Diabetes Type 1:

In type 1, the pancreas stop producing insulin due to autuimmune response or possibly viral
attack on pancreas. In absence of insulin, body cells dont get the required glucose for producing
ATP (Adenosin Triphosphate) units which results into primary symptom in the form of nausea
and vomiting. In later stage, which leads to ketoacidosis, the body starts breaking down the
muscle tissue and fat for producing energy hence, causing fast weight loss. Dehydration is also
usually observed due to electrolyte disturbance. In advanced stages, coma and death is
witnessed.
Diabetes Type 2:

Increased fatigue : Due to inefficiency of the cell to metabolize glucose, reserve fat of
body is metabolized to gain energy. When fat is broken down in the body, it uses more
energy as compared to glucose, hence body goes in negative calorie effect, which
results in fatigue.
Polydipsia : As the concentration of glucose increases in the blood, brain receives signal
for diluting it and, in its counteraction we feel thirsty.
Polyuria: Increase in urine production is due to excess glucose present in body. Body
gets rid of the extra sugar in the blood by excreting it through urine. This leads to
dehydration because along with the sugar, a large amount of water is excreted out of the
body.
Polyphegia : The hormone insulin is also responsible for stimulating hunger. In order to
cope up with high sugar levels in blood, body produces insulin which leads to increased
hunger.
Weight flactuation : Factors like loss of water (polyuria), glucosuria , metabolism of body
fat and protein may lead to weight loss. Few cases may show weight gain due to
increased appetite.
Blurry vision : Hyperosmolar hyperglycemia nonketotic syndrome is the condition when
body fluid is pulled out of tissues including lenses of the eye, which affects its ability to
focus, resulting blurry vision.
Irritability : It is a sign of high blood sugar because of the inefficient glucose supply to
the brain and other body organs, which makes us feel tired and uneasy.
Infections : The body gives few signals whenever there is fluctuation in blood sugar (due
to suppression of immune system) by frequent skin infections like fungal or bacterial or
UTI (urinary tract infection).
Poor wound healing : High blood sugar resists the flourishing of WBC, (white blood cell)
which are responsible for body immune system. When these cells do not function
accordingly, wound healing is not at good pace. Secondly, long standing diabetes leads
to thickening of blood vessels which affect proper circulation of blood in different body
parts.

Type 1 diabetes
Type 1 Diabetes is autoimmune disease that affects 0.3% on average. It is result of destruction of
beta cells due to aggressive nature of cells present in the body. Researchers believe that some of
the Etiology and Risk factors which may trigger type 1 diabetes may be genetic, poor diet
(malnutrition) and environment (virus affecting pancreas). Secondly, in most of the cases,
diabetes occurs because there is abnormal secretion of some hormones in blood which act as
antagonists to insulin. Example- Adrenocortical hormone, Adrenaline hormone and Thyroid
hormone.
Type 2 diabetes

Type 2 Diabetes is also called non insulin-dependent diabetes mellitus (NIDDM) or adult-onset
diabetes. It occurs when the body produces enough insulin but cannot utilize it effectively. This
type of diabetes usually develops in middle age. A general observation says that about 90-95 %
of people suffering with diabetes are type 2; about 80 percent are overweight. It is more common
among people who are older; obese; have a family history of diabetes; have had gestational
diabetes. There are number of risk factors found to be responsible for type 2 diabetes like, the
more the Etiology and Risk factors carried by an individual, the higher the risk for developing
diabetes.

Following are the Causes of Diabetes

Hereditary or Inherited Traits : It is strongly believed that due to some genes which
passes from one generation to another, a person can inherit diabetes. It depends upon
closeness of blood relationship as mother is diabetic, the risk is 2 to 3%, father is
diabetic, the risk is more than the previous case and if both the parents are diabetic, the
child has much greater risk for diabetes.
Age : Increased age is a factor which gives more possibility than in younger age. This
disease may occur at any age, but 80% of cases occur after 50 year, incidences increase
with the age factor.
Poor Diet (Malnutrition Related Diabetes) : Improper nutrition, low protein and fiber
intake, high intake of refined products are the expected reasons for developing diabetes.
Obesity and Fat Distribution : Being overweight means increased insulin resistance,
that is if body fat is more than 30%, BMI 25+, waist grith 35 inches in women or 40 inches
in males.
Sedentary Lifestyle : People with sedentary lifestyle are more prone to diabetes, when
compared to those who exercise thrice a week, are at low risk of falling prey to diabetes.
Stress : Either physical injury or emotional disturbance is frequently blamed as the initial
cause of the disease. Any disturbance in Cortiosteroid or ACTH therapy may lead to
clinical signs of the disease.
Drug Induced: Clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal),
quetiapine (Seroquel) and ziprasidone (Geodon) are known to induce this lethal disease.
Infection : Some of the strephylococci is suppose to be responsible factor for infection in
pancreas.
Sex : Diabetes is commonly seen in elderly especially males but, strongly in women and
those females with multiple pregnancy or suffering from (PCOS) Polycystic Ovarian
Syndrome.
Hypertension : It had been reported in many studies that there is direct relation between
high systolic pressure and diabetes.
Serum lipids and lipoproteins : High triglyceride and cholesterol level in the blood is
related to high blood sugars, in some cases it has been studied that risk is involved even
with low HDL levels in circulating blood.

Diet plays a significant role in controlling the diabetes. The diabetic diet may be used alone or
else in combination with insulin doses or with oral hypoglycemic drugs. Main objective of diabetic
diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood
sugar levels in blood. The diet plan for a diabetic is based on height, weight, age, sex, physical
activity and nature of diabetes. While planning diet, the dietician has to consider complications
such as high blood pressure, high cholesterol levels.
With respect to the above factors, a dietician will assess calories to be given, like scheming the
carbohydrates, proteins, fats, type of carbohydrate, amount of fiber and so on.
Exchange meal plan is a diet program which balances the amount of carbohydrate that we intake
per day. Glucose is a sugar released from carbohydrate so, if we want to control blood sugar

we have to limit the consumption of simple carbohydrate. Carbohydrate foods are given as value
per portion, known as the exchange. This plan helps us to decide on the type of food to be taken,
the amount of food and also the time to eat. You can plan for more flexible meals as you get more
knowledge about the diet for a diabetic, may be like the counting carbohydrate meal plan or
constant carbohydrate. But there is no common diet that works for everyone. Nor is there any
particular diet that works perfectly for any diabetic over a long period. While planning diabetes
diet we should adhere to certain important factors, they are as follows:

Fiber should be at least 1.4 oz / day

Instead of 3 heavy meals, we should go for 4-5 small mid intervals
Replace bakery products and fast foods by simple whole cooked cereals, and don't eat
carbohydrates 2 hours before bedtime
Consume fresh fruit and vegetables at least 5 exchange/ day

Diabetics always need to take care of their diet and also about the food they eat. Care has to be
taken because all foods contain not only carbohydrate, but also some energy value. Protein and
fat available in the food are converted to glucose in the body. This glucose has some effect on the
blood sugar level, which has to be taken care of. Furthermore, you neednt have to eat only the
bland boring diet. Instead, you can eat more fruits, vegetables and whole grains. All it means is
that you need to select foods that are high in nutrition and low in calories.
Diabetes is an insidious disease. In fact, moderately high levels of blood glucose (180-200 mg/dl)
produce no symptom and may go unnoticed for many months or even years. Most patients with
Type 1 diabetes pass large volumes of urine, experience an increase in the frequency of
urination, undue thirst and hunger, and rapid weight loss. These symptoms provide clues to the
diagnosis of diabetes.
Men and women with Type-2 diabetes may not have the above symptoms. Some of them may
experience an increase in the frequency of urination and abnormal thirst. They may however feel
tired, irritable, lack concentration at work, proneness to infection, delay in wound healing, intense
itching and need for frequent change of eye glasses.
At the age of 45yrs or later, if you foresee the risk of developing diabetes, get your fasting blood
glucose test, 2-hrs after a drink of 3.527 oz of glucose, at least once a year. Blood glucose values
of 200mg/dl and higher would suggest the diagnosis of diabetes mellitus.
Can diabetes be cured?
Diabetes cannot be cured completely, but can be effectively controlled. People with diabetes can
lead a healthy life if, their blood glucose level is under control. The decrease in life span of a
diabetic is restored to normal by maintaining good blood glucose control (90-130 mg/dl at fasting
and with less than 180 mg/dl 2hrs after meals).
Sometimes, patients may not need any tablet/insulin or, even diet control to keep their blood
glucose in control. This period is called honeymoon phase (in Type-1 diabetes). The duration may
vary from a few days to over six months. Some patients mistake this for cure of diabetes.
Cardiovascular disease accounts for 70-75% deaths in diabetic people with acute myocardial
infarction being responsible for 30% mishaps. Diabetes typically doubles heart attack risk in men
and triples in women. Diabetes causes more extensive coronary atherosclerosis with triple vessel
involvement. Long-duration diabetes and diabetes in elderly people is more likely to cause silent
heart attack (painless MI) with increased chances of death.

Diabetes can be a tough disease to handle. There are many reasons for it, firstly, causes of the
disease are not clearly known, it is difficult to prevent. Secondly, once you get the disease, it is
not possible to cure the same and you need to take care of your health for entire life. This task
can be quite daunting; here are a few tips to help you.
Diabetic Care Tips
If you have diabetes, you need to take some precautions, in your day to day life as well and not
only at those times, when you feel sick. Here are some precautions that you can take in your
everyday life:

You should monitor your blood glucose level regularly. Depending on the severity of
your condition, your doctor would tell you about the intervals, in which you should take
the test.
You should take regular doses of medicine or insulin, as have been prescribed.
Regular exercise proves to be useful in controlling glucose levels. However, you should
avoid few exercises, that are known to cause further complications like cardiovascular
diseases, hypoglycemia etc.
In case your glucose level drops suddenly during or after exercise, you should consume
a fruit juice or some similar drink that provides you with sugar.
Weight reduction is a key of success in managing diabetes; hence take all the measures
of carb control, what you can.

In case you are suffering from any ailment like flu, cold or any other disease or infection, some
extra precautions need to be taken, to avoid further complications by diabetes:

Check your blood sugar level more frequently, to ensure that no harm is being caused by
diabetes.
The illness may force some changes in your diet; consult your doctor/endocrinologist
about the changes you need to make in your diabetes medicine accordingly.
You should drink lots of water and other clear liquids.
Remember not to cut yourself completely from food even if you are not experiencing
hunger.
Consult the doctor, if you feel abnormal in any manner. For example you may be feeling
excessively sleepy, giddy, may have trouble with urination etc.

Even though diabetes is a chronic condition, the same does not mean, that you will have to avoid
every activity you enjoy, once you contract it. You can have the same amount of fun, provided,
that you take certain precautions. Remember, if you have diabetes, you cannot ignore the
precautions, nor do you need to get bogged down completely by them.
Juvenile diabetes is an autoimmune disorder which can be due to environmental trigger or virus,
which hampers the function of beta cell. Once the beta cells are destroyed the body is unable to
produce insulin. It is also believed that Type 1 diabetes results from an infectious or toxic insult to
a child, whose immune system is predisposed to develop an aggressive autoimmune response
either against molecules of the B cell or against altered pancreatic B antigens, resembling a viral
protein. A child with diabetic siblings is more prone to develop juvenile diabetes than the child
from a totally unaffected family. It is considered to be a more hereditary problem than excess
eating or being obese.
Pancreas produces the exact amount of insulin, to breakdown the sugar produced in the body.
The juvenile diabetic lack the production of insulin so, sugar builds up high in the blood,
overflows into the urine and passes from the body unused.

It is estimated that about 10-15% in United States are suffering with juvenile diabetes.
Approximately 35 American children are diagnosed with juvenile diabetes every day.
Dia control
When blood glucose remains higher than 200mg/dl for 8-10 weeks, the concentration of
glycosylated hemoglobin (HbA1c) arises. A (HbA1c) measurement therefore reflects the blood
glucose control over a preceding 2-3 months period, while the estimates of blood glucose indicate
the glucose value at the time of blood test. HbA1c values between 6-7% indicate very good
control on diabetes. You should aim at keeping your blood glucose in the normal range i.e.
between 90-130 mg/dl while fasting and less than 180 mg/dl after meals and HbA1c around 7%.
Frequent tests for blood glucose are necessary when starting treatment with insulin.
If you are doing capillary blood glucose test using a hand held glucometer, do not squeeze the
finger to bring out a sample after you have picked. This invariably gives a low glucose value. Ask
your diabetes nurse for a demonstration of capillary blood glucose test.
Urine test for sugar is not reliable indicator of diabetes control. Although spillage of sugar in urine
occurs when the blood glucose exceeds 180 mg/dl in the majority of healthy persons, this is not
always so in a patient with diabetes. Most patients with diabetes of many years acquire an
increase in the renal threshold for glucose (capacity to prevent spillage of glucose into urine).
Hence urine test for glucose is not helpful for assessing control of diabetes. In the presence of
urinary infections, the bacteria eats up the sugar present in urine, thereby making urine test for
sugar unreliable.

The increasing rate of diabetes is alarming,

but much of this major public health problem can be prevented with early detection,
improved care, and education on diabetes self-management. According to the CDC,
physicians should take advantage of their patients routine office visits to conduct foot
and kidney exams, as well as recommend eye screenings once a year.
If you or a loved one is already diagnosed with diabetes, then an emphasis on proper
diabetes management should become a part of your daily routine. Taking control of your
diabetes can help you feel better and stay healthy. Research shows that keeping your
blood glucose (blood sugar) close to normal reduces your chances of having eye, kidney,
and nerve problems. To control your diabetes, you need to become very familiar with
your blood glucose numbers and your target goals (know them like your shoe size).
The A1C test (pronounced A-one-C) is a simple blood test that reflects your average
blood glucose level over the last 3 months. It is the best way to know your overall blood
glucose control during this period of time, and will help you and your health care team
better understand how well your treatment plan is working over time. The test shows if
your blood glucose levels have been close to normal or too high. The higher the amount

of glucose in your blood, the higher your A1C result will be. A high A1C result will
increase your chances for serious health problems.
Reducing other risk factors such as excessive weight and high blood pressure can be
managed through lifestyle changes that include regular physical activity, eating a low-fat
diet and quitting smoking. Consult your healthcare team, which can include your
physicians and exercise/nutritional coaches to help implement some of these very
important changes into your daily routines.