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Diabetes

What is diabetes?
Diabetes is a metabolic abnormality affecting all nutrients, especially the way your body uses blood sugar (glucose), your main source of energy. y Insulin and glucagon, two hormones produced by your pancreas, regulate the amount of glucose in your bloodstream. When a person has diabetes, this process does not function properly.
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³Medical essay: Diabetes.´ Supplement to Mayo Clinic Health Letter. Mayo Clinic. February 2004.

Diabetes
Once, Once, there were two types of diabetes; children mainly got one type and adults mostly got the other. Today, we know that younger people can get type 2 and that type 1 often appears in adulthood. During pregnancy, diabetes, women can get gestational diabetes, which resembles type 2 and usually disappears after childbirth.

Gestational
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During pregnancy, women can get gestational diabetes, which resembles type 2 and usually disappears after childbirth. And scientists have identified several other diabetes subtypes beyond types 1 and 2.

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Latent autoimmune diabetes
The National Institutes of Health (NIDDK) defines LADA as ´a condition in which Type 1 diabetes develops in adults.µ y LADA is a genetically-linked, hereditary autoimmune disorder that results in the body mistaking the pancreas as foreign and responding by attacking and destroying the insulin-producing beta islet cells of the pancreas. Simply stated, autoimmune disorders, including LADA, are an "allergy to self.µ
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LADA (Latent Autoimmune Diabetes in Adults)
The most common of these is called latent autoimmune diabetes in adults (LADA), and it accounts for roughly 10 percent of people with diabetes, making it probably more widespread than type 1.

U.S. statistics
In 2000, 17,702,000 people in the U.S. had diabetes y In 2030, it is projected that 30,312,000 people in the U.S. will have diabetes y More than 20% of Americans 65 and older have diabetes y An estimated 6 million Americans with diabetes do not even know they have it
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³Medical essay: Diabetes.´ Supplement to Mayo Clinic Health Letter. Mayo Clinic. February 2004. Diabetes: Country and regional data. World Health Organization. http://www.who.int/diabetes/facts/world_figures/en/index3.html Accessed 9/5/2006

Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes) BRFSS, 1990,1995 and 2001
1990 1995

2001

No Data

<4%

4%4%-6%

6%-8% 6%-

8%-10% 8%-

>10%

Source: Mokdad, et al. Diabetes Care 2000;23:1278-83; J Am Med Assoc 2001;286:10.

Does diabetes affect you? you?
Or does it affect someone you know? Do you want to know more about it? Can it be prevented - or treated? Let·s take a look!

Complications
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Type I diabetes can affect almost every major organ of your body, including: Heart Blood vessels Nerves Eyes Kidneys

Type I diabetes. Mayo Clinic. http://www.mayoclinic.com/health/type-1-diabetes/DS00329/DSECTION=4 Accessed 9/5/2006

Health problems: Cardiovascular
y

Type II diabetes can cause: Heart attacks x 2-4 times the risk of dying from heart disease Strokes x 2-4 times the risk of stroke High blood pressure x Increase risk several fold

Health problems that diabetes can cause. Harvard Medical School¶s Consumer Health Information. http://www.intelihealth.com/IH/ihtIH/WSIHW000/35072/35073/360341.html?d=dmtContent Accessed 10/3/2006 ³Medical essay: Diabetes.´ Supplement to Mayo Clinic Health Letter. Mayo Clinic. February 2004.

Health problems: Kidneys
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Type II diabetes can cause: Kidney damage (nephropathy) x Signs and symptoms include fatigue, high blood pressure, swollen ankles, feet or hands, shortness of breath, low levels of red blood cells (anemia), and leakage of albumin (a blood protein) into the urine Kidney failure x 40% of people needing dialysis have kidney failure from diabetes

³Medical essay: Diabetes.´ Supplement to Mayo Clinic Health Letter. Mayo Clinic. February 2004. Health problems that diabetes can cause. Harvard Medical School¶s Consumer Health Information. http://www.intelihealth.com/IH/ihtIH/WSIHW000/35072/35073/360341.html?d=dmtContent Accessed 10/3/2006

Health problems: Eyes
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Type II diabetes can cause: Eye Damage x More than 60% of people with Type II diabetes develop deterioration in the blood vessels of the retina x Diabetes increases the risk of developing cataracts and glaucoma Blindness x Diabetes is the most common cause of blindness that starts between ages 20 and 74

³Medical essay: Diabetes.´ Supplement to Mayo Clinic Health Letter. Mayo Clinic. February 2004. Health problems that diabetes can cause. Harvard Medical School¶s Consumer Health Information. http://www.intelihealth.com/IH/ihtIH/WSIHW000/35072/35073/360341.html?d=dmtContent Accessed 10/3/2006

Health problems: Nerves
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Type II diabetes can cause: Peripheral neuropathy x Feet and legs can develop tingling, pain, or a loss of feeling Amputations x Nearly 86,000 amputations are performed every year in the U.S. on diabetics, which accounts for 50% of all amputations in the U.S.

Health problems that diabetes can cause. Harvard Medical School¶s Consumer Health Information. http://www.intelihealth.com/IH/ihtIH/WSIHW000/35072/35073/360341.html?d=dmtContent Accessed 10/3/2006

Health problems
y

Type II diabetes can cause: Sexual-function problems x Impotence Localized nerve failures x Single muscle can lose its function x Problems that may result: xEye movement problems with double vision xDrooping of the cheek or one side of the head (Bell·s palsy)

Health problems that diabetes can cause. Harvard Medical School¶s Consumer Health Information. http://www.intelihealth.com/IH/ihtIH/WSIHW000/35072/35073/360341.html?d=dmtContent Accessed 10/3/2006

Health problems
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Type II diabetes can cause: Stomach and bowel problems x Nausea, constipation, or diarrhea Dizziness when standing x Poor circulation causing low blood pressure and dizziness when standing

Health problems that diabetes can cause. Harvard Medical School¶s Consumer Health Information. http://www.intelihealth.com/IH/ihtIH/WSIHW000/35072/35073/360341.html?d=dmtContent Accessed 10/3/2006

Controllable risks: LDL
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Reduce low-density lipoprotein (LDL) cholesterol in the blood LDL promotes accumulation of fats in the arteries Diet should not include any animal products of any kind Avoid free fats (mayonnaise, oils, margarine, etc.)

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42

Controllable risks: HDL
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Increase high-density lipoprotein (HDL) cholesterol in the blood HDL removes fats from blood and tissues Increased by: x Exercise x Weight reduction x Stopping smoking

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42

Controllable risks: Stress & Hypertension
y

Religious experience Develop a daily program of Bible study and prayer Learn to control thoughts and to dwell on heavenly themes

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 160-163

Controllable risks: Stress & Hypertension
Control talking x Not too much, not too little x Talk only about cheerful subjects x Do not talk about yourself x Do not talk about a single subject

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 160-163

Controllable risks: Stress & Hypertension
Exercise x Start with a graduated exercise program x Take a brisk walk x Hold your head up x Breathe deeply x Maintain good posture x Walk in nature an hour or more each day Do deep breathing exercises

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 160-163

Controllable risks: Stress & Hypertension
Observe strict regularity for meals Omit all evening food Guard against overeating or undereating x Stress increases after too much food Eliminate sugar, honey, coconut, dried or very sweet fruits and vegetables during periods when you are feeling stressed

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 160-163

Controllable risks: Stress & Hypertension
Avoid nerve stimulating or irritating foods x Examples: hot pepper, ginger, cinnamon, cloves, nutmeg, vinegar, anything made with vinegar (pickles, mayonnaise, catsup, mustard, etc.)

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 157-160

Controllable risks: Stress & Hypertension
Avoid foods having a fermenting, putrefying or rotting phase of processing Examples: sauerkraut, cheese, soy sauce and similar products y Eliminate all concentrated foods such as wheat germ, margarine, dried skim milk and all animal products
y
Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 157-160

Controllable risks: Stress & Hypertension
Abstain from baking soda and baking powder products, caffeine and other methyl xanthines such as theophylline and theobromine which are found in coffee, tea, colas, chocolate and nicotine y Eat freely of foods high in B-vitamins such as greens, legumes and whole grains
y
Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 157-160

Controllable risks: Stress & Hypertension
Take a sunbath daily, weather permitting Early in the morning (<10:00 a.m.) Late in the afternoon (>3:00 p.m.) y Take a neutral bath daily
y
Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 157-160

Controllable risks: Stress & Hypertension
y

Herbal teas Diuretics x Watermelon seed x Buchu x Burdock x Dandelion x Cornsilk Hawthorn berry and Dandelion together

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42, 157-160

Diabetes management: Controllable risks
y Stop

the smoking habit Smoking intensifies all risks in diabetes and must not be a part of the diabetic·s lifestyle y Avoid being overweight

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 42

In almost all cases of Type II diabetes, control of the disease is completely determined by control of appetite, weight and exercise.

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 151

Control of appetite
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General guidelines: Eat at set times x Do not snack! Chew thoroughly Eat slowly Fasting x Along with other benefits, fasting helps people learn how to manage their appetites and lose weight

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 156, 50

Weight control

Weight control
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Rule of thumb for average weight: Give yourself 100 pounds for your first five feet in height. Women: add 5 pounds per inch thereafter Men: add 6-7 pounds per inch thereafter (depending on how muscular you are)

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 156

Weight control: Obesity
y Definition:

having a very high amount of body fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher y BMI = a measure of an adult·s weight in relation to his or her height

Obesity trends among U.S. adults between 1985 an d 2004. CDC http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/obesity_trends_2004.pdf

Weight Control: Body Mass Index
Examples Height: Normal (19-24): Overweight (25-29): Obese (30-39): Extreme obesity (>40):

64´ (5¶4´) 110-140 lbs 145-169 lbs 174-227 lbs > 232 lbs

72´ (6¶) 136-172 lbs 184-213 lbs 221-287 lbs >294 lbs

National Institutes of Health. http://www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.pdf Accessed 8/29/2006

Obesity Trends* Among U.S. Adults BRFSS, 1991, 1996, 2004
(*BMI u30, or about 30 lbs overweight for 5¶4´ person) 1991 1996

2004

No Data

<10%

10%±14%

15%±19%

20%±24%

•25%

Source: Behavioral Risk Factor Surveillance System, CDC.

Weight control: Factors that affect weight
Positive effect: Regular, moderate exercise Green, leafy vegetables and salads y Negative effect: The amount and type of dietary fats Sedentary lifestyle
y

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 153

Weight control: Factors that affect weight
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Negative effect: Irregular meal times Eating sweets Loss of sleep Late and heavy suppers Eating many varieties at one meal Protein of animal origin

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 153

Weight control: Guidelines
Cut out all free fats Includes: butter, margarine, mayonnaise, fried foods, cooking fats, salad oils, peanut butter and all other nut or seed butters y Consider becoming a total vegetarian Animal products predispose us to many ailments, and are not needed to get essential nutrients
y
Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 153

Weight control: Guidelines
Eat nothing after 3:00 p.m. Metabolism changes about that time, so eating increases your likelihood of gaining weight y Do not eat between meals y Eat more raw foods Could include juices or purees x Home-made is best
y
Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 154-6

Weight control: Guidelines
Eat a small variety of food at one meal Lower weight gain Beneficial for digestion and health of insulin receptors y Exercise immediately after meals About 25 minutes Non-strenuous, but brisk Walking or bicycling will suffice
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Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 154-6

Exercise

Exercise: DPP study
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y

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The Diabetes Prevention Program (DPP) performed a 3-year, federally funded, study of 3,234 people at high risk for diabetes. The goal of the study was to find out if moderate diet changes and exercise will delay and prevent Type II diabetes. The answer was yes: diet and exercise sharply reduced the chances that a person with impaired glucose tolerance would develop diabetes

Am I at risk for Type II diabetes? Taking steps to lower your risk of getting diabetes. National Diabetes Information Clearinghouse, NIH. Diabetes Prevention Program. NIH NDIC. http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/index.htm Accessed 10/23/2006

Exercise: DPP study
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y

y

The participants were divided into two groups: the lifestyle change group, and the group that took the diabetes drug metforim. Those in the lifestyle change group exercised ~30 minutes a day 5 days a week, usually by walking, and lowered their intake of fat and calories. The lifestyle change group reduced their risk of getting diabetes by 58% (71% for those over 60.) The metforim group only reduced their risk by 31%

Am I at risk for Type II diabetes? Taking steps to lower your risk of getting diabetes. National Diabetes Information Clearinghouse, NIH.

Exercise: multiple benefits
The National Institutes of Health recommend that you should ´be physically active every day.µ y Regular exercise benefits in several ways Helps you lose weight Keep your cholesterol and blood pressure under control Helps your body use insulin
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Am I at risk for Type II diabetes? Taking steps to lower your risk of getting diabetes. National Diabetes Information Clearinghouse, NIH.

Exercise: How?
y y y y

If you are not very active, start slowly Work up to 30 minutes a day most days of the week Choose activities you enjoy Incorporate it into your daily life Examples: take the stairs instead of the elevator; park at the far end of the parking lot and walk; get off the bus a few stops early and walk the rest of the way

Am I at risk for Type II diabetes? Taking steps to lower your risk of getting diabetes. National Diabetes Information Clearinghouse, NIH.

Case history 1: 58 year-old female yearHistory: Gained ~30 pounds over the past year Sugar level = 350 mg/dl y Diagnostics before starting program Weight = 160 lbs, Height = 5·5·· Blood pressure = 160/90 Fasting blood sugar = 368 Serum cholesterol = 348
y

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 111-2

Case history 1: 58 year-old female yeary

Treatment Diet x Predominately vegetarian x Very low in fats x High in unrefined carbohydrates x Plenty of raw foods Exercise Weight control

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 111-2

Case history 1: 58 year-old female yeary

Result 2 weeks x Lost 6 pounds x Fasting blood sugar was down to 190 4 weeks x Fasting blood sugar dropped to 124 x Cholesterol dropped to 220

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 111-2

Case history 1: 58 year-old female yeary

Result 4 months x Lost 30 pounds x Blood sugar was normal Ongoing x Blood pressure continued to drop slowly x Cholesterol reached 190 x Dropped to 118 pounds
Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 111-2

Case history 2: 68 year-old male yeary

History: Taking 65 units of NPH insulin daily On medication for hypertension Had a heart attack several years before Continued to have severe angina Had osteoarthritis in many joints Had chronic phlebitis in both lower legs Weight: 215 pounds Blood sugar: 265; serum cholesterol: 258 Blood pressure: 176/100

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 112-3

Case history 2: 68 year-old male yearTreatment, part 1: Stopped the insulin immediately Went on a two day fast y Result Blood pressure dropped to 150/90 Blood sugar dropped to 200
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Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 112-3

Case history 2: 68 year-old male yeary

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Treatment, part 2: Mildly heated whirlpool to lower extremities Massage Mild exercise Diet: total vegetarian, oil-free, high in unrefined carbohydrates Results Within 3 days, his blood sugar had dropped within the normal range In 3 weeks, his serum cholesterol came down to 186

Thrash, Agatha and Calvin, M.D. Diabetes & the hypoglycemic syndrome: facts, findings and natural treatments. Seale, AL: NewLifestyle Books, 1993. p. 112-3