Patti Labelle: Living with Diabetes

Source:  Uploaded by mediaADA on Jun 28, 2007 to YouTube

Patti Labelle explains how working with a registered dietitian can help you live a healthy life if you have diabetes.

Diabetics get Blood Vessels Made From Donor Cells

 

By MARILYNN MARCHIONE, AP Medical Writer

2:28 p.m., June 27, 2011

 

Three dialysis patients have received the world’s first blood vessels grown in a lab from donated skin cells. It’s a key step toward creating a supply of ready-to-use arteries and veins that could be used to treat diabetics, soldiers with damaged limbs, people having heart bypass surgery and others.

The goal is to one day have a refrigerated inventory of these in various sizes and shapes that surgeons could order up as needed like bandages and other medical supplies.

The work so far is still early-stage. Three patients in Poland have received the new vessels, which are working well two to eight months later. But doctors are excited because this builds on earlier success in about a dozen patients given blood vessels grown in the lab from their own skin – a process too long and expensive to be practical.

“This version, built from a master donor, is available off the shelf and at a dramatically reduced cost,” estimated at $6,000 to $10,000, said Todd McAllister, chief of Cytograft Tissue Engineering Inc., the San Francisco-area company leading the work.

The American Heart Association considers it so promising that the group featured it on Monday in the first of a new series of webcasts about cutting-edge science.

“This is tremendously exciting,” because the failure of blood vessels used in dialysis is “a huge public health problem,” said Duke University‘s Dr. Robert Harrington, a heart expert who had no role in the work.

If a larger study getting under way now in Europe and South America shows success, “this is big news,” Harrington said.

Kidney failure, which is common in diabetics, requires dialysis to filter wastes from the blood through a connection between an artery and a vein called a shunt. It gets punctured several times a week to hook patients up to the dialysis machine, and complications include blood clots, clogging and infection.

What’s more, patients often run out of suitable sites for these shunts as problems develop. Plastic versions have high rates of failure and complications, too. Doctors have long wished for a natural substitute.

The lab-grown vessels are free of artificial materials. They don’t involve stem cells, so they’re not controversial.

Researchers start with a snip of skin from the back of a hand, remove cells and grow them into sheets of tissue that are rolled up like straws to form blood vessels.

So far, these lab-grown vessels have been tolerated by the recipients’ immune systems; no anti-rejection medicine or tissue matching is needed. That’s not surprising because lab-grown skin is already used to treat many burn victims.

“There are literally hundreds of thousands of patients that could use this technology,” McAllister said.

Each year, nearly 400,000 Americans undergo dialysis and half of them use plastic shunts. More than 160,000 people lose limbs because of poor circulation that might be improved with lab-grown vessels.

About 300,000 people have heart bypass operations using blood vessels taken from other parts of the body to create detours around clogged heart arteries. Some heart patients say the leg wound from removing the long vein to create heart bypasses hurts more than the chest wound for the open-heart surgery.

In 2005, Cytograft reported success with its first attempt at dialysis shunts using patients’ own skin. Some of the early work was sponsored by the National Heart, Lung and Blood Institute.

The new work, using donor cells, makes this advance more practical for wide use, said Dr. Timothy Gardner, a heart surgeon at Christiana Care Health Services in Newark, Del., and former American Heart Association president.

“It provides the option or the opportunity for off-the-shelf graft availability as opposed to something that has to be built from the individual’s own cells,” he said.

Cytograft plans a study in Europe and South America comparing 40 patients getting the lab-grown vessels to 20 getting plastic shunts. Studies also are planned on a mesh version for people with poor leg circulation. 

Online:

Company and video: http://www.cytograft.com

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Source:  The Associated Press/San Diego Union-Tribune

Diabetic Foot Care – Podiatrist in Jacksonville, FL

Source: Uploaded by webpowervideo on Dec 3, 2009 to YouTube

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it’s at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Here’s some basic advice for taking care of your feet:

Always keep your feet warm.Don’t get your feet wet in snow or rain.
Don’t put your feet on radiators or in front of the fireplace.
Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
Don’t soak your feet.
Don’t use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.

Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.

Wash your feet every day with mild soap and warm water.
Wear loose socks to bed.
Wear warm socks and shoes in winter.
When drying your feet, pat each foot with a towel and be careful between your toes.
Buy shoes that are comfortable without a “breaking in” period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don’t wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don’t lace your shoes too tightly or loosely.

Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.
When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced “sharko”) foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn’t hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot’s movement and supports its contours if you don’t put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

Visit our website: http://www.firstcoastfootclinic.com

Canadian Diabetes Association – FYI

Margaret Wallis-Duffy, Real Life Wellness Expert, chats with Sylvia & Karen about the deeper issues involved with diabetes and how the Canadian Diabetes Association is helping.

Source: ReaLifeonCTS on YouTube

FDA Approves New Treatment for Type 2 Diabetes

A-Z Index

FDA NEWS RELEASE

For Immediate Release: May 2, 2011

FDA approves new treatment for Type 2 diabetes

The U.S. Food and Drug Administration today approved Tradjenta (linagliptin) tablets, used with diet and exercise, to improve blood glucose control in adults with Type 2 diabetes.

People with Type 2 diabetes do not produce or respond normally to insulin, a hormone that regulates the amount of glucose in the blood. Over time, high blood glucose levels can increase the risk for serious complications, including heart disease, blindness, and nerve and kidney damage.

“This approval provides another treatment option for the millions of Americans with Type 2 diabetes,” said Mary Parks, M.D., director of the Division of Metabolism and Endocrinology Products in the FDA’s Center for Drug Evaluation and Research. “It is effective when used alone or when added to existing treatment regimens.”

Type 2 diabetes is the most common form of the disease, affecting between 90 percent and 95 percent of the 24 million people in the United States with diabetes. Tradjenta increases the level of hormones that stimulate the release of insulin after a meal by blocking the enzyme dipeptidyl peptidase-4 or DPP-4, which leads to better blood glucose control.

Tradjenta was demonstrated to be safe and effective in eight double-blind, placebo-controlled clinical studies involving about 3,800 patients with Type 2 diabetes. The studies showed improvement in blood glucose control compared with placebo.

Tradjenta has been studied as a stand-alone therapy and in combination with other Type 2 diabetes therapies including metformin, glimepiride, and pioglitazone. Tradjenta has not been studied in combination with insulin, and should not be used to treat people with Type 1 diabetes or in those who have increased ketones in their blood or urine (diabetic ketoacidosis).

Tradjenta will be dispensed with an FDA-approved Patient Package Insert that explains the drug’s uses and risks. The most common side effects of Tradjenta are upper respiratory infection, stuffy or runny nose, sore throat, muscle pain, and headache.

Tradjenta is marketed by Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Conn., and Indianapolis-based Eli Lilly Co.

For more information:

• Approved Drugs: Questions and Answers

Source: FDA – U.S. Food and Drug Administration

4 Steps to Control Your Diabetes For Life

NDEP is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations.

• Tengo diabetes
• ¿Corro riesgo?

 

4 Steps to Control Your Diabetes. For Life.

4 Steps to Control Your Diabetes. For Life.

Also available in these languages:

Cambodian, Chinese, Gujarati, Haitian Creole, Hindi, Hmong, Indonesian, Japanese, Korean, Laotian, Samoan, Spanish, Tagalog, Thai, Tongan, Vietnamese

Related Publications

Take Care of Your Heart. Manage Your Diabetes (in English)

(NDEP-52EN)

This patient education sheet explains the link between diabetes and heart disease. It encourages patients to work with their health care team to set targets and manage their blood glucose, blood pressure, and cholesterol. It includes a record form to track target numbers.

Tips to Help You Stay Healthy

(NDEP-8)

This tip sheet helps people work with their health care team to make a successful diabetes action plan.

In addition to a downloadable file (PDF) of the four-page tip sheet, online only, two-page PDF versions in two-color and black &white formats are available for ease of printing.

Find Similar Publications

To find similar publications based on keywords and/or audience, click the links below:

Diabetes Status: I Have Diabetes

Audiences:General Audience, Asian American and Pacific Islander, Older Adults, Adults

Keywords:A1C, Blood Pressure, Blood Glucose, Cholesterol

View more Publications »

These four steps help people with diabetes understand, monitor, and manage their diabetes to help them stay healthy. This publication is excellent for people newly diagnosed with diabetes or who just want to learn more about controlling the disease.

Publication date: 11/01/2009

 

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Contents

• Introduction
• Step 1: Learn about diabetes.
• Step 2: Know your diabetes ABCs.
• Step 3: Manage your diabetes.
• Step 4: Get routine care.
• My Diabetes Care Record
• Where to get help

---

This booklet presents four key steps to help you manage your diabetes and live a long and active life.

Diabetes is a serious disease. It affects almost every part of your body. That is why a health care team may help you take care of your diabetes:

• doctor
• dentist
• diabetes educator
• dietitian
• eye doctor
• foot doctor
• mental health counselor
• nurse
• nurse practitioner
• pharmacist
• social worker
• friends and family

You are the most important member of the team.

The marks in this booklet show actions you can take to manage your diabetes.

• Help your health care team make a diabetes care plan that will work for you.
• Learn to make wise choices for your diabetes care each day.

 

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Step 1: Learn about diabetes.

Diabetes means that your blood glucose (blood sugar) is too high. There are two main types of diabetes.

Type 1 diabetes – the body does not make insulin. Insulin helps the body use glucose from food for energy. People with type 1 need to take insulin every day.

Type 2 diabetes – the body does not make or use insulin well. People with type 2 often need to take pills or insulin. Type 2 is the most common form of diabetes.

Gestational (jes-TAY-shon-al) diabetes – occurs in some women when they become pregnant. It raises her future risk of developing diabetes, mostly type 2. It may raise her child’s risk of being overweight and developing type 2 diabetes.

Diabetes is serious.

You may have heard people say they have “a touch of diabetes” or that their “sugar is a little high.” These words suggest that diabetes is not a serious disease. That is not correct. Diabetes is serious, but you can learn to manage it!

It’s not easy, but it’s worth it!

All people with diabetes need to make healthy food choices, stay at a healthy weight, and move more every day.

Taking good care of yourself and your diabetes can help you feel better. It may help you avoid health problems caused by diabetes such as:

• heart attack and stroke
• eye problems that can lead to trouble seeing or going blind
• nerve damage that can cause your hands and feet to hurt, tingle, or feel numb. Some people may even lose a foot or a leg.
• kidney problems that can cause your kidneys to stop working
• gum disease and loss of teeth

When your blood glucose is close to normal you are likely to:

• have more energy.
• be less tired and thirsty and urinate less often.
• heal better and have fewer skin, or bladder infections.
• have fewer problems with your eyesight, feet, and gums.

• Ask your health care team what type of diabetes you have.
• Learn why diabetes is serious.
• Learn how caring for your diabetes helps you feel better today and in the future.
  

 

---

Step 2: Know your diabetes ABCs.

Talk to your health care team about how to manage your A1C, Blood pressure, and Cholesterol. This can help lower your chances of having a heart attack, stroke, or other diabetes problems. Here’s what the ABCs of diabetes stand for:

A for the A1C test (A-one-C).

It shows what your blood glucose has been over the last three months. The A1C goal for many people is below 7. High blood glucose can harm your heart and blood vessels, kidneys, feet, and eyes.

B for Blood pressure.

The goal for most people with diabetes is below 130/80.

High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.

C for Cholesterol (ko-LES-ter-ol).

The LDL goal for people with diabetes is below 100.
The HDL goal for men with diabetes is above 40.
The HDL goal for women with diabetes is about 50.

LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or “good” cholesterol helps remove cholesterol from your blood vessels.

• Ask your health care team:
  • what your A1C, blood pressure, and cholesterol numbers are
  • what your A1C*, blood pressure, and cholesterol numbers should be
  • what you can do to reach your targets
• Write down all your numbers on the record card at the back of this booklet.

*An A1C of less than 7 is the goal for many people but not for everyone. Talk to your health care team about what A1C target is right for you.

---

Step 3: Manage your diabetes.

Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your health care team to reach your ABC target. Use this self-care plan.

• Follow your diabetes meal plan.If you do not have one, ask your health care team to help you develop a meal plan.
  • Eat healthy foods such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese.
  • Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a deck of cards). Bake, broil, or grill it.
  • Eat foods that have less fat and salt.
  • Eat foods with more fiber such as whole grain cereals, breads, crackers, rice, or pasta.
• Get 30 to 60 minutes of physical activity on most days of the week. Brisk walking is a great way to move more.
• Stay at a healthy weight by using your meal plan and moving more.
• Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.
• Learn to cope with stress. Stress can raise your blood glucose. While it is hard to remove stress from your life, you can learn to handle it. NDEP’s Diabetes HealthSense provides online access to resources that support people with diabetes in making changes to live well. For more information visit www.YourDiabetesInfo.org/HealthSense.
• Stop smoking. Ask for help to quit. Call 1-800-QUITNOW (1-800-784-8669)
• Take medicines even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects.
• Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away.
• Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums
• Check your blood glucose. You may want to test it one or more times a day. Use the card at the back of this booklet to keep a record of your blood glucose numbers. Be sure to show it to your health care team.
• Check your blood pressure if your doctor advises.
• Report any changes in your eyesight to your health care team.

• Talk with your health care team about your blood glucose targets. Ask how and when to test your blood glucose and how to use the results to manage your diabetes.
• Use this plan as a guide to your self-care.
• Discuss how your self-care plan is working for you each time you visit your health care team.

 

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Step 4: Get routine care.

See your health care team at least twice a year to find and treat any problems early.

At each visit be sure you have a:

• blood pressure check
• foot check
• weight check
• review of your self-care plan shown in Step 3

Two times each year have an:

• A1C test – it may be checked more often if it is over 7

Once each year be sure you have a:

• cholesterol test
• triglyceride (try-GLISS-er-ide) test – a type of blood fat
• complete foot exam
• dental exam to check teeth and gums – tell your dentist you have diabetes
• dilated eye exam to check for eye problems
• flu shot
• urine and a blood test to check for kidney problems

At least once get a:

• pneumonia (nu-mo-nya) shot

• Ask your health care team about these and other tests you may need. Ask what yours results mean.
• Write down the date and time of your next visit.
• Use the card at the back of this booklet to keep a record of your diabetes care.
• If you have Medicare, ask your health care team if Medicare will cover some of the costs for
  • learning about healthy eating and diabetes self-care
  • special shoes, if you need them
  • medical supplies
  • diabetes medicines

 

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My Diabetes Care Record

Record your targets and the date, time, and results of your tests. Take this card with you on your health care visits. Show it to your health care team to remind them of tests you need.

My Diabetes Care Record card

Self Checks of Blood Glucose

Record your targets and the date, time, and results of your checks. Take this card with you on your health care visits. Show it to your health care team.

Self Checks of Blood Glucose card

---

Where to get help:

Many of these groups offer items in English and Spanish.

National Diabetes Education Program
1-888-693-NDEP (1-888-693-6337)
www.YourDiabetesInfo.org

Diabetes HealthSense
An online library of resource for living well.
www.YourDiabetesInfo.org/HealthSense

National Kidney Disease Education Program
1-866-4-KIDNEY (1-866-454-3639)
www.nkdep.nih.gov

National Institute of Diabetes and Digestive and Kidney Diseases
National Diabetes Information Clearinghouse
1-800-860-8747
www.niddk.nih.gov

American Association of Diabetes Educators
1-800-TEAM-UP4 (1-800-832-6874)
www.diabeteseducator.org

American Diabetes Association
1-800-DIABETES (1-800-342-2383)
www.diabetes.org

American Dietetic Association
1-800-366-1655
www.eatright.org

American Heart Association
1-800-AHA-USA1 (1-800-242-8721)
www.americanheart.org

Centers for Disease Control and Prevention
1-800-CDC-INFO (1-800-232-4636)
www.cdc.gov/diabetes

Centers for Medicare & Medicaid Services
1-800-MEDICARE (1-800-633-4227)
www.medicare.gov/navigation/manage-your-health/preventive-services/diabetes-screening.aspx

Source:

Gestational Diabetes

Cathy Moulton, a Diabetes UK care adviser, explains how gestational diabetes affects pregnant women. Kimberly, who was diagnosed with gestational diabetes, talks about the symptoms she experienced and how she dealt with the condition. Find out about complications of gestational diabetes http://www.nhs.uk/Conditions/gestational-diabetes/Pages/Complications.aspx

Source: NHSChoices on YouTube

Diabetes in America: Emotional Support Needed

Diabetes In America: Emotional Support Needed

By: Jeff Roaderick

According to the Center for Disease Control almost 11% of the adult population in the United States has been diagnosed with either type-1 or type-2 diabetes. An additional 57 million people have pre-diabetes which is a condition when average blood glucose levels are higher than normal but not high enough for a diabetes diagnosis. Both of these populations total 81.6 million people in the US that have diabetes or are at risk for a diabetes diagnosis if their lifestyles are not changed. The agency projects that as many as 1 in 3 adults will have diabetes by 2050 which equates to 39 million people. The majority, 90% to 95%, of these individuals have type-2 diabetes.

Taking Control

Although these statistics indicate a significant epidemic, the outlook for individuals does not have to be a hopeless one. Unlike other chronic illnesses, diabetes allows individuals to take control of their lifestyle and make significant impacts on their quality of life. By taking control and incorporating healthy habits into ones daily life, one can significantly minimize the risk of diabetes complications which can include eye complications, kidney disease, heart disease, stroke, sexual dysfunction, and extremity amputation. For some individuals there is even a possibility of reversing diabetes.

The Diabetes Lifestyle

So what does a healthy diabetes lifestyle consist of? First, for many it involves the elimination of unhealthy habits such as smoking, excessive drinking, overeating, poor diet and a sedentary lifestyle. Second, it involves the incorporation of healthy lifestyle habits into one daily life that includes a low carbohydrate and low sugar diet, exercise, glucose monitoring, a medication regimen, consistent visits to a medical team and constant learning about the disease and its lifestyle.

Even though individuals with diabetes can significantly reduce the risk of diabetes complications by adhering to a healthy lifestyle, very few individuals do. For example, 70% of the individuals with type-2 diabetes are considered overweight and their diabetes diagnosis is correlated with their being overweight. For many of these individuals, losing weight can reverse a type-2 diabetes diagnosis. Given this, diabetes continues to grow with almost 90% of the diagnosis being type-2.

So why is it difficult for individuals to make healthy lifestyle changes and significantly impact diabetes complications and quality of life? The answer is complicated and it may involve practical and emotional dynamics which include knowledge and acceptance. A research study concluded that 95% of diabetes care is considered self-care. That means that only 5% of diabetes care is provided by a medical team and the remaining 95% of the care must be provided by the individual with diabetes and their families. In general, self-care consists of making significant lifestyle changes that include the elimination of unhealthy behaviors and the integration of healthy behaviors. This may mean giving up favorite foods, stopping smoking, and starting an exercise program For many learning the diabetes lifestyle and incorporating it into ones life can be an overwhelming and emotional endeavor. It is no wonder that many people with diabetes are not motivated to make such significant lifestyle changes.

Support

How can individuals be supported through this transition to a healthy diabetes lifestyle and how can one become motivated to learn and live a diabetes lifestyle? Countless studies have been conducted on the correlation between depression and diabetes. Depression has been identified as a significant factor why individuals do not adhere to a healthy diabetes lifestyle, even though the benefits are compelling. Other emotional struggles also appear to interfere with ones motivation to make the necessary lifestyle adjustments, such as fear, anger, sadness and denial. The process of developing motivation can be emotional as one works through these emotional dynamics. Trained counseling professionals at the Colorado Counseling and Wellness Institute can provide support and guidance to help individuals move towards acceptance and develop motivation to live a healthy life with diabetes. Diabetes is being called a lifestyle disease, and hopefully if all Americans can begin to live a healthy lifestyle, the diabetes trend will starting moving down.

Article Source: http://www.articlesnatch.com

a href=”http://66trp.com/c/6591-38456-825176?us=click-5371569-10874749%3FPPCPN%3D8669431352″ target=”_top”>

About the Author:
Jeff Roaderick is the Principal Owner of Colorado Counseling and Wellness Institute which is an organization that provides counseling services to support individuals with diabetes who are experiencing emotional and psychological challenges. You can contact Jeff via email jeff@coloradocwi.com or go to the website www.coloradocwi.com.

What I Need to Know About Diabetes Medicines

 

What I need to know about Diabetes Medicines

On this page:

• What do diabetes medicines do?
• What targets are recommended for blood glucose levels?
• What happens to blood glucose levels in people with diabetes?
• Medicines for My Diabetes
• Types of Diabetes Medicines
• What do I need to know about side effects of medicines?
• For More Information
• Acknowledgments

Inserts:

• Insert A: My Diabetes Medicines
• Insert B: Questions to Ask about Your Diabetes Medicines
• Insert C: Types of Insulin
• Insert D: Glyset and Precose (Alpha-Glucosidase Inhibitors)
• Insert E: Glucophage, Glucophage XR, and Riomet (Biguanides)
• Insert F: Starlix (D-Phenylalanine Derivative)
• Insert G: Januvia (DPP-4 Inhibitor)
• Insert H: Prandin (Meglitinide)
• Insert I: Amaryl, DiaBeta, Diabinese, Glucotrol, Glucotrol XL, Glynase PresTab, Micronase, tolazamide, and tolbutamide (Sulfonylureas)
• Insert J: Actos and Avandia (Thiazolidinediones)
• Insert K: Actoplus Met, Avandamet, Avandaryl, Duetact, Glucovance, Janumet, and Metaglip (Combination Diabetes Pills)
• Insert L: Symlin (Amylin Mimetic)
• Insert M: Byetta (Incretin Mimetic)
• Insert N: About Low Blood Glucose

What do diabetes medicines do?

Over time, high levels of blood glucose, also called blood sugar, can cause health problems. These problems include heart disease, heart attacks, strokes, kidney disease, nerve damage, digestive problems, eye disease, and tooth and gum problems. You can help prevent health problems by keeping your blood glucose levels on target.

Everyone with diabetes needs to choose foods wisely and be physically active. If you can’t reach your target blood glucose levels with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends on your type of diabetes, your schedule, and your other health conditions.

You may need diabetes medicines to reach your blood glucose targets.

Diabetes medicines help keep your blood glucose in your target range. The target range is suggested by diabetes experts and your doctor or diabetes educator. See below for more information about target levels for good health.

 

What targets are recommended for blood glucose levels?

The National Diabetes Education Program uses blood glucose targets set by the American Diabetes Association (ADA) for most people with diabetes. To learn your daily blood glucose numbers, you’ll check your blood glucose levels on your own using a blood glucose meter.

Target blood glucose levels for most people with diabetes
My targets:

Before meals:
70 to 130 mg/dL^*

1 to 2 hours after the start of a meal:
Less than 180 mg/dL

* Milligrams per deciliter.

Also, you should ask your doctor for a blood test called the A1C at least twice a year. The A1C will give you your average blood glucose for the past 3 months.

Target A1C result for people with diabetes
My targets:

Less than 7 percent

Your personal A1C goal might be higher or lower than 7 percent. Keeping your A1C as close to normal as possible—below 6 percent without having frequent low blood glucose—can help prevent long-term diabetes problems. Doctors might recommend other goals for very young children, older people, people with other health problems, or those who often have low blood glucose.

Talk with your doctor or diabetes educator about whether the target blood glucose levels and A1C result listed in the charts above are best for you. Write your own target levels in the charts. Both ways of checking your blood glucose levels are important.

If your blood glucose levels are not on target, you might need a change in how you take care of your diabetes. The results of your A1C test and your daily blood glucose checks can help you and your doctor make decisions about:

• what you eat
• when you eat
• how much you eat
• what kind of exercise you do
• how much exercise you do
• the type of diabetes medicines you take
• the amount of diabetes medicines you take

 

What happens to blood glucose levels in people with diabetes?

Blood glucose levels go up and down throughout the day and night in people with diabetes. High blood glucose levels over time can result in heart disease and other health problems. Low blood glucose levels can make you feel shaky or pass out. But you can learn how to make sure your blood glucose levels stay on target—not too high and not too low.

What makes blood glucose levels go too high?

Your blood glucose levels can go too high if: 

• you eat more than usual
• you’re not physically active
• you’re not taking enough diabetes medicine
• you’re sick or under stress
• you exercise when your blood glucose level is already high

        Some diabetes medicines can also lower your blood glucose too much. Ask your doctor whether your diabetes medicines can cause low blood glucose. SeeInsert N for information about low blood glucose.

The results of your blood glucose checks can help you make decisions about your diabetes medicines, food choices, and physical activity.

 

Medicines for My Diabetes

Ask your doctor what type of diabetes you have and write down your answer.

I have:

• type 1 diabetes
• type 2 diabetes
• gestational diabetes
• another type of diabetes: ____________________

Medicines for Type 1 Diabetes

Type 1 diabetes, once called juvenile diabetes or insulin-dependent diabetes, is usually first found in children, teenagers, or young adults. If you have type 1 diabetes, you must take insulin because your body no longer makes it. You also might need to take other types of diabetes medicines that work with insulin.

Medicines for Type 2 Diabetes

Type 2 diabetes, once called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. It can start when the body doesn’t use insulin as it should, a condition called insulin resistance. If the body can’t keep up with the need for insulin, you may need diabetes medicines. Many choices are available. Your doctor might prescribe two or more medicines. The ADA recommends that most people start with metformin, a kind of diabetes pill.

Medicines for Gestational Diabetes

Gestational diabetes is diabetes that occurs for the first time during pregnancy. The hormones of pregnancy or a shortage of insulin can cause gestational diabetes. Most women with gestational diabetes control it with meal planning and physical activity. But some women need insulin to reach their target blood glucose levels.

Medicines for Other Types of Diabetes

If you have one of the rare forms of diabetes, such as diabetes caused by other medicines or monogenic diabetes, talk with your doctor about what kind of diabetes medicine would be best for you.

 

Types of Diabetes Medicines

Diabetes medicines come in several forms.

Insulin

If your body no longer makes enough insulin, you’ll need to take it. Insulin is used for all types of diabetes. Your doctor can help you decide which way of taking insulin is best for you.

• Taking injections. You’ll give yourself shots using a needle and syringe. The syringe is a hollow tube with a plunger. You will put your dose of insulin into the tube. Some people use an insulin pen, which looks like a pen but has a needle for its point.
• Using an insulin pump. An insulin pump is a small machine about the size of a cell phone, worn outside of your body on a belt or in a pocket or pouch. The pump connects to a small plastic tube and a very small needle. The needle is inserted under the skin and stays in for several days. Insulin is pumped from the machine through the tube into your body.
• Using an insulin jet injector. The jet injector, which looks like a large pen, sends a fine spray of insulin through the skin with high-pressure air instead of a needle.
  If your body no longer makes enough insulin, you’ll need to take it.

What does insulin do?

Insulin helps keep blood glucose levels on target by moving glucose from the blood into your body’s cells. Your cells then use glucose for energy. In people who don’t have diabetes, the body makes the right amount of insulin on its own. But when you have diabetes, you and your doctor must decide how much insulin you need throughout the day and night.

What are the possible side effects of insulin?

Possible side effects include:

• low blood glucose (for more information, see Insert N)
• weight gain

How and when should I take my insulin?

Your plan for taking insulin will depend on your daily routine and your type of insulin. Some people with diabetes who use insulin need to take it two, three, or four times a day to reach their blood glucose targets. Others can take a single shot. Your doctor or diabetes educator will help you learn how and when to give yourself insulin.

Types of Insulin

Each type of insulin works at a different speed. For example, rapid-acting insulin starts to work right after you take it. Long-acting insulin works for many hours. Most people need two or more types of insulin to reach their blood glucose targets.

Look at the list of types of insulin on Insert C. Check off the names of the kinds of insulin you take. Then print and write the names of your insulins under My Insulins in the chart on Insert A.

Diabetes Pills

Along with meal planning and physical activity, diabetes pills help people with type 2 diabetes or gestational diabetes keep their blood glucose levels on target. Several kinds of pills are available. Each works in a different way. Many people take two or three kinds of pills. Some people take combination pills. Combination pills contain two kinds of diabetes medicine in one tablet. Some people take pills and insulin.

Diabetes pills help people with type 2 diabetes or gestational diabetes keep their blood glucose levels on target.

Your doctor may ask you to try one kind of pill. If it doesn’t help you reach your blood glucose targets, your doctor may ask you to:

• take more of the same pill
• add another kind of pill
• change to another type of pill
• start taking insulin
• start taking another injected medicine

If your doctor suggests that you take insulin or another injected medicine, it doesn’t mean your diabetes is getting worse. Instead, it means you need insulin or another type of medicine to reach your blood glucose targets. Everyone is different. What works best for you depends on your usual daily routine, eating habits, and activities, and your other health conditions.

For information about the different kinds of pills and what they do, see the inserts. You’ll see the brand name and the generic name—the scientific name—for each medicine. Find your diabetes pills and check off the names. Then print and write the names of your diabetes pills under My Pills and Injected Medicines in the chart on Insert A.

Injections Other Than Insulin

In addition to insulin, two other types of injected medicines are now available. Both work with insulin—either the body’s own or injected—to help keep your blood glucose from going too high after you eat. Neither is a substitute for insulin.

See the cards in the pocket of this booklet for more information about these injected medicines. Check off the kinds you take. Then write the names of your injected medicines under My Pills and Injected Medicines in the chart on Insert A.

Talk with your doctor if you have questions about your diabetes medicines. Do not stop taking your diabetes medicines without checking with your doctor first. See Insert B for a list of questions to ask your doctor about your medicines.

 

What do I need to know about side effects of medicines?

A side effect is an unwanted problem caused by a medicine. For example, some diabetes medicines can cause nausea or an upset stomach when you first start taking them. Before you start a new medicine, ask your doctor about possible side effects and how you can avoid them. If the side effects of your medicine bother you, tell your doctor.

 

For More Information

To find diabetes educators—nurses, dietitians, and other health professionals—near you, call the American Association of Diabetes Educators toll-free at 1–800–TEAMUP4 (1–800–832–6874). Or go to www.diabeteseducator.org and see the “Find a Diabetes Educator” section.

For additional information about diabetes, contact

American Diabetes Association
National Service Center
1701 North Beauregard Street
Alexandria, VA 22311–1742
Phone: 1–800–DIABETES (1–800–342–2383)
Fax: 703–549–6995
Email: AskADA@diabetes.org
Internet: www.diabetes.org

Juvenile Diabetes Research Foundation International
26 Broadway, 14th Floor
New York, NY 10004
Phone: 1–800–533–CURE (1–800–533–2873)
Fax: 212–785–9595
Email: info@jdrf.org
Internet: www.jdrf.org

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20814–9692
Phone: 1–888–693–NDEP (1–888–693–6337)
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: ndep@mail.nih.gov
Internet: www.ndep.nih.gov

This publication may contain information about medications. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov. Consult your doctor for more information.

 

Acknowledgments

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This booklet was reviewed by Stuart T. Haines, Pharm.D., University of Maryland School of Pharmacy, Baltimore.

The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.

---

Source

National Diabetes Information Clearinghouse

1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1978, the Clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. The NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

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NIH Publication No. 11–4222
October 2010

Foot Health Critical for People With Diabetes

 

Foot Health Critical for People With Diabetes

April is Foot Health Month. Remember: Don’t take foot health for granted—especially if you have diabetes. Prevent foot problems by controlling diabetes and practicing good foot health.

Diabetes and Foot Health

Almost 26 million people in the United States have diabetes and many more are at high risk for developing diabetes. Problems with the legs and feet caused by diabetes are common and can be severe. These problems cause suffering and reduce one’s quality of life. In recognition of Foot Health Month, April 2011, the Centers for Disease Control and Prevention’s Division of Diabetes Translation (CDC/DDT) wants to make sure that you are aware that people with diabetes can develop many different foot problems and to remind you that foot health should not be taken for granted.

In 2006 alone, about 65,700 people with diabetes had a leg or foot amputated. This is more than 60% of the amputations of legs and feet not resulting from an injury, such as from a car crash. Many of these amputations could be prevented by taking good care of your feet and your health:

• Learning to manage your diabetes
• Making healthy food choices
• Staying at a healthy weight
• Being physically active every day
• Taking your medicines even when you feel good
• Having your doctor give you a comprehensive foot exam every time you visit (but at least four times a year)
• Checking your feet for sores and other injuries every day
• Wearing shoes that fit right and do not rub or pinch your feet, or cause blisters. Never walking barefoot or while wearing just socks.

Links to Foot Health Resources

The National Diabetes Education Program (NDEP), jointly led by CDC/DDT and the National Institutes of Health, provides several web pages and publications with helpful information on foot care and diabetes care. Click on the web links below and see the Foot Health Facts section of this feature for important information on diabetes prevention and control, foot health, and what you can do to maximize your likelihood for good health in the future.

Take Care of Your Feet for a Lifetime is a booklet from NDEP with information on foot care and how to avoid foot problems.

Cuide sus pies durante toda su vida es un folleto ilustrado de NDEP que le ayuda a cuidar sus pies y ofrece consejos para evitar problemas graves de los pies.

4 Steps to Control Your Diabetes. For Life.  [PDF - 2.87MB] These four steps help people with diabetes understand, monitor, and manage their diabetes to help them stay healthy. This publication, available in English, Spanish, and other languages, is excellent for people newly diagnosed with diabetes or for those who want to learn more about controlling the disease. It has information on the importance of getting routine care to avoid diabetes complications.

Feet Can Last a Lifetime: A Health Care Provider’s Guide to Preventing Diabetes Foot Problems is a foot care guide from NDEP targeted to health care professionals.

What should I do on a regular basis to take care of my feet?is a CDC diabetes web page with a list of simple ways to care for and avoid potential problems with your feet.

Chapter 9. Foot Problemsin DDT’s Take Charge of Your Diabetespublication compiles tips for diabetes control and care along with information on diabetes and its health complications.

Foot Health Facts

• 
• These are some of the ways that diabetes can harm your feet:  
  • Diabetes slows blood flow to certain areas of the body, especially limbs such as the legs, which impairs your body’s ability to heal injuries.
  • Diabetes nerve damage may cause you to no longer feel pain in your feet, and you may not realize you have a wound or injury that needs care.
• Diabetic nerve damage appears to be more common in people who have had problems controlling their blood glucose (sugar) levels, in those with high cholesterol or high blood pressure, in overweight people, and in people older than 40 years.
• These are some signs of problems with your feet or legs. If you experience any of these symptoms, you need to contact your health care provider or a podiatrist (foot doctor) right away.
  • You may feel pain in your legs or cramping in your buttocks, thighs, or calves during physical activity.
  • Your feet may tingle, burn, or hurt.
  • You may lose the sense of touch or not be able to feel heat or cold very well.
  • The shape of your feet may change over time.
  • The color and temperature of your feet may change.
  • You may lose hair on your toes, feet, and lower legs.
  • The skin on your feet may become dry and cracked.
  • Your toenails may turn thick and yellow.
  • Fungus infections may appear between your toes.
  • You may experience blisters, sores, ulcers, infected corns, and ingrown toenails.

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Contact Us:

• Centers for Disease Control and Prevention
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  Atlanta, GA 30333
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Content source: National Center for Chronic Disease Prevention and Health Promotion, Division of Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
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Diagnostic Tests to Confirm (or Deny) Presence of Diabetes

By: Type Free Diabetes  

I’m Deborah Susan, a dietician and personal trainer specializing in nutrition and physical fitness for diabetics. Today I will write on diagnostic tests you can take to confirm (or deny) presence of diabetes.

Diagnostic tests to confirm (or deny) presence of diabetes

The most common tests are the urine and finger prick test. However, to be doubly sure, you need to conduct at least two or three lab tests including random or fasting blood glucose test meter and oral glucose tolerance tests. If test results are positive, it is a good idea to redo the tests on another randomly selected day.

Finger prick test. A finger is pricked with a sterilized device and a tiny drop of blood is collected and placed on a accu-chek active test strips. The strip is inserted into a digital diabetic test strip and an instant readout is obtained. This test takes less than a minute.

Urine test A chemical coated dipstick is dipped into a sample bottle that contains a sample of your urine. The dipstick instantly changes color in proportion to the level of glucose in the urine. This test too takes less than a minute.

Random blood glucose test A diabetic syringes is used to collect a small sample of your blood which is then analyzed in a lab. The results are often delivered the following day.

Oral glucose tolerance test You are requested not to eat or drink anything in the morning. A small blood sample is taken and sent for analysis to a laboratory. You are again requested to visit the clinic one hour after having lunch and fresh sample of blood is collected for analysis. The two pre and post results indicate your glucose tolerance level. A low tolerance level could indicate that you either have Type 2 diabetes or are on the verge of developing it.

Fasting Blood Sugar Testing Your last drink and meal should be at least 8 hours prior to taking this test. An insulin syringes is used to collect a tiny blood sample which is sent to the lab for analysis. The test results are usually received the same evening or following morning.

If all the above test results are returned positive for presence of excessive glucose, I recommend you redo the test the following week preferably at a different clinic. If the second test set too returns similar results than you can be sure you do have diabetes. Typically, glucose above 6 millimoles / liter of blood is not normal and you should consult your doctor immediately.

If diabetes is confirmed, it would be a good idea to also run a checkup on your body fat percentage through body fat monitor, blood pressure by automatic blood pressure monitor, kidneys, liver and thyroid. Additionally you should undergo a foot examination (for circulation and nerve supply) and eye examination (check for any damage due to glucose buildup).

This article concludes information I had to impart on the pre-diabetic stage. My next article shall deal with post-confirmation stage i.e. monitoring your blood glucose levels by blood glucose monitors at home and how to take care of your diabetes.

Typefreediabetes offers a full line of diabetic testing supplies, including adult incontinence product; supplements for diabetes, wrist blood pressure monitor, glucose tablets, blood glucose monitors, durable diabetes medical equipment, Lancing devices and many other home health care products and supplies. Typefreediabetes offers quality products at discounted prices on a wide selection of quality name brand equipment and supplies.

Click for Recipes for diabetics

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Article Source: http://www.articlesnatch.com

About the Author:
TypeFreeDiabetes.com is the premier source for your diabetic needs on-line. At TypeFreeDiabetes.com, you can enjoy a balanced diabetic lifestyle by learning about – how to control blood sugar, lower body fat, diet to prevent diabetes, reduce diabetes medications and reverse diabetes complications.

Diabetes in Toronto Neighborhoods

Clip from Global Ontario Podcast, Nov 1, 2007
Certain neighbourhoods in Toronto with high diabetes rates linked to poverty and urban layout.

Source: ghubbers on YouTube

Diabetic Neuropathies: The Nerve Damage of Diabetes

Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight. 

What causes diabetic neuropathies?

The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors:

• metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin
• neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves
• autoimmune factors that cause inflammation in nerves
• mechanical injury to nerves, such as carpal tunnel syndrome
• inherited traits that increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use 

What are the symptoms of diabetic neuropathies?

Symptoms depend on the type of neuropathy and which nerves are affected. Some people with nerve damage have no symptoms at all. For others, the first symptom is often numbness, tingling, or pain in the feet. Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time. Symptoms can involve the sensory, motor, and autonomic—or involuntary—nervous systems. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe.

Symptoms of nerve damage may include:

• numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
• wasting of the muscles of the feet or hands
• indigestion, nausea, or vomiting
• diarrhea or constipation
• dizziness or faintness due to a drop in blood pressure after standing or sitting up
• problems with urination
• erectile dysfunction in men or vaginal dryness in women
• weakness

Symptoms that are not due to neuropathy, but often accompany it, include weight loss and depression. 

What are the types of diabetic neuropathy?

Diabetic neuropathy can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in various ways.

• Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, hands, and arms.
• Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.
• Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs.
• Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected. 

Neuropathy Affects Nerves Throughout the Body

Peripheral neuropathy affects:

• toes
• feet
• legs
• hands
• arms

Autonomic neuropathy affects:

• heart and blood vessels
• digestive system
• urinary tract
• sex organs
• sweat glands
• eyes
• lungs

Proximal neuropathy affects:

• thighs
• hips
• buttocks
• legs

Focal neuropathy affects:

• eyes
• facial muscles
• ears
• pelvis and lower back
• chest
• abdomen
• thighs
• legs
• feet 

What is peripheral neuropathy?

Peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is nerve damage in the arms and legs. Your feet and legs are likely to be affected before your hands and arms. Many people with diabetes have signs of neuropathy that a doctor could note but feel no symptoms themselves. Symptoms of peripheral neuropathy may include:

• numbness or insensitivity to pain or temperature
• a tingling, burning, or prickling sensation
• sharp pains or cramps
• extreme sensitivity to touch, even light touch
• loss of balance and coordination

These symptoms are often worse at night.

Peripheral neuropathy affects the nerves in your toes, feet, legs, hands, and arms.

Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in the way a person walks. Foot deformities, such as hammertoes and the collapse of the midfoot, may occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. If foot injuries are not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated. Some experts estimate that half of all such amputations are preventable if minor problems are caught and treated in time. 

What is autonomic neuropathy?

Autonomic neuropathy affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels. Autonomic neuropathy also affects other internal organs, causing problems with digestion, respiratory function, urination, sexual response, and vision. In addition, the system that restores blood glucose levels to normal after a hypoglycemic episode may be affected, resulting in loss of the warning symptoms of hypoglycemia.

Autonomic neuropathy affects the nerves in your heart, stomach, intestines, bladder, sex organs, sweat glands, eyes, and lungs.

Hypoglycemia Unawareness

Normally, symptoms such as shakiness, sweating, and palpitations occur when blood glucose levels drop below 70 mg/dL. In people with autonomic neuropathy, symptoms may not occur, making hypoglycemia difficult to recognize. Problems other than neuropathy can also cause hypoglycemia unawareness. For more information about hypoglycemia, see the fact sheet Hypoglycemia at www.diabetes.niddk.nih.gov/dm/pubs/hypoglycemia.

Heart and Blood Vessels

The heart and blood vessels are part of the cardiovascular system, which controls blood circulation. Damage to nerves in the cardiovascular system interferes with the body’s ability to adjust blood pressure and heart rate. As a result, blood pressure may drop sharply after sitting or standing, causing a person to feel light-headed or even to faint. Damage to the nerves that control heart rate can mean that your heart rate stays high, instead of rising and falling in response to normal body functions and physical activity.

Digestive System

Nerve damage to the digestive system most commonly causes constipation. Damage can also cause the stomach to empty too slowly, a condition called gastroparesis. Severe gastroparesis can lead to persistent nausea and vomiting, bloating, and loss of appetite. Gastroparesis can also make blood glucose levels fluctuate widely, due to abnormal food digestion. For more information, see the fact sheet Gastroparesis at www.digestive.niddk.nih.gov/ddiseases/pubs/gastroparesis.

Nerve damage to the esophagus may make swallowing difficult, while nerve damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. Problems with the digestive system can lead to weight loss.

Urinary Tract and Sex Organs

Autonomic neuropathy often affects the organs that control urination and sexual function. Nerve damage can prevent the bladder from emptying completely, allowing bacteria to grow in the bladder and kidneys and causing urinary tract infections. When the nerves of the bladder are damaged, urinary incontinence may result because a person may not be able to sense when the bladder is full or control the muscles that release urine.

Autonomic neuropathy can also gradually decrease sexual response in men and women, although the sex drive may be unchanged. A man may be unable to have erections or may reach sexual climax without ejaculating normally. A woman may have difficulty with arousal, lubrication, or orgasm.

For more information, see the fact sheets Nerve Disease and Bladder Control and Sexual and Urologic Problems of Diabetes at www.kidney.niddk.nih.gov.

Sweat Glands

Autonomic neuropathy can affect the nerves that control sweating. When nerve damage prevents the sweat glands from working properly, the body cannot regulate its temperature as it should. Nerve damage can also cause profuse sweating at night or while eating.

Eyes

Finally, autonomic neuropathy can affect the pupils of the eyes, making them less responsive to changes in light. As a result, a person may not be able to see well when a light is turned on in a dark room or may have trouble driving at night. 

What is proximal neuropathy?

Proximal neuropathy, sometimes called lumbosacral plexus neuropathy, femoral neuropathy, or diabetic amyotrophy, starts with pain in the thighs, hips, buttocks, or legs, usually on one side of the body. This type of neuropathy is more common in those with type 2 diabetes and in older adults with diabetes. Proximal neuropathy causes weakness in the legs and the inability to go from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The length of the recovery period varies, depending on the type of nerve damage. 

What is focal neuropathy?

Focal neuropathy appears suddenly and affects specific nerves, most often in the head, torso, or leg. Focal neuropathy may cause:

• inability to focus the eye
• double vision
• aching behind one eye
• paralysis on one side of the face, called Bell’s palsy
• severe pain in the lower back or pelvis
• pain in the front of a thigh
• pain in the chest, stomach, or side
• pain on the outside of the shin or inside of the foot
• chest or abdominal pain that is sometimes mistaken for heart disease, a heart attack, or appendicitis

Focal neuropathy is painful and unpredictable and occurs most often in older adults with diabetes. However, it tends to improve by itself over weeks or months and does not cause long-term damage.

People with diabetes also tend to develop nerve compressions, also called entrapment syndromes. One of the most common is carpal tunnel syndrome, which causes numbness and tingling of the hand and sometimes muscle weakness or pain. Other nerves susceptible to entrapment may cause pain on the outside of the shin or the inside of the foot. 

How can I prevent diabetic neuropathies?

The best way to prevent neuropathy is to keep your blood glucose levels as close to the normal range as possible. Maintaining safe blood glucose levels protects nerves throughout your body.

For additional information about preventing diabetes complications, including neuropathy, see the Prevent Diabetes Problems Series at www.diabetes.niddk.nih.gov/dm/pubs/complications. 

How are diabetic neuropathies diagnosed?

Doctors diagnose neuropathy on the basis of symptoms and a physical exam. During the exam, your doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch.

Foot Exams

Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams. A comprehensive foot exam assesses the skin, muscles, bones, circulation, and sensation of the feet. Your doctor may assess protective sensation or feeling in your feet by touching your foot with a nylon monofilament—similar to a bristle on a hairbrush—attached to a wand or by pricking your foot with a pin. People who cannot sense pressure from a pinprick or monofilament have lost protective sensation and are at risk for developing foot sores that may not heal properly. The doctor may also check temperature perception or use a tuning fork, which is more sensitive than touch pressure, to assess vibration perception.

Other Tests

The doctor may perform other tests as part of your diagnosis.

• Nerve conduction studies or electromyography are sometimes used to help determine the type and extent of nerve damage. Nerve conduction studies check the transmission of electrical current through a nerve. Electromyography shows how well muscles respond to electrical signals transmitted by nearby nerves. These tests are rarely needed to diagnose neuropathy.
• A check of heart rate variability shows how the heart responds to deep breathing and to changes in blood pressure and posture.
• Ultrasound uses sound waves to produce an image of internal organs. An ultrasound of the bladder and other parts of the urinary tract, for example, can show how these organs preserve a normal structure and whether the bladder empties completely after urination. 

How are diabetic neuropathies treated?

The first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin will help control blood glucose levels. Symptoms may get worse when blood glucose is first brought under control, but over time, maintaining lower blood glucose levels helps lessen symptoms. Good blood glucose control may also help prevent or delay the onset of further problems. As scientists learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent, or even reverse nerve damage.

As described in the following sections, additional treatment depends on the type of nerve problem and symptom. If you have problems with your feet, your doctor may refer you to a foot care specialist.

Pain Relief

Doctors usually treat painful diabetic neuropathy with oral medications, although other types of treatments may help some people. People with severe nerve pain may benefit from a combination of medications or treatments. Talk with your health care provider about options for treating your neuropathy.

Medications used to help relieve diabetic nerve pain include:

• tricyclic antidepressants, such as amitriptyline, imipramine, and desipramine (Norpramin, Pertofrane)
• other types of antidepressants, such as duloxetine (Cymbalta), venlafaxine, bupropion (Wellbutrin), paroxetine (Paxil), and citalopram (Celexa)
• anticonvulsants, such as pregabalin (Lyrica), gabapentin (Gabarone, Neurontin), carbamazepine, and lamotrigine (Lamictal)
• opioids and opioid-like drugs, such as controlled-release oxycodone, an opioid; and tramadol (Ultram), an opioid that also acts as an antidepressant

Duloxetine and pregabalin are approved by the U.S. Food and Drug Administration specifically for treating painful diabetic peripheral neuropathy.

You do not have to be depressed for an antidepressant to help relieve your nerve pain. All medications have side effects, and some are not recommended for use in older adults or those with heart disease. Because over-the-counter pain medicines such as acetaminophen and ibuprofen may not work well for treating most nerve pain and can have serious side effects, some experts recommend avoiding these medications.

Treatments that are applied to the skin—typically to the feet—include capsaicin cream and lidocaine patches (Lidoderm, Lidopain). Studies suggest that nitrate sprays or patches for the feet may relieve pain. Studies of alpha-lipoic acid, an antioxidant, and evening primrose oil have shown that they can help relieve symptoms and may improve nerve function.

A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs. Acupuncture, biofeedback, or physical therapy may help relieve pain in some people. Treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful but need further study. Researchers are also studying several new therapies in clinical trials.

Gastrointestinal Problems

To relieve mild symptoms of gastroparesis—indigestion, belching, nausea, or vomiting—doctors suggest eating small, frequent meals; avoiding fats; and eating less fiber. When symptoms are severe, doctors may prescribe erythromycin to speed digestion, metoclopramide to speed digestion and help relieve nausea, or other medications to help regulate digestion or reduce stomach acid secretion.

To relieve diarrhea or other bowel problems, doctors may prescribe an antibiotic such as tetracycline, or other medications as appropriate.

Dizziness and Weakness

Sitting or standing slowly may help prevent the light-headedness, dizziness, or fainting associated with blood pressure and circulation problems. Raising the head of the bed or wearing elastic stockings may also help. Some people benefit from increased salt in the diet and treatment with salt-retaining hormones. Others benefit from high blood pressure medications. Physical therapy can help when muscle weakness or loss of coordination is a problem.

Urinary and Sexual Problems

To clear up a urinary tract infection, the doctor will probably prescribe an antibiotic. Drinking plenty of fluids will help prevent another infection. People who have incontinence should try to urinate at regular intervals—every 3 hours, for example—since they may not be able to tell when the bladder is full.

To treat erectile dysfunction in men, the doctor will first do tests to rule out a hormonal cause. Several methods are available to treat erectile dysfunction caused by neuropathy. Medicines are available to help men have and maintain erections by increasing blood flow to the penis. Some are oral medications and others are injected into the penis or inserted into the urethra at the tip of the penis. Mechanical vacuum devices can also increase blood flow to the penis. Another option is to surgically implant an inflatable or semirigid device in the penis.

Vaginal lubricants may be useful for women when neuropathy causes vaginal dryness. To treat problems with arousal and orgasm, the doctor may refer women to a gynecologist.

Foot Care

People with neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers.

More than half of all lower-limb amputations in the United States occur in people with diabetes—86,000 amputations per year. Doctors estimate that nearly half of the amputations caused by neuropathy and poor circulation could have been prevented by careful foot care.

Follow these steps to take care of your feet:

• Clean your feet daily, using warm—not hot—water and a mild soap. Avoid soaking your feet. Dry them with a soft towel and dry carefully between your toes.
• Inspect your feet and toes every day for cuts, blisters, redness, swelling, calluses, or other problems. Use a mirror—laying a mirror on the floor works well—or get help from someone else if you cannot see the bottoms of your feet. Notify your health care provider of any problems.
• Moisturize your feet with lotion, but avoid getting the lotion between your toes.
• After a bath or shower, file corns and calluses gently with a pumice stone.
• Each week or when needed, cut your toenails to the shape of your toes and file the edges with an emery board.
• Always wear shoes or slippers to protect your feet from injuries. Prevent skin irritation by wearing thick, soft, seamless socks.
• Wear shoes that fit well and allow your toes to move. Break in new shoes gradually by first wearing them for only an hour at a time.
• Before putting your shoes on, look them over carefully and feel the insides with your hand to make sure they have no tears, sharp edges, or objects in them that might injure your feet.
• If you need help taking care of your feet, make an appointment to see a foot doctor, also called a podiatrist.

For additional information about foot care, contact the National Diabetes Information Clearinghouse at 1–800–860–8747. See the publication Prevent diabetes problems: Keep your feet and skin healthy at www.diabetes.niddk.nih.gov/dm/pubs/complications_feet. Materials are also available from the National Diabetes Education Program, including the fact sheet Take Care of Your Feet for a Lifetime at www.ndep.nih.gov/campaigns/Feet/Feet_overview.htm. 

Points to Remember

• Diabetic neuropathies are nerve disorders caused by many of the abnormalities common to diabetes, such as high blood glucose.
• Neuropathy can affect nerves throughout the body, causing numbness and sometimes pain in the hands, arms, feet, or legs, and problems with the digestive tract, heart, sex organs, and other body systems.
• Treatment first involves bringing blood glucose levels within the normal range. Good blood glucose control may help prevent or delay the onset of further problems.
• Foot care is an important part of treatment. People with neuropathy need to inspect their feet daily for any injuries. Untreated injuries increase the risk of infected foot sores and amputation.
• Treatment also includes pain relief and other medications as needed, depending on the type of nerve damage.
• Smoking significantly increases the risk of foot problems and amputation. If you smoke, ask your health care provider for help with quitting. 

Hope through Research

The National Institute of Diabetes and Digestive and Kidney Diseases conducts and supports research to help people with diabetes. A complete listing of clinical research studies, including those related to diabetic neuropathies, can be found at www.ClinicalTrials.gov.

The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory. 

For More Information

For more information, contact the following organizations:

American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1–800–DIABETES (342–2383)
Email: AskADA@diabetes.org
Internet: www.diabetes.org

American Urological Association Foundation
1000 Corporate Boulevard
Linthicum, MD 21090
Phone: 1–866–RING–AUA (746–4282)
or 410–689–3700
Fax: 410–689–3800
Email: patienteducation@auafoundation.org
Internet: www.auafoundation.org
www.UrologyHealth.org

American Podiatric Medical Association
9312 Old Georgetown Road
Bethesda, MD 20814–1621
Phone: 1–800–FOOTCARE (366–8227)
or 301–581–9200
Fax: 301–530–2752
Email: askapma@apma.org
Internet: www.apma.org

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation
4770 Buford Highway NE, Mail Stop K–10
Atlanta, GA 30341–3717
Phone: 1–800–CDC–INFO (232–4636) or 770–488–5000
Email: cdcinfo@cdc.gov
Internet: www.cdc.gov/diabetes

Juvenile Diabetes Research Foundation International
26 Broadway, 14th Floor
New York, NY 10004
Phone: 1–800–533–CURE (2873)
Fax: 212–785–9595
Email: info@jdrf.org
Internet: www.jdrf.org

Lower Extremity Amputation Prevention Program
Health Resources and Services Administration
5600 Fishers Lane
Rockville, MD 20857
Phone: 1–888–ASK–HRSA (275–4772)
Internet: www.hrsa.gov/leap

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892–3560
Phone: 1–800–438–5383
Fax: 703–738–4929
Email: ndep@mail.nih.gov
Internet: www.ndep.nih.gov

National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892–3570
Phone: 1–800–891–5389
Fax: 703–738–4929
Email: nddic@info.niddk.nih.gov
Internet: www.digestive.niddk.nih.gov

National Heart, Lung, and Blood Institute Information Center
P.O. Box 30105
Bethesda, MD 20824–0105
Phone: 301–592–8573
Fax: 240–629–3246
Email: nhlbiinfo@nhlbi.nih.gov
Internet: www.nhlbi.nih.gov

National Institute of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824
Phone: 1–800–352–9424 or 301–496–5751
Internet: www.ninds.nih.gov

National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892–3580
Phone: 1–800–891–5390
Fax: 703–738–4929
Email: nkudic@info.niddk.nih.gov
Internet: www.kidney.niddk.nih.gov

Pedorthic Footwear Association
2025 M Street NW, Suite 800
Washington, DC 20036
Phone: 1–800–673–8447 or 202–367–1145
Fax: 202–367–2145
Email: info@pedorthics.org
Internet: www.pedorthics.org

You may also find additional information about this topic by visiting MedlinePlus at www.medlineplus.gov.

This publication may contain information about medications. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov. Consult your doctor for more information.

Source:

---

National Diabetes Information Clearinghouse

1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1978, the Clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. The NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.

This publication was originally reviewed by Peter J. Dyck, M.D., Peripheral Neuropathy Research Laboratory, Mayo Clinic Rochester, Rochester, MN; Eva L. Feldman, M.D., Ph.D., Department of Neurology, University of Michigan, Ann Arbor, MI; and Aaron I. Vinik, M.D., Ph.D., Strelitz Diabetes Research Institute, Eastern Virginia Medical School, Norfolk, VA. Dr. Feldman also reviewed the updated version of the publication.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

---

NIH Publication No. 08–3185
February 2009

s

Diabetes and Pregnancy

 

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Diabetes and Pregnancy

Diabetes is often diagnosed in women during their childbearing years and can affect the health of both the mother and her unborn child. Poor control of diabetes during pregnancy increases the chances for birth defects and other problems for the baby. It can cause serious complications for the woman, also. Proper healthcare before and during pregnancy can help prevent birth defects and other poor outcomes.

About Diabetes

Diabetes is a condition in which the body cannot use the sugars and starches (carbohydrates) it takes in as food to make energy. The body either makes no insulin or too little insulin or cannot use the insulin it makes to change those sugars and starches into energy. As a result, extra sugar builds up in the blood.

The three most common types of diabetes are:

Type 1

The pancreas makes no insulin or so little insulin that the body can’t use blood sugar for energy. Type 1 diabetes must be controlled with daily insulin.

Learn more about type 1 diabetes and pregnancy here:

Type 2

The body either makes too little insulin or can’t use the insulin it makes to use blood sugar for energy. Sometimes type 2 diabetes can be controlled through eating a proper diet and exercising regularly. Many people with type 2 diabetes have to take diabetes pills, insulin, or both.

Learn more about type 2 diabetes and pregnancy here:

Gestational

This is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Often gestational diabetes can be controlled through eating a healthy diet and exercising regularly.  Sometimes a woman with gestational diabetes must also take insulin.

For most women with gestational diabetes, the diabetes goes away soon after delivery. When it does not go away, the diabetes is called type 2 diabetes.  Even if the diabetes does go away after the baby is born, half of all women who had gestational diabetes develop type 2 diabetes later. It’s important for a woman who has had gestational diabetes to continue to exercise and eat a healthy diet after pregnancy to prevent or delay getting type 2 diabetes. She should also remind her doctor to check her blood sugar every 1 to 3 years.

Learn more about gestational diabetes and pregnancy here:

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Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348, 24 Hours/Every Day – cdcinfo@cdc.gov

Tips for Taking Care of Diabetic Feet

By Chris Dillon

People who have diabetes know that they need to take extra care of their feet to reduce or eliminate the pain and complications often associated with the disease. Pain, numbness and tingling in the extremities, including the feet, are commonly experienced by people with diabetes. Neuropathy can cause injuries to go unnoticed, and reduced circulation to the extremities can slow healing after an injury has occurred. Here are a few precautions that may be recommended to help care for diabetic feet:

Thoroughly inspect feet for injuries each day. A loss of sensation can lead cuts, bruises, blisters or ulcers on the feet to go unnoticed in people with diabetes. Discovering and treating any such problems early can help keep them from worsening. Examining the feet daily is a good idea for anyone with diabetes.

Contact your medical professional immediately if any foot problems are observed. Discovering and treating any potential foot issues early gives you the chance to begin treatment right away. Many foot related problems can worsen or become infected if they go unnoticed.

Wear properly fitted diabetic footwear for your needs. Diabetic footwear is designed to provide optimal support and distribute the weight of the body such that foot pain is minimized. Podiatrists and certified pedorthists can help people with diabetes select appropriately fitted footwear for their needs.

Avoid going barefoot to reduce the chance of injury. Preventing cuts and other foot injuries is a precaution that can help minimize foot problems and infections in diabetics. Wearing shoes at all times is one way to help prevent unnecessary injuries that can lead to infections.

Wash and dry feet well daily. Washing the feet daily helps promote foot health. Drying the feet completely, particularly between the toes, is also very important for people who have diabetes.

Work with your doctor to determine what treatments work for you. Since the same treatments options may not work for each patient, working with a medical professional such as a podiatrist or certified pedorthist will help you determine the best way to care for your feet.

Note: This information is not intended to supplement or replace advice from a medical professional, or to diagnose or treat any condition.

Article Source: http://www.articlesbase.com/diseases-and-conditions-articles/tips-for-taking-care-of-diabetic-feet-1165282.html

About the Author

Chris Dillon is the V.P. of MMAR Medical Group Inc., a provider of wholesale orthopedic products including diabetic footwear, custom orthotics, braces and more. Please visit www.mmarmedical.com for more information.

Diabetes and Pregnancy, Why Women Should Worry

By Eddie Lamb

There are many concerns a woman will have during her pregnancy, and one that can easily be put to rest with a simple test is gestational diabetes mellitus or more commonly known as diabetes during pregnancy. Gestational diabetes can arise during the second or third trimesters, and can cause complications for the mother as well as the unborn child. Diabetes during pregnancy occurs in a relatively small percentage of expectant mothers, and can often be controlled by diet and exercise throughout the pregnancy.

Many doctors will routinely test for diabetes in pregnancy between 24 and 28 weeks of gestation, especially if a woman has risk factors that will increase her odds of developing it. These risk factors include a history of high blood pressure, obesity, ethnicity and a family history of diabetes. Women who have experienced diabetes in pregnancy in the past have a greater chance of developing it again in subsequent pregnancies. Women who are pregnant at an older age also have a greater risk of diabetes in pregnancy.

The test will include fasting and then drinking glucola, which is a mixture of concentrated sugar. Once the glucola is ingested, a blood test is done to check blood sugar levels. If gestational diabetes is diagnosed, a program of diet and exercise will be prescribed to try to control the diabetes during the pregnancy.

What Does Diabetes in Pregnancy Look Like?

Often diabetes during pregnancy is diagnosed before symptoms become obvious. Some of the symptoms that can show up are an increase in hunger, thirst and urination, recurrent vaginal infections and increased blood pressure. Many women complain of fatigue, although this is not a good test, since fatigue is a common symptom of pregnancy. Often sugar will show up in urine during a routine test and this will prompt the doctor to proceed with the glucose test.

It is important to diagnose and treat diabetes in pregnancy as quickly as possible, since it can cause complications during pregnancy. Risks to the mother include raised blood pressure which can lead to a dangerous condition known as ecclampsia. It can also increase the chances of a woman developing Type 2 diabetes later in life. The unborn child can have problems with its heart or kidneys as a result of the mother’s diabetes during pregnancy.

Diabetes during pregnancy is certainly an unwanted complication, but fortunately it can be diagnosed easily and treated effectively. The important thing to remember is to stay on schedule with prenatal visits to the doctor so that the doctor can stay on top of any potential problems.

Source: http://www.articlecircle.com/ – Free Articles Directory

About the Author
Eddie Lamb publishes an abundance of vital information on a range of health topics. We believe a better understanding of your condition can help reduce unnecessary anxiety. You’ll find a host of useful articles all about pregnancy listed on our site map page at http://www.pregnancyunderstood.com

Diabetes and Your Feet – Video

Source: roboubi on YouTube
Serenity Well Being Clinic P.A. Dr. Nazanin Roboubi 

Diabetes – The Perfect Storm

 

By Caleb Hellerman

 

(CNN) — The number of Americans with diabetes will nearly double in the next 25 years, and the costs of treating them will triple, according to a new report.

The figures, in a University of Chicago report released Friday, add fuel to the congressional debate regarding reining in the cost of health care.

By 2034, 44.1 million Americans will be living with diabetes — nearly twice the current number of 23.7 million, according to the report, published in the December issue of the journal Diabetes Care. About 90 percent of those with diabetes have type 2, a version of the condition that develops over time.

Accounting for inflation, the direct medical cost of treating them will rise from $113 billion annually to $336 billion, the report says.

Current health care proposals in Congress attempt to slow the growth of spending on chronic diseases such as diabetes by funding programs to prevent disease in the first place, and by offering incentives for insurers and medical providers to encourage early treatment through so-called “accountable care organizations.”

In those organizations, doctors might be paid a flat fee to treat a diabetes patient for a year, with bonuses if they meet certain benchmarks of patient health.

The staggering numbers in the new paper dwarf potential savings that have lately been discussed. For example, Health and Human Services Secretary Kathleen Sebelius earlier this month released a report urging improvements in diabetes care. If the most successful statewide programs for controlling diabetes could be duplicated nationwide, it estimates, annual savings from reducing hospitalizations and treatment for various complications would total $216 million.

The numbers are disturbing, said Dr. Elbert Huang, an assistant professor of medicine at the University of Chicago. He said he considers the predictions “very conservative” because they don’t account for the growing proportion of overweight children and teenagers, who are at higher risk for developing diabetes.

The estimates also don’t factor in immigration, or the rising population of ethnic minorities. Latinos and African-Americans suffer diabetes at higher rates than the U.S. population as a whole.

Type 1 diabetes is a condition in which a person loses the ability to break down glucose in the blood and turn food into energy. The condition often develops when people are young.

In type 2 diabetes, the condition develops over time. The process is complex, but aside from ethnic background, risk factors include having a family history of diabetes, high blood pressure or heart disease. The most common risk factor is simply being overweight.

Even modest weight loss will reduce the chance of developing type 2 diabetes, according to the Centers for Disease Control and Prevention.

More ambitious lifestyle changes, such as diet, regular exercise and assistance through counseling lowered the risk of diabetes by 58 percent, even without medication, in a major federally funded study.

The model used by Huang and his colleagues assumes that the prevalence of diabetes in each age group will stay constant, but that the number of cases will grow as the population gets older. For the Medicare-eligible population alone, the paper predicts the diabetes caseload will rise from 8.2 million people to 14.6 million, and that the total annual cost of treatment will go from $45 billion to $171 billion.

To estimate cost, the researchers assumed that the standard progression of the disease, and mix of therapies used to treat it, will remain constant. According to a 2005 federal report, nearly three in four adults with diabetes uses oral medication to control the disease. About one in four takes insulin.

Diabetes is the leading cause of kidney failure, according to the American Diabetes Association, and nerve damage and damaged blood vessels are also common. About 15 percent of diabetics require amputation of a lower extremity at some point in their life, according to a 1998 paper in Diabetes Care.

It’s certainly possible that medical breakthroughs will improve care, but it’s unlikely to lead to lower costs, Huang said. “In the past, in general, medical discoveries have driven costs up, not down.”

The study was funded by the company Novo Nordisk, which makes insulin delivery systems to treat diabetics. Novo Nordisk approved the final manuscript, but the authors say the company did not play a role in designing the study or collecting data.

“Without significant changes in public or private strategies, this population and cost growth are expected to add a significant strain to an overburdened health care system,” the report concludes.

The new report is concerning, but doesn’t change the big picture of health care spending, said Jonathan Gruber, an MIT economist who has schooled many politicians about the intricacies of health care.

“Even without this change, over the next 75 years we’ve made promises that exceed the revenues we have to pay for them,” he said.

There’s no compelling evidence that better preventive care can significantly reduce the cost of treating diabetes, Gruber said, but he believes accountable care organizations could make a big impact. He also likes the idea of allowing insurers to charge higher premiums to people who don’t meet certain health benchmarks, such as losing weight if they’re obese.

“The thing about diabetes, it’s among the most preventable of major illnesses,” Gruber said. “We need to put patient financial incentives at stake.”

Huang said he won’t be surprised if the surge in diabetes turns out to be even worse than he projects.

“Prior estimates have all said there would be a dramatic rise in the diabetes type 2 population,” he said, but in every case “the actual [diabetic] population has ended up being larger than the estimates.”

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We recommend “Reversing Diabetes is Possible”.

Source: CNN by Caleb Hellerman, (published November 27, 2009).
Caleb Hellerman is CNN Medical News senior producer.
Photo By FoodSpook

Type 2 Diabetes: What Doctors Don’t Tell You

 

 

 

 

By Emily Saar

 

Original published October 12, 2007. Reprinted here November 10, 2009.

Emily Saar is a recovered type 2 diabetic as a result of using Eleotin and the owner of http://www.BetaTherapy.com. Visit to learn more about Eleotin and the truth about diabetes.

http://www.BetaTherapy.com

View all articles by Emily Saar Type 2 Diabetes: What Doctors Don’t Tell You
According to the CDC (Center for Disease Control) type 2 diabetes is an epidemic that affects more than 18,000,000 people in the U.S alone. Statistics prove that more than 2,500 people daily are diagnosed with this disease. Almost everyone knows someone who has it. It is estimated that 1 in 4 Americans have type 2 diabetes, many do not know they have it.

Type 2 diabetes is a silent killer of thousands every year. It doesn’t come on overnight and it isn’t painful (at first). In fact, a majority of people who are newly diagnosed with type 2 diabetes are usually being treated for another problem. Many do not take this disease seriously enough to do anything about it until complications begin to surface.

Complications vary from person to person, but the first signs of type 2 diabetes usually include: extreme thirst, dry itchy skin, tingling in the hands and feet, increased urination, increased hunger and blurry vision. Untreated, it can eventually lead to: poor circulation, nerve damage, blindness, amputations, heart disease, stroke, kidney failure, dialysis and death. Pretty serious complications.

Twenty years ago, type 2 diabetes was a disease most commonly diagnosed in people over 50. Today, our children are being diagnosed. What a sad future they have to look forward to. Life expectancy is shortened by at least 12 years along with a lifetime of insulin shots, medications and eventually dialysis.

Healthcare professionals deal with this epidemic by prescribing medications. Many of these drugs are very harmful and even deadly. Most have to be taken for life and lose their effectiveness over time, meaning the doses will have to be increased or other drugs added to the original prescription. Considering the complications associated with type 2 diabetes, our healthcare system profits quite nicely from this disease.

Avandia, a very common diabetes medication, was once thought to be a very effective drug in treating type 2 diabetes. Until it started killing
people. Now known as a drug that increases risk of heart attack by 70%, many patients went scrambling to their doctors to change their meds, not knowing the amount of damage already done by this drug. This FDA approved drug. Avandia is not the only one. Almost all diabetes drugs carry some type of harmful side-effects from headaches and vomiting to heart and liver failure.

Knowing the amount of money the pharmeceutical companies make from type 2 diabetes and all of it’s complications, it’s no wonder a cure has never been found. Think carefully about what would happen if an FDA approved cure was made available. Entire wings of hospitals would shut down, doctors that specialize in diabetes would be out of work and dialysis clinics would fold. This is a very small part of the revenue made by other complications such as blindness, physical therapy due to amputations, heart institutes would lose hundreds of millions. There is just too much money to lose in making a cure available.

Canada has had a natural type 2 diabetes herbal remedy available to the public since 1999 called Eleotin. Researched for more than 20 years, Eleotin works on a metabolic level to lower blood sugars naturally and reverse type 2 diabetes by correcting the causes.

Type 2 diabetes has two main causes. Insufficient insulin produced by the pancreas (beta cell damage) or insulin resistance, when cells in the body resist insulin that is made. Eleotin restores beta cell function, restores the health of the pancreas and strengthens insulin receptors to make them more sensitive to the insulin naturally made by the body. Eleotin has no harmful side-effects, is made entirely from herbs used as foods in many countries. It is even safe for children.

Eleotin is sweeping the globe. Almost 100,000 people worldwide have used Eleotin. Many have reversed their type 2 diabetes completely. It’s time we take this disease more seriously and stop waiting for the FDA approved cure that will never appear. How many years have we dumped money into diabetes research? Where is their cure? For many thousands of people who have used Eleotin, they have already found theirs.

Source: Emily Saar

Type 2 Diabetes Epidemic

 

 

 

 

By Mike Fletcher

 

According to the American Diabetes Association (ADA), there are 15.7 million Americans who have diabetes. This disease is the main cause of blindness in people between the ages of twenty and seventy and is the sixth leading cause of death in the U.S.

If this disease is not properly managed, diabetes can cause kidney disease, hypertension, heart disease, edema, neuropathy, and infections of the mouth, feet, skin, lungs and genitalia. The skin infections do not heal properly and can even lead to amputation of extremities.

Type 2 diabetes has become the most common form of disease affecting 90-95 percent of the people who have diabetes. For people who have type II diabetes, not enough insulin is manufactured by the pancreas. Another problem is that the cells can become insulin resistant. When this happens, glucose accumulates in the blood instead of entering the cells.

Type 2 diabetes usually develops later in life; however, the disease is now becoming more common in people in their thirties and even late twenties.
The most common risk factors among those who develop this condition include diet, weight, race, age, lack of exercise and genetics. The most common ethnic groups to have type 2 diabetes are Latinos, American Indians, African-Americans, and American Asians.

The real danger of diabetes is the complications associated from inconsistent insulin levels and elevated blood glucose. One dangerous complication is diabetic ketoacidosis (DKA), or another dangerous condition known as hyperosmolar syndrome. DKA happens when insulin levels are so low that the body starts metabolizing stored fat to use as fuel. When the fat breaks down, a by-product is released that is known as ketones which cause the body to become too acidic.

Ketoacidosis is typically seen in those with type 1 diabetes, but can happen to those with type 2 as well. The symptoms can include nausea, sweet breath, having a hard time breathing and confusion which can lead to a coma.

Hyperosmolar syndrome is a result of elevated blood sugars accompanied with dehydration. This condition is more common in those with type 2 diabetes who also take steroid medications. Hyperosmolar syndrome can also be a result of a stress from another illness. Symptoms can include confusion, tiredness, and in the most severe cases, coma. Often, in older adults, type 2 diabetes is not discovered until the symptoms of hypersmolar syndrome are reported to a doctor.

If you have recently been diagnosed with diabetes, you probably have a lot of questions and may even have a hard time grasping the severity and the responsibilities that come with this condition. It must now become a priority to take care of your body. If you are overweight, it is time to drop those extra pounds. You will also need to cut back on sugars, eat more fiber, and limit fours and white rice and to start a regular exercise regime.

You will also want to make an appointment with an optometrist make sure that your eyes are in good shape.

Source: Mike Fletcher

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