TYPES OF DIABETES

In medical parlance, this disease is known as “diabetes mellitus” - diabetes from the Greek word for siphon, to illustrate the excessive thirst and urination, which is characteristic of this condition, and mellitus from the Latin word for honey - as urine of a diabetic person contains sugar and is sweet.

Commonly, this disease is called diabetes.

There are many types of diabetes, but the three most common are:

?Type 1 diabetes
?Type 2 diabetes
?Gestational diabetes

1. Type 1 diabetes (also known as insulin dependent diabetes):

This is an autoimmune disease where the body’s own immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. It can appear at any age, although mostly under 30 (very often in childhood or during teens), and is caused by environmental factors such as viruses, diet or people genetically predisposed. This type of diabetes, is also known as juvenile-onset diabetes.

It is not really known what causes type 1 diabetes and it is not caused by eating too much sugar or sweets.

Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin much earlier. Common symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme weakness. If not timely diagnosed and treated with insulin, a person with type 1 diabetes can go into life-threatening diabetic coma, also known as diabetic ketoacidosis.

2. Type 2 diabetes (non-insulin dependent diabetes):

This is the most common form of diabetes, affecting 85-90% of all diagnosed people. It is also known as late-onset diabetes, and is characterised by insulin resistance and relative insulin deficiency.
Type 2 diabetes is genetic in origin, but other factors such as excess weight, sedentary lifestyle, high blood pressure, ethnicity and faulty diet are its major risk factors. Symptoms may not show up for many years, and by the time they crop up, considerable harm may have been done to the body.

In this condition, the pancreas is usually producing enough insulin, but for reasons unknown, the body cannot use the insulin effectively - termed as insulin resistance. As a result, glucose builds up in the blood and the body cannot make proficient use of its main source of energy.

The symptoms of type 2 diabetes develop gradually. Symptoms include weakness, nausea, frequent urination, excess thirst, weight loss, blurred vision, frequent infections, and slow healing of wounds. Some people may show no symptoms.

Type 2 diabetes is a progressive, lifetime condition; and over time, it may be difficult to keep the blood glucose level in the target range. However, good diabetes care and management can prevent or delay the onset of complications.

One can do this by:

?Eating healthy meals and snacks

?Following regular physical activity

?Taking diabetes medications (including insulin), if prescribed.

3. Gestational diabetes:

Gestational diabetes develops only during pregnancy. In most cases, all diabetic symptoms disappear following delivery. Women who have had gestational diabetes have a 20 to 50 % chance of developing type 2 diabetes within 5 to 10 years, especially if they were overweight before the pregnancy.

Gestational diabetes is not caused by a lack of insulin, but by blocking effects of other hormones (estrogen, cortisol, and human placental lactogen) on the insulin that is produced, a condition referred to as insulin resistance. Normally, the pancreas is able to make additional insulin to overcome insulin resistance. However, when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.

Carbohydrate intolerance is diagnosed during pregnancy through an oral glucose tolerance test (OGTT). While the carbohydrate intolerance usually returns to normal level after delivery, the mother has a significant risk of developing permanent diabetes later on; while the baby is more likely to develop obesity and impaired glucose tolerance and/or diabetes later in life.

Risk factors include a family history of diabetes, increasing maternal age, obesity and being a member of a ethnic group with a high risk of developing type 2 diabetes.

The complications of gestational diabetes are usually manageable and preventable. The key to prevention is careful control of blood sugar levels as soon as the diagnosis of gestational diabetes is made.
Other types of diabetes -

4. Diabetes insipidus:

Diabetes insipidus is an uncommon condition, that occurs when the kidneys are unable to conserve water as they perform their function of filtering blood. The anti-diuretic hormone (ADH, also called vasopressin) controls the amount of water conserved. Diseases of the kidney (for example, polycystic kidney disease) and the effects of certain drugs may also cause nephrogenic diabetes insipidus.
The common symptoms are excessive urination and extreme thirst.

5. Syndrome X:

Syndrome X, also known as the “metabolic syndrome” or “Insulin Resistance Syndrome”, is a condition that is linked to an increased risk of diabetes and heart disease.

It is characterised by abdominal obesity, elevated levels of triglycerides, low levels of HDL (good) cholesterol, high blood pressure and high blood sugar levels. Other symptoms include smoking, high fat and calorie diet, pre-diabetes or Type 2 diabetes, polycystic ovary syndrome.

This is more common in older people than in younger people. In addition, women were more likely to have the syndrome than men.

by tom alter

DIABETES DIET

There is no such thing as a “diabetic diet.”

A balanced diet is recommended. All foods cause a varying insulin response in our bodies. Eat plenty of foods such as green vegetables, legumes, whole grains, and fibre that influence the release of sugar into the bloodstream. Foods that should be avoided are refined sugar, processed food, junk food, pastries, and cookies.

When checking labels, watch out for hidden forms of sugar, such as dextrose, glucose, sucrose, corn sweeteners, fructose, dextrin, lactose, maltose, malt, fruit juice concentrate.
Protein snacks should be eaten in between meals.

Alcohol, tobacco, and caffeine should be avoided.
Foods that are high on the “glycemic index” cause the blood sugar level to rise quickly, than those with a lower rating. Essentially, the glycaemic index is based on how quickly a particular food is digested, metabolized and then released into the bloodstream as glucose.

Higher glycemic index foods are white bread, sweets, packaged foods, pastries, frozen desserts, dried fruit, whole milk, burgers. Lower glycemic index foods are most vegetables, leafy greens, 100% whole grain bread, skim milk, buttermilk, chicken, fish, and many nuts. Many factors go on to influence the glycemic index of a food, such as preparation and consumption method.

Tips for planning a healthy diet for a diabetic patient:

?Eat a variety of foods - A platter of different-coloured foods give you nutrition from all the food groups. Include more of high-fibre foods, such as fruits, leafy green vegetables, and whole grains.

?Limit salt intake - which affects blood pressure. Avoid packaged snack foods, chips, pickles. Sodium intake of no more than 3000 mg per day is suggested. For people with high blood pressure, sodium should be limited to 2400 mg per day or as advised by a physician.

?Avoid saturated fats - like butter, ghee, and cheese. They increase “bad” (LDL) cholesterol. Instead, go for good fats, like omega-3 fats in fish, and vegetable oils made from plants such as groundnut oil, safflower oil etc.

?Eat good quantity of fibre - Rich sources of fibre are whole wheat breads, high-fibre cereals, green vegetables, and fibre supplements such as isabgol. Foods with fibre also help one manage blood sugar level as they reduce the need for insulin and also lower the level of fats in the blood.

?Fix up on portions you eat -. Eat about the same amount of food each day. Do not keep fluctuating your diet, or the quality of meals.

?Do not skip meals. Eat small meals about every four to five hours.

?Eat meals at regular times every day. If you are on a diabetes medicine, eat your meals and take your medicine about the same time each day.

?Include in your diet all foods which you like to eat. Even sweets can be eaten occasionally in moderate amounts. If your diet includes foods that you dislike, or if something you like eating is left out, you’re less likely to continue with the meal plan.

A simple diet plan -

A proper diet for a diabetic patient is one that is low in fat and simple sugars, and high in fibre and complex carbohydrates, so that it helps balance the blood sugar and control weight. The goal of a diabetes nutrition plan is to provide a mixture of fats, carbohydrates, and proteins at each meal at an appropriate calorie level to provide both essential nutrients as well as create a smooth release of glucose into the blood.

Choose a diet so that the approximate calories from the various components of the food is as follows:
Proteins - 20 percent
Fats - 20 percent

Carbohydrates - 60 percent

?Diabetics should fill up on leafy vegetables, bitter gourd (karela), papaya, oranges, lentils, legumes with strings and skin intact, whole grain cereals, pulses, sprouted moong, and 10 to 20 grams of guar ki phali (from cluster beans).

?Eat apples and other fruits which are high in pectin. One can go for a midmorning and afternoon snack of fruit such as apple to keep blood sugar stable.

?Get protein mostly from vegetable sources, such as grains and legumes. Fish and low-fat dairy products (buttermilk, low fat yoghurt, skimmed milk) are also acceptable sources of protein. Try and avoid fatty meat.

?Eat more carbohydrates.

?Do not take large doses of vitamins B1 (thiamine), B3 and C, as excessive amounts may inactivate the insulin. These vitamins should, however, be taken in normal amounts.

Being recommended a diabetic diet is nothing to be frightened of. It is neither a torture nor a nightmare; a little bit of planning and one can make it into a much-looked forward meal. So if diagnosed with diabetes, take it in your daily routine and just pay a little more attention to your diet from now on!!!

by tom alter

VITAMINS FOR DIABETES

Vitamins are essential to sustain life and we need to take the required amounts from our daily foods or dietary supplements. The benefits they provide help people feel more energetic, and assist the body in its regular functions.

As a diabetic patient is not able to get all the required nutrition from diet because of impaired functioning of the system, some vitamins may be required to take along with the regular medication. But, before taking any vitamin supplements, it is important to check with a doctor for what affect it may have upon diabetes.

Some of the essential vitamins for diabetics are -

Vitamin E

People with diabetes need extra vitamin E, which improves insulin activity and acts as an antioxidant (helps reduce the risk of diabetic complications), fights toxins and oxygenates the blood. Research has shown that people with low blood levels of vitamin E are more likely to develop Type 2 diabetes. In type 2 diabetics, it improves glucose tolerance.

It may require at least 2-3 months or more of regular intake of Vitamin E supplementation for benefits to become apparent. If one is taking an anticoagulant like ecospirin, aspirin (blood thinner), consult a physician before taking supplemental vitamin E.

Dietary sources include fortified & multi-grain cereals, nuts, wheat germ, vegetable oils, green leafy vegetables.

Vitamin C

Type 1 diabetic patients generally have low vitamin C levels. By increasing the amount of vitamin c in the bloodstream, the amount of sorbitol may get reduced. Sorbitol is a destructive sugar that can accumulate and lead to increased risk of diabetic complications such as retinopathy (eye), neuropathy (nerves) and renal damage. Vitamin C also helps improve glucose tolerance in the case of type 2 diabetic people. Doctors recommend between 1 - 3 g of Vitamin C dosage per day for diabetics.

Dietary sources include fresh vegetables and citrus fruits, such as broccoli, green and red pepper, cauliflower, lemon, cabbage, pineapples, strawberries, oranges, olives, citrus fruits.

Vitamin B6

Vitamin B6 is also known as pyridoxine. Diabetics who have a deficiency of this vitamin mostly suffer from neuropathy (nerve damage), and benefit from its supplementation. Peripheral neuropathy is a common outcome of vitamin B6 deficiency. Pyridoxine supplements are able to improve glucose tolerance, particularly for women with gestational diabetes, or impaired glucose tolerance caused by intake of birth control pill.

Vitamin B6 is also important in preventing other diabetic complications as it is an important non-protein compound that combines with the protein - collagen to form an active enzyme.
Dietary sources include chicken, fish, liver, whole grains, nuts, and legumes.

Vitamin B12

Vitamin B12 supplementation does to quite an extent help treat diabetic neuropathy. The presence of Vitamin B 12 is necessary for the correct functioning of nerve cells, and therefore taking it as a supplement may help reduce nerve damage.

Vitamin B12 may be taken orally in capsule form or intravenously or by injection to reduce nerve damage caused by diabetes in most people.
Recommended dosage is up to 500 mcg of Vitamin B12 three times a day.
Dietary sources include liver, yogurt, dairy products, fish, non fat milk.

Vitamin D

Vitamin D is both a hormone and a vitamin. Vitamin D deficiency predisposes individuals to type 1 and type 2diabetes. Low levels of vitamin D interfere with the proper functioning of insulin-producing cells. If not enough insulin is present, blood glucose levels will begin to rise.

Those with higher blood levels of vitamin D have better sensitivity to insulin and lower blood glucose levels compared to those with low vitamin D levels.

The skin is the most plentiful source of vitamin D. When exposed to ultraviolet light, our skin can produce as much as 20,000 IU of vitamin D. Food sources are limited to egg yolks, liver, cod liver oil and fortified milk.

Biotin (Vitamin B8) -

Biotin is a B vitamin needed to process glucose. It works in harmonization with insulin in the body, and independently increases the activity of the enzyme glucokinase (responsible in the primary step of glucose utilization). Glucokinase is formed only in the liver, and its concentration may be extremely low in diabetic patients.

Supplements of biotin may have a significant effect on glucose metabolism for both type 1 and type 2 diabetics. It might to an extent help reduce pain from diabetic nerve damage.

Experts advise taking 16mg of biotin for a few weeks to see for any changes in blood sugar levels.

Dietary sources include cereal, grain products, yeast, liver, legumes.

Niacin (Vitamin B3)

High levels of niacin may actually weaken glucose tolerance, and should therefore be avoided by diabetics. However, smaller amounts (500-750 mg per day for one month followed by 250 mg per day) can help some type 2 diabetics to lower their glucose levels.

Dietary sources include liver, poultry, milk, leafy green vegetables.
ALA and GLA

ALA (alpha-lipoic acid) is a potent and natural antioxidant, and may function to help diabetic neuropathy and reduce pain from free-radical break up. Some studies link ALA to decreased insulin resistance and thus, the control of blood sugar.

GLA (gamma-lipoic acid) is another naturally occurring antioxidant. It is helpful for improving damaged nerve function, which is common in diabetes.

by tom alter

DIABETES-FOODS TO EAT AND AVOID

What one eats is very important from the point of view of his health.
The chief concern while monitoring and controlling diabetes is to see that the sugar level does not cross the normal range. This means that one needs to cut down on certain types of food and consume regularly those foods, which are good at regulating diabetes.

People with diabetes should try to maintain a healthy weight and eat a diet that is:

« low in fat
« low in sugar
« low in salt
« high in fruit and vegetables (at least five portions a day)
« high in starchy carbohydrate foods, such as bread, chapatti, rice.

There is no such food that people with diabetes should never eat. In addition, there is no need to cut out all sugar. But, people with diabetes should try and eat only small amounts of foods that are high in sugar, fat. So, if you have diabetes you can treat yourself to cakes and biscuits once a blue moon, as part of a balanced diet.

What foods to eat?

« A diabetic patient must eat lots of fruits and vegetables in which fibre content is very high. Such type of food lowers the requirement for insulin, the reason being it releases energy into the body cells slowly. A high fibre diet means more chromium, which is very helpful in the treatment of diabetes.

« As for vegetables, onion, garlic, ginger, radish, spinach, kale, cucumber, carrot, tomato, cabbage and cucumber are excellent in the treatment of diabetes. Moong, kidney beans which have been sprouted, and unripe banana which is cooked, are also recommended.

« Fenugreek seeds which have been soaked in water are good for diabetic patients.

« For fruits, take guava, Indian blackberry (jamun), fig, kiwi fruit, apples, citrus fruits and pomegranate juice. Let these things be a part of your morning breakfast. Since, fruit juice is high in fructose (fruit sugar) and can cause blood sugar levels to rise quickly, it’s best for diabetics to drink fruit juice with a meal and avoid having more than one small glass a day.

« Replace white sugar with palm sugar, dates and honey, if you want to have something sweet.
« Unpolished rice, sprouted grain should be taken in moderate quantity.
« Fats like olive oil and peanut oil are good in diabetes.
« Drink plenty of water, at least 8 to 10 glasses per day.
« Single helping of fish or seafood, as it provides omega 3 fatty acids.
« Condiments such as pepper, chilli, mustard, herbs and spices
« Raw vegetables need to be taken in large quantity, as cooked food raises the level of blood sugar fast.
« Eat non-fat dairy such as skim milk, non-fat yogurt and non-fat cheese, plain yoghurt, avoid cottage cheese a sit is high in carbohydrates.
« Some herbs and vegetables are specifically prescribed for diabetes, like Bitter Gourd and bitter melon juice.
What to avoid?
« Processed foods, white sugar, white flour and junk food, must be totally given up. Avoid sweets, glucose, fruit sugar, cakes, ice cream, chocolates, soft drinks, cream and fried foods.
« Anything that contains harmful preservatives and too much salt should be avoided.
« Avoid smoking and alcohol.
« Try and abstain from sweets, ice-creams and chocolates, including the so-called sugar-free types.
« Foods made from white flour, rye, corn, polished rice, bread, pasta, pastry, cakes, biscuits, pies.
« Starchy vegetables such as potatoes in particular; and go easy with beet, carrots, peas, beans.
« Avoid concentrated dairy products, such as khoya, kheer, cheese, cottage cheese.

« Fruits such as bananas, mango, grapes, strawberry, custard apple, date.

« Cottage cheese (except in small amounts)

« Avoid commercially packaged foods such as fast foods, chips, ready-to-eat foods, snack foods and “health foods.”

« Fruit juices, as these are much higher in carbohydrates than fresh fruit. Moreover, they also lack in dietary fibre.

A few helpful tips if eating out -

· Avoid items called jumbo, combo, giant, deluxe, as they tend to have more calories.
· Choose grilled, baked roasted or steamed food.
· Choose water and calorie-free “diet” drinks instead of regular soda, fruit mock tails, sweet tea and other sugar-sweetened drinks
· Avoid creamy toppings, like mayonnaise. Add flavour with pepper, tomato, and onion.
· Watch out for high-fat topping salads, dressings, cheeses, and croutons.
· Choose a thin-crust pizza with extra vegetable toppings. Limit yourself to one or two slices. Keep off the extra cheese, which add calories, fat, and sodium.
· End your meal with sugar-free, fat-free frozen simple yogurt or a small cone of fat-free yogurt. Better still, go for a platter of fresh fruit salad.
· Check out on your portion size.
SO, EAT WELL AND BE WELL.

by tom alter