Wednesday 28 July 2010

Tips for Managing Diabetes

Tips for Managing Diabetes

By the year 2025, it is estimated that approximately 380 million individuals worldwide will be affected by type 2 diabetes, according to the Archives of Internal Medicine.

With this world-wide exposure, the chances that you, a family member or someone you know will be affected by type 2 diabetes are considerable.

Therefore, it behooves all of us to understand at least a little about this disease and how we can reduce the likelihood that it will bring misery to us and our families.

DIABETES: TYPE 1 OR TYPE 2?

Insulin is necessary for the body to be able to use glucose for energy. Insulin is a hormone that comes from the pancreas, a gland located just behind the stomach. When you eat, the pancreas secretes insulin into the bloodstream. As insulin circulates, it acts like a key in unlocking microscopic doors that allow sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.

Glucose, or sugar, is a main source of energy for the cells that make up muscles and other tissues. Glucose comes from two major sources: the food you eat and your liver. After intestinal digestion and absorption, sugar is absorbed into the bloodstream. Normally, sugar then enters cells with the help of insulin.

Type 1 diabetes, in which the body produces little or no insulin, is one of the most common chronic diseases in children. This type of diabetes tends to run in families and usually peaks around puberty.

Type 2 diabetes is the most common form of diabetes in the United States and accounts for at least 90 to 95 percent of all diabetes cases, according to some estimates. In type 2 diabetes, either the body does not produce enough insulin or the cells simply ignore the insulin.

Type 2 diabetes usually develops in adults over the age of 40 and is most common among adults over age 55. Although typically thought of as "adult onset," public health findings indicate that type 2 diabetes is an increasing problem for both children/teens and adults today. Why? More Americans are putting themselves at risk for type 2 diabetes primarily because of the growing problem of obesity. Lifestyle changes account for much of this increase. Increased consumption of soft drinks, eating larger portions of food and decreased levels of physical activity often are cited.

WHO IS AT RISK?

People ages 45 years or older who have one or more of the following characteristics are more at risk of developing type 2 diabetes:

* Being more than 20 percent above ideal body weight or having a body mass index of 27 or higher;

* Having an immediate family member, including a mother, father, brother, or sister, with diabetes;

* Being African American, Alaska Native, American Indian, Asian American, Hispanic American, or Pacific Islander American;

* Giving birth to a baby weighing more than 9 pounds (lbs.) or having diabetes during pregnancy;

* Having blood pressure above 140/90.

* Having abnormal blood lipid levels, such as high-density lipoprotein, or HDL, cholesterol less than 35 mg, or triglycerides greater than 250 mg.

A diabetes prevention study, originally published in the New England Journal of Medicine in 2001, is still relevant as it established several important findings:

* It was the first major clinical trial of Americans at high risk for type 2 diabetes to show that lifestyle changes in diet and exercise and losing a little weight can prevent or delay the disease. Participants who made lifestyle changes reduced their risk of getting type 2 diabetes by 58 percent.

* The lifestyle intervention was effective for participants of all ages and all ethnic groups.

The study also indicated that patients who lost 5 percent of their body weight lowered their diabetes risk by about 61 percent. In addition, every 3 kilograms (approximately 6.6 pounds) decrease in weight resulted in doubling health benefits.

PREVENTING DIABETES COMPLICATIONS

Preventing diabetes and the complications brought on by diabetes can be a lifelong battle.

Adhering to a diabetes treatment plan takes round-the-clock efforts and commitment. But such diabetes care can reduce your risk of serious complications. The Mayo Clinic encourages the following ten steps in diabetes care to enable you to enjoy a healthy life.

* Commit to managing your diabetes. Learn all you can about diabetes. Make healthy eating habits and physical activity part of your daily routine. Maintain a healthy weight. Regularly monitor your blood sugar level and follow your doctor's instructions for keeping your blood sugar level within your target range.

* Quit smoking.If you smoke or use other types of tobacco, quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage and kidney disease. In fact, smokers who have diabetes are three times more likely to die of cardiovascular disease than are nonsmokers who have diabetes, according to the American Diabetes Association.

* Control your blood pressure and cholesterol. Like diabetes, high blood pressure can damage your blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when you have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions. Eating healthy foods and exercising regularly play important roles in controlling high blood pressure and cholesterol.

* Schedule yearly physicals and regular eye exams. Your regular diabetes checkups are not intended to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications -- including signs of kidney damage, nerve damage and heart disease -- as well as screen for other medical problems. In addition, your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.

* Keep all vaccines up to date. High blood sugar can often weaken your immune system, which makes routine vaccines more important than ever. A yearly flu vaccine can help you stay healthy during flu season, as well as prevent serious complications from the flu. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you're age 65 or older, you may need a five-year booster shot. Lastly, stay up to date with your tetanus shot and its 10-year boosters and ask your doctor about the hepatitis B vaccine. Depending on the circumstances, your doctor may recommend other vaccines as well.

* Maintain good dental health. Diabetes may leave you susceptible to gum infections. Brush your teeth at least twice a day and floss your teeth at least once a day. Schedule dental exams at least twice a year. Consult your dentist immediately if your gums bleed or look red or swollen.

* Pay close attention to your feet and maintain good foot care. High blood sugar can damage the nerves in your feet and reduce blood flow to your feet. Left untreated, cuts and blisters can lead to serious infections. Check your feet every day for blisters, cuts, sores, redness or swelling. Consult your doctor if you have a sore or other foot problem that doesn't heal within a few days.

* Take a daily aspirin. Aspirin helps to reduce the blood's ability to clot. Taking a daily aspirin can reduce your risk of heart attack and stroke, which are major concerns if you suffer from diabetes. In fact, daily aspirin therapy is recommended for most people who have diabetes. But be sure and ask your doctor about daily aspirin therapy, including which strength of aspirin would be best.

* If you drink alcohol, do so responsibly. Alcohol can cause low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation.

* Control your stress levels. If you're stressed, it's easy to overlook your usual diabetes care routine. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. Take control and set limits. Prioritize your tasks. Learn relaxation techniques. Another great tip - get plenty of rest and sleep.

FOOT CARE IS IMPORTANT

Poor blood flow to the feet or nerve damage in the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections. Severe damage might require toe, foot or even leg amputation. It is also important to take good care of your feet by following these tips:

* Inspect your feet daily. Check your feet for blisters, cuts, sores, redness or swelling once a day. Even a single blister can lead to an infection that won't heal.

* Wash your feet daily. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes.

* Don't go barefoot. Protect your feet with comfortable socks and shoes, even indoors. Make sure new shoes fit well. Wear socks made of fibers that pull (wick) sweat away from your skin, such as cotton and special acrylic fibers -- not nylon. Avoid those with tight elastic bands that reduce circulation or that are thick or bulky. Bulky socks often fit poorly, and a poor fit can irritate your skin.

* Practice good foot care. Trim your nails straight across. If you have any nail problems or poor feeling in your feet, consult your doctor immediately.

CAN COFFEE HELP REDUCE YOUR RISK OF TYPE 2 DIABETES?

Several recent studies report new evidence that drinking coffee may help prevent diabetes and that caffeine may be the ingredient largely responsible for this effect.

According to a new study in the American Chemical Society's Journal of Agricultural and Food Chemistry, drinking coffee -- and lots of it -- may help prevent Type 2 Diabetes.

It's due to the caffeine, claim the scientists from Nagoya University in Japan.

Their findings, among the first animal studies to demonstrate this apparent link, appear in the June issue of the Journal of Agricultural and Food Chemistry.

Fumihiko Horio, Ph.D. Department of Applied Molecular Bioscience at Nagoya University, and colleagues from Nagoya University note that past studies have suggested that regular coffee drinking may reduce the risk of type 2 diabetes.

The scientists gave either water or coffee to a group of laboratory mice commonly used to study diabetes. They found that coffee consumption prevented the development of high blood sugar and also improved insulin sensitivity in the mice, thereby reducing the risk of diabetes. Coffee also caused several other beneficial changes in fatty liver, which is a disorder where fat builds up in liver cells, primarily in obese people. Additional lab studies showed that caffeine may be "one of the most effective anti-diabetic compounds in coffee," according to the scientists.

Another study published in the December 2009 issue of Archives of Internal Medicine reports that individuals who drink more coffee (regular or decaffeinated) or tea appear to have a lower risk of developing Type 2 Diabetes.

By the year 2025, approximately 380 million individuals worldwide will be affected by Type 2 Diabetes, according to background information in the article.

"Despite considerable research attention, the role of specific dietary and lifestyle factors remains uncertain, although obesity and physical inactivity have consistently been reported to raise the risk of diabetes," the authors write.

Rachel Huxley of The George Institute for International Health at the University of Sydney, Australia, and colleagues identified 18 studies involving 457,922 participants and assessing the association between coffee consumption and diabetes risk published between 1966 and 2009. When the authors combined and analyzed the data, they found that each additional cup of coffee consumed in a day was associated with a 7 percent reduction in the excess risk of diabetes. Individuals who drank three to four cups per day had an approximately 25 percent lower risk than those who drank between zero and two cups per day.

In addition, in the studies that assessed decaffeinated coffee consumption, those who drank more than three to four cups per day had about a one-third lower risk of diabetes than those who drank none. Those who drank more than three to four cups of tea had a one-fifth lower risk than those who drank no tea.

"That the apparent protective effect of tea and coffee consumption appears to be independent of a number of potential confounding variables raises the possibility of direct biological effects," the authors write.

Remember, diabetes care is within your control. If you're willing to do your part, diabetes won't prevent you from enjoying an active, healthy lifestyle.

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