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, Symptoms
glucose must get inside al of the body’s cel s. Insulin, a 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 insulin resistance. 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 diabetes (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 DIET – The most important thing you can do is eat
• Insulin 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 • Amylinomimetic – (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 – 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 Nephropathy – 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 – nerve 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 – MEDICATION – 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 atherosclerosis 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 • Biguanides - 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 • Sulfonylureas- 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 • Meglitinides (Prandin) and d-phenylalanine
they should be checked for nerve damage by your derivatives (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. • Alpha-Glucosidase
Inhibitors
In summary
Precose) work in your intestines to delay how fast your • Fol ow these steps to plan for success: • Thiazolidinediones, 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.

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