Diabetes Mellitus - Type 1, 2 - Diabetic Symptoms, Diet, Gestational

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Diabetes Mellitus - Type 1, 2 - Diabetic Symptoms, Diet, Gestational - Pg 1
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Diabetes Mellitus - Type 1, 2 - Diabetic Symptoms, Diet, Gestational - Pg 1
Reprinted by permission from Bill Faloon of The Life Extension Foundation

Diabetes mellitus is a metabolic disorder that interferes with the body's ability to convert digested food into energy and growth.  When we eat, the body converts food into glucose, a simple sugar that is our main source of energy.  Once glucose becomes available in the bloodstream, it must enter the cells to provide this energy.  The pancreatic hormone insulin is required to allow glucose to enter the cells.  In a healthy person, the pancreas's beta cells produce exactly the amount of insulin needed to match the amount of food ingested.  Blood sugar regulation is accomplished by the most finely controlled system in the body;  blood sugar should remain in a very small range of approximately 70 to 120 mg/dl (milligrams per deciliter) even after a heavy meal.

When diabetes mellitus occurs, this metabolic process is altered.  Depending on the type of diabetic symptoms, there is either insufficient insulin or an inability to utilize the insulin that is produced.  In both cases, glucose builds up in the bloodstream and the cells starve.  Once blood sugar levels pass a certain point, unused sugar spills into the urine as the body attempts to rid itself of the excess.  This causes frequent urination and unquenchable thirst because of the continual dumping of fluids to transport the extra sugar into the bladder.

The body is forced to turn to other sources of energy.  Its solution is to break down stored fats for their small glucose contents.  A by-product of this breakdown, ketone bodies, builds up in the blood and may be extremely dangerous.  Ketoacidosis accounts for 10% of deaths due to diabetes.  Besides thirst and frequent urination, some of the diabetic symptoms are:

  • Extreme hunger (because food is not assimilated),

  • Weakness (because the body lacks cellular energy),

  • Weight loss (food eaten is just passed through the body).  This is not always seen in Type II diabetes,

  • Tiredness (both because of the high blood sugar and because energy isn't absorbed),

  • Frequent infection (partially due to high sugar levels acting as a growth medium for bacteria),

  • Cuts and bruises slow to heal,

  • Long-term complications that may become evident without other obvious causative agents (impotence, blurry vision, numbness, and pain in the extremities),

  • Sweet-smelling breath (from ketoacidosis, a result of fat metabolism),

  • Diabetes has two primary forms, as well as some minor, transient ones.

Type I (also known as insulin-dependent diabetes mellitus, IDDM)
This form of diabetes was once called juvenile diabetes because it commonly occurs in younger patients.  It is considered an autoimmune disease and results when the immune system attacks the insulin-producing beta cells of the pancreas, destroying them.  The result is a pancreas that produces little or no insulin.  The exact cause of the attack on the beta cells is not known, but both genetic and viral factors are believed to be involved.

A person with Type I diabetes requires exogenous insulin (insulin from an outside source) to sustain life.  This insulin must be injected daily, and often several times a day.  Originally, insulin was obtained from pigs and cows, though today's purified forms are of recombinant DNA origin.  Type I patients constitute only about 10% of all diabetics, but they often find the condition to be devastating in its impact, in both short-and long-term damage.  There are currently several experiments in progress involving the prevention of Type I diabetes in those who have genetic predisposition to the disorder with beta cell antibodies present.  The National Coordinating Center (800) 425-8361 has a list of screening sites around the country, in case you, or people you know, have an interest in participating.

Type II (also known as non-insulin-dependent diabetes mellitus, NIDDM)
This is the most common form of diabetes, affecting approximately 15 million people in this country alone.  There may be an equal number of as-yet-undiagnosed Type II diabetics, because of the often subtle early signs of the disorder.  It has been called adult onset diabetes because it commonly occurs after age 40, most often in the middle 50's and later.  In the great majority of cases, the Type II diabetic is overweight, putting additional demands on an aging organ system.

Type II patients usually produce insulin, but for some reason (either insufficient production or insulin resistance by the cells) their bodies are unable to process glucose efficiently.  The resulting condition is similar to that of Type I:  an excess of glucose in the blood and the lack of fuel for the cells.  Type II may have varying effects in different people.  The extreme levels of high blood sugar found in Type I are not as prevalent in Type II patients, and the short-term dangers are not as acute.  However, unchecked or poorly controlled Type II will produce long-term damage similar to that found in Type I.  Many Type II diabetics eventually take insulin because their disorder cannot be controlled without it.

Gestational Diabetes - Severe environmental and situational stressors, such as pregnancy, may produce high levels of blood sugar.  This is similar to the effects of stress on other organ systems.  (For example, temporary hypertension or tachycardia may be found among those in extreme situations.)  Gestational diabetes is treated with insulin and usually disappears post-partum.  However, women with gestational diabetes have a higher incidence of Type II in their later years.

Complications of Diabetes

Short-term complications
The short-term dangers of diabetes are most common among patients with Type I, though Type II patients taking the class of drugs known as sulfonylureas (Diabinese and Glucotrol, for example) may experience problems with hypoglycemia (low blood sugar).  This is because the sulfonylureas act by directly stimulating the pancreas to produce additional insulin.  Type II diabetics do not independently produce enough effective insulin, or insulin that successfully transports glucose into the cells.

One way of solving this problem is to increase the total amount of insulin available.  These diabetics and those on injectable insulin are using treatments that directly increase the amount of glucose assimilation in the body.  Taking too much insulin or oral medication, or eating fewer carbohydrates, will cause a precipitous drop in blood sugar.  This may result in the body going into shock, a medical emergency.  Shock may be treated through the ingestion of sugar, preferably in an easy to assimilate form.  (This cannot be attempted if the person is unconscious.)  These diabetics should carry glucose tablets or gels or similar products capable of quickly raising blood sugar.

The other short-term danger is of the opposite type - coma.  This condition comes from extremely high levels of blood sugar and can result in death if left untreated.  Note:  if a diabetic is unconscious, never give insulin; wait for blood sugar tests given by a health care professional.  To give insulin mistakenly to an unconscious diabetic in shock could be fatal.

Long-term complications
The cumulative effects of diabetes are system-wide.  Because diabetes causes both vascular and neurological damage, the end results are enormously significant.  This is true for diabetics of both major types.  Be aware that diabetics may feel healthy and unaffected while these effects are developing.  Type I diabetics, because of the greater number of years with the disease and because of the higher blood sugar levels often seen, may experience more damage at an earlier age.  Poorly controlled Type II patients may see similar damage, however.  Even well-controlled diabetics can suffer from some degree of these long-term complications:

  • Kidney Failure -- Though most common in Type I cases, circulatory dysfunction may lead to difficulty or failure of this organ.  Diabetes is the leading cause of end-stage renal disease,

  • Stroke -- Diabetes is the major cause of strokes in the United States,

  • Amputation -- Over 50% of amputations are diabetes related,

  • Blindness -- Diabetes is the number one cause of blindness in the United States,

  • Cardiovascular disease -- Diabetics are 2 to 4 times as likely to have heart disease as people without diabetes, according to the American Diabetes Association,

  • Impotence -- Among diabetics, both vascular and neurological damage causes high rates of impotence,

  • Neuropathy -- Peripheral neuropathy (pain and numbness in the extremities, usually in the feet and legs) is common in diabetes.

Medical Treatment of Diabetes
The diagnosis of diabetes is made with simple blood sugar (BS) tests.  BS tests are often administered when a person sees a physician because of symptoms that suggest to the doctor that diabetes may be present.  Other types of blood test are the fasting blood sugar (FBS) performed in the morning before any food is taken and the two-hour post-prandial BS (performed 2 hours after a meal).  Any BS reading over 140 mg/dl indicates a malfunction in the metabolic system.  Besides these tests, factors that help determine the type and degree of diabetes, as well as the most appropriate treatment for each patient, include the level of hyperglycemia, age of onset, other existing medical conditions, and family history of diabetes or those with diabetic symptoms.

Medicine also has an excellent measure of long-term diabetes control, superior to any blood sugar test that reflects only the patient's status at the moment.  This is the hemoglobin A1c test, based on the level of glycosylated hemoglobin, a substance that accumulates over time in the blood.  It is found in excessive amounts in poorly controlled diabetics.  Because it is a test of an accumulated substance rather than an indicator of a momentary sugar level, the HbA1c indicates the level of control during the preceding two or three months.

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