Diabetes: Types

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Diabetes is a chronic, insidious disease on the rise in the community. Among its many debilitating complications are heart and vascular disease, kidney disease and eye disease. It is important to understand who is at risk of the complications of diabetes, and discover ways to mitigate the effects of the disease.

Diabetes + Smoking = Trouble

Cigarette smoking is the leading cause if avoidable death world over, and it accounts for almost 500,000 deaths a year. Smoking plays a role in one out of every five deaths in the World per year.  Where the health of diabetic smokers is concerned, the statistics are even worse. There is an increased risk of premature death and the development of heart disease in patients who have diabetes and continue to smoke. There is also evidence that links cigarette smoking with microvascular disease (kidney and eye damage) in diabetes. Additionally, there is data that shows that smoking may actually play a role in the development of type 2 diabetes.

Diabetes Causes

Type 1 diabetes: Type 1 diabetes is believed to be an autoimmune disease. The body's immune system attacks the cells in the pancreas that produce insulin.

·         A predisposition to develop type 1 diabetes may run in families, but genetic causes (a postitive family history) is much more common for type 2 diabetes.

·         Environmental factors, including common unavoidable viral infections, may also contribute.

·         Type 1 diabetes is most common in people of non-Hispanic, Northern European descent (especially Finland and Sardinia), followed by African Americans, and Hispanic Americans. It is relatively rare in those of Asian descent.

·         Type 1 diabetes is slightly more common in men than in women.

Type 2 diabetes: Type 2 diabetes has strong genetic links, meaning that type 2 diabetes tends to run in families. Several genes have been identified and more are under study which may relate to the causes of type 2 diabetes. Risk factors for developing type 2 diabetes include the following:

·         High blood pressure

·         High blood triglyceride (fat) levels

·         Gestational diabetes or giving birth to a baby weighing more than 9 pounds

·         High-fat diet

·         High alcohol intake

·         Sedentary lifestyle

·         Obesity or being overweight

·         Ethnicity, particularly when a close relative had type 2 diabetes or gestational diabetes: certain groups, such as African Americans, Native Americans, Hispanic Americans, and Japanese Americans, have a greater risk of developing type 2 diabetes than non-Hispanic whites.

·         Aging: Increasing age is a significant risk factor for type 2 diabetes. Risk begins to rise significantly at about age 45 years, and rises considerably after age 65 years.

A Guide to Diabetic Women during and after Pregnancy

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 Introduction

Do you have type 1 or type 2 diabetes and pregnant or hoping to get pregnant soon. You need to know what to do to have a healthy baby. You also learn how to take care of your diabetes before, during, and after your pregnancy. Times of pregnancy and new motherhood bring great excitement, worry, and change for any woman. Pregnancy for women who have diabetes is automatically considered a high-risk. The women carrying twins-or more-or who are beyond a certain age are also considered to have high-risk pregnancies. The words ‘high risk’ do not mean you will have problems. To the contrary it means you need to pay special attention to your health and you may need to see specialized doctors. Most births form the so called high-risk pregnancies produce very healthy babies without the mother’s health being affected. What matters is special care and attention.

How to take care of yourself and the baby

Before and during pregnancy, and during your pregnancy, keeping your blood glucose as close to normal as possible is the most important thing you can do to stay healthy and have a healthy baby. Your dietician can help you learn how to use meal planning, physical activity, and medications to reach the desired blood glucose goals. Through his/her guidance, you will create a plan for taking care of yourself and your diabetes.

It is common knowledge that pregnancy causes a number of changes in your body, so you might need to make changes in the ways you manage your diabetes. Even if you have had diabetes for years, you may need changes in your meal plan, physical activity routine and medications. Together with this, your needs might change as you get closer to your delivery date.

Did you know that Diabetes Can Affect You and Your Baby

Avoid high blood glucose levels before and during pregnancy because it can:

• result in long-term diabetes complications, such as vision problems, heart disease, and kidney disease
• increase the chance of problems for the baby, such as being born too early, weighing too much or too little, and having low blood glucose or other health problems at birth
• increase the risk of the baby having birth defects
• increase the risk of losing your baby through miscarriage or stillbirth

However, research has shown that when women with diabetes keep blood glucose levels under control before and during pregnancy, the risk of birth defects is about the same as in babies born to women who do not have diabetes.

When your blood glucose level is too high, then the baby also gets too much glucose since glucose in a pregnant woman's blood passes through to the baby. Therefore, if your blood glucose level is too high during pregnancy, so is your baby's glucose level before birth.

Your Diabetes, Before and During Your Pregnancy

In diabetes, blood glucose levels are above normal. Regardless of whether you have type 1 or type 2 diabetes, you can manage your blood glucose levels and lower the risk of health problems.

The brain, heart, kidneys, and lungs of the baby form during the first 8 weeks of pregnancy; high blood glucose levels are especially harmful during this early part of pregnancy. Unfortunately, most women do not realize they are pregnant until the 5th or the 6th week after conception. This not withstanding, you will work with your health care provider to get the blood glucose under control before you get pregnant; assuming the pregnancy is not accidental.

If the later happens, and you realize you are pregnant, see your doctor as soon as possible to make plans for taking care of yourself and your baby. Even if you learn you are pregnant later in your pregnancy, you can still do a lot for the baby's health and your own.

Pregnancy and Gestational Diabetes

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 Did you know there is a particular type of diabetes which develops in women pregnancy called gestational diabetes?

Diabetes can develop during pregnancy in women who have not previously had the condition. This is called gestational diabetes, and it affects around 2 to 7 out of 100 pregnant women. It can lead to problems for the mother and baby if it is not controlled properly.

About diabetes in pregnancy

Diabetes is a condition in which your blood sugar level is high because there isn't enough insulin in your blood, or your body is not responding to insulin properly. Insulin is a hormone that allows your body to break down sugar in your blood to be used as energy. During pregnancy, various hormones block the usual action of insulin. This helps to make sure your growing baby gets enough sugar. Your body needs to produce more insulin to cope with these changes. Gestational diabetes develops when your body can't meet the extra insulin demands of the pregnancy. This type of diabetes usually begins in the second half of pregnancy, and goes away after the baby is born. If it does not go away after the baby is born, there could be a possibility that there is a slowly developing form of what is known as type 1 diabetes, and that it was picked up by chance during pregnancy. The other form of diabetes is called type 2 diabetes and both type 1 and 2 are lifelong conditions.

Symptoms of diabetes in pregnancy

This form of diabetes does not usually cause any symptoms. Sometimes the main symptom is high blood sugar, including:

• increased thirst
• frequent urination
• feeling tired

Sometimes these symptoms are also common in a normal pregnancy.

Complications of diabetes in pregnancy

Gestational diabetes is not an immediate threat to the health of the pregnant woman. However, poorly controlled diabetes in pregnancy exposes you to a higher risk of various problems. These include:

• a condition called pre-eclampsia, which causes high blood pressure
• premature labor
• too much amniotic fluid (the fluid around your unborn baby)

Women, who suffer from gestational diabetes, are more likely to need a caesarean delivery than those who don't have diabetes. They are also more likely to develop gestational diabetes in future pregnancies, and are at a higher risk of developing type 2 diabetes later in life.

For your baby

The baby may grow larger than usual in women who experience cases of high blood sugar levels.  This is because he or she has to make extra insulin to control the increased blood sugar, which causes more fat and tissue to be stored. This can make delivery difficult. For example, there is an increased risk of shoulder dystocia (difficult childbirth). This can occur when the baby's head has been born but one of his or her shoulders is stuck behind the pelvic bone, preventing his or her body being delivered. This in turn can damage nerves in the baby's neck or result in a fracture of one of his or her arms or shoulders. Very rarely, it can cause brain damage if the blood supply to the baby’s brain is blocked off for too long.

The baby may have low blood sugar (hypoglycaemia) after birth. This is because he or she makes extra insulin to respond to the mother’s high blood sugar levels. Shortly after birth, the baby may continue to make extra insulin causing his or her blood sugar level to be too low.

In order to avoid such instances, It is recommended that the baby be breastfeed within 30 minutes of delivery to keep his or her blood sugar levels at a safe level. Otherwise, he or she may be given a sugar solution through a drip (directly into a vein). Midwives or doctors should check the baby's blood sugar level regularly.

The newborn baby is at risk of jaundice (yellowing of the skin and whites of the eyes). This usually fades without the need for medical treatment. In some cases however, the baby may need treatment with a special ultraviolet light after being born. There is a likelihood that the baby will be born with a birth defect. At times, babies born by a mother who had gestational diabetes could present with respiratory distress syndrome, in which the baby has problems breathing because his or her lungs have not developed as they should. This usually clears up with time, although it may mean that the baby needs to be ventilated with a machine.

Sometimes there is a higher chance of stillbirth or death as a newborn, but this is rare as long as blood sugar levels in both the mother and the baby are well controlled. There is also an increased risk of the baby becoming obese as a child and an increased risk of him or her developing diabetes during childhood.

Causes of diabetes in pregnancy

No empirical research has been done to establish why some women develop gestational diabetes and others don't, but the following category of are more at risk:

• have a family history of gestational diabetes (ie mother, grandmother or sister had it)
• have previously given birth to a large baby, weighing over 4.5kg (9lb)
• are overweight or obese
• have polycystic ovary syndrome (PCOS)

There are also incidences of gestational diabetes in Women whose families originate from certain area. These include women from South Asia (specifically India, Pakistan or Bangladesh), the Middle East (specifically Saudi Arabia, United Arab Emirates, Iraq, Jordan, Syria, Oman, Qatar, Kuwait, Lebanon or Egypt) and black Caribbean women.

Diagnosis of diabetes in pregnancy

Diagnosis can be done using a glucose tolerance test, which is carried out in the morning, normally before taking breakfast. The doctor gives the patient a solution of glucose to drink and then takes blood samples at different intervals to see how the body deals with the glucose over time.

If a Woman is at risk of developing diabetes in pregnancy, she will be offered a glucose tolerance test by her doctor or midwife between 24 and 28 weeks. If she has had gestational diabetes before, she will be offered a test at 18 weeks, and another one at between 24 and 28 weeks if the first is normal.

Treatment of diabetes in pregnancy

This is done by doctors and nurses who are experienced in looking after pregnant women with diabetes

1.      Self management

 Most women can control their blood sugar level through a carefully planned diet and regular exercise. The doctor or a dietitian should be able to give advice on what to eat. An important part of the diet will be to eat plenty of slowly absorbed carbohydrates such as wholemeal bread and pasta, oats, brown rice, potatoes, lentils and beans. These types of food have a low glycaemic index (GI) and can help even out blood sugar levels in diabetic mothers. The meal plan will probably consist of such slow absorbing carbohydrates and a variety of lean proteins, as well as at least five portions of fruit and vegetables each day.  Exercises, such as walking or cycling, helps to reduce blood sugar levels and promote a sense of wellbeing. At least 30 minutes of activity that gets the patient slightly breathless each day will be good.  Regular testing of blood sugar levels will be paramount. The family doctor should will give you advice on how to test for blood sugar level, how often to do it, and the levels that are healthy; this should be every day.

 

2.      Medicines

Some cases of gestational diabetes cannot be controlled with diet and exercise and will need insulin injections or tablets. The doctor will teach the pregnant mother how to use injections, or when to take tablets if necessary. It is possible to have too much insulin; this can cause low blood sugar (hypoglycaemia - sometimes called a 'hypo'). Common symptoms of this are paleness, shaking, hunger and sweating. The doctor will explain how to recognise the symptoms of hypoglycaemia, and what to do if it happens. Keeping a sugary soft drink handy will be a good idea in dealing with low blood sugar. Sometimes, low blood sugar can cause lose of consciousness, in such incidences, an injection is necessary.

Finally, it is advisable that the family and friends know what to do if the blood sugar gets very low and you pass out.

After your baby is born

The mother and the baby should have your blood sugar levels monitored after birth to make sure they are back to normal. Doctors recommend that the baby be breastfeed within 30 minutes of delivery to keep his or her blood sugar levels at a safe level and then every two to three hours.

Any medication for diabetes which was being taken can be stopped after the baby has been born.    

Prevention of type 2 diabetes

If you have had gestational diabetes chances are that you can get type 2 diabetes, however, healthy lifestyle choices can reduce this risk. Aim to eat a balanced diet, take regular exercise and maintain the correct weight for your height.Everyone needs this  

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History of Diabetes

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The essence of the interest in the history of diabetes is to help those suffering understand how treatment has evolved over the years. This knowledge can help in understanding diabetes symptoms, treatment and the differences in the diabetes types.  

A Greek physician, Aretaeus of Cappadocia gave Diabetes its first name after the word dia-bainein which means “to siphon” in the First A.D. This was related to the patients passing excessive amounts of urine.

Around the same time, Indians called diabetes “sweet urine disease” because they tested for it by observing whether ants were attracted to the persons urine or not. In 1425, the word diabete was first recorded in an English medical text, to cement the history of diabetes.

In 1675, a English physician Dr. Thomas Willis described the sugar taste of urine in people with diabetes. This was followed by diagnosis of diabetes by 'water tasters,' who drank the urine of those suspected of having diabetes; the urine of people with diabetes was thought to be sweet-tasting. Then the Latin word for honey (referring to its sweetness), 'mellitus’, was added in 1750 by Cullen, a scientist; the term diabetes emerged as a result.

In 1869 Paul Langerhans, a German medical student discovered that the pancreas contains two systems of cells. One set to secrete the normal pancreatic juice, while the function of the other was unknown. Several years later, these cells were identified as the 'islets of Langerhans.'

In 1889, Drs Oskar Minkowski and Joseph von Mering removed the pancreas of a dog at the University of Strasbourg, France, to determine the effect of an absent pancreas on digestion. They thus discovered that the pancreas plays a major role in diabetes.

The advancement in the discovery and treatment of diabetes continued in the 19^th century with a French researcher, Claude Bernard, studying the working of the pancreas and the glycogen metabolism of the liver. At the same time, Czech researcher, I.V. Pavlov, discovered the link between the nervous system and gastric secretion, making an important contribution to science's knowledge of the physiology of the digestive system.

In 1901, Eugene Opie linked diabetes with islet cells, which are clusters of cells in the pancreas that makes insulin.  

In 1920, R.D. Lawrence developed the dietary exchange system which helped to develop a diet for diabetes. Earlier in 1919, Frederick Allen had published a book: “Total Dietary Regulation in the Treatment of Diabetes”, citing exhaustive case records of 76 of the 100 diabetes patients he observed. The idea of a special diet for diabetes persons was first mooted by a French physician, Bouchardat, who noticed the disappearance of glycosuria in his diabetes patients during the rationing of food in Paris while under siege by Germany during the Franco-Prussian War in the 1870s; he the formulated an idea of individualized diets for his diabetes patients.

In 1920, Dr. Banting also conceived the idea of insulin after reading Moses Barron's paper 'The Relation of the Islets of Langerhans to Diabetes with Special Reference to Cases of Pancreatic Lithiasis' in the November issue of Surgery, Gynecology and Obstetrics. For the next year, with the assistance of Best, Collip and Macleod, Dr. Banting continued his research using a variety of different extracts on de-pancreatized dogs. Towards the end of 1921, they discovered insulin as a diabetes medication, after realising that de-pancreatized dogs were successfully treated with insulin.

In the years 1922 to 1923, Frederick G Banting and John J.R. Macleod  won the Nobel Prize for their discovery of insulin, after using it in the first patients for the treatment of diabetes.

In 1936, Sir Harold Percival Himsworth recognised two major types of diabetes; type 1(insulin-dependent) and 2 (non-insulin-dependent) diabetes.  

Other Milestone in the development of diabetes treatment

In 1936, PZI (Protamine Zinc Insulin) veterinary insulin was used on animals; it is a combination of pork/beef derived insulin or beef-derived insulin. In the same year, NPH (Neutral Protamine Hagedorn) was created by adding neutral protamine to regular insulin.

In 1942, the first sulfonylurea was identified as an anti-diabetic drug to help manage type 2 diabetes, and in 1956 oral medications were developed.

In 1944, Becton-Dickinson started marketing a standard insulin syringe, thus helping to make diabetes management more uniform and easy.

In 1952, Lente insulin was created using zinc, a natural component of the body to obtain the best effects without the use of protamine.

In 1969, Ames Diagnostics created the first portable blood glucose meter to help monitor the different types of diabetes.

In 1977, the radioimmunoassay for insulin was discovered by Rosalyn Yalow and Solomon Berson. In 1979, the hemoglobin A1C test was created which made measurement of blood sugar control more precise.

In same year, the Derma-Ject needle-free insulin delivery system was marketed by The Derata Corporation.

In 1988, Dr. Gerald Reaven identified metabolic syndrome, which was a combination of medical disorders that increase the risk of a diabetes diagnosis.

In 1992, Lispro was tested, by Eli Lilly, as a diabetes medication. In the following year, the Diabetes Control and Complications Trial concluded that the best diabetes management was "tight control."

In 1995, Precose and Metformin were approved for use to help with type 2 diabetes symptoms. While in 2007, stem cells were used to treat diabetes patients, the cells were from their own bone marrow; the treatment showed that most of the patients did not require insulin treatments for extended periods of time. 

PREVENTION AND TREATMENT OF DIABETIC WOUND

Treat the diabetic wound, do not amputate

Here's what you need to know about preventing foot sores and treating them in order to avoid an amputation.

How to Treat a Diabetic Wound

 

People with diabetes are at increased risk for complications from wound healing for several reasons. First, diabetes decreases blood flow, so injuries are slower to heal than in people who do not have the disease. Second, many people with diabetes also have neuropathy, that is: reduced sensation in their hands or feet which means they do not easily notice an injury right away.

Why are feet at more risk for diabetes wounds? Because feet just take more of a beating in our daily lives than hands do, and we do not look at them as often, so it is harder to spot a wound.

5 Tips for Preventing Foot Sores

 

The best way to prevent wound complications is to prevent the wound in the first place. You do that by taking good care of your feet. Top ways to keep your feet in good health include:

a)   Check your feet every single day, and wash them with mild soap and water. (Be sure to check the water temperature first.) Make it part of your daily routine, just like brushing your teeth. 

b) Dry your feet well. Moisture retained between the toes can cause skin breakdowns.  

c) Be cautious in nail salons. Though some specialists recommend avoiding salons and having your nails cut only by a podiatrist, others simply urge caution. "You want to make sure the salon's certification is current and visible," says Brunilda Nazario, MD, a diabetes specialist. And ask when the salon was last inspected by the state, Nazario says. Before treatment, watch to see that the tools are properly sanitized. They should be freshly unwrapped or have just been removed from heat or chemical sterilization -- if it's not clear, ask. If you choose, you could also bring your own nail files. Will you be using a foot spa? Find out whether it's been cleaned and disinfected.  

·                       d) Keep your feet from drying and cracking with regular applications of foot cream.  

  

No matter how small or superficial a wound is, you should not ignore it if you have diabetes, If you stub your toe, get a blister from tight shoes, or nick your chin while shaving, you probably give it little thought. But if you have diabetes, you should seek proper treatment.

Knowing how to treat minor wounds will help you avoid infection and speed healing.

Why Diabetic Wounds Can Cause Problems

Diabetes is a chronic disease where your body can't use glucose, or sugar, the way it should. It can cause a number of complications, including some that make it harder for wounds to heal. These include:

1.      Nerve damage (neuropathy). When you have neuropathy, you may not feel the pain of a cut or blister until it has grown worse or become infected.

2.      Weakened immune system. When the body's natural defenses are down, even a minor wound may become infected.

3.      Narrow arteries. People with clogged arteries in their legs are more likely to develop wounds, have severe wound infections, and have problems healing. Narrowed arteries makes it harder for blood to get to the wound. Blood flow promotes healing, so anything that blocks it can make wounds more likely to become infected.

TREATMENT

How to Treat a Diabetic Wound

If you have a wound, no matter how small, take the following steps to avoid infection and promote healing:

1.      Take care of the wound immediately. Even a minor wound can become infected if bacteria are allowed to build up after injury.

2.      Clean the wound. Rinse the wound under running water to remove dirt. Don't use soap, hydrogen peroxide, or iodine, which can irritate the injury. Then apply antibiotic ointment to prevent infection, and cover the wound with a sterile bandage. Change the bandage daily, and use soap to clean the skin around the wound. Inspect your wound daily for any signs of infection.

3.      See your doctor. Don't take any chances, have your doctor check minor skin problems or areas of redness before they turn into larger problems. 

4.      Keep pressure off the wound as it heals. For example, if your wound is on the bottom of the foot, a common place for diabetic people to develop calluses and blisters, stay off it as much as possible so it will have a better chance to heal.

Treat diabetic wounds with potion21 

If you get the wound in spite of the precautions, the Malaysian herbal treatment known as potion21 is known to produce positive results faster that most known treatments for diabetic wounds. Please find out from here  how users have benefited from this product that doctors say is a product that science cannot explain how it works.

Diabetic Wound

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What is a Diabetic Foot Ulcer?

A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot in approximately 15 percent of patients with diabetes. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication.

Diabetes is the leading cause of non-traumatic lower extremity amputations in the World, and approximately 14 to 24 percent of patients with diabetes who develop a foot ulcer have an amputation. Research, however, has shown that the development of a foot ulcer is preventable.
     

Who Can Get a Diabetic Foot Ulcer?

Anyone who has diabetes can develop a foot ulcer.  People who use insulin are at a higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease.  Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers. 

Avoid amputation with the prevention and early treatment of skin sores.

Every 30 seconds, somewhere in the world, someone loses a lower limb as a result of diabetes. That is because diabetes and wounds are a dangerous combination.

If you have diabetes, there is no such thing as a minor wound to the foot -- even a small foot sore can turn into an ulcer that, if not properly treated, can lead to amputation. The rate of amputation for people with diabetes is 10 times higher than for those who don't have the disease. 

The Basics of a healthy diet for a diabetic person

Contrary to what you may have heard, there is no "diabetes diet," per se -- and that's good news! The foods recommended for a diabetes diet to control blood glucose (or blood sugar) are good for those with diabetes -- and everyone else. This means that you and your family can eat the same healthy foods at mealtime. However, for people with diabetes, the total amounts of carbohydrates consumed each day must be monitored carefully. Of the different components of nutrition -- carbohydrates, fats, and proteins -- carbohydrates have the greatest influence on blood sugar levels. Most people with diabetes also have to monitor total fat consumption and protein intake, too.

To keep your blood sugar levels in check, you need to make healthy food choices,exercise regularly, and take the medicines your health care provider prescribes. A dietitian can provide in-depth nutrition education to help you develop a personalized meal plan that fits your lifestyle and activity level, and meets your medical needs.

Generally speaking there are about 21 types of skin-based problems. They are acne, bedsores, blocked nose, burns, cold sores, diabetic sores, genital rashes, infected wound, mouth ulcer, sinusitis, skin rashes and sore throat to mention but a few. And Potion 21 can effectively treat all of them. Nutri Huang guarantees this fact.
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Diabetic wounds treatment with potion21

Potion 21 is a Malaysian Nutri huang's product marketed online worldwide. It treats 21 types of skin-based problems like diabetic wound. Spray onto the affected area. Do not bandage the wound because each time you peel off the bandage you do more damage to the wound. The Holistic properties in this product gives it the potency to clear the wound completely after a short time after commencement of use. These properties are:

1. Analgesic: it relieves the pain
2. Anti-inflammatory: reduce swelling of the wound
3. Anti-histaminic: control the release of histamines within the skin
4. Anti-exudates: prevent the production of skin fluid to allow the wound to dry faster
5. Antipruritic properties: controls / stop itch
6. Antibiotic: cleanse the skin of harmful bacteria and virus
7. Anti-toxin: it neutralizes poison produced by the decaying tissue , bacteria or virus
8. A skin surface cleanser
9. Promotes micro blood circulation to bring efficient cell and tissue regeneration to quickly dry up the wound

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