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Diabetes mellitus
Classification and external resources

Universal blue circle symbol for diabetes.[1]
ICD-10 E10.E14.
ICD-9 250
MedlinePlus 001214
eMedicine med/546 emerg/134
MeSH C18.452.394.750
Diabetes mellitus
Related articles
Types of diabetes
Prediabetes:
   • Impaired fasting glycaemia
   • Impaired glucose tolerance
Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes
Blood tests
Blood sugar
Glycosylated hemoglobin
Glucose tolerance test
Fructosamine
Diabetes management
Diabetic diet
Anti-diabetic drugs
Insulin therapy
Glossary of diabetes
Complications
Cardiovascular disease
Diabetic comas:
   • Diabetic hypoglycemia
   • Diabetic ketoacidosis
   • Nonketotic hyperosmolar
Diabetic myonecrosis
Diabetic nephropathy
Diabetic neuropathy
Diabetic retinopathy
Diabetes and pregnancy
.Diabetes mellitus (pronounced /ˌdaɪ.əˈbiːtiːz/ or /ˌdaɪ.əˈbiːtɨs/; /mɨˈlaɪtəs/ or /ˈmɛlɨtəs/)—often simply referred to as diabetes—is a condition in which a person has a high blood sugar (glucose) level as a result of the body either not producing enough insulin, or because body cells do not properly respond to the insulin that is produced.^ This leads to very high blood sugar levels, sugar in the urine, and very high blood insulin levels.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Insulin resistance is a condition in which the body produces insulin but does not use it properly.
  • 5 Steps to Reversing Type 2 Diabetes and Insulin Resistance 19 January 2010 8:50 UTC www.ultrawellness.com [Source type: General]

^ Your body secretes insulin to help glucose in your blood to enter your body cells and produce energy.
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

.Insulin is a hormone produced in the pancreas which enables body cells to absorb glucose, to turn into energy.^ Your pancreas produces insulin to move glucose into cells where it is metabolized into energy which fuels the body.
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

^ Insulin, a hormone made by the pancreas, helps the body use glucose for energy.
  • 5 Steps to Reversing Type 2 Diabetes and Insulin Resistance 19 January 2010 8:50 UTC www.ultrawellness.com [Source type: General]

^ Beta Cells produce insulin that converts glucose into energy.
  • Diabetics - Associated Content - Topic - associatedcontent.com 12 September 2009 7:40 UTC www.associatedcontent.com [Source type: General]

.If the body cells do not absorb the glucose, the glucose accumulates in the blood (hyperglycemia), leading to various potential medical complications.^ Most blood glucose comes from carbohydrates in the food you eat, but your body can make glucose from stored proteins and fat as well.
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

^ Once glucose is inside cells, the energy is released for use by the body or converted into fat for storage.
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

^ Frequency of visits depends on blood glucose control, changes in the treatment regimen, and presence of complications of diabetes or other medical conditions.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

[2][3]
There are many types of diabetes,[3] the most common of which are:
.
  • Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin.
  • Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency.
  • Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy.^ People with type 1 diabetes who exercise require less insulin.

    ^ People with diabetes cannot properly process glucose, a sugar the body uses for energy.
    • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
    • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

    ^ All pregnant women should be screened for gestational diabetes.
    • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

    It may precede development of type 2 DM.
.Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.^ Therapy for diabetes mellitus and related disorders.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Genetics of type 1 diabetes mellitus .
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ The fourth type of diabetes mellitus is a group of "other specific types" that have surgery, drugs, malnutrition, or infections among the causal factors.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

.All forms of diabetes have been treatable since insulin became medically available in 1921, and type 2 diabetes can be controlled with tablets, but it is chronic condition that usually cannot be cured.^ Medical management of type 2 diabetes .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Type 1 diabetes is usually diagnosed in childhood.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ Type 2 diabetes can often be controlled by diet or a combination of diet and tablets.

.Pancreas transplants have been tried with limited success in type 1 DM; gastric bypass surgery has been successful in many with morbid obesity and type 2 DM; and gestational diabetes usually resolves after delivery.^ Gumbiner B. Treating obesity in type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Type 1 diabetes is usually diagnosed in childhood.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ And as obesity has increased, so has type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Diabetes without proper treatments can cause many complications.^ RC660.5.S45 2000 Discusses the different kinds of diabetes, their symptoms and proper treatment, as well as medical complications connected with this lifetime disease.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Frequency of visits depends on blood glucose control, changes in the treatment regimen, and presence of complications of diabetes or other medical conditions.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Alternative names Causes Symptoms & Signs Exams and Tests Treatments Where to get support Prognosis Possible Complications When to contact a medical professional Prevention References Disclaimer Diabetes has been added to your Health Portfolio.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

.Acute complications include hypoglycemia, diabetic ketoacidosis, or nonketotic hyperosmolar coma.^ Complications of diabetes include hypertension, heart attack, stroke, circulation problems, kidney failure, and blindness.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ In some patients, the condition may culminate in diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic coma.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Kitabchi AE, Matteri R, Murphy MB. Optimal insulin delivery in diabetic ketoacidosis and hyperglycemic, hyperosmolar nonketotic coma.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.Serious long-term complications include cardiovascular disease, chronic renal failure, retinal damage.^ Long-term complications include: .
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ Complications of diabetes include hypertension, heart attack, stroke, circulation problems, kidney failure, and blindness.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ If undiscovered, patients can develop serious complications such as blindness, kidney disease and nerve damage that could lead to amputation .

.Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as smoking cesation and maintaining a healthy body weight.^ Action to help control blood pressure .

^ See the Blood Pressure Control algorithm.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ See the Blood Pressure Control algorithm .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

.As of 2000 at least 171 million people worldwide suffer from diabetes, or 2.8% of the population.^ Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Baseline: 8.8 deaths per 1,000 persons with diabetes listed anywhere on the death certificate occurred in 1997 (age adjusted to the year 2000 standard population).

^ Blood Pressure Control Algorithm Control of BP is at least as important as glycemic control for people with type 2 diabetes in reducing the risk of complications [A] .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

[4] .Type 2 diabetes is by far the most common, affecting 90 to 95% of the U.S. diabetes population.^ Most people with type 2 diabetes are overweight.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ This is more common in type 2 diabetes.

^ Type 2 diabetes is the most common form of diabetes in cats.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

[5]

Contents

Classification

.Most cases of diabetes mellitus fall into the three broad categories of type 1 or type 2 and gestational diabetes.^ Follow-up: Diabetes Mellitus, Type 2 .
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Most people with type 2 diabetes are overweight.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Treatment of type 2 diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

A few other types are described.
.The term diabetes, without qualification, usually refers to diabetes mellitus, which roughly translates to excessive sweet urine (known as "glycosuria").^ Diabetes Mellitus as it is known in full, is a common health condition where there is too much glucose (sugar) in the blood .

^ Ravid M, Lang R, Rachmani R. Long-term renoprotective effect of angiotensin-converting enzyme inhibition in non-insulin-dependent diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Reichard, P.; Nilsson, B.; and Rosenqvist, U. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus.

.Several rare conditions are also named diabetes.^ Diabetic acidosis: A severe condition of diabetes.

.The most common of these is diabetes insipidus in which large amounts of urine are produced (polyuria), which is not sweet (insipidus meaning "without taste" in Latin).^ Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Most doctors recommend that people with diabetes cut intake of sugar from snacks and processed foods, and replace these foods with high- fiber , whole foods.

^ People eating large amounts of foods with high glycemic indices (such as those mentioned above), have been reported to be at increased risk of type 2 diabetes.

.The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM).^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ A trial of nicotinamide in newly diagnosed patients with type 1 (insulin-dependent) diabetes mellitus.

^ Absence of TAP2 contribution to association with insulin-dependent diabetes mellitus.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

.Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes mellitus (NIDDM).^ Gumbiner B. Treating obesity in type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ A trial of nicotinamide in newly diagnosed patients with type 1 (insulin-dependent) diabetes mellitus.

.Beyond these two types, there is no agreed-upon standard nomenclature.^ There are two types of diabetes mellitus, type 1 and type 2.
  • DIABETES MELLITUS 19 January 2010 8:50 UTC www.acma.org [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ There are two types of diabetes - type 1 and type 2.
  • Diabetes - Introduction 19 January 2010 8:50 UTC www.nhs.uk [Source type: FILTERED WITH BAYES]

^ Beyond these numbers, there is no agreed standard.

Various sources have defined "type 3 diabetes" as: gestational diabetes,[6] insulin-resistant type 1 diabetes (or "double diabetes"), type 2 diabetes which has progressed to require injected insulin, and latent autoimmune diabetes of adults (or LADA or "type 1.5" diabetes)[7]

Type 1 diabetes

.Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency.^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ [Abstract] Porte D. 1991 B cells in type 2 diabetes mellitus.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

^ Treatment of type 2 diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

.This type of diabetes can be further classified as immune-mediated or idiopathic.^ Diabetes is classified into 3 types.

^ Genetic susceptibility Infectious diseases Immune-mediated disease Pancreatitis Predisposing diseases Drugs Obesity Cancer of the pancreas What are the signs of Diabetes Mellitus?

^ Type 1 diabetes is classified as an autoimmune disease, meaning a condition in which the body's immune system 'attacks' one of the body's own tissues or organs.

.The majority of type 1 diabetes is of the immune-mediated nature, where beta cell loss is a T-cell mediated autoimmune attack.^ There are three major types of diabetes: .
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ In the great majority of patients with type 2 diabetes (±80%), the delay in immediate insulin response is accompanied by a secondary hypersecretory phase of insulin release as a result of either an inherited or acquired defect within the ß-cell or a compensatory response to peripheral insulin resistance.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

^ In some early-onset patients with type 2 diabetes (perhaps as many as 20%) ( 4 , 5 ), there may be a deficiency in insulin secretion that may or may not be due to autoimmune destruction of the ß-cell and is not due to a deficiency in the glucokinase gene.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

[2] .There is no known preventive measure against type 1 diabetes, which causes approximately 10% of diabetes mellitus cases in North America and Europe.^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Diabetes can cause a type of nerve damage known as diabetic neuropathy.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ There are two types of diabetes mellitus, type 1 and type 2.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

.Most affected people are otherwise healthy and of a healthy weight when onset occurs.^ Most people affected by type 1 diabetes are otherwise healthy and of a healthy weight when onset occurs.

^ Many people may have cardiovascular disease and be unaware, hence allowing cardiovascular disease to become silent killers of otherwise healthy individuals.

^ Affected individuals usually experience an abrupt onset of symptoms, including thirst, excessive urination, increased appetite, and paradoxic weight loss.
  • Acupuncture.Com - Herbology - Treatment of Diabetes with Herbs 19 January 2010 8:50 UTC www.acupuncture.com [Source type: Academic]

.Sensitivity and responsiveness to insulin are usually normal, especially in the early stages.^ Sensitivity and responsiveness to insulin are usually normal, especially in the early stages.

^ In type 2 diabetes, there is generally enough insulin but the cells upon it should act are not normally sensitive to its action.
  • Diabetes mellitus definition - Diabetes Mellitus, Type 2 Diabetes, Type 1, and Metabolic Disorders Treatment and Medications on MedicineNet.com 19 January 2010 8:50 UTC www.medterms.com [Source type: FILTERED WITH BAYES]

^ While insulin can keep IDDM under control so that the dog lives a normal life, the most effective type of insulin for each dog depends on its individual body and the stage of its disease.
  • Dog Owner's Guide: Canine Diabetes 19 January 2010 8:50 UTC www.canismajor.com [Source type: Academic]

.Type 1 diabetes can affect children or adults but was traditionally termed "juvenile diabetes" because it represents a majority of the diabetes cases in children.^ The majority of diabetic patients are of type 2.
  • DIABETES MELLITUS 19 January 2010 8:50 UTC www.acma.org [Source type: Academic]

^ Type 1 Diabetes (juvenile diabetes) .
  • About Diabetes 16 September 2009 22:31 UTC chi.unt.edu [Source type: Reference]

^ Type 1 diabetes is traditionally treated with insulin.

Type 2 diabetes

.Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion.^ In insulin resistance, the anabolic process is reduced.

^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ There are two types of diabetes mellitus, type 1 and type 2.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

.The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor.^ For others, the insulin is normal, but the cells of the body are producing insulin receptors that are defective.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ As obesity or an increase in intraabdominal adipose tissue is associated with insulin resistance in the absence of diabetes, it is believed by some that insulin resistance in type 2 diabetes is entirely due to the coexistence of increased adiposity ( 47 ).
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

^ I have believed from day one that if the cells in your body can 'Learn' to be Insulin resistant, they can by golly 'Unlearn' it!
  • 5 Steps to Reversing Type 2 Diabetes and Insulin Resistance 19 January 2010 8:50 UTC www.ultrawellness.com [Source type: General]

However, the specific defects are not known. .Diabetes mellitus due to a known defect are classified separately.^ Diabetes Mellitus as it is known in full, is a common health condition where there is too much glucose (sugar) in the blood .

^ Jerry L. Nadler, MD - The link between diabetes mellitus and magnesium deficiency is well known.

^ Gestational diabetes mellitus (GDM): Refers to the development of hyperglycemia during pregnancy in an individual not previously known to have diabetes.

.Type 2 diabetes is the most common type.^ Most people with type 2 diabetes are overweight.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ This is more common in type 2 diabetes.

^ The studies, however, were of relatively weak design, and pharmacotherapy for weight loss cannot be recommended for most patients with type 2 diabetes.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

.In the early stage of type 2 diabetes, the predominant abnormality is reduced insulin sensitivity.^ Ginkgo biloba Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.

^ Insulin therapy can cause further weight gain in obese type 2 diabetics and increase the risk of hypoglycemia (although less commonly than in type 1 diabetes) ( 109 ).
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

^ In some early-onset patients with type 2 diabetes (perhaps as many as 20%) ( 4 , 5 ), there may be a deficiency in insulin secretion that may or may not be due to autoimmune destruction of the ß-cell and is not due to a deficiency in the glucokinase gene.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

.At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver.^ They also reduce glucose production by the liver.
  • Acupuncture.Com - Herbology - Treatment of Diabetes with Herbs 19 January 2010 8:50 UTC www.acupuncture.com [Source type: Academic]

^ Medications that increase sensitivity to insulin.
  • HowStuffWorks "Diabetes - Medical Dictionary" 19 January 2010 8:50 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]
  • Diabetes Information from Drugs.com 16 September 2009 22:31 UTC www.drugs.com [Source type: FILTERED WITH BAYES]

^ Metformin reduces insulin resistance, and the production of glucose by the liver.
  • DoctorNDTV: Health Information on Diabetes mellitus 19 January 2010 8:50 UTC doctor.ndtv.com [Source type: FILTERED WITH BAYES]

.As the disease progresses, the impairment of insulin secretion occurs, and therapeutic replacement of insulin may sometimes become necessary in certain patients.^ In some early-onset patients with type 2 diabetes (perhaps as many as 20%) ( 4 , 5 ), there may be a deficiency in insulin secretion that may or may not be due to autoimmune destruction of the ß-cell and is not due to a deficiency in the glucokinase gene.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

^ As the disease progresses and the damage continues, more symptoms may appear.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ [Abstract/ Free  Full Text] O’Rahilly S, Turner R, Matthews D. 1988 Impaired pulsatile secretion of insulin in relatives of patients with non-insulin dependent diabetes.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

[citation needed]

Gestational diabetes

.Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness.^ What are the risk factors of Type 1 Diabetes Mellitus?
  • Medifocus Guidebook on Type 1 Diabetes Mellitus 19 January 2010 8:50 UTC diabetes1-info.com [Source type: Academic]

^ GAD treatment and insulin secretion in recent-onset type 1 diabetes .
  • Public - Diabetes Mellitus, Type 1 - Resources 19 January 2010 8:50 UTC pier.acponline.org [Source type: Academic]

^ Prior to the purification of insulin, type 1 diabetes mellitus was uniformly lethal.
  • Case Based Pediatrics Chapter 19 January 2010 8:50 UTC www.hawaii.edu [Source type: Academic]

.It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery.^ Gestational diabetes mellitus (GDM) occurs in about 2%–5% of all pregnancies.

^ Gestational diabetes mellitus (GDM) occurs in about 2%–5% of all pregnancies .

^ It develops during pregnancy and may improve or disappear after delivery.

.Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy.^ Diabetes requires professional care.

^ Gestational diabetes mellitus , or pregnancy-induced diabetes.
  • DoctorNDTV: Health Information on Diabetes mellitus 19 January 2010 8:50 UTC doctor.ndtv.com [Source type: FILTERED WITH BAYES]

^ Standards of medical care in diabetes -- 2008.
  • Diabetes - Symptoms, Diagnosis, Treatment of Diabetes - NY Times Health Information 12 September 2009 7:40 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]
  • Type 2 Diabetes - Symptoms, Diagnosis, Treatment of Type 2 Diabetes - NY Times Health Information 15 September 2009 21:39 UTC health.nytimes.com [Source type: General]
  • Diabetes - Symptoms, Diagnosis, Treatment of Diabetes - NY Times Health Information 11 September 2009 4:16 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]

.About 20%–50% of affected women develop type 2 diabetes later in life.^ Women who have gestational diabetes are more likely to develop type 2 diabetes in later life.

^ Gestational diabetes affects about 4% of all pregnant women!
  • Diabetes Signs...Diabetic Health...Symptoms of Diabetes...Prediabetes 19 January 2010 8:50 UTC www.diabetes-health-talk.com [Source type: FILTERED WITH BAYES]

^ Type 1 diabetes: recent developments .
  • Public - Diabetes Mellitus, Type 1 - Resources 19 January 2010 8:50 UTC pier.acponline.org [Source type: Academic]

.Even though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother.^ Even though it may be transient, gestational diabetes may damage the health of the fetus or mother, and about 20%–50% of women with gestational diabetes develop type 2 diabetes later in life.

^ Weight loss may be dramatic, even though the child's appetite usually remains good.
  • Diabetes mellitus Cure, Diabetes mellitus cure, Acupuncture Diabetes mellitus Malaysia Herbal Medicine Centre Treatment, special kids, hyperactive, high levels sugar, water-electrolyte imbalance, kuala lumpur, Asperger's syndrome, loss body weight, polyphagia 11 September 2009 4:16 UTC www.geocities.com [Source type: FILTERED WITH BAYES]

^ About 18,000 women with preexisting diabetes deliver babies each year, and an estimated 135,000 expectant mothers are diagnosed with gestational diabetes.

.Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations.^ Approximately 9% of pregnancies complicated by pregestational diabetes result in the birth of infants with central nervous system, cardiac, renal, skeletal, and other malformations.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Central nervous system dysfunction in persons with HHNKC is probably due to hyperosmolarity.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Other factors that may increase the risk for fetal anomalies include early age at onset of maternal diabetes and microvascular disease in the mother.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.Increased fetal insulin may inhibit fetal surfactant production and cause respiratory distress syndrome.^ Insulin therapy can cause further weight gain in obese type 2 diabetics and increase the risk of hypoglycemia (although less commonly than in type 1 diabetes) ( 109 ).
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

^ When researchers at Michigan State University exposed rodent pancreatic cells to anthocyanins, insulin production increased 50%.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Researchers believe that some of the proteins found in animal products may stimulate the pancreas to produce even more excessive amounts of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Hyperbilirubinemia may result from red blood cell destruction.^ High levels of blood ketones may result in a serious condition called ketoacidosis .
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ The different results in these studies may have been due in part to differences in body weight, initial blood sugar levels, and medication use among the different populations studied.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Autoimmune destruction of pancreatic ß-cells may be a factor in a small subset of type 2 diabetic patients and has been termed the syndrome of latent autoimmune diabetes in adults.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

.In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment.^ This may occur due to inconsistencies in treatment.
  • Diabetes Mellitus ~ Pawprints and Purrs, Inc. 19 January 2010 8:50 UTC www.sniksnak.com [Source type: General]
  • Diabetes mellitus 19 January 2010 8:50 UTC www.animalhealthcare.com [Source type: FILTERED WITH BAYES]

^ In severe cases, perinatal death may occur, most commonly as a result of poor placental profusion due to vascular impairment.

^ Pale, cool, moist skin and delayed capillary refill are due to peripheral vasoconstriction If signs of poor perfusion, consider placing patient supine .
  • http://www.lbfdtraining.com/Pages/emt/sectionb/diabetes.html 16 September 2009 22:31 UTC www.lbfdtraining.com [Source type: Academic]

Labor induction may be indicated with decreased placental function. .A cesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.^ Medical nutrition therapy Increased physical exercise Pharmacotherapy Beneficial effects of statins on cardiovascular risk reduction may, in part, be independent of their effects on lipids.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes; 90 however, heavy drinking does increase the risk of developing diabetes and should be avoided.

^ Low blood levels of adiponectin are a marker for metabolic syndrome, are common in obesity, and are also associated with increased heart attack risk.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.A 2008 study completed in the U.S. found that more American women are entering pregnancy with preexisting diabetes.^ Reviews Zonya Foco,Other Format, English-language edition,Pages:388,Pub by American Diabetes Association more .
  • Meals For Diabetics - Shop Smarter.com 12 September 2009 7:40 UTC www.smarter.com [Source type: General]

^ Risk factors include people with a family history of diabetes, those who are overweight, and women who have suffered from gestational diabetes (diabetes which occurs during, and is related to, pregnancy ).
  • vitacost.com - Science & Research - Diabetes 16 September 2009 22:31 UTC www.vitacost.com [Source type: Academic]

^ Women with diabetes who become pregnant should have their eyes checked each trimester because diabetic eye problems can worsen quickly during pregnancy.
  • Adult Health Advisor 2009.1: Diabetes Mellitus: Type 1 19 January 2010 8:50 UTC www.med.umich.edu [Source type: General]
  • Pediatric Advisor 2009.1: Diabetes Mellitus: Type 2 19 January 2010 8:50 UTC www.med.umich.edu [Source type: General]

.In fact the rate of diabetes in expectant mothers has more than doubled in the past 6 years.^ I had type–1 diabetes for 36 years‚ but not any more.

^ Lisa Roney Sweet Invisible Body : More than 16 million people in the United States have diabetes.
  • IOH - Famous and celebrity diabetics 12 September 2009 7:40 UTC www.isletsofhope.com [Source type: General]

^ More than 16 million Americans alone suffer from diabetes.
  • Signs & Symptoms of Diabetes - Natural Supplement to Treat Diabetes 19 January 2010 8:50 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

[8] .This is particularly problematic as diabetes raises the risk of complications during pregnancy, as well as increasing the potential that the children of diabetic mothers will also become diabetic in the future.^ RC660.5.S45 2000 Discusses the different kinds of diabetes, their symptoms and proper treatment, as well as medical complications connected with this lifetime disease.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

Other types

.Pre-diabetes indicates a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes.^ My blood glucose levels have actually been lower than before.
  • 5 Steps to Reversing Type 2 Diabetes and Insulin Resistance 19 January 2010 8:50 UTC www.ultrawellness.com [Source type: General]

^ Diagnosis of Type 2 Diabetes Diagnosis of type 2 diabetes [R] .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ For example, people with diabetes can use it to track their blood glucose levels.

.Many people destined to develop type 2 diabetes spend many years in a state of pre-diabetes which has been termed "America's largest healthcare epidemic,"[9]:10–11.^ Mansmann I have had diabetic neuropathy for over 10 years.

^ Most people with type 2 diabetes are overweight.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Emerging epidemic of type 2 diabetes in youth.

.Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon.^ Type 1 diabetes is treated with insulin.
  • ACOG Education Pamphlet AP051 -- Diabetes and Pregnancy 19 January 2010 8:50 UTC www.acog.org [Source type: FILTERED WITH BAYES]

^ The exact cause of type 1 diabetes is not known.
  • Diabetes 19 January 2010 8:50 UTC www.umm.edu [Source type: Academic]

^ Insulin injections are used in Type 1 diabetes and in some cases of Type 2.
  • Diabetes overview 19 January 2010 8:50 UTC www.netdoctor.co.uk [Source type: FILTERED WITH BAYES]

.Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function.^ The immune-mediated process leading to development of T1D is highly specific to pancreatic beta cells.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ Its antioxidants and unique polysaccharides can halt the genetic mutations that can lead to cancer.

^ Most often this type of diabetes represents an autoimmune destructive disease in beta (insulin-producing) cells of the pancreas in genetically susceptible individuals.

.Abnormal insulin action may also have been genetically determined in some cases.^ To determine the duration of action of the insulin ie.

^ Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of Insulin-dependent Diabetes, called Type 1 Diabetes.

^ Some cats with diabetes may lose their requirement for insulin for reasons that are not completely understood Once your pet has been diagnosed with diabetes, its specific insulin requirements need to be determined.
  • Michigan Veterinary Specialists - Diabetes Mellitus for the Dog and Cat Owner 19 January 2010 8:50 UTC www.michvet.com [Source type: FILTERED WITH BAYES]

.Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis).^ Cardiovascular disease is the leading cause of morbidity and mortality among persons with diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Patient Education Principles: Inform patients that sight-threatening eye disease is a common complication of diabetes and may be present even with good vision.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ As the disease progresses and the damage continues, more symptoms may appear.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Diseases associated with excessive secretion of insulin-antagonistic hormones can cause diabetes (which is typically resolved once the hormone excess is removed).^ The multifaceted associations of hepatobiliary disease and diabetes.
  • Diabetes - Kosmix : Reference, Videos, Images, News, Shopping and more... 19 January 2010 8:50 UTC www.kosmix.com [Source type: FILTERED WITH BAYES]

^ Diabetes is caused by a problem with insulin .
  • ACOG Education Pamphlet AP051 -- Diabetes and Pregnancy 19 January 2010 8:50 UTC www.acog.org [Source type: FILTERED WITH BAYES]

^ A lack of insulin or a resistance to insulin causes diabetes.

.Many drugs impair insulin secretion and some toxins damage pancreatic beta cells.^ The autoimmune destruction of pancreatic β-cells leads to a deficiency of insulin secretion.

^ Sulfonylurea drugs stimulate pancreatic secretion of insulin.
  • Diabetes: Online References For Health Concerns 19 January 2010 8:50 UTC www.lef.org [Source type: Academic]

^ (Beta cells are responsible for the production of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

The ICD-10 (1992) diagnostic entity, malnutrition-related diabetes mellitus (MRDM or MMDM, ICD-10 code E12), was deprecated by the World Health Organization when the current taxonomy was introduced in 1999.[10]

Signs and symptoms

Overview of the most significant symptoms of diabetes.
.The classical symptoms of DM are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).^ While a diagnosis of diabetes mellitus is readily entertained when a patient presents with classic symptoms (ie, polyuria, polydipsia, polyphagia, weight loss), most patients with type 2 diabetes mellitus are asymptomatic for years.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ It is important to recognize that risks of medications are often increased with advancing age, but this does not justify the withholding of medications that may reduce the symptoms of polyuria, nocturia, and frequent visits to the bathroom that may place the patient at risk of hip fracture or falls.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

[11] .Symptoms may develop quite rapidly (weeks or months) in type 1 diabetes, particularly in children.^ Infrequently, an adult may develop type 1 diabetes.

^ Type 1 diabetes: recent developments .
  • Public - Diabetes Mellitus, Type 1 - Resources 19 January 2010 8:50 UTC pier.acponline.org [Source type: Academic]

^ Symptoms may develop suddenly.
  • Adult Health Advisor 2009.1: Diabetes Mellitus: Type 1 19 January 2010 8:50 UTC www.med.umich.edu [Source type: General]

.However, in type 2 diabetes symptoms usually develop much more slowly and may be subtle or completely absent.^ (This test is used more for type 2 diabetes.
  • Diabetes - Symptoms, Diagnosis, Treatment of Diabetes - NY Times Health Information 12 September 2009 7:40 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]
  • Diabetes: MedlinePlus Medical Encyclopedia 19 January 2010 8:50 UTC www.nlm.nih.gov [Source type: FILTERED WITH BAYES]
  • Diabetes - Symptoms, Diagnosis, Treatment of Diabetes - NY Times Health Information 11 September 2009 4:16 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]

^ What are the symptoms of type 2 diabetes?
  • Diabetes - advice videos on Diabetes 19 January 2010 8:50 UTC www.videojug.com [Source type: General]

^ Type 1 diabetes: recent developments .
  • Public - Diabetes Mellitus, Type 1 - Resources 19 January 2010 8:50 UTC pier.acponline.org [Source type: Academic]

.Type 1 diabetes may also cause a rapid yet significant weight loss (despite normal or even increased eating) and irreducible mental fatigue.^ Red meat may also contribute to an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ And as obesity has increased, so has type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ In most studies, type 2 diabetes has improved with weight loss.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

.All of these symptoms except weight loss can also manifest in type 2 diabetes in patients whose diabetes is poorly controlled, although unexplained weight loss may be experienced at the onset of the disease.^ Effects of melatonin and zinc on glycemic control in type 2 diabetic patients poorly controlled with metformin.

^ In most studies, type 2 diabetes has improved with weight loss.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Signs may include weight loss and erratic glycemic control.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.Final diagnosis is made by measuring the blood glucose concentration.^ Fasting glucose (a measure of short-term blood sugar control) was also lower in the group taking the higher dose of chromium.

^ The tracker logged and graphed the blood glucose measurements that you entered manually.

^ This assay yields an accurate measure of time-averaged blood glucose during the previous six to eight weeks.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

.When the glucose concentration in the blood is raised beyond its renal threshold (about 10 mmol/L, although this may be altered in certain conditions, such as pregnancy), reabsorption of glucose in the proximal renal tubuli is incomplete, and part of the glucose remains in the urine (glycosuria).^ Insist that patients contact you promptly when the blood glucose level remains at 240 mg/dL or more, ketonuria develops, or acute illness persists.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Counsel patients about nutrition and teach them how to monitor their blood glucose levels and how to adjust their insulin treatment.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Frequency of visits depends on blood glucose control, changes in the treatment regimen, and presence of complications of diabetes or other medical conditions.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. .Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst.^ Polydipsia: Increased thirst, which may be insatiable, is secondary to the osmotic diuresis causing dehydration.
  • Diabetes Mellitus, Type 1: eMedicine Pediatrics: General Medicine 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Hence, fluid is lost and thirst increased to compensate for ensuing dehydration.

^ This causes an increase in blood pressure.

.Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape.^ As a result, glucose stays in the blood, causing blood glucose levels to rise.
  • Diabetes: Treatment Options for Adult Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.naturaleyecare.com [Source type: FILTERED WITH BAYES]

^ High blood glucose and type 2 diabetes .

^ This leads to too much glucose in their blood.

.Blurred vision is a common complaint leading to a diabetes diagnosis; type 1 should always be suspected in cases of rapid vision change, whereas with type 2 change is generally more gradual, but should still be suspected.^ (This test is used more for type 2 diabetes.
  • Diabetes - Symptoms, Diagnosis, Treatment of Diabetes - NY Times Health Information 12 September 2009 7:40 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]
  • Diabetes - Symptoms, Diagnosis, Treatment of Diabetes - NY Times Health Information 11 September 2009 4:16 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]

^ It is much more common in type 1 diabetes than type 2, but can still occur in patients with type 2 diabetes.

^ Some forms of diabetes, such as type 2 diabetes , are becoming more common.
  • Diabetes Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 19 January 2010 8:50 UTC www.wrongdiagnosis.com [Source type: Academic]

.Patients (usually with type 1 diabetes) may also initially present with diabetic ketoacidosis (DKA), an extreme state of metabolic dysregulation characterized by the smell of acetone on the patient's breath; a rapid, deep breathing known as Kussmaul breathing; polyuria; nausea; vomiting and abdominal pain; and any of many altered states of consciousness or arousal (such as hostility and mania or, equally, confusion and lethargy).^ Wagner AM, Perez A, Calvo F. Apolipoprotein(B) identifies dyslipidemic phenotypes associated with cardiovascular risk in normocholesterolemic type 2 diabetic patients.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes; 90 however, heavy drinking does increase the risk of developing diabetes and should be avoided.

^ Effects of exenatide (exendin-4) on glycemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

.In severe DKA, coma may follow, progressing to death.^ Diabetic ketoacidosis can progress to coma and death.
  • Diabetes Mellitus (DM): Children's Health Issues: Merck Manual Home Edition 11 September 2009 4:16 UTC www.merck.com [Source type: FILTERED WITH BAYES]

^ In severe DKA, coma (unconsciousness) may follow, progressing to death if untreated.

^ Untreated DKA can lead to coma and death.
  • Diabetes Dictionary - American Diabetes Association 11 September 2009 4:16 UTC www.diabetes.org [Source type: FILTERED WITH BAYES]

.Diabetic ketoacidosis is a medical emergency and requires immediate hospitalization.^ Diabetic ketoacidosis is a medical emergency, because it can cause coma and death.
  • Diabetes Mellitus: Diabetes Mellitus (DM): Merck Manual Home Edition 19 January 2010 8:50 UTC www.merck.com [Source type: FILTERED WITH BAYES]

^ Dogs in this state, called ketoacidosis , may require a week or more of hospitalization with quite a bit of laboratory testing.
  • Diabetes Mellitus ~ Pawprints and Purrs, Inc. 19 January 2010 8:50 UTC www.sniksnak.com [Source type: General]

^ All diabetic patients who undergo amputation require close supervision for other medical problems, particularly coronary artery disease.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.A rarer but equally severe possibility is hyperosmolar nonketotic state, which is more common in type 2 diabetes and is mainly the result of dehydration due to loss of body water.^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ However, several other studies have failed to find chromium helpful for improving blood sugar control in type 2 diabetes.

^ Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some, 126 but not all, trials.

.Often, the patient has been drinking extreme amounts of sugar-containing drinks, leading to a vicious circle in regard to the water loss.^ Often, the patient has been drinking extreme amounts of sugar-containing drinks, leading to a vicious circle in regard to water loss.

^ Often, the patient has been drinking extreme amounts of sugar-containing drinks, leading to a vicious circle in regard to the water loss.

^ Sugars Diabetes and Nerve Pain: An Overview of Lyrica Diabetes is a condition, when untreated, which leads to a energy loss and significant other health issues.
  • Diabetics - Associated Content - Topic - associatedcontent.com 12 September 2009 7:40 UTC www.associatedcontent.com [Source type: General]

.A number of skin rashes can occur in diabetes that are collectively known as diabetic dermadromes.^ This increase in the number of cases of diabetes has occurred particularly within certain racial and ethnic groups.

Causes

.Type 2 diabetes is determined primarily by lifestyle factors and genes.^ The fourth type of diabetes mellitus is a group of "other specific types" that have surgery, drugs, malnutrition, or infections among the causal factors.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Pandey JP, Zamani M, Cassiman JJ. Epistatic effects of genes encoding tumor necrosis factor-alpha, immunoglobulin allotypes, and HLA antigens on susceptibility to non-insulin-dependent (type 2) diabetes mellitus.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[12]

Lifestyle

.A number of lifestyle factors are known to be important to the development of type 2 diabetes.^ For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes; 90 however, heavy drinking does increase the risk of developing diabetes and should be avoided.

^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Preliminary studies have found that early introduction of cows’ milk formula feeding increases the risk of developing type 1 diabetes, although contradictory results have also been published.

.In one study, those who had high levels of physical activity, a healthy diet, did not smoke, and consumed alcohol in moderation had an 82% lower rate of diabetes.^ Moderate physical activity in adolescents .

^ In addition, those with diabetes have a higher mortality rate if they also have high homocysteine levels.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ A prospective study of moderate alcohol drinking and risk of diabetes in women.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

When a normal weight was included the rate was 89% lower. .In this study a healthy diet was defined as one high in fiber, with a high polyunsaturated to saturated fat ratio, and a lower mean glycemic index.^ Healthy Fats : A Mediterranean diet is rich in healthy unsaturated fats from olive oil, cold water fish, nuts and seeds.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Beans, peas, fruit, and oats have low glycemic indexes, despite their high carbohydrate content, due mostly to the health-promoting effects of soluble fiber .
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Moreover, people eating the high-fiber diet experienced significant reductions in total cholesterol, triglycerides, and LDL (“bad”) cholesterol compared to those eating the ADA diet.

[13] .Obesity has been found to contribute to approximately 55% type 2 diabetes,[14] and decreasing consumption of saturated fats and trans fatty acids while replacing them with unsaturated fats may decrease the risk.^ Gumbiner B. Treating obesity in type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Red meat may also contribute to an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ And as obesity has increased, so has type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[12] .The increased rate of childhood obesity in between the 1960s and 2000s is believed to have lead to the increase in type 2 diabetes in children and adolescents.^ Gumbiner B. Treating obesity in type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ And as obesity has increased, so has type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Overweight or obesity in children and adolescents .

[15]
.Environmental toxins may contribute to recent increases in the rate of type 2 diabetes.^ Red meat may also contribute to an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ And as obesity has increased, so has type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes; 90 however, heavy drinking does increase the risk of developing diabetes and should be avoided.

.A positive correlation has been found between the concentration in the urine of bisphenol A, a constituent of some plastics, and the incidence of type 2 diabetes.^ Correlations between the incidence of childhood-onset of type 1 diabetes in Europe and HLA genotypes.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ This combination of agents would appear to correct most of the pathophysiological defects found in type 2 diabetic individuals.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

[16]

Medical conditions

.Subclinical Cushing's syndrome (cortisol excess) may be associated with DM type 2.[17] The percentage of subclinical Cushing's syndrome in the diabetic population is about 9%.^ For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes; 90 however, heavy drinking does increase the risk of developing diabetes and should be avoided.

^ Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ However, in a double-blind trial, taurine supplementation (2 grams per day for 12 months) failed to improve kidney complications associated with type 2 diabetes.

[18] .Diabetic patients with a pituitary microadenoma can improve insulin sensitivity by removal of these microadenomas.^ Insulin sensitivity in subjects with type 2 diabetes.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in non-insulin dependent diabetics.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Raghuram TC, Sharma RD, Sivakumar B, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

[19]
.Hypogonadism is often associated with cortisol excess, and testosterone deficiency is also associated with diabetes mellitus type 2,[20][21] even if the exact mechanism by which testosterone improve insulin sensitivity is still not known.^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Absence of TAP2 contribution to association with insulin-dependent diabetes mellitus.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ There are two types of diabetes mellitus, type 1 and type 2.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

Genetics

.Both type 1 and type 2 diabetes are partly inherited.^ Gymnema also improves the ability of insulin to lower blood sugar in people with both type 1 and type 2 diabetes.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Genetic factors in type 2 diabetes The susceptibility to type 2 diabetes in humans, monkeys, and rodents is inherited, and preliminary data support a genetic influence in cats ( 12 ).
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

^ Both type 1 and type 2 diabetes have a significant genetic component.

.Type 1 diabetes may be triggered by certain infections, with some evidence pointing at Coxsackie B4 virus.^ The fourth type of diabetes mellitus is a group of "other specific types" that have surgery, drugs, malnutrition, or infections among the causal factors.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes; 90 however, heavy drinking does increase the risk of developing diabetes and should be avoided.

^ Genetic susceptibility markers in Danish patients with type 1 (insulin-dependent) diabetes ¾ evidence for polygenecity in man.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

.There is a genetic element in individual susceptibility to some of these triggers which has been traced to particular HLA genotypes (i.e., the genetic "self" identifiers relied upon by the immune system).^ This clustering of autoimmune susceptibility loci suggests that there may be related genetic backgrounds contributing to susceptibility of clinically distinct disease, and that the genes identified in these clusters are most likely to be involved in primary or secondary regulation of the immune system.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ Furthermore, there may be some cause for concern given the high doses of vanadium used in some of these studies.

^ The best evidence for a genetic component in the susceptibility to T1D comes from studies of the HLA genes in both populations and families as well as from animal models.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

.However, even in those who have inherited the susceptibility, type 1 diabetes mellitus seems to require an environmental trigger.^ Type 1 diabetes mellitus* .
  • Diagnosis and Classification of Diabetes Mellitus: New Criteria -October 15, 1998 - American Academy of Family Physicians 19 January 2010 8:50 UTC www.aafp.org [Source type: Academic]

^ Type 1 diabetes mellitus .

^ Who is most likely to get type 2 diabetes?
  • Diabetes - advice videos on Diabetes 19 January 2010 8:50 UTC www.videojug.com [Source type: General]

.There is a stronger inheritance pattern for type 2 diabetes.^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ There are two types of diabetes mellitus, type 1 and type 2.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Generally there are two types of diabetes.
  • Diabetes - Diabetes Treatment,Diabetes Diet,Diabetes Cure 19 January 2010 8:50 UTC www.herbalcureindia.com [Source type: FILTERED WITH BAYES]

.Those with first-degree relatives with type 2 have a much higher risk of developing type 2, increasing with the number of those relatives.^ Gestational diabetes also increases the risk for developing type 2 diabetes.
  • Diabetes 19 January 2010 8:50 UTC www.umm.edu [Source type: Academic]

^ Increasing age is a major risk factor for the development of type 2 diabetes.
  • Diabetes Care for Older Adults 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

^ Those with first-degree relatives with type 2 have a much higher risk of developing type 2.

.Concordance among monozygotic twins is close to 100%, and about 25% of those with the disease have a family history of diabetes.^ Folic acid and vitamin B12 are two nutrients that are associated with reduced risk of heart disease and therefore may be important to those with type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ The genetics of T1D has a long history of studies evaluating candidate genes for association with disease status in either case-control or family-based studies.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ Obtain a baseline electrocardiogram in all patients with diabetes and repeat the procedure yearly for those with clinically apparent cardiovascular disease.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.Genes significantly associated with developing type 2 diabetes, include TCF7L2, PPARG, FTO, KCNJ11, NOTCH2, WFS1, CDKAL1, IGF2BP2, SLC30A8, JAZF1, and HHEX.^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Type 2 diabetes, especially in vulnerable racial and ethnic groups, may be associated with a thrifty gene.

^ Increased weight gain in infancy has been associated with a one-and-a-half-fold increase in the risk of developing type 1 diabetes in childhood.

[22] .KCNJ11 (potassium inwardly rectifying channel, subfamily J, member 11), encodes the islet ATP-sensitive potassium channel Kir6.2, and TCF7L2 (transcription factor 7–like 2) regulates proglucagon gene expression and thus the production of glucagon-like peptide-1.^ The ENSA gene encodes -endosulfine, an endogenous regulator of beta-cell K (ATP) channels, 158 and the recombinant -endosulfine has been shown to inhibit sulfonylurea binding to beta-cell membranes, to reduce K(ATP) channel currents, and to stimulate insulin secretion.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ Another candidate gene, ZNF236 , which encodes a Kruppel-like zinc-finger protein, has recently been identified in this region; this gene may be a candidate for diabetic nephropathy 136 in particular.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ Heron L, Virsolvy A, Apiou F, Le-Cam A, Bataille D. Isolation, characterization, and chromosomal localization of the human ENSA gene that encodes alpha-endosulfine, a regulator of beta-cell K(ATP) channels.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

[2] .Moreover, obesity (which is an independent risk factor for type 2 diabetes) is strongly inherited.^ Obesity is the main risk factor for type 2 diabetes .

^ Gumbiner B. Treating obesity in type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Obesity is one of the major risk factors in Type 2 Diabetes.
  • Signs & Symptoms of Diabetes - Natural Supplement to Treat Diabetes 19 January 2010 8:50 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

[23]
Monogenic forms, e.g., MODY, constitute 1–5 % of all cases.[24]
.Various hereditary conditions may feature diabetes, for example myotonic dystrophy and Friedreich's ataxia.^ In some patients, the condition may culminate in diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic coma.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Secondary diabetes may occur in patients taking glucocorticoids or when patients have conditions that antagonize the actions of insulin (eg, Cushing syndrome , acromegaly , pheochromocytoma ).
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Diabetes mellitus may be caused by other conditions.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

Wolfram's syndrome is an autosomal recessive neurodegenerative disorder that first becomes evident in childhood. It consists of diabetes insipidus, diabetes mellitus, optic atrophy, and deafness, hence the acronym DIDMOAD.[25]
.Gene expression promoted by a diet of fat and glucose as well as high levels of inflammation related cytokines found in the obese results in cells that "produce fewer and smaller mitochondria than is normal," and are thus prone to insulin resistance.^ Normally, certain cells in the pancreas produce a substance called insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ This situation is referred to as insulin resistance, as the cells are resistant to the normal effects of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ For others, the insulin is normal, but the cells of the body are producing insulin receptors that are defective.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[26]

Pathophysiology

.
The fluctuation of blood sugar (red) and the sugar-lowering hormone insulin (blue) in humans during the course of a day with three meals.
^ Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Patients will require three meals and up to three snacks each day.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Animal research has also revealed a direct blood sugar-lowering effect of ginseng.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

One of the effects of a sugar-rich vs a starch-rich meal is highlighted.
.
Mechanism of insulin release in normal pancreatic beta cells.
^ (Beta cells are responsible for the production of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Type 1 (insulin-dependent) diabetes mellitus (T1D) [MIM 222100] develops as a result of pancreatic beta-cell destruction and is characterised by absolute insulin deficiency, an abrupt onset of symptoms, proneness to ketosis and dependency on exogenous insulin to sustain life.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ Independent development of pancreatic alpha- and beta-cells from Neurogenin3-expressing precursors ¾ A role for the notch pathway in repression of premature differentiation.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

.Insulin production is more or less constant within the beta cells, irrespective of blood glucose levels.^ In this type the body stops producing insulin or produce less to regulate the level of blood glucose.
  • Home Remedies for Diabetes - Treatment & Cure - Natural Remedy for Diabetes – Diabetes Diet 19 January 2010 8:50 UTC www.natural-homeremedies.com [Source type: FILTERED WITH BAYES]

^ The hormone insulin, made in the beta cells of the pancreas, controls the glucose levels in the blood.
  • Diabetes Mellitus - Kosmix : Reference, Videos, Images, News, Shopping and more... 19 January 2010 8:50 UTC www.kosmix.com [Source type: FILTERED WITH BAYES]

^ Blood glucose levels were determined at 0, 1, 3, 5, 6th month, and insulin levels at 1, 3, 6th month.

.It is stored within vacuoles pending release, via exocytosis, which is primarily triggered by food, chiefly food containing absorbable glucose.^ It is stored within vacuoles pending release, via exocytosis, which is triggered by increased blood glucose levels.

^ Pure glucose is the preferred treatment; however, ingestion of glucose or carbohydrate-containing foods will work.
  • USPharmacist.com > Gestational Diabetes Mellitus 19 January 2010 8:50 UTC www.uspharmacist.com [Source type: Academic]

^ Most blood glucose comes from carbohydrates in the food you eat, but your body can make glucose from stored proteins and fat as well.
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

The chief trigger is a rise in blood glucose levels after eating
.Insulin is the principal hormone that regulates uptake of glucose from the blood into most cells (primarily muscle and fat cells, but not central nervous system cells).^ Insulin is a hormone that controls the production of glucose by the liver and allows cells to remove glucose from the blood.

^ Insulin is a hormone responsible for transporting glucose into cells.
  • Diabetes: Online References For Health Concerns 19 January 2010 8:50 UTC www.lef.org [Source type: Academic]

^ It can pass from the blood to cells with the help of a hormone called insulin .

.Therefore deficiency of insulin or the insensitivity of its receptors plays a central role in all forms of diabetes mellitus.^ Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types".

^ Insulin plays a role in storing magnesium.

^ Inhaled insulin for diabetes mellitus .
  • Public - Diabetes Mellitus, Type 1 - Resources 19 January 2010 8:50 UTC pier.acponline.org [Source type: Academic]

.Humans are capable of digesting some carbohydrates, in particular those most common in food; starch, and some disaccharides such as sucrose, are converted within a few hours to simpler forms most notably the monosaccharide glucose, the principal carbohydrate energy source used by the body.^ Yale's log sheet lets you enter blood glucose readings, insulin dosages, carbohydrate grams, and exercise (which you can put on a scale of 1 to 5) for any hour of the day.

^ Insulin and glucose responses to various starch-containing foods in type II diabetic subjects.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ However, they should be substituted for other carbohydrate sources, or if added, covered with insulin or other glucose-lowering medication.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

.The most significant exceptions are fructose, most disaccharides (except sucrose and in some people lactose), and all more complex polysaccharides, with the outstanding exception of starch.^ Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some, 126 but not all, trials.

^ Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most, 126 , 127 , 128 but not all, 129 double-blind trials.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some, 101 but not all, trials.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

The rest are passed on for processing by gut flora largely in the colon. .Insulin is released into the blood by beta cells (β-cells), found in the Islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating.^ Insulin is a hormone responsible for transporting glucose into cells.
  • Diabetes: Online References For Health Concerns 19 January 2010 8:50 UTC www.lef.org [Source type: Academic]

^ As a result, glucose stays in the blood, causing blood glucose levels to rise.
  • Diabetes: Treatment Options for Adult Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.naturaleyecare.com [Source type: FILTERED WITH BAYES]

^ Blood glucose levels were determined at 0, 1, 3, 5, 6th month, and insulin levels at 1, 3, 6th month.

.Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage.^ Insulin enables most body cells (about 2/3 is the usual estimate, including muscle cells and adipose tissue) to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage.

^ Insulin lowers the blood glucose level.
  • Diabetes Symptoms and Treatment Guide | Information for your Diabetes 19 January 2010 8:50 UTC www.euromedonline.com [Source type: FILTERED WITH BAYES]

^ There is plenty of insulin in the body but the cells are unable to use it.

.Insulin is also the principal control signal for conversion of glucose to glycogen for internal storage in liver and muscle cells.^ The passage of the glucose is controlled by insulin.

^ Insulin is also the principal control signal for conversion of glucose (the basic sugar used for fuel) to glycogen for internal storage in liver and muscle cells.

^ When there is excess glucose in the blood, insulin is secreted from the pancreas and signals the liver and muscles to store glucose as glycogen.
  • Diabetes: Online References For Health Concerns 19 January 2010 8:50 UTC www.lef.org [Source type: Academic]

.Lowered glucose levels result both in the reduced release of insulin from the beta cells and in the reverse conversion of glycogen to glucose when glucose levels fall.^ The hormone insulin, made in the beta cells of the pancreas, controls the glucose levels in the blood.
  • Diabetes Mellitus - Kosmix : Reference, Videos, Images, News, Shopping and more... 19 January 2010 8:50 UTC www.kosmix.com [Source type: FILTERED WITH BAYES]

^ Insulin lowers the blood glucose level.
  • Diabetes Symptoms and Treatment Guide | Information for your Diabetes 19 January 2010 8:50 UTC www.euromedonline.com [Source type: FILTERED WITH BAYES]

^ (Beta cells are responsible for the production of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

This is mainly controlled by the hormone glucagon which acts in the opposite manner to insulin. .Glucose thus forcibly produced from internal liver cell stores (as glycogen) re-enters the bloodstream; muscle cells lack the necessary export mechanism.^ Once the insulin binds to these receptors, cells are able to start absorbing sugar, also known as glucose, from the bloodstream.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ First off, it may be able to improve the ability of cells to absorb glucose, thus lowering high blood sugar levels.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Relative insulin deficiency usually occurs because of resistance to the actions of insulin in muscle, fat, and the liver and an inadequate response by the pancreatic beta cell.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

.Normally liver cells do this when the level of insulin is low (which normally correlates with low levels of blood glucose).^ Low blood levels of adiponectin are a marker for metabolic syndrome, are common in obesity, and are also associated with increased heart attack risk.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Insist that patients contact you promptly when the blood glucose level remains at 240 mg/dL or more, ketonuria develops, or acute illness persists.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Counsel patients about nutrition and teach them how to monitor their blood glucose levels and how to adjust their insulin treatment.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.Higher insulin levels increase some anabolic ("building up") processes such as cell growth and duplication, protein synthesis, and fat storage.^ Some children who drink cows’ milk produce antibodies to the milk, and it has been hypothesized that these antibodies can cross-react with and damage the insulin-producing cells of the pancreas.

^ In the type that develops early in childhood (type 1), the insulin-secreting cells of the pancreas are destroyed (probably by a viral infection), and blood levels of insulin drop nearly to zero.

^ Saturated fats make cell membranes less permeable and receptive to signals from messenger molecules such as insulin, while the omega-3-fatty acids supplied by cold water fish, walnuts and flaxseed render cell membranes more flexible and receptive.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Insulin (or its lack) is the principal signal in converting many of the bidirectional processes of metabolism from a catabolic to an anabolic direction, and vice versa.^ In insulin resistance, the anabolic process is reduced.

^ Insulin is the principal signal in converting many of the bidirectional processes of metabolism from a catabolic to an anabolic direction, and vice versa.

^ Diabetes Mellitus, Type 1 (juvenile diabetes) Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin, an anabolic hormone.

.In particular, a low insulin level is the trigger for entering or leaving ketosis (the fat burning metabolic phase).^ In particular, it is the trigger for entering or leaving ketosis (ie, the fat burning metabolic phase).

^ In particular, it is the trigger for entering or leaving ketosis (i.e.

^ Low blood levels of adiponectin are a marker for metabolic syndrome, are common in obesity, and are also associated with increased heart attack risk.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.If the amount of insulin available is insufficient, if cells respond poorly to the effects of insulin (insulin insensitivity or resistance), or if the insulin itself is defective, then glucose will not have its usual effect so that glucose will not be absorbed properly by those body cells that require it nor will it be stored appropriately in the liver and muscles.^ Healthy cell membranes are able to appropriately respond to insulin and therefore absorb glucose better.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ This situation is referred to as insulin resistance, as the cells are resistant to the normal effects of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ For others, the insulin is normal, but the cells of the body are producing insulin receptors that are defective.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.The net effect is persistent high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis.^ End the risk of high blood sugar levels and risk of other diseases.
  • Home Remedies for Diabetes - Treatment & Cure - Natural Remedy for Diabetes – Diabetes Diet 19 January 2010 8:50 UTC www.natural-homeremedies.com [Source type: FILTERED WITH BAYES]

^ A high blood glucose level is always better than hypoglycemia.
  • Diabetes Mellitus in Cats ~ Pawprints and Purrs, Inc. 19 January 2010 8:50 UTC www.sniksnak.com [Source type: FILTERED WITH BAYES]

^ In four other cases, manganese supplementation had no effect on blood glucose levels.
  • Diabetes: Treatment Options for Adult Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.naturaleyecare.com [Source type: FILTERED WITH BAYES]
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

Diagnosis

1999 WHO Diabetes criteria[27]
Condition 2 hour glucose Fasting glucose
mmol/l(mg/dl) mmol/l(mg/dl)
Normal <7.8 (<140) <6.1 (<110)
Impaired fasting glycaemia <7.8 (<140) ≥ 6.1(≥110) & <7.0(<126)
Impaired glucose tolerance ≥7.8 (≥140) <7.0 (<126)
Diabetes mellitus ≥11.1 (≥200) ≥7.0 (≥126)
Diabetes mellitus is characterized by recurrent or persistent hyperglycemia, and is diagnosed by demonstrating any one of the following:[10]
.
  • Fasting plasma glucose level at or above 7.0 mmol/L (126 mg/dL).
  • Plasma glucose at or above 11.1 mmol/L (200 mg/dL) two hours after a 75 g oral glucose load as in a glucose tolerance test.
  • Symptoms of hyperglycemia and casual plasma glucose at or above 11.1 mmol/L (200 mg/dL).
  • Glycated hemoglobin (hemoglobin A1C) at or above 6.5. (This criterion was recommended by the American Diabetes Association in 2010; it has yet to be adopted by the WHO.^ Possible screening tests for these conditions include a fasting plasma glucose or an oral glucose tolerance test.
    • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

    ^ Fasting plasma glucose greater than or equal to 126 mg/dL Casual plasma glucose greater than or equal to 200 mg/dL plus typical symptoms of diabetes In the absence of unequivocal hyperglycemia associated with acute metabolic decompensation, the results should be confirmed by repeat testing on a different day.
    • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

    ^ Diagnostic Testing for Diabetes or Prediabetes Prediabetes is now the term recommended for patients with impaired glucose tolerance or impaired fasting glucose.
    • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

    )[28]
.About a quarter of people with new type 1 diabetes have developed some degree of diabetic ketoacidosis (a type of metabolic acidosis which is caused by high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids) by the time the diabetes is recognized.^ The New family cookbook for people with diabetes .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Most people with type 2 diabetes are overweight.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ New insights into type 2 diabetes.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

.The diagnosis of other types of diabetes is usually made in other ways.^ It heals diabetes types and other diseases too!

^ Or do you have any of the other diabetes types?

^ Type 1 diabetes is usually diagnosed in childhood.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

.These include ordinary health screening; detection of hyperglycemia during other medical investigations; and secondary symptoms such as vision changes or unexplainable fatigue.^ Other symptoms can include fatigue, blurred vision, increased hunger, and sores that do not heal.

^ Other people may have symptoms, such as: .
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

^ The most common are (1) ordinary health screening, (2) detection of hyperglycemia when a doctor is investigating a complication of longstanding, though unrecognized, diabetes, and (3) new signs and symptoms due to the diabetes, such as vision changes or unexplainable fatigue.

.Diabetes is often detected when a person suffers a problem that is frequently caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing or a foot ulcer, certain eye problems, certain fungal infections, or delivering a baby with macrosomia or hypoglycemia.^ Problems with the circulatory and immune systems can lead to poor wound healing and dangerous infections in diabetics.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Diabetes can lead to poor wound healing , higher risk of infections , and many other problems involving the eyes, kidneys, nerves, and heart.

^ People with diabetes are at high risk for heart disease , atherosclerosis , cataracts , retinopathy , stroke , poor wound healing , infections , and damage to the kidneys and nerves.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

.A positive result, in the absence of unequivocal hyperglycemia, should be confirmed by a repeat of any of the above-listed methods on a different day.^ A positive result should be confirmed by any of the above-listed methods on a different day, unless there is no doubt as to the presence of significantly-elevated glucose levels.

^ Fasting plasma glucose greater than or equal to 126 mg/dL Casual plasma glucose greater than or equal to 200 mg/dL plus typical symptoms of diabetes In the absence of unequivocal hyperglycemia associated with acute metabolic decompensation, the results should be confirmed by repeat testing on a different day.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ A positive result should be confirmed by another of the above-listed methods on a different day, unless there is no doubt as to the presence of significantly-elevated glucose levels.

.Most physicians prefer to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test.^ Fasting glucose (a measure of short-term blood sugar control) was also lower in the group taking the higher dose of chromium.

^ When glucose levels were monitored over a 24-hour period, participants eating the high-fiber diet had an average glucose level that was 10% lower than participants eating the ADA diet.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most, 126 , 127 , 128 but not all, 129 double-blind trials.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

[29] .According to the current definition, two fasting glucose measurements above 126 mg/dL (7.0 mmol/L) is considered diagnostic for diabetes mellitus.^ Current therapy of diabetes mellitus .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ There are two types of diabetes mellitus, type 1 and type 2.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ There are two types of diabetes mellitus.

.Patients with fasting glucose levels from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) are considered to have impaired fasting glucose.^ Insist that patients contact you promptly when the blood glucose level remains at 240 mg/dL or more, ketonuria develops, or acute illness persists.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Average bedtime plasma glucose values are less than 120 mg/dL with a goal of 110 to 150 mg/dL Bedtime glucose goals vary dependent on the patient's treatment program, risks for hypoglycemia, and time after last meal.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Weekly measurements of fasting and postprandial glucose levels are also an acceptable method of monitoring.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.Patients with plasma glucose at or above 140 mg/dL (7.8 mmol/L), but not over 200 mg/dL (11.1 mmol/L), two hours after a 75 g oral glucose load are considered to have impaired glucose tolerance.^ Diagnosis of Prediabetes Fasting plasma glucose of 100 mg/dL to 125 mg/dL Oral glucose tolerance test (OGTT) two-hour plasma glucose: 140 mg/dL to 199 mg/dL [R] Treatment of Prediabetes Patients who are identified with prediabetes should be referred for education and lifestyle interventions.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Average bedtime plasma glucose values are less than 120 mg/dL with a goal of 110 to 150 mg/dL Bedtime glucose goals vary dependent on the patient's treatment program, risks for hypoglycemia, and time after last meal.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

.Of these two pre-diabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus as well as cardiovascular disease.^ "Prediabetes" is either impaired fasting glucose or impaired glucose tolerance; the latter in particular is a major risk factor for progression to full-blown diabetes mellitus as well as cardiovascular disease.

^ Diabetes and cardiovascular disease.

^ Insulin resistance is a major contributor to progression of the disease and to complications of diabetes.
  • Treatment of Type 2 Diabetes Mellitus - May 15, 1999 - American Academy of Family Physicians 19 January 2010 8:50 UTC www.aafp.org [Source type: Academic]

[30]

Screening

.Diabetes screening is recommended for many people at various stages of life, and for those with any of several risk factors.^ Hypomagnesemia, a risk factor in diabetic retinopathy.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Among persons with diabetes, part of the increased likelihood of cardiovascular disease appears to be a consequence of the increased frequency of risk factors.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.The screening test varies according to circumstances and local policy, and may be a random blood glucose test, a fasting blood glucose test, a blood glucose test two hours after 75 g of glucose, or an even more formal glucose tolerance test.^ Blood for glucose values is drawn at 1 hour, 2 hours, and 3 hours.
  • Gestational Diabetes Mellitus 19 January 2010 8:50 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ L or 11.1 mmol/l two hours after a 75 g oral glucose load as in a glucose tolerance test.

^ The common fasting glucose test measures the amount of glucose in the blood after fasting.
  • Diabetes: Online References For Health Concerns 19 January 2010 8:50 UTC www.lef.org [Source type: Academic]

.Many healthcare providers recommend universal screening for adults at age 40 or 50, and often periodically thereafter.^ Many healthcare providers recommend universal screening for adults at age 40 or 50, and sometimes occasionally thereafter.

^ Symptoms of diabetes can develop suddenly (over days or weeks) in previously healthy children or adolescents, or can develop gradually (over several years) in overweight adults over the age of 40.
  • Diabetes: Treatment Options for Adult Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.naturaleyecare.com [Source type: FILTERED WITH BAYES]

^ Ask about aspirin use and recommend aspirin use in patients age 40 and over unless contraindicated [R] .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

.Earlier screening is typically recommended for those with risk factors such as obesity, family history of diabetes, high-risk ethnicity (Hispanic, Native American, Afro-Caribbean, Pacific Islander, or Māori).^ Type 2 is associated with several risk factors including family history, obesity, increased age, and ethnicity.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Native Hawaiian and other Pacific Islander .

^ Hypomagnesemia, a risk factor in diabetic retinopathy.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

[31][32]
.Many medical conditions are associated with diabetes and warrant screening.^ Many medical conditions are associated with a higher risk of various types of diabetes and warrant screening.

^ American Diabetes Association: Screening for type 2 diabetes.
  • Diabetes Care for Older Adults 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

^ Many medical conditions are associated with diabetes and warrant screening.

.A partial list includes: subclinical Cushing's syndrome,[17] testosterone deficiency,[20] high blood pressure, elevated cholesterol levels[citation needed], coronary artery disease[citation needed], past gestational diabetes, polycystic ovary syndrome, chronic pancreatitis, fatty liver, hemochromatosis[citation needed], cystic fibrosis, several mitochondrial neuropathies and myopathies (such as MIDD), myotonic dystrophy, Friedreich's ataxia, some of the inherited forms of neonatal hyperinsulinism.^ High blood pressure .

^ Diabetes is considered a coronary artery disease equivalent.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ High blood pressure control .

.The risk of diabetes is higher with chronic use of several medications, including long term corticosteroids, some chemotherapy agents (especially L-asparaginase), as well as some of the antipsychotics and mood stabilizers (especially phenothiazines and some atypical antipsychotics).^ Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ While this effect could be helpful in controlling diabetes , no research has investigated the long-term effects of taking starch blockers for this condition.

^ It has been suggested that since the actions of these various ginseng constituents are not well defined at this time, ginseng should not be used to treat diabetes until more is known.

.People with a confirmed diagnosis of diabetes are tested routinely for complications.^ This takes time and energy, but many people with diabetes do it successfully and live full lives without many complications.
  • Health Information on Consequences of Diabetes 15 September 2009 21:39 UTC www.quickmedical.com [Source type: FILTERED WITH BAYES]

^ Diabetes is diagnosed quite simply by measuring the levels of glucose in the blood and so a blood test is usually necessary to make a confirmed diagnosis.
  • Signs & Symptoms of Diabetes - Natural Supplement to Treat Diabetes 19 January 2010 8:50 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

^ NDEP's goal is to reduce the morbidity and mortality associated with diabetes and its complications by improving the treatment and outcomes for people with diabetes , promoting early diagnosis, and ultimately, preventing the onset of diabetes .
  • Diabetes - Kosmix : Reference, Videos, Images, News, Shopping and more... 19 January 2010 8:50 UTC www.kosmix.com [Source type: FILTERED WITH BAYES]

.This includes yearly urine testing for microalbuminuria and examination of the retina of the eye for retinopathy.^ Instruct patients with microalbuminuria or diabetic nephropathy to receive yearly eye examinations.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Studies have shown that retinal examinations by physicians who are not eye care specialists are not reliable in detecting retinopathy [A] , [C] , [R] .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Children in this developmental stage should have yearly eye examinations, regardless of how long they have had diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

Prevention

Type 1

.Type 1 diabetes risk is known to depend upon a genetic predisposition based on HLA types (particularly types DR3 and DR4), an unknown environmental trigger (suspected to be an infection, although none has proven definitive in all cases), and an uncontrolled autoimmune response that attacks the insulin producing beta cells.^ Pozzilli, P. Prevention of insulin-dependent diabetes.

^ Type 1, previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, is caused by autoimmune, genetic, and environmental factors.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ (Beta cells are responsible for the production of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[33] .Some research has suggested that breastfeeding decreased the risk in later life;[34][35] various other nutritional risk factors are being studied, but no firm evidence has been found.^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ There is no evidence that type 2 diabetes occurs in dogs or that obesity is a risk factor for canine diabetes.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

^ Other risk factors for peripheral vascular disease should be treated, including hypertension, hypercholesterolemia, and perhaps hyperglycemia.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

[36] .Giving children 2000 IU of Vitamin D during their first year of life is associated with reduced risk of type 1 diabetes, though the causal relationship is obscure.^ Association of CTLA4 gene A-G polymorphism with type 1 diabetes in Chinese children.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ The fourth type of diabetes mellitus is a group of "other specific types" that have surgery, drugs, malnutrition, or infections among the causal factors.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Wagner AM, Perez A, Calvo F. Apolipoprotein(B) identifies dyslipidemic phenotypes associated with cardiovascular risk in normocholesterolemic type 2 diabetic patients.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

[37]
Children with antibodies to beta cell proteins (i.e. at early stages of an immune reaction to them) but no overt diabetes, and treated with vitamin B-3 (niacin), had less than half the diabetes onset incidence in a 7-year time span as did the general population, and an even lower incidence relative to those with antibodies as above, but who received no vitamin B3.[38]

Type 2

Lifestyle
.Type 2 diabetes risk can be reduced in many cases by making changes in diet and increasing physical activity.^ Type 2 diabetes can be prevented in many cases by making changes in diet and increasing physical activity.

^ Red meat may also contribute to an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Many diabetics were unsuccessful when they changed their diet and exercise.
  • Death to Diabetes: Beat & Reverse Type 2 Diabetes -- Cure Diabetes Naturally Without Drugs 19 January 2010 8:50 UTC www.deathtodiabetes.com [Source type: General]

[39][40][41] .The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least 2½ hours of exercise per week (several brisk sustained walks appear sufficient), having a modest fat intake, and eating sufficient fiber (e.g., from whole grains).^ Diabetic diarrhea May last from a few hours to several weeks.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Warshaw, Hope S. The American Diabetes Association guide to healthy restaurant eating .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Encourage all nonpregnant adults with diabetes, especially those with renal involvement, to limit their daily protein intake to 0.8 g/kg of body weight, as recommended by the American Diabetes Association.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.The ADA does not recommend alcohol consumption as a preventive, but it is interesting to note that moderate alcohol intake may reduce the risk (though heavy consumption absolutely and clearly increases damage to bodily systems significantly); a similarly confused connection between low dose alcohol consumption and heart disease is termed the French Paradox.^ In these circumstances, protein intake should be reduced to the adult recommended daily allowance of 0.8 to 1.0 g/kg body weight per day with microalbuminuria present, and 0.8 g/kg body weight per day with macroalbuminuria present [R] .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Medical nutrition therapy Increased physical exercise Pharmacotherapy Beneficial effects of statins on cardiovascular risk reduction may, in part, be independent of their effects on lipids.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes; 90 however, heavy drinking does increase the risk of developing diabetes and should be avoided.

[citation needed]
.There is inadequate evidence that eating foods of low glycemic index is clinically helpful despite recommendations and suggested diets emphasizing this approach.^ Beans, peas, fruit, and oats have low glycemic indexes, despite their high carbohydrate content, due mostly to the health-promoting effects of soluble fiber .
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ For this reason, low-carbohydrate and low glycemic-index diets have been promoted for the prevention of type 2 diabetes.

^ People eating large amounts of foods with high glycemic indices (such as those mentioned above), have been reported to be at increased risk of type 2 diabetes.

[42]
.Diets that are very low in saturated fats reduce the risk of becoming insulin resistant and diabetic.^ High-fat diets are associated with an increased risk for diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Low-carbohydrate diets, restricting total carbohydrate to less than 130 g/day, are not recommended in the management of diabetes.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Diabetics should greatly reduce their intake of saturated fats found in meat and dairy products; excess omega-6 fats, highest in meat, dairy products, and corn, safflower and sunflower oils; and trans fats, which are found in margarine, non-dairy creamers, and processed foods.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[43][44] .Study group participants whose "physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes."^ Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Low blood levels of adiponectin are a marker for metabolic syndrome, are common in obesity, and are also associated with increased heart attack risk.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

[13] .In another study of dietary practice and incidence of diabetes, "foods rich in vegetable oils, including non-hydrogenated margarines, nuts, and seeds, should replace foods rich in saturated fats from meats and fat-rich dairy products.^ Diabetics should greatly reduce their intake of saturated fats found in meat and dairy products; excess omega-6 fats, highest in meat, dairy products, and corn, safflower and sunflower oils; and trans fats, which are found in margarine, non-dairy creamers, and processed foods.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Avoiding hydrogenated oils and deep fried food is a must for diabetics.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Instead, use olive oil to replace other oils, like corn, sunflower, or safflower oil, and other sources of fat, such as the saturated fats found in meat and dairy products, or the unhealthy trans fats found in margarines.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Consumption of partially hydrogenated fats should be minimized."^ Consumption of animal products and the use of refined vegetable oils should be minimized and replaced with health-promoting fats.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[12]
.There are numerous studies which suggest connections between some aspects of Type II diabetes with ingestion of certain foods or with some drugs.^ What is the difference between type 1 and type 2 diabetes?
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Other connections between mercury and type 1 diabetes have also been demonstrated.
  • Diabetes incidence is increasing drastically 19 January 2010 8:50 UTC www.flcv.com [Source type: Academic]

.Breastfeeding may also be associated with the prevention of type 2 of the disease in mothers.^ Breastfeeding might also be correlated with the prevention of type 2 of the disease in mothers.

^ Women who have type 2 diabetes and take these medications may be switched to insulin during pregnancy and while breastfeeding.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ They may also take aspirin to prevent a heart attack , a stroke , or other large blood vessel diseases ( macrovascular disease ).
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

[45]
Medications
.Some studies have shown delayed progression to diabetes in predisposed patients through prophylactic use of metformin,[40] rosiglitazone,[46] or valsartan.^ In some patients, the condition may culminate in diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic coma.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Preliminary studies suggest that some diabetic patients with hypertriglyceridemia may benefit by restricting carbohydrate intake to 40% to 45% of total calories.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Studies show that type 2 diabetes patients have higher levels of free radicals in their bodies than non-diabetics.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[47] .In patients on hydroxychloroquine for rheumatoid arthritis, incidence of diabetes was reduced by 77% though causal mechanisms are unclear.^ In addition, vitamin E has been shown to reduce the symptoms of poor circulation and nerve damage in patients with advanced diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Reduced coronary events in simvastatin-treated patients with coronary heart disease and diabetes or impaired fasting glucose levels: subgroup analyses in the Scandinavian Simvastatin Survival Study.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Tell patients with diabetic retinopathy about the availability and benefits of early and timely laser photocoagulation therapy in reducing the risk of visual loss.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

[48] .Lifestyle interventions are however more effective than metformin at preventing diabetes regardless of weightloss.^ There is no question, however, that people who are obese have a far greater tendency to develop type 2 diabetes than those who are relatively slim; therefore, weight loss (especially when accompanied by increase in exercise) is clearly an effective step for prevention.

^ At present, strategies for preventing diabetic nephropathy must be viewed as limited in their effectiveness, since the exact pathogenic factors responsible for this condition are unknown.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ However, olive oil, though more stable than some oils, can still be damaged by heat.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[49]

Management

.Diabetes mellitus is a chronic disease which is difficult to cure.^ Alcohol intake and the risk of coronary heart disease mortality in persons with older-onset diabetes mellitus.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ The LDL cholesterol goal for people with diabetes mellitus without coronary artery disease (CAD) is less than 100 mg/dL. The goal with CAD is less than 70 mg/dL. .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Prevalences of type 2 diabetes mellitus, the insulin resistance syndrome, and coronary heart disease in an elderly, biethnic population .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

.Management concentrates on keeping blood sugar levels as close to normal ("euglycemia") as possible without presenting undue patient danger.^ Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Insist that patients contact you promptly when the blood glucose level remains at 240 mg/dL or more, ketonuria develops, or acute illness persists.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Counsel patients about nutrition and teach them how to monitor their blood glucose levels and how to adjust their insulin treatment.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.This can usually be with close dietary management, exercise, and use of appropriate medications (insulin only in the case of type 1 diabetes mellitus.^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ People with type 1 diabetes who exercise require less insulin.

^ McDevitt HO. Closing in on type 1 diabetes.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

.Oral medications may be used in the case of type 2 diabetes, as well as insulin).^ Oral magnesium supplementation in insulin-requiring type 2 diabetic patients.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Medical management of type 2 diabetes .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Insulin sensitivity in subjects with type 2 diabetes.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

Lifestyle modifications

.There are roles for patient education, dietetic support, sensible exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds.^ Patient Education Principles: Help patients maintain good control of their blood glucose levels.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Effect of Konjac food on blood glucose level in patients with diabetes.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Insist that patients contact you promptly when the blood glucose level remains at 240 mg/dL or more, ketonuria develops, or acute illness persists.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure[50] in patients with hypertension, cholesterol in those with dyslipidmia, as well as exercising more, smoking less or ideally not at all, consuming a recommended diet[citation needed].^ Action to help control blood pressure .

^ High blood pressure control .

^ Before and during the trial, cats in our study consumed complete and balanced diets that met the Association of American Feed Control Officials standards for adult maintenance, and were expected to contain adequate chromium levels.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

.Patients with foot problems are also recommended to wear diabetic socks[citation needed], and possibly diabetic shoes[citation needed].^ Psychiatric problems unrelated to the patient's diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ If the foot is deformed, the patient will likely need consultation and should benefit from having specially molded shoes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Since anaerobes frequently occur in the foot ulcers of diabetic patients, take both aerobic and anaerobic bacterial cultures to help select antibiotics.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

Medications

Oral medications
Insulin
.Type 1 treatments usually include combinations of regular or NPH insulin, and/or synthetic insulin analogs.^ Impact of ubiquinone (coenzyme Q10) treatment on glycaemic control, insulin requirement and well-being in patients with Type 1 diabetes mellitus.

^ Conventional treatment for type 1 diabetes includes insulin injections and careful dietary monitoring.

^ Effects of chromium treatment in patients with poorly controlled, insulin-treated Type 2 diabetes mellitus [abstract 756].

Support

.In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects.^ Over time, this alliance may lead to better glycemic control by helping the patient address such self-care barriers as low motivation, preconceived judgments about treatment, and fears about diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Basil Preliminary trials of holy basil (Ocimim sanctum) leaves and hairy basil (Ocimum canum) seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels.

^ Animal research has also revealed a direct blood sugar-lowering effect of ginseng.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

.In other circumstances, general practitioners and specialists share care of a patient in a team approach.^ In other circumstances, general practitioners and specialists may share care of a patient in a team approach.

^ In other circumstances, general practitioners and specialists share care of a patient in a team approach.

^ In countries with a general practitioner system, such as the United Kingdom, care may be extended mainly in the community, with hospital-based specialist input only in case of complications, difficult blood sugar control, or participation in research.

.Optometrists, podiatrists/chiropodists, dietitians, physiotherapists, nursing specialists (e.g., DSNs (Diabetic Specialist Nurse)), nurse practitioners, or Certified Diabetes Educators, may jointly provide multidisciplinary expertise.^ Usually appropriate education may require the expertise of the diabetes educator.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ These programs may be staffed with endocrinologists or primary care providers plus diabetes educators including dietitians, nurses, and other health care providers who are Certified Diabetes Educators (CDE) or have didactic and experiential expertise in diabetes care and education.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Medicare reimbursement for diabetes self-management training requires this service be provided by an education program that has achieved recognition by the American Diabetes Association; the staff in such a program is multidisciplinary and includes at least a registered dietician (RD) and a registered nurse (RN) with experiential preparation in education and diabetes management [R] .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

.In countries where patients must provide for their own health care (e.g.^ Thus, the degree that improved relationships can be established be-tween diabetes specialists and primary care health providers will determine the quality of diabetes care.

^ Yet changing the behaviors of persons with diabetes, health care providers, or other individuals or organizations involved in diabetes health care (for example, health maintenance organizations and employers) is difficult.

^ Peters AL, Legorreta AP, Ossorio RC. Quality of outpatient care provided to diabetic patients.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

in the US, and in much of the undeveloped world).
.Peer support links people living with diabetes.^ People with diabetes who smoke are at higher risk for kidney damage, 68 heart disease, 69 and other diabetes-linked problems.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ People with diabetes who smoke are at higher risk for kidney damage, 94 heart disease, 95 and other diabetes-linked problems.

.Within peer support, people with a common illness share knowledge and experience that others, including many health workers, do not have.^ Many other factors could be involved, including genetics and excess weight.

^ These and other health problems associated with diabetes contribute to an impaired quality of life and substantial disability among people with diabetes.

Peer support is frequent, ongoing, accessible and flexible and can take many forms—phone calls, text messaging, group meetings, home visits, and even grocery shopping. .It complements and enhances other health care services by creating the emotional, social and practical assistance necessary for managing disease and staying healthy.^ These programs may complement the care and education that are routinely part of standard medical practice, and may enhance a patient's ability to self-manage diabetes.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ The health care provider can treat periodontal disease by helping the patient achieve good glycemic control.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Yet changing the behaviors of persons with diabetes, health care providers, or other individuals or organizations involved in diabetes health care (for example, health maintenance organizations and employers) is difficult.

Prognosis

.Patient education, understanding, and participation is vital since the complications of diabetes are far less common and less severe in people who have well-managed blood sugar levels.^ B Vitamins Many people with diabetes have low blood levels of vitamin B6 .

^ People with type 1 diabetes who exercise require less insulin.

^ Unfortunately, high intakes of this nutrient can cause high blood sugar levels in people with diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[51][52] .Wider health problems may accelerate the deleterious effects of diabetes.^ If diabetes is a public health problem, why not treat it as one?

^ While the United States Public Health Service and the American College of Physicians do not recommend routine screening for diabetes, targeted screening may be useful.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ There are several things that may cause the problem of type 2 diabetes, and they may start sooner than we think.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise.^ High blood pressure .

^ Regular exercise has also been shown to have a beneficial effect on blood pressure.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ High blood pressure control .

.According to one study, women with high blood pressure (hypertension) were three times more likely to develop type 2 diabetes as compared with women with optimal BP after adjusting for various factors such as age, ethnicity, smoking, alcohol intake, body mass index (BMI), exercise, family history of diabetes, etc.^ A prospective study of moderate alcohol drinking and risk of diabetes in women.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ The type 2 family: a setting for development and treatment of adolescent type 2 diabetes mellitus.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Cigarette smoking and the risk of diabetes in women.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

[53] .The study was conducted by researchers from the Brigham and Women’s Hospital, Harvard Medical School and the Harvard School of Public Health, USA, who followed over 38,000 female health professionals for ten years.^ For 12 years, researchers followed 38,394 men aged 40 to 75 years, who were participants in the Health Professionals Follow-up Study.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ In one of the studies, a research team from the Harvard School of Public Health followed 85,060 women for 18 years and 42,872 men for 12 years.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Lu Qi and colleagues at the Harvard School of Public Health found a significant association between red meat and dietary iron intake and incidence of fatal coronary heart disease, coronary revascularization and total coronary heart disease in the 6,161 women with type 2 diabetes who were enrolled in the study, which ran from 1980 to 2000.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Except in the case of type 1 diabetes, which always requires insulin replacement, the way type 2 diabetes is managed may change with age.^ People with type 1 diabetes who exercise require less insulin.

^ Medical management of type 1 diabetes .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Oral magnesium supplementation in insulin-requiring type 2 diabetic patients.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

.Insulin production decreases because of age-related impairment of pancreatic beta cells.^ (Beta cells are responsible for the production of insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Insulin production decreases because of the age-related impairment of pancreatic beta cells.

^ Beta cells of pancreas are responsible in production of a protein known as insulin.
  • Diabetes - Diabetes Treatment,Diabetes Diet,Diabetes Cure 19 January 2010 8:50 UTC www.herbalcureindia.com [Source type: FILTERED WITH BAYES]

.Additionally, insulin resistance increases because of the loss of lean tissue and the accumulation of fat, particularly intra-abdominal fat, and the decreased tissue sensitivity to insulin.^ Weight loss may be recommended as body fat increases a person's resistance to insulin.
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

^ Insulin resistance increases due to the loss of lean tissue and the accumulation of fat, particularly intra-abdominal fat, and the decreased tissue sensitivity to insulin.

^ Insulin resistance refers to markedly decreased insulin sensitivity ( 21 ).
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

.Glucose tolerance progressively declines with age, leading to a high prevalence of type 2 diabetes and postchallenge hyperglycemia in the older population.^ Extremely high glucose levels can lead to diabetic coma.
  • Fighting Diabetes Mellitus 19 January 2010 8:50 UTC www.healthguidance.org [Source type: FILTERED WITH BAYES]

^ The high prevalence of diabetes in older adults is inevitable.
  • Diabetes Care for Older Adults 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

^ Type II diabetes was the 'privilege' of the middle age and older people.
  • Fighting Diabetes Mellitus 19 January 2010 8:50 UTC www.healthguidance.org [Source type: FILTERED WITH BAYES]

[54] .Age-related glucose intolerance in humans is often accompanied by insulin resistance, but circulating insulin levels are similar to those of younger people.^ Age-related glucose intolerance in humans is often accompanied by insulin resistance, but circulating insulin levels are similar to those of younger people.

^ Insulin levels are especially relevant when fasting glucose and insulin levels do not show insulin resistance.
  • Type 2 Diabetes Mellitus in Childhood: Obesity and Insulin Resistance -- Schwartz and Chadha 108 (9): 518 -- Journal of the American Osteopathic Association 19 January 2010 8:50 UTC www.jaoa.org [Source type: Academic]

^ Role of insulin resistance in human disease.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

[55] .Treatment goals for older patients with diabetes vary with the individual, and take into account health status, as well as life expectancy, level of dependence, and willingness to adhere to a treatment regimen.^ Dietary therapy is the mainstay of treatment for patients with gestational diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Raghuram TC, Sharma RD, Sivakumar B, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Since anaerobes frequently occur in the foot ulcers of diabetic patients, take both aerobic and anaerobic bacterial cultures to help select antibiotics.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

[56] .Glycated hemoglobin is better than fasting glucose for determining risks of cardiovascular disease and death from any cause.^ Cardiovascular disease deaths in persons with diabetes .

^ Cardiovascular disease deaths in persons with chronic kidney failure .

^ Among persons with diabetes, part of the increased likelihood of cardiovascular disease appears to be a consequence of the increased frequency of risk factors.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

[57]

Epidemiology

.
Prevalence of diabetes worldwide in 2000 (per 1000 inhabitants).
^ Baseline: 8.8 deaths per 1,000 persons with diabetes listed anywhere on the death certificate occurred in 1997 (age adjusted to the year 2000 standard population).

^ Baseline: 343 deaths from cardiovascular disease per 100,000 persons with diabetes occurred in 1997 (age adjusted to the year 2000 standard population).

^ Baseline: 4.1 lower extremity amputations per 1,000 persons with diabetes occurred in 1997 (age adjusted to the year 2000 standard population).

World average was 2.8%.
     no data      ≤ 7.5      7.5–15      15–22.5      22.5–30      30–37.5      37.5–45      45–52.5      52.5–60      60–67.5      67.5–75      75–82.5      ≥ 82.5
Disability-adjusted life year for diabetes mellitus per 100,000 inhabitants in 2002.[58]
     no data      ≤ 100      100-200      200-300      300-400      400-500      500-600      600-700      700-800      800-900      900-1000      1000-1500      ≥ 1500
.In 2000, according to the World Health Organization, at least 171 million people worldwide suffer from diabetes, or 2.8% of the population.^ The world health organization multinational study of vascular disease in diabetes.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ In 2006, according to the World Health Organization, at least 171 million people worldwide suffer from diabetes.

^ Geneva: World Health Organization; 1985.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

[4] .Its incidence is increasing rapidly, and it is estimated that by 2030, this number will almost double.^ The number of persons with diabetes has increased steadily over the past decade; presently, 10.5 million persons have been diagnosed with diabetes, while 5.5 million persons are estimated to have the disease but are undiagnosed.

[4] .Diabetes mellitus occurs throughout the world, but is more common (especially type 2) in the more developed countries.^ Follow-up: Diabetes Mellitus, Type 2 .
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ There are four types of diabetes mellitus.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Type 2 diabetes mellitus is slightly more common in older women than men.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

.The greatest increase in prevalence is, however, expected to occur in Asia and Africa, where most patients will probably be found by 2030.[4] The increase in incidence of diabetes in developing countries follows the trend of urbanization and lifestyle changes, perhaps most importantly a "Western-style" diet.^ CDC. Trends in the prevalence and incidence of self-reported diabetes mellitusUnited States, 19801994.

^ Wannamethee SG, Shaper AG. Weight change and duration of overweight and obesity in the incidence of type 2 diabetes.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.This has suggested an environmental (i.e., dietary) effect, but there is little understanding of the mechanism(s) at present, though there is much speculation, some of it most compellingly presented.^ This has suggested an environmental (i.e., dietary) effect, but there is little understanding of the mechanism(s) at present, though there is much speculation, some of it most compellingly presented.

^ Some cats aren't friendly enough to allow any testing and some clients are a little too squeamish but most can do this.
  • Diabetes in Cats 15 September 2009 6:06 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ There was an Italian study of new-onset diabetes, not the most robust or authoritative of studies, but it indicated that the effect of new-onset diabetes on clinical events did not emerge for at least 5 years.
  • http://www.marshallprotocol.com/forum37/3088.html 19 January 2010 8:50 UTC www.marshallprotocol.com [Source type: Academic]

[4]
.For at least 20 years, diabetes rates in North America have been increasing substantially.^ The prevalence rate of retinopathy in diabetic subjects over 74 years of age ranges between 25 and 70%.
  • Diabetes Care for Older Adults 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

^ Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Diabetes is sweeping through America like a wildfire, afflicting nearly 21 million Americans and fueling an estimated $20 billion industry for treatment.
  • Diabetes: News & Videos about Diabetes - CNN.com 19 January 2010 8:50 UTC topics.cnn.com [Source type: News]

.In 2008 there were about 24 million people with diabetes in the United States alone, from those 5.7 million people remain undiagnosed.^ Of those, 5.4 million are not aware that they are diabetic.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ People eating large amounts of foods with high glycemic indices (such as those mentioned above), have been reported to be at increased risk of type 2 diabetes.

^ Diabetes is increasingly common in the United States and the world.

.Other 57 million people are estimated to have pre-diabetes.^ Immune problems in people with type 1 diabetes have been tied to other allergies as well, 61 and the importance of focusing only on the avoidance of dairy products remains unclear.

^ However, since this was a trial conducted among people in a vitamin B1-deficient developing country, these improvements might not occur in other people with diabetes.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ People with diabetes who smoke are at higher risk for kidney damage, 68 heart disease, 69 and other diabetes-linked problems.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

[59]
.The Centers for Disease Control has termed the change an epidemic.^ Many were also able to reduce pain medications, but no long-term change in blood-sugar control was observed.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Note: Unless otherwise noted, data are from the Centers for Disease Control and Prevention, National Center for Health Statistics, Healthy People 2000 Review, 199899.

^ Diabetes mellitus is the leading cause of end-stage renal disease (ESRD), accounting for 44% of new cases, according to the Centers for Disease Control and Prevention (CDC).
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

[60] .The National Diabetes Information Clearinghouse estimates that diabetes costs $132 billion in the United States alone every year.^ Diabetes is a costly disease; estimates of the total attributable costs of diabetes are around $100 billion ($43 billion direct; $45 billion indirect).

^ Diabetes is increasingly common in the United States and the world.

^ CLOSE WINDOW ] Prevalence of diabetes mellitus type 2 in various racial and ethnic groups in the United States (2007 estimates).
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

.About 5%–10% of diabetes cases in North America are type 1, with the rest being type 2. The fraction of type 1 in other parts of the world differs.^ Other specific types of diabetes account for a smaller proportion of cases in each species.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

^ Little is known about the environmental or genetic causes of diseases that produce other specific types of diabetes in cats.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

^ Type 1 Diabetes or Juvenile Diabetes is a very different condition from type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

Most of this difference is not currently understood. .The American Diabetes Association cite the 2003 assessment of the National Center for Chronic Disease Prevention and Health Promotion (Centers for Disease Control and Prevention) that 1 in 3 Americans born after 2000 will develop diabetes in their lifetime.^ Alexandria, VA, American Diabetes Association, 2000.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ According to the Centers for Disease Control and Prevention, 15.7 million Americans have diabetes.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ RC660.5.S45 2000 Discusses the different kinds of diabetes, their symptoms and proper treatment, as well as medical complications connected with this lifetime disease.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

[61][62]
.According to the American Diabetes Association, approximately 18.3% (8.6 million) of Americans age 60 and older have diabetes.^ American Diabetes Association (2004).
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

^ American Diabetes Association (2000).
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

^ American Diabetes Association (2008).
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

[63] .Diabetes mellitus prevalence increases with age, and the numbers of older persons with diabetes are expected to grow as the elderly population increases in number.^ The prevalence of diabetes mellitus by age is shown in the image below.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ The prevalence of glaucoma increases with the patient's age and with the length of time the patient has had diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Diabetes mellitus in the elderly .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

.The National Health and Nutrition Examination Survey (NHANES III) demonstrated that, in the population over 65 years old, 18% to 20% have diabetes, with 40% having either diabetes or its precursor form of impaired glucose tolerance.^ Dietary factors determining diabetes and impaired glucose tolerance.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults: The Third National Health and Nutrition Examination Survey, 19881994.

^ Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS. .

[54]
.Indigenous populations in first world countries have a higher prevalence and increasing incidence of diabetes than their corresponding non-indigenous populations.^ Diabetes incidence is increasing drastically.
  • Diabetes incidence is increasing drastically 19 January 2010 8:50 UTC www.flcv.com [Source type: Academic]

^ The increase in incidence of diabetes in developing countries follows the trend of urbanization and lifestyle changes, perhaps most importantly a "Western-style" diet.

^ Data from throughout the world 27 - 29 show that obesity, associated insulin resistance, and type 2 diabetes have dramatically increased in locations where lifestyles have recently been "westernized."
  • Type 2 Diabetes Mellitus in Childhood: Obesity and Insulin Resistance -- Schwartz and Chadha 108 (9): 518 -- Journal of the American Osteopathic Association 19 January 2010 8:50 UTC www.jaoa.org [Source type: Academic]

.In Australia the age-standardised prevalence of self-reported diabetes in Indigenous Australians is almost 4 times that of non-indigenous Australians.^ The prevalence of glaucoma increases with the patient's age and with the length of time the patient has had diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ The prevalence rate of retinopathy in diabetic subjects over 74 years of age ranges between 25 and 70%.
  • Diabetes Care for Older Adults 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

^ CDC. Trends in the prevalence and incidence of self-reported diabetes mellitusUnited States, 19801994.

[64] .Preventative community health programs such as Sugar Man (diabetes education) are showing some success in tackling this problem.^ Massage therapy has shown some promise for enhancing blood sugar control in children with diabetes.

^ Patient Education Principles: For patients with diabetic ketoacidosis-- Be sure your patients with diabetes know the following: If they are at risk for DKA. When they are most susceptible to DKA. What they can do to prevent DKA. When they should contact you.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ People with type 2 diabetes tend to be zinc deficient, 175 but some evidence indicates that zinc supplementation does not improve their ability to process sugar.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

History

.The term diabetes (Greek: διαβήτης, diabētēs) was coined by Aretaeus of Cappadocia.^ So close is the relationship between obesity and type 2 diabetes that researchers have coined a new term to describe it: diabesity .
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.It was derived from the Greek verb διαβαίνειν, diabaínein, itself formed from the prefix dia-, "across, apart," and the verb bainein, "to walk, stand."^ It is derived from the Greek word διαβαίνειν , diabaínein that literally means "passing through," or "siphon", a reference to one of diabetes' major symptoms—excessive urine production.

.The verb diabeinein meant "to stride, walk, or stand with legs asunder"; hence, its derivative diabētēs meant "one that straddles," or specifically "a compass, siphon."^ It is derived from the Greek word διαβαίνειν , diabaínein that literally means "passing through," or "siphon", a reference to one of diabetes' major symptoms—excessive urine production.

.The sense "siphon" gave rise to the use of diabētēs as the name for a disease involving the discharge of excessive amounts of urine.^ It is derived from the Greek word διαβαίνειν , diabaínein that literally means "passing through," or "siphon", a reference to one of diabetes' major symptoms—excessive urine production.

^ The name which was originated by Aretaeus (30-90 CE) came from the Greek words meaning 'siphon' and 'to run through', signifying the chronic excretion of an excessive volume of urine.
  • Acupuncture.Com - Diabetes Mellitus- Traditional Chinese Medicine 19 January 2010 8:50 UTC www.acupuncture.com [Source type: Academic]

^ When the level of sugar in the urine rises even higher, the kidneys excrete additional water to dilute the large amount of sugar.
  • Diabetes Mellitus: Diabetes Mellitus (DM): Merck Manual Home Edition 19 January 2010 8:50 UTC www.merck.com [Source type: FILTERED WITH BAYES]

.Diabetes is first recorded in English, in the form diabete, in a medical text written around 1425. In 1675, Thomas Willis added the word mellitus, from the Latin meaning "honey", a reference to the sweet taste of the urine.^ Diabetes mellitus: a fundamental and clinical text .
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Queale WS, Seidler AJ, Brancati FL. Glycemic control and sliding scale insulin use in medical inpatients with diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ NGC:005856 American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

.This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, Indians, and Persians.^ This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, and Indians.

^ The ancient Indians tested for diabetes by observing whether ants were attracted to a person's urine, and called the ailment "sweet urine disease" (Madhumeha).

^ In 1675 Thomas Willis added the word mellitus to the disease, a word from Latin meaning "honey", a reference to the sweet taste of the urine.

.In 1776, Matthew Dobson confirmed that the sweet taste was because of an excess of a kind of sugar in the urine and blood of people with diabetes.^ People with diabetes have high blood sugar.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ Dobson M. Nature of the urine in diabetes.

^ In 1776 Matthew Dobson confirmed that the sweet taste was because of an excess of a kind of sugar in the urine and blood of people with diabetes.

[65]
.Diabetes mellitus appears to have been a death sentence in the ancient era.^ It appears to be a safe observation that patients with diabetes mellitus have thicker skin on their extremities.

^ Superimposition of caloric excess (typically, high intake and low expenditure) on a susceptible genotype appears to cause type 2 diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ Diabetic How to Deal With Diabetes: Confessions of a Closet Diabetic I refuse to accept the 'diabetic death sentence'.
  • Diabetics - Associated Content - Topic - associatedcontent.com 12 September 2009 7:40 UTC www.associatedcontent.com [Source type: General]

.Hippocrates makes no mention of it, which may indicate that he felt the disease was incurable.^ Low-dose oral contraceptives or a progestin-only pill may be offered to patients who have no evidence of hypertension or vascular disease.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Generally, no effective medical treatment is available for patients with peripheral vascular disease, although some patients may benefit from pentoxifylline.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Liver transplantation may be performed in patients with type 1 diabetes without any increased risk for graft or patient survival regardless of the underlying liver disease indication.
  • Liver Disease and Diabetes Mellitus 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

.Aretaeus did attempt to treat it but could not give a good prognosis; he commented that "life (with diabetes) is short, disgusting and painful."^ Is this consumption OK? My husband is a diabetic, could you give me some help in filling lunch pails for him?
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

^ Type 2 diabetes is usually first treated by attempts to change physical activity (generally an increase is desired), the diet (generally to decrease carbohydrate intake), and weight loss .

^ My husband is a diabetic, could you give me some help in filling lunch pails for him?
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

[66]
Sushruta (6th century BCE) identified diabetes and classified it as Medhumeha.[67] He further identified it with obesity and sedentary lifestyle, advising exercises to help "cure" it.[67] .The ancient Indians tested for diabetes by observing whether ants were attracted to a person's urine, and called the ailment "sweet urine disease" (Madhumeha).^ Development and progression of renal disease in Pima Indians with non-insulin-dependent diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ However, when ill or stressed, the patient with diabetes should promptly test the glucose level in blood and/or urine and test the urine for ketones.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Although hypertriglyceridemia is common among persons with non-insulin- dependent diabetes mellitus, whether the triglyceride level independently predicts cardiovascular disease is uncertain.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

The Korean, Chinese, and Japanese words for diabetes are based on the same ideographs (糖尿病) which mean "sugar urine disease".
.In medieval Persia, Avicenna (980–1037) provided a detailed account on diabetes mellitus in The Canon of Medicine, "describing the abnormal appetite and the collapse of sexual functions," and he documented the sweet taste of diabetic urine.^ Ravid M, Brosh D, Levi Z. Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ A simplified scheme for the pathophysiology of abnormal glucose metabolism in type 2 diabetes mellitus is depicted in the image below.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ The beneficial effect of fish oil supplements on serum lipids and clotting function of patients with type II diabetes mellitus.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

Like Aretaeus before him, Avicenna recognized a primary and secondary diabetes. .He also described diabetic gangrene, and treated diabetes using a mixture of lupine, trigonella (fenugreek), and zedoary seed, which produces a considerable reduction in the excretion of sugar, a treatment which is still prescribed in modern times.^ In folk medicine it has been used to treat diabetes.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Raghuram TC, Sharma RD, Sivakumar B, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Ginkgo biloba Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.

.Avicenna also "described diabetes insipidus very precisely for the first time", though it was later Johann Peter Frank (1745–1821) who first differentiated between diabetes mellitus and diabetes insipidus.^ Ginkgo biloba Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.

^ Any woman with known diabetes who becomes pregnant should be examined for retinopathy early in the first trimester.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Diabetes insipidus, diabetes mellitus, optic athrophy and deafness (DIDMOAD) caused by mutations in a novel gene ( wolframin ) coding for a predicted transmembrane protein.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

[68]
.Although diabetes has been recognized since antiquity, and treatments of various efficacy have been known in various regions since the Middle Ages, and in legend for much longer, pathogenesis of diabetes has only been understood experimentally since about 1900.[69] The discovery of a role for the pancreas in diabetes is generally ascribed to Joseph von Mering and Oskar Minkowski, who in 1889 found that dogs whose pancreas was removed developed all the signs and symptoms of diabetes and died shortly afterwards.^ The association between canine diabetes and the major histocompatibility complex in a heterogeneous population strongly suggests that both a genetic predisposition and the immune response have roles in the pathogenesis of diabetes in dogs ( 84 ).
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

^ Environmental factors such as the feeding of high-fat diets that result in lipemia and disturbances in lipid metabolism are implicated as potential etiological factors in dogs with obesity-associated pancreatitis ( 109 ) and likely play a role in the development of pancreatitis in diabetic dogs.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

^ This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[70] .In 1910, Sir Edward Albert Sharpey-Schafer suggested that people with diabetes were deficient in a single chemical that was normally produced by the pancreas—he proposed calling this substance insulin, from the Latin insula, meaning island, in reference to the insulin-producing islets of Langerhans in the pancreas.^ Gymnema may stimulate the pancreas to produce insulin in people with type 2 diabetes.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Normally, certain cells in the pancreas produce a substance called insulin.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Gymnema Gymnema may stimulate the pancreas to produce insulin in people with type 2 diabetes.

.The endocrine role of the pancreas in metabolism, and indeed the existence of insulin, was not further clarified until 1921, when Sir Frederick Grant Banting and Charles Herbert Best repeated the work of Von Mering and Minkowski, and went further to demonstrate they could reverse induced diabetes in dogs by giving them an extract from the pancreatic islets of Langerhans of healthy dogs.^ Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in non-insulin dependent diabetics.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Ginkgo biloba Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.

^ Insulin-like effect of vanadyl ion on streptozocin-induced diabetic rats.

[71] Banting, Best, and colleagues (especially the chemist Collip) went on to purify the hormone insulin from bovine pancreases at the University of Toronto. .This led to the availability of an effective treatment—insulin injections—and the first patient was treated in 1922. For this, Banting and laboratory director MacLeod received the Nobel Prize in Physiology or Medicine in 1923; both shared their Prize money with others in the team who were not recognized, in particular Best and Collip.^ For this, Banting and laboratory director MacLeod received the Nobel Prize in Physiology or Medicine in 1923 ; both shared their Prize money with others in the team who were not recognized, in particular Best and Collip.

^ This led to the availability of an effective treatment—insulin injections—and the first patient was treated in 1922.

^ Banting, Best, and colleagues (especially the chemist Collip ) went on to purify the hormone insulin from bovine pancreases at the University of Toronto .

.Banting and Best made the patent available without charge and did not attempt to control commercial production.^ Banting and Best made the patent available without charge and did not attempt to control commercial production.

^ By replacing products made with refined flours and grains with whole grain foods, you can prevent high blood sugar spikes and improve your blood sugar control.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Insulin production and therapy rapidly spread around the world, largely as a result of this decision.^ Insulin production and therapy rapidly spread around the world, largely as a result of this decision.

^ Interferon therapy used to treat hepatitis B and C may induce hyperglycemia, result in the development of type 2 diabetes, and necessitate increased insulin requirements in patients with type 1 diabetes.
  • Liver Disease and Diabetes Mellitus 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

^ Interferon therapy has resulted in the development of type 1 diabetes likely through the development of insulin autoantibodies.
  • Liver Disease and Diabetes Mellitus 19 January 2010 8:50 UTC journal.diabetes.org [Source type: Academic]

Banting is honored by World Diabetes Day which is held on his birthday, November 14.
The distinction between what is now known as type 1 diabetes and type 2 diabetes was first clearly made by Sir Harold Percival (Harry) Himsworth, and published in January 1936.[72]
.Despite the availability of treatment, diabetes has remained a major cause of death.^ Despite the availability of treatment , diabetes has remained a major cause of death.

^ Despite the evidence that obesity causes impaired glucose tolerance, it appears that very few dogs develop overt diabetes as a consequence of obesity-induced insulin resistance.
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? -- Rand et al. 134 (8): 2072S -- Journal of Nutrition 19 January 2010 8:50 UTC jn.nutrition.org [Source type: Academic]

^ Committee members were told that based on the rates of diabetes seen in Finland following the hemophilus vaccine that the pneumococcal vaccine could cause a major epidemic of diabetes.

.For instance, statistics reveal that the cause-specific mortality rate during 1927 amounted to about 47.7 per 100,000 population in Malta.^ Rate per 1,000 .

^ Target: 45 deaths per 100,000 population.

^ Rate per 100,000 .

[73]
Other landmark discoveries include:[69]
.
  • Identification of the first of the sulfonylureas in 1942
  • Reintroduction of the use of biguanides for Type 2 diabetes in the late 1950s.^ Effects of exenatide (exendin-4) on glycemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes.
    • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

    ^ Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring.
    • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

    ^ Ravid M, Brosh D, Levi Z. Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus.
    • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

    The initial phenformin was withdrawn worldwide (in the U.S. in 1977) due to its potential for sometimes fatal lactic acidosis and metformin was first marketed in France in 1979, but not until 1994 in the US.
  • The determination of the amino acid sequence of insulin (by Sir Frederick Sanger, for which he received a Nobel Prize)
  • The radioimmunoassay for insulin, as discovered by Rosalyn Yalow and Solomon Berson (gaining Yalow the 1977 Nobel Prize in Physiology or Medicine)[74]
  • The three-dimensional structure of insulin (PDB 2INS)
  • Dr Gerald Reaven's identification of the constellation of symptoms now called metabolic syndrome in 1988
  • Demonstration that intensive glycemic control in type 1 diabetes reduces chronic side effects more as glucose levels approach 'normal' in a large longitudinal study,[75] and also in type 2 diabetics in other large studies
  • Identification of the first thiazolidinedione as an effective insulin sensitizer during the 1990s
.In 1980, U.S. biotech company Genentech developed human insulin.^ The pharmaceutical companies are now relying more on human recombinant (genetically engineered) insulin.
  • Sugar 19 January 2010 8:50 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

.The insulin is isolated from genetically altered bacteria (the bacteria contain the human gene for synthesizing human insulin), which produce large quantities of insulin.^ New forms of purified insulin, such as human insulin produced through genetic engineering.
  • Acupuncture.Com - Diabetes Mellitus- Traditional Chinese Medicine 19 January 2010 8:50 UTC www.acupuncture.com [Source type: Academic]

^ Hammond-Kosack MC, Dobrinski B, Lurz R, Docherty K, Kilpatrick MW. The human insulin gene linked polymorphic region exhibits an altered DNA structure.
  • Genetics of type 1 diabetes mellitus 19 January 2010 8:50 UTC www.nature.com [Source type: Academic]

^ Time of onset of non–insulin-dependent diabetes mellitus and genetic variation in the β3-adrenergic-receptor gene.
  • Type 2 Diabetes Mellitus in Childhood: Obesity and Insulin Resistance -- Schwartz and Chadha 108 (9): 518 -- Journal of the American Osteopathic Association 19 January 2010 8:50 UTC www.jaoa.org [Source type: Academic]

.Scientists then purify the insulin and distribute it to pharmacies for use by diabetes patients.^ Raghuram TC, Sharma RD, Sivakumar B, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Some studies have shown delayed progression to diabetes in predisposed patients through the use of metformin, [30] rosiglitazone , [32] or valsartan .

^ (Suppl 1):93A. Mahler RJ. 1995 Metformin: actions and indications for use in non-insulin dependent diabetes mellitus.
  • Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment -- Mahler and Adler 84 (4): 1165 -- Journal of Clinical Endocrinology & Metabolism 19 January 2010 8:50 UTC jcem.endojournals.org [Source type: Academic]

Society and culture

.The 1990 "St Vincent Declaration"[76][77] was the result of international efforts to improve the care accorded to those with diabetes.^ Through the Quality Interagency Coordination (QuIC) task force, Federal agencies with health care responsibilities are collaborating to use DQIP to better focus efforts to improve diabetes care.

^ Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some, 126 but not all, trials.

^ Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some, 101 but not all, trials.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

.Doing so is important both in terms of quality of life and life expectancy but also economically-expenses due to diabetes have been shown to be a major drain on health-and productivity-related resources for healthcare systems and governments.^ The recommendations relate to the prevention, detection, and treatment of the major complications of diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Diabetes is a major clinical and public health challenge within certain racial and ethnic groups where both new cases of diabetes and the risk of associated complications are great.

^ These and other health problems associated with diabetes contribute to an impaired quality of life and substantial disability among people with diabetes.

.Several countries established more and less successful national diabetes programmes to improve treatment of the disease.^ Several countries established more and less successful national diabetes programmes to improve treatment of the disease.

^ RC660.5.S45 2000 Discusses the different kinds of diabetes, their symptoms and proper treatment, as well as medical complications connected with this lifetime disease.
  • Diabetes Mellitus-Science Tracer Bullet-Library of Congress 19 January 2010 8:50 UTC www.loc.gov [Source type: Academic]

^ Stern E. Successful use of Atriplex halimus in the treatment of type II diabetic patients.

[78]
.A study shows that diabetic patients with neuropathic symptoms such as numbness or tingling in feet or hands are twice as likely to be unemployed as those without the symptoms.^ If only those patients with recognized historical or clinical risk factors are screened, a significant number of cases of gestational diabetes will be missed.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Preliminary studies suggest that some diabetic patients with hypertriglyceridemia may benefit by restricting carbohydrate intake to 40% to 45% of total calories.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Studies show that type 2 diabetes patients have higher levels of free radicals in their bodies than non-diabetics.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

[79]

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  57. ^ "NEJM -- Glycated Hemoglobin, Diabetes, and Cardiovascular Risk in Nondiabetic Adults". http://content.nejm.org/cgi/content/short/362/9/800. 
  58. ^ "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002. http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls. 
  59. ^ http://www.cdc.gov/Features/diabetesfactsheet/
  60. ^ "CDC's Diabetes Program-News and Information-Press Releases-October 26, 2000". http://www.cdc.gov/Diabetes/news/docs/010126.htm. Retrieved 2008-06-23. 
  61. ^ Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF (October 2003). "Lifetime risk for diabetes mellitus in the United States". JAMA 290 (14): 1884–90. doi:10.1001/jama.290.14.1884. PMID 14532317. 
  62. ^ American Diabetes Association (2005). "Total Prevalence of Diabetes & Pre-diabetes". http://www.diabetes.org/diabetes-statistics/prevalence.jsp. Retrieved 2006-03-17. 
  63. ^ "Seniors and Diabetes". Elderly And Diabetes-Diabetes and Seniors. LifeMed Media. 2006. http://www.dlife.com/dLife/do/ShowContent/daily_living/seniors/. Retrieved 2007-05-14. 
  64. ^ Australian Institute for Health and Welfare. "Diabetes, an overview". http://www.aihw.gov.au/indigenous/health/diabetes.cfm. Retrieved 2008-06-23. 
  65. ^ Dobson, M. (1776). "Nature of the urine in diabetes". Medical Observations and Inquiries 5: 298–310. 
  66. ^ Medvei, Victor Cornelius (1993). The history of clinical endocrinology. Carnforth, Lancs., U.K: Parthenon Pub. Group. pp. 23–34. ISBN 1-85070-427-9. 
  67. ^ a b Dwivedi, Girish & Dwivedi, Shridhar (2007). History of Medicine: Sushruta – the Clinician – Teacher par Excellence. National Informatics Centre (Government of India).
  68. ^ Nabipour, I. (2003). "Clinical Endocrinology in the Islamic Civilization in Iran". International Journal of Endocrinology and Metabolism 1: 43–45 [44–5]. 
  69. ^ a b Patlak M (December 2002). "New weapons to combat an ancient disease: treating diabetes". The FASEB Journal 16 (14): 1853. PMID 12468446. 
  70. ^ Von Mehring J, Minkowski O. (1890). "Diabetes mellitus nach pankreasexstirpation". Arch Exp Pathol Pharmakol 26: 371–387. doi:10.1007/BF01831214. 
  71. ^ Banting FG, Best CH, Collip JB, Campbell WR, Fletcher AA (November 1991). "Pancreatic extracts in the treatment of diabetes mellitus: preliminary report. 1922". CMAJ 145 (10): 1281–6. PMID 1933711. 
  72. ^ Himsworth (1936). "Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types". Lancet i: 127–30. doi:10.1016/S0140-6736(01)36134-2. 
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  76. ^ Theodore H. Tulchinsky, Elena A. Varavikova (2008). The New Public Health, Second Edition. New York: Academic Press. p. 200. ISBN 0-12-370890-7. 
  77. ^ Piwernetz K, Home PD, Snorgaard O, Antsiferov M, Staehr-Johansen K, Krans M (May 1993). "Monitoring the targets of the St Vincent Declaration and the implementation of quality management in diabetes care: the DIABCARE initiative. The DIABCARE Monitoring Group of the St Vincent Declaration Steering Committee". Diabetic Medicine 10 (4): 371–7. doi:10.1111/j.1464-5491.1993.tb00083.x. PMID 8508624. 
  78. ^ Dubois, HFW and Bankauskaite, V (2005). "Type 2 diabetes programmes in Europe" (PDF). Euro Observer 7 (2): 5–6. http://www.euro.who.int/Document/Obs/EuroObserver7_3.pdf. 
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External links


Study guide

Up to date as of January 14, 2010

From Wikiversity

.Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice.^ The information presented in Aisle7 is for informational purposes only.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ The information provided here is for educational and informational purposes only.
  • Diabetes Mellitus, Type 2: eMedicine Endocrinology 19 January 2010 8:50 UTC emedicine.medscape.com [Source type: Academic]

^ The information presented in Healthnotes is for informational purposes only.

.The information is not intended to replace medical advice offered by physicians.^ This information does not replace the advice of a doctor.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Do not delay seeking or disregard medical advice based on information on this site.
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

^ This site and its services, including the information above, are for informational purposes only and are not a substitute for professional medical or health advice, examination, diagnosis, or treatment.
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

Please refer to the full text of the Wikiversity medical disclaimer.
.Diabetes mellitus refers to a number of diseases that have in common elevated blood sugar levels.^ The key to treating type 2 diabetes is controlling blood sugar levels.
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

^ This effect can reduce the elevation of blood sugar levels that is typical after a meal.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ Checking your blood sugar levels.
  • Type 2 Diabetes - Yahoo! Health 16 September 2009 22:31 UTC health.yahoo.com [Source type: General]

Contents

Definitions

.Diabetes is a disease defined as the human body’s ability to produce or properly use the hormone insulin.^ Americans have Diabetes , a disease where the body loses its ability to properly produce and use insulin.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ Type I, or Juvenile Diabetes , is defined by the pancreas losing its ability to produce insulin.

^ Human insulin should generally be used.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.Insulin converts sugar also know as glucose, as well as starches found in food into energy.^ In the normal digestive process, food sugars and starches (carbohydrates) are changed into sugar glucose.
  • Acupuncture.Com - Diabetes Mellitus- Traditional Chinese Medicine 19 January 2010 8:50 UTC www.acupuncture.com [Source type: Academic]

^ Insulin is necessary for energy in food to be released.
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

^ These disorders prevent or disrupt the bodys ability to produce or properly use insulin, a hormone needed to convert sugar, starch and other foods into the energy that sustains life.

.There are many forms of diabetes (Pre-diabetes, Type 1 diabetes, and Type 2 diabetes) and thousands of undiagnosed people world-wide.^ Most people with type 2 diabetes are overweight.
  • Diabetes 19 January 2010 8:50 UTC www.puritan.com [Source type: Academic]
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ There are two types of diabetes mellitus, type 1 and type 2.
  • Type 2 Diabetes - [Alternative Medicine] 19 January 2010 8:50 UTC www.peacehealth.org [Source type: Academic]

^ There are 2 main types of diabetes: .

Management

.Following diagnosis, a change in attitude and behaviour is required to ensure a healthy quality of life.^ Diabetes Recipes Diabetes Will Change Your Life The long anticipated diagnosis of diabetes 2 has made major change my life.
  • Diabetics - Associated Content - Topic - associatedcontent.com 12 September 2009 7:40 UTC www.associatedcontent.com [Source type: General]

^ In Healthy People 2000, five diabetes-related objectives were included in a group of objectives addressing chronic conditions linked by their potential impact on quality of life and disability.

.The most important treatment (as with any disease) is to follow instruction from qualified health care providers.^ The health care provider's approach to medical care.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ Because the accuracy of self-monitoring blood glucose is instrument and user dependent, it is important for health care providers to evaluate each patient's monitoring technique.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ The health care provider can treat periodontal disease by helping the patient achieve good glycemic control.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.To successfully manage diabetes, it is important to educate one's self, family, and friends to be proactive in one's care and regime.^ Cultural sensitivity is an important aspect of education for self-management [D] .
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ Identification and management of depression is an important aspect of diabetes care.
  • NGC - NGC Summary 19 January 2010 8:50 UTC www.guideline.gov [Source type: Academic]

^ A single psychosocial evaluation of the family unit may be important to the overall educational process of raising a child who has diabetes.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

.For many people, being proactive before diagnosis, by exercising and watching their diet, reduces the likelihood of acquiring the disease.^ If enough people use them on a regular basis more modules (diet, exercise, pump support etc.

^ People who may have atherosclerosis or heart disease should see a doctor before starting an exercise program.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ The researchers' conclusion: including cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

.Even so, exercise and watching one's diet can dramatically and positively affect the quality of life for those with various types of diabetes.^ Diabetes One on One who have type 1 or type 2 diabetes.
  • On-line Diabetes Resources 19 January 2010 8:50 UTC www.mendosa.com [Source type: General]

^ Weight Control Through Diet and Exercise Treatment of type 2 diabetes mellitus necessitates a multidisciplinary approach that includes the physician, diabetes nurse educator, dietician, exercise physiologist or personal trainer, social worker, and psychologist.
  • Type 2 Diabetes Mellitus in Childhood: Obesity and Insulin Resistance -- Schwartz and Chadha 108 (9): 518 -- Journal of the American Osteopathic Association 19 January 2010 8:50 UTC www.jaoa.org [Source type: Academic]

^ Data from throughout the world 27 - 29 show that obesity, associated insulin resistance, and type 2 diabetes have dramatically increased in locations where lifestyles have recently been "westernized."
  • Type 2 Diabetes Mellitus in Childhood: Obesity and Insulin Resistance -- Schwartz and Chadha 108 (9): 518 -- Journal of the American Osteopathic Association 19 January 2010 8:50 UTC www.jaoa.org [Source type: Academic]

Prevention

Nuvola apps korganizer.png
Things that can be done to lower one's risk of diabetes include:
  • Lose weight (if overweight)
  • Become active, walk, or exercise regularly
  • Eat a well balanced diet of low fat meals.

Hypoglycemia

.Hypoglycemia means low glucose in the blood.^ Hypoglycemia is a condition that occurs when your blood sugar (glucose) is too low.
  • Diabetes | LIVESTRONG.COM 19 January 2010 8:50 UTC www.livestrong.com [Source type: General]

^ Patient education and self-monitoring of blood glucose are the best approaches to preventing hypoglycemia.
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

^ I was wondering how to tell when blood glucose readings are just "low" and when they are "deadly" low?
  • Diabetes - Ask the Dietitian® 19 January 2010 8:50 UTC www.dietitian.com [Source type: General]

Signs and symptoms of hypoglycemia can include:
  • shakiness
  • dizziness
  • hunger
  • headaches
  • sudden mood swings or behavior changes
  • jerky movements of muscles
  • confusion.

Hyperglycemia

.Hyperglycemia means high glucose in the blood.^ This means that it may be important to not only keep blood sugar levels under control, but also to prevent blood insulin levels from getting too high.
  • WHFoods: Type 2 Diabetes Mellitus 19 January 2010 8:50 UTC www.whfoods.com [Source type: Academic]

^ Too much or too little of these hormones (or if they are somehow ineffective) can cause blood sugar levels to fall too low (hypoglycemia) or rise too high (hyperglycemia).
  • Acupuncture.Com - Diabetes Mellitus- Traditional Chinese Medicine 19 January 2010 8:50 UTC www.acupuncture.com [Source type: Academic]

^ Symptoms associated with acute hyperglycemia generally develop more slowly (over hours or days) than do symptoms associated with an acute fall in the level of blood glucose (over minutes).
  • Complications of Diabetes Mellitus 19 January 2010 8:50 UTC wonder.cdc.gov [Source type: Academic]

Signs and symptoms of hyperglycemia can include:
  • a very dry mouth with extreme thirst
  • nausea and vomiting
  • shortness of breath.

See also

Wikipedia-logo.png Run a search on Diabetes mellitus at Wikipedia.

External links


Simple English

Diabetes is a disease where people do not have enough insulin in their blood, or their body has a problem using the insulin they do have. There are other kinds of diabetes, like diabetes insipidus. However, when people say "diabetes", they usually mean diabetes mellitus. People with diabetes mellitus are called "diabetics".

Glucose is not regular sugar that is available in stores and supermarkets. Glucose is a natural carbohydrate that our bodies use as sources for energy. The kind of sugar sold in supermarkets is called sucrose, and is much different from glucose. High concentrations of glucose can be found in soft drinks and fruits.[1]

Diabetes mellitus is a disease where people do not have enough insulin in their blood or their body has a problem using the insulin they do have. Glucose level in the blood is controlled by several hormones. Hormones are chemicals in your body that send messages from cells to other cells. Insulin is a hormone made by the pancreas. When you eat, the pancreas makes insulin to send a message to other cells in the body. This insulin tells the cells to take up glucose from the blood. This glucose is used by cells for energy. Extra glucose that is not needed right away is stored in some cells as glycogen. When you are not eating, cells break down glycogen to have glucose to use as energy.

Contents

Types of diabetes

Type 1 diabetes mellitus

Type 1 diabetes mellitus happens when the part of the pancreas that makes insulin is destroyed by that person’s own immune system. When a person does not make insulin, glucose – sugar – in the blood cannot get into the parts of the body that need sugar to live. In order to live, a person with Type 1 diabetes must take insulin for the rest of their life. They also need to check the amount of sugar in their blood many times each day. Type 1 diabetes happens most of the time in younger people, however it can occur in adults, although this is much less common. About 1 out of every 10 people with diabetes have Type 1 Diabetes.

Type 2 diabetes mellitus

Type 2 diabetes mellitus is a very different illness from Type 1 diabetes. In Type 2 diabetes, the person makes insulin, but either the insulin does not work in that person’s body as it should, or they do not make enough to process the glucose. When insulin does not work as it should, glucose (sugar) in the blood cannot get into the parts of the body that need sugar. Type 2 diabetes happens most of the time in an older person who is overweight.

Gestational diabetes

Gestational diabetes mellitus is like Type 2 diabetes. It happens to some women when they are pregnant.

Other types of diabetes

Other types of diabetes include but are not limited to:

Latent autoimmune diabetes of adults (LADA)

Maturity onset diabetes of the young (MODY)

Complications of diabetes

Complications are problems that happen because of a disease. In the case of diabetes, there are two kinds of complications. The first kind happens quickly and can be dealt with quickly. This kind is called acute complications. The other kind is caused by the blood glucose being too high for many years, and this kind is called chronic complications or long-term complications.

Too high blood glucose is called 'hyperglycemia'. If very high, it can cause acute complications. In Type 1 diabetics, one of these complications is diabetic ketoacidosis which is always a medical emergency and can often be noticed by a kind of fruity smell on the breath. Another acute complication, more common in Type 2 diabetics, is non-ketotic hyperosmolar coma which is also very dangerous.

Too low blood glucose is called hypoglycemia. It can also cause acute complications. If too low, diabetics can have many symptoms such as sweating, trembling, anger (or feeling passive), and possibly even passing out. But diabetics with hypoglycemia may be confused or even unconscious. They may even appear to have had too much alcohol. Severe hypoglycemia is very dangerous and can cause death. The best treatment of hypoglycemia is avoiding it. If it happens, eating a glucose-containing food (for instance, table sugar) usually makes it better, and pretty quickly. Sometimes it is also treated by giving an injection of a medicine called 'glucagon'. Glucagon is a hormone that is also made by the pancreas. It does the opposite of insulin. So giving it will cause the blood glucose to rise by forcing stored glucose into the blood. Hypoglycemia is usually caused by too much diabetic medication, insufficient food, too much exercise, or some combination of these.

Chronic complications are mostly caused by hyperglycemia (but not high enough to always cause acute complications). It causes damage to blood vessels and nerves. Damage to blood vessels can eventually cause strokes, heart attacks, kidney failure, blindness, slow healing of skin breaks, and so more infections, and even amputations from poor circulation (decreased blood flow, usually to the feet and toes). Damage to nerves can make diabetics not feel pain (when this happens, it's usually in their feet). This causes them to have more injuries and not realize they have hurt themselves. Damage to nerves can also cause pain even when there's no real injury. It's a kind of phantom pain or ghost pain. This can be so bad that people need strong pain medicines.

Monitoring of diabetes

Because of the damage that is caused by high blood glucose it is important to treat diabetes mellitus. The goal of treatment is to keep the blood glucose normal. The normal range for blood glucose is 80-120 mg/dL (milligrams of glucose per deciliter of blood) or 3.5-7 mmol/l (millimole per liter of blood.) These are different ways of saying the same thing, very much like yards and meters are different ways of measuring distance.

Diabetics should check their blood glucose often. This is to make sure they do not get hypoglycemia or hyperglycemia. A glucometer is a battery powered measuring machine that checks the level of glucose in blood. Diabetics often carry a glucometer with them to check their level several times in a day. They may also suffer severe constipation.

Doctors may also use a blood test called a hemoglobin A1C. This is sometimes written Hgb-A1C or several other ways; there's no standard name. This tells the doctor what the average blood glucose has been for about the past 90 days. If the level has been too high, it may be that new medicines, or different doses, or better diet may be needed.

Diabetics also must be monitored for signs of the complications of diabetes. They should see an eye doctor regularly to be checked for damage to the blood vessels in the eyes. If this is not found early and treated it can cause blindness. They also should have their urine or blood checked regularly for signs of kidney damage. And they must check their feet for cuts, bruises, blisters, and so on at least every day. And they should have their feet checked regularly for nerve damage, circulation, and infections.

Treatment of diabetes

The most important goal in diabetes is to keep blood glucose as normal as possible. Since it usually goes up after eating, and down after exercise, coping with it sensibly is often complex, and usually takes care and thought. And treatment differs between Type 1 and Type 2. People with Type 1 diabetes are treated with insulin. People with Type 2 usually begin with diet, exercise, and weight loss, perhaps moving to pills (and, though not as common, insulin).

Education is important for both types of diabetes. Diabetics must learn about diet. They learn how to estimate and keep track of how much carbohydrate, protein, and fat are in different foods. They plan their meals to have the right amount of carbohydrates, proteins, and fats. Patients with Type 1 may decide how much insulin to take before a meal based on how much they will eat.

Diabetics must also be careful about exercise. Exercise is important to stay healthy. But too hard or too long exercise may cause hypoglycemia. So diabetics must also carefully plan exercise like they plan meals.

In addition to controlling blood glucose other treatments may be needed. Diabetics often have blood vessel diseases, so it is important to pay attention to other diseases which may affect blood vessels. In people with diabetes, treating high blood pressure (hypertension) and high cholesterol is even more important than usually. Both of these diseases damage blood vessels. The treatment goals can change for diabetics. For instance, in people without diabetes, blood pressure should be 140/90 or less. In diabetics it should be 130/80 or less.

Other websites

References

  1. "What is glucose? What does "bG" mean?" (HTML). FAQS.ORG. http://www.faqs.org/faqs/diabetes/faq/part1/section-8.html. Retrieved 2009-02-10. 


Citable sentences

Up to date as of December 08, 2010

Here are sentences from other pages on Diabetes mellitus, which are similar to those in the above article.








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