Diabetes

Last reviewed: June 27, 2012.

Diabetes is usually a lifelong (chronic) disease in which there are high levels of sugar in the blood.

Causes, incidence, and risk factors

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy. This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally Both of the above

There are two major types of diabetes. The causes and risk factors are different for each type: Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown. Type 2 diabetes makes up most diabetes cases. It most often occurs in adulthood. However, because of high obesity rates, teens and young adults are now being diagnosed with it. Many people with type 2 diabetes do not know they have it. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. Diabetes affects more than 20 million Americans. Over 40 million Americans have pre-diabetes (which often comes before type 2 diabetes).

Symptoms
High blood sugar levels can cause several symptoms, including: Blurry vision Excess thirst Fatigue Hunger Urinating often

Weight loss

Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period of time. People may be very sick by the time they are diagnosed. After many years, diabetes can lead to other serious problems: You could have eye problems, including trouble seeing (especially at night) and light sensitivity. You could become blind. Your feet and skin can get painful sores and infections. Sometimes, your foot or leg may need to be removed. Nerves in the body can become damaged, causing pain, tingling, and a loss of feeling. Because of nerve damage, you could have problems digesting the food you eat. This can cause trouble going to the bathroom. Nerve damage can also make it harder for men to have an erection.

Signs and tests

A urine analysis may show high blood sugar. However, a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done. Blood tests: Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL twice. Levels between 100 and 126 mg/dL are called impaired fasting glucose or pre-diabetes. These levels are risk factors for type 2 diabetes. Hemoglobin A1c test -o o o Normal: Less than 5.7% Pre-diabetes: 5.7% - 6.4% Diabetes: 6.5% or higher

Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours of drinking a glucose drink. (This test is used more often for type 2 diabetes.)

Screening for type 2 diabetes in people who have no symptoms is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years Overweight adults (BMI greater than 25) who have other risk factors Adults over age 45, repeated every 3 years

Treatment
Early on in type 2 diabetes, you may be able to reverse the disease with lifestyle changes. Also, some cases of type 2 diabetes can be cured with weight-loss surgery.

There is no cure for type 1 diabetes. Treatming both type 1 diabetes and type 2 diabetes involves medicines, diet, and exercise to control blood sugar levels and prevent symptoms and problems. Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your health care provider at least two to four times a year. Talk about any problems you are having.

Diabetic Nutritional Chart

Here is a TRUE Diabetic Nutrition Chart designed to help those with diabetes control their blood sugar. This food pyramid along with free Diabetic Dietary Guidelineswill help you improve your health. Please continue to read for more information on how to use these Diabetic Dietary Guidelines.

Do you know that many other Diabetic Diet Charts, even the one found on the American Diabetes Association (ADA) website is far too high in carbohydrates, starches and hydrogenated vegetable oils? Do you know this will cause most diabetics to require an ever increasing amount of drugs and insulin? How do I know this? 1. I am a diabetic who lost 78 pounds and weaned myself off of four insulin shots and other drugs for Diabetes, Hypertension and High Cholesterol. 2. I have helped MANY Diabetics reduce their drugs and insulin usage by following the exact same Diabetic Nutrition Chart you see above.

YOU CAN REDUCE DRUGS AND INSULIN TOO! Successful Diabetes Management is very simple but it is NOT easy. Follow these Diabetic Dietary Guidelines for improving health and reducing or eliminating dependence on drugs:

Follow this Diabetic Nutrition Chart (I also follow a low inflammatory meal plan more to come on this). Exercise: This can be based on your current level of fitness and by following the Diabetic Diet Chart above; you will find yourself able to do more than you thought you could. Remember, you do not need to exercise for hours a day IF you workout smart.

There are no short cuts and no quick fixes. I sell no lotions, potions nor pills. I give you solid evidence that has helped many diabetics improve their health and vitality.

Details Behind the Diabetic Nutrition Chart

Since August 2009, I have consumed less than 50 grams of carbs per day, and typically I stay below 30 grams per day. However over the past six months, I have been consuming only 15 to 25 grams of carbohydrates per day while exercising ALMOST every day. This Diabetic Nutrition Chart is not just for Diabetes Management, it is truly a chart that ALL PEOPLE can thrive on.

What to AVOID
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Sugar includes soft drinks, fruit juices, fructose, sucrose, agave and the obvious cookies, cakes, etc. Read more here Starch both potatoes and rice are high in starches; which means they are high in carbs. Do you really want to use your daily carb allowance (30 50 grams) on one potato? or exceed 30g on 1 cup of rice? not including the condiments you put on, in, or around it to make it palatable. Plus make no mistake eating 30g of carbohydrate at once will cause your blood glucose to spike. Successfully living with diabetes (especially Type II) is all about rationing carbs. Grains especially wheat (gluten) in ANY form; flour, pasta, breads, crackers, cakes, etc Read more: Here, Here, Here, Here, Here, Here, Here (I could go ON and ON). Trans fats, hydrogenated oils - including corn and vegetable oils. Ditch the canola oil and bring back the real butter!

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Cereals All kinds. Legumes including beans and peanuts (peanuts are technically a legume and not a nut). Pasteurized milk High Carb Fruits - especially bananas and pineapple. High Carb Vegetables avoid potatoes.

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Reduced Fat Anything why? typically they are reducing natural fats AND adding sugar to compensate.

You may be wondering whats left after that big list of no-nos, but believe me, theres plenty. You can eat a satisfying daily diet on these Diabetic Dietary Guidelines.

What You Can Eat Every Day (I do!)

Please follow this simple rule: Eat when hungry and when not hungry, dont eat.

Meats beef, pork, fish, shrimp, poultry, eggs, etc. Organ Meats are particularly high in nutritional value. Vegetables Low In Carbohydrates - such as greens, cauliflower, broccoli, green peppers, celery, asparagus, cabbage, mushrooms and more. (Complete list coming soon). Fat Coconut Oil, Butter, Rendered Fat (such as bacon grease or lard). Drinks water, unsweetened tea and coffee with heavy cream only Do NOT use non-dairy liquid or powdered creamer. Condiments/Spices Tony Chacheres, Tabasco, Texas Pete (1 g per serving), Black and Red Pepper, Paprika, Cumin Vinegar apple cider on salads or greens. Cheese typically I will add cheese to my low carb Cauli-crust pizza or my low carb Primal Chili, but I do try to limit it. EVOO Extra Virgin Olive Oil, on salads or slaw but also for low to medium temperature cooking. Nuts walnuts, pecans, cashews, almonds, etc. (except peanuts) Low Carb Fruits not daily and in small portions. avocado and tomato. Stevia and Artificial Sweeteners are okay during the transitional period but not for long term usage. You want to break the addiction to carbohydrates and that is more difficult if you

continue to use artificial sweeteners. This is true for Diet Sodas as well! There are many anecdotal tales of people having blood glucose spikes after consuming diet soda, even though it technically does not contain sugar. This stuff is loaded with chemicals and preservatives and questionable ingredients for your health, stay away!

Diet Chart
Counting Carbohydrates

Counting carbohydrates in the foods you eat can help you control your blood glucose. This is because carbohydrates raise your blood glucose more than any other nutrient. The balance between the amount of carbohydrates you eat and insulin determines how much your blood glucose level goes up after meals. This means you need to know what foods have carbohydrates and how many carbohydrate servings to eat to keep your blood glucose within the target range.
DIET CHART FOR ILLUSTRATION PURPOSES ONLY FOOD ITEM SERVING SIZE 1CU=15GM CARB CALORIE(KCALS) PROTEIN(GMS) FAT(GMS)

CARB(CH

Main Course

Wheat Flour Chapati

1(90gm flour)

1/3 chapati

240

7.2

0.6

48

Tuar Dal (plain)

1 katori

1 katori

100.5

6.69

0.51

17.28

Paneer Palak

1 serving

1 serving

407

8.3

36.3

11.6

Jeera Aloo

1 serving

1serving

209

1.3

15.1

17.1

Plain steamed rice

1katori

3/4 katori

86.25

1.7

0.12

19.55

Breakfast Idli 1 idli(72.5gm) 1 idli 115.65 3.7 1.51 21.81

Masala Dosa

1(200gm)

Qtr dosa

400

12

65

Upma

130

1katori

210

55

26

Banana

1(100gm)

43.5gm

116

1.2

0.3

27.2

Others

Chilli Chicken

1 serving

307.4

44.16

7.65

15.62

Cheese Burger

1 sandwich

1/2

310

15

12

35

Cheese pan pizza

1slice

1/2

280

11

13

29

French fries(Small)

68gm

39gm

210

10

26

Coca Cola (Medium)

480ml

179ml

150

40

The Diabetes foundation (India) has recommended new dietary guidelines for Indians. The new guidelines for Indian Diabetics contains dietary recommendations based on several factors like calculation of Ideal body weight, Calorie needs as per body weight , no. of servings for different food groups/types for different calorie needs. It covers food for all regional diabetics. It also covers Breakfast, Lunch, Snacks, Dinner for Diabetics in India. It covers foods of various types viz, Cereals, Salads, Meat, Leafy Vegetables, Pulses, Beans, Chapatis, Rava Idli, Curd, Coffee, Dosa, Butter milk and many more. The chart below was sourced from Livemint.com and is prepared as per recommendations from Diabetes Foundation (India).

Note: 1lb = 0.45359237 kg 100 lb = 45.359237 kg 106 lb = 48.08079122 kg 1CU = 1Carb Unit

Managing Diabetes
As is already known, controlling blood glucose is important for avoiding hypoglycemia and hyperglycemia-blood glucose lows and highs.

Hyperglycemia

Hyperglycemia, or high blood glucose, occurs when levels rise above your recommended range. A healthcare professional managing diabetes will help determine the proper healthy blood glucose range. High blood glucose can be caused by many things, including: Eating too much food

Little or no physical activity Not taking medications Stress, infection or illness Bad or spoiled insulin High blood glucose can cause serious problems and is a major cause of long-term diabetes

complications. Some warning signs of high blood glucose include: Tiredness or fatigue

Increased thirst Frequent urination Blurred vision Dry mouth or skin Slow-healing cuts and sores Unexplained weight loss It is important to keep blood glucose level within the recommended target range set by the treating doctor. Checking blood glucose often may help avoid hyperglycemia. High blood glucose levels can damage many parts of the body, including eyes, heart and toes.

Hypoglycemia

Hypoglycemia occurs when blood glucose level drops too low. The body responds to low blood glucose levels with warning signs that may be different in each

person. Some warning signs of low blood glucose are feeling: Weak Shaky

Irritable or confused Low blood glucose may occur if meal or snack is delayed or missed, after vigorous physical activity, or if too much insulin is given. In a person without diabetes, the pancreas will stop producing insulin if the blood glucose level falls below normal. In a person with diabetes, the insulin they inject or pump

keeps working, even when the blood glucose level is low. Low blood glucose may be caused by the following: Not following the meal plan

Too much exercise or exercising for a long time without eating a snack Too much medication or a change in the time one takes medication Stress Side effects from other medications Alcohol intake, especially without food Regular testing may help avoid hypoglycemia. Low blood glucose can happen very quickly, so one should be prepared to act fast to correct it. If untreated, hypoglycemia can cause serious effects, such as seizures or unconsciousness. By keeping blood glucose level in the target range decided by treating physician, one can delay or prevent long-term complications. The good news is that along with treating doctor, one can easily be able to lessen the impact of diabetes complications on life. This section lists some of the more common diabetes-related complications, their symptoms and treatments, and some steps doctor may recommend to help reduce risk.

Foot Complications
Proper foot care should be an important part of a diabetic's daily routine. High blood glucose levels can damage the blood vessels that carry oxygen and nutrients to the legs and feet. This can lead to nerve damage, poor circulation, infections and foot deformities. Diabetes is often associated with foot problems and amputation. Not including those caused by accidents or trauma, more than 60% of lower-limb amputations performed each year are on people with diabetes. What to Look For The American Diabetes Association recommends all individuals with diabetes should receive an annual foot examination to identify high-risk foot conditions. People with one or more high-risk foot conditions should be evaluated more frequently for the development of additional risk factors. People with neuropathy should have a visual inspection of their feet at every visit with a health care professional. Doctor visit is required in case one experiences any of the following symptoms:

Pain or less sensitivity in the leg or foot Cuts or breaks in the skin Ingrown nails Changes in the shape of foot Corns or calluses Healthy Diabetic Foot-Care Habits By keeping blood glucose level within the range recommended by doctor and paying special attention to feet every day, one can

be able to prevent long-term complications. For healthy toes and feet, following these simple steps helps: Check feet regularly - look for redness, sores, swelling etc.

Wear comfortable shoes that fit

Wash your feet daily with soap and lukewarm water Moisturize feet daily to avoid dry skin Trim toenails straight across and not too short Get medical advice early if one notices any change or problem