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There is basically two types of diabetes - Type 1 and Type 2. There is another kind called gestational diabetes, but it only occurs in pregnant women.

Type 1 diabetes is mostly genetic and is caused by a decrease in insulin produced in the body. Type 2 diabetes on the other hand is caused by resistance in the body to insulin, which could be caused due to many factors, including lifestyle changes. There are various signs of high blood sugar, but some of them can be difficult to detect in a pre-diabetic stage. If you experience any sign of high blood sugar, then it is very important that you get yourself check as soon as possible to avoid any complications later on.

Here are some of the most obvious sign or symptoms of high blood sugar-

-Feeling thirsty all the time, without any obvious reason, like sickness or during exercising.
-Feeling hungry all the time, in-spite of eating regularly.
-Frequent urination, specially during the night.
-Feeling tired or fatigued after eating meals is another very good sign of sugar problems.
-Extreme or sudden weight loss, without any reason.

The only problem is that some of these symptoms could also be related to some other kind of sickness, therefore it is very important that a person gets himself checked for diabetes any which ways. The blood tests required for checking for diabetes is very simple, and it should be done on the first indication of these symptoms. Diabetes is a very controllable condition, if treated in time.

If diabetes left untreated, could eventually lead to serious complications, such as permanent eye damage due to macular degeneration, which may also lead to blindness. Some other complications could be nerve damage, numbness throughout the body, persistent infections in the body, dry skin conditions and severe heart complications.

Glucose in your blood is the main source of energy for all humans and animals. It is basically a type of sugar which circulates throughout the blood providing the much needed energy. Glucose is manufactured in the body, through the food we eat, mainly carbohydrates. The glucose levels in are blood are controlled by the an hormone called insulin, which is produced by the pancreas. It is very important for a person to maintain normal blood glucose levels in his body, to avoid any complication or conditions like diabetes.

Lets discuss what the normal blood glucose levels should be in a person. The normal levels fall in the range of 70-150mg. They typically vary between these two values throughout the day, depending on the time of the day and the kind of meals a person has had. If the levels go above 150 mg for a period of time then a condition occurs called hyperglycemia, and if they fall below 70 mg then a person is know to have to hypoglycemia. Consistent low blood sugar levels can be potentially fatal. Some of the common symptoms of low blood sugar are- tiredness, fatigue, lack of focus and in some extreme cases even coma. On the other hand consistently high blood sugar levels results in diabetes in a person. Diabetes if not treated in time can lead to eye, kidney, heart and nerve damage.

The surest way to measure your glucose levels is through a blood test. It is very important that person do these tests at regular intervals, if he is showing any of the symptoms of irregular blood sugar. There are different kinds of blood tests which can be done. If a person is being diagnosed for diabetes the first test he normally does is called a “fasting blood test”, which is done after a 8 hour fasting period. The results of this test should be between 70-99 mg to indicate normal blood glucose levels.

There is another test called the “two-hour postprandial blood sugar”, which is done after 2 hours of eating a meal. The levels for this test should fall between 70-145 mg.

A third test called the random testing method is done usually at random time throughout the day. The normal levels for this test are 70-125 mg. If the results vary a lot, then it may indicate a problem.

Lastly there is a test called the “oral glucose tolerance test”, which helps to diagnose diabetes. This test is done after supplying the patient with a glucose drink or snack.

If you have any of the symptoms or signs of diabetes or low blood sugar, then it is advisable to contact your physician immediately to get your tested in time.

While talking about diabetes, you may be frightened from the idea that you may have it. Or maybe, you may have it in the future. You want to know if you are at risk to develop diabetes and anxiously you’re looking to find if you have any diabetes symptom.

Anyway, you must keep in mind some other features in order for you to be classified as a diabetic person, such as being part of a high-risk population, having a family history of diabetes, and so on.

Actually, there is no clear symptom for diabetes. The most common symptoms of diabetes are as follow:

- being all the time thirsty
- frequent urination
- increased hunger
- feeling all the time tired; having an excessive fatigue,

On the other hand, there are some other symptoms of diabetes that are prescribed as diabetes complications in fact. These symptoms are:

- vision changes;
- recurrent skin infections very difficult to heal;
- tingling or numbness you may feel in your extremities;
- gums disorders;
- Hair loss and many others.

Some other possible symptoms of diabetes are classified as diabetes early symptoms. They are like a ringing bell for your to make you know that diabetes is very near to you, and you must be alert for what will go on in the future. Most of them can not be noticed, and are common for both two, type1 and 2 diabetes.

You must keep in mind that you may have one of the above as diabetes symptom or even all of them. Educating yourself on recognizing the possible diabetes symptom, may help you preventing the onset of diabetes complications.

Diabetes is a disease in which blood glucose levels are above normal level. Those with diabetes have improper energy metabolism - the process of converting food into energy. Food we ingest is broken down into glucose and is carried by the blood to cells throughout the body. This glucose in blood is processed by the hormone insulin, made in the pancreas, to convert blood glucose into energy.

In case of diabetics the cells in various organs like muscles, liver, fat tissues etc. do not process insulin in proper way. This may be because there is insufficient amount of insulin secreted by the pancreas or resistance to insulin. As a result, the amount of glucose in the blood increases and the cells are deprived of energy. Over a period of time high blood glucose damages nerves and blood vessels. This can lead to complications like heart disease, stroke, retinopathy, kidney disease, nerve problems, gum infections and amputation.

Diabetes is indeed a silent killer disease that is spreading in epidemic proportions. In America alone more than 30 million are diabetic and 2 million join the ranks every year. While diabetes can strike at anyone certain ethic groups like African Americans, Hispanics and Asians are at an increasing risk of developing diabetes.

Type 2 diabetes, often characterized as adult onset diabetes, is the most frequently occurring form. It develops when the cells of a body fail to attain enough insulin for proper functioning. This can a couple of ways: Either the body stops creating insulin at a fast enough rates, or the cells build up a resistance to insulin. With the cells lacking insulin major organs such as your eyes, nerves or even heart will not have enough energy to maintain themselves ultimately resulting in long term damages.

People with type 2 diabetes are required to lead a healthy eating lifestyle in order to keep their blood sugar levels in control. A healthy type 2 diabetes diet should provide your body with enough time for food processing. The following shows a healthy type 2 diabetes diet plan.

Eating plenty of vegetables and fruits is high on the list of dietary changes. These foods contain more nutrients, more fiber and less sugar and starches. Non-starchy vegetables, such as green beans, cucumbers and broccoli, and leafy greens like spinach or kale, are your best choice.

If you deside to eat grains, choose unprocessed whole grain foods which are better than highly processed foods. Be sure that you read the label, since many whole grain products may in fact contain processed grain. Whole grain releases its sugar more slowly than processed grain, that evens out blood glucose. They also have more nutritive elements such as minerals and vitamines.

Diet plans for diabetes should balance out sugar and starch intake against protein, all while avoiding too much fat. This should include the choice of lean meat cuts, such as pork and beef, it is also important to include fish several times a week. If you are preparing poultry, make sure that you remove the skin as that is where most of the fat is found. Another good source of proteins can come from dried beans and navy beans, as well as lentils.

Limit chips, cookies, cakes, and other foods and drinks with high calories. These foods can cause a sudden rise in blood glucose. This sudden rise can be problematic for the body. Choose water or other low-calorie alternatives over soft drinks which contain a high level of sugar and a low level of nutrients.

It is possible to have too much of a good thing! Your type 2 diabetes diet should include watching your portion sizes and balancing your intake. At your meals, make sure half of your plate is filled with non-starchy vegetables. The other half should be split between your protein (such as meat, fish or tofu) and whole grains, pasta, potatoes, corn or peas. This will help ensure balanced nutrition.

The recommended diet for diabetics balances sugar and starch intake with healthy, nutritious foods. Your type 2 diabetes diet can help you avoid the worst damage to your body and maintain wellness for a long and healthy life.

Diabetes is a common endocrine condition affecting 1.4 million people in the UK, with an estimated 1 million undiagnosed (Diabetes UK, 2004). Approximately 11000 people have diabetes in the Bolton area; and at any one time 15-20% of all hospital admissions are for people who have diabetes (Page and Hall, 1999). Surgery in people with diabetes is linked with an increased risk of surgical complications that can be reduced by professionals adhering to local and national guidelines (Department of Health, 2003). This article highlights the need for perioperative assessment of people with diabetes. Previous to the implementation of a care pathway, perioperative assessment had been done by junior medical staff, surgical ward nurses and anaesthetists on an ad hoc basis. A nurse-led pathway of assessment prior to admission and care planning for people with diabetes would ensure consistency and safety of care. This has resulted in an individualised perioperative care plan for the individual’s hospital stay at Royal Bolton Hospital.

People with diabetes are at an increased risk of developing perioperative complications and mortality (Rahman and Beattie, 2004). In response to physical stress, such as that caused by surgery, the neuro-endocrine system releases counter-regulatory hormones (cortisol, epinephrine and growth hormone), which can result in insulin resistance (Pickup and Williams, 1996). The physical stress of surgery can also lead to acute hyperglycaemia by the suppression of insulin release, which could cause diabetic ketoacidosis (DKA; Stagnaro-Green et al, 1995).

Raised blood glucose levels can lead to delayed wound healing and an increased risk of contracting postoperative infections (Rahman and Beattie, 2004). Optimum care that maintains stable blood glucose levels helps prevent the complications of surgery and reduce the inpatient’s length of stay (Ahmann, 2004). Raised blood glucose levels in people with diabetes can lead to a prolonged length of stay, up to 3 days longer than an individual without diabetes admitted for the same reason (Ahmann, 2004). People who have to fast prior to surgery can become hypoglycaemic (Pickup and Williams, 1996).

People with type 2 diabetes often have cardiovascular and renal problems which can complicate surgery (Pickup and Williams, 1996). Therefore, effective and simple guidelines for the safe management of the person with diabetes undergoing surgery are essential. Standard 8 of the National Service Framework (NSF) for diabetes addresses the need for such guidelines for the care of the person with diabetes during his or her stay in hospital (Department of Health, 2003).

Problems on wards

At Royal Bolton Hospital the treatment of diabetes on surgical wards used to be fragmented with little or no continuity in care. Current guidelines at the hospital recommend two sliding scales and intravenous fluid regimens for those undergoing a surgical procedure or investigation. Firstly, a glucose-potassium-insulin (GKI) sliding scale should be used for patients undergoing a short procedure who can eat within 6 hours postsurgery.

Secondly, a variable rate insulin regimen is used for people with diabetes who, following surgery, may not eat within 6 hours. This regimen has 50 units of insulin in 50 ml of normal saline solution in a syringe and 10% dextrose solution administered concurrently.

Although these guidelines were accessible, there was poor adherence to them by the multidisciplinary team. This highlighted confusion in terms of the appropriate regimen to use.

Previous to the implementation of preoperative assessment guidelines, there were frequent requests by nursing and medical staff for advice regarding the appropriate regimen to be used; more worryingly, the staff did not contact any member of the diabetes team, which resulted in inconsistencies in the treatment of diabetes during inpatients’ hospital stays. With the publication of the NSF for diabetes and a drive towards day surgery it has highlighted the need for patients with diabetes requiring individualised care dependent on their diabetes treatment and complications prior, during and after surgery (Healy and McWhinnie, 2003).

Audit

A retrospective re-audit of perioperative care of people with diabetes in 2002/2003 showed poor adherence with local diabetes guidelines and incomplete preoperative assessment of their care needs. This was despite the fact that 6 years previously a surgical audit was performed, the results of which led to the formulation and implementation of much needed guidelines.

The re-audit was conducted to establish the guidelines’ effectiveness. One hundred and nine case notes were retrieved with support from the clinical audit department. This included people with both type 1 and type 2 diabetes undergoing major and minor surgery.

Findings

Was diabetes recognised as a potential problem upon preoperative assessment?

Fifty-nine per cent of all staff recognised diabetes as a potential problem upon preoperative assessment; however, few commented on the presence or lack of complications of diabetes prior to surgery. Table 1 shows a breakdown by profession.

Diabetes has staggering health and economic effects. There are an estimated 16-17 million people with diabetes in the United States (Centers for Disease Control and Prevention 2002) and, given the aging of the population, changes in ethnic makeup, and the dramatic increase in obesity and sedentary lifestyles in the United States, the prevalence of diabetes is increasing at an epidemic rate (Boyle et al. 2001). In 1997, a cross-sectional analysis found that the direct medical cost of diabetes care was more than $44 billion (American Diabetes Association 1998). However, the effects of lost productivity have been felt to be even more substantial (American Diabetes Association 1998).

The indirect costs of diabetes are largely related to the disability resulting from complications of the disease, rather than to the disease itself. Microvascular diabetes complications, such as retinopathy, nephropathy, and neuropathy, are the leading causes of blindness, end-stage renal disease, and nontraumatic amputation, respectively, in the United States (National Institutes of Health 1995). Even more important is macrovascular disease (including coronary artery disease, stroke, and peripheral vascular disease). Patients with diabetes have two to four times the risk of macrovascular disease and mortality compared to age and sex-matched controls; as a result, more than 70 percent of patients with diabetes die from these complications (Abbott et al. 1987; deGrauw et al. 1995; deMarco R et al. 1999; Donahue and Orchard 1992; Hadden et al. 1997).

Although the numbers of disabling diabetes complications are staggering, many are preventable, and appropriate therapy could lead to substantial reductions in complications and associated disability. However, the true economic impact of diabetes remains unclear. While there are a number of past studies of the costs of diabetes, these analyses have substantial limitations and often reach widely disparate conclusions because of differences in data sources and methodology. For example, these studies have been forced to look at indirect costs by compiling data from multiple sources, have had nonrepresentative data sources, or have not examined the economic impact of all diabetes-related disabilities (American Diabetes Association 1998; Gregg et al. 2000; Ramsey et al. 2002; Gregg et al. 2002). To date, no studies have been able to use a consistent or representative data source to identify the impact of diabetes on workforce participation. Understanding the economic impact of diabetes on workforce-related outcomes allows a more complete understanding of the cost-effectiveness of diabetes treatment programs, and may provide a rationale for employers to begin to address workplace programs to improve health.

Using the Health and Retirement Study (HRS), we analyzed the effects of diabetes on workforce participation and lost productivity. The HRS is a longitudinal survey designed to follow a national sample of U.S. adults born between 1931 and 1941 (and their spouses) as they make the transition from active working status into retirement. The HRS provides an excellent opportunity to overcome limitations with prior studies and to better estimate the impact of diabetes on economic productivity.

METHODS

Data

The HRS is a national longitudinal cohort study that is funded by the National Institute on Aging and is conducted by the Institute for Social Research at the University of Michigan (Juster and Suzman 1995). Approximately 70,000 households, obtained from an area probability sample, were screened to identify all age-eligible respondents (51 to 61 years of age). The HRS is a nationally representative survey of households, not of individuals. For example, if a spouse is outside of the age range specified in the study, they were still included in the dataset; therefore, the complete HRS dataset is not a perfectly representative sample of those 51 to 61 years of age at the time of the study. Thus, we restricted our analyses to the age-eligible population in the HRS.

Census tracts containing a high density of African Americans and Florida residents were oversampled two to one. All spouses were interviewed regardless of age because of the frequency of dual-earner couples and the influence of spouses in the retirement decision. The overall response rate was 82 percent. Information was collected for domains including demographics, health status, housing, family structure, employment, work history, disability, retirement plans, net worth, income, and health and life insurance. To date, five waves of data collection have been completed; the first was in 1992, and the ensuing four waves were collected at two-year intervals through 2000 (Health and Retirement Study 2003).

Variables

Classification of Outcome Variables: Work Status and Duration. The HRS has detailed information on the work status of the study participants. For the cross-sectional analyses using wave 1 data, we subdivided the population into those who were and were not working outside the home. Those who were working outside the home were asked whether they missed work days in the prior year due to illness, and if so, the total number of days. Subjects who were not currently working were subdivided into those who reported being retired, those who reported being disabled, and those who were homemakers. Of note, there are different possible definitions of disability; we examined both those with self-reported overall disability and also those who were not working specifically due to a health condition, although we used self-reported disability in our main analyses. Dates of retirement and disability were used to determine the duration of each outcome. In the case of those disabled at baseline, we also projected their future lost income through the year 2000 in a separate analysis. This analysis took into account the reported rates of returning to work among those disabled at baseline.

Insulin-producing islet cells from the pancreases of newborn pigs successfully reversed type 1 diabetes in primates, paving the way for human clinical trials, according to scientists involved in the research.

The findings from two new studies, one at the University of Minnesota in Minneapolis and the second at the University of Alberta, Edmonton, Canada, mean transplants using piglet cells could ultimately be used to treat diabetes, after three years of successful experiments in monkeys, the researchers reported in the journal Nature Medicine.

Both studies examined the potential of transplanting islet cells from newborn piglets in diabetic rhesus macaque monkeys. In the Canadian study, the transplanted cells worked so well that the four monkeys involved were able to stop needing insulin injections, one for almost a year. The University of Minnesota researchers achieved similar results.

ALAMEDA, CALIF. — Abbott Diabetes Care started shipping its latest FreeStyle Lite meter last month. The new meter features no-coding-necessary technology, and allows a user to re-apply a second blood sample within 60 seconds for an accurate reading if the first blood drop should miss its mark. That functionality will eliminate much of the strip waste associated with testing for blood sugar levels.

The FreeStyle Lite system employs an Abbott technology exclusive to all FreeStyle meters based on coulometric measurement. This patented electrochemical technology makes it ideal for measuring a small blood sample size, only 0.3 microliter, or a drop about the size of a pin head, is required.

The Robert Wood Johnson Foundation is funding a new program launched by the American Heart Association and the Alliance for a Healthier Generation to prevent childhood obesity. In the 2006-7 school year, the Healthy Schools Program will be implemented in 285 schools in 13 states, providing technical assistance and financial support to improve the nutritional value of cafeteria food and vending machine products, increase students’ physical activity, and create staff wellness programs.

A campaign to combat obesity and diabetes among veterans and their families, Healthier US Veterans, was launched by the HHS and the Department of Veterans Affairs (VA). The rate of diabetes in U.S. veterans is almost three times that of the general population. Through VA medical centers, the new campaign will provide education about healthy eating and physical activity and will offer tailored weight-loss programs, pedometers, and diet advice.