Type 2 Diabetes: Yesterday, Today & Tomorrow

• Diabetes, Type 2

 

YESTERDAY

• No proven strategies existed to prevent the disease or its complications.
• The only ways to treat diabetes were the now-obsolete forms of insulin from cows and pigs, and drugs that stimulate insulin release from the beta cells of the pancreas (sulfonylureas). Both of these therapies cause dangerous low blood sugar reactions and weight gain. Patients monitored their glucose levels with urine tests, which recognized high but not dangerously low glucose levels and reflected past, not current, glucose levels. More reliable methods for testing glucose levels in the blood had not been developed yet.
• While scientists knew that genes played a role (i.e., the disease often runs in families), they had not identified any specific culprit genes.
• National efforts were not being made to combat obesity—a serious risk factor for the disease. Fewer people developed type 2 diabetes compared to today because overweight, obesity, and physical inactivity were not pervasive.
• Patients were almost exclusively adults—the reason that the disease was formerly called “adult onset diabetes.” It was rare in children or young adults.

TODAY

• Type 2 diabetes can be prevented or delayed. The NIH-funded Diabetes Prevention Program (DPP) clinical trial (http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/) found a lifestyle intervention (modest weight loss of 5 to 7 percent of body weight and 30 minutes of exercise 5 times weekly) reduced the risk of getting type 2 diabetes by 58 percent in a diverse population of over 3000 adults at high risk for diabetes. In another arm of the study, the drug metformin reduced development of diabetes by 31 percent.
• Based on the DPP findings, the National Diabetes Education Program developed the education campaign, “Small Steps. Big Rewards. Prevent Type 2 Diabetes.” to help people at high risk take the necessary steps to prevent the disease (www.ndep.nih.gov).
• Ongoing NIH translational research efforts are testing cost effective ways to deliver the DPP-proven lifestyle change in real-world settings. This vigorous effort is needed to address the escalating prevalence of type 2 diabetes which now affects 7.8 percent of Americans, disproportionate affects minorities, and is conservatively estimated to be the seventh leading cause of death in the U.S.
• Type 2 diabetes is increasing in children, in tandem with rising obesity rates. This trend is alarming because, as younger people develop the disease, the complications, morbidity, and mortality associated with diabetes are all likely to occur earlier. Also, offspring of women with type 2 diabetes are more likely to develop the disease. Thus, the burgeoning of diabetes in younger populations could lead to a vicious cycle of ever-growing rates of diabetes.
• The SEARCH for Diabetes in Youth Study (www.searchfordiabetes.org) has provided the first national data on incidence and prevalence of diabetes in youth. About 3700 youth under 20 years old are diagnosed with type 2 diabetes each year, and the disease is particularly prevalent in minority youth.
• Research has vastly expanded understanding of the molecular underpinnings of diabetes and its complications. Recent work has boosted to nearly 40 the number of gene regions associated with increased risk of type 2 diabetes, laying the foundation for new approaches to prevention and therapy.
• NIH-supported clinical trials validated a marker called hemoglobin A1C (A1C). This marker reflects average blood sugar control over a 3 month period. This technology, along with tests that allow patients to monitor their own blood glucose throughout the day, helps make better blood glucose control achievable for many people with type 2 diabetes.
• Because lower A1C levels have been shown to be predictive of longer life and fewer complications, the test has helped speed development and approval of better forms of insulin and new diabetes medicines that work though a variety of mechanisms. New drugs are available that lower glucose without weight gain or even with modest weight loss. Several agents targeting the specific metabolic abnormalities of type 2 diabetes are now available and can be combined, thus delaying the need for insulin.
• Tight blood sugar control has become a standard of treatment for most diabetes patients based on results from NIH clinical trials demonstrating that keeping A1C below 7 can prevent or delay devastating disease complications.
• A large clinical trial showed that older patients with longstanding type 2 diabetes at high risk of heart disease do not benefit from more intensive blood glucose control than is currently recommended. These findings spare patients from unneeded therapy and provide important data to help individualize therapy, with less stringent A1C targets suggested for some people such as those with advanced diabetes complications.
• Clinical trials have shown that blood pressure and lipid control reduce diabetes complications by up to 50 percent. Physicians are now much better equipped to prevent and control heart disease, which often accompanies diabetes, and is the leading cause of death in people with diabetes.
• Nationwide improvements in risk factor control show research-proven strategies are being translated into practice. Improvements in control of cholesterol, blood glucose, and blood pressure have added an estimated one year to the expected lifespan of a person with type 2 diabetes since 1992, and improved quality of life by reducing the incidence of burdensome complications like blindness, lower limb amputations, kidney failure, and coronary heart disease.
• As a result of research proving their benefits, Medicare now covers blood glucose self monitoring materials and diabetes education services, helping people to better control their diabetes.
• Kidney disease can be detected earlier via urine tests. Therefore, patients can be treated earlier to slow the rate of kidney damage. Improved control of glucose and blood pressure prevents or delays progression of kidney disease to kidney failure. With good care, less than 10 percent of patients develop kidney failure.
• With timely laser surgery and appropriate follow-up care, people with advanced diabetic retinopathy can reduce their risk of blindness by 90 percent. A recent study showed a drug which limits blood vessel growth can be an important supplement to laser therapy for diabetic macular edema.
• The NIH spent over $1.1 billion on diabetes research in fiscal year 2009. In 2007, total costs attributable to diabetes for Americans was estimated at $174 billion—an increase of 32 percent since 2002.

TOMORROW

• Research will find better ways to bring proven diabetes prevention strategies to more people at lower cost.
• Earlier and more aggressive treatment approaches may help better prevent diabetes complications.
• New understanding of the biology of obesity and insulin resistance is informing the development of new therapeutics to prevent and treat type 2 diabetes.
• Identification of susceptibility genes for diabetes and its complications will enable earlier implementation of prevention measures targeted to those at highest risk.
• Research on the effect of maternal diabetes on offspring may help to break the vicious diabetes cycle.
• Continued research on the mechanisms underlying the development and progression of disease complications will result in the ability to predict who is likely to develop them. Personalized treatments could then be developed to preempt complications. This strategy would dramatically improve the health and well-being of patients.
• NIH clinical trials will identify new approaches to prevent and treat the emerging problem of type 2 diabetes in children.

For more information, contact The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): NIDDKinquiries@nih.gov
The National Institute of Diabetes and Digestive and Kidney Diseases www.niddk.nih.gov

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Obesity is Getting Bigger in the United States

July 7th, 2011

Obesity is getting bigger in the United States

Two-thirds of all adults and about a third of all children and teenagers in the United States are overweight or obese according to a report release Thursday by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

According to “F as in Fat: How Obesity Threatens America’s Future 2011,” adult obesity increased in 16 states during the past year and rates soared to 30% or more in these 12 states: Alabama, Arkansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia. Four years ago, only one state – Mississippi – had an adult obesity rate of more than 30%. No state showed a decrease in it obesity rate in Thursday’s report.

Nine of the 10 states with the highest adult obesity numbers are in the South. Mississippi, for the seventh year in a row, had the highest adult obesity rate at 34.4%. Colorado, at 19.8%, had the lowest, and in fact is the only state in the country with an adult obesity rate under 20%. Twenty years ago no rate was above 15%. The report found rates grew fastest in Alabama, Tennessee and Oklahoma and slowest in Colorado, Connecticut and the District of Columbia.

“There was a clear tipping point in our national weight gain over the last twenty years,” said Jeff Levi, Executive director of TFAH. “And we can’t afford to ignore the impact obesity has on our health and corresponding health care spending.”

According to the Centers for Disease Control and Prevention, the medical costs associated with obesity are staggering– totaling about $147 billion in 2008. More than 80% of people in this country with type-2 diabetes are overweight and new diagnoses doubled in 10 years, according to Thursday’s report. Overweight and obese people are at risk of developing high blood pressure and high cholesterol, risk factors for cardiovascular disease and stroke. They may also be at greater risk of colon, kidney and esophageal cancer.

African Americans, Latinos, those with low incomes and less education had the highest overall rates, topping 30 to 40% in many states. The report found about 33% of adults who made less than $15,000 a year or did not graduate from high school were obese.

The researchers found that a lack of access to fresh fruits, vegetables and other healthful foods in some neighborhoods and a dearth of safe community areas for families to walk and for children to play all factor into the obesity epidemic.

But there’s more to it. “Portion sizes in restaurants are much larger than they have been, soft drinks at convenience stores are much larger than they have been,” said Dr. James Marks, senior vice president of the Robert Wood Johnson Foundation. “When people have a larger size they will eat more. Snacking has gone up more and more. All of these things contribute.”

“We’ve built inactivity into our lifestyles. We’ve designed communities around cars,” said Levi. “Kids are watching TV and sitting around computers. We’ve found plenty of ways to entertain ourselves that don’t include activity.”

“The information in this report should spur us all – individuals and policymakers alike – to redouble our efforts to reverse this debilitating and costly epidemic,” said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation. “Changing policies is an important way to provide children and families with vital resources and opportunities to make healthier choices easier in their day-to day-lives.”

Recommendations include making sure all food and drinks sold in schools meet the most recent Dietary Guidelines for Americans, increasing access to quality and affordable foods, expanding the amount and intensity of physical activity in schools and in out-of-school programs, increasing physical activity by providing communities safe places to walk, bike and play, introducing pricing incentives to help people buy healthier foods and regulating how and where unhealthy foods are marketed to children.

Marks says what’s particularly tragic is the increase in type 2 diabetes among younger adults and kids. “Since the 1970s, the rate of obesity has tripled or quadrupled in children,” said Marks. “We’ve got an even larger problem coming in our children.”

Source:  Saundra Young – CNN Medical Senior Producer

Michael Pollen’s : “Don’t Buy Any Food You’ve Ever Seen Advertised”. Parts 1 and 2 on Democracy Now 5/14/09

Part 1

Part 2

Source: Uploaded by mediagrrl9 on May 14, 2009 on YouTube

Michael Pollan is one of the nations leading writers and thinkers in this country on the issue of food. He is author of several books about food, including The Botany of Desire, The Omnivores Dilemma and his latest, In Defense of Food: An Eaters Manifesto. In light of what he calls the processed food industry’s co-option of sustainability and its vast spending on marketing, Pollan advises to be wary of any food that’s advertised.

Diabetes: The Worldwide Epidemic

 

 by Ty Bolton (submitted 2011-06-04)

 

Diabetes has become an ever increasing problem, and is a worldwide epidemic. There’s an estimated 285 million people living with diabetes. That number is expected to grow to almost 430 million by the year 2030, and affect 7% of the World’s adult population.

The majority of those being diagnosed with diabetes live in low income countries. India currently has the largest population of those diagnosed with diabetes. Estimates say there are 40 million people living with diabetes in India alone, followed by China. Africa is expected to have the largest increase of diabetes in the years to come.

Diabetes can affect a person at any age, but people between the ages of 40-59 have the highest risk of being diagnosed with the disease. There’s been an increase of diabetes in all nations, for the last 50 years.

In spite of warnings from health organizations, the epidemic continues to grow throughout the world. Leaders from around the world still continue to ignore the threat. Complications from diabetes are one of the leading causes of premature death.

There are many people that live with Type 2 Diabetes for years before being diagnosed. Living with diabetes for an extended period of time without any treatment will cause many adverse health problems.

If diabetes is left untreated, the complications can range from kidney failure to death. Type 2 Diabetes can be prevented in 80-85% of people, if they change their lifestyle. Managing Type 2 Diabetes is as simple as changing your diet and exercising.

A good quality of life, can often times reverse Type 2 Diabetes. Type 2 Diabetes is diagnosed among minorities and lower income people more than any other group. Environmental factors, and poor living conditions also play a part in developing Type 2 Diabetes.

These groups normally don’t’ have the income or access to healthy foods that can help prevent them from getting the disease. Instead, they have to consume unhealthy processed foods and drinks.

Substance abuse can also play a role in contributing to diabetes. If you’re a diabetic, you should never smoke or drink alcohol. Getting plenty of rest and reducing your stress levels will help reduce your chances of developing further diabetes complications.

Know and understand the early warning signs and symptoms of diabetes. If you’re at risk for premature diabetes, change your lifestyle and see your doctor. A simple treatment plan and lifestyle change will possibly save you from being diagnosed with diabetes.

Diabetes is a deadly disease, and accounts for thousands of deaths each year from complications. Each year, diabetes kills the same amount of people as those who die from HIV/AIDS complications each year.

About the Author

We all should learn more about the causes of diabetes and how food, cigarettes and other factors contribute to diabetes. http://1n2.co

Ty Bolton

Source: GoArticles.com © 2011, All Rights Reserved.

Natural Cures For Diabetes –Treat it the Natural Way

 

 

By Marilyn Reid

Frequent urination, unquenchable thirst, weakness, fatigue, tingling, numbness of extremities, and sudden weight loss. These are the common symptoms that a person suffering from diabetes experiences. Are you experiencing the same thing? If you are, then it’s high time you pay your doctor a visit and have your blood sugar checked.

What is diabetes? Diabetes is a disorder on which the body is not able to regulate the amount of sugar, particularly glucose, in the blood. Glucose plays a vital function in the body as it provides you with the energy to perform daily activities like brisk walking, working, jogging, and many others. It is regulated by the insulin, the hormone produced by the pancreas, and allows it to move from the blood to the muscle, liver, and fat cells to be used for fuel.  Now, if a person’s body does not produce enough insulin, also known as type 1 diabetes, or produce enough but does not use it properly, referred to as type 2 diabetes, then he or she should find diabetes treatment at once.

What are some natural cures for diabetes? When you are diagnosed with diabetes, perhaps the first thing that comes to your mind is to know what medications to take in order to treat it. Although it’s true that there are prescribed medicines for this disorder, you can always treat it the natural way just by knowing what the natural cures are. Natural cures for diabetes could range from regular exercise, good eating habits, and including raw foods in your diet.

Make sure that you get enough physical exercise to burn off the extra energy producing glucose. It can also help prevent complications that may arise from diabetes like poor circulation in the feet and legs and nervous disorders. Good eating habits, on the other hand, means managing what you eat, how much you eat, and when during the course of the day you sit down to eat. People suffering from diabetes should commit to keeping their diet varied and include a large amount of vegetables, fruits, and whole grains and they should see to it that they do not eat too much or too little during every meal.

A raw food diet can also do a lot to treat diabetes the natural way. People who have tried a diet of raw and organic foods revealed that it had helped reverse diabetes without the need for pharmaceutical medication. Although it can be difficult to change your diet, especially from cooked meals to raw, the little sacrifice can be worth it in the end as it helps you achieve a healthier you.

Diabetes may be a serious disorder but it can be easily managed and treated if done the right way. Regular exercise, good eating habits, and eating raw foods can certainly do a lot. The first two may be easy for you to follow, but the third could be not. Why not learn more about rawfood nutrition and sunfoods from David Wolfe for you to be enlighten further as to what it can do to treat diabetes?

For the past 10 years Marilyn Reid has been active as an advocate for Alternative Health Therapies, with an emphasis on healthy living and raw food diets. Marilyn has been fascinated with the work of the Healthy Lifestyle Nutritionist and Guru, David Wolfe and has a blog which keeps up with the latest in the world of Healthy Lifestyles. See more facts about Diabetes.

Source:www.isnare.com

Onions And Garlic Are Quite Effective In Diabetes Herbal Cure

 

 

By: Gaurisharma

 

Commonly used vegetables, Onion and Garlic, scientifically known as Allium Cepa and Allium Sativum respectively, are quite effective in Diabetes herbal cure. These are very helpful in lowering blood sugar levels. They contain ingredients like Allyl Propyl Disulphide (APDS) and Diallyl Disulphide Oxide (allicin) and certain flavonoids, which play a significant role in curing the disease while keeping the blood circulation at a normal level.

Onions are a good source of the mineral chromium, needed for glucose metabolism and insulin sensitivity. Onions can fulfill 20 percent of your daily chromium requirement in one cup, and fight against diabetes and heart disease. There are scientific evidences to suggest that APDS, found in Onions, lowers glucose levels by competing with insulin for insulin-inactivating points in the liver. This results in an increase of free insulin. APDS, administered in doses of 125 mg/ kg to fasting humans, was found to cause a marked fall in blood glucose levels and an increase in serum insulin. Allicin doses of 100 mg/kg produced a similar effect.

Researches and studies suggest that Onion extract reduces blood sugar levels during oral and intravenous glucose tolerance. The effect improved as the dosage was increased. The effects were similar in both raw and boiled onion extracts. Onions affect the hepatic metabolism of glucose and increase the release of insulin to prevent insulin’s destruction, thereby helping in the herbal treatment of diabetes.

Garlic is helpful in preventing any damages to your kidneys, blood vessels, skin and eyes, which are usually caused by diabetes. Garlic slows down the glycation process that happens due to high blood sugar levels. Other additional benefits of the garlic and diabetes interaction are connected to its cardiovascular effects. Heart disease and stroke are among the most terrible diabetes complications when you have uncontrolled diabetes.

The additional benefit of the use of garlic and onions are their beneficial cardiovascular effects. They are helpful in lowering lipid levels, inhibit platelet aggregation and are anti-hypertensive.

Hence, liberal use of onion and garlic is recommended for diabetes herbal cure. Daily habit of using onion and garlic in your meals will not only help combating the disease but also bring enormous benefits to your health. Divine Wellness is a comprehensive online portal that provides a great deal of information on all kinds of diabetes herbal cure and treatments that can help you cure diabetes naturally. Diabetes herbal treatment is more cost-effective and has fewer side effects and is therefore recommended to people who are looking for an alternative to medicines.

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

Foods to Eat With Type 2 Diabetes – What to Serve a Diabetic Friend

 

By RJ Brand

Keeping to a healthily balanced diet is important for everybody, and it is even more important for people suffering from any form of diabetes (and pre-diabetes). Foods to eat with type 2 diabetes are basically the same foods as you would serve to anyone following a low fat weight control regime. In short, nothing is forbidden but the amount consumed of certain things needs to be minimized.

Most people associate diabetes with a boring and restricted diet. If you have a friend or relative diagnosed with diabetes, the first time you prepare a meal for them can be a bit worrying, but it needn’t be. Don’t forget that the diabetic person will have been taught how to take care of themselves when it comes to matters of diet. As long as you don’t serve food that is too fatty, loaded with sugar or high in carbohydrates, the person with type 2 diabetes will be able to enjoy the meal in safety.

The importance of what is eaten by people with type 2 diabetes should not be underestimated; weight control is one of the first things to learn about how to manage diabetes and keeping blood sugar levels balanced is vital. Certain foods are recommended as being particularly beneficial for diabetics: for example, soya beans, chicken and curd, so opt for cooking chicken rather than beef. Starchy or sugary foods raise blood sugar, so they should be avoided; include plenty of non-starchy vegetables in the meal instead of highly processed foods such as white bread or rice.

The recommended diet of a diabetic is designed to maintain a steady level of blood glucose (sugar). If the person suffering from type 2 diabetes does not stick to an appropriate diet, their blood sugar levels can fluctuate and the health of the diabetic person will be in jeopardy if the level goes too high or too low. The diabetic person could fall into a coma, and you can die as a result of diabetic coma.

Diabetes occurs when the a person’s pancreas fails to produce a hormone called insulin, or fails to produce sufficient quantities of insulin for normal functioning, or the person’s body fail to use insulin properly. The result of any of these factors is that sugar is not absorbed into the body’s cells and instead builds up in the bloodstream. It is well-known that too much sugar can be very dangerous for a diabetic (particularly if they don’t exercise), so it is obviously safer to avoid cakes and pastries, but it should also be borne in mind that some fruits have a higher sugar content than is desirable.

As with any low fat diet, certain foods are best avoided altogether, while other foods can be eaten in small portions; the amount of fat consumed is important, and the number of calories must be considered at the same time. When you are first learning about the type of foods to eat with type 2 diabetes, it can seem like a minefield; it is obviously worrying to think about how seriously food can affect a person with type 2 diabetes. The safest way of dealing with catering for diabetic friends or relatives is to invest in a proper diabetic cookbook; this will remove any element of guesswork for you and make mealtimes pleasurable.

Source: www.isnare.com

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

What to Eat: Sensible Choices in an Era of Food Confusion

Proper nutrition is on all of our minds, but how do we make smart choices in today’s world of savvy marketing? Join us for this eye-opening lecture from one of the leading author’s on how the food industry influences our nutrition and health. Marion Nestle, Ph.D., is an author and professor of Nutrition, Food Studies and Public Health at New York University. Series: “UCSD Moores Cancer Center Presents”

Source: UCtelevision on YouTube

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

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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.
  

 

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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.

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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.

 

---

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

 

---

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

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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:

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

Surviving Abundance: Overweight Kids In Crisis

Source: WHROTV on YouTube

A half hour documentary, produced by WHRO, examines the epidemic of childhood obesity. Childhood health professionals paint a grim picture for the future of overweight children unless we begin to make systemic changes that support more healthy choices. Local, state and national childhood health experts, including William H. Dietz, Jr., MD, PhD, Director of Nutrition & Physical Activity at the Center for Disease Control and Prevention, discuss steps we can take to turn the tide, and the program highlights organizations with exemplary programs which encourage healthier lifestyles.

Surviving Abundance was produced in collaboration with the Consortium for Infant and Child Health (CINCH), a community partnership to promote health and prevent disease among all children in Hampton Roads.

Type 2 Diabetes – Prevent Prediabetes and Diabetes Before It’s Too Late!

  

By  Beverly H. Piepers 

Diabetes is a disease no one wants to find out they have. However, if there is a good thing about this illness is that it can be prevented long before it’s ever diagnosed. So many people are walking around in a constant state of prediabetes and have absolutely no idea they are heading down a dark, potentially fatal road. If you have prediabetes or are overweight, you have an opportunity to turn your life around and improve your health.

Prediabetes is a medical condition that can be treated well in advance of turning into full-blown Type 2 diabetes…it is defined as having a fasting blood sugar reading of 100 to 125 mg/dL (5.5 to 6.9 mmol/L). This blood sugar level is not high enough to give you a diagnosis of Type 2 diabetes, but it surely means if you do not intervene now, you are well and truly on your way.

Recently, the Diabetes Prevention Program study proved conclusively that people with prediabetes are able to prevent the development of the disease by making simple changes in their diet and increasing their level of physical activity. Many of these people are able to return their blood sugar levels back to a normal range.

Another part of the study showed that certain medications might help to delay the development of Type 2 diabetes, but exercise and diet actually worked better than the medications. Simply exercising 30 minutes a day at a moderate pace, paired with a 5 to 10% reduction in body weight equaled a 58% reduction in diabetes.

The American Diabetes Association (ADA) is working hard to help people grasp their risk of developing prediabetes. The idea is to try to “turn back the clock” so that people can know their risk early and prevent diabetes from ever becoming a problem at all.

Among some of the recommendations being made by the ADA are certain dietary suggestions. For instance, people with prediabetes should be eating:

• a lot of fruits and vegetables from every color of the rainbow -
• they need to consume non-starchy vegetables such as broccoli, green beans and spinach with meals-   
• another recommendation would be to add more whole-grain foods over processed grain products that you normally see in the interior section of your grocery store -
• including more fish in the diet is also a recommendation along with choosing lean cuts of meat and non-fat dairy such as skim milk -

Of course, there are many other tips and tricks that a prediabetic can use to avoid contracting the illness.

Stopping Type 2 diabetes in its tracks before it becomes a potentially life-threatening disease is so important as it is growing more and more prevalent in today’s society. Fast food and on the go lifestyles are not helping people to understand that their Type 2 diabetes risk is growing daily.

To discover answers to questions you may be asking yourself about Type 2 Diabetes, click on this link… Natural Diabetes Treatments

Clicking on this link will help you to learn more about Type 2 Diabetes Solutions… Beverleigh Piepers RN… the Diabetes Detective.

Beverleigh Piepers is the author of this article. This article can be used for reprint on your website provided all the links in the article are complete and active. Copyright (c) 2010 – All Rights Reserved Worldwide

Article Source: http://EzineArticles.com/?expert=Beverleigh_H_Piepers

Insulin Pump Therapy

Dr. Steven Edelman discusses how insulin pump therapy works, who can benefit from using an insulin pump, and common concerns people have before starting.

Source: UCtelevision on YouTube

Tips for Teens: Dealing With The Ups and Downs of Diabetes

• Tengo diabetes?
• Corro riesgo?

Tips For Teens: Dealing With The Ups and Downs of Diabetes

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Feelings

Many teens like you deal with diabetes everyday. Most of the time, it’s not a problem, you just deal with it. But sometimes, you may just want it to go away.

Do you ever…

• Ask “why me?”
• Think you’re the only one who feels sad, mad, alone, afraid, or different?
• Get tired of others teasing you if you are overweight?
• Blame yourself or your family for your diabetes?

All of these feelings are normal. Lots of teens who have diabetes feel the same way. It’s okay to get angry, feel sad, or think you’re different every now and then. But then you need to take charge and do something to feel better.

Everyone feels down sometimes. You are not alone.

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Still down?

Reach out for help. Talk to someone in your family or where you worship, a friend, a school counselor, teacher, or your doctor or diabetes educator. It might help to write down your feelings in a journal. If you still feel down or sad, ask your parents to help you find a counselor.

It is okay to ask for help.

 

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Speak up

There are many people who care about you and want to help you stay healthy and happy. Your health care team (diabetes educator, dietitian, doctor, nurse, psychologist, and social worker) can help you learn how to make healthy food choices, be more active, and feel good about yourself. Stay in touch with them. Let your health care team know how you feel and what you need.

---

Let your school know what’s up

You or your parents need to give the school nurse, teacher, or other school staff a copy of your diabetes care plan. Let people at your school know you have diabetes and that you need to eat healthy foods, eat your meals, take your medicine on time, and be physically active.

Don’t let diabetes stop you from joining in school activities. You can do all the things your friends do and then some!

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Mom, Dad, other family members, get with it!

It’s easier to manage diabetes when the whole family works at it with you. So…

• Ask your family to choose the same healthy foods you eat—fruits and vegetables; whole grain breads; and low-fat meats, milk, and cheese. Ask them to keep healthy foods in the house and not tempt you with cookies, cake, candy, or regular soda.
• Get everyone moving by being more physically active. Play hard. Shoot hoops, throw a ball, ride bikes, or go for a walk — together. Being active can also help you relax and lower stress.

What’s healthy for you is healthy for everyone in your family.

 

---

Want to meet other teens who feel like you do?

• Programs and support groups for teens with diabetes can be found in clinics, health centers, or hospitals. Ask your diabetes educator or doctor for help to find one that works for you.
• Head to a diabetes or weight loss summer camp. You will do all the things that other campers do: swim, hike, dance, and more. But the best part is that everyone has diabetes or is there to lose weight, just like you. Some groups may have funds to help pay for teens to attend summer camps.
• Find a pen pal or email buddy. Sometimes it is good to share how you feel about having diabetes with someone else.
• Check out the resources at the end of this tip sheet.

---

Still my friend?

Ever worry that your friends may have wrong ideas about diabetes?

• Tell them that you have diabetes. You don’t have to keep it to yourself. The more people know about diabetes, the more they will understand. Explain that your body needs help to use the food you eat.
• Be sure everyone knows that no one can catch diabetes from you.
• Good friends help each other out. They understand your needs and offer support. Hang on to friends who help you make healthy food choices when you are eating out.

Ever have kids make fun of you about your diabetes or weight?

Teasing hurts. The best thing is to just walk away.

talk to someone…write down your feelings in a journal…write to a pen pal…email a buddy…stay in touch

 

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Take Action!

It’s time for YOU to do something about your diabetes care.

• Set goals for what you will do. Start small and work your way up. For example: “I will cut down on regular soda and drink water instead.” When that’s going well…take the next step. Add another goal—“I will dance or bike ride a couple of times a week.” Then add a new goal—“I will eat smaller servings of cookies, burgers, and fries.”
• Try to make each new goal just a bit harder. After you shoot hoops twice a week, try adding another activity on three other days. Raise the goal until you reach a level that works for you.
• Avoid goals that will be too hard to meet. For example, rather than saying you’ll never eat a burger or a candy bar again, say you’ll only eat one a week.
• Tell your family or friends about your goals. Maybe they’ll be active with you or help out some other way.
• Reward yourself when you reach each goal. Keep in mind that rewards can be anything—not just food. You do not have to reach all your goals at once. Start with one or two, then add more.

Write down your top three goals—use the chart on the back page!

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Write down your Top 3 Goals

Choose goals that you really can meet. Put in the date when you set the goal and when you met it.

---

Got it.

Take it one step at a time. Make healthy food choices, be more active, and work towards a healthy weight. Soon you’ll see progress and feel great.

 

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Attention visually impaired visitors: To use common screen reading programs with PDF documents, please visit access.adobe.com, which provides a set of free tools that convert PDF documents to simple HTML or ASCII text. 

 Source:

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.

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NIH Publication No. 08–3185
February 2009

s

Diabetes Foods – A Realistic Approach to Diabetic Menu Planning

By Ben Freeman

If you are diabetic, you must learn all about the food for diabetics and how to incorporate the same in your regular meal plan. One of the best ways of treating diabetes is by controlling your food intake; it helps in relieving the symptoms of the condition. It is imperative to know what you must eat and what you must avoid when you are diabetic.

Scientists have cited that in the next two decades the global rate of patients with Type 2 diabetes would be twice the present number, which indeed is alarming. It is only through a proper diet for diabetics that you can actually control the condition and relieve yourself from the diabetes symptoms.

Ideally a diet containing higher amounts of fiber and lower amounts of fats is what is recommended for a diabetic patient. One has to cut out saturated and trans fats from their diet and also reduce the use of sugar and sweet foods. Saturated fats include animal fats like lard, butter and cheese, cream, chocolate and milk.

Foods for Diabetics – What You Can Eat

A diabetes menu can include adequate portions of carbohydrates. However, there is a measured portion for every individual which is better recommended by the doctor. Carbohydrates are the valuable sources of energy, minerals and essential vitamins. It provides you body with healthy fiber as well that helps in maintaining the blood glucose levels. Peas, beans, barley, oats and other foods belonging to these groups are loaded with fiber. You can include whole grain products like bread and some diabetic cookies for the purpose. These foods are very much a part of the regular American diabetes diet.

You must include a lot of vegetables in your regular diabetic diet plan; vegetables are the perfect foods for diabetics. You can include a wide variety of vegetables like tomatoes, broccoli, carrots, spinach, cucumbers and cabbage. You can have them raw as salads or cooked with very little oil.

Fruits are good foods for diabetics as well, but as they contain natural sugars it is better to choose fruits with caution. Although diabetics need at least 2 servings of fruits regularly, you must avoid canned fruits as they are packed with sugary preservatives. Instead you can have whole fruits.

Proteins are a must for every diabetes meal. You can include lean meat, tofu, peanut butter, egg whites, fish, poultry, nuts and bans as some of the richest sources of proteins.

Foods to Avoid

There are certain foods that diabetics must not take. If you want to control the rising and falling blood glucose levels, you have to be strict about what you are eating.

Carbohydrates as stated above are good for diabetics when eaten in moderation. However, there are certain carbohydrates that you cannot eat, such as corn and potatoes. They are harmful.

Fruits are not recommended for diabetics due to high sugar content. Although natural, sugar has the same effect in any form. Less sugary fruits should be chosen in this respect.

Milk and milk products are strictly restricted, especially full cream milk. The skimmed version should be fine if taken in moderation.

Sweets and fats are better to be avoided. They have no nutritional value and they only add up to your tension and anxiety and increasing blood glucose numbers.

Ben Freeman is an ex-diabetic who writes passionately about how to reverse diabetes. Visit his diabetes foodssite and discover proven ways to plan a diabetic menu.

Article Source: http://EzineArticles.com/?expert=Ben_Freeman

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:

Related Pages

• Diabetes
• Before Pregnancy
• Healthy Pregnancy
• Birth Defects
• CDC’s National Center on Birth Defects and Developmental Disabilities 

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• Content source: Division of Birth Defects, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention

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

The Diabetes Epidemic Among African Americans

WHAT IS DIABETES?

 Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.

 Diabetes is one of the leading causes of death and disability in the United States. Total health care and related costs for the treatment of diabetes run about $174 billion annually.

WHAT ARE THE DIFFERENT TYPES OF DIABETES?

 Type 1 diabetes (formerly called juvenile diabetes) results when the body’s immune system attacks and destroys its own insulin-producing beta cells in the pancreas. People with type 1 diabetes must have insulin delivered by injection or a pump. Symptoms of type 1 diabetes – increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue – usually develop over a short period of time. If type 1 diabetes is not diagnosed and treated, a person can lapse into a life-threatening coma.

Type 1 diabetes accounts for approximately 5 percent of all diagnosed cases of diabetes in adults.

 Type 2 diabetes (formerly called adult-onset diabetes) occurs when the body does not make enough insulin or cannot use the insulin it makes effectively. This form of diabetes usually develops in adults over the age of 40 but is becoming more prevalent in younger age groups – including children and adolescents. The symptoms of type 2 diabetes – feeling tired or ill, unusual thirst, frequent urination (especially at night), weight loss, blurred vision, frequent infections, and slow-healing wounds – may develop gradually and may not be as noticeable as in type 1 diabetes. Some people have no symptoms.

 Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults.

 A person is more likely to develop type 2 diabetes if they:

o have a family history of diabetes
o are a member of an ethnic group like African Americans
o are overweight or obese
o are 45 year old or older
o had diabetes while pregnant (gestational diabetes)
o have pre-diabetes (glucose levels are elevated but not high enough to be diagnosed as diabetes)
o have high blood pressure
o have abnormal cholesterol (lipid) levels
o are not getting enough physical activity
o have polycystic ovary syndrome (PCOS)
o have blood vessel problems affecting the heart, brain or legs
* have dark, thick and velvety patches of skin around the neck and armpits (This is
called acanthosis nigricans.)

 Gestational diabetes develops during pregnancy. Women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes, mostly type 2, in the next 10 to 20 years.

HOW MANY AFRICAN AMERICANS HAVE DIAGNOSED AND UNDIAGNOSED DIABETES?

 4.9 million; 18.7 percent of all non-Hispanic blacks ages twenty and older have diagnosed and undiagnosed diabetes

 12.6 percent had diagnosed diabetes according to age adjusted 2004-2006 national survey data

WHAT IS THE LINK BETWEEN CARDIOVASCULAR DISEASE AND DIABETES?

 Cardiovascular disease is the leading cause of death for people with diabetes – about two out of three people with diabetes die of heart disease or stroke.

 Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes.

 The risk for stroke is two to four times higher among people with diabetes.

 About 67 percent of adults with diabetes also have high blood pressure.

 Smoking doubles the risk for heart disease in people with diabetes.

WHAT CAN AFRICAN AMERICANS DO TO PREVENT HEART DISEASE OR STROKE AND OTHER DIABETES COMPLICATIONS?

 Diabetes is a self-managed disease. People with diabetes must take responsibility for their day-to-day care. The chances of having diabetes complications can be reduced or delayed significantly by keeping blood glucose (blood sugar), blood pressure, and cholesterol levels (called the ABCs of Diabetes) in the target range.

 The National Diabetes Education Program recommends the following targets for reducing the risk of heart disease and stroke for most people with diabetes:

A1C (Blood Glucose) Less than 7 percent **
(check at least twice a year)

Blood Pressure Less than 130/80 mmHg
(check every doctor’s visit)

Cholesterol (LDL) Less than 100 mg/dl
(check once a year)

**Targets should be individualized – less stringent targets may be advised with severe hypoglycemia, limited life expectancy, other medical conditions, or longstanding diabetes.

 People with diabetes can manage their disease by eating healthy foods, being physically active, taking diabetes medicine as prescribed and testing blood glucose levels.

 Community education and support programs can help people with diabetes and their families to manage their diabetes.

CAN TYPE 2 DIABETES BE PREVENTED?

 YES! The Diabetes Prevention Program (DPP), an important trial sponsored by the National Institutes of Health, and the DPPOS, the 10 year follow up study to the DPP, showed that type 2 diabetes can be delayed or prevented in overweight adults with pre-diabetes, including African Americans. Pre-diabetes is a condition where blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes.

 Risk factors for pre-diabetes are the same as those listed for type 2 diabetes.

 To prevent diabetes, the people who participated in the DPP study:

 Lost 5 to 7 percent of their body weight (that is 10 to 14 pounds for a person who weighs 200 pounds).

 Were physically active for 30 minutes a day, 5 days a week. Most participants chose brisk walking.

 Made healthier food choices and limited the amount of calories and fat in their diet.

WHERE CAN I GO FOR MORE INFORMATION?

For more information about preventing and controlling diabetes, call 1-888-693-NDEP (1-888-693-6337) or visit the National Diabetes Education Program website at www.YourDiabetesInfo.org.

Source: Adapted from the Centers for Disease Control and Prevention. National Diabetes Fact Sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
Updated January 2011

Lack of Sleep Leads to Weight Gain

By Samuel Peterson

Lack of sleep makes the body low on energy and thus, lethargic. Apart from this it makes us skip all the exercises in the day and to add to it, we indulge in eating sugary and fatty food. Once we gain weight, these tendencies tend to continue and harm all efforts to lose the extra pounds also.

Many experts have researched and concluded that that if the body gets less sleep than it needs the appetite for high calorie food increases. The whole idea to eat healthy is disrupted and we thus, put on weight. The human body has many hormones and two of these affect the appetite and the satiety levels. Ghrelin results in eating more and the other Leptin stops the appetite and encourages expenditure of energy.

Lack of sleep results in increased levels of Ghrelin and reduced levels of Leptin, which means we eat much more than the body wants. Sleep deprived people eat high calorie food and put on weight. The extra calories that we consume tend to accumulate around the stomach. The increased waistline is very dangerous as it increases the risk of type II diabetes.

Insulin levels get altered in the body due to less of sleep thus, increasing the risk of diabetes. The body’s tolerance for glucose is said to decrease when it does not get sufficient sleep. Ideally the glucose levels act perfectly when one gets about nine hours of sleep at night. It is not that if you sleep less for one night you tend to put on weight as the next day you will be eating sugary food. This causes a problem if lack of sleep becomes a routine.

The extent of the problem when one sleeps less can be controlled by being careful what you eat. Sleeping less after a healthy diet can still lead to increased weight but the amount can be controlled. An unhealthy diet with insufficient sleep hours apart from causing weight gain makes it extremely difficult to reduce weight.

The problem of less sleep and obesity is also noticed in children. Doctors say that if you sleep properly it is not certain that you will lose weight but this is a fact, lack of sleep will lead to weight gain. Sound sleep is very essential for the body to function the way it has to. To get a proper sleep one needs to take proper rest. The body needs it and you need to give it, there is no alternative to it.

One should exercise early in the day and not before bedtime. Exercise is said to help one sleep properly, only if done at the right time. One needs to eat right, like adequate proteins. Whole grains and fibre rich food is very essential for the body. Many people think alcohol calms you but if had near bedtime it tends to disrupt sleep. It increases calories and results in less sleep thus, the weight gain.

The key to a healthy body is to give it sufficient sleep and rest. The body works like machinery and it also needs its share of care and rest to keep working the way it is designed to.

I’m the head copywriter for Online Pharmacy No Prescription. If you would like to learn How to Order Drugs Without Prescription or to Buy Xenical No Prescription visit http://www.onlinepharmacynoprescription.us/

Source:www.isnare.com

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