The blood sugar roller coaster

Fiber does two major things in the body that can contribute directly and indirectly to energy. First and foremost, it helps control blood sugar. When your blood sugar is out of control, so is your energy. Low-fiber foods, especially processed carbohydrates that also don’t contain much fat or protein, send your blood sugar rocketing, which, in short order, sets you up for a big fat crash in energy.

A candy bar may give you a rush of blood sugar, but half an hour later you’ll be pinching yourself to keep your eyes open as your blood sugar plummets. On the other hand, eat some beans and your blood sugar will rise slowly and stay up there for a week. (I’m kidding, but you get the point).

How turmeric can lower blood sugar levels?

Turmeric, also known as haldi in hindi, is one of the most widely used spices to add colour and flavour to food. However, if you suffer from diabetes, this spice is an essential ingredient you need to include in all your food preparations without fail. Known to be a potent antiseptic and a powerful antioxidant agent, turmeric is packed with numerous health benefits. Moreover, turmeric acts as an effective natural remedy to keep your blood sugar levels in control. Here’s what makes it a natural anti-diabetic compound.

How does it work?

Diabetes: Canola oil-enriched diet helps lower diabetes

Switching to a diet low in simple sugars and high in healthy fats, like the types found in canola oil, could help people with type 2 diabetes control their blood sugar, according to a new study.

People with type 2 diabetes who were advised to follow a diet with a low glycemic index supplemented with extra canola oil had lower blood glucose levels and greater reductions in heart risk than those who ate a diet high in whole grains, researchers found.

How diabetes predisposes individuals to Alzheimer's disease

Diabetes and dementia are rising dramatically in the United States and worldwide. In the last few years, epidemiological data has accrued showing that older people with diabetes are significantly more likely to develop cognitive deterioration and increased susceptibility to onset of dementia related to Alzheimer's disease. Now, a research team led by Giulio Maria Pasinetti, MD, PhD, the Saunders Family Chair and Professor of Neurology at the Icahn School of Medicine at Mount Sinai, discovered a novel mechanism through which this may occur. The results are published online in the journal Diabetes.

Dr. Pasinetti and colleagues pinpointed changes in post-mortem brains of human subjects. They reported that gene expression was dysfunctional in the brains of diabetic human subjects, and this increase was associated with reduced expression of important molecules that play a critical role in maintaining the structural integrity of brain regions associated with learning.

Excited by this finding, Dr. Pasinetti reasoned that if the hypothesis was correct, similar conditions should be repeated in the laboratory by inducing diabetes in mice genetically predisposed to developing Alzheimer's type memory deterioration.

In fact, Dr. Pasinetti's laboratory confirmed this prediction in the mouse model, supporting the hypothesis that diabetes, through epigenetic changes in the brain, may casually promote onset and progression of Alzheimer's disease. Epigenetic changes are chemical changes in DNA that effect gene expression, but don't alter the actual genetic code.

"This new evidence is extremely intriguing, given that approximately 60 percent of Alzheimer's disease patients have at least one serious medical condition associated with diabetes," said Dr. Pasinetti. "What this adds is much needed insight into the potential mechanism that might explain the relationship between diabetes and Alzheimer's disease onset and progression by mechanisms through which DNA functions."

The discovery in Dr. Pasinetti's laboratory has staggering societal implications. More than 5 million are affected by Alzheimer's disease dementia, and the disease incidence is expected to skyrocket in the three decades as the population ages.

"The next question we must ask is how we can translate this into the development of novel disease prevention and treatment strategies," Dr. Pasinetti added. "If we can find out how DNA epigenetic modification can be manipulated pharmacologically, these studies will be instrumental in the formulation of novel treatments and possible preventative strategies in Alzheimer's disease.

source: IANS

Reduce Diabetic Foot Infections With Proper Treatment

Diabetics often suffer from foot infections, yet appropriate care can save limbs, and ultimately lives, according to the Infectious Diseases Society of America's new guidelines.

The mortality rate for diabetics due to poor treatments of infected foot wounds that can subsequently lead to lower extremity amputation is worse than for the majority of cancers, given that around 50% of diabetics with foot amputations die within five years. The IDSA diabetic foot infection guidelines published in the journal Clinical Infectious Diseases have now revealed that about half of these lower extremity amputations can in fact be prevented through proper care of foot infections.

Diabetics generally suffer from poor blood circulation, which means their sense of touch or pain sensitivity can be greatly compromised. For instance, a simple sore caused by a rubbing shoe or a cut can easily go unnoticed and become worse. One in four diabetics will have a foot ulcer, i.e. an open sore in their lifetime, which can easily become infected. If left untreated, these infections can spread and kill soft tissue and bone, which means that the dead and infected tissue needs to be surgically removed, and in severe cases, this means amputation of the toe, foot, or even part of the leg. Almost 80% of all non-traumatic amputations are performed in people with diabetes, and 85% of these amputations start with an open foot sore.

Leading author, Benjamin A. Lipsky, MD, chair of the review panel, guidelines and professor of medicine at Washington University and VA Puget Sound in Seattle declared:

"Lower extremity amputation takes a terrible toll on the diabetic patient. People who have had a foot amputated often can no longer walk, their occupational and social opportunities shrink, and they often become depressed and are at significant risk for a second amputation. Clearly, preventing amputations is vital, and in most cases, possible."

The guidelines highlight the importance for a rapid and appropriate treatment of infected wounds on the lower extremities. For instance, surgically removing (debridement) dead tissues, administering proper antibiotics and, wherever required, alleviating pressure on the wound and restoring blood flow to the area. Solely prescribing antibiotics for diabetics with foot infections, as is often the case, often proves insufficient if the wound is not also properly cared for, including surgical interventions.

Treating diabetic foot infections can pose a real challenge. The revised and updated IDSA 2004 diabetic foot infections guidelines therefore recommend involving a multidisciplinary team that can evaluate and address different aspects of the problem. According to research since the previous guidelines, many foot infections are treated inappropriately, i.e. by prescribing the wrong antibiotic, or failing to take into account underlying conditions like peripheral arterial disease.

The new guidelines feature 10 common questions health care providers may encounter when considering treatment options for a diabetic patient with a foot wound, to which the IDSA panel of experts has written a comprehensive answer based on extensive evidence. For instance, the first step is establishing whether the wound is infected. The guidelines state that a sign of infection includes at least two of the following symptoms: redness, tenderness, warmth, pain or swelling. Around 50% of ulcers are not infected and therefore do not require antibiotic therapy, unlike those in which an infection has been diagnosed, whilst individuals with a severe infection should be referred for immediate hospitalization.

Diabetics with infected foot ulcers should generally have their foot imaged to determine whether the infection has spread to the bone. Another important treatment aspect is to grow a culture of the bacteria that has caused the infection, as this will assist in choosing the best antibiotics. The guidelines recommend employing a multidisciplinary team due to the complexity of diabetic foot infections, which includes infectious diseases specialists, surgeons, podiatrists and orthopedists. Dr. Lipsky noted that doctors in rural areas could potentially use telemedicine in order to consult with the necessary experts.

The guidelines' co-author, Warren S. Joseph, DPM, a consultant for lower extremity infectious diseases at Philadelphia's Roxborough Memorial Hospital explained:

"There is quite a bit of over-prescribing or inappropriate prescribing of antibiotics for diabetic foot wounds, which doesn't help the patient and can lead to antibiotic resistance. The guidelines note that when antibiotics are necessary they should be discontinued when the infection is gone, even if the wound hasn't completely healed."

The voluntary guidelines have been developed to support doctors in their decision-making for each individual patient given that all patients' circumstances are different.

IDSA has developed over 50 treatment guidelines for various conditions and infections, which range from HIV/AIDS to Clostridium difficile. All IDSA guidelines will be available in smart phone format and as a pocket-sized quick-reference edition.

Written By Petra Rattue

Source: Medical News Today

Pre-diabetes Found In Greater Number Of US Teens

Government researchers recently announced that they found a higher percentage of U.S. teens with “pre-diabetes” and type 2 diabetes over the past few years.

Diabetes is a condition where the body doesn’t produce enough insulin or doesn’t know how to use it correctly. Insulin helps glucose migrate to cells, where it is used for energy. Those who have conditions of pre-diabetes have higher-than-normal blood sugar levels and can have an increased risk of developing full blown type 2 diabetes. Type 2 diabetes can be dangerous as it is tied to a higher risk of heart disease, kidney disease, and stroke. Generally, it is found more so in middle-aged and older adults. In the U.S., there are about 26 million people who are estimated to have diabetes, the majority of which are type 2. 11 million of those cases are 65 years old and up

“Even at borderline-high levels of blood pressure and cholesterol, and especially with multiple risk factors, you’re probably getting some… organ damage already,” explained Dr. Elaine M. Urbina, director of preventive cardiology at Cincinnati Children’s Hospital Medical Center and unaffiliated with the study, in an article by CNN.

While the pre-diabetes percentage has doubled, obesity rates decreased between 1999 and 2008 with rates generally between 18 and 20 percent over the past few years. Rates of high blood pressure and high LDL cholesterol showed no change. However, this is not the case for pre-diabetes; nine percent of teens showed signs of pre-diabetes between 1999 and 2000, and that number increased to 23 percent between 2007 and 2008. This national survey data from the Center for Disease Control and Prevention (CDC) is reported in an issue of the journal Pediatrics.

“That was unexpected, especially since obesity has been leveling off,” lead researcher Ashleigh May of the CDC told Reuters Health. “The question of why that is will require more research.”

According to May, the study did not separate pre-diabetes and type 2 diabetes, so there is no clear indication of the number of cases that were related to type 2 diabetes rather than pre-diabetes. In the past, type 2 diabetes in children was a rare occurrence but, with the rise of obesity over the past years, more kids have been diagnosed with type 2 or pre-diabetes. Between 2002 and 2005, the CDC has estimated that the annual rate of new diabetes diagnoses was 8.5 for every 100,000 kids between the ages of 10 and 19. The higher blood sugar levels may not affect teenagers immediately, but it can have a toll on them as they grow older and have increased risk of suffering heart attacks or strokes. In the data, boys were shown to be more prone to risk factors than girls; similarly, older children showed to have more risk factors than younger children.

“It’s promising that we didn’t see a rise in obesity or hypertension or (high LDL),” May said. “But we still have a lot of work to do.”

Between 1999 and 2008, the study by the CDC conducted physical exams and blood tests from a sample of around 3,400 teenagers. During those years, obesity rates remained consistent; in 2008, 20 percent were obese and 15 percent of kids were overweight. By 2008, 20 percent of teens reported pre-hypertension, where their blood pressure was higher than normal but not high enough to be considered hypertension. The same year, six percent of teens had high LDL cholesterol levels and 13 percent were considered border-line. These figures were similar to ones reported ten years earlier and only the pre-diabetes rate had changed.

Even though pre-diabetes/diabetes and other heart risk factors were found predominantly in overweight and obese kids, normal-weight peers were also found to be at risk. According other study, in the group of thinner kids, 37 percent showed at least one heart risk factor.

“All kids can benefit from a healthy lifestyle,” May explained in the Reuters Health article.

Overall, the study shows the importance of eating healthy and participating in exercise to manage pre-diabetes. There are a number of things that the community can do to help children. May encourages parents to act as role models, eating healthy foods and engaging in exercise. They should also stock their kitchen with plenty of fruits, vegetables, and whole grains rather than junk food.

“To get ahead of this problem, we have to be incredibly aggressive and look at children and adolescents and say you have to make time for physical activity,” noted Dr. Larry Deeb, pediatric endocrinologist as well as former president of medicine and science for the American Diabetes Association, in a USA Today article.

Similarly, pediatricians are recommended to follow the guidelines on obesity screenings and offer behavioral counseling to families whose children are diagnosed as overweight or obese.

“Pediatricians and other healthcare providers who work with adolescents need to be aware of, and follow through with, screening guidelines and recommendations for obesity and also other cardiovascular risk factors, and suggest appropriate behavioral interventions,” remarked May in the CNN article.

Regarding the study, there are a few stated limitations. Notably, pre-diabetes and diabetes were determined with a single blood sugar measurement. This could be less reliable in kids than in adults.

Source: Connie K. Ho for RedOrbit.com

How to reduce your risk of diabetes?

With the number of diabetes sufferers in the UK set to reach 6.25 million by 2035, here’s how to make sure you and your kids don’t become a statistic

Diabetes is the silent killer that we ignore at our peril. New figures show it is now the fastest growing ­disease in the world – and could bankrupt the NHS within the space of 20 years.

In the UK alone the condition affects nearly four million people and costs the health service £9.8billion annually. But that is expected to rise to £16.9billion by 2035.

David Haslam, chairman of the National Obesity Forum, says: “Perhaps what’s even more shocking is the fact that Type 2 ­diabetes is one of the few conditions that’s almost ­entirely preventable.

“Just by losing those ­excess pounds and exercising more you can massively reduce your risk.”

What is Type 2 diabetes?

There are two types of diabetes. Type 1 is the form you’re born with, while Type 2 is generally caused by leading an unhealthy lifestyle and develops as you get older.

It occurs when the body becomes resistant to the hormone insulin, resulting in a gradual increase in the body’s blood sugar levels.

People who are overweight and inactive are more at risk, particularly those who carry lots of fat around their middle.

Uncontrolled diabetes can lead to an increased risk of heart attack and stroke, kidney damage, blindness and damage to the blood vessels in the feet, which can even result in them being amputated.

A deadly disease

Despite the fact that it’s so preventable, rates of Type 2 diabetes have rocketed as the nation has got fatter – with 26% of us now considered obese.

Worse still, we’re now finding out that the disease has even more side effects than originally thought.

One study by the University of Cambridge last year found that being diagnosed with diabetes in middle age could knock six years off your life.

While previous studies have found that diabetes could double the risk of heart attack and stroke, the recent findings ­suggest that it also puts sufferers at greater risk of dying from a host of other causes – ­including cancer and infections – as well as suffering mental illness.

All of which is pretty worrying when you consider that an estimated 850,000 people in the UK already have diabetes but don’t know it – a delay which could have potentially deadly repercussions.

“Unfortunately, by the time they’re ­diagnosed with the condition, half of all sufferers have already developed ­complications as they may have been living with it for up to 10 years,” says Libby ­Dowling, clinical adviser at Diabetes UK.

Are my kids at risk?

Most cases of Type 2 diabetes are still ­diagnosed in people over 40.

But parents should take note – as ­childhood obesity soars, so does the risk of them developing diabetes.

Just 10 years ago, Type 2 diabetes was virtually unknown in teenagers, but ­Diabetes UK now estimates that around 500 children are suffering from it – and many more are likely to follow unless we act now to reverse the trend.

The warning signs

See your GP if you begin to notice any of the ­following symptoms:

● Feeling very thirsty

● Weeing frequently – often getting up in middle of the night to go to the toilet

● Blurred vision

● Feeling excessively tired

● Cuts and wounds taking much longer to heal than they normally do

● Suffering frequent episodes of thrush infection

For more advice and to assess whether you are at risk, visit www.diabetes.org.uk.

Catching the disease early

Amid all the doom and gloom, it’s important to remember that rising rates of diabetes don’t have to be an ­inevitable fact of life.

A few simple changes to your diet and exercise habits now will protect you and your children in the future.

Two large-scale US studies have shown that people with pre-diabetes – those with high blood sugar levels who have not yet developed the full-blown disease – can slash their risk of diabetes by 60% with the right lifestyle changes.

Better still, losing weight and ­exercising more was found to be twice as effective as conventional medication in preventing it from taking hold.

And even if you already suffer from ­diabetes, making these changes could still reduce your reliance on medication to control it and your chances of developing some of the nastier conditions related to the disease.

Research shows the following simple lifestyle changes will significantly reduce your chances of developing the condition.

Find out your family history

If there’s diabetes in your immediate family then you’re automatically at greater risk of getting the disease. Visit your GP to get tested.

Banish your jelly belly

If you’re overweight, you’re 100 times more likely to develop diabetes. Carrying weight around your middle is particularly dangerous.

As a rule of thumb, your waist should measure less than 31in for women and 37in for men. Losing just 10% of your body weight offers significant protection.

Get a move on

The best way to cut your risk or manage the disease if you already have it is with exercise.

Studies have found that just 30 minutes, five days a week, of any activity that makes your heart rate faster, will cut your risk by up to 60%.

You are what you eat

Not only the amount, but the type of food you eat can play a big part in decreasing or increasing your diabetes risk.

Research has shown that a diet high in fat, salt and sugar doesn’t help, while a diet high in fibre and fruit and veg will reduce your risk.

A 2010 study found spinach and cabbage specifically can help keep it at bay.

Change traditional white bread for wholemeal

A recent study by Tufts University in the US found that the more whole grain foods a person eats, the lower their diabetes risk.

This means it’s a good idea to switch from eating white bread, rice and pasta to granary bread, brown rice and wholemeal pasta.

Drink more coffee

Another study revealed that three compounds found in coffee – caffeine, caffeic acid and ­chlorogenic acid – can block the protein that is known to trigger developing the disease long-term.

Check your blood pressure

Uncontrolled high blood pressure can double your risk of developing Type 2 diabetes, so ask your GP to measure it for you.

Get some more shut-eye

A study by the University at Buffalo in New York found that sleeping less than six hours a night could increase your risk of diabetes.

Inadequate sleep will also make it harder to exercise and stick to a healthy diet.

source: mirror

Great tips to control diabetes naturally

Top natural tips Beat diabetes

1. Frequently drinking bitter gourd juice is good for diabetes.

2. Drink half a glass of curd with teaspoon of fenugreek powder on an empty stomach to control diabetes.

3. A tablespoon of the juice of fresh fenugreek leaves taken early in the morning to control diabetes.

4. Dates are good for controlling diabetes.

5. Take two tablespoons of water in which neem leaves have bee boiled.

6. Dry and powder mango leaves. Take half a teaspoon of this powder twice a day in the morning.

7. Eating curry leaves in the morning for three months is said o ward off diabetes that may set in due to hereditary factors.

8. Chew ten basil leaves in the morning.

9. Take half a teaspoon of turmeric powder with honey daily.

10. Take half a teaspoon of cinnamon powder with every meal to control blood sugar.

Metabolic Breathalyzer Will Detect Diseases Early

The diagnosis of most particular types of disease is a time-consuming process. But that’s going to change in the future thanks to a new breathalyzer-like technology that is currently under development at the University of Wisconsin-Madison. The researchers there believe that the tech could be used to diagnose a wide range of diseases including cancer and diabetes.

The human body reacts differently to different conditions. It is capable of shifting between energy sources when required.

According to Warren Porter, a UW-Madison professor of zoology, “When we’re healthy we use the food that we eat. When we get sick, the immune system takes over the body and starts tearing apart proteins to make antibodies and use them as an energy source“.

This shift between energy sources leads to different biochemical pathways. As a result, there will be changes in the carbon isotopes in the exhaled CO2. The “breathalyzer” will be used to detect these changes in isotopic signatures of carbon-containing metabolic by-products.

One of the main advantages of such a system will be the early detection of diseases. Diseases could be diagnosed well before symptoms start to show up. As you already know, early detection is very important when it comes to diseases such as cancer. And the use of a single technique to survey the entire body will also simplify diagnosis to a great extent.

The research on the technique was done on mice which were injected with glucose containing a single atom of carbon-13. This was done to detect the most active metabolic pathways in sick and healthy mice. They found out that there were changes in the ratio of carbon-12 to carbon-13 in the exhaled CO2 by the healthy and sick mice. Furthermore, different ratios were detected for different diseases.

At the moment, the “breathalyzer” is about the size of a shoebox, but they are planning to make it smaller. Head here to know more about the study.

source: mobilemag

First proof of epigenetic risk factor for type 2 diabetes

Research carried out at the Hebrew University of Jerusalem has provided the first proof of molecular risk factors leading to type 2 diabetes, providing an "early warning" sign that could lead to new approaches to treating this and other human disease conditions.

Despite extensive research on the molecular basis for the variance in susceptibility between individuals to common diseases, the subject is still poorly understood. A prime example of this is type 2 diabetes (T2D), a very widespread human disorder.

What is it that characterizes the susceptibility to this disease? Epigenetic variations - which are small molecular marks superimposed on the DNA structure - have been frequently hypothesized to modify predisposition, but direct evidence was missing.

Now, a research team led by Dr. Asaf Hellman of the Hebrew University's Institute of Medical Research Israel Canada has developed a novel, multistep, study design involving the analysis of disease-contributing epigenetic variations among hundreds of patients and control individuals. The research was presented in a scientific conference at the Cambridge University Genomic Center and was recently published in the scientific journal Human Molecular Genetics

Taking an innovative research direction, the Hebrew University research team decided to map DNA methylation variations rather than DNA sequence variations, as was traditionally done. The team undertook a proof-of-concept study among 1,169 type 2 diabetes patients and non-diabetic controls. The results demonstrated the unique abilities of this novel research approach by revealing a clear-cut, disease-predisposing DNA methylation signature. This is a first report in the scientific literature of epigenetic risk factor for T2D.

DNA methylation is a naturally occurring mechanism used to regulate genes and protect DNA from some types of cleavage. It is one of the regulatory processes that are referred to as epigenetic, in which an alteration in gene expression occurs without a change in the nucleotide sequence of the DNA. Defects in this process cause several types of disease that afflict humans.

The method used by Hellman was developed during postdoctoral training at the Harvard University Medical School. Later, his research students at the Hebrew University, Gidon Tperoff and Dvir Aran, further developed it into an efficient, genome-wide mapping method.

The mapping was carried out on the methylation sites in cooperation with Prof. Benjamin Glaser, head of the Endocrinology and Metabolism Department at the Hebrew University-Hadassah Medical School and a leading researcher of T2D genetics, and with additional key researchers including Professors Jeremy Kark and Yechiel Friedlander from the Braun Hebrew University-Hadassah School of Public Health and Community Medicine, Prof. Julio Wainstein from the Wolfson Medical Center, and Prof. Ephrat Levy-Lahad from the Shaare Zedek Medical Center.

This analysis not only revealed, for the first time, a clear-cut epigenetic signature in T2D, telltale methylation signature marks were also shown to appear on the DNA of young individuals who latter developed impaired glucose metabolism, even before the appearance of clinical diabetic manifestations.

These findings shed new light on the mechanism of individual predisposition to T2D and pave the way for the elucidating of similar mechanisms in a long list of common human diseases, including many metabolic, autoimmune and psychiatric disorders.

Given that epigenetic marks are sensitive to a wide range of environmental clues, including diets, chemical exposures, intrauterine environments, and also to therapeutic drugs, these finding may open the way for the development of new prevention and/or intervention epigenetic therapies.

Source: Hebrew University of Jerusalem

Study's predictions on diabetic conditions 'staggering'

More than half of all adults in the U.S. will suffer from diabetes or pre-diabetic conditions by 2020, Northwestern University researchers say.

The staggering health risk relates to the fact that more than half of adults are expected to be overweight by 2020. The problems could signal the reversal of a 50-year trend of declining cardiovascular disease deaths in the nation, because obesity is linked to heart disease.

"We've seen substantial declines in age-adjusted heart disease mortality rates since the 1960s," said the study's lead author, Dr. Mark Huffman, a cardiologist who teaches preventive medicine at Northwestern University's Feinberg School of Medicine. "But, these trends are stalling and can lead to increases in health care costs and mortality."

The positive trend is stalling particularly among children and young adults, he said. People who are overweight have a body mass index of 25 to 29 kg/m2, or weight divided by height squared. Someone who is 5 feet 10 inches tall and weighs 180 pounds would be defined as overweight with a BMI of about 26.

Feinberg researchers looked at data from the National Health and Nutrition Examination Surveys from 1988 to 2008. They reviewed health records of about 35,000 Americans across the country. Researchers surveyed adults age 20 and older, and then Huffman and his colleagues made projections for 2020 based upon data patterns. The study has not been published.

About 11 percent of men had diabetes and about 51 percent of men had dysglycemia by 2008, Huffman said. Dysglycemia is a term encompassing both diabetes and pre-diabetic conditions.

When Huffman's team projected the data forward based on increasing rates of obesity, more than 75 percent of men would have some form of dysglycemia by 2020, a result he said is "staggering." For women, the dysglycemia outlook would be about 50 percent.

"Blood pressure, blood cholesterol and smoking are getting better," he said, but not enough to offset the toll of body weight and dysglycemia. "So, it's not looking too favorable."

One limitation of the study is sampling variability. A study subject might not remember, for instance, what types of food she ate throughout the past week.

Many people who read the Feinberg study might not feel implicated, said Jessica Crandall, a registered dietitian and spokeswoman for the American Dietetic Association.

"Rarely do you make changes until you're diagnosed," she said. "People have blinders on."

Holly Herrington, a registered dietitian at Northwestern Memorial Hospital who was not involved in the study, reinforced Huffman's projections. She works with people 18 and older to help with weight loss and managing diabetes.

"What did stick out was that it says currently 60 to 70 percent of people are overweight or obese," she said. "But, these people often don't realize they are. They think, 'Oh, I look just like everybody else.' People are getting into a mindset that this is a normal thing."

While being overweight is not inherently unhealthy, Herrington urges people to live healthy lives. She cited a limited intake of refined sugar, which is included in items such as white bread and candy, as one method of mindful eating.

Huffman said deterring people from smoking is also imperative. He said policies must be enacted to reduce cigarette smoke, increase access to healthy food such as fish and vegetables and offer more public transportation options.

"I'm supportive of (Chicago) Mayor (Rahm) Emanuel's efforts to expand bike-lane access throughout the city," he said. "There are also expansions of access to fruits and vegetables through the Link Card program, which offers voucher assistance throughout the state."

He also advocates continuing smoking controls in the city, possibly through increased state-level excise taxes.

An excise tax on sugar-sweetened beverages would reduce soft drink consumption among young people, he said, noting that such policies have not been enacted anywhere in the U.S.

Dr. Rasa Kazlauskaite, an endocrinologist at Rush University Medical Center who was not involved in the study, shares Huffman's view that policy change is important for Chicago.

"We need to think of how we can restructure the environment. Imagine right now if our mayor said, 'We'll have a soda-free Chicago,' and what kind of uproar that would create. 'I won't have my diet pop?' We are not ready for that, but maybe someday."

The food industry is seductive, she said, but she contends that human beings manufacture the temptations that we succumb to.

"Probably half of us have some sort of diabetes gene that predisposes us to having diabetes, but if we wouldn't have the environment that was conducive to this, it would never manifest."

Crandall wants people to understand that losing even one pound helps reduce the risk of diabetes.

"It doesn't have to be a 360 degree makeover," Crandall said. "Before 2020, we still have some time to turn these results around and embrace these changes."

source: nwtimes

Top 7 Signs of Type 2 Diabetes

Not exercising. Supersize portions. Our love affair with food has taken a drastic turn. The number of Americans with type 2 diabetes—21 million, including adults and children—has risen with the obesity epidemic. Should you or you child get tested? Yes, if you have a family history of the disease and/or any of the following:

1. You’re overweight. Even being just 10 to 15 pounds overweight can increase your risk of developing type 2 diabetes. If your child is overweight, make sure his pediatrician tests him, because type 2 diabetes is on the rise in kids. The encouraging news is that losing just 5% to 7% of your body weight can reduce your risk of diabetes, according to research from the Diabetes Prevention Program. Testing usually involves screening your blood for high glucose (sugar) levels. If they’re too high, you could have either type 1 or type 2. (See box, right, for explanations of the two types.) Your doctor will most likely be able to sort it out based on your age and symptoms. In some cases, you may also need to see an endocrinologist (specialist).

2. You’re constantly running to the bathroom. “If your body doesn’t make enough insulin [a hormone that carries glucose into your cells to give them energy],” which can happen with type 1 or type 2 diabetes, “glucose builds up in your bloodstream and comes out in your urine,” explains Janet Silverstein, MD, chief of pediatric endocrinology at the University of Florida. Because you’re urinating a lot, you’ll probably also be very thirsty and drinking more than usual.

3. Your vision is blurry. High blood sugar levels cause glucose to build up in the lens of your eyes, making it harder for you to focus. This could mean that you have type 1 or type 2 diabetes.

4. You’re losing weight for no apparent reason. This is usually a sign of type 1 diabetes, but it sometimes happens with type 2. When the body can’t make insulin, glucose (sugar) from food can’t be used by the body’s cells for energy or stored, says Dr. Silverstein. In addition, fat starts to break down, making you lose more weight.

5. There’s a dark ring around your neck. When your body starts pumping out too much insulin—which is common with type 2—receptors in the skin folds respond by making extra pigment, says Alyne Ricker, MD, pediatric endocrinologist at Joslin Diabetes Center in Boston.

6. You’re getting frequent yeast infections. This can happen with type 1 or type 2, because a buildup of glucose can cause an overgrowth of yeast. Symptoms often include vaginal itching and thick discharge. Keep in mind that young children might instead get a diaper rash, and boys might get urethritis, a yeast infection of the urethra.

7. You’re 45 or older. Diabetes risk goes up with age, so the American Diabetes Association recommends getting screened at least every three years starting at age 45. Learn more at NDEP.nih.gov.

Diabetes Defined

Type 1: An autoimmune condition in which the body doesn’t make insulin, a hormone needed to move sugar from the bloodstream into cells for energy. Usually diagnosed in kids.

Type 2: The most common type in adults: You don’t make enough insulin or the body doesn’t respond to it properly. Not an autoimmune condition, it’s strongly linked to obesity because fat cells are more resistant to insulin.

Why men develop diabetes easily

Type 2 diabetes is a long-term condition, which is on the increase all over the world. Nonetheless, experts reason that men stand a higher risk of developing diabetes more easily and at a young age than women, because of the way fat is distributed around men’s body, reports Sade Oguntola.

Historically, men have not been comfortable discussing issues about their health, particularly conditions like diabetes, depression or sexual dysfunction. This has resulted in shorter and less healthy lives for men compared to women.

But times have changed, and so must men. Today’s men need a strong grasp of diseases like diabetes and their related conditions, actively engage their health care providers, get informed and proactively manage their health. It is worrying that men develop type 2 diabetes at a higher rate than their female counterparts.

Type 2 diabetes is caused by too much sugar in the blood, which occurs when the body’s ability to regulate sugar levels in several different organs becomes disturbed. The condition is linked to excess fat in some of these organs such as the liver and muscles. There are several risk factors for developing the disease, including age, ethnicity, family history, and of course, being overweight. Sadly being overweight was a major risk factor for developing type 2 diabetes. A diet that is low in carbohydrates and fibre, or high in fat can also increase risk. In addition, an inactive lifestyle is also a factor.

Symptoms of Type 2 diabetes may include fatigue, thirst, weight loss, blurred vision and frequent urination. Some people have no symptoms. A blood test can show if you have diabetes.

The prevalence of diabetes in Nigeria is estimated at 4.7 per cent while the average in Africa is 3.8 per cent. A total of 13.1 million people in Africa have diabetes and this is projected to double by 2030.

Unfortunately, in the year 2009, over 79,000 deaths in Nigeria were attributed to diabetes, while the total African mortality (death) was 332,000.

What more with diabetes reaching an epidemic level in many countries of the world and the fact that men appear to be at higher risk for diabetes makes it imperative to take the “modern man” challenge: get out, get active, get informed! Ironically, a new study has revealed that men apparently don’t have to be as overweight as women to develop type 2 diabetes.

For the study, researchers analysed data collected from 51,920 men and 43,137 women in Scotland with diabetes and compared their Body Mass Index (BMI) rates (measured within one year of diagnosis), taking into account factors like age and smoking status. Body Mass Index is a person’s weight in kg divided by their height in metres squared and is used in health research and practice as a measure of obesity.

They found mean BMI at diabetes diagnosis in men was 31.83, but 33.69 in women and the difference was most marked at younger ages.

Why would men develop diabetes with less weight gain than women? The researchers reason that men stand a higher risk of developing diabetes more easily and at a young age than women because of the way fat is distributed around their body.

Generally, men without diabetes have more fat around the abdomen and in the liver than women, who on the other hand tend to carry a greater proportion of their body fat under the skin as well as in thighs and buttocks, which is thought to be less risky for type 2 diabetes and other health problems.

Certainly, the disparity between men and women could also be due to the fact women now a days, have gone calorie conscious irrespective of age and they follow a strict regime which encloses regular exercise and balanced diet.

What’s the connection between obesity and diabetes? According to experts, the increase in incidence of diabetes world over is a sort of evolutionary backlash. Humans today are programmed to resist famine, because over time, the only people who survived and propagated are those who are well-equipped to survive famine. Now an overabundance of food has become more dangerous than a lack of it. With food becoming more available and less expensive all over the world, obesity and diabetes have followed.

Part of the body’s protection against famine is insulin resistance. That means that our muscles are not as receptive to insulin, which is critical to moderating blood sugar. To make matters worse, more than half of people who are obese also have insulin resistance. That means their pancreas have to work even harder to produce more insulin so their muscles know it’s there.

In an overfed state, the pancreas is forced into an overproduction of insulin because there is so much food to process, and the pancreas quickly becomes exhausted and cuts down on insulin production.

When the pancreas gives up, or slows down production, blood sugar starts to rise. That’s when people get the symptoms of diabetes, including excessive thirst, excessive urination and blurred vision.

Paradoxically individuals can do a lot to guard against diabetes, stated Dr Olubiyi Adesina, a diabetes expert at the Federal Medical Centre, Abeokuta, Ogun State. He stated that there was considerable research supporting simple measures that are protective against diabetes.

Dr Adesina, a member of Strategy for Improving Diabetes Care, Nigeria (SIDCAIN), declared that such simple steps as exercising, weight control and increased fruits and vegetable intake were helpful in people with blood glucose levels that are higher than normal, but not yet high enough to be diagnosed as diabetes, do not become diabetic.

According to him, “exercise helps the body to burn fat. A high level of body fat, in particular abdominal body fat, decreases the body’s sensitivity to insulin. This decreased sensitivity to insulin is one of the major causes of type 2 diabetes. Through exercise, the body’s sensitivity to insulin is increased, thus helping the body to prevent the onset of diabetes.”

In addition, exercise helps to lower stress levels, control anxiety, and relieve depression. People with low stress levels and who have a positive outlook on life are less likely to get diabetes. The stress hormones trigger the body’s “fight or flight” response. These hormones cause the liver to release sugar into the blood for the anticipated need for energy.

Nonetheless, fruits are loaded with vitamins, minerals, fibre and perfectly filled with water that allows better absorption of their natural nutritive properties. The natural water and fibre content of fruit actually causes a slow release of sugar into the bloodstream. This is quite unlike the instant sugar impact of no-fibre, high-chemical, heavily processed white bread that is also quite dehydrating.

Furthermore, since foods with high fibre content allow the blood sugar levels to slowly rise, this reduces stress on the pancreas and decreases a person’s risk for developing diabetes.

It is very important that people with diabetes have regular check-ups, control their weight and cholesterol, follow an exercise programme, lower high blood pressure, and not smoke. If you know that you have diabetes, you should already be under the care of a doctor. If you think that you have diabetes but are not sure, see your doctor for tests.

source: tribune

How to Avoid Diabetes Without Medications?

New research suggests that when it comes to lowering your risk of diabetes, the more changes you make to your diet and lifestyle, the better.

Led by Jared Reis at the National Heart, Lung and Blood Institute, scientists report in the Annals of Internal Medicine that people can lower their risk of developing diabetes by as much as 80% if they adhere to a combination of lifestyle changes: exercising more, not drinking as much alcohol, quitting smoking, avoiding obesity and eating high-fiber, low-fat foods.

Although the advice sounds familiar, the new study is the first to demonstrate the effect of combining all the recommendations together. Previous studies have shown that losing weight or eating healthier can independently help reduce the risk of diabetes, but this study is the first to show the potential cumulative benefits of making multiple lifestyle changes.

The study involved more than 207,000 men and women aged 50 to 71 who were enrolled in the National Institutes of Health (NIH)–AARP Diet and Health Study. The participants were all healthy and free of heart disease, cancer and diabetes at the start of the study in 1995-96. When they joined, the volunteers filled out questionnaires about their lifestyle and diet, including what they ate, how much they weighed, how physically active they were, and whether they smoked or drank alcohol. The researchers tracked them for nearly a decade to see who developed diabetes.

Reis and his team then divided the volunteers into low- and high-risk groups, depending on their responses to the lifestyle questions. People included in the low-risk diet group, for example, were those who ate foods with a low glycemic index (that is, foods that don't cause a sharp a spike in blood glucose levels, which can impair the body's ability to break down the sugar with insulin), more unsaturated as opposed to saturated fats, higher fiber and lower trans fats.

Women in the low-risk alcohol group drank no more than one alcoholic beverage a day; men drank no more than two. The low-risk physical activity group got at least 20 minutes of exercise three or more times a week. People whose BMI fell into normal ranges were considered low risk in terms of weight.

Each low-risk lifestyle habit was associated with a reduction in diabetes risk. Among men, those who were normal weight had a 70% lower risk of developing diabetes over 10, compared to those were overweight or obese. For women, the reduction in risk was 78%.

For men, the next most influential factors were not smoking and exercising regularly: non-smokers had a 24% lower risk of diabetes than current smokers or those who quit less than 10 years ago, and men who reported being physically active enjoyed a similar reduction in diabetes risk, compared with more sedentary men.

For women, avoiding overindulgence in alcohol was an important factor in reducing diabetes risk: those who drank just one glass or less a day had a 37% lower risk, compared with women who drank more. And being physically active also helped women avoid diabetes; those who exercise regularly were 23% less likely to develop the disease than those who didn't.

What was more intriguing was how much the participants were able to lower their diabetes risk when they combined many of these healthy lifestyle habits. A man who ate a high-fiber, low-saturated fat diet and exercised regularly, for example, had a 28% lower risk of diabetes than his counterpart who ate less healthily and spent more time on the couch. If that man was also a non-smoker, his risk of diabetes dropped by 32%; if he also cut back on his alcohol, his risk fell by 39%. If he maintained a normal weight on top of everything, his overall risk of developing diabetes was 72% lower than his peers who adhered to none of the healthy lifestyle behaviors.

The numbers were even more impressive for women, who, by combining all five lifestyle factors, were able to lower their risk of developing diabetes by 84%.

While there are effective medications to treat diabetes, it's encouraging news that standard lifestyle modifications such as losing weight, eating right, exercising, quitting smoking and drinking in moderation can significantly lower the risk of the disease. Not everything, it seems, needs to be treated with a pill.

source: healthland

Liver Enzymes can Predict Pre-diabetes and Diabetes

Nonalcoholic fatty liver disease includes a number of conditions affecting the liver, ranging from accumulation of fat in the liver to more serious inflammatory changes resulting in steatohepatitis, fibrosis and cirrhosis of the liver.

Nonalcoholic fatty liver disease has been associated with diabetes. A study was conducted in Germany to study the association between increase in liver enzymes and fatty liver, and the presence of pre-diabetes and diabetes.


The study was conducted on 3009 individuals that included 1556 females and 1453 males aged between 32 to 81 years.

A person in the study was said to be pre-diabetic if certain blood glucose tests were abnormal, that is, the person showed impaired glucose tolerance test (IGT) or fasting blood glucose (IFG), or both. Some of the participants had known or newly diagnosed diabetes. Blood glucose levels, HbA1c and C-reactive protein levels were estimated in all participants.

Liver function was estimated by checking for liver enzymes like gamma-glutamyltransferase (GGT), glutamate-pyruvate transaminase (GPT), glutamate-oxalacetate transaminase (GOT) and alkaline phosphatase (AP). The fatty liver index, that is, Bedogni Fatty Liver Index (FLI), was also calculated and a score of greater or equal 60 points was considered as positive for fatty liver disease.

Other information on socio-demographic variables, smoking habits, physical activity, medication use, alcohol consumption, household characteristics, educational attainment and physical activity were also collected. The participants were also examined for waist and hip circumferences measurements, body mass index, blood pressure and had to undergo blood testing.

Among the participants included in the study, 229 participants reported known diabetes, 106 had newly diagnosed diabetes, 107 had IFG, 309 had IGT, 69 were had both IFG as well as IGT, and 74 could not be classified (due to inconsistent information regarding diabetes status or glucose tolerance test could not be successfully conducted due to various reasons).

The researchers found that liver enzymes were increased in people with pre-diabetes and diabetes. More specifically, GGT and GPT were significantly increased in all participants with pre-diabetes and the diabetes. The other liver enzymes were increased only in some groups: GOT was not significantly increased in persons with known diabetes and unknown status, but all other groups. AP was significantly increased in persons with IFG, IGT, newly diagnosed diabetes and known diabetes, but not in the group of participants who had IFG/IGT and the group with unknown glucose tolerance status.

The study also inferred some other findings. Briefly, these are:

• Glucose disturbances occurred in older individuals

• More males suffered from glucose disturbances

• A number of individuals with less than 10 years education had IGT, newly diagnosed diabetes or known diabetes.

• People suffering from pre-diabetes and diabetes had higher body mass index, waist, hip circumference and high blood pressure.

• Pre-diabetics had a higher value of total cholesterol.

• People with glucose disturbances had higher values of triglycerides, CRP, HbA1c and uric acid.

• People with known diabetes had lower alcohol intake

• Smoking was less common in patients with IFG

• People with known diabetes were physically less active during their leisure time

Patients with pre-diabetes and diabetes had higher incidence of fatty liver, as estimated using the fatty liver index. People taking diabetes medication showed a decreased association between diabetes and fatty liver, indicating a beneficial effect of diabetes medication on fatty liver.

The study thus indicates that increase in liver enzymes and fatty liver is associated not only with diabetes, but also with pre-diabetes, as defined by an impaired fasting glucose or impaired glucose tolerance, or both. These enzymes could thus be used as inexpensive and easily available early indicators of abnormal glucose metabolism.

Reference:

1. Association between Markers of Fatty Liver Disease and Impaired Glucose Regulation in Men and Women from the General Population: The KORA-F4-Study; Ina Maria et al; Plos One 2011.

Source-Medindia

Gene That Worsens Risk Factors for Heart Disease, Diabetes Identified

A scientist at the Gladstone Institutes has discovered how a gene known as SIRT3 contributes to a suite of health problems sweeping across America, offering new insight into how to combat these potentially fatal conditions.

In a paper being published today in Molecular Cell, Gladstone Senior Investigator Eric Verdin, MD, describes how SIRT3, when switched off, accelerates the build-up of fats throughout the body. This can lead to obesity, high blood pressure and a decreased ability to process sugar—the combination of which is known as the "metabolic syndrome." Metabolic syndrome significantly increases one's risk for developing heart disease and diabetes.

"Estimates indicate that one-third of Americans have the metabolic syndrome, and more develop it each year," said Warner Greene, MD, PhD, who directs virology and immunology research at Gladstone, a leading and independent biomedical-research organization. Dr. Greene is also a professor of medicine, microbiology and immunology at the University of California San Francisco (UCSF), with which Gladstone is affiliated. "By showing how the absence of SIRT3 can exacerbate obesity, Dr. Verdin's group offers important clues concerning new ways to alleviate the symptoms of this American epidemic."

To better understand the origins of obesity and this associated syndrome, Dr. Verdin and his colleagues deactivated, or turned off, the SIRT3 gene in laboratory mice. They then fed the mice a high-fat diet and observed the animals' response at a molecular level.

Normally, SIRT3 sets off a complex chain of events to transform fat into energy at the cellular level. But deleting the SIRT3 gene disrupted this chain, and fat deposits weren't broken down as they should have been.

source: medindia.net

How high-fat diet causes type-2 diabetes

US scientists believe they have discovered why a fatty diet may trigger the onset of type-2 diabetes.

Researchers at the University of California, Santa Barbara (UCSB) say that high levels of dietary fat switch off production of a key enzyme that promotes glucose sensing in pancreatic beta cells, called GnT-4a glycosyltransferase.

This malfunction in pancreatic beta cells appears to play a significant role in the onset and severity of type-2 diabetes.

When the researchers gave a high-fat diet to healthy mice, the animals' beta cells lost the ability to sense and respond to blood glucose.

However, even obese mice in which GnT-4a function was preserved did not develop diabetes, according to a report of the study in the journal Nature Medicine.

Lead researcher Dr Jamey Marth said: 'The identification of the molecular players in this pathway to diabetes suggests new therapeutic targets and approaches towards developing an effective preventative or perhaps curative treatment.'

The scientist, who leads the Centre for Nanomedicine, a collaboration between UCSB and Sanford-Burnham Medical Research Institute, added that this may be possible via beta call gene therapy or drugs that interfere with the pathway and help to maintain normal beta cell function.

Dr Iain Frame, director of research at the charity Diabetes UK, said the research was of 'great interest'.

source: netdoctor

Diabetes Drug Might Raise Cancer Risk - FDA

The U.S. Food and Drug Administration is warning consumers that the popular diabetes drug Actos (pioglitazone) may increase the risk of bladder cancer when used for more than a year.

The agency's warning comes five days after Germany and France pulled Actos from the market, citing similar concerns. Actos is in a class of drugs called thiazolidinediones, the only other member of which, Avandia (rosiglitazone), was taken off U.S. pharmacy shelves in May because it was linked to an increased risk of heart attacks.

The new cancer warning will appear on the labeling, the FDA said.

However, although Actos does have some side effects, "the beneficial effects of Actos, I think, outweigh any possible risk of cancer," said Dr. Joseph Giangola, medical director of diabetes at Hackensack University Medical Center in Hackensack, N.J.

Actos is used to control blood sugar and is sold alone or in combination with metformin (Actoplus Met, Actoplus Met XR) and glimepiride (Duetact). In 2010, more than 2 million patients were taking these drugs, according to the FDA.

The new warning is based on FDA's review of data from an ongoing study, which found that Actos increased the risk of bladder cancer among patients taking the drug over a long period at the highest doses.

In one study involving more than 193,000 patients with diabetes, patients taking Actos were on the drug for an average of two years, the FDA said. "Compared to never being exposed to pioglitazone, a duration of pioglitazone therapy longer than 12 months was associated with a 40 percent increase in risk [for bladder cancer]," the agency said.

In addition, the agency says it is aware of the French study that caused France to pull the drug. That study showed a dose-response effect, where risks for bladder cancer rose as time spent taking Actos lengthened past one year.

Right now, the FDA is advising doctors not to use Actos in patients with bladder cancer and to use it with caution in patients who have had bladder cancer. In addition, the agency says that "the benefits of blood sugar control with pioglitazone should be weighed against the unknown risks for cancer recurrence."

The agency said diabetes patients should also tell their doctor if they are having symptoms of bladder cancer such as blood or red color in urine, an urgent need to urinate or pain while urinating and pain in back or lower abdomen.

In addition, patients should talk to their doctor about any concerns they have about Actos, the FDA noted.

For his part, Giangola said he is cautious when prescribing Actos. "We try to select the most insulin-resistant people to give Actos to," he said. "Those people do well with Actos."

But if Actos was taken off the market, there would be nothing to replace it, Giangola said. With Avandia essentially gone, "there is no medicine that directly influences insulin resistance the way Actos does," he said.

Giangola added that patients should not be overly concerned right now. "To jump now when we have only one medication in this class would be rash," he said. "They really ought to wait until there is more definitive evidence."

"What's worse -- the theoretical risk [of cancer] or the well-known risk of letting your blood sugar remain high? I say it's clearly [the risk of] letting your blood sugar run higher," Giangola said.

In a statement, Takeda Pharmaceuticals North America Inc., the maker of Actos, said it remains positive about the drug.

The company said in a statement that it is "confident in the therapeutic benefits of Actos and its importance as a treatment for type 2 diabetes. The company remains committed to Actos and Actos-containing medications, and to the millions of people living with the disease."

source: news.yahoo

New "master switch" to treat obesity

Scientists have found that a gene linked to diabetes and cholesterol is a "master switch" that controls other genes found in fat in the body, and say it should help in the search for treatments for obesity-related diseases.

In a study published in the journal Nature Genetics, the British researchers said since fat plays an important role in peoples' susceptibility to metabolic diseases like obesity, heart disease and diabetes, the regulating gene could be a target for drugs to treat such illnesses.

"This is the first major study that shows how small changes in one master regulator gene can cause a cascade of other metabolic effects in other genes," said Tim Spector of King's College London, who led the study.

More than half a billion people, or one in 10 adults worldwide, are obese and the numbers have doubled since the 1980s as the obesity epidemic has spilled over from wealthy into poorer nations.

In the United States, obesity-related diseases already account for nearly 10 per cent of medical spending - an estimated $NZ186 billion a year.

Type 2 diabetes, which is often linked to poor diet and lack of exercise, is also reaching epidemic levels worldwide as rates of obesity rise.

Scientists have already identified a gene called KLF14 as being linked to type 2 diabetes and cholesterol levels, but until now they didn't know what role it played.

Spector's team analysed more than 20,000 genes in fat samples taken from under the skin of 800 British female twin volunteers. They found a link between the KLF14 gene and the levels of many other distant genes found in fat tissue, showing that KLF14 acts as a master switch to control these genes.

They then confirmed their findings in 600 fat samples from a separate group of people from Iceland.

In a report of their study, the researchers explained that other genes found to be controlled by KLF14 are linked to a range of metabolic traits, including body mass index, obesity, cholesterol, insulin and glucose levels.

"KLF14 seems to act as a master switch controlling processes that connect changes in the behaviour of subcutaneous fat to disturbances in muscle and liver that contribute to diabetes and other conditions," said Mark McCarthy from Britain's Oxford University, who also worked on the study.

"We are working hard to understand these processes and how we can use this information to improve treatment of these conditions."

source: reuters

Healthy habits are key to diabetes management

If you have diabetes, you know that it can affect every area of life. People with diabetes must be vigilant about their health, to maintain good quality of life and prevent potential diabetes complications.

More than 25.8 million people in the United States have diabetes, 7 million people are undiagnosed, and 1.9 million people have been diagnosed with diabetes in 2010, according to the American Diabetes Association. Because diabetes increases the risk of other serious, chronic conditions and terminal diseases, it's critical to make a commitment to healthier habits to delay the onset of the long-term effects of diabetes and related diseases.

Common diabetic complications include:

Kidney disease. Diabetes can damage the blood vessels in your kidneys, making it harder for them to filter waste. Each year, more than 100,000 U.S. residents are diagnosed with kidney failure and diabetes is the most common cause. This is why some diabetics eventually need dialysis, or in severe cases, a kidney transplant.

Cardiovascular disease. Diabetes increases your risk for heart disease and stroke, particularly if you smoke, have high blood pressure, are overweight or have a family history of heart disease. It is not uncommon to have both high blood pressure and diabetes — which more than doubles the risk for cardiovascular disease, according to the American Heart Association. The risk of stroke is also two to four times higher among people with diabetes.

Eye problems. Diabetes can damage the retina, causing fluid leakage and swelling in the eye that can lead to blurry vision and, in severe cases, blindness. In fact, diabetes is the number one cause of blindness in adults ages 20 to 74.

Nerve damage. Nearly 70 percent of people with diabetes have nervous system damage. This can include impaired sensation or pain in the feet or hands, slowed digestion of food, carpal tunnel syndrome, erectile dysfunction, or other nerve problems. The loss of feeling in the legs and feet can be particularly dangerous, because this make it hard to tell if there is a foot sore or an injury. Sores can become infected — in some cases resulting in a foot or leg amputation. Good foot health is critical for diabetics.

People with diabetes are susceptible to a host of other health issues as well, including gum disease, pregnancy complications, and a weakened immune system, making them more susceptible to illnesses like pneumonia or the flu.

Diabetes is a complex condition to manage, so your doctor will probably involve other professionals in your care: a nutritionist or dietitian, certified diabetes educator, and other specialists such as an eye doctor, an endocrinologist (a doctor who specializes in hormonal disorders), a podiatrist (a foot doctor), a dentist, and possibly, an exercise trainer. If you are a diabetic, you should see your doctor every four to six months if your treatment involves oral medication or diet — or every three to four months if you're receiving insulin shots. This is however, at the discretion of your physician.

At each visit, your doctor will test your blood, check your blood pressure and your feet, and discuss your general well-being, including any recent illnesses or unusual symptoms.

Whether your diabetes diagnosis is recent or you have had diabetes for years, diabetes management begins with controlling your blood sugar. Keeping blood sugar near normal helps reduce risks for diabetes complications. A healthy diet, regular exercise, and weight maintenance are imperative. Regular checks of your blood sugar level — which show the effect of your diet, exercise and any prescribed medication — also provide an overview of how well you're controlling your diabetes.

You should test your blood sugar regularly at home, and your doctor will check it during scheduled exams. Your doctor will provide guidance on how often and when to check your blood sugar level and will recommend a target level based on your health history and treatment plan. If you cannot control your blood sugar with diet and exercise alone, your doctor may prescribe medication or insulin injections.

Dr. Jeffrey Freeman is a graduate of the College of Osteopathic Medicine and Surgery, Des Moines, Iowa. He completed a rotating internship at Pontiac Osteopathic Hospital, Pontiac, Mich., and a residency in internal medicine at John F. Kennedy Memorial Hospital. He is board certified in internal medicine and endocrinology and metabolism by the American Osteopathic Board. Freeman has been a member of the Pottstown Memorial Medical Center medical staff since March 1996.

source: pottsmerc