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Diabetes: The Silent Epidemic

~by Jo Jordan

Toes are sawed off. Kidneys fail. Organ transplantation and dialysis become the only options for survival. Nerve damage, stroke, and heart disease wreck havoc on the body; daily life becomes a grueling struggle.

This is the fallout from diabetes. And, according to the experts, this thriving epidemic will only get worse.

In 2006, The New York Times reported that nearly half the patients at the Montefiore Medical Center in the Bronx were there as a result of diabetes-related complications. That year, one in eight New Yorkers – 800,000 – had diabetes.1 And according to the Centers for Disease Control (CDC), nearly twenty-four million Americans had diabetes in 2007; about one quarter (or 5.7 million) didn’t even know they had the disease.2

Diabetes Stats

  • The CDC says one in three American children born in 2000 are expected to become diabetic.3
  • Type 2 diabetes – almost unheard of twenty years ago – is showing up in children at an alarming rate.
  • The American Diabetes Association says that for the first time in over a century the average life expectancy for Americans may have decreased because of diabetes.


What is Diabetes?

Also known as adult onset diabetes, non-insulin dependent diabetes, and sugar diabetes, this disease is a disorder of metabolism (the mechanism by which we use the glucose from digested food for growth and energy).

Diabetics are unable to produce or properly use insulin – a hormone produced by the pancreas that unlocks the cells of the body, enabling glucose to enter and fuel them – so glucose accumulates in the blood, overflows into the urine, and is excreted from the body in urine. The end result is a loss of the body’s main fuel source.

A diet replete in the sugars and fats – staples of the processed food industry – a Super-Size-Me culture that promotes overeating via 20,000 hours of commercials4 for junk food while at the same time discouraging activity and exercise, and an aging population all contribute to this growing epidemic.

Fifty-seven million Americans are pre-diabetic with highly elevated blood sugar levels yet, oddly, national health authorities have ignored this chronic illness5.

The exact cause of diabetes remains a mystery, although both genetics and environmental factors such as obesity and lack of exercise are key players.

While inheriting diabetes doesn’t occur in a straightforward pattern, some people are genetically more likely to contract diabetes than others – for example, people who’ve inherited risk factors from both parents is predominant with type 1, and a strong family history of type 2 is a prevalent risk factor for Americans and Europeans. Type 1 and type 2 diabetes have different causes, but two factors are vital: an inherited predisposition to the diabetes and an environmental trigger.


Four Types of Diabetes

1. Pre-Diabetes

Also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), pre-diabetes is a condition that occurs when blood glucose levels are higher than normal, but not high enough to warrant a diabetes diagnosis. Pre-diabetes raises the risk of developing type 2 diabetes, heart disease, and stroke. Within ten years, many with pre-diabetes go on to develop type 2 diabetes.

Signs and Symptoms of Pre-Diabetes

  • Blurred vision
  • Constant hunger
  • Frequent bladder infections or dysfunction
  • Frequent gum or skin infections
  • Frequent vaginal infections
  • Loss of feeling in hands or feet
  • Slow healing of cuts and wounds
  • Symptoms of flu including weakness and fatigue
  • Tingling in hands or feet
  • Unexpected weight gain
  • Unexplained weight loss


2. Gestational Diabetes

In the United States, three to eight percent of pregnant women develop gestational diabetes during pregnancy.6 The disease is triggered by pregnancy hormones or a shortage of insulin.

While gestational diabetes usually disappears once the mother has given birth, five to ten percent of sufferers develop type 2 diabetes immediately after delivery.7 Women with gestational diabetes are forty to sixty percent likely to develop type 2 diabetes five to ten years after pregnancy.8

Signs and Symptoms of Gestational Diabetes

  • Blurred vision
  • Fatigue
  • Frequent infections of bladder, skin, and vagina
  • Frequent urination
  • Nausea
  • Sugar in urine (can be confirmed by a simple test performed by your health car provider)
  • Unusual thirst

Predisposition:

  • A family history of diabetes, especially on mother’s side
  • Older mothers
  • Overweight women
  • More prevalent in certain ethnic groups
Complications:

...that may affect your baby:
  • Excess growth
  • Jaundice
  • Low blood sugar
  • Major birth defects
  • Respiratory distress syndrome
  • Type 2 diabetes later in life
...that may affect you:
  • Increased risk of pre-eclampsia
  • More likely to have gestational diabetes with subsequent pregnancies
  • More likely to develop type 2 diabetes as you get older
  • Spontaneous abortions

Prognosis: Physical activity and striving for a healthy body weight may prevent the onset of type 2 diabetes.


3. Type 1 Diabetes

An autoimmune disease, type 1 diabetes causes the immune system to attack and destroy the pancreas’s insulin-producing beta cells. As a result, the body produces little or no insulin, and must have insulin each day in order to stay alive.

Type 1 diabetes – also known as juvenile or insulin-dependent diabetes – accounts for five to ten percent of diagnosed diabetes cases in the United States, developing most often in children and young adults.

Signs and Symptoms of Type 1 Diabetes

  • Blurred vision
  • Extreme hunger
  • Fatigue
  • Frequent urination
  • Increased thirst
  • Weight loss

Predisposition and Triggers:

  • Autoimmune factors (the immune system attacks and destroys the insulin-producing beta cells in the pancreas, decreasing insulin production)
  • Cold weather may be a trigger
  • Early diet – type 1 diabetes is less common in people who were breastfed
  • Genetics – risk factors normally inherited from both parents
  • Injury to the pancreas from toxins, trauma, or after the surgical removal of the majority (or all) of the pancreas (very rare)
  • May follow a viral infection such as cytomegalovirus, encephalitis, Epstein-Barr virus, mumps, influenza, measles, polio, or rubella
  • Occurs equally among females and males; more common in whites; can occur at any age, but more likely to develop in children
  • Presence of certain blood auto-antibodies years prior to onset
Short-term complications:

Left untreated, these conditions can cause seizures and coma:
  • Diabetic ketoacidosis (increased organic compounds [aka ketones] in your urine)
  • High blood sugar (hyperglycemia)
  • Low blood sugar (hypoglycemia)
Long-term complications:
  • Eye damage
  • Foot damage
  • Heart and blood vessel disease (adult diabetics have heart disease death rates two to four times higher than those without14)
  • Kidney damage (nephropathy) and disease (diabetes is the leading cause of kidney failure)
  • Nerve damage (neuropathy) (i.e. stomach nerve damage such as gastroparesis)
  • Osteoporosis
  • Skin and mouth conditions (i.e. bacterial and fungal infections, itching, and gum infections and disease)

Prognosis: Many major organs are at risk of being negatively affected by type 1 diabetes. However, maintaining a normal blood sugar level as often as possible dramatically reduces the risk of complications.


4. Type 2 Diabetes

Type 2 diabetes sufferers are unable to use insulin well, a condition known as insulin-resistance. Onset of type 2 diabetes – the most common form of the disease – is gradual. While function diminishes, when initially diagnosed the pancreas is often producing insulin in adequate amounts; however, for reasons that aren’t understood, the body cannot use it properly, and the resulting build-up of blood glucose leaves the body unable to use its own fuel.

Also known as adult-onset or non-insulin-dependent diabetes, type 2 diabetes – a potentially life threatening disease – accounts for ninety to ninety-five percent of diabetes cases in America. Approximately eighty percent of type 2 diabetes sufferers are overweight.9

Signs and Symptoms of Type 2 Diabetes

  • Blurred vision
  • Extreme hunger
  • Fatigue
  • Frequent urination
  • Increased thirst
  • Slow-healing sores or frequent infections
  • Weight loss
Predisposition
  • A stronger genetic basis than type 1
  • Family history of type 2 diabetes is a strong risk factor for Americans and Europeans (linked to too much fat, and too little carbohydrates, fiber, and exercise)
  • High caloric intake
  • More common in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanics/Latinos10
  • More common in older people, especially the overweight
  • More dependent on environmental factors than type 1
  • Obesity is a strong risk factor for type 2 diabetes, especially for youth and for those who’ve long been obese
  • Physical inactivity
  • Possible incomplete islet cell destruction (twenty percent of people with type 2 diabetes have antibodies to islet cells resulting in low levels of insulin)11
  • Previous history of gestational diabetes
Complications:

Left untreated, these conditions can cause seizures and coma:
  • Diabetic ketoacidosis (increased organic compounds [aka ketones] in your urine)
  • High blood sugar (hyperglycemia)
  • Low blood sugar (hypoglycemia)
Long-term complications:
  • Alzheimer's disease
  • Eye damage
  • Foot damage
  • Heart and blood vessel disease (i.e. peripheral artery disease, PAD)
  • Kidney damage (nephropathy)
  • Nerve damage (neuropathy) (i.e. stomach nerve damage such as gastroparesis)
  • Osteoporosis
  • Skin and mouth conditions (i.e. bacterial and fungal infections, itching, and gum infections)

Prognosis: The outcome for type 1 and 2 diabetics varies. With proper treatment, sufferers can live long, healthy lives. Careful control of blood glucose can prevent or delay complications to the eyes, kidneys, and nervous system. However, problems may arise even with good diabetes control.

The early detection of symptoms can reduce the risk of developing complications from diabetes. Symptoms of type 1 diabetes tend to appear suddenly, while those of type 2 diabetes develop gradually. Some people have no symptoms whatsoever.


Diagnosing Diabetes

  • Methods for diagnosing diabetes include the Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). The American Diabetes Association recommends the FPG as it’s quick, easy, and inexpensive to conduct.

  • If you’re forty-five or older – especially if you’re overweight – the American Diabetes Association strongly recommends blood glucose screening.

  • The CDC projects the prevalence of diagnosed diabetes in the United States to increase 165 percent by 2050.12


Other Complications from Diabetes

Many people are unaware that they have diabetes until a complication develops. Diabetes complications are numerous, varied, sometimes extremely frightening, and can be life-threatening.

  • Amputations (71,000 lower-limb amputations were performed in 2004 on people with diabetes13)
  • Arteriosclerosis/atherosclerosis (a hardening of medium and large arteries)
  • Blindness (the leading cause of new cases of blindness in adults twenty to seventy-four years of age14)
  • Bone and joint problems
  • Diabetic hyperosmolar syndrome (a diabetic coma caused by extremely high blood glucose levels)
  • Diabetic ketoacidosis (a dangerous complication in which the chemical balance of the body becomes exceedingly acidic)
  • Diabetic retinopathy (damage to the retina in the eyes)
  • High blood pressure(hypertension) (seventy-three percent adult diabetics have high blood pressure15)
  • Leg swelling
  • Liver disease (nonalcoholic fatty liver disease [NAFLD], nonalcoholic cirrhosis; conditions related to diabetes such as high cholesterol and obesity increase the risk of NAFLD)
  • Obesity
  • Sexual problems (male: erectile dysfunction and retrograde ejaculation; female: decreased vaginal lubrication and decreased or absent sexual response)
  • Stroke (risk is two to four times higher, and death risk from stroke 2.8 times higher among diabetics17)
People with diabetes are more vulnerable than those without to a range of other illnesses, and their prognosis – once ill – is far worse. A diabetic is more likely to die, for example, from the flu or pneumonia than a non-diabetic.

A new report by the University Medical Centre in Rotterdam, Netherlands, indicates that over the age of 50, diabetic men and women have a shorter lifespan by up to seven years.


Is There a Solution? Can Diabetes Be Cured?

There has been talk in the news recently about a cure for diabetes. An artificial pancreas would put an end to the tyranny of daily injections and hormone dependency. However, while the world is on the brink of a first-generation artificial pancreas that would continuously sensor glucose levels, this breakthrough technology is years from being available.

Currently, there is no cure for diabetes. It can, however, be avoided in some cases through prevention and – after onset – managed through diet, exercise, and treatment.


Six Steps To Diabetes Prevention and Management

Much can be done to delay or prevent diabetes altogether. If you have pre-diabetes, you can reduce the risk of diabetes onset through diet and increased physical activity (two and a half hours a week) by losing five to seven percent of your body weight.

Research illustrates this type of weight loss lowers the incidence of type 2 diabetes by nearly sixty percent.18

Prevention is also vital if you're at high risk for developing type 2 diabetes because of a family history of the disease, or if you’re overweight.

Step 1: Multi-vitamin Supplementation

Various minerals and vitamins affect insulin function and the metabolizing of glucose.19 Research shows that large percent of people who have diabetes are dangerously deficient in nutrients and micronutrients.20

Multi-vitamin supplementation can fill in the nutritional gaps commonly present in pre-diabetics and diabetics. Look for a multi-vitamin that contains,


Step 2: Adequate Fiber Intake

Sufficient fiber intake may reduce diabetes risk by improving blood sugar control, and promoting weight loss. Adequate fiber levels are also linked to decreasing heart disease risk. High-fiber foods include beans, fruits, nuts, seeds, vegetables, and whole grains.21


Step 3: Shed Excess Weight

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For those who are overweight, diabetes prevention could depend on shedding a few pounds. One study determined that overweight adults who lost just five to ten percent of their body weight decreased the risk of diabetes onset by fifty-eight percent over three years.22


Step 4: Whole Grains and Healthier Choices

Whole grains are believed to decrease the risk of diabetes because they help maintain healthy blood sugar levels. Foods made from whole grains include breads, cereals, and pasta products. Check the label to ensure wheat content is whole grain.

Dieting or cutting out whole foods groups such as carbohydrates may result in nutritional deficiencies. Instead of dieting, it’s best to implement portion control, and the incorporation of a variety of foods that will promote overall health.


Step 5: Physical Activity

Research illustrates that regular exercise and weight loss substantially decreases the risk for onset of diabetes. To help maintain healthy blood sugar levels, physical activity is a must. Adequate exercise also increases the body’s sensitivity to insulin.


Step 6: Internal Cleansing

A great way to kick start your six steps is with a colon and liver cleanse. If you are overweight, odds are you do not have regular bowel movements and you have low energy. It’s been suggested that the average person has between five and twenty-five pounds of waste trapped or slowly moving through their colon. Cleanse your colon of this waste and speed up your bowel transit time, and you’ll be well on your way to shedding those unwanted pounds and boosting your energy levels.

Choosing the right program is the key if you have diabetes. The Puristat Cleansing Programs include colon cleanses, liver cleanses, dietary modifications, and a digestive wellness oriented multi-vitamin – just what the diabetes doctor ordered! Take the Puristat Colon Health Assessment Test to determine which program is right for you.


Diabetes Management and Treatment

While insulin was the first breakthrough in treatment, it is not a cure for diabetes.

  • Healthy eating, physical activity, and insulin therapy are the three basic treatments for type 1 diabetes.
  • Healthy eating, physical activity, and blood glucose testing are the steps for managing type 2 diabetes. Some type 2 diabetes sufferers may also require various medications and insulin to control blood glucose levels.

If blood glucose levels drop too low, hypoglycemia can cause a person to become confused, nervous, and shaky. Fainting and impaired judgment can follow.

blood glucose levels rise too high, hyperglycemia can result in dehydration, ketoacidosis, testicular dysfunction, reduced fertility potential, and various other health problems.

It is also important to manage blood pressure and cholesterol levels through diet, exercise, and – in some cases – various medications.


Advances in Management and Treatment of Diabetes

Recent advances in treatment and technology help to minimize the severity of the disease and the risk of complications, as well as maximize the ability to lead a comfortable, healthy life in spite of having diabetes.

  • Controlling blood pressure decreases heart disease and stroke risk in people with diabetes by thirty-three to fifty percent; risk of eye, kidney, and nerve diseases by about thirty-three percent23
  • External insulin pumps can often replace daily injections
  • Foot care programs including regular examinations and patient education may prevent up to eighty-five percent of diabetes-related amputations24
  • Pancreas and kidney transplantation in people whose kidneys fail because of diabetes are viable solutions
  • Laser treatment for diabetic eye disease reduces the risk of blindness by fifty to sixty percent
  • More effective ways to monitor blood glucose, including self-monitoring, are now available
  • New drugs to treat types 1 and 2 diabetes and better ways to manage this form of diabetes through weight control are now recommended
  • Quick-acting, long-acting, and inhaled insulins are available
Research has shown that proper management of blood glucose levels reduces the likelihood and may even prevent the development of complications from diabetes. It has also been discovered that two types of antihypertensive drugs – ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) – are more effective than other antihypertensive drugs in minimizing reduced kidney function in diabetics.26

 



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Notes:
1. N.R. Kleinfield, “Diabetes and Its Awful Toll Quietly Emerge as a Crisis,” The New York Times, January 9, 2006, http://query.nytimes.com/gst/fullpage.html?sec=health&res=9907E2DA1F30F93AA35752C0A9609C8B63 (accessed April 1, 2009).
2. Centers for Disease Control and Prevention (CDC), “November is American Diabetes Month,” http://www.cdc.gov/Features/LivingWithDiabetes/ (accessed April 1, 2009).
3. Centers for Disease Control and Prevention (CDC), “Preventing Diabetes and Its Complications,” http://www.cdc.gov/nccdphp/publications/factsheets/prevention/diabetes.htm (accessed April 1, 2009).
4. N.R. Kleinfield, “Diabetes and Its Awful Toll Quietly Emerge as a Crisis,” The New York Times, January 9, 2006, http://query.nytimes.com/gst/fullpage.html?res=9907E2DA1F30F93AA35752C0A9609C8B63&sec=health&spon=&pagewanted=2 (accessed April 1, 2009).
5. Centers for Disease Control and Prevention (CDC), “Preventing Diabetes and Its Complications,” http://www.cdc.gov/nccdphp/publications/factsheets/prevention/diabetes.htm (accessed April 1, 2009).
6. National Diabetes Information Clearinghouse (NDIC), “Diabetes Overview,” http://diabetes.niddk.nih.gov/dm/pubs/overview/ (accessed April 1, 2009).
7. American Diabetes Association, “All About Diabetes,” http://www.diabetes.org/about-diabetes.jsp (accessed April 1, 2009).
8. National Diabetes Information Clearinghouse (NDIC), “Diabetes Overview,” http://diabetes.niddk.nih.gov/dm/pubs/overview/ (accessed April 1, 2009).
9. LNational Diabetes Information Clearinghouse (NDIC), “Diabetes Overview,” http://diabetes.niddk.nih.gov/dm/pubs/overview/ (accessed April 1, 2009).
10. Ibid
11. National Diabetes Information Clearinghouse (NDIC), “Diabetes Overview,” http://diabetes.niddk.nih.gov/dm/pubs/overview/ (accessed April 1, 2009).
12. Endocrineweb.com, “Symptoms, Diagnosis, & Treatments of Type 2 Diabetes,” http://www.endocrineweb.com/diabetes/2diabetes.html (accessed April 1, 2009).
13. American Diabetes Association, “Complications of Diabetes in the United States,” http://www.diabetes.org/diabetes-statistics/complications.jsp (accessed April 1, 2009).
14. Ibid
15. Ibid
17. Ibid
18. National Diabetes Information Clearinghouse (NDIC), “Diabetes Overview,” http://diabetes.niddk.nih.gov/dm/pubs/overview/ (accessed April 1, 2009).
19. Tufts Ebcam: Tufts University Program in Evidence-based Complementary and Alternative Medicine, “Multivitamins and Type 2 Diabetes,” http://www.tufts.edu/med/ebcam/nutrition/multi-diabetes.html (accessed April 1, 2009).
21. Melissa Diane Smith, “The Importance of a Daily Multivitamin and Mineral Supplement For People with Diabetes and Prediabetes,” Diabetes in Control.com, June 21, 2005, Issue 26, http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=2865 (accessed April 1, 2009).
22. Mayo Foundation for Medical Education and Research (MFMER), “Diabetes: Prevention,” http://www.mayoclinic.com/health/diabetes/DA99999 / (accessed April 1, 2009).
23. Mayo Foundation for Medical Education and Research (MFMER), “Diabetes prevention: 5 tips for taking control,” http://www.mayoclinic.com/health/diabetes-prevention/DA00127 (accessed April 1, 2009).
24. Centers for Disease Control and Prevention (CDC), “Preventing Diabetes and Its Complications,” http://www.cdc.gov/nccdphp/publications/factsheets/prevention/diabetes.htm (accessed April 1, 2009).
25. Ibid
26. National Diabetes Information Clearinghouse (NDIC), “Diabetes Overview,” http://diabetes.niddk.nih.gov/dm/pubs/overview/ (accessed April 1, 2009).

 
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