing type 2 diabetes by becoming a fitter person.

2) PRE-DIABETES:- Pre-diabetes is effectively an early indicator of type 2 diabetes. If you are diagnosed with pre-diabetes you are still have the opportunity to take preventative action before full type 2 diabetes develops. But what is this preventative action? Yes, you guessed it – a healthy diet and regular exercise. So not only is improving your fitness an excellent way to reduce your risk of developing type 2 diabetes but it is also a fantastic way to stop any symptoms that do manifest from developing further.

3) TREATING DIABETES:- There are a number of treatments for diabetes. Some diabetics may require insulin injections or medication. However, all diabetics can benefit from regular exercise and a healthy diet. Regular exercise helps you keep your blood sugar under control, improves your body’s sensitivity to insulin and helps you maintain a healthy weight. Eating a healthier diet can also help you keep your diabetes under control with an increasing amount of evidence suggesting that certain types of food (including fibre, fruit and vegetables) can assist in keeping your blood sugar levels normal.

There is still a lot to learn about diabetes. Very little is known about the exact causes and at the moment there are no effective cures. However, the information that we do have presents a strong link between diabetes and fitness levels. By improving your fitness levels and leading a healthier lifestyle, you can seriously reduce your chances of developing diabetes. Even if you are already diabetic, improving your health and fitness can significantly reduce the impact that diabetes has on your life. Whatever your current situation is, the evidence we do have regarding diabetes presents another compelling case for improving your fitness levels.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. Before making any lifestyle changes you should always seek your doctors advice. If you have any concerns regarding any form of diabetes then you should speak to your doctor right away.

7 Types of Damage Caused by Diabetes

As regular readers of this blog probably know by now, diabetes develops either when your body stops producing insulin or your body’s cells stop responding to insulin. As a result your body struggles to convert blood sugar/glucose into energy and your blood sugar levels start to rise. Over time these high blood sugar levels cause damage to your blood vessels, nerves and organs. In this article I will be outlining the main areas of your body that diabetes can cause damage to and discuss how this damage can be avoided.

1) THE HEART:- If you suffer from diabetes then unfortunately you have an increased chance of suffering from heart disease also. The reason for this is that high blood sugar levels can damage your blood vessels and restrict the flow of blood to your heart.

There are a number of symptoms related to heart disease which you should try to look out for. These include:

- Breathlessness.
- Chest Pains.
- Irregular Heartbeats.
- Swollen Ankles.

To reduce your risk of contracting heart disease you must first make sure that you are treating your diabetes effectively. After you have done this you should also consult your doctor to see if there is anything else you can do. Quitting smoking, reducing your alcohol intake and maintaining a healthy weight all contribute to a reduced risk of heart disease.

2) THE KIDNEYS:- Diabetes can cause damage to the kidneys with this type of damage being commonly known as diabetic nephropathy. The kidney’s main function is to filter waste products from the blood and if the blood vessels in the kidneys become damaged, the kidneys function less effectively. In the worst cases diabetic nephropathy can lead to kidney failure, although this is very rare.

To treat diabetic nephropathy, you again need to be treating your diabetes effectively. The next step after this is to get your blood pressure checked because hypertension (high blood pressure) is known to accelerate diabetic nephropathy. If you have high blood pressure also then you will need to consult your doctor who will be able to give you advice on treating high blood pressure.

3) THE EYES:- As I mentioned when discussing the symptoms of diabetes, diabetics are at risk of diabetic retinopathy. This occurs when the light sensitive tissues on your retina become damaged by the high levels of glucose in your blood. Over time this can cause your vision to become blurred and in the worst cases lead to complete loss of vision. People with diabetes are also twice as likely to develop cataracts (when the clear lens of the eye becomes clouded) and glaucoma (when the optic nerve of the eye becomes damaged).

To reduce the risk of getting eye damage you need to keep your diabetes under control and also have yearly eye examinations, so that if any eye damage does develop it can be treated in the early stages. If the eye damage gets too serious it can be treated through surgery in most cases.

4) THE NERVES:- Poorly controlled diabetes can lead to nerve damage which contributes to diabetic neuropathy (a nerve disorder caused by diabetes). There are a number of types of neuropathy including:

- Peripheral Neuropathy:- Nerve disorders associated with the feet, toes, lower and upper legs, the hands and the arms.
- Autonomic Neuropathy:- Nerve disorders affecting the bowel, the bladder, the digestive system, perspiration and sexual response.
- Proximal Neuropathy:- Nerve disorders affecting the hips, buttocks and thighs.
- Focal Neuropathy:- Nerve disorders which rapidly affect a nerve or a group of nerves.

The symptoms of diabetic neuropathy vary depending upon the type and the individual. Some people will experience no symptoms at all. Others will feel numbness, tingling or pain.

To prevent diabetic neuropathy you need to keep your blood sugar levels stable by managing your diabetes properly. This will help to keep your nerves protected. More specific treatments may also be used for specific types of neuropathy.

5) THE FEET:- Peripheral neuropathy is one of the most common types of diabetic neuropathy and it very often affects the sensory nerves in the legs and feet. If the nerves in your legs and feet become damaged, your feet usually become numb meaning that cuts and sores often go unnoticed. On top of this, the blood vessels in your legs and feet can become damaged by the high levels of glucose in your blood, meaning that the blood supply to the feet is restricted. Therefore, these unnoticed cuts and sores take longer to heal and are more likely to become infected. If they do become infected this can lead to further complications and in the worst cases amputation may be necessary.

To prevent damage to the feet a number of precautions are required. First, you should make sure that you are taking good care of your feet. Your footwear should be comfortable, your nails should be cut regularly and your feet should be washed daily. Secondly, you should inspect your feet daily to identify any cuts, sores, bruises or ulcers. If you find any these should be treated by yourself or your doctor as soon as possible. Thirdly, you should have a regular foot examination performed by a professional. They may be able to detect foot problems which your daily inspection has missed. Finally, you need to keep your diabetes under control. This will reduce your risk of developing foot complications as your nerves will be more receptive to feeling and the blood flow to your feet will be improved.

6) THE GUMS:- The blood vessel damage caused by diabetes can weaken the gums and make them more susceptible to infections. On top of this, high levels of glucose in the mouth fluids encourage bacteria to grow.

There are a number of symptoms related to gum infection which you should look out for. These include:

- Bleeding of the gums that is stimulated by brushing or flossing.
- Constant Bad Breath.
- Loose Teeth.
- Puss in between the teeth or gums.
- Receding Gums.

However, for the most accurate diagnosis you should consult your dentist. If you are diagnosed with gum disease then they will be able to advise you on the most effective treatment.

To reduce your risk of developing gum disease you need to keep your diabetes under control and combine this with a good oral health routine. Daily brushing and flossing can significantly reduce the chances of gum disease developing.

7) THE SEXUAL ORGANS:- Diabetes can affect the sexual organs of both men and women. Diabetic neuropathy in men can lead to the erectile tissue becoming damaged, ultimately causing erectile dysfunction. According to Diabetes.co.uk nearly one third of male diabetics suffer from erectile dysfunction. Damage to the blood vessels also puts female diabetics at risk of vaginitis (inflammation of the vagina), cystitis (inflammation of the bladder lining) and limited clitoral stimulation during sex because of the limited blood flow.

In the majority of cases, damage to the sexual organs can be reduced through stricter treatment of your diabetes. In fact, many of the above problems will disappear with better diabetes management. However, if you are on top of your diabetes and still experiencing problems with your sexual organs you should consult your doctor. They will then be able to determine the probable cause and give you further advice and treatment.

I hope this article has shown you just how serious diabetes can be. I’m not trying to use scare tactics but if you don’t stick to an effective diabetes treatment plan you can cause a lot of damage to your body. The majority of this damage can be avoided completely if you stick to a healthy diet, exercise regularly and follow a sensible diabetes treatment plan in order to keep your blood sugar levels under control.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. Before making any lifestyle changes you should always seek your doctors advice. If you have any concerns regarding any form of diabetes then you should speak to your doctor right away.

Sources:
Blood Sugar/Glucose Information (Wikipedia)
Diabetes Complications Information 1 (Diabetes.co.uk)
Diabetes Complications Information 2
Diabetes and Sex Information (Diabetes.co.uk)
Type 1 Diabetes Complications (NHS Direct)
Type 2 Diabetes Complication (NHS Direct)

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6 Steps for Treating Diabetes Effectively

My last few articles have discussed the various types of diabetes, aspects of diabetes and a number of treatments for diabetes. In this article, I am going to bring this information together and explain how you can treat diabetes effectively.

Diabetes (whatever the type) is essentially caused by your body not getting enough insulin (a hormone which helps the body convert blood sugar into energy). This is usually a result of; your cells becoming resistant to insulin, your pancreas (a gland which produces a number of vital hormones) not producing enough insulin or a combination of both. This lack of insulin causes large fluctuations in your blood sugar/glucose (your body’s primary source of energy) levels which can lead to the development of further symptoms. Therefore, the key to controlling your diabetes is to control your blood sugar levels. But how do you do this? Like with most things, there is not one set answer. There are actually a number of things you need do to keep your blood sugar levels within a normal range. In the list below I have outlined the main things you can do to keep your blood sugar levels normal and keep your diabetes under control:

1) MONITOR YOUR BLOOD SUGAR LEVELS:- Keeping a check on your blood sugar levels is essential, whatever type of diabetes you may have. Regular blood sugar testing will allow you to see if your blood sugar is staying within normal levels and check how well your body is responding to your current diabetes treatments.

The frequency with which you need to check your blood sugar levels will depend entirely on you and your diabetes. Typically, type 1 diabetics will need to check their blood sugar levels more often (up to five times per day) whereas type 2 diabetics will only need to check once every few days. However, remember that this is only a general rule and you should seek the advice of your doctor to get more accurate advice.

There are a number of tests which allow you to monitor your blood sugar levels. The most convenient of these is the random blood glucose (RBG) test which can be performed using a portable blood glucose monitor. This will allow you to test your blood sugar levels whenever and wherever you want. Normal blood sugar levels are generally as follows:

- Between 70 and 130 milligrams per decilitre (mg/dL) before eating.
- Less than 180 mg/dL after eating.
- Approximately 140 mg/dL just before going to bed.

Normal blood sugar readings suggest that your diabetes is under control and your diabetes treatments are proving effective. However, blood sugar readings that are consistently above normal levels indicate that your current diabetes treatments are not working effectively. In this case you should notify your doctor immediately because your diabetes is not under control and could become hazardous to your health if not treated quickly.

2) MODIFY YOUR DIET:- Modifying your diet is probably the most effective natural treatment for diabetes. Your body gets glucose from the food you consume, so it makes sense that by choosing your food more carefully you can have greater control over your blood sugar levels. To keep your blood sugar levels within control the following dietary changes are recommended:

- Eat smaller meals more often.
- Control your daily caloric intake.
- Eat a balanced diet consisting of 45%-65% carbohydrates, 15%-20% proteins and 20%-35% fats.
- Moderate your intake of sugars and simple carbohydrates.
- Increase your intake of fibre.
- Eat at least five portions of fruit and veg per day.
- Reduce your salt intake.
- Reduce your alcohol consumption.

As you can see there’s nothing too drastic here. In fact most of the changes would be made as part of normal healthy diet. However, by implementing them you can reduce your body’s resistance to insulin and keep your blood sugar levels much more stable.

3) DO MORE EXERCISE:- Exercise helps control your diabetes in a number of ways. Firstly, exercise makes you burn more glucose for energy and therefore is an effective way to keep your blood sugar levels under control. Secondly, it can improve your body’s sensitivity to insulin according to this this article. Finally, exercise helps you keep your weight under control which according to this article from DLife further improves your body’s sensitivity to insulin.

For best results you should try to exercise regularly (at least 3 or 4 times per week) and perform a combination of cardiovascular exercise (e.g. cycling, swimming, jogging) and resistance training (e.g. bodyweight training, weight lifting). However, when exercising make sure that you keep yourself hydrated, check your blood sugar levels regularly and have a quick supply of glucose and insulin to hand in case your blood sugar change rapidly.

4) USE INSULIN IF NECESSARY:- Insulin helps your body use blood sugar for energy and in doing this helps keep your blood sugar levels under control. If you have type 1 diabetes you will need to take insulin because your body can no longer produce it. 40% of type 2 diabetics require insulin, so if you have type 2 you may be able to get by without it. The best way to determine whether or not you need insulin is to consult your doctor.

There are lots of different types and brands of insulin available but they all fall under four main categories:

- Rapid Acting Insulin:- This type of insulin reaches the blood 15 minutes after injection and peaks 30 to 90 minutes later. It can last for up to 5 hours.
- Short Acting Insulin:- This type of insulin reaches the blood 30 minutes after injection and peaks 2 to 4 hours later. It can last between 4 to 8 hours.
- Intermediate Acting Insulin:- This type of insulin reaches the blood 2 to 6 hours after injection and peaks 4 to 14 hours later. It can last for 14 to 20 hours
- Long Acting Insulin:- This type of insulin reaches the blood 6 to 14 hours after injection and does not peak (or peaks very slightly 10 to 16 hours after injection). It can last for 20 to 24 hours.

Since each individual responds to insulin differently there is no set rule for the type of insulin you use or the frequency with which you administer it. You will need to consult your doctor to decide upon which insulin type is suitable and how often you will need to take it.

Injection is the most common way to administer insulin. However, research into diabetes has meant that a number of alternatives are becoming available including:

- Insulin Inhalers:- Insulin inhalers are a realistic alternative to insulin injections. However, the increased cost of insulin inhalers means (at present) they have failed to gain the popularity of insulin injections.
- Insulin Jet Injectors:- These devices send a fine spray of insulin through the skin using high pressure air.
- Insulin Pumps:- These programmable devices allow multiple insulin injections to be administered automatically in accordance with your daily regime.
- Oral Insulin:- It is difficult to administer insulin orally because the body’s digestive system breaks it down before it reaches the bloodstream. However, a number of advances have been made and according to this article oral insulin may soon be a reality.

When taking insulin you need to take a number of precautions. First, you need to make sure that it does not interact with any other medications you are taking. This article provides a list of medications that are known to interact with insulin but you are advised to also consult your GP. Secondly, you need to make sure that you do not overdose on insulin. Taking too much insulin causes hypoglycaemia (extremely low blood sugar levels) for which the symptoms range from mild (dizziness, headaches, sweating) to serious (coma, seizure).

5) ALWAYS CARRY FAST ACTING CARBOHYDRATES:- Just as insulin is necessary for lowering your blood sugar levels, fast acting carbohydrates may be needed to raise your blood sugar levels if they get too low. Apart from overdosing on insulin your blood sugar levels also become low if you eat too little, consume too much alcohol and sometimes following exercise.

Fast acting carbohydrates are simply carbohydrates which enter your bloodstream quickly. Sources include; sugar, fruit and glucose tablets. You should always carry some with you so that you are prepared should your blood sugar levels drop.

6) TRY ALTERNATIVE NATURAL REMEDIES:- Natural remedies are not a substitute for diet, exercise and possible insulin injections. However, they can be an effective supplement to your existing diabetes treatment. There are lots of natural remedies for diabetes that have been suggested. For example, fish oils are believed to improve the body’s response to insulin and massage can improve circulation which relieves a number of diabetic complications.

For the majority of people, treating diabetes will mean that lifestyle changes are necessary. However, that does not mean diabetes has to control your life. You will have to do some exercise, you will have to monitor your blood sugar levels, you will most probably have to alter your diet and you may have to take insulin. This change will be difficult in the beginning but as you get your diabetes under control it will become easier.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. Before making any lifestyle changes you should always seek your doctors advice. If you have any concerns regarding any form of diabetes then you should speak to your doctor right away.

Sources:
Blood Sugar/Glucose Information (Wikipedia)
Diabetes and Blood Glucose Information (Diabetes.co.uk)
Diabetes and Blood Glucose Monitors Information (Diabetes.co.uk)
Diabetes Causes and Risks Information (DLife)
Exercise and Insulin Sensitivity Information (Diabetes Care Journals)
Hypoglycaemia Information (Net Doctor)
Insulin Information (Wikipedia)
Insulin Side Effects Information (Diabetes.co.uk)
Oral Insulin Information (Diabetes.co.uk)
Pancreas Information (Wikipedia)

Manage Diabetes with Exercise

In my previous article I discussed how important diet can be when controlling your diabetes. However, exercise can also be a very important factor when treating diabetes. In this article I will discuss how exercise can help control your diabetes, the precautions you should take when exercising and finally which exercises are the most effective at fighting diabetes.

So how does exercise help control your diabetes? Well it actually helps in multiple ways. I have outlined three of the most important below:

1) BETTER BLOOD SUGAR CONTROL:- When you exercise you need more energy. Your muscles burn glucose to get this energy and as a result your blood sugar levels are reduced. Therefore, exercise can act as an effective substitute for insulin. In fact in certain cases involving type 2 diabetics, exercise has removed the need for insulin injections and medication completely.

2) IMPROVED INSULIN SENSITIVITY:- According to this article, exercise can improve insulin sensitivity in type 2 diabetics. Since one of the primary problems amongst diabetics is the body not getting enough insulin, this is another fantastic way in which exercise can help control your diabetes.

3) IMPROVED WEIGHT CONTROL:- Exercise helps you to lose weight in two ways. Firstly, cardiovascular exercise burns extra calories both during and after your workout. According to this article you can burn up to 15% more calories in the 48 hours following a cardiovascular workout. That means by doing a cardiovascular training session every other day you can be constantly burning up to 15% more calories, plus you will burn even more calories when you are actually doing the exercise.

Secondly, resistance training can help you lose weight because muscle requires more calories to maintain than fat. By increasing your muscle mass through resistance training you can increase the total amount of calories your body burns each day. The actual amount of calories muscle burns has been heavily exaggerated in the past but according to this article a pound of muscle can burn around 6 calories per day compared with a pound of fat which burns 2 calories per day.

Combining cardiovascular training with resistance training can therefore be a very effective way to burn excess calories and control your body weight. But why is this important for your diabetes? Well according to this article from Dlife excess body fat makes your body more resistant to insulin so keeping your body fat levels under control is essential if you want to stay on top of your diabetes.

As you can see exercise can be a really effective form of diabetes treatment. Not only does it help lower your blood sugar levels but it also improves your body’s resistance to insulin and helps keep your body weight under control. However, there are a number of precautions that you need to take before starting your exercise program:

1) MONITOR YOUR BLOOD SUGAR LEVELS:- As I have already stated, exercise can help reduce your blood sugar levels which is generally a good thing for diabetics. However, this is not always the case. If you have not eaten enough or you have taken insulin or medication prior to exercising, your blood sugar levels may be low already. In this instance, exercise could lower your blood sugar to hypoglycaemic levels. Furthermore, intense exercise can actually have the opposite effect by causing your body to release stress hormones which increase blood sugar levels. Therefore, it is highly important that you monitor your blood sugar levels before, during and after exercise.

2) CARRY GLUCOSE AND INSULIN:- You should carry glucose and insulin at all times when exercising because (as outlined above) your blood sugar levels can fluctuate massively. Intense exercise can cause your blood sugar levels to rise rapidly meaning you may require insulin or medication. Contrastingly, prolonged exercise can cause your blood sugar levels to fall meaning that you may need a quick fix of glucose during or after exercise.

3) STAY HYDRATED:- Dehydration can cause your blood sugar levels to rise and affect your performance whilst exercising. Therefore, it is highly important that you drink lots of water to keep yourself hydrated throughout your workout.

4) CONSULT YOUR DOCTOR:- It is recommended that you talk to your doctor before embarking on any exercise program BUT it is even more important when you are suffering from diabetes because the consequences of not exercising properly can be much more severe. Make sure that you inform your doctor of the type of exercise program you wish to participate in and ask them if there are any additional precautions that you should take. They will then be able to tell you if you need to combine any foods and/or medication with your exercise plan and provide further recommendations to allow you to exercise safely.

So now that you know the benefits of exercise and the precautions to take you should be ready to get started. But how much exercise should you be doing and what types of exercise are best? Ideally you should try and do at least 30 minutes of exercise each day. If this is not possible try and make sure you are doing at least 30 minutes of exercise every other day. The actual exercise (as I have mentioned above) should be a combination of cardiovascular exercise and resistance training:

1) CARDIOVASCULAR EXERCISE:- This type of exercise focuses on improving your aerobic fitness which increases the amount of oxygen that is delivered to your muscles and allows them to work for longer. Cardiovascular exercise is also a great way to stimulate the burning of glucose (which lowers your blood sugar levels) and control your weight (which makes your body more receptive to insulin). When it comes to cardiovascular exercise you have many choices including; jogging, walking, swimming, cycling and team sports.

2) RESISTANCE TRAINING:- This type of exercise focuses on strengthening the muscles, either through bodyweight training or through the use of weights (in the form of free weights or machine weights). Apart from increasing your muscle mass and helping you control body fat levels, resistance training has also been linked with the treatment of diabetes. According to the study in this article 16 weeks of resistance training produced improvements in glucose control amongst Hispanic men and women, that were so significant they could be compared with taking diabetes medication.

Along with diet, regular exercise is a great way to treat diabetes naturally. By doing a combination of cardiovascular training and resistance training you can really keep your condition under control and maybe even remove the need for insulin injections or medication completely. As long as you stick to your program, exercise regularly, stay sensible and take the necessary precautions, exercise can be a great weapon in your fight against diabetes.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. Before making any lifestyle changes you should always seek your doctors advice. If you have any concerns regarding any form of diabetes then you should speak to your doctor right away.

Sources:
Blood Sugar/Glucose Information
Diabetes and Exercise Information
Does Exercise without Weight Loss Improve Insulin Sensitivity?
Exercise for Diabetics Information
How Many Calories Does Muscle Really Burn?
Hypoglycaemia Information
Insulin Information
Type 2 Diabetes and Exercise Information

500 Delicious Diabetic Recipes

My last few posts have discussed diabetes in detail so I thought today I would give you all a relevant freebie which is not quite so information intensive.  Plus, my last post was 8 Ways to Manage Diabetes with a Healthy Diet so I thought that now would be the perfect time to give this freebie away.  The freebie is an ebook that I put together entitled 500 Delicious Diabetic Recipes.  The ebook does exactly what it says, providing readers with 500 (well 515 actually) diabetic recipes.  Whatever you want to eat there should be a recipe for you here, whether it be beef, chicken, pasta, rice, cookies or cakes.

Here’s a few sample recipes from 500 Delicious Diabetic Recipes:

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1) MEATLOAF

1 1/2 lb. lean ground beef
1 beaten egg
2 tbsp. chopped onions
1 c. allspice
1 c. corn flakes
1/4 c. water
1/2 tsp. sage
1/2 tsp. garlic

Mix egg, water and corn flakes; let set for 10 minutes.  Mix with meat and remaining ingredients.  Pack into an oiled loaf pan.  Bake at 350 degrees for 1 hour.  Yields 9 servings.  Exchanges: 1 serving = 3 lean meat and 1 fat.  Calories per serving = 186.  Carbohydrate = 2.6 grams.  Fat = 14.8 grams.  Protein = 21.4 grams.  Sodium = 45 milligrams.  Cholesterol = 86 milligrams.

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2) CHOCOLATE CHIP COOKIES

1/4 c. margarine
1 tbsp. granulated fructose
1 egg
1 tsp. vanilla extract
3/4 c. flour
1/4 tsp. salt
1/2 c. mini semi-sweet chocolate chips

Cream together margarine and fructose, beat in egg, water and vanilla.  Combine flour, baking soda and salt in sifter.  Sift dry ingredients into creamed mixture, stirring to blend thoroughly.  Stir in chocolate chips.  Drop by teaspoonsful onto lightly greased cookie sheet about 2 inches apart.  Bake at 375 degrees for 8 to 10 minutes.  Makes 30 cookies.

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3) CHICKEN BREASTS WITH CARROT AND ZUCCHINI STUFFING

2  small (whole) skinless, boneless chicken breasts
1 c. carrots, shredded (about 2 sm.)
1 c. zucchini, shredded (about 1 med.)
1 tsp. salt
1/4 tsp. poultry seasoning
1 envelope chicken-flavored bouillon
1/4 c. water

In medium bowl, combine carrots, zucchini, salt and poultry seasoning.  Spoon about 1/2 cup mixture into each pocket (each breast should open similar to a butterfly); secure with toothpicks.  In place chicken in a Med size skillet, sprinkle with bouillon.

Add water to skillet and cook over medium high heat, heat to boiling.  Reduce heat to low; cover and simmer about 40 minutes or until chicken is fork tender.  Remove toothpicks.  Makes 4 servings, 180 calories per serving.

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4) MOLTED VEGETABLE SALAD

1 pkg. sugar-free lemon Jello
2 c. boiling water
2 tbsp. lemon juice
2/3 c. cabbage, chopped
2/3 c. green pepper, chopped
2 slices pimiento
Lettuce leaves

Dissolve gelatin in boiling water and stir until completely dissolved.  Add lemon juice, add chopped vegetables and chill.  Slice when firm and serve on lettuce leaves with low-calorie dressing.  This recipe may be a free food.  It is 20 calories and has large amounts of vitamins A and C.

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5) LO-CAL CHEESE CAKE

12 oz. low fat Ricotta cheese
4 eggs, separated
3/4 c. Fruit Sweet
Grated peel of 1 lemon
3 graham crackers, finely crushed
12 oz. low fat cottage cheese
2/3 c. non-instant milk powder
5 tbsp. lemon juice or to taste
2 tsp. pure vanilla
Butter or oleo for pan

Put cheese in process with egg yolks and Fruit Sweet and blend.  Add milk, powder and process until smooth.  Add vanilla, lemon juice and peel to cheese mixture.  Blend until smooth.  Beat egg whites until frothy, then add to the processor and blend for about 2 seconds, until mixed.  Butter the bottom and 1/2 way up the sides of a 9″ springform pan.

Pour the graham cracker crumbs into the pan and shake until buttered area is coated.  Leave any extra on the bottom.  Pour cheesecake mixture into pan and bake at 350 degrees with a pan of water in the oven to prevent drying.    Bake for 45 minutes or until inserted knife emerges clean.  Cool.  May serve with Wax Orchards All-Fruit Fanciful preserve of your choice.  Variations:  All cottage or all ricotta cheese may be used.  For standard cream cheese cake, substitute 24 ounces cream cheese, 3 eggs, 1/2 cup powdered milk and 2/3 cup Fruit Sweet.  Adjust lemon.

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Some tasty stuff I’m sure you’ll agree.  If you want to download all 515 tasty diabetic recipes then click the link below.  Also don’t forget that the ebook comes with full giveaway rights so if you want to pass it on to your friends, family or website visitors please do so.

Click Here to Download 500 Delicious Diabetic Recipes!

8 Ways to Manage Diabetes with a Healthy Diet

This is yet another article I wrote when the Free Fitness Tips blog was just a baby. It is also another article which I have decided needs a rewrite. Partly, because I feel it could be written with a lot more detail and partly because some of the statements were just plain wrong. In particular, this one sticks out;

“Specifically, diabetics need to avoid refined sugar which is found in candy, cookies, cake, chocolate and donuts. Refined sugars enter the bloodstream and release insulin, which causes your glucose levels to go sky-high. Unfortunately, if you are diabetic then these foods will be on your list of things to avoid. ”

At the time I thought this was true because (as I discussed in my previous article on the causes of diabetes) a common misconception is that sugar can cause diabetes. Being a beginner I failed to do my research properly and did not check if this rumour was true. Now I am a little more experienced at blogging and I have properly researched the topic I know that diabetics can have sugar and in fact sometimes need it if they are experiencing hypoglycaemia. Anyway, the article has now been rewritten and should not contain any more blatant, factual errors (fingers crossed). Please read on and enjoy the new, improved version of ‘Managing Diabetes with a Healthy Diet’…

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One of the most effective ways to manage your diabetes (whatever the type) is through a healthy eating plan. The food you eat can have a major influence on your blood sugar levels and because of this diet is a key way to keep your diabetes under control. A common misconception regarding diabetes diets is that they have to be restrictive and complicated. However, the reality is that you can eat a variety of foods as part of a diabetes diet, so long as they are eaten in moderation and regular meal times are adhered to. In fact most parts of a diabetes diet are identical to a normal healthy eating plan. In this article I am going to explain the key role food can have in controlling your diabetes and help you create a healthy diabetes diet.

As I mentioned in the above paragraph, what you eat can have a large impact on your diabetes both in the short term and the long term. Eating too much food at once can cause your blood sugar levels to rise and potentially cause hyperglycaemia (higher than normal blood sugar levels). Contrastingly, going too long without food can make your blood sugar levels drop dramatically causing hypoglycaemia (lower than normal blood sugar levels) (for more information on hyperglycaemia and hypoglycaemia you can read my article on diabetes symptoms). In the long term, what you eat also has an impact on your overall body fat levels. Controlling your weight is a key part of controlling your diabetes (particularly type 2 diabetes) because fatty tissue increases your body’s resistance to insulin. So to summarise, by eating poorly you can potentially cause your blood sugar levels to fluctuate massively, aggravating your diabetes in the short term and further increase your body’s resistance to insulin in the long term. However, by eating more healthily you can stabilise your blood sugar levels, reduce your body fat levels, (allowing your body to become more receptive to insulin) and keep your diabetes under control in both the short term and the long term.

So you are now probably wondering what exactly constitutes a healthy diabetes diet? Well to be honest there is no exact answer to this question. A common belief used to be that controlling your intake of carbohydrates was the key to controlling your diabetes. However, this idea neglected the fact that protein and fats can be converted into glucose and therefore have an impact on blood sugar levels too. It is now believed that eating a healthy, well balanced diet is the best way to combat diabetes and you can do this by sticking to the following guidelines:

1) EAT SMALLER MEALS MORE FREQUENTLY:- Just as eating mini meals frequently can boost your metabolism it can also help control your blood sugar levels. When we eat food it is converted into glucose which is then released into the blood stream. Eating a lot of food in one sitting causes a surge in blood sugar levels. Non-diabetics can get away with this surge because their bodies can produce additional insulin (a hormone which helps the body convert glucose into energy) to cope. However, diabetics do not have this safety mechanism. By eating smaller meals you can avoid any rapid increases in blood sugar levels and by eating more frequently you can stop your blood sugar levels getting too low (because the food will give your body a regular supply of glucose). The combination of these factors means that blood sugar levels remain much more stable when eating small, regular meals instead of less frequent, large meals.

2) CONTROL YOUR DAILY CALORIES:- Apart from controlling your blood sugar levels it is also important to keep your weight under control if you have diabetes. According to Dlife excess body fat can aggravate your condition further because fat cells have fewer insulin receptors than muscle, fat cells interfere with the breaking down of blood sugar and the more fat cells you have the greater number of cells your pancreas has to supply with the limited amount of insulin available. Therefore, minimising your body fat levels can greatly reduce the severity of your diabetes.

To begin this process you first need to see your doctor and ask him what the ideal weight is for your condition. Once you have your ideal weight you then need to calculate your basal metabolic rate (BMR) (which you can do using this BMR calculator). Your BMR will tell you approximately how many calories are required to maintain this ideal weight.

Once you have this information you then need to formulate your daily eating plans around it. Now you do not have to count every single calorie that goes into every single meal. However, you do need to have a general understanding of the calories contained in the food you are eating. In the beginning it will be quite tough and you will probably have to keep a check on your calories BUT in a few weeks you will develop an understanding of how many calories are in everything you eat and you will start to know how much food you can eat each day.

3) EAT A BALANCED DIET:- This phrase is bounced around the weight loss community quite a lot and there are a number of different interpretations. In this instance I am referring to a balanced diet in the sense that it incorporates all of the three major food groups; carbohydrates, proteins and fats. According to Mayo Clinic a balanced diabetes diet should include:

- Carbohydrates: 45%-65% of your daily calories.
- Proteins: 15%-20% of your daily calories.
- Fats: 20%-35% of your daily calories.

So for a person who has a BMR of 2000 calories it is recommended that 900-1300 of these calories come from carbohydrates, 300-400 of these calories come from proteins and 400-700 of these calories come from fats.

4) MODERATE YOUR INTAKE OF SUGAR AND SIMPLE CARBOHYDRATES:- For a long time it was believed that sugar could cause diabetes and that diabetics should avoid sugar completely. However, research has shown that this is not the case. Even so diabetics still need to moderate their intake of sugars.  This is because they usually have a very low nutritional value and could be better replaced with more nutritious complex carbohydrates.  Futhermore, simple sugars are a much more concentrated carbohydrate source and therefore cause a sharper increase in blood glucose levels.  Whilst there are exceptions to this rule (a diabetic may be suffering from hypoglycaemia and require some simple sugars) in most cases you should choose natural, nutrient rich carbohydrate sources such as fruits and vegetables.

5) INCREASE YOUR FIBRE INTAKE:- Fibre makes your bodies digestive system work harder which burns more calories and makes it easier to keep your weight under control. Furthermore, according to this study from the Internet Health Library a diet which is high in fibre can actually help control blood sugar levels. Participants in the study were put on a diet which contained a moderate amount of fibre (24 grams daily) for 6 weeks and then put on a high fibre diet (50 grams daily) for 6 weeks. The results showed that the high fibre diet reduced blood sugar levels by 8.9% more than the moderate fibre diet. Fibre also has many other benefits for your body so increasing your intake makes sense. Dietary sources of fibre include; wholegrain cereals, fruits, nuts and vegetables.

6) EAT AT LEAST FIVE PORTIONS OF FRUIT AND VEGETABLES EACH DAY:- A number of the above points have mentioned that you should try to make sure the majority of your carbohydrates have a high nutritional value. Well fruits and vegetables fit the bill perfectly here. Most varieties are packed with nutrients and they are also usually high in dietary fibre. By eating at least five different varieties of fruit and vegetable every day you will provide your body with lots of essential nutrients and find it much easier to keep your body fat levels under control.

Furthermore, new research suggests that fruit and vegetables may actually prevent diabetes. According to this study the Mediterranean diet (which includes a high number of fruits and vegetables) could be linked with the prevention of type 2 diabetes. Although, the results of the study were not conclusive it is highly likely that the fruit and vegetable component of the Mediterranean diet had an impact on the results and further suggests that fruit and vegetables are a valuable part of a diabetes diet.

7) CUT DOWN ON THE SALT:- According to the American Diabetes Association a high intake of salt is linked with hypertension (high blood pressure). Unfortunately, people with diabetes also have a greater chance of developing hypertension than non-diabetics. Putting the two together further increases the risk of high blood pressure developing. High blood pressure seriously increases your chances of heart disease and stroke, plus it can cause significant damage to all your major organs. Therefore, if you want to reduce your chances of developing this condition you need to cut back on the salt. The recommended intake is about 6g per day so you should try and stick to this.

MODERATE YOUR ALCOHOL INTAKE:- Alcohol is OK in moderation with some research even suggesting that moderate consumption can have a positive impact on your health. However, excessive consumption of alcohol can be damaging to your health and aggravate your diabetes. Most alcoholic beverages are full of sugar and simple carbohydrates and provide little nutritional value. Furthermore, alcohol reduces the level of glucose in your blood and can cause hypoglycaemia when consumed excessively. Men should try to limit their intake to 3 units per day or 21 units per week whilst women should stick to 2 units per day or 14 units per week.

Although the exact causes of diabetes are not fully known, it is universally agreed that diet has a large impact on both the development and management of the disease. A diabetes diet does not have to be restrictive, complicated and boring. In fact most of the suggested changes in this article are standard parts of a healthy diet. By making these changes to your diet you can take control of your diabetes and hopefully start to notice significant improvements.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. Before making any changes to your diet you should always seek your doctors advice. If you have any concerns regarding any form of diabetes then you should speak to your doctor right away.

Sources:
Blood Sugar/Glucose Information
BMR Calculator
Diabetes Diet Information
Diabetes Diet Basics
Fat and Diabetes Information
Fibre and Diabetes Information
Hyperglycaemia Information
Hypertension Information
Hypoglycaemia Information
Insulin Information
Managing Diabetes with your Diet
Mediterranean Diet reduces Type 2 Diabetes
Salt and Diabetes Information
Sugar and Diabetes Information 1
Sugar and DIabetes Information 2
What Causes Diabetes?

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If you are looking for additional information on controlling your diabetes with diet you may be interested in Toma’s Diabetic Diet. This 144 page ebook explains how to select proper glycemic foods, which foods can lower your blood glucose and much more.

The Symptoms of Diabetes

This is another article that I wrote when the Free Fitness Tips Blog was just getting started. However, after reviewing it I have decided it is due for a significant rewrite. So here is the new and improved version of ‘The Symptoms of Diabetes’…

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As I have discussed in my previous diabetes articles the symptoms of diabetes are often quite difficult to notice. However, if you know what to look for you have a much greater chance of identifying the symptoms. In this article I am going to discuss with you the major symptoms of diabetes and explain why they occur.

1) HYPERGLYCAEMIA (High Blood Sugar/Glucose):- Hyperglycaemia occurs when your blood sugar (the body’s main source of energy) levels become higher than normal, usually due to a lack of insulin. Insulin helps the body convert blood sugar into energy. If the body is not getting enough insulin this blood sugar cannot be broken down and instead stays in the blood stream, causing blood sugar levels to rise.

Hyperglycaemia can also be caused by eating too many sugars and carbohydrates (which release extra glucose into your blood stream), failing to exercise (which can reduce the effectiveness of insulin) and by being physically or mentally stressed (which can lead to the body producing extra glucose).

Blood sugar levels are said to reach hyperglycaemic levels when they are consistently above 126 milligrams per decilitre (mg/dL). When your blood sugar reaches hyperglycaemic levels the following symptoms may develop:

- Blurred Vision.
- Increased Hunger Levels.
- Increased Need to Urinate.
- Increased Susceptibility to Infection.
- Increased Thirst Levels.
- Nausea.
- Weakness/Tiredness.
- Weight Loss.

Hyperglycaemia can affect all diabetics and can be managed in two ways, depending upon the severity of the condition. Mild hyperglycaemia can usually be self treated by injecting insulin. More serious hyperglycaemia can lead to diabetic ketoacidosis and hyperosmotic non-ketotic acidosis (HONK) (see below for further details) for which you will need urgent hospital treatment.

2) HYPOGLYCAEMIA (Low Blood Sugar/Glucose):- Hypoglycaemia occurs when your blood glucose levels drop to lower than normal levels, usually because there is excessive insulin in your body. The presence of this extra insulin means that too much glucose is converted into energy and as a result your blood sugar levels start to decline.

Hypoglycaemia can also be caused by not consuming enough calories to meet the body’s energy requirements, either on a day to day basis or before exercise (your body burns extra calories during exercise so you need to make sure these additional calories are made available in the foods you eat prior to exercising). Alcoholic beverages also lower blood sugar levels and excessive alcohol consumption often causes hypoglycaemia.

Blood sugar levels are said to be hypoglycaemic when they are consistently below 70 mg/dL. When your blood sugar drops to hypoglycaemic levels the following symptoms may develop:

- Blurred Vision.
- Coma.
- Confusion.
- Convulsions
- Dizziness.
- Fatigue.
- Hunger Pangs.
- Increased Heart Rate.
- Paleness.
- Shaking.
- Sweating.
- Weakness.

Hypoglycaemia can affect all diabetics but it is more prevalent in people suffering from type 1 diabetes because they have to inject insulin regularly. If they inject too much insulin this often causes hypoglycaemia. Mild hypoglycaemia can normally be self treated by consuming approximately 10g – 20g of sugar. Glucose tablets are available for this specific purpose. More serious hypoglycaemia will often lead to a loss of consciousness and requires medical attention. In this case paramedics will often inject glucagon to raise blood sugar back to normal levels.

3) DIABETIC KETOACIDOSIS (DKA):- Diabetic ketoacidosis occurs when there are a high concentration of ketone bodies in your blood stream. When your body does not get the glucose it requires (usually because of a lack of insulin) it starts to break down fat and muscle for energy instead. Ketones (fatty acids) are released into the blood stream when fat is broken down for energy. If your body uses fat for energy over a prolonged period, these ketones build up in your blood stream and this leads to a state of diabetic ketoacidosis.

The main cause of diabetic ketoacidosis is a lack of insulin which means the body cannot break down glucose properly and so it is forced to turn to fat and muscle for energy. However, it can also be brought on by illness and infection.

The symptoms of diabetic ketoacidosis include:

- Abdominal Pain.
- Confusion.
- Fruity Smelling Breath (similar to the smell of nail polish remover).
- Hot and Dry Skin.
- Loss of Appetite.
- Vomiting.

All diabetics can suffer from diabetic ketoacidosis but it is much more prevalent amongst type 1 diabetics, especially when they fail to inject insulin regularly. Unlike hyperglycaemia and hypoglycaemia, there are no mild forms of diabetic ketoacidosis. It is a very serious medical condition and needs to be addressed immediately. Untreated diabetic ketoacidosis can be fatal so if you notice any of the symptoms described you must seek immediate medical treatment.

4) HYPEROSMOTIC NON-KETOTIC ACIDOSIS (HONK):- This is a type of diabetic coma also known as nonketotic hyperosmolar coma, nonketotic hyperglycaemia and hyperosmolar hyperglycemic nonketotic coma (HHNKC). It is brought on by a lack of insulin in the body which causes glucose levels to rise excessively. The body responds by passing more urine to remove this excessive glucose from the blood. Failure to consume enough fluids can lead to extreme dehydration and eventual hyperosmotic non-ketotic acidosis.

Like with diabetic ketoacidosis, the main cause of hyperosmotic non-ketotic acidosis is a lack of insulin. However, it can also be triggered by illness or infection. The symptoms of hyperosmotic non-ketotic acidosis include:

- Dry Skin (that does not sweat).
- Fever with a Temperature.
- Hallucinations.
- Increased Thirst (which does not disappear despite adequate fluid consumption).
- Sleeplessness.
- Weakness in one side of the body.

Hyperosmotic non-ketotic acidosis can affect all diabetics but is more common amongst type 2 diabetics. Like with diabetic ketoacidosis, it is a very serious condition and requires immediate hospital treatment.

5) PERIPHERAL NEUROPATHY:- Peripheral neuropathy describes the loss of nerve functions in the arms and/or legs. It is usually brought on by nerve damage caused by diabetes. However, it can also be caused by alcoholism, exposure to poisons (usually from certain medication), other diseases (including kidney disease and liver disease), pressure on the nerves (especially when the peripheral neuropathy is affecting a single nerve) and vitamin deficiency (with vitamin B being particularly important for nerve health).

The major symptoms of peripheral neuropathy include:

- Extreme Sensitivity to Touch.
- Lack of Co-Ordination.
- Numbness and Tingling in your Hands and Feet (which may spread upwards into your arms and legs).
- Sharp, Jabbing Pains.

Peripheral neuropathy can affect all diabetes sufferers and the symptoms can range from mild to severe. Peripheral neuropathy can usually be managed by eating a healthy diet which is high in B vitamins. However, painkillers may also be used for treatment if the condition starts to cause prolonged pain.

6) DIABETIC RETINOPATHY:- Diabetic retinopathy describes damage to the blood vessels of the light sensitive tissue located on the retina. This damage is caused by high blood sugar levels which initially cause the lens in your eye to swell (and may lead to blurred vision) and eventually cause permanent damage to the capillaries which supply your retina with blood.

The symptoms of diabetic retinopathy include:

- Blurred Vision.
- Dark Streaks which Block your Vision.
- Floating Spots in your Vision.
- Loss of Vision.
- Poor Night Vision.

All diabetics are susceptible to diabetic retinopathy. The symptoms can be reduced by managing your diabetes effectively, eating a healthy diet and exercising regularly. However, for severe diabetic retinopathy corrective laser surgery may be required.

As you can see there are a lot of potential symptoms that can act as warning signs for diabetes. Generally, any symptoms develop gradually in type 2 diabetics and much more rapidly in type 1 diabetics. However, many of the symptoms are not caused exclusively by diabetes. Even if your blood sugar levels are low or your vision is blurred, this does not necessarily mean that you have diabetes. The only way to be sure is to get tested by your doctor. They will be able to make an accurate diagnosis and confirm whether you have pre-diabetes, gestational, type 1 or type 2 diabetes.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. If you have any concerns regarding any form of diabetes you should seek the advice of your doctor immediately.

Sources:
Blood Glucose/Sugar Information (Wikipedia)
Diabetes and Hyperglycaemia Information (Diabetes.co.uk)
Diabetes and Hypoglycaemia Information (Diabetes.co.uk)
Diabetic Ketoacidosis Information (Yahoo Health)
Diabetic Retinopathy Information (Mayo Clinic)
Glucagon Information (Wikipedia)
Hyperglycaemia Information (NHS Direct)
Hypoglycaemia Information (NHS Direct)
Hyperosmotic Non-Ketotic Acidosis Information (Diabetes Wikia)
Insulin Information (Wikipedia)
Peripheral Neuropathu (Mayo Clinic)

Testing for Diabetes

I originally published this blog post on October 16th 2007. However, since then this blog has come along way and so has my writing (or at least I hope it has). After re-reading some of my initial posts I identified this one as a post that I could improve a lot. So without further ado, please read the new, improved version of ‘Testing for Diabetes’.

Diabetes is a disease which develops when the cells in your body are no longer getting enough insulin (a hormone which helps your cells convert glucose into energy). There are a number of causes which vary depending upon the type of diabetes. There are also a number of symptoms which can indicate that you are suffering from diabetes. However, the problem with these symptoms is that in a lot of cases they are quite hard to spot. The only way to be certain that you have diabetes is to get yourself tested by a qualified medical practitioner. There are a number of tests available and whilst there is no universal standard by which diabetes is measured, certain tests have become more popular than others. In this article I will discuss 6 tests that can be used to look for diabetes.

1) FASTING PLASMA GLUCOSE (FPG) TEST:- This test measures glucose (the body’s main source of energy) levels in a person’s blood following a period of fasting (not eating). It is one of the most popular diabetes tests but is only given to non-pregnant adults. Therefore, it can be used to test for pre-diabetes, type 1 diabetes and type 2 diabetes BUT it cannot be used to test for gestational diabetes.

You will usually have to fast for eight hours prior to the FPG test. Following your fast a blood sample will then be taken (usually from a vein in your arm). This blood sample will then be used to measure your blood glucose levels and the results will indicate whether or not you have diabetes:

- A blood sugar reading of 99 milligrams per decilitre (mg/dL) or below is considered normal.
- A blood sugar reading of between 100 mg/dL and 125 mg/dL indicates that you have impaired fasting glucose (a form of pre-diabetes).
- A blood sugar reading of 126 mg/dL or above indicates that you have either type 1 or type 2 diabetes. If this is the case you will be given another FPG test and the results of the two will be compared. If the results are consistent your doctor will diagnose you with diabetes and investigate further to determine whether it is type 1 or type 2.

2) ORAL GLUCOSE TOLERANCE TEST (OGTT):- This test measures blood sugar levels following the consumption of a sugary drink containing glucose. Unlike FPG this test can be used to diagnose all forms of diabetes including gestational diabetes (although the methodology does change slightly when testing for gestational diabetes).

If the OGTT is being used to test for pre-diabetes, type 1 diabetes or type 2 diabetes then it acts as an extension to the FPG test. You will be required to fast for eight hours and then have a blood sample taken (as you would for the FPG test). After this your doctor will give you a sugary drink that contains a measured amount of glucose (which should be between 75g and 100g). Following consumption of the glucose your doctor will take blood samples at regular intervals (usually one hour, two hours and three hours after consumption).

If the OGTT is being used to test for gestational diabetes the same procedure will be followed except you will not be required to fast before the test. However, your doctor may recommend that you perform the test first thing in the morning before you have eaten anything.

Whichever type of diabetes the OGTT is measuring, the final blood sample will provide a good indicator as to whether you have diabetes or not:

- A blood sugar reading of 139 mg/dL or below is considered normal.
- A blood sugar reading of between 140 mg/dL and 199 mg/dL indicates that you have impaired glucose tolerance (a form of pre-diabetes).
- A blood sugar reading of 200 mg/dL or above indicates that you have either type 1, type 2 or gestational diabetes. If this is the case your doctor will either diagnose you with gestational diabetes (if the OGTT was to test for gestational diabetes) or investigate further and diagnose you with either type 1 or type 2 diabetes.

3) RANDOM BLOOD GLUCOSE (RBG) TEST:- Unlike the above tests, a RBG test can be performed at any time regardless of when you ate. It can also be performed at home, without the assistance of a doctor, using a glucose meter (a medical device which calculates the approximate level of glucose in the blood). No fasting is required for this type of test. The idea behind this is that although eating does affect blood sugar levels they should not fluctuate hugely if tested at random intervals during the day. This test can be used to test for all forms of diabetes but should not be used as the only basis for diagnosis because there are concerns regarding the accuracy of RBGs.

This test is relatively simple compared with the above tests. You simply prick your finger using a lancing device (a device which pricks your skin in a very controlled way to draw a small drop of blood) then place a single drop of blood on a disposable test strip. You then place this test strip into your glucose meter and it will give you an approximate blood sugar reading. Diagnosis from a RBG is very similar to an FBG with a blood sugar level of 200 mg/dL or over indicating that you have diabetes.

Although this type of test is easier and more convenient than other tests, there are problems with accuracy. Glucose meters are believed to have just 10% of the accuracy of a laboratory test. This is because their main function is to monitor blood sugar levels in diabetics – NOT diagnosing diabetes. Therefore, home RBG tests should only be used to identify the warning signs of diabetes. If this home testing indicates that you may have diabetes do not attempt to self diagnose. Instead, consult your doctor immediately and they will be able to perform further, more accurate tests and give you a proper diagnosis.

4) KETONE TEST:- This test looks for ketones (substances produced by the body when it breaks down fat for energy) in your urine or your bloodstream. The presence of ketones indicates that your body is burning too much fat because; you are not getting enough carbohydrates in your diet OR your body is not using glucose properly. High levels of ketones in your body are a warning sign for all types of diabetes. However, type 1 diabetics are the most likely to experience this because their body produces no insulin (people suffering from gestational diabetes and type 2 diabetes often produce limited insulin). The presence of excessive ketones can also be a sign of diabetic ketoacidosis, a potentially life threatening blood chemical imbalance.

You can test for ketones using either a blood test or a urine test. The blood test is the more accurate but the urine test is the most commonly used because it is more convenient. Blood testing is performed by your doctor and involves a blood sample being taken from your arm. Your doctor will then take this blood sample and test it for the presence of ketones. If ketones are found in your bloodstream your doctor will investigate to determine the cause and then give you further advice.

The urine test can be performed at home using special test strips that are available from your doctor and over the counter at some chemists. It involves urinating in a clean container and then placing a test strip into the urine. If the test strip changes colour there are ketones present in your urine and you should seek the advice of your doctor immediately. They will then be able to investigate further and determine the cause of the ketones in your urine.

5) URINE GLUCOSE TEST:- Urine usually contains little to no glucose. However, when blood sugar levels start to reach 180 mg/dL and above, glucose starts to spill over into the urine. The urine glucose test is not an accurate way to diagnose diabetes because glucose can also appear in the urine when your kidneys get damaged or diseased. However, it does indicate possible diabetes and your doctor will usually follow up with one of the above blood glucose tests if sugar is found in your urine.

To perform a urine test you urinate in a plastic container and then give it to your doctor who will pass it on to the laboratory for analysis. As I mentioned above, the urine test is not used to diagnose diabetes. The chances are that you will be having a urine test for something completely unrelated. If the analysis uncovers glucose in your urine you will then be given further tests for diabetes as a precaution.

6) GLYCOSYLATED HAEMOGLOBIN TEST:- When glucose binds with haemoglobin in the blood, glycosylated haemoglobin is created. The glucose stays attached to the haemoglobin for the life of the blood cell (usually between two to four months). Glycosylated haemoglobin levels increase in people who are not managing their diabetes properly. Therefore, the glycosylated haemoglobin test can be used to measure a person’s blood sugar levels over the last two to four months and check how effective any diabetes treatments have been.

This test is performed in the same way as a normal blood test. Your doctor will take a blood sample (usually from a vein in your arm) and the levels of glycosylated haemoglobin in this sample are then measured. Your doctor will interpret the results as follows:

- Non-diabetics should have a glycosylated haemoglobin level of between 4% and 6%.
- Diabetics who are treating the condition effectively should have glycosylated haemoglobin of less than 7%.
- Levels of glycosylated haemoglobin above 7% indicate that your current diabetes treatment is not performing effectively and needs to be changed. However, the results will need to be further interpreted by your doctor because other factors can affect your glycosylated haemoglobin levels.

As you can see there are a lot of ways that you can test for diabetes with some being more accurate and others being more convenient. However, the best way to test for diabetes is by consulting your doctor. All the tests discussed above measure the number of ketones or the level of glucose in your body. Whilst high blood sugar and high levels of ketones are a good indicator of diabetes there can be other factors affecting them. For example, your blood sugar levels often rise when you are unwell and ketones may be present in your blood if you are not eating enough. Your doctor has the professional skills to look at these signs, determine the cause and make the call as to whether it is diabetes or not.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. If you have any concerns regarding any form of diabetes you should seek the advice of your doctor immediately.

Sources:
Blood Sugar/Glucose Information (Wikipedia)
Blood Sugar Test Results Information (Mayo Clinic)
Diabetes and Ketones Information (Diabetes.co.uk)
Diabetic Ketoacidosis Information (Yahoo Health)
Fasting Plasma Glucose Test (Diabetes Self Management)
Glucose Meter Information (Wikipedia)
Glucose Urine Test Information (Web MD)
Glycosylated Haemoglobin Information (Med Terms)
Glycosylated Haemoglobin Test (Health A to Z)
Haemoglobin Information (Wikipedia)
Impaired Fasting Glucose Information (Wikipedia)
Insulin Information (Wikipedia)
Ketone Test (Web MD)
Oral Glucose Tolerance Test (Web MD)
Screening for Diabetes (Patient UK)
Type 1 Diabetes Diagnosis Information (Health A to Z)
Type 2 Diabetes Diagnosis Information (Health A to Z)

The Causes of Diabetes

In my last few articles I have mentioned a number of the possible reasons behind the development of diabetes. These included; obesity, a sedentary lifestyle, age and family. However, many of these are risk factors and do not directly cause diabetes themselves. In this article I will attempt to drill down the causes of the various types of diabetes so that you can take preventative measures and reduce your risk of contracting diabetes.

1) GENERAL CAUSES:- The main cause of diabetes is the cells of your body not getting enough insulin (the hormone which breaks glucose down into energy). This may be because your pancreas is not producing enough insulin or because your body’s cells have become resistant to insulin.

2) GESTATIONAL DIABETES (GDM):- It is currently not known exactly what causes gestational diabetes. However, the widely accepted belief is that changes to your body in the second and third trimesters of pregnancy influence the development of GDM. During this time your baby is growing and relies on glucose (the body’s primary source of energy) for nourishment. To ensure the baby receives enough glucose during these two trimesters, the placenta releases insulin blocking hormones. This causes women’s insulin requirements to increase by two or three times the normal rate during pregnancy. Failure to produce enough insulin to meet this excess demand whilst pregnant causes gestational diabetes to develop.

3) TYPE 1 DIABETES:- Again the exact cause of type 1 diabetes is unknown. The condition develops when the pancreas becomes damaged. In most cases this damage is the result of an auto-immune response (where the body’s immune system attacks its own cells). In the case of type 1 diabetes, the beta cells of the pancreas (which produce insulin) are attacked by the body’s immune system meaning that insulin can no longer be produced. Whilst we know WHAT happens to cause type 1 diabetes, we do not know WHY this happens but there are a number of popular suggestions which include:

- An unknown viral infection instigates this auto-immune response.
- Unknown toxins in the foods we eat cause this auto-immune response.
- Faulty nerves in the pancreas cause this auto-immune response.

4) TYPE 2 DIABETES AND PRE-DIABETES:- Pre-diabetes is an early indicator of type 2 diabetes and the causes of each are almost identical. As with the other types of diabetes listed above, the exact cause of type 2 diabetes and pre-diabetes is unknown. The conditions develop when the body’s cells start to resist insulin. The pancreas responds by producing more insulin and the liver responds by releasing more glucose (because the body is not processing the glucose that is already in the blood). Over time this limits the pancreas’s ability to produce insulin and increases the body’s resistance to insulin. Like with type 1 diabetes it is not know why the body’s cells start to resist insulin. However, there are a number of specific, associated risk factors including:

- Age: Exercising regularly and keeping control of your weight reduces your risk of contracting type 2 diabetes. However, as we age we generally gain weight and exercise less. If you follow this pattern then the older you get the greater chance you have of developing type 2 diabetes.

- Ethnicity: It is not known why ethnic origin affects your chances of diabetes but unfortunately it does. Blacks, Hispanics, American Indians and Asian-Americans are all ethnicities which are at an increased risk of developing type 2 diabetes.

- Family: Again it is not understood why but having a parent or sibling with type 2 diabetes greatly increases the risk of you contracting it too.

- Gestational Diabetes (GDM): If you develop gestational diabetes whilst pregnant the unfortunate news is that you are at an increased risk of developing type 2 diabetes at a later stage. On the bright side, effective management of gestational diabetes reduces the impact it has on the future development of type 2 diabetes.

- Inactivity: When you exercise you use additional glucose for energy and this helps to moderate your blood sugar levels. Furthermore, regular exercise helps you control your weight which makes your cells more receptive to insulin. By being inactive you are negating all these benefits and increasing your risk of developing type 2 diabetes.

- Obesity: An increased amount of fatty tissue increases insulin resistance in your body’s cells. According to DLife this is because; fat cells have fewer insulin receptors than muscles, fat cells release free fatty acids which interfere with glucose metabolism and excess glucose is stored as body fat which increases the number of cells the pancreas has to supply with insulin.

- Pre-Diabetes: This one only counts for type 2 diabetes obviously. As discussed above pre-diabetes is an early sign for the development of type 2 diabetes. If preventative action is not taken pre-diabetes can easily develop into type 2 diabetes.

5) RUMOURS:- Since the exact cause of diabetes is unknown, a number of rumours have developed regarding its origins. In particular, these rumours falsely suggest that specific factors can cause diabetes. Below I have addressed three of the most popular rumours:

- Diabetes is Contagious: Diabetes is NOT contagious. You cannot catch diabetes of another person and if you are a diabetic you cannot pass it on to anyone else. However, having parents or siblings with diabetes increases your risk of contracting it. Therefore, whilst you cannot catch diabetes directly off another human being (e.g. you will not get diabetes by being in the same room as, touching, kissing or having intercourse with another diabetic) there is a hereditary element to the disease.

- Sugar Causes Diabetes: This is one of the most popular rumours around. Diabetics need to monitor their sugar intake quite closely and because of this sugar is often linked with causing diabetes. Eating lots of sugar DOES NOT cause diabetes. However, sugary foods are often very low in nutritional value and rarely satisfy your hunger, hence the reason that they are often referred to as “empty calories” (for example you do not feel fuller after drinking a bottle of lemonade but you have still consumed “empty calories” by drinking it).  Consuming too much sugar very often leads to you becoming overweight because the excess calories from the sugar are not satisfying you in the same way that more complex carbohydrates would. Being overweight makes your cells more resistant to insulin which does increase your risk of contracting type 2 diabetes. Therefore, whilst sugar is not directly related to the development of diabetes it is still a good idea to moderate your consumption.

- Stress Causes Diabetes: Stress can aggravate diabetes and make the condition worse if you are a diabetic. It is also possible that stress can trigger an auto-immune attack, similar to those that lead to the development of type 1 diabetes. However, to date there is NO EVIDENCE which suggests that stress causes diabetes.

Whilst we have a general understanding of what causes the various types of diabetes the exact triggers are unknown. No one is 100% sure why the body’s immune system attacks the pancreas in type 1 diabetes. Nobody knows for sure why the cells of type 2 diabetics start to resist insulin. However, an increasing amount of evidence suggests that regular exercise and healthy eating can help prevent diabetes if you are not a sufferer, and minimise the impact of diabetes if you are a sufferer. Therefore, whilst you cannot be 100% certain of what causes diabetes you can be confident in the fact that you know what prevents it. Try to exercise for at least 30 minutes each day and consume healthy foods most of the time, and the chances are you will never have to worry about what causes diabetes because you will not be at risk from it in the first place.

Every intention has been made to make this article accurate and informative but it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. If you have any concerns regarding any form of diabetes you should seek the advice of your doctor immediately.

Sources:
Blood Glucose/Sugar Information (Wikipedia)
The Causes of Diabetes
Type 2 Diabetes: Causes and Risk Factors (DLife)
Sugar and Diabetes Information (Health Castle)
Stress and Diabetes Information (Health A to Z)
Insulin Information (Wikipedia)
Obesity Information (Wikipedia)
Type 2 Diabetes Risk Factors (Mayo Clinic)

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