The incidence of diabetes is growing rapidly both in the United States and worldwide. For example, it is estimated that more than 250 million people worldwide are afflicted with diabetes, and the prevalence is expected to exceed 350 million by the year 2030.
Diabetes mellitus is not one disease, but rather is a heterogeneous group of multifactorial, polygenic syndromes characterized by an elevation of fasting blood glucose that is caused by a relative or absolute deficiency in insulin. Diabetes is the leading cause of adult blindness and amputation, and a major cause of renal failure, nerve damage, heart attacks, and stroke.
The American Diabetes Association (ADA) recognizes four clinical classifications of diabetes: type 1 diabetes (formerly, insulin dependent diabetes mellitus), type 2 diabetes (formerly, non-insulin dependent diabetes mellitus), gestational diabetes, and diabetes due to other causes (for example, genetic defects or medications).
Type 1 Diabetes
Type 1 diabetics constitute approximately 10% of diabetics in the United States. The disease is characterized by an absolute deficiency of insulin caused by an autoimmune attack on the β cells of the pancreas. This destruction requires a stimulus from the environment (such as a viral infection) and a genetic determinant that allows the β cell to be recognized as ‘nonself’. The metabolic abnormalities of type 1 diabetes mellitus include hyperglycemia, ketoacidosis, and hyper triacylglycerolemia. They result from a deficiency of insulin and a relative excess of glucagon.
Treatment of Type 1 Diabetes
Type 1 diabetics must rely on exogenous insulin injected subcutaneously to control hyperglycemia and ketoacidosis. The goal in administering insulin to Type 1 diabetics is to maintain blood glucose concentrations as close to normal as possible and to avoid wide swings in glucose levels that may contribute to long-term complications. Insulin may also be delivered by a pump, which allows continuous subcutaneous infusion of insulin 24 hours a day at preset levels and the ability to program doses (a bolus) of insulin as needed at meal times.
Type 2 diabetes
Most diabetic patients have type 2 disease. Type 2 diabetes is influenced by genetic factors, aging, obesity, and peripheral insulin resistance, rather than by autoimmune processes or viruses. It results from a combination of insulin resistance and dysfunctional β cells. Insulin resistance is the decreased ability of target tissues, such as liver, adipose tissue, and muscle, to respond properly to normal (or elevated) circulating concentrations of insulin.
[wp_ad_camp_4]Obesity is the most common cause of insulin resistance. However, most people with obesity and insulin resistance do not become diabetic. In the absence of a defect in β-cell function, non -diabetic, obese individuals can compensate for insulin resistance with elevated levels of insulin. Insulin resistance alone will not lead to type 2 diabetes. Rather, type 2 diabetes develops in insulin-resistant individuals who also show impaired β-cell function. The metabolic alterations observed in type 2 diabetes are milder than those described for the insulin-dependent form of the disease, in part, because insulin secretion in type 2 diabetes- although not adequate- does restrain ketogenesis and blunts the development of diabetic ketoacidosis. Available treatments for diabetes moderate the hyperglycemia, but fail to completely normalize metabolism. The long standing elevation of blood glucose is associated with the chronic complications of diabetes- premature atherosclerosis, retinopathy, nephropathy, and neuropathy.
Treatment of type 2 diabetes
The goal in treating type 2 diabetes is to maintain blood glucose concentrations within normal limits, and to prevent the development of long-term complications. Weight reduction, exercise, and medical nutrition therapy (dietary modifications) often correct the hyperglycemia of newly diagnosed type 2 diabetes. Hypoglycemic agents or insulin therapy may be required to achieve satisfactory plasma glucose levels.
Gestational Diabetes/ Diabetes in Pregnancy
Gestational diabetes is defined as carbohydrate intolerance with onset or first recognition during pregnancy. It is important to maintain adequate glycemic control during pregnancy, because uncontrolled gestational diabetes can lead to fetal macrosomia (abnormally large body) and shoulder dystocia (difficult delivery), as well as neonatal hypoglycemia. Diet, exercise, and/or insulin administration are effective in this condition. Glyburide and metformin may be reasonably safe alternatives to insulin therapy for gestational diabetes. However, larger randomized studies are needed to fully assess neonatal outcomes and optimal dosing regimens.
How To Avoid Diabetes
There are precautions you can take to avoid getting diabetes
Exercise Exercise helps keep a healthy blood sugar level, maintain a healthy weight, manage stress, and Improve steep
Eat Healthy Eat a balanced diet tow in saturated fats and sugars in order to maintain healthy weight and blood sugar level
Manage Weight Make sure you are at a healthy weight for your body type and take special notice to any weight you gain around your midsection
Manage Your Diabetes
Don’t Skip Medication Follow your doctor’s recommendations and do not skip a dose even if you feel happy
Don’t Stress Stress can complicate diabetes so speak to someone if you ever need support
Don’t Smoke In addition to its many other dangers smoking can harm your circulatory system
Keep Teeth Healthy Higher blood sugar levels lead to an increased risk of tooth decay and gum disease
Check Blood Glucose Keep track of your blood sugar levels to stay in control of your diabetes
Check Your Feet Check your feet daily for cuts, sores, and swelling and call your doctor if they don’t go away