Wellness and Prevention Part II Chapter 3

Manage Diabetes

What Is Diabetes?

In diabetes, the body does not produce or properly use insulin, a hormone that is needed to convert sugars, starches, and other nutrients into energy.

The two major forms of diabetes are type 1 and type 2. Type 1 diabetes was once called "juvenile diabetes" because onset usually occurs in childhood or adolescence. It results from the failure of the pancreas to produce insulin. People with type 1 diabetes need to take insulin daily to sustain life.

Type 2 diabetes accounts for about 90% of all diabetes cases in developed countries, and the incidence is growing worldwide. Type 2 used to be called "adult-onset" diabetes, but this name is no longer used because the disease is now occurring in younger people, chiefly due to the epidemic of obesity. In type 2 diabetes, the pancreas produces insulin, but the liver, fat, and muscle cells it attaches to are unable to use it properly. This is called insulin resistance. Over time, insulin resistance causes an abnormal rise in blood sugar levels after a meal. Eventually, the pancreas stops producing insulin, and the result is full-blown diabetes.

Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications. More than half of all people with type 2 diabetes require insulin to control their blood sugar levels at some point during the course of their illness.

Diabetes and Cardiovascular Disease

Diabetics are twice as likely as people without diabetes to have cardiovascular disease. In fact, two thirds of people with diabetes die of heart attack or stroke. For this reason, it's extremely important that people with diabetes manage other, controllable risk factors-blood cholesterol, blood pressure, blood sugar, exercise, smoking, and weight-for cardiovascular disease. Medication may be required, but lifestyle changes are vital.

Why are diabetics so susceptible to cardiovascular disease?

There are a number of reasons. Diabetes usually occurs along with other conditions that damage the heart and arteries, including high blood cholesterol, hypertension, and obesity. All of these lead to atherosclerosis, or hardening of the arteries, in which the arteries become clogged with hardened deposits called plaque. Atherosclerosis weakens the heart by causing it to work harder, and can lead to heart attack or stroke when a plaque ruptures and produces a clot.

Another part of the answer is that blood vessels, both large and small, are damaged by high levels of blood glucose (sugar). The endothelial cells lining the inside walls of the blood vessels take in more glucose than normal. They then form more surface glycoproteins (components of the cell membrane) than normal, and cause the basement membrane, which underlies the endothelial cells, to grow thicker and weaker. When this happens in the smaller blood vessels, it can cause damage to the nerves, kidneys, retina, and heart. When it occurs in larger blood vessels, it can result in coronary artery disease, leading to angina or heart attack; stroke; peripheral vascular disease, in which circulation to the extremities is restricted; and muscle wasting.

Prevention and Treatment

If you have risk factors for diabetes, like high blood pressure, being overweight, or a family history of diabetes, see your doctor about what you can do to reduce your chances of getting the disease. You will probably need to exercise, make changes in your diet, and quit if you smoke. Medications to help lower your cholesterol and blood pressure can also reduce your risk.

If you have diabetes, lifestyle issues are critical for managing the disease and remaining healthy and active. Exercise is essential for everyone, but especially for those with diabetes. Regular physical activity can help lower your blood glucose levels and aid you in losing weight and keeping it off. It can also prevent serious complications, like foot and lower extremity problems, eye disease, and kidney disease. A healthy diabetic diet will focus on lean protein, fruits and vegetables, fiber, and healthy fats-just like a healthy diet for someone without diabetes.

Along with lifestyle changes, regular monitoring of blood glucose levels is necessary. Checking glucose levels several times a day lets you know how your body is responding to medications, exercise, and diet. Your doctor will probably prescribe an oral medication to help lower your blood glucose levels. There are many types of drugs for blood glucose, and they all act in different ways to lower your glucose levels.

Blood Pressure Reading

Photo Copyright 2006, Lemuel Cantos

More on this topic

Wake-Up Call (VIDEO)

Control Blood Pressure

Manage Diabetes

Medical Checkups

Manage Stress

Get Enough Sleep

Social & Spiritual Support

Environmental Toxins & Free Radicals

Keep It Clean

Avoid Addictions

Prevention Begins in Childhood

The Cardiovascular Continuum

Related Health Centers:

The 9 Visual Rules of Wellness, Wellness and Prevention Part I, Wellness and Prevention Part II, Reverse Aging

The material on this site is for informational purposes only and is not intended as medical advice. It should not be used to diagnose or treat any medical condition. Consult a licensed medical professional for the diagnosis and treatment of all medical conditions and before starting a new diet or exercise program. If you have a medical emergency, call 911 immediately.