WHAT IS DIABETES

Diabetes is a malfunction in the body's ability to convert (carbohydrates)
sweets and starchy foods, such as fruits, breads and vegetables--into enegy to power the body. The medical term for this is diabetes mellitus meaning "honey-sweet
diabetes". Diabetes is characterized by abnormally high and persistant concentration of sugar in the bloodstream. Other characteristics are sugar in the urine, excessive urine production, unusual thirst and hunger. People affected with diabetes require life long medical care to control the disease.

Carbohydrates are a problem not so much for the carbohydrates per se, but the way the body uses then to create energy.The progess of converting food into energy is called metabolism. Thus diabetes mellitus is a metabolic system disorder.

In a normal body, carbohydrates are converted to glusose and other simple sugars in the stomach and small intestines. Glucose moves from these organs into the veins. The blood circulates glucose through the body, where it goes to the liver, muscle and fat cells to be stored for later use or for immediate energy. In other words glucose enters body cells, powering the muscles, heart and brain, assisting the body in maintaining a
constant temperature. A body of a person with diabetes also convert carbohydrates to sugars and sends them into the blood. At this point the system comes to a crashing halt. The glucose is unable to enter the cells. The reason for this has to do with insulin, a hormone that enables the body to burn carbohydrates. Insulin comes from the pancreas, the gland located behind the stomach. In healthy people the pancreas secretes many fluids, including Insulin. In a person with diabetes, one of two things happens: No insulin - or not enough insulin is being produced OR what the pancreas does produce is not functioning properly. In either case, the system has gone awry, the end result is that glucose remains in the blood and cannot be processed as energy.

Insulin is important. The hormone enables the cells to absorb glucose for use as energy. Without it a "glucose glut" eventually results - high levels of unused blood sugar are trapped in the bloodstream. As sugar builds in the blood stream, the kidneys try to pump it out. To eliminate the sugar, the kidneys must dissolve it. The more sugar there is to eliminate the more urine that must be passed. This leads to frequent urinations, increased thirst and dehydration. At the same time the kidneys are furiously flushing the system of sugar, the body is seriously low on fuel. The body's cells, unable to burn sugar, begin to use protein and body fat as a source of energy. The breakdown of fats for fuel releases toxic acids called keytones. Eventually the keytones accumulate and at high levels can lead to a condition called Ketoacidosis, which is in effect a poisoning of the system. In extreme cases, this can cause unconsciousness or diabetic coma.

Type I Diabetes commonly called juvenile onset. They must have insulin to live. Their bodies can not produce insulin becuase their beta cells have been irrevocabl destroyed. They are life dependent on insulin injections and must watch their diet as any diabetic must. Type II diabetes is commonly referred to as adult onset and while they may eventually become insulin dependent, most can control their sugar levels through some combination of drugs, weight loss, diet and exercise.

WHAT YOU NEED TO DO

You begin by understanding TYPE I Diabetes and what you need to understand about the ways in which insulin, food and exercise affect blood sugar. If you have TYPE II Diabetes yo need to understand the role of obesity, exercise and food consumption in insulin resistence. The last two things are more than a matter of looking good - they're about making it easier for your body to produce and use insulin.The fact of the matter remains (in all types of diabetes) the same. Managing your diabetes is demanding and at all times, difficult. It is a daily, lifelong process. (Gestational diabetes (diabetes in pregnancy) is usually only present during pregnancy and may not be present after delivery)

Diabetics must monitor their blood sugar which is done by poking the finger, using the drop of blood on a test strip and putting the strip in a machine to give you the reading. This is called a glucose meter and is about the size of a hand calculator. You also need to do frequent testing of urine for glucose, protein and keytones (sometimes called acetones). This is also done by self reading test strips. Your Doctor will discuss with you the frequency of the testing.

Nutrition is important since diabetes is basically a misfunction of the body's ability to use food as energy. The kinds of food a person eats will influence the course of the disease.That is why people with diabetes are often referred to a dietitian for assistance in analyzing their eating habits and forging better eating plans. You need to eat well, following sound nutritional principles. You will have to make some adjustments in how much you eat, how often you eat and in what you eat. Food's consist of proteins, fats and carbohydrates (simple and complex). Generally American Diabetes Association suggest that 15-20 percent of total calories come from proteins., around 30 percent or less from fats and 55-60 percent from carbohydrates. Fiber should range between 25 percent for women to 40 percent for men.

The basic nutritional principles apply to all types of diabetes, so the foods remain the same. However, the goals of the diet therapy differ. People with TYPE I follow a simple formula. Eating increases blood sugar, exercise and insulin lower blood sugar. For that reason they are very concerned about the timing of their meals. Meals and snacks MUST be coordinated with insulin injections and exercise so that blood sugar remains within target levels. People with TYPE II MUST remember that eating increased blood sugar and that consuming a lot of calories at one time overwhelms the body's limited ability to use insulin efficiently. This limited ability of insulin resistence seems to be triggered or intensified by obesity. Most people with Type II are overweight. Their diet goals center on reducing food consumption (which reduces insulin demands on the body) and losing weigh (which enables what insulin is present to operate more efficiently). Since food intake affect blood glucose, both groups should take care NOT to make any major changes to their diets WITHOUT CONSULTING THEIR PHYSICIAN.

SIMPLE CARBOHYDRATES are ones that can be quickly converted into glucose. It also causes a swift rise in blood glucose levels. Simple carbohydrates are often called simple sugars. They include soft drinks, candy and sugars (table, granlated, brown sugar and molasses and so forth). For many diabetics sugar (in MODERATION) is not necessarily taboo. Research shows that sugar intake by itself doesn't govern blood-glucose levels. For example one recent study found that some type I diabetes could eat two snacks a day withat contain some sugar. There are very effective sugar substitutes on the market today. Saccharin and Aspartame are both valid substitutes.

COMPLEX CARBOHYDRATES: Because of their cellular structure is more complex, these carbohydrates take longer to be broken down and absorbed into the blood stream. Thus complex carbohydrates don't increase blood-sugar levels as rapidly as simple carbohydrates. Complex carbohydrates include legumes (beans and peas), grains (like rice), breads, pastas, fruit and starchy vegetables. The best carbohydrates, according to recent research are those that contain a lot of fiber. General theory is that diets high in carbohydrates (especially complex ones) makes it difficult to attain normal blood-sugar levels for several hours after eating and the goal is to keep the levels normal at all points in the day. (Most Doctor's expect and accept a highter level postprandial or after meal blood-sugr levels).

In general the goal of the type II diabetic is to reduce food intake. The reason is simple. The more food you eat, the greater the demand for insulin. The amount you eat depends on your age, height, sex and the amount of exercise you get. Your health care provider or nutritionist can help you map out the best plan for you. Also the American Diabetic Association can provide you with excellent information on diets. You can't make the decision alone. Make it in conjunction with your Doctor, "who is your partner in your health care". Always delve into the issues and discuss them with your Doctor. The moral is "speak up and ask questions."

*The contents here are for general information only and are
in no way intended to replace your Doctor, Health Care
Provider or Pharmacist.*