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Diabetes

Diabetes or Diabetes mellitus is defined as a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbances of carbohydrate, protein and fat metabolism resulting from defects in insulin secretion, insulin action, or both. is a defect in the body’s ability to convert glucose (sugar) to energy. Glucose is the main source of fuel for the body.

Foods that affect blood sugars are called carbohydrates. Carbohydrates, when digested, change to glucose. Examples of some carbohydrates are: bread, rice, pasta, potatoes, corn, fruit, and milk products. Individuals with diabetes should eat carbohydrates but must do so in moderation. Glucose is then transferred to the blood and is used by the cells for energy. In order for glucose to be transferred from the blood into the cells, the hormone – insulin is needed. Pancreas—an organ, located between the stomach and spine, that helps with digestion—releases a hormone it makes, called insulin, into the blood. Insulin helps the blood to carry glucose to all the body’s cells. Sometimes the body doesn’t make enough insulin or the insulin doesn’t work the way it should. The blood glucose levels get too high and can cause diabetes or prediabetes.

What is prediabetes?

Prediabetes is when the amount of glucose in the blood is above normal yet not high enough to be called diabetes. With prediabetes, the chances of getting type 2 diabetes, heart disease, and stroke are higher. With some weight loss and moderate physical activity, it can be delayed or prevented.

Over time, diabetes can lead to blindness, kidney failure, and nerve damage. These types of damage are the result of damage to small vessels, referred to as microvascular disease. Diabetes is also an important factor in accelerating the hardening and narrowing of the arteries (atherosclerosis), leading to strokes, coronary heart disease, and other large blood vessel diseases. This is referred to as macrovascular disease. Diabetes affects approximately 26 million people in the United States, while another 79 million have prediabetes. An estimated 7 million people in the United States have diabetes and don’t even know it. Diabetes is the seventh leading cause of death in the United States.

Types of Diabetes

Type 1 diabetes occurs most frequently in children and young adults, although it can occur at any age. Type 1 diabetes accounts for 5-10% of all diabetes in the United States. There does appear to be a genetic component to Type 1 diabetes, but the cause has yet to be identified. In type 1 diabetes, the body no longer makes insulin or enough insulin because the body’s immune system, which normally protects the body from infection by getting rid of bacteria, viruses, and other harmful substances, has attacked and destroyed the cells that make insulin.

Type 2 diabetes is much more common and accounts for 90-95% of all diabetes. Type 2 diabetes primarily affects adults, however recently Type 2 has begun developing in children. There is a strong correlation between Type 2 diabetes, physical inactivity and obesity. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals.

Gestational diabetes affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Overweight or obese women have a higher chance of gestational diabetes. Also, gaining too much weight during pregnancy may increase the likelihood of developing gestational diabetes. Gestational diabetes most often goes away after the baby is born. However, a woman who has had gestational diabetes is more likely to develop type 2 diabetes later in life. Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes.

Causes

Diabetes causes vary depending on your genetic makeup, family history, ethnicity, health and environmental factors. There is no common diabetes cause that fits every type of diabetes.

Type 1

Type 1 diabetes is caused by the immune system destroying the cells in the pancreas that make insulin. This causes diabetes by leaving the body without enough insulin to function normally. This is called an autoimmune reaction, or autoimmune cause, because the body is attacking itself. There is no specific diabetes causes, but the following triggers may be involved:

  • Viral or bacterial infection
  • Chemical toxins within food
  • Unidentified component causing autoimmune reaction

Underlying genetic disposition may also be a type 1 diabetes cause.

Type 2

Type 2 diabetes causes are usually multifactorial – more than one diabetes cause is involved. Often, the most overwhelming factor is a family history of type 2 diabetes. This is the most likely type 2 diabetes cause. There are a variety of risk factors for type 2 diabetes, any or all of which increase the chances of developing the condition. These include:

  • Obesity
  • Living a sedentary lifestyle
  • Increasing age
  • Bad diet

Other type 2 diabetes causes such as pregnancy or illness can be type 2 diabetes risk factors.

Gestational Diabetes

The causes of diabetes in pregnancy also known as gestational diabetes remain unknown. However, there are a number of risk factors that increase the chances of developing this condition –

  • Family history of gestational diabetes
  • Overweight or obese
  • Suffer from polycystic ovary syndrome
  • Have had a large baby weighing over 9lb

Causes of gestational diabetes may also be related to ethnicity – some ethnic groups have a higher risk of gestational diabetes.

Other Causes

  • Pancreatitis or pancreatectomy as a cause of diabetes. Pancreatitis is known to increase the risk of developing diabetes, as is a pancreatectomy.
  • Polycystic Ovary Syndrome (PCOS). One of the root causes of PCOS is obesity-linked insulin resistance, which may also increase the risk of pre-diabetes and type 2 diabetes.
  • Cushing’s syndrome. This syndrome increases production of the cortisol hormone, which serves to increased blood glucose levels. An over-abundance of cortisol can cause diabetes.
  • Patients with glucagonoma may experience diabetes because of a lack of equilibrium between levels of insulin production and glucagon production.
  • Steroid induced diabetes (steroid diabetes) is a rare form of diabetes that occurs due to prolonged use of glucocorticoid therapy.

Medications and Chemical Toxins – Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action. These drugs can increase the risk of pancreatitis, beta cell damage, and diabetes. Also, glucocorticoids—steroid hormones that are chemically similar to naturally produced cortisol—may impair insulin action. Glucocorticoids are used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis.

Many chemical toxins can damage or destroy beta cells in animals, but only a few have been linked to diabetes in humans. For example, dioxin—a contaminant of the herbicide Agent Orange, used during the Vietnam War—may be linked to the development of type 2 diabetes.

 

Symptoms

Diabetes often goes undiagnosed because many of its symptoms seem harmless or don’t always appear right away. Recent studies show that early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

Symptoms of diabetes include:

  • Increased thirst
  • Increased hunger
  • Having to urinate more often – especially at night
  • Feeling very tired
  • Weight loss
  • Blurry vision
  • Sores that do not heal
  • Tingling/numbness in the hands and feet

People who are concerned that they might have diabetes should talk to their doctor or health care provider to find out how to get tested for diabetes.

If blood sugar is consistently high, over time it can affect the heart, eyes, kidneys, nerves, and other parts of the body. These problems are called complications. Sometimes people with diabetes don’t realize that they have the disease until they begin to have other health problems. For example, a doctor or health care provider may detect signs of diabetes damage even though the patient does not know that he/she has the disease.

Other Complications

  • Heart Disease – People with diabetes have a higher risk for heart attack and stroke.
  • Eye Complications – People with diabetes have a higher risk of blindness and other vision problems.
  • Kidney Disease – Diabetes can damage the kidneys and may lead to kidney failure.
  • Nerve Damage (neuropathy) – Diabetes can cause damage to the nerves that run through the body.
  • Foot Problems – Nerve damage, infections of the feet, and problems with blood flow to the feet can be caused by diabetes.
  • Skin Complications – Diabetes can cause skin problems, such as infections, sores, and itching. Skin problems are sometimes a first sign that someone has diabetes.
  • Dental Disease – Diabetes can lead to problems with teeth and gums, called gingivitis and periodontitis.
  • Erectile dysfunction– Male impotence.
  • HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome)– Blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition.

Treatment

Insulin Shots

  • Insulin shot – The patients use a needle attached to a syringe—a hollow tube with a plunger—that is filled with a dose of insulin. Some people use an insulin pen, a penlike device with a needle and a cartridge of insulin. Never share insulin needles or insulin pens, even with family.
  • Insulin pump – An insulin pump is a small device filled with insulin that you wear on your belt or keep in your pocket. The pump connects to a small, plastic tube and a small needle.
  • Insulin jet injector – This device sends a fine spray of insulin through the skin with high-pressure air instead of a needle.
  • Insulin injection port – The patient or the doctor inserts a small tube just beneath your skin, where it remains in place for several days.

Medications

  • Metformin is usually the first treatment offered, however, and it is the most widely used oral antihyperglycemic. Metformin is a sensitizer in the class known as biguanides; it works by reducing the amount of glucose released by the liver into the bloodstream and increasing cellular response to insulin.
  • Sulphonylureas are secretagogues that increase pancreatic insulin secretion. There are several drug names in this class, including – Chlorpropamide, Glimepiride, Glipizide, Glyburide.
  • Glitazones (also known as thiazolidinediones) are sensitizers – they increase the effect of insulin in the muscle and fat and reduce glucose production by the liver.
  • Alpha-glucosidase inhibitors are intestinal enzyme inhibitors that block the breakdown of carbohydrates into glucose, reducing the amount absorbed in the gut.
  • Dipeptidyl peptidase-4 (DPP4) inhibitors include alogliptin, linagliptin, saxagliptin and sitagliptin. Also known as gliptins, DPP4 inhibitors have a number of effects, including stimulating pancreatic insulin (by preventing the breakdown of the hormone GLP-1). They may also help with weight loss through an effect on appetite.
  • Sodium-glucose co-transporter 2 (SGLT2) inhibitors include canagliflozin and dapagliflozin. They work by inhibiting the reabsorption of glucose in the kidneys, causing glucose to be excreted in the urine (glycosuria).
  • Meglitinides include repaglinide and nateglinide. They stimulate the release of insulin by the pancreas. Meglitinides are associated with a higher chance of hypoglycemia and must be taken with meals three times a day.

The side effects of above drugs include – flatulence, diarrhea and bloating, urinary infection, nausea and vomiting, weight gain or swelling etc.

Alternative Treatment

Alpha-lipoic acid (ALA) – ALA is a chemical compound that is found in food (especially high in spinach, broccoli, and tomatoes), produced endogenously, and sold as a nutritional supplement. As an antioxidant, ALA may mitigate high levels of oxidative stress, which in patients with diabetes contributes to insulin resistance and secondary complications such as diabetic neuropathy.

Chromium – As an essential mineral, chromium plays an important role in facilitating glucose metabolism.

Coenzyme Q10 – Coenzyme Q10 is a cofactor used in oxidative respiration and is produced endogenously. Supplementation of coenzyme Q10 is especially popular for cardiovascular diseases.

Magnesium – Magnesium is an abundant mineral in the human body involved in numerous biochemical processes, including glucose metabolism.

Omega-3 fatty acid – Omega-3 polyunsaturated fatty acids (PUFAs) are one of the most common dietary supplements taken in the United States.3 Major sources of omega-3 PUFAs include fish, marine-derived supplements, and prescription formulations. Based on multiple studies, high omega-3 PUFA intake does not prevent the onset of type 2 diabetes.

Vanadium – Vanadium is a mineral with no known biological importance or deficiency-associated disease. Although three controlled studies of vanadium for type 2 diabetes reported significant decreases in fasting blood glucose levels, small sample sizes and lack of randomization limit these results.

Ginseng – The panex genus contains multiple species described as ginseng, with two varieties most frequently used and studied: panex ginseng (Asian ginseng, Chinese ginseng, Korean ginseng) and panex quinquefolius (American ginseng). The root of this herb traditionally has been used in Asia and is one of the most popular botanicals in the United States.

 

Botanical products and Herbs like Allium sativum (garlic), Aloe vera, Coccinia indica (ivy gourd), Gymnema sylvestre (gymnema), Momordica charantia (bitter melon), Opuntia streptacantha (prickly pear cactus, nopal), Trigonella foenum graecum (fenugreek) are very essential for Diabetes.

 

 

Reference

http://www.medicalnewstoday.com/info/diabetes/

https://www.nlm.nih.gov/medlineplus/diabetes.html

http://www.webmd.com/diabetes/

http://www.diabetes.org/diabetes-basics/type-2/?referrer=https://www.google.co.in/

http://www.diabetes.org/diabetes-basics/type-2/

http://www.who.int/nmh/publications/fact_sheet_diabetes_en.pdf

http://www.diabeteswellness.net/Portals/0/files/DRWFUSdiabetes.pdf

http://www.medicinenet.com/diabetes_mellitus/article.htm

https://www.idf.org/sites/default/files/IDF-Guideline-for-Type-2-Diabetes.pdf

http://www.sign.ac.uk/pdf/sign116.pdf

https://www.health.ny.gov/diseases/conditions/diabetes/what_are_the_symptoms.htm

http://www.mayoclinic.org/diseases-conditions/diabetes/basics/symptoms/con-20033091