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In a healthy individual the body is able to
automatically control the level of blood glucose depending on
the body's needs. However, in the case of a diabetic this
automatic control mechanism does not function properly. Blood
glucose levels in a healthy person range from around 3.5 to 7
mmol/l. Diabetics will have higher blood glucose levels, often
in excess of 15 mmol/l.
Glucose is produced when the body digests carbohydrates, starch
or sugars. This glucose is transported in the blood to cells
where they can be converted to energy to power the muscles. Any
surplus is stored in the liver. Insulin is an essential hormone
which enables the glucose to enter the cells or be stored in
the liver. In a diabetic patient however, insulin is either not
produced at all or does not perform as expected.
There are 3 main forms of diabetes:
Type 1 or Juvenile onset diabetes. This is commonly diagnosed
in patients under the age of 30. In type one diabetes the
body's immune system attacks and destroys the cells in the
pancreas that produce insulin. As a result the pancreas no
longer produces insulin. This type of diabetes is less common
than type 2 and occurs in people with a genetic
predisposition.
Type 2 also called mature onset diabetes occurs usually in the
age group above 30 but is known to also occur in obese
teenagers and children. In this case the body produces insulin
but it is not effective.
The third form of diabetes is Gestational diabetes, which is a
temporary condition occurring during pregnancy. However, women
who suffer gestational diabetes have a high likelihood of
developing type 2 diabetes at some point in their life.
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High levels of blood glucose
over long periods of time can cause many health
problems including blood vessel damage, nerve
damage, kidney and liver damage, impotence,
problems with feet as well as increased risk of
heart disease and stroke. It is therefore
extremely important to diagnose diabetes as
early as possible so appropriate treatment can
be provided.
However, many patients may
have the disease but have no symptoms till
glucose levels become extremely high.
Common
symptoms of diabetes are:
Extreme thirst:
As glucose builds up in the blood the kidneys
have to work overtime to clear it out. As a
result frequent urination is also common.
Tiredness and lethargy
Blurred vision
Infections such as thrush
Unexplained weight loss (usually associated
with type 1 diabetes)
Appropriate treatment depends on the type of
diabetes.
In the case of type 1
diabetes the body no longer produces insulin.
Hence, treatment invariably includes insulin
replacement therapy in the form of insulin
injections.
Gestational diabetes occurs in pregnancy. Since
oral diabetes medication may be harmful to the
fetus, insulin injections may be prescribed
where dietary adjustments and exercise are
found to be inadequate.
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Type 2 diabetes is by the far the most
common and is reaching almost epidemic proportions in western
countries. This is very much a lifestyle related disease and is
closely connected with obesity and lack of exercise. Type 2
diabetes is often treated with a combination of dietary changes
and an exercise regime. Where these prove insufficient to
control blood glucose levels oral medications may be used.
There are many categories of tablets used for treatment of type
2 diabetes each of which may act different. It is therefore
quite common to combine more than one form of medication.
Categories of medication include:
Category 1 - Sulphonylureas - This includes medications such as
daonil, Glimel and Diamicron and helps by making the pancreas
secrete more insulin.
Category 2 - Meglitinides - Similar to Sulphonylureas these
drugs stimulate production of insulin in the pancreas. However,
it generally has a shorter term effect, typically about 4
hours.
Category 3 - Biguanides - reduces absorption of glucose into
the blood stream and also helps improve sensitivity to
insulin.
Category 4 - Acarbose - Affects the absorption of glucose from
the small intestines.
Category 5 - Thiazolidinediones - Reduces glucose released from
the liver and helps insulin work more effectively to reduce
glucose levels in the blood.
Many herbs have also been credited with an ability to reduce
blood sugar levels or increase insulin tolerance. These include
Bitter Melon, Garlic, Onion, Fenugreek, Bilberry, Asian
Ginseng.
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While limited success has
been recorded in lab tests, especially on
animal subjects there is no evidence that herbs
have sufficient impact on blood glucose levels
to warrant use of herbs as a treatment to the
exclusion of all others.
Diabetes has no cure and
treatment is geared towards reducing and
postponing complications as long as possible
while trying to maintain blood glucose levels
as close as possible to normal levels.
It is also a sad fact that
oral diabetes medication becomes less and less
effective as time passes and most diabetics
will in the long term find themselves with no
option other than insulin injections.
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