You must know the symptoms of Diabetes

As I have discussed in my previous diabetes articles the symptoms of diabetes are often quite difficult to notice. However, if you know what to look for you have a much greater chance of identifying the symptoms. In this article I am going to discuss with you the major symptoms of diabetes and explain why they occur.

1) HYPERGLYCAEMIA (High Blood Sugar/Glucose):- Hyperglycaemia occurs when your blood sugar (the body’s main source of energy) levels become higher than normal, usually due to a lack of insulin. Insulin helps the body convert blood sugar into energy. If the body is not getting enough insulin this blood sugar cannot be broken down and instead stays in the blood stream, causing blood sugar levels to rise.

Hyperglycaemia can also be caused by eating too many sugars and carbohydrates (which release extra glucose into your blood stream), failing to exercise (which can reduce the effectiveness of insulin) and by being physically or mentally stressed (which can lead to the body producing extra glucose).

Blood sugar levels are said to reach hyperglycaemic levels when they are consistently above 126 milligrams per decilitre (mg/dL). When your blood sugar reaches hyperglycaemic levels the following symptoms may develop:

- Blurred Vision.
- Increased Hunger Levels.
- Increased Need to Urinate.
- Increased Susceptibility to Infection.
- Increased Thirst Levels.
- Nausea.
- Weakness/Tiredness.
- Weight Loss.

Hyperglycaemia can affect all diabetics and can be managed in two ways, depending upon the severity of the condition. Mild hyperglycaemia can usually be self treated by injecting insulin. More serious hyperglycaemia can lead to diabetic ketoacidosis and hyperosmotic non-ketotic acidosis (HONK) (see below for further details) for which you will need urgent hospital treatment.

2) HYPOGLYCAEMIA (Low Blood Sugar/Glucose):- Hypoglycaemia occurs when your blood glucose levels drop to lower than normal levels, usually because there is excessive insulin in your body. The presence of this extra insulin means that too much glucose is converted into energy and as a result your blood sugar levels start to decline.

Hypoglycaemia can also be caused by not consuming enough calories to meet the body’s energy requirements, either on a day to day basis or before exercise (your body burns extra calories during exercise so you need to make sure these additional calories are made available in the foods you eat prior to exercising). Alcoholic beverages also lower blood sugar levels and excessive alcohol consumption often causes hypoglycaemia.

Blood sugar levels are said to be hypoglycaemic when they are consistently below 70 mg/dL. When your blood sugar drops to hypoglycaemic levels the following symptoms may develop:

- Blurred Vision.
- Coma.
- Confusion.
- Convulsions
- Dizziness.
- Fatigue.
- Hunger Pangs.
- Increased Heart Rate.
- Paleness.
- Shaking.
- Sweating.
- Weakness.

Hypoglycaemia can affect all diabetics but it is more prevalent in people suffering from type 1 diabetes because they have to inject insulin regularly. If they inject too much insulin this often causes hypoglycaemia. Mild hypoglycaemia can normally be self treated by consuming approximately 10g – 20g of sugar. Glucose tablets are available for this specific purpose. More serious hypoglycaemia will often lead to a loss of consciousness and requires medical attention. In this case paramedics will often inject glucagon to raise blood sugar back to normal levels.

3) DIABETIC KETOACIDOSIS (DKA):- Diabetic ketoacidosis occurs when there are a high concentration of ketone bodies in your blood stream. When your body does not get the glucose it requires (usually because of a lack of insulin) it starts to break down fat and muscle for energy instead. Ketones (fatty acids) are released into the blood stream when fat is broken down for energy. If your body uses fat for energy over a prolonged period, these ketones build up in your blood stream and this leads to a state of diabetic ketoacidosis.

The main cause of diabetic ketoacidosis is a lack of insulin which means the body cannot break down glucose properly and so it is forced to turn to fat and muscle for energy. However, it can also be brought on by illness and infection.

The symptoms of diabetic ketoacidosis include:

- Abdominal Pain.
- Confusion.
- Fruity Smelling Breath (similar to the smell of nail polish remover).
- Hot and Dry Skin.
- Loss of Appetite.
- Vomiting.

All diabetics can suffer from diabetic ketoacidosis but it is much more prevalent amongst type 1 diabetics, especially when they fail to inject insulin regularly. Unlike hyperglycaemia and hypoglycaemia, there are no mild forms of diabetic ketoacidosis. It is a very serious medical condition and needs to be addressed immediately. Untreated diabetic ketoacidosis can be fatal so if you notice any of the symptoms described you must seek immediate medical treatment.

4) HYPEROSMOTIC NON-KETOTIC ACIDOSIS (HONK):- This is a type of diabetic coma also known as nonketotic hyperosmolar coma, nonketotic hyperglycaemia and hyperosmolar hyperglycemic nonketotic coma (HHNKC). It is brought on by a lack of insulin in the body which causes glucose levels to rise excessively. The body responds by passing more urine to remove this excessive glucose from the blood. Failure to consume enough fluids can lead to extreme dehydration and eventual hyperosmotic non-ketotic acidosis.

Like with diabetic ketoacidosis, the main cause of hyperosmotic non-ketotic acidosis is a lack of insulin. However, it can also be triggered by illness or infection. The symptoms of hyperosmotic non-ketotic acidosis include:

- Dry Skin (that does not sweat).
- Fever with a Temperature.
- Hallucinations.
- Increased Thirst (which does not disappear despite adequate fluid consumption).
- Sleeplessness.
- Weakness in one side of the body.

Hyperosmotic non-ketotic acidosis can affect all diabetics but is more common amongst type 2 diabetics. Like with diabetic ketoacidosis, it is a very serious condition and requires immediate hospital treatment.

5) PERIPHERAL NEUROPATHY:- Peripheral neuropathy describes the loss of nerve functions in the arms and/or legs. It is usually brought on by nerve damage caused by diabetes. However, it can also be caused by alcoholism, exposure to poisons (usually from certain medication), other diseases (including kidney disease and liver disease), pressure on the nerves (especially when the peripheral neuropathy is affecting a single nerve) and vitamin deficiency (with vitamin B being particularly important for nerve health).

The major symptoms of peripheral neuropathy include:

- Extreme Sensitivity to Touch.
- Lack of Co-Ordination.
- Numbness and Tingling in your Hands and Feet (which may spread upwards into your arms and legs).
- Sharp, Jabbing Pains.

Peripheral neuropathy can affect all diabetes sufferers and the symptoms can range from mild to severe. Peripheral neuropathy can usually be managed by eating a healthy diet which is high in B vitamins. However, painkillers may also be used for treatment if the condition starts to cause prolonged pain.

6) DIABETIC RETINOPATHY:- Diabetic retinopathy describes damage to the blood vessels of the light sensitive tissue located on the retina. This damage is caused by high blood sugar levels which initially cause the lens in your eye to swell (and may lead to blurred vision) and eventually cause permanent damage to the capillaries which supply your retina with blood.

The symptoms of diabetic retinopathy include:

- Blurred Vision.
- Dark Streaks which Block your Vision.
- Floating Spots in your Vision.
- Loss of Vision.
- Poor Night Vision.

All diabetics are susceptible to diabetic retinopathy. The symptoms can be reduced by managing your diabetes effectively, eating a healthy diet and exercising regularly. However, for severe diabetic retinopathy corrective laser surgery may be required.

As you can see there are a lot of potential symptoms that can act as warning signs for diabetes. Generally, any symptoms develop gradually in type 2 diabetics and much more rapidly in type 1 diabetics. However, many of the symptoms are not caused exclusively by diabetes. Even if your blood sugar levels are low or your vision is blurred, this does not necessarily mean that you have diabetes. The only way to be sure is to get tested by your doctor. They will be able to make an accurate diagnosis and confirm whether you have pre-diabetes, gestational, type 1 or type 2 diabetes.

Whilst every intention has been made to make this article accurate and informative, it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. If you have any concerns regarding any form of diabetes you should seek the advice of your doctor immediately.

New Treatment Options for Diabetes Patients

Over the past decade, the list of type 2 diabetesmedications has grown — helping people gain better blood sugar control. But the drugs’ side effects — plus taking several pills every day — can be frustrating.

“There are two problems with diabetes,” explains Ronald Goldberg, MD, associate director of the Diabetes Research Institute at the University of Miami Medical Center. “Your body doesn’t make enough insulin. And your organs are resistant to using insulin that is produced.”

If lowering high blood sugar is the primary goal, today’s diabetes drugs do their job “but only to a limited extent,” Goldberg tells WebMD. “Even when patients respond to one drug, they will need more and more drugs over time, as the pancreas deteriorates.” Read more

Good Information for all diabetes patients

Diabetes is a disorder that affects the way our body uses food for energy. Normally, the sugar we take in is digested and broken down to a simple sugar – glucose. The glucose circulates in our blood where it waits to enter cells to be used as fuel. Insulin (a hormone produced by the pancreas) helps move the glucose into cells. A healthy pancreas adjusts the amount of insulin based on the level of glucose. But, if you have diabetes, this process breaks down, and blood sugar levels become too high (watch this video!)

Aretaeos Cappedocian, coined the name “diabetes mellitus” in the second to third century AD. Diabetes is from a Greek word that means to siphon. This refers to the excessive urination seen in undiagnosed diabetics. Mellitus – comes from a Latin word that means sweet like honey – and like the urine of diabetics which contains extra sugar (glucose).

But there are good news for all these peoples – a unique miniaturized insulin-delivery pump, developed by Debiotech and industrialized by STmicroelectronics. The miniaturized disposable insulin pump combines Debiotech’s expertise in insulin delivery systems with STMicroelectronics’ strengths in manufacturing high-volume silicon-based microfluidic devices. The Nanopump is based on MEMS. Its size is: 65mm x 38mm x 11mm (27ml) with an insulin reservoir capacity of 4 to 6ml. Insulin pump therapy, is an attractive alternative to individual insulin injections that must be administered several times a day. With CSII (Continuous Subcutaneous Insulin Infusion), the patient is connected to a programmable pump including a storage reservoir, from which insulin is infused into the tissue under the skin throughout the day according to specific needs as programmed by the patient.
The principle is a volumetric membrane pump, with a pair of check valves, integrated in a MEMS chip. The chip is a stack of 3 layers bonded together: a silicon on insulator (SOI) plate with micromachined pump-structures and two Pyrex cover plates with through-holes. The MEMS chip is assembled with a piezoelectric actuator that moves the membrane in a reciprocating movement to compress and decompress the fluid in the pumping chamber. The MEMS technology used in this device allows a tight control of the pumping mechanism (each pump actuation injects only 200 nanoliters of drug).

Diabetes Management with 4 M

Diabetes is a complex disease that requires a comprehensive management plan. Bartol pointed out that a comprehensive diabetes plan must be composed of what he calls the “4 Ms” of diabetes management: Motivation, Meals/exercise, Monitoring blood sugar, and Medications.[2] The most successful clinicians and patients integrate all 4 of these modalities.
Motivation

Of the 4 modalities, motivation is most likely the most important. A patient who is unmotivated to take an active role in the management of his diabetes is less likely to successfully manage the disease.[2] Bartol stated, “Motivation is crucial for those with diabetes, more so than any other disease, as 95% of all diabetes care must be carried out by the patient.”[2]

Healthcare providers often struggle with the patient who appears to be unmotivated to take control of his diabetes. One role of a healthcare provider is to develop and use techniques or strategies to improve a client’s motivation. Motivation to manage diabetes or alter behaviors will come if the patient feels in control of the disease.[2] Bartol emphasized that feeling in control is facilitated by involving the patient in the decision-making process. This is done by empowering him/her to make decisions that are appropriate for his given situation.[2]

Bartol provided a number of examples of patient empowerment. For instance, a clinician can discuss the various medications that are available and appropriate with the patient. Rather than telling the patient what he needs to do, the clinician should ask the patient “Which of the medications discussed do you think would be best?”[2] This type of process allows the patient to take a more active role in the management of the disease.

Bartol cautioned the NPs in attendance that patients are often erroneously labeled as being “noncompliant.” This seasoned speaker believes that, in fact, there is no such thing as noncompliance.[2] If a clinician perceives a patient as being “noncompliant,” the clinician needs to stop and critically re-examine the situation. What is often labeled noncompliance is a communication problem rather than a behavioral issue and, in fact, may be 2 people working toward 2 different, nonarticulated goals.[2]

The job of the clinician is that of an advocate, educator, cheerleader, and consultant. No longer should the clinician dictate what is appropriate for any given patient but should enable the patient to take charge to lead the entire diabetes team in the management of disease.[2]
Meals/Exercise

Patients with diabetes should be referred to a dietitian, preferably one who is a certified diabetic educator.[2] Nutrition therapy is essential to adequately manage this disease. However, there is no such thing as one diet fits all. Each individual with diabetes should have a customized diet, tailored to fit his lifestyle. Dietitians who are able to design and customize a diet to fit into the particular patient’s lifestyle will be the most successful.

If a registered dietitian is not available, NPs can encourage the patient to make small yet significant dietary changes. The patient can be encouraged to eat smaller portion sizes, snack on vegetables, or reduce the amount of fat in his diet. Even small changes can result in a significant improvement in glycemic control.[2]

Exercise is also essential. According to Bartol, “Exercise is the best insulin sensitizer on the market; better than any medication we currently have available”[2] Initiation of exercise is often difficult for the patient with diabetes. The clinician can increase the chances of the patient “buying into” the exercise regimen by asking the patient to set his own exercise goals.[2] Although it would be ideal to have the individual with diabetes exercise daily, it is important to remember that even some exercise is better than none.

Routine weight checks should also be done at every visit, regardless of the nature of the appointment. By routinely checking the weight, the patient is often reminded of the need for weight loss. If the patient loses or even maintains his current weight, encouragement and affirmation should be provided by the clinician. In his practice, Bartol has learned that “a small amount of positive affirmation goes a long way.”[2]
Monitoring of Blood Glucose

The individual with diabetes must be instructed to test his own blood glucose. This enables the patient to monitor his blood glucose in relation to various foods. Rather than telling a patient that a food is “bad,” “good,” or will raise his blood sugar, Bartol recommended that we tell a patient to eat the particular food and then check his 2 hour postprandial blood sugar.[2] If the blood glucose is elevated beyond 140-160 mg/dL 2 hours after starting the particular food, it provides the patient with useful, objective feedback. This type of feedback is invaluable and serves as a positive behavioral modification tool.

In addition, Bartol recommended that the patient check his blood sugar 4 times/day, 2 days weekly.[2] Rather than checking the blood sugar once daily, checking the blood sugar 4 times daily on selected days provides very useful information for both the patient and the clinician.[2] It gives the clinician a view of the blood sugars in the context of other results over a given day.
Medications

There are a number of medications available for the patient with diabetes. One of the latest medications to come on to the market for individuals with diabetes is insulin glargine (Lantus). This insulin is a 24-hour basal insulin. One advantage of this insulin over a product such as NPH insulin is that there is no peak. By eliminating a peak in its action, there are fewer hypoglycemic events. When given at night, it is a useful tool for individuals with type 2 diabetes who are unable to be controlled by other modalities.

Bartol recommended starting the patient with type 2 diabetes on 10 units of insulin glargine at bedtime.[2] The units are then adjusted based on fasting blood sugars. Bartol recommended increasing the dosage by 4 units if the fasting blood glucose is > 140 mg/dL or by 2 units if the fasting blood glucose is between 120 and 140 mg/dL.[2] According to the American Diabetes Association, the target goal for a fasting plasma glucose should be </= 110 mg/dL

Diabetes Healthy Diet for Heart

Although there are many major dietary approaches for protecting health, experts generally agree on the following recommendations for heart protection:

• Choose fiber-rich food (whole grains, legumes, nuts) as the main source of carbohydrates, along with a high intake of fresh fruits and vegetables. Walnuts in particular have cholesterol-lowering properties and are a good source of antioxidants and alpha-linolenic acid.

• Avoid saturated fats (found mostly in animal products) and trans fatty acids (found in hydrogenated fats and many commercial products and fast foods). Choose unsaturated fats (particularly omega-3 fatty acids found in vegetable and fish oils).

• In selecting proteins, choose soy protein, poultry, and fish over meat. A 2006 study found that soy does not help improve cholesterol. However, experts still recommend it as a heart healthy food choice.

• Weight control, quitting smoking, and exercise are essential companions of any diet program.

• After embarking on any heart healthy diet, it generally takes an average of 3 to 6 months before any noticeable reduction in cholesterol occurs, although some people have reported better levels in as few as 4 weeks. An intensive program may be necessary to achieve any significant improvements in cholesterol levels and to reduce heart risk factors.

Calorie for Diabetes Diet

WHAT YOU SHOULD KNOW

If you are both diabetic and overweight, your doctor may recommend a diet that limits your intake to 1,500 calories a day. To keep blood sugar levels under control, a diabetic diet strikes a balance among the carbohydrates, fats, and protein you take in. In addition, a 1,500-calorie diabetic diet restricts calories and fat.
WHAT YOU SHOULD DO

A sample 1,500 calorie diet is listed below. You can exchange or trade one food for another from the same food group. For example, you can choose 1 slice of bread instead of 3/4 cups of dry cereal, or a potato instead of a dinner roll. For other alternatives, see the lists under “Diabetic Exchange Diet.”
BREAKFAST Food Groups

* 2 breads or starches, such as 3/4 cup (6 ounces) corn flakes and 1 slice toast
* 1 fruit, such as 1 small (5-inch) banana or 1/2 of a 9-inch banana
* 1 milk, such as 1 cup skim or 1 cup 1 percent milk
* 1 fat, such as 1 tsp. margarine

LUNCH Food Groups

* 2 ounces meat or protein, such as 2 ounces sliced turkey breast
* 2 breads or starches, such as 2 slices bread
* 1 vegetable, such as 1 lettuce leaf and 2 tomato slices
* 1 fat, such as 1 tsp. regular mayonnaise or 2 tsp. low-fat mayonnaise

AFTERNOON SNACK Food Groups

* 1 milk, such as 1 cup (8 ounces) skim or 1 cup 1 percent milk
* 1 vegetable, such as 1 cup carrot sticks
* 1 fat, such as 2 Tbs. fat-free salad dressing (can use with carrot sticks)

DINNER Food Groups

* 3 ounces meat or protein, such as 3 ounces lean roast beef
* 2 starches, such as one 3-inch baked potato and 1 medium (2-1/2 inch) dinner roll
* 1 fat, such as 1 tsp. margarine
* 2 vegetables, such as 1 cup (8 ounces) cooked mixed vegetables
* 1 fruit, such as 1-1/4 cups fresh strawberries

EVENING SNACK Food Groups

* 1 bread, such as three 2-1/2 inch square graham crackers
* 1 meat or meat substitute, such as 1/4 cup low-fat cottage cheese