Islets of Hope for persons with type 2 diabetes
Article by Lahle Wolfe, Founder, Islets of Hope.
See "Treatment" for more information about insulin, shots, and insulin pumps.
Life Without Bread
First Sentence: CONTRARY TO CURRENT POPULAR WISDOM, it is carbohydrates, not fat, that contribute to many dietary related diseases.
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RESOURCE LINKS FOR
American Association for Clinical Chemistry
American Association for Clinical Chemistry
National Diabetes Clearinghouse Information
National Institutes of Health
RESOURCE LINKS FOR
All About Diabetes (ADA)
Center for Disease Control (CDC) Diabetes Public Health Resource
Center for Disease Control (CDC) Frequently Asked Questions About Diabetes
Food and Drug Administration (FDA) Diabetes Information
Islets of Information
Type 2 diabetes is the most common form of diabetes-- affects an estimated 15 million Americans. It most often occurs in people over age 45, but has been diagnosed even in children. Left untreated, it can lead to serious health compli- cations including blindness, heart disease, stroke, kidney failure and limb amputation. All told, diabetes consumes $98 billion in US health care dollars annually.
Diabetes, which is the sixth highest cause of death by disease in the United States, strikes an estimated 16 million Americans -- 90 to 95% of whom have type 2 diabetes. Type 2 is one of the most costly health problems in America due to is devestating complications. It is the leading cuase of adult blindness, kidney failure, and non-traumatic loss of limb (amputation) in the US.
Diabetes is a chronic disease characterised by high blood sugar levels that result from defects in the body's ability to use and/or produce insulin. There are two main types of diabetes: type 1 and type 2. People with type 1 diabetes are usually diagnosed when they are children or young adults. In type 1 diabetes, the pancreas makes little or no insulin, so patients must test their blood sugar and inject insulin every day. In type 2 diabetes, the pancreas continues to produce insulin, but the body inefficiently uses the insulin. Many patients with type 2 diabetes will eventually require insulin injections.
Did you know? Type 2 diabetes is the most common form of diabetes, afflicting men, women, and children. Once, type 2 was most commonly seen in older persons. Now, the rate of diabetes type 2 in children has reached epidemic proportion.
M. Sarah Rosenthal
Dr. David Nathan
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Type 2 Diabetes - Section 1
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With type 2 diabetes the pancreas may not make sufficient insulin (which may result in weight loss), or the body is resistant to the insulin it does produce (which may result in weight gain). Blood glucose levels become too high when there is not enough insulin present in the body, or, it cannot be properly used by the body. The overworked pancreas may eventually stop producing enough insulin and the person with type 2 diabetes may need to take daily injections of insulin.
A carefully controlled lifestyle for type 2 diabetes (including a diet of low glycemic, healthy carbohydrates high in fiber, low in fat, and plenty of exercise) may be enough to manage the disease but oral medications are also used to treat type 2 diabetes.
What is Type 2 Diabetes?
Type 2 diabetes is an autoimmune disease. An autoimmune disease is when the body attacks and destroys good cells and tissues mistaking them as foreign intruders. With type 2 diabetes the insulin-producing beta-cells in the pancreas either do not make enough insulin, or, the person with type 2 is not sensitive to the insulin produced (insulin resistant). Over time, the pancreas may wear out and stop producing insulin altogether. If this happens, a person will be required to inject insulin each day to live.
Diabetes is a disease, not a syndrome (like insulin resistance syndrome) so to be diagnosed as diabetic a person must meet all of certain diagnostic criteria. A syndrome, such as in Metabolic Syndrome (sometimes referred to as Syndrome X), or another autoimmune disorder, polycystic ovarian syndrome (PCOS) has multiple symptoms. To be diagnosed with a syndrome a person can have some (not all) of the symptoms associated with the particular disorder.
Included in the list of problems with PCOS are diabetes and insulin resistance, but PCOS itself is not diabetes. Two other common disorders that are often seen in diabetics are Hashimoto’s Thyroiditis and celiac’s disease. Anyone diagnosed with type 2 diabetes should also consider being tested for these autoimmune disorders as well.
Diagnostic Criteria for Type 2 Diabetes
For information about diagnosing diabetes in easy-to-read chart format:
A person with two fasting plasma glucose levels of 126 mg per dL (7.0 mmol per L) or greater is considered to have diabetes mellitus. Some doctors may use a 2-hour postprandial (2 hours after eating) oral glucose tolerance test (OGTT) instead of the fasting test. The OGTT measures blood glucose 2 hours after 75 g of glucose is given. Any 2-hour postprandial reading over 200 is considered diabetic. And, any two casual readings of 200 mg/dL or higher is also considered diabetic.
Remember, the while fasting glucose tolerance tests are preferred for diagnosis, any two abnormal tests are sufficient to classify a person as diabetic. Additionally:
Current research indicates that people with type 2 have inherited a genetic predisposition to developing diabetes. Diabetes may then be triggered by virus, chemical, or environmental factors. But the most commonly associated (and controllable) trigger for type 2 diabetes is lifestyle -- poor eating habits and a sedentary lifestyle are both major contributing factors in onset of type 2 diabetes.
What is considered to be normal blood sugar ranges?
What if you are not in the normal range, but not in the diabetic range?
Blood glucose levels higher than normal, but lower than diabetic ranges, classify a person as having impaired glucose homeostasis, specifically as follows:
Both IFG and IGT are associated with an increased risk in developing type 2 diabetes and may classify a person as being pre-diabetic. Although there is no cure for type 1 or type 2 diabetes, pre-diabetes may be completely reversed if properly treated. Lifestyle changes, including weight loss and an exercise program, as well as possible oral medications such as Glucophage may prevent onset of type 2 diabetes.
Genetics and The Environment:
The two main types of diabetes are type 1 and type 2. They have different causes and require different treatment approaches but both have a strong a genetic factor involved. With both types of diabetes you can inherent the predisposition for diabetes and second, something in the environment must trigger the disease. With type 2 diabetes the environmental trigger is usually poor diet and a sedentary lifestyle.
Twin studies show that genetic predisposition to diabetes is not enough to become diabetic. Only half of identical twins with a diabetic twin sibling will also become type 1 diabetic. However, the likelihood of an identical twin developing type 2 diabetes when a twin sibling has type 2 is much greater, with about a 75% chance of type 2 onset.
Daily Concerns With Type 2 Diabetes
Type 2 diabetes must be managed on a daily basis. This includes monitoring blood glucose, following a healthy lifestyle including a food and exercise plan, testing urine for ketones, and most importantly, thinking long term. How you manage your diabetes on a daily basis will have tremendous impact on health years down the road.
Daily concerns of type 2 diabetes include watching for, and dealing with, hypoglycemia (low blood glucose), and hyperglycemia. Both can present dangerous situations immediately, on unchecked, can also present possibility of long-term complications as well. The likelihood of hypoglycemia in type 2 diabetes increases when a person is taking oral diabetes medications or insulin.
Hypoglycemia (think "O" is in too low) is when blood glucose becomes too low to be healthy or safe. Your doctor should help you determine what constitutes a mild versus a severe low. In children, a serious low may be anything below 70 mg/dL, while an adult might not be considered critical until experiencing a low blood glucose reading of 50 mg/dl.
What is considered low varies between individuals as well as time of day, when insulin was last administered, and level of activity. Medically speaking, a reading of 40 mg/dl or lower is always considered critical for anyone with diabetes. If blood glucose becomes too low a person becomes disoriented, may experience seizures, loss of consciousness, coma, and even death. See "Hypoglycemia" for symptoms, causes, treatment, and prevention of low blood glucose.
Hyperglycemia (think hyper as in too active, too much) is too much blood glucose in the blood stream. See "Hyperglycemia" for symptoms, causes, treatment, and prevention of low blood glucose.
Long-Term Complications of Diabetes
Complications of diabetes are grim and include heart disease, blindness, high blood pressure, nerve damage, diabetic retinopathy (which can lead to blindness), amputation, and kidney failure. But it is possible to maintain tight control over diabetes and help reduce the risk of long-term complications. High blood glucose over time destroys nerves (neuropathy) and tissues (see image below). Blood glucose kept in good target ranges will help preserve organs, eyesight and improve longevity. To better understand why it is important to test your blood glucose often (read diabetes statistics).
Important Medical Disclaimer
This site contains information for your personal enrichment, but should not be used for self- diagnosis or self-treatment. We highly recommends you seek the advice of a medical professional for diagnosis and treatment options, or, before making any changes to your diabetes care plan.
Page Updated 04/04/2006