FREE ESSAY ON DIABETES

DIABETES

Diabetes 
Diabetes, Diabetes Mellitus, is a chronic illness this means that it has no cure and the
symptoms persist over a long period of time. This illness is a result of an imbalance of
hormones, insulin, produced in the pancreas. Insulin plays an important role in how the
body uses food. Insulin enables the cells in the bloodstream to absorb and use glucose
for fuel. If the pancreas produces too little or no insulin or if the insulin doesn't
work properly the person may become diabetic. Therefore, diabetics are not able to
properly convert food into fuels needed by the body to function, which can seriously lead
to physical consequences. 
The pancreas, located behind the stomach, is a long, thin organ about the length of the
hand. It is the organ that is responsible for the development of diabetes. The pancreas
has two different types of cells, called alpha and beta cells, which produce insulin.
Insulin is responsible for breaking down food that enters the body, turning into fuel
that can be used by the body, and distributing it to the various parts of the body. The
fuels needed for the body to function are known as glucose. 
Glucose is sugar manufactured when the carbohydrates we eat are digested. Carbohydrates
are foods that contain a large amount of sugar or starch. Bread, fruit, ice cream, and
cereal are good examples of foods that are high in carbohydrates. Glucose is the main
provider of energy for the majority of bodily functions. The glucose level in the blood
changes in response to a person's a daily activity, from eating a meal, to stressful
situations. 
Attempts to transplant part of a normal pancreas into a diabetic have not been very
successful. The operation is a difficult one and only about 40 percent of the
transplanted organs are still working. One major problem is that some way has to be found
to stop the digestive juices leaking out and digesting the insulin. Pancreatic
transplants have mainly been attempted in patients who have kidney failure due to the
diabetes. Since the pancreas lies up against one of the kidneys, it is technically
possible to transplant the two organs together, simultaneously. But, this operation has
only ever been attempted a few times. 
A possibly more promising hope for the future is transplanting just the islet cells. They
could be injected into the abdomen without any surgery. The problem is how to stop the
body from recognizing them as foreign cells and trying to destroy them. Tiny jelly-like
beads have been developed to protect the islet cells from white blood cells, which would
otherwise attack the islet cells and gobble them up. But, the insulin can still seep out
through the beads. 
Normally the level of glucose in the body rises after a person eats a meal. This rise in
blood glucose stimulates the beta cells to release insulin. Insulin then either helps
body cells take up glucose to use as energy or promotes the conversation of glucose to
fat, which are used by the cells later. Some glucose maybe stored in the liver this is
called glycogen. Then the level of glucose drops (usually several hours after the meal
has been eaten), other cells in the pancreas stimulate the conversion of glycogen to
glucose and its release into the bloodstream. In this way, the level of glucose in the
bloodstream stays relatively constant until the next meal is eaten. 
The body tends to deal with this imbalance by filtering out excess glucose throughout the
kidneys, resulting in high levels of sugar in the urine. As glucose level rises the
kidneys over-whelmed and don't function normally. They lose their ability to absorb much
water the result is frequent urination. This is commonly the earliest sign of diabetes.
It is often followed by unquenchable thirst as the body tries to regain the lost fluids.
It often seems that more fluid comes out than went in. 
The name "diabetes mellitus" describes two striking symptoms of disease. The first part
of the name, meaning a siphon or drain, seems quite appropriate. The urine of a person
with diabetes contains sugar, which is the reason for the "mellitus" part, from the Latin
word for honey. Most people just talk about "diabetes", but physicians prefer to use its
more precise, full name, diabetes mellitus. In this way they avoid confusion with another
much rarer disease called diabetes insipidus, in which great qualities of urine are also
produced, but it does not contain sugar. 
Although it is still unclear exactly what causes diabetes, doctors and scientists believe
that there are a number of possible causes: 
The body's immune system plays an important role in the development of diabetes. The
immune system protects us from foreign substances that may enter our bodies, such as
viruses and bacteria. For some reason that scientists have yet to understand, the immune
system of people with diabetes seeks out the cells that produce insulin and destroys
them. This causes people with diabetes to stop producing insulin partially or completely.
Without the presence of insulin, diabetes develops. Scientists are still trying to
discover what causes the immune system to attack these cells. Heredity plays a role in
determining who will develop diabetes. 
Diabetes-especially Type II diabetes-tends to develop in people with a family history of
the disorder. Along with other traits, such as eye color and height, parents can also
pass on certain characteristics that may predispose their children to develop diabetes.
In the case of Type I diabetes, scientists believe that if a father has diabetes, his
children have a 5 to 10 percent chance of developing the disorder before the age of
twenty. If a mother has Type I diabetes the children have half the risk, a 2 to 5 percent
chance of developing the illness. In addition, the risk of developing Type I diabetes
increases with the number of relatives affected. For example, if one sibling has Type I
diabetes, there is only a small risk that a brother or sister will have it, too. However,
if two siblings have Type I diabetes, the risk of third sibling developing the disease
rises to 10 percent. For Type II diabetes, the genetic ling is even stronger. If one
parent has this condition, his or her child has as much as a 25 to 30 percent chance of
developing the disease. If both parents have Type II, the risk of inheriting the illness
rises to nearly 75 percent. 
Scientists strongly believe that one or many forms of stress in the body may trigger the
onset of diabetes. For example, these can include surgical operations, a serious accident
or injury, and even emotional trauma, such as a divorce or a death in the family. Also
the results of extensive research show that certain viruses (disease causing
microorganisms) may infect the pancreas, reducing or destroying its ability to produce
insulin. 
One of the first steps diabetics have to control is their blood pressure. Two-thirds of
adults with diabetes have high blood pressure, or hypertension. This condition is serious
because it leads to an increased risk of stroke, heart disease, and kidney and eye
problems. Hypertension does not, or rarely has symptoms, so it is important to have your
blood pressure checked regularly. Though blood pressures do vary, if it is 140/90 or
higher you should consult your doctor for the best treatment. In addition to medication
blood pressure can be regulated through exercise and a healthy meal plan low in fat and
salt-actions that also limit the risk of other complications associated with diabetes. 
Diabetes does not cause cavities, nor does it increase the chances of having cavities.
But people with diabetes are more prone to gum disease or periodontal disease if their
glucose levels are not relatively stable. High glucose levels make it more difficult for
the body to fight infection. Periodontal disease can cause gum loss and eventually tooth
loss. Smoking also increases the risk of periodontal disease. Tooth loss makes it
difficult to chew food and thus may discourage proper nutrition. Teeth that come out as a
result of periodontal disease cannot be replaced. Because periodontal disease damages the
gums, dentures will not be able to fit properly, and again this will discourage proper
dietary habits. It is very important to maintain good dental hygiene at home by brushing
and flossing daily and to have regular dental checkups at least every six months. 
Diabetes may cause similar changes in the blood vessels of the kidneys. This condition,
called diabetic nephropathy, may lead to kidney failure. The nerves may also be affected
by diabetes. This complication, known as diabetic neuropathy, can result in loss of
felling or abnormal sensations in different parts of the body. Various treatments can
control many cases of diabetic retinopathy, diabetic nephropathy, and diabetic
neuropathy. Diabetes can also lead to atherosclerosis, a form of arteriosclerosis,
hardening of the arteries, that may cause a stroke, heart failure, or gangrene. 
Diabetic neuropathy can occur with long-term diabetes, usually after several years of
uncontrolled high blood glucose. Glucose proteins, called glycoproteins, form in the
nerves, primarily those of the leg and feet. When the nerves in the feet are damaged, the
brain can not recognize pain in that area. Nerve damage from diabetic neuropathy can lead
to weakness in the muscles of the leg and feet. Because there muscles work as a system,
neuropathy can lead to other foot problems, such as hammer toes, calluses, bunions, and
other foot deformities. These deformities are dangerous because of their risk of
infection. A simple blister from tight shoes can spell disaster for diabetics. When
diabetes is out of control (the blood glucose is consistently high) the risk of infection
is always present. A foot infection can begin after a minor injury because the high blood
glucose impairs the white cells' ability to correct the problem. Left untreated,
infections can be life threatening. 
Diabetic foot ulcers are crater-like depressions caused by neuropathy, poor circulation,
or both. If bacteria are present, infection can develop. When not treated properly, such
ulcers can lead to diabetic gangrene or death of the tissue. In gangrene, the tissue is
black, and this alone should cause immediate concern. The black tissue can be dry or wet
and must be given immediate attention. Many times, amputation is necessary when gangrene
is present. 
All bruises, scratches, nicks, abrasions, cuts, swelling, or any change in the condition
of diabetic's feet must be taken seriously. This does not mean they should panic over one
scratch on the foot, but not to take it lightly either. Wash the scratch with a mild
antibacterial soap and apply an antibacterial ointment such as bacitracin. Then watch
that this scratch heals properly and does not become infected. Some people might be
tempted to soak their feet in warm water, maybe even with Epsom salts, to soothe their
feet or get rid of dead skin. But soaking actually dries out the skin, which then leads
to cracking and peeling. That opens the door to bacteria and infections. 
In addition to nerves, diabetes affects blood vessels. It is among the top four risk
factors for premature hardening of the arteries, or atherosclerosis and arteriosclerosis.
Cigarette smoking decreases peripheral vascular blood flow (circulation in the
extremities). Diabetes also peripheral vascular blood flow. Diabetics are particularly
prone to this narrowing of the arteries in the legs and feet. If they have poor
circulation they may notice a lack of hair growth on the tops of their feet and nails may
look deformed and unhealthy. 
Neuropathy can also affect sexual functioning. Until now it was thought that sexual
dysfunction was only limited to men, but it has been found that women also develop this
with long-term diabetes. Impotence in the diabetic man has long been recognized. It is
now more fully understood. In men, damage to the pelvic autonomic nerves can lead to a
complication called retrograde ejaculation. Instead of moving forward, semen is propelled
backward into the bladder. Problems of fertility and sterility must be considered if
retrograde ejaculation is diagnosed in the diabetic male. 
Diabetic men have a 50 to 60 percent incidence of impotence, much higher than among men
in the general population. Impotence may occur any time after adolescence. If the nerves
that stimulate erection are damaged, there will be no erection. Other causes of impotence
include hormone imbalances, blood vessel and heart diseases, and some medications. Men
and women are at equal risk of neuropathic damage to the pelvic autonomic nerves. For
women, difficulty with lubrication or difficulty reaching orgasm may be caused by
decreased nerve sensitivity. 
According to the American Diabetes Association, diabetics spend a total of more than 24
million days in the hospitals each year in the US. Nearly 6000 people lose their eyesight
annually because of diabetes, making it the most common cause of adult blindness. People
with diabetes are at least twice as likely to develop heart disease and suffer heart
attacks and strokes. They have kidney problems 17 times more frequently than people
without diabetes undergo 40 times as many amputations. Diabetes is the direct cause of
more than 40000 deaths a year and an indirect cause of more than 300000 deaths a year,
counting patients who die of diabetes-related kidneys, heart, and circulatory problems.
Diabetes is the third most common cause of death in the US today, after heart disease and
cancer. Although these statistics can be frightening, most people are able to live normal
lives. This requires keeping blood sugar levels under control. For some diabetics, daily
injections are necessary. For most people with diabetes, however, a proper diet and
regular exercise are sufficient. Recognizing the early signs of diabetes is crucial to
finding out the risk of getting this disease. Unfortunately, as many as 5 million people
in the US have diabetes and do not know it. 
Diabetes is divided into two main types: insulin dependent and non-insulin dependent.
They are sometimes mistakenly called "sugar diabetes". 
Insulin-dependent diabetes or Insulin Dependent Diabetes Mellitus (IDDM) is called Type I
diabetes. In the past it was called juvenile-onset diabetes because it seemed to appear
only during childhood or adolescence. Now doctors know that it can appear at any time in
life. It is an auto immune disorder that stems from the destruction of the
insulin-producing cells in the pancreas. The body produces little or no insulin, and is
unable to lower the level of glucagon. The glucagon accumulates in the blood, raising a
person's blood sugar level. This is called hyperglycemia or high blood sugar. When the
blood sugar level gets too high, glucose is removed from the body in urine as waste.
Because most waste is removed from the body in urine, a person with high blood sugar may
go to the bathroom as often as his or her body gets rid of the extra glucose. Frequent
urination can result in loss of water, because water is the main component of urine. This
may cause a person to feel very thirsty or experience a dry mouth. Dehydration can cause
dry skin and blurry vision. 
Also if the cells cannot get the glucose they need, they "starve". This may make a person
feel very hungry even when he or she has just finished eating. Diabetics do not get the
fuel that their body needs. That person may often feel weak and tired. Weight loss may
also occur as the body's demand for fuel force the breakdown of fat cells. High glucose
levels also damage nerves, which may result a tingling feeling in the feet or leg cramps
at night. High glucose levels make it easier for bacteria to grow and may result in
various skin infections. 
If hyperglycemia is not treated, the result can be diabetic ketoacidosis (DKA) coma. When
there is a lack of insulin, the body looks for alternative fuel. That alternative fuel is
fat. When fat is broken down into energy, it produces a poisonous waste called ketones.
Ketones will accumulate in the blood and eventually the urine. Eventually if the
condition is not treated, the person will lose consciousness and possibly die.
Insulin-dependent diabetes affects males and females equally. Treatment for Type I
diabetes includes daily injections of insulin to help the body use the glucose it needs.
Insulin treatment is often balanced with diet and exercise. 
Most people with Type I diabetes must take insulin on a daily basis. The insulin is
injected beneath the skin into the body's subcutaneous tissue. If it were taken orally in
pill form, the stomach's digestive juices would destroy the hormone before it worked. The
symptoms of Type I often seem to come on suddenly and in some crisis situations the
person's life may even be at risk unless immediate medical attention is sought. Unlike
people with Type II diabetes, who tend to be overweight, those with Type I are frequently
lean. There are key signs in Type I diabetes which are a significant weight loss in a
short period of time by someone who hasn't been dieting, excessive urination and
drinking, irritability, and nausea and vomiting. 
Effectively controlling Type I diabetes largely depends on achieving a correct balance of
food, exercise, and insulin. While hyperglycemia may result when a person with diabetes'
blood sugar level soars, another dangerous condition can occur when the opposite is true.
Hypoglycemia, also known as low blood sugar or an insulin reaction, appears when the
blood sugar level drops. In a person with Type I diabetes it is often the result of too
little food, too much exercise, or too much insulin. 
The physical symptoms of hypoglycemia include irritability, headache, nausea, hunger,
weakness, and confusion. Insulin reactions often come on suddenly and are dangerous,
since an individual in this condition can slip into unconsciousness. To counteract
hypoglycemia the person should take some milk, orange juice, about two packets of sugar,
honey, or a sugared soft drink. 
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. 
Diabetics live a social world of family, friends and other relationships. These
relationships are important in terms or practical and emotional support and may help a
diabetic adjust to leading a normal and enjoyable life. There is no reason why a healthy
man or woman with diabetes should not have children. It a woman is going to have a baby
there is no reason why she should not be able to care for the child until it is grown up,
in the same way as other mothers who do not have diabetes. Once pregnancy is confirmed a
woman must maintain, however, good control over diabetes. During the pregnancy it will
probably be necessary to visit a doctor every 2 to 4 weeks so that diabetic control can
be monitored as carefully as possible. The insulin requirement is likely to increase
during pregnancy, especially during the second half. 
Sport is for everybody. As exercise decreases the blood glucose levels reduces the need
for insulin, taking up a sport as a hobby is important for us all, but especially for
people with diabetes. Summer camps for diabetics provide an opportunity for people with
diabetes to try a variety of sports and activities, such as canoeing, skiing and sailing.
Training staff teaches the children how to cope with tests, injections, hypoglycemic
attacks and the routine of daily living with diabetes. This helps children how to look
after themselves and become more independent. Children can enjoy a vacation in a
situation where they are the same as everyone else. 
About 1 in every 20 Americans has diabetes, a disease today that has no cure. Diabetics
must learn to control their diabetes through special diets, regular self-testing of blood
glucose levels, and insulin injections. It takes a lot of self-discipline to change old
habits and stick to new ones for the rest of your life. But diabetics who have this
self-discipline find that they are able to control their disease. Many successful and
well-known people have diabetes, but it does not control their lives. By researching all
the diabetics can about diabetes, taking charge of their healthy and getting support from
friends and family, diabetics can live with their disease-not spite of it. 
Although the research only involved those who had Type I diabetes, doctors feel the
results may be useful for individuals with Type II as well. That's because complications
in both forms of the illness often develop for the same reasons. Undoubtedly, the outlook
for curing diabetes has brightened and physicians remain optimistic about the future.
Technological and medical advances have helped make life better for many diabetics.
Better awareness of methods of prevention has also helped many who are at high risk for
diabetes to avoid developing the disease. In the years to come, many more advances will
be made. This will make it sill easier for people with diabetes to lead healthy, normal
lives. And there is hope that those with diabetes today may live to see their disease
completely cured.