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Microsoft word - diabetes.doc
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What is it?
What are the symptoms?
Diabetes mel itus
(sugar diabetes or more
Very often the symptoms aren’t obvious and come
commonly just diabetes
) is a disease that affects the
on very slowly. Sometimes there are no symptoms. But
way the body uses food, causing sugar levels in the
when there are symptoms, they usually include:
blood to go too high. Digestion breaks down most of our
food into glucose
, a kind of sugar that is the body’s main
source of energy. But before it can be used as energy,
glucose must get inside al of the body’s cel s. Insulin
hormone produced by the pancreas
, acts as the “key”
that opens the door to cel s, letting the glucose in.
There are two types of diabetes mel itus – type 1
• Weight loss, even with increased appetite
diabetes (previously known as juvenile diabetes) which
accounts for about 10% of people with diabetes, and
type 2 diabetes (previously adult diabetes) which
includes over 90% of diabetics. In people with diabetes,
either the body doesn’t make enough insulin (type 1) or it
• Frequent skin, gum, or bladder infections
can’t effectively use the insulin it makes (type 2) due to
. As a result, blood glucose rises.
What causes it?
How do you prevent it?
No one knows the exact cause of diabetes. But we
do know that certain behaviors and conditions, cal ed
Recent research suggests that diabetes might be
risk factors, can make you more likely to get diabetes. In
preventable by maintaining a proper weight, along with
particular, type 2 diabetes mostly affects people who are
regular exercise and a healthy diet. We already know
overweight (the single most important risk factor), are
these habits can delay the disease in people who have
sedentary, have other close family members with
inherited the tendency to develop diabetes.
diabetes (2x risk), are over age 45, or are members of
certain ethnic groups such as Native Americans (5x
risk), Hispanic Americans (3x risk) or African Americans
Can it be treated?
(2x risk). Women who had gestational diabetes during
pregnancy or delivered a baby >9 pounds also are at
Although there is no cure for diabetes, it can be
higher risk of developing diabetes sometime later in life.
control ed. No matter which type of diabetes you have, it
is important to understand that diet and exercise form
the foundation of any successful treatment plan.
Who gets it?
Medications can be added if diet and exercise alone are
not enough. The goal of treating diabetes is to control
Approximately 16 mil ion Americans have diabetes,
your blood sugar level by keeping it as close to normal
but only 1/3 have been diagnosed. In addition,
as possible, which has been shown to prevent or delay
approximately another 15 mil ion Americans have pre-
many of the long-term complications of diabetes. In
(formerly borderline diabetes). The lifetime risk
general, sugar levels before meals should be between
of diabetes for US men in 33% and for women 39%.
80 and 130 mg/dl and not more than 180 after meals.
Diabetes shortens the average lifespan 9-12 years.
Fol ow the advice of your doctor. Take your medicine as
It is currently the fourth leading cause of death by
directed. Keep track of your blood sugars and learn al
– The most important thing you can do is eat
works directly at the cel level to open
the right food, in the right amounts, at about the same
time everyday. Eat plenty of fiber. Fiber helps slow
– (Symlin) slows absorption of
down the release of sugar into your blood after eating,
carbohydrate and suppresses glucose output from the
so it helps control your blood sugar level. Avoid high
liver. It is injected before meals at the same time as
sugar foods. Switch to sugar-free foods and drinks.
insulin. Nausea is the most common side effect.
Use sugar substitutes if needed. About 10-20% of
calories should come from protein, less than 10 % from
Are there complications?
saturated fats (which are solid at room temperature), up
to 10% from polyunsaturated fats, and then 60-70% from
Diabetes can cause serious health problems, often
carbohydrates. Daily cholesterol intake should be less
without symptoms. These problems usual y develop
than 300mg. And if you are overweight, losing even 5-
after many years of having constant or repeated high
10% of body weight can lower your blood sugar and
blood sugar levels. When blood sugar levels are high it
causes damage to the small blood vessels in the body.
Organs that are particularly dependent upon smal
– Exercise can lower blood glucose
vessels for nourishment are affected most often and
levels, help you lose weight, and improve your
most severely. Complications of diabetes include:
circulation, blood pressure, and heart health. It can also
– kidney damage in which the kidneys can
give you more energy, make you stronger, and help
no longer filter wastes as effectively and may eventually
relieve stress. You can choose any nonstop activity that
fail leading to dialysis; Retinopathy
– eye disease
makes your heart and lungs work harder than normal.
leading possibly to blindness; Neuropathy
This is called aerobic
exercise. Running, walking,
damage which can cause numbness, tingling, or a
swimming and cycling are all aerobic exercises. It is
burning feeling in the feet and legs; Vasculopathy
important to do some exercise nearly every day.
damage to the blood vessels to the brain or legs which
can cause stroke or amputation; and Cardiomyopathy
– With type 1 diabetes you wil need
blockages in the blood vessels of the heart known as
to take insulin. With type 2, treatment starts with helping
which can lead to heart attacks. The
your body more effectively use the insulin it does make
best thing to prevent these problems is to take good care
by reducing insulin resistance. In time, most people with
of yourself and keep your blood sugars in control.
type 2 diabetes produce less and less insulin.
Most complications can be prevented. The
Therefore, treatment wil change over time.
American Diabetes Association targets several key
- Metformin (Glucophage) works on
areas in which good care makes a difference. You
the liver to keep it from releasing too much glucose,
should have your long-term glucose control (A1C
particularly at night when you sleep. The liver has
checked by your doctor every 3-6 months with the goal
stored glucose that normal y is released between meals.
being less the 7.0%. Your cholesterol (a risk for heart
Glyburide, glipizide, glimepiride
disease) and urine protein (a sign of kidney damage)
(Micronase, Glynase, Glucotrol, Amaryl) are the oldest
should be checked yearly. You should have a complete
class of medications available and primarily work on the
eye examination yearly by your eye doctor. You should
pancreas to make and release more insulin.
get into the habit of examining your feet everyday, and
(Prandin) and d-phenylalanine
they should be checked for nerve damage by your
(Starlix) are similar to the sulfonylureas by
doctor yearly. If you smoke, you should quit. And your
primarily working on the pancreas to release more
blood pressure should be checked regularly, at least
insulin. However, they are quicker acting and quicker
every 3-6 months, with the goal less than 130/80.
peaking to more closely mirror the release of glucose
after a meal which helps to prevent the blood sugar from dropping too low between meals.
Precose) work in your intestines to delay how fast your
• Fol ow these steps to plan for success:
, also known as “glitizones”
(Avandia, Actos) help your body use insulin more
effectively by decreasing insulin resistance.
• DPP-4 inhibitors
(Januvia) work only when
blood sugar is elevated to release more insulin from the
pancreas and control production of glucose by the liver.
• Incretin mimetic
– (Byetta) stimulates insulin
• For more information, contact the American
secretion only when blood sugar is high and not
Diabetes Association at (800) 232-3472, or at
control ed with oral agents. It does not cause weight
www.diabetes.org or the National Diabetes
gain like many other agents. It is injected before meals.
It is not for use with Type I diabetes or with insulin.
COMED INC. 14 REDGATE COURT, SILVER SPRING, MD 20905-5726 LANDMARK STUDY: AUTISM RECOGNIZED AS MEDICALLY TREATABLE PRESS RELEASE CONTACTS: CoMeD President [Rev. Lisa K. Sykes (Richmond, VA) 804-364-8426] CoMeD Sci. Advisor [Dr. King (Lake Hiawatha, NJ) 973-263-4843] WASHINGTON, DC – In April of 2008, the American College of Medical Genetics (ACMG), an AMA-recognized
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