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<title>What You Should Know About Diabetes</title>
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<td><a href="index.html"><img src="images/p-abt.gif" alt="JDF" border="0" width="84" height="45"></a></td>
<td align="center"><font size="6"><b>What You Should Know
About Diabetes</b></font></td>
<td align="right"><a href="info_pub.htm"><img src="images/p-pub.gif" border="0" width="80" height="103"></a></td>
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<p><br>
</p>
<ul>
<li><a href="#whatis">What is Diabetes?</a> </li>
<li><a href="#types">Types of Diabetes</a> </li>
<li><a href="#symptoms">Symptoms of Diabetes</a> </li>
<li><a href="#who">Who Is at Risk for Diabetes?</a> </li>
<li><a href="#treatment">Treatment of Diabetes</a> </li>
<li><a href="#low">Low Blood Sugar (Hypoglycemia, Insulin
Reaction)</a> </li>
<li><a href="#monitoring">Importance of Monitoring Blood
Sugar</a> </li>
<li><a href="#treatment-1">Treatment for Type I</a> </li>
<li><a href="#careforkids">About Supervising Children with
Diabetes</a> </li>
<li><a href="#treatment-2">Treatment for Type II Diabetes</a>
</li>
<li><a href="#employ">Employment</a> </li>
<li><a href="#complications">A Word About Complications</a> </li>
<li><a href="#hope">Hope for the Future</a> </li>
</ul>
<hr>
<h3><a name="whatis"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>What is Diabetes?</h3>
<p>Diabetes is a chronic disease that impairs the body's ability
to use food properly. </p>
<p>Normally, glucose, a form of sugar produced when starches and
sugars are digested, is burned as fuel to supply the body with
energy. This process--turning food into energy--is called
metabolism. </p>
<p>But in order to metabolize glucose properly, the body requires
another substance: Insulin. Insulin is a hormone produced by the
pancreas, a gland located just beneath the stomach; its job is to
regulate the body's use of glucose. Insulin is essential to the
metabolic process. </p>
<p>Trying to burn glucose without insulin is like trying to set
fire to a pile of logs without a match. It can't be done. And
that's the problem for people with diabetes: they either don't
produce enough insulin to properly metabolize glucose, or the
insulin they have works inefficiently. </p>
<p>Without insulin to turn glucose into energy the glucose piles
up in the bloodstream and spills into the urine showing as
&quot;sugar in the urine.&quot; Excessively high levels of sugar
in the blood and the urine are the hallmarks of untreated
diabetes. </p>
<p>While there is no cure for diabetes as yet, it can be
controlled. The main goal of diabetes treatment is to control
blood sugar levels and keep them in the normal range. The
specific kind of treatment used to control blood sugars depends
on the type of diabetes a person has. </p>
<h3><a name="types"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Types of
Diabetes</h3>
<ul>
<li><b><i>Type I (Insulin-Dependent or Juvenile) Diabetes.</i></b><br>
In this form of diabetes, a person's pancreas produces
little or no insulin. Although the causes for this are
not entirely known, scientists believe that the body's
own defense system (the immune system) attacks and
destroys the insulin-producing cells in the pancreas.
Because insulin is necessary for life, people with Type I
diabetes must take one or more injections of insulin
every day in order to metabolize their food. <p>Before
the discovery of insulin in 1921, people with Type I
diabetes would fall into a diabetic coma and die, usually
within a few weeks of onset. </p>
<p>This form of diabetes used to be known as <i>juvenile
diabetes</i> because it usually starts in children or
young adults. </p>
</li>
<li><b><i>Type II (Non-Insulin-Dependent or Adult-Onset)
Diabetes.</i></b><br>
In this form of diabetes, the pancreas still produces
insulin, but for some reason the body is not able to use
it effectively. So, in spite of the presence of adequate
amounts of insulin, blood glucose levels are not normal. <p>Fortunately,
Type II diabetes can be treated in a variety of ways,
including weight loss (many Type II's are overweight),
proper diet, reduced sugar intake and exercise. More
severe cases may be treated with oral drugs or insulin
injections. </p>
<p>Type Il, which is also known as <i>adult-onset
diabetes</i>, occurs most often in people over 40. Other
less common forms of diabetes include: </p>
</li>
<li><b><i>Gestational Diabetes</i></b><br>
Diabetes can suddenly appear in pregnant women who have
never exhibited any signs of high blood glucose -- this
is called gestational diabetes. The hormonal changes of
pregnancy stress the mother's system and, in some cases,
the pancreas is unable to produce sufficient insulin.
Treatment for gestational diabetes ranges from diet
management to insulin therapy. While this type of
diabetes usually disappears after the birth of the baby,
30 to 40 percent of these women develop diabetes within 5
to 10 years. </li>
<li><b><i>Glucose Intolerance</i></b><br>
This condition used to be called latent or borderline
diabetes, but it is no longer considered a form of
diabetes. People with glucose intolerance have an
abnormal response when large amounts of carbohydrates are
consumed. They are unable to metabolize it normally. Such
people are at increased risk for developing diabetes, but
most do not. </li>
</ul>
<h3><a name="symptoms"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Symptoms of Diabetes</h3>
<p>If you notice one or more of these symptoms on a recurring
basis, you should see a doctor. He or she can find out, through a
simple series of tests, if you have diabetes. </p>
<h4>Type I</h4>
<p>These symptoms may occur suddenly: </p>
<ul>
<li>Frequent urination, in large quantities </li>
<li>Excessive thirst </li>
<li>Extreme hunger all the time </li>
<li>Sudden weight loss, for no apparent reason </li>
<li>Weakness, drowsiness or exhaustion </li>
<li>Sudden vision changes or blurred vision </li>
<li>Nausea and vomiting </li>
</ul>
<h4>Type II</h4>
<p>These symptoms usually occur gradually: </p>
<ul>
<li>Any of the symptoms listed for Type I </li>
<li>Recurring or hard-to-heal skin, gum or urinary tract
infections </li>
<li>Drowsiness </li>
<li>Tingling or numbness in hands or feet </li>
<li>Itching of the skin and genitals </li>
</ul>
<h3><a name="who"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Who Is at Risk
for Diabetes?</h3>
<p>Nearly one in every 20 North Americans has diabetes. Out of
about eight million diagnosed with diabetes, one million are Type
I and seven million are Type II. Another eight million are Type
II and have not yet been diagnosed. High risk categories include
the following: </p>
<ul>
<li>People with diabetic relatives: Diabetes appears to have
an inherited genetic tendency. </li>
<li>People who are overweight: The chance of developing Type
II diabetes doubles with every 20 percent excess weight.
It is believed that excess body fat prevents insulin from
working properly. </li>
<li>People over forty: Type II diabetes is most common in
middle and old age. </li>
</ul>
<h3><a name="treatment"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Treatment of Diabetes</h3>
<p>Treatment of diabetes aims to do what a normal body does
naturally--maintain a proper balance of insulin and glucose. </p>
<h4>How Diabetes is Controlled</h4>
<p>Diabetes &quot;control&quot; means keeping the level of sugar
(glucose) in the blood as close to normal as possible. The three
elements of diabetes &quot;control&quot; are: </p>
<ol>
<li>Food </li>
<li>Exercise </li>
<li>Insulin </li>
</ol>
<p>The rule of thumb is: food makes the glucose level rise;
exercise and insulin make the glucose level fall. </p>
<p>Diabetes control is a constant balancing act of these three
factors. If the balance is thrown off, there is the danger of
either of two diabetic emergencies: hypoglycemia (low blood
sugar--insulin reaction) or hyperglycemia (high blood sugar).
Hyperglycemia will be encountered much less frequently as a
problem than hypoglycemia. </p>
<h3><a name="low"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Low Blood Sugar
(Hypoglycemia, Insulin Reaction)</h3>
<p>Sometimes called &quot;insulin shock,&quot; this happens
suddenly if a person using insulin eats too little food, doesn't
eat soon enough, takes too much insulin, or exercises too much.
This condition must be treated quickly with sugar or sugary foods
because hypoglycemia can lead to unconsciousness. If a person
becomes unconscious, honey or syrup should be rubbed inside the
person's cheek, where it can be absorbed without risk of choking.
If the person still does not respond in 10 to 15 minutes,
glucagon, a hormone that raises blood sugar, may need to be
injected. </p>
<ul>
<li>Symptoms appear rapidly: One or more of these symptoms
may suddenly occur. Each person has a particular set of
personal symptoms and you will come to recognize them.
(Note: Some patients show no preliminary symptoms and
therefore need to monitor their blood sugar levels more
frequently.) <ul>
<li>Inappropriate responses </li>
<li>Crankiness </li>
<li>Confusion and inattention </li>
<li>Lack of coordination </li>
<li>Drowsiness </li>
<li>Pale complexion </li>
<li>Perspiration </li>
<li>Headache </li>
<li>Trembling </li>
<li>Sudden hunger </li>
<li>Dizziness </li>
</ul>
</li>
</ul>
<h4>Ketoacidosis</h4>
<p>If a diabetic gets into a state of hyperglycemia--too much
sugar and not enough insulin to use it--and the condition isn't
treated, a dangerous biological process occurs. Since the body
can't use the sugar to supply its energy needs, it starts to
&quot;steal&quot; energy from the fats stored in the body. When
fats are broken down, acids called &quot;ketones&quot; are formed
in the body. Too many ketones in the system become poisonous.
Without proper treatment, the diabetic may fall into a coma
requiring hospitalization. This condition can be fatal. </p>
<p>Fortunately, this condition develops gradually--over several
hours or days. Prompt attention to the warning signs can avert a
serious problem. Usually a diabetic coma occurs only in Type I
diabetes. </p>
<ul>
<li>Symptoms occur gradually: <ul>
<li>Extreme thirst </li>
<li>Drowsiness, lethargy </li>
<li>Sugar in urine </li>
<li>Dry, hot skin </li>
<li>Lack of appetite </li>
<li>High levels of sugar and ketones in the blood </li>
<li>Fruity, sweet or wine-like odor on breath </li>
<li>Heavy, labored breathing </li>
<li>Eventual stupor or unconsciousness </li>
</ul>
</li>
</ul>
<h4>Monitoring Your Blood Sugar</h4>
<p>One of the most important advances in diabetes treatment and
control has been the ability to measure and monitor one's own
blood sugar levels at home. </p>
<p>Whether insulin-dependent or non-insulin-dependent, people
with diabetes must understand how the disease works and learn how
to manage their blood sugar levels. They must take very good care
of themselves, paying attention to diet, eating habits and
exercise. They should test their blood at specified times of the
day in order to keep a watch on blood sugar levels. </p>
<h3><a name="monitoring"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Importance of Monitoring Blood Sugar</h3>
<ul>
<li>To help prevent diabetic emergencies. </li>
<li>To possibly reduce and even reverse some of the long-term
complications of diabetes. </li>
<li>To feel good. The closer to normal the blood sugar is
kept, the better a person with diabetes feels. </li>
<li>To enjoy greater freedom to participate in any activity. </li>
</ul>
<p>There are two types of tests used to monitor blood sugar
levels: blood tests and urine tests. See JDF brochure
&quot;Monitoring Your Blood Sugar.&quot; </p>
<h4>Blood Tests</h4>
<p>Blood sugar levels can be measured at home with a blood
glucose monitoring system. It involves placing a drop of blood on
a chemically treated strip which is then put into a meter for a
blood sugar reading. Another method relies on a visual comparison
of the strip with a color-coded chart. It is believed that with
more precise monitoring and better &quot;control,&quot; the
complications of diabetes can be reduced, even reversed. </p>
<h4>Urine Tests</h4>
<p>Although a urine test using tablets or strips will indicate if
sugar has spilled into the urine at some point, this method does
not measure the actual level of blood sugar. Urine tests are
useful, however, for monitoring ketones, whose presence are a
warning sign of ketoacidosis, which can lead to diabetic coma. </p>
<h4>Frequency of Testing</h4>
<p>People with insulin-dependent diabetes are advised to test
their blood sugar levels frequently, before meals and at bedtime.
</p>
<h4>Keep Records of Tests</h4>
<p>It is recommended that people with diabetes keep records of
the self-tests. Not only should they share this information with
their physician (who may make appropriate adjustments in insulin
dosages), they can also learn how to adjust their own intake of
food or medication according to their physical activities. </p>
<h3><a name="treatment-1"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Treatment for Type I</h3>
<p>Type I diabetic patients must take insulin injections every
day to make up for the hormone their bodies do not supply. But
how do you determine what amount of insulin your body needs at
any given time? </p>
<h4>Balancing Blood Sugar and Insulin Levels</h4>
<p>An insulin injection is only a rough estimate of what is
really needed. If you take a shot in the morning, and then
suddenly decide to do some vigorous exercise without taking into
account the extra sugar that will be burned--your body will be
left with too little sugar and too much insulin. This may produce
hypoglycemia, described above. Any person with Type I diabetes
learns that before engaging in strenuous activity, you must take
some extra carbohydrates to make up for the sugar that will be
burned, or take less insulin that day. This regimen should be
discussed with your doctor. </p>
<ul>
<li>Factors that can upset the balance <ul>
<li>Physical activity </li>
<li>Illness </li>
<li>Infection </li>
<li>Periods of growth </li>
<li>Fatigue </li>
<li>Excitement </li>
<li>Anxiety </li>
<li>Hormonal changes </li>
</ul>
</li>
</ul>
<h4>Be Prepared</h4>
<p>You must be prepared to treat an insulin reaction by carrying
a fast-acting sugar at all times, and making sure it is available
at home, at school or in the workplace. It can be in the form of
orange juice, non-diet soda, candy, or sugar itself. </p>
<p>You should carry identification stating that you have
diabetes. ID bracelets and cards are available through Medic
Alert. You should carry enough money to summon help in case of
emergency. </p>
<h3><a name="careforkids"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>About Supervising Children with Diabetes</h3>
<p>If you are supervising a child with diabetes, you should
realize that: </p>
<ul>
<li>Children with diabetes can lead a normal life. </li>
<li>Children with diabetes have the same needs for guidance,
support and understanding as other children. </li>
<li>Diabetes is not contagious. </li>
</ul>
<p>With some simple guidelines, no one should be worried about
taking care of a child with diabetes, either at camp, in school
or on a &quot;sleepover&quot; date. </p>
<h4>General Guidelines</h4>
<ul>
<li>Watch the child's behavior before meals and snacks. </li>
<li>Try not to assign strenuous physical exercise just before
a meal when the child may be in need of sugar. </li>
<li>Arrange an inconspicuous means of taking the mid-morning
and/or afternoon snacks if they are part of the child's
diet. This same consideration should be used for insulin
injections and monitoring blood sugar levels </li>
<li>Keep sugar readily available. </li>
<li>Encourage the child to carry some form of sugar. </li>
<li>Make sure all necessary personnel are aware and informed.
</li>
<li>The child should take a snack before bedtime. </li>
<li>Keep any child suspected of having a &quot;reaction&quot;
with an adult. </li>
<li>DO NOT send the child home alone. You must make sure the
reaction has been taken care of before the child is left
alone or allowed to go home. </li>
</ul>
<h3><a name="treatment-2"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Treatment for Type II Diabetes</h3>
<p>Most cases of Type II diabetes can be controlled by diet and
exercise alone. The specific diet and exercise plan a doctor or
dietitian suggests depends on the person's age, lifestyle and
overall condition. In some cases, oral drugs or insulin
injections may be necessary, too. The key is to determine the
right balance of these elements. </p>
<h4>Diet</h4>
<ul>
<li>Concentrated sugars should not be eaten because insulin
can&#146;t be produced fast enough to burn them. </li>
<li>A personal meal plan should aim for a fixed number of
calories each day. </li>
<li>Cholesterol and saturated fats should be restricted
because people with diabetes are at a higher risk of
heart attack. </li>
<li>Weight loss through diet is a must for the overweight
person with diabetes. Often, once the desired weight is
maintained, no other treatment is necessary. </li>
</ul>
<h4>Exercise</h4>
<ul>
<li>Exercise is important both because it helps to control
weight and because it burns food, reducing demand on the
pancreas to produce insulin. </li>
<li>Check with your physician before starting an exercise
program to determine what activities will be best for
you. </li>
</ul>
<h4>Scheduling</h4>
<p>Maintain a regular pattern of eating, exercising, and resting.
Changes of schedule require adapting the diet or insulin dosages
appropriately. For instance, if you have Type II diabetes and
you're going to a very late dinner, you should work in a little
snack at your normal dinner hour. </p>
<h3><a name="employ"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Employment</h3>
<p>People with diabetes can work and work well. The discipline
demanded in order to control the diabetes often makes for a
better employee. They must eat at regular times, but other than
that, they can do even a very physically demanding job. People
with diabetes work in nearly every walk of life. </p>
<ul>
<li>Insurance Rates: Hiring people with diabetes usually does
NOT affect a firm's insurance rates. Employees are often
covered automatically under most group plans upon
completion of a short waiting period after hiring. </li>
</ul>
<h3><a name="complications"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>A Word About Complications</h3>
<p>As time goes on, diabetes can cause complications in organs
and systems throughout the body. </p>
<ul>
<li>Diabetes affects the blood vessels and the heart,
increasing the risk of heart disease, stroke, and other
problems caused by poor circulation, such as gangrene. </li>
<li>Diabetes is the leading cause of adult blindness in North
America. Some damage to the blood vessels in the retina
is evident in 90 percent of all persons who have had
diabetes for 15 years or longer. </li>
<li>Kidney disease is a major complication of diabetes. About
30 percent of new dialysis patients have diabetes-caused
kidney failure. </li>
<li>The incidence of stroke is two to six times higher in
people with diabetes. </li>
</ul>
<p><i>Simply put, diabetes is a chronic, complicated and
destructive disease.</i> </p>
<h3><a name="hope"></a><a href="#top"><img src="images/a_up.gif" border="0" hspace="6" width="20" height="20"></a>Hope for the
Future</h3>
<p>There is increasing hope that diabetes and its problems can be
cured. Significant progress has been made, and JDF funding has
been involved in all of these areas: </p>
<ul>
<li>Transplanting insulin-producing cells and pancreases in
human subjects. </li>
<li>Understanding how the body's own immune system destroys
insulin-producing cells. </li>
<li>Identifying the genes involved in diabetes to define who
is at risk. </li>
<li>Establishing how viruses may work as a
&quot;trigger&quot; mechanism in diabetes. </li>
<li>Improving laser techniques to treat eye problems. </li>
<li>Developing insulin pumps and other experimental
insulin-delivery systems. </li>
<li>Developing new ways to monitor blood glucose. </li>
<li>Developing drugs that may reduce diabetic complications. </li>
</ul>
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