In some cases after beginning insulin shots, a person with Type I diabetes will go out into remission. During this period, the individual?s pancreas once again secretes insulin and the patient?s need for the daily shots disappear. In these instances, the blood sugar level (the amount of sugar in the person?s bloodstream) stays with in the normal range. Such individuals may feel as though they no longer have the disease, but this isn?t so. In fact, this stage of Type I diabetes is sometimes referred to as the ?honeymoon period, ? because it doesn?t last. At any time, without warning, the individual?s blood sugar level may rise, leaving the person in dire need of insulin.
People who have Type I diabetes must also monitor their blood sugar, or glucose levels. This is necessary since the outside factors such as excitement, infection, growth periods, hormonal changes, fatigue, and alcohol and other drugs can upset the necessary balance. Without monitoring, the individual will not know there?s a problem before physical symptoms appear.
In recent years, easy-to-use test have been developed to enable people with diabetes to monitor their own blood sugar at home or anywhere else they happen to be. Self blood-glucose monitoring is an extremely valuable tool for those with diabetes since their blood sugar levels often quickly change. Many teenagers with diabetes find it especially helpful as it allows them to continue their activities uninterrupted. Prior to going to a fast-food restaurant with non-diabetic friends, they can quickly take a blood glucose reading to determine precisely what they can eat.
Even though a finger capillary blood sample is not as accurate as a venous blood sample for determining blood glucose. I recommend having a routine blood chemistry test with fasting blood glucose, triglycerides, and both high-and low-density lipoprotein measurements every four months or, at the very least, every six months. Another important test measures the average blood glucose level during a certain amount of time. Glycosylated hemoglobin (hemoglobin A1c) tests show how much glucose has become attached to hemoglobin, a part of the red blood cells that carries oxygen. The diabetic should check with their doctors, or whatever is best for them.
Regular testing accomplishes two very important things. First, it provides the diabetic and the doctor with the vital information on the real status of their diabetes and their health in general. Second, it prompts you to see their doctor regularly. The best diabetes management program always includes good communication with the diabetics? doctor and diabetes team. It is especially important with today?s high-tech medicine to use the team-management approach. But you have a responsibility to evaluate advice, practice good diabetes techniques, and become better educated in this complex subject.
Knowing their blood sugar levels also helps people with Type I diabetes determine how much insulin they need. Previously, insulin was generally injected into the body with a syringe, but more recently new methods of delivery have been devised.
Today the available options include the following:
Jet Injections, these needle-less injections pressurized jet injectors send insulin through the person?s skin in a tiny stream. Some of the new injectors work quite quickly, taking less time to administer insulin than with a standard hypodermic needle.
Insulin Pens, the insulin pen looks like a fountain pen. It is ideal diabetics who needs insulin while away from home but does not want to take insulin vials and syringes along. The small pen contains everything necessary for an insulin injection.
Insulin Pumps, the insulin pump, which is worn by the person, sends insulin from a storage container through a plastic tube attached to a needle in his or her skin. These devices send a slow trickle of insulin into the body 24 hours a day in an attempt to imitate the action of a well functioning pancreas. Insulin pumps first became available in the late 1970s. However, today?s models are lighter and more compact. They also deliver the insulin more precisely, affording a greater degree of control.
Infuser Methods, these entail planting a needle within the skin that serves as a gateway for the insulin shots.
Even though people with Type I diabetes may learn to advantageously use insulin, they still must choose their foods wisely. In the past, people with diabetes were encouraged to eat high-protein, meat-based meals. Bread, potatoes and other starches were only permitted in small portions. Although they could still vegetables, at the time these foods were not considered to be particularly useful in lowering blood sugar levels. However, following much research, these thoughts have changed.
Today the American Diabetes Association (ADA) recommends a diet that is low in fat and high in fiber and complex carbohydrates, such as peas, brown rice, and cereals, act to raise sugar levels gradually and are often nutritional. Complex carbohydrates differ from less desirable food such as cakes, danishes and candy, which contain simple carbohydrates that rapidly raise blood glucose levels and aren?t rich in vitamins and nutrients.
All insulin produced in the US was at one time made from insulin that had been taken from the pancreases of cattle and pigs. Unfortunately, this insulin was filled with impurities that sometimes upset the systems of those who injected it. Today, insulin is available in two forms-a semisynthetic from made by converting pork insulin and recombinant insulin, a form that is also basically identical to human insulin made through genetic engineering (genetic engineering is the manipulation of genes from animals or plants in a laboratory.) A doctor decides which form of insulin is the best for the diabetic.
Although there are two ways of manufacturing it, there are three types of insulin that serve for different purposes in the body, these are:
Rapid or regular-acting insulin, this type of insulin reaches the bloodstream and begins lowering blood sugar within thirty minutes after injected, which is commonly known as ?time of onset.? Rapid or regular-acting insulin reaches its maximum strength, or ?peaks? about two to five hours later. It remains in the bloodstream for an additional eight to sixteen hours. This type of insulin is often used when a person?s diabetes goes out of control, such as after hormonal shifts, changes in diet or exercise, an accident, minor surgery, or an illness.
Intermediate-acting insulin, there are two types of intermediate-acting insulin: Lente (called L) and NPH (called N). This intermediate- or slow-acting insulin reaches the bloodstream about ninety minutes after injection and peak anywhere between four and twelve hours later. They remain in the bloodstream for about twenty-fours.
Long-acting insulin or Ultralente (called U), long-acting insulin usually takes about four to six hours to reach the bloodstream, but its effects last for about thirty-six hours. It tends to reach its maximum strength about fourteen to twenty-four hours after it has been injected. Often, people will require a combination of different types of insulin, depending on their individual needs, eating habits, activity schedules, and particular course of disease.
Type II diabetes, or Non-Insulin Dependent Diabetes Mellitus (NIDDM), usually, but not always, occurs in people who are overweight. This is also called insulin resistance. It used to be called adult-onset diabetes because it normally occurred in adults over the age of forty. But as with Type I diabetes, doctors realized that Type II diabetes could appear at any time as well. Type II diabetes often strikes those who are overweight or obese.
In Type II diabetes, the body doesn?t produce enough insulin, or it produces enough but the body does not use the insulin properly or the body resists it. When Type II is diagnosed in young people, it is called Maturity Onset Diabetes in the Young or MODY. Type II diabetes affects mostly females, but it affects males as well. If there is a diabetic with Type II diabetes in someone?s family and they are overweight, they are at higher risk for developing Type II diabetes. This type of diabetes is usually treated with a combination of diet and exercise. Some people with Type II diabetes are also treated with insulin. Weight loss will help the body use the insulin better.
While Type I diabetes tend to strike younger individuals, people who have Type II are generally more than 30 years of age. Everyone metabolizes (uses) sugar less effectively as they grow older and this can sometimes trigger an inherited tendency toward the illness. The majority of these people are also overweight. Type II diabetes tends to come on slowly and many of its victims may not even realize that they have the illness.
Sex and race influence the probability of getting Type II diabetes. Until the age of 30, men have just as great a chance of getting the disease, as do women. Beyond 30, however, women make up a larger and larger proportion of the people with this disease. For people 45 and over, women are twice as likely to get the disease as men are. The incidence of diabetes also varies among racial and ethnic groups. Some American Indian tribes have a much higher rate of Type II diabetes than the general population. It is also known that black Americans are nearly twice as likely to die from diabetes as are white Americans.
There has been many debates concerning this matter. Some researchers feel the higher incidence of diabetes among black s is due more to economic and obesity factors than to race. Unfortunately, many black people still occupy lower income groups, and poor people tend to eat poorer-quality food, with a higher content of fat. They also do not receive the same quality in medical care. Poor people seem to be more obese more frequently than the general population and to be less informed about health matters. But it seems that blacks will get diabetes more frequently than whites regardless of weight or diet. The genetic link, however, is unproved.
Unfortunately, older individuals frequently mistake the early effects of Type II diabetes for the beginning signs of aging, and therefore fail to seek medical attention. Although at times the symptoms of Type II diabetes are so mild they go undetected. The most common signs of the illness include: increase thirst and urination, exhaustion, nausea, blurred vision, dry flaky skin, skin wounds that are slow to heal, tingling or loss of sensation in the hands or feet.
Even though it is essential for Type I diabetics to monitor their blood sugar levels. It is also essential for Type II diabetics to check their blood sugar also because it allows them to see how different eating patterns affect their blood sugar and overall control of the disease. Another extremely important element in controlling Type II diabetes is exercise. Exercise is especially important for people with Type II diabetes since their bodies are often unable to effectively use insulin. In addition, exercise burns off excess calories, which assists these individuals with weight control.
Wearing a medical identification bracelet or necklace and/or carrying an identification card can also help in case of an emergency. Information on the illness and what to do in case of insulin reaction or ketoacidosis, as well as the name of the diabetic and the name of someone to contact this may mean the difference between life and death if the diabetic is found unconscious. A nonprofit organization, Medic-Alert Foundation, can provide diabetics with an identification card or tag and maintains a central file containing vital information on every case registered with it. This information can be obtained twenty-four hours a day by a collect telephone call.
While doctors routinely encourage exercise to help control Type II diabetes, scientists have recently found that physical exercise may even be useful in preventing the disease entirely in some patients. Harvard University researchers who followed more than 22000 male physicians for a five-year period found that those who exercised vigorously at least once a week were 36 percent less likely to develop diabetes. The study further showed that the more individual exercised the risk of developing Type II diabetes lowered.
Some doctors say that diabetics should not have alcohol. Others permit a drink or two. But drinking has some special pitfalls for someone with diabetes. First of all, alcohol has calories, and they count in the diet. In addition, alcohol lowers blood sugar at first. Alcohol also impairs a person?s judgment. Dr. Raymond Herskowitz at the Joslin Diabetes Center in Boston points out that teens are more likely to have a serious insulin reaction when they?ve been drinking. A person who is ?high? may not be alert to the warning signs, and other people might mistake the effects of low blood sugar for drunken behavior.
Marijuana, like alcohol, can dull diabetics? judgements and make them forget about eating a meal or taking an insulin injection. Or it may make them so hungry that they?ll even forget to stick to their diet. Cigarettes have been linked with so many damaging effects on the heart, lungs, and other body systems that smoking is not a very good idea for anyone. It is an even worse idea for people with diabetes, who are already at risk for heart disease.
Some doctors feel that people with diabetes shouldn?t use sugar substitutes because they simply maintain their ?sweet tooth.? If the patients tried eating a more sensible diet, these doctors say, they would soon lose their rich taste for rich, sweet foods, and that would be a good thing. But some people feel that life just wouldn?t be worth living if they couldn?t have candy, a soft drink, or some other sweet tasting treat at least occasionally. And some doctors feel that sugar substitutes are good because they permit people with diabetes, especially young ones, to enjoy some of the same treats as their friends, which can help then feel less ?different.?
Nutritive sweeteners contain calories, and are usually carbohydrates that end in ?ose, such as glucose, fructose, dextrose, and sucrose (sugars), or ?ol, such as sorbitol and mannitol (sugar alcohols). They each contain four calories per gram. Non-nutritive sweeteners provide almost no calories and do not affect blood glucose levels. Saccharin and aspartame (sold under the brand name NutraSweet) are the two major sugar substitutes. Aspartame actually contains the same four calories per gram as do the nutritive sweeteners; however, because it is 180 times sweeter than table sugar, much less has to be used. Saccharin is 300 times sweeter than sucrose and has no calories at all.
Gestational Diabetes is another form of diabetes that occurs only in pregnant woman. About 3 percent of all pregnant women develop this form of diabetes. If a woman has been diagnosed with diabetes before the pregnancy she has pregestational diabetes. So far no one knows what causes gestational diabetes, but scientists have some ideas. Hormones from the placenta that help the baby grow also inhibit the mother?s ability to absorb glucose. This causes insulin resistance. This can lead to high levels of glucose in the blood or hyperglycemia.
The treatment for gestational diabetes is a combination of careful diet, exercise, and sometimes insulin injections. The American Diabetes Association (ADA) believes that all women should be tested for gestational diabetes when they are about six months pregnant, which is when insulin requirements for the mother rise. After the mother gives birth, her insulin resistance usually disappears. Women who have had gestational diabetes frequently develop it again during subsequent pregnancies. Many of them also develop Type II diabetes later in life. Insulin resistance also causes Type II diabetes. Proper diet and exercise are important tools in a healthy lifestyle and will help prevent or delay the onset of Type II diabetes and its many complications.
Brittle diabetes occurs when a person?s blood sugar level goes from one extreme to the other for no apparent reason this rising and falling cannot be predicted and may not be preceded by any symptoms. Sometimes people confuse brittle diabetes with Type I diabetes. This is because of the fluctuations in blood glucose levels that occur during puberty. This is not brittle diabetes. The blood sugar of people with brittle diabetes is out of control. Brittle diabetes is also called unstable diabetes or labile diabetes.
There is another disease with the name ?diabetes? Diabetes Insipidus. Diabetes Insipidus is NOT diabetes. It is a disease caused by a lack of hormone produced in the pituitary gland, which is in the brain, and not the lack of insulin, which is produced in the pancreas.
The percentage of people to have Type I diabetes to Type II is 10 to 15 percent Type I and 85 to 90 percent Type II. The age when usually diagnosed is usually under 30 Type I and usually over 40 Type II. Usual weight of patient Type I is often thin or normal weight, Type II is often overweight. The General treatments are insulin injections, diet, and exercise in Type I, and diet exercise and if needed, oral agents or insulin in Type II. The onsets or the symptoms are usually sudden, very apparent in Type I, and in Type II it is usually gradual and often subtle.