What is diabetes?
Diabetes is a disease where your blood
glucose (sugar) levels are above normal. It results from the inability
of the glucose to get into your cells. As a result your cells are
starving for their food (glucose). It would be like a starving person
surrounded by tables of wonderful food but their mouth has been sewn
closed and they can't eat.
About 17 million Americans are believed
to have diabetes and one-third of those patients don't even know they
have it. Diabetes can cause serious health complications including heart
disease, blindness, kidney failure, and lower-extremity amputations.
Diabetes is the 6th leading cause of death in the US. And most diabetics
develop heart disease. In fact, just having diabetes carries the same
risk of having a heart attack as someone who has already had such an
event. Therefore it is very important for patients that have diabetes to
also have a physician that closely monitors and treats their
cholesterol levels as well as their blood pressure. Additionally, any
use of tobacco products multiplies the risks and should be stopped.
Are there different kinds of diabetes?
Certainly.
But the basic features of the disease are same. In any form of
diabetes there is some underlying reason why your body is not able to
utilize glucose (sugar) for energy, and that causes the levels of
glucose (sugar) in your blood build up above normal. There are three
areas that are important for you to understand in diabetes. First, the
cells in your body which use the glucose are important as they must be
able to remove sugar from the blood and put it inside the cell as a
fuel. Secondly, the insulin which is made by your pancreas (an organ
near your stomach) is important to allow the sugar to enter the cell
(the key to unlock the door to enter), and lastly, glucose which is
broken down from your food or from muscle and liver from a storage form
of glucose called glycogen. Now if you think of the disease diabetes as
involving a locking gas cap on your car, it will be easier to
understand.
If you understand how a locking gas cap works, then
you can understand how diabetes works. All of the cells in your body
have a locking gas cap on them. Insulin is the key to the locking gas
cap, and glucose would be the fuel for the car. In one form of diabetes,
the body totally quits making insulin (keys) so you can't get glucose
(fuel) into your cells. In other forms of diabetes, your body makes some
insulin (keys) but not much as your body needs.
Therefore, only a few
of the cells can be unlocked and opened to put the glucose (fuel)
inside. Another thing that happens is that some of the locks on the
cells become rusty and won't work properly. So even if you have insulin
(keys) you can't get the cells to open. This is called insulin
resistance. If the cells won't open, you can't get glucose (fuel) inside
the cell for energy. The result of all of this is excess glucose in
your blood.
Types Of Diabetes.
Type 1 diabetes is usually
diagnosed in children and young adults and only accounts for 5-10% of
diabetes patients. In type 1 diabetes the pancreas doesn't make any
insulin (keys) at all.
Type 2 diabetes is the most common form of
the disease. It accounts for 90-95% of all the cases of diabetes. In
type 2 diabetes, either your body doesn't make enough insulin (keys), or
the cells in your body ignore the insulin (the lock is rusty and
doesn't work) so they can't utilize glucose like they are supposed to.
When your cells ignore the insulin, as mentioned above, it is often
referred to as insulin resistance.
Other types of diabetes which
only account for a small number of the cases of diabetes include
gestational diabetes, which is a type of diabetes that only pregnant
women get. If not treated, it can cause problems for mothers and babies
and usually disappears when the pregnancy is over. Other types of
diabetes resulting from specific genetic syndromes, surgery, drugs,
malnutrition, infections, and other illnesses may account for 1% to 2%
of all cases of diabetes.
How do you get diabetes?
There are
risk factors that increase your chance of developing diabetes. Risk
factors for type 2 diabetes include older age, obesity, family history
of diabetes, prior history of gestational diabetes, impaired glucose
tolerance, physical inactivity, and race/ethnicity. Risk factors are
less well defined for type 1 diabetes than for type 2 diabetes, but
autoimmune, genetic, and environmental factors are involved in
developing this type of diabetes.
What are the symptoms of diabetes?
People
who think they might have diabetes must visit a physician for a
diagnosis. They might have SOME or NONE of the following symptoms:
frequent urination, excessive thirst, unexplained weight loss, extreme
hunger, sudden vision changes, tingling or numbness in hands or feet,
feeling very tired much of the time, very dry skin, sores that are slow
to heal, more infections than usual. Nausea, vomiting, or stomach pains
may accompany some of these symptoms in the abrupt onset of type 1
diabetes.
Glucose is sugar! So all I have to do is avoid sweets, right?
It
is not that simple. The truth is, most food, and all of the
carbohydrates you eat, are broken down into its simplest structure,
glucose. As food arrives in your stomach, the acid starts to break the
food down immediately. Proteins are broken down for their amino acids,
and carbohydrates for their glucose. Once your gastrointestinal system
breaks your food down into something your body can utilize, the blood
picks it up and carries it to your cells to for energy. In healthy
people, the blood picks up the glucose absorbed from the GI tract, and
sends a signal to your pancreas (an organ near your stomach) to make and
release insulin. Remember, in Type 2 diabetes your body doesn't make
enough insulin (keys), or some of your cells ignoring the insulin that
is there. (The locks are rusty and won't work) In both situations, your
cells don't get the glucose they need for energy and they are starving
while all the extra glucose is just floating around in your blood and
can't be used.
The worst part is, when all that extra glucose is
floating around in your blood, it is causing damage to your blood
vessels and organs and that damage increase your risk of heart disease.
That is why it is very important to keep your blood glucose levels as
close to normal as possible. When the glucose levels get really high,
the glucose starts to leak out into your urine.
How do you treat diabetes?
There
are several things you need to do to help control your diabetes. For
type 1 diabetes, Healthy eating, physical activity, and insulin
injections are the basic therapies. The amount of insulin taken must be
balanced with food intake and daily activities. For patients with type 1
diabetes, blood glucose levels must be closely monitored through
frequent blood glucose testing.
For type 2 diabetes, healthy
eating, physical activity, and blood glucose testing are the basic
therapies. In addition, many people with type 2 diabetes require oral
medication, insulin, or both to control their blood glucose levels.
Some of the oral medications work by stimulating your pancreas to make
more insulin (keys). Other oral medicines work to make the rusty locks
start working again. In a sense they are kind of like WD-40 for the
rusty locks on the cells. It fixes the lock on the cells so the insulin
(keys) can open the cell to allow the glucose (fuel) inside. Once the
glucose (fuel) is allowed inside the cells, your blood sugar levels will
drop back down to normal.
What medicine am I going to have to take for my diabetes?
There
are many different types of medications that your doctor may prescribe
for diabetes; however these prescriptions can cause certain nutritional
deficiencies that may increase your risk for chronic degenerative
diseases. NutraMD Diabetes Essential Nutrients® supplement was designed
to work with your diabetic medications by replacing lost nutrients
reducing the risk of dangerous side effects, and promote better health
The main classes of diabetic medications include sulfonylureas, biguanides, and thiazolidinediones.
Sulfonylureas include the following medications:
Orinase ,Tolinase, Diabinese, Glipizide, Glyburide, Amaryl, Prandin, Strarlix
The main function of sulfonylureas is to increase insulin production
in the beta cells of the pancreas. Sulfonylureas can interfere with the
body's normal metabolism of Coenzyme Q10. Because CoQ10 is necessary
to make energy in all tissues of the body, this effect may decrease your
body's natural ability to utilize or "burn up" sugars, and may even
reduce the ability of the pancreas to produce insulin over time.
Biguanides include the following medications:
Glucophage (Metformin)
Glucovance (metformin + glyburide)
The
main functions of biguanides are to lower the production of glucose by
the liver thereby reducing blood glucose levels. Your doctor may
prescribe this type of medicine in combination with sulfonylureas
insulin, or a class of drugs known as thiazolidinediones. Unfortunately,
biguanides have been shown to deplete vitamin B-12, folic acid and
Coenzyme Q10 (CoQ10). A few of the problems which may arise from
deficiencies of folate and vitamin B-12 include the following: Heart
disease, stroke, anemia, arthritis, joint pain, muscle pain, and
neuropathies (nerve damage). Because diabetes increases your risk for
heart disease, stroke, and neuropathy, it is especially important to
prevent nutritional deficiencies which may add to these risk factors.
Therefore to reduce potential side effects of nutrient deficiencies you
should take NutraMD Diabetes Essential Nutrients® supplement as long as
you are on your diabetic medication.
Because both medication types
listed above can deplete CoQ10, it is important to understand some of
the symptoms of a deficiency. CoQ10 deficiency has been linked to the
following diseases and symptoms: Congestive heart failure, high blood
pressure, rhabdomyolysis (muscle break down), muscle and joint pain, and
fatigue. Therefore to achieve maximum benefit from the diabetes
medications and minimize potential side effects of nutrient
deficiencies, you should compliment your prescription medication by
taking NutraMD Diabetes Essential Nutrients® supplement. By doing this,
you will balance the risk/benefit ratio further in your favor.
In
summary, diabetic medications prescribed by your doctor are necessary to
treat your condition; however, you should also be aware that the long
term potential nutritional side effects may be just as big a risk factor
for your health as the disease you set out to treat in the first place.
Put the odds in your favor and maintain your health with NutraMD
Diabetes Essential Nutrients® supplement
How do I know I am keeping my blood sugar under control?
Frequent blood tests are used to monitor your blood sugar. Most
patients with diabetes should have a home blood monitoring kit. Some
doctors ask their patients to check their blood sugar as frequently at 6
times a day, though this is an extreme. The more information you have
about your blood sugar levels, the easier it will be for you to control
it. People with diabetes must take responsibility for their day-to-day
care, and keep blood glucose levels from going too low or too high.
When
your blood sugar is too high, your doctor refers to it as
hyperglycemia. When your blood sugar is too high, you may not
experience any symptoms, but the high levels of glucose in your blood is
causing damage to your blood vessels and organs. That is why it is
important to have your body utilize the sugar properly and get it out of
your bloodstream.
When your blood sugar is too low, your doctor
refers to it as hypoglycemia. Having low blood sugar can be very
dangerous and patients taking medication for diabetes should watch for
symptoms of low blood sugar. It is also important that your monitor
your blood sugar regularly to avoid both low as well as high blood
sugar. It is important that you keep your blood sugar as close to normal
as possible at all times.
How does my doctor know if I am keeping my blood sugar under control?
Some patients are may not follow the proper diet and exercise except
for the days leading up to a blood test in the doctor's office. They
want to look like they are doing a good job controlling their blood
sugar. This way their fasting blood glucose test results will be good
for the doctor. But, there is a test that will show your doctor the
real picture over the past 3 months or so. It is called the hemoglobin
A1C (HbA1C) test. Hemoglobin is the part of your blood, or red cells,
that carries oxygen to your cells. Glucose sticks to the hemoglobin in
your red cells of the blood as they emerge from the bone marrow where
they are made.
The amount of sugar on the red cell is
proportionate to the blood sugar level at the moment the red cell goes
into circulation, and remains at that level for the life of the red
cell. So if there has been a lot of extra glucose in your blood, there
will be a lot of glucose stuck all over your hemoglobin. Since the
average lifespan of the hemoglobin in your blood is 90-100 days, a HbA1C
test shows a doctor how well you have been controlling your blood sugar
over the last 3 months. This test is a check on the overall sugar
control, not just the fasting blood sugar. So it is important to control
your blood sugar at all times, and not just before visiting the doctor.
The most important reason to control your blood sugar is so that you
can live a longer, healthier life without complications that can be
caused by not controlling your diabetes.
What happens if I do not control my diabetes?
The complications of diabetes can be devastating. Both forms of
diabetes ultimately lead to high blood sugar levels, a condition called
hyperglycemia. The damage that hyperglycemia causes to your body is
extensive and includes:
Damage to the retina from diabetes (diabetic retinopathy) is a leading cause of blindness.
Diabetes
predisposes people to high blood pressure and high cholesterol and
triglyceride levels. These independently and together with hyperglycemia
increase the risk of heart disease, kidney disease, and other blood
vessel complications.
Damage to the nerves in the autonomic
nervous system can lead to paralysis of the stomach (gastroparesis),
chronic diarrhea, and an inability to control heart rate and blood
pressure with posture changes.
Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of kidney failure.
Damage
to the nerves from diabetes (diabetic neuropathy) is a leading cause of
lack of normal sensation in the foot, which can lead to wounds and
ulcers, and all too frequently to foot and leg amputations.
Diabetes
accelerates atherosclerosis or "hardening of the arteries", and the
formation of fatty plaques inside the arteries, which can lead to
blockages or a clot (thrombus), which can then lead to heart attack,
stroke, and decreased circulation in the arms and legs (peripheral
vascular disease).
Hypoglycemia, or low blood sugar, occurs from
time to time in most people with diabetes. It results from taking too
much diabetes medication or insulin, missing a meal, doing more exercise
than usual, drinking too much alcohol, or taking certain medications
for other conditions. It is very important to recognize hypoglycemia and
be prepared to treat it at all times. Headache, feeling dizzy, poor
concentration, tremors of hands, and sweating are common symptoms of
hypoglycemia. You can faint or have a seizure if blood sugar level gets
too low.
Diabetic ketoacidosis is a serious condition in which
uncontrolled hyperglycemia (usually due to complete lack of insulin or a
relative deficiency of insulin) over time creates a buildup in the
blood of acidic waste products called ketones. High levels of ketones
can be very harmful. This typically happens to people with type 1
diabetes who do not have good blood glucose control. Diabetic
ketoacidosis can be precipitated by infection, stress, trauma, missing
medications like insulin, or medical emergencies like stroke and heart
attack.
Hyperosmolar hyperglycemic nonketotic syndrome is a
serious condition in which the blood sugar level gets very high. The
body tries to get rid of the excess blood sugar by eliminating it in the
urine. This increases the amount of urine significantly and often leads
to dehydration so severe that it can cause seizures, coma, even death.
This syndrome typically occurs in people with type 2 diabetes who are
not controlling their blood sugar levels or have become dehydrated or
have stress, injury, stroke, or medications like steroids.
My doctor says I have pre-diabetes? What is that?
Pre-diabetes is a common condition related to diabetes. In people
with pre-diabetes, the blood sugar level is higher than normal but not
high enough to be considered diabetes. Pre-diabetes increases your risk
of getting type 2 diabetes and of having heart disease or a stroke.
Pre-diabetes can be reversed without insulin or medication by losing a
modest amount of weight and increasing your physical activity. This can
prevent, or at least delay, onset of type 2 diabetes. When associated
with certain other abnormalities, it is also called the metabolic
syndrome.
What are normal blood glucose levels? The amount of
glucose (sugar) in your blood changes throughout the day and night. Your
levels will vary depending upon when, what and how much you have eaten,
and whether or not you have exercised. The American Diabetes
Association categories for normal blood sugar levels are the following,
based on how your glucose levels are tested:
A fasting blood
glucose test: This test is performed after you have fasted (no food or
liquids other than water) for eight hours. A normal fasting blood
glucose level is less than 100 mg/dl. A diagnosis of diabetes is made if
your blood glucose reading is 126 mg/dl or higher. (In 1997, the
American Diabetes Association lowered the level at which diabetes is
diagnosed to 126 mg/dl from 140 mg/dl.)
A "random" blood glucose
test can be taken at any time. A normal blood glucose range is in the
low to mid 100s. A diagnosis of diabetes is made if your blood glucose
reading is 200 mg/dl or higher and you have symptoms of disease such as
fatigue, excessive urination, excessive thirst or unplanned weight loss.
Another
test called the oral glucose tolerance test may be performed instead.
For this test, you will be asked, after fasting overnight, to drink a
sugar-water solution. Your blood glucose levels will then be tested over
several hours. In a person without diabetes, glucose levels rise and
then fall quickly after drinking the solution. In a person with
diabetes, blood glucose levels rise higher than normal and do not fall
as quickly.
A normal blood glucose reading two hours after
drinking the solution is less than 140 mg/dl, and all readings between
the start of the test until two hours after the start are less than 200
mg/dl. Diabetes is diagnosed if your blood glucose levels are 200 mg/dl
or higher.
What else do I need to do if I have diabetes?
People with diabetes should see a health care provider who will
monitor their diabetes control and help them learn to manage their
diabetes. In addition, people with diabetes may see endocrinologists,
who may specialize in diabetes care; ophthalmologists for eye
examinations; podiatrists for routine foot care; and dietitians and
diabetes educators who teach the skills needed for daily diabetes
management.
Diabetes, and its precursor, the metabolic syndrome,
can lead to a multitude of problems if not adequately controlled. These
include vascular diseases that result in heart attack and stroke, kidney
damage leading to kidney failure, damage to nerves (neuropathy),
retinal damage leading to blindness, high blood pressure, and various
metabolic defects such as high triglycerides or high cholesterol. It is
therefore crucial to control the diabetes as well as all the other risk
factors for artery diseases that cause heart attack and stroke.
To
do this, your doctor will insist on a good diet and regular exercise.
Medications are added to lower the blood sugar, and if these are
inadequate, insulin or other injectable medication will be required. The
medications that treat diabetes may cause depletion of folic acid,
which in turn can cause a high homocysteine, which is a risk factor for
artery disease that underlies heart attack and stroke. You can shift the
risks in your favor by taking NutraMD Diabetes Essential Nutrients
along with your doctor prescribed medications.
By
Don Ford, M.D.
