1. What is diabetes?
2. What are the symptoms of diabetes?
3. What are the types and risk factors of diabetes?
4. What is the treatment for diabetes?
5. What causes type 1 diabetes?
6. Can diabetes be prevented?
7. Is there a cure for diabetes?
8. What is hyperglycemia?
9. What is hypoglycemia?
10. What is the glycemic Index?
11. How are diabetics affected by cardiovascular disease?
12. What are the recommended blood sugar levels?
13. What are some other sources for information on diabetes?
14. Where can I find new and used books on diabetes?
15. Where can I buy diabetic products and supplies onlibe?
16. How can I cut the cost of my diabetic prescriptions?
17. Are there natural alternative ways to manage diabetes?

1. What is diabetes?

Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.

2. What are the symptoms of diabetes?

People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:

• Frequent urination
• Excessive thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in hands or feet
• Feeling very tired much of the time
• Very dry skin
• Sores that are slow to heal
• More infections than usual.

Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.

3. What are the types and risk factors of diabetes?

The following types of diabetes and some of their risk factors are quoted from the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US Department of Health and Human Services, 1997):

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or -onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.

Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly 40% of women with a history of gestational diabetes developed diabetes in the future.

Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of diabetes.

4. What is the treatment for diabetes?

"Let food be your medicine and medicine be your food" - Hippocrates.

We storngly advise that management of your diabetes should be planned  with a qualified diabetes team.  We like to emphasize this point because not all doctors and nurses knows about diabetes and how to treat it.

The following information on treatments for diabetes is from the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US Department of Health and Human Services, 1997):

Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues.

Treatment of type 1 diabetes: Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to control. Treatment requires a strict regimen that typically includes a carefully calculated diet, planned physical activity, home blood glucose testing several times a day, and multiple daily insulin injections. Stress management is also a key factor in controlling type 1 diabetes.

Treatment of type 2 diabetes: Treatment typically includes diet control, (such as a balance diet of low fat, low carbohydrateand high fiber or eating foods with a low glycemic value) daily exercise, home blood glucose testing, and in some cases, oral medication and/or insulin.

Approximately 40% of people with type 2 diabetes require insulin injections. Stress management is also a key factor in controlling type 2 diabetes.

5. What causes type 1 diabetes?

The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for development of both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.

6. Can diabetes be prevented?

A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. It also appears to be associated with obesity. Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes, but prevention, as well as a cure, remains elusive.

7. Is there a cure for diabetes?

In response to the growing health burden of diabetes mellitus (diabetes), the diabetes community has three choices: prevent diabetes; cure diabetes; and take better care of people with diabetes to prevent devastating complications. All three approaches are actively being pursued by the US Department of Health and Human Services.

Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on being sure that the proven science is put into daily practice for people with diabetes.

The basic idea is that if all the important research and science are not made meaningful in the daily lives of people with diabetes, then the research is, in essence, wasted.

Several approaches to "cure" diabetes are being pursued:

• Pancreas transplantation
• Islet cell transplantation (islet cells produce insulin)
• Artificial pancreas development
• Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted  then these "pseudo" islet cells are transplanted into people with type 1 diabetes).

Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.

8. What is Hyperglycemia?

Hyperglycemia is high blood glucose. The symptoms are:

• tired
• thirsty
• flushed
• nauseous
• frequent urination
• dry itchy skin
• vomiting
• blurry vision
• genital itching

Possible causes of hyperglycemia are:

• infection
• illness
• overeating or improper eating
• skipping exercise
• emotional stress
• skipped oral agents or insulin
• certain medications
   

9. What is Hypoglycemia?

Hypoglycemia is low blood glucose. The symptoms are:

• shaky
• sweaty
• lightheaded
• heart pounding
• irritable
• confused
• hungry
• blurry vision

Possible causes are:

• skipped or delayed meal
• too much insulin/oral agents
• incorrect type of insulin/oral agents
• too much exercise or wrong time
• alcohol without food intake

*Source: Diabetes Treatment Centers of America and The Diabetes Association www.diabetes.org)

10. What is the Glycemic Index?*

The Glycemic Index was developed by Dr. David Jenkins, a Professor of nutrition at The University of Toronto, Canada. It is an easy and simple ranking of foods based on the immediate effect on blood glucose levels. It measures how much your blood sugar levels increases over a period of two to three hours after a meal.

Generally speaking, foods rich in fat and protein like fish, chicken, beef, pork and meat in general, will not affect your blood glucose levels very much.

But foods rich in carbohydrates, such as rice, pasta, bread, bagels, donuts, potatoes and even carrots have a very high rating on the Glycemic Index that will push your glucose levels through the roof if you are not careful. 

Here is the  Glycemic Index Top 10 List:

Click here for the full glycemic index list

Source: "How to loose weight permanently using the Glycemic Index" *

The complete list is published in the book "How to loose weight permanently" by Peter Ganesh, President of The Diabetes Foundation.

The List covers most popular American and international  foods and it is organized by categories such as bakery products, beverages, breads, breakfast cereals, cereal grains, cookies, crackers, dairy foods, fruit and fruit products, legumes, pasta, root vegetables, snack foods, soups, sugars, indigenous foods, Mexican foods, Asian Indian foods, Australian Aboriginal foods, Pacific Island foods, Chinese foods, Latin foods, European and other miscellaneous foods.

You can pre-order the book here "How to loose weight permanently using  the Glycemic Index" by Peter Ganesh, President of The Diabetes Foundation.

11. How are diabetics affected by cardiovascular disease?

Cardiovascular disease is the number one killer in the US today and the leading cause of diabetes related deaths. Research indicates that cardiovascular disease and type 2 diabetics share a common root - Insulin resistance.

Insulin resistance occurs when the body does not produce enough or does not respond very well to it's own natural insulin. Insulin is a hormone (much like a key) that helps blood sugar to get into the cells of the body to be stored or converted into energy.

Researchers propose that consistently high blood sugar (sticky blood) may contribute to  blood clotting, inflammation and hardening of the arteries.  This in turn may lead to cardiovascular disease and heart attacks.

2. What are the recommended blood sugar levels?

You should consult your doctor before determining what your blood sugar levels should be before and after meals.  Here are some general recommendations:

• Fasting before meals - 80 to 120 (4.44 to 6.67 mmol/L)
• Two hours after meals - less than 140 (7.77 mmol/L)
• Before bed time - 100 to 140 (5.55 to 7.77 mmol/L)

13. What are some other sources for information on diabetes?

The following organizations may help in your search for more information on diabetes:

Indian Health Service
Diabetes Program
5300 Homestead Road NE, Albuquerque, NM 87110
505/248-4182
 

National Diabetes Education Program
 

The NDEP is a nationwide initiative of the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). It is an inclusive, partnership-based program involving many diverse public and private sector partner organizations. The goal of the program is to reduce the morbidity and mortality of diabetes and its complications.

For more information on NDEP, call toll free 1-800-438-5383.

National Institute of Diabetes and Digestive and Kidney Diseases
1 Information Way, Bethesda, MD 20892-3560
800/GET LEVEL (800/438-5383) or 301/654-3327
 

National Eye Institute (NEI)
Bldg. 31, Room 6A32
31 Center Drive, MSC 2510
Bethesda, MD 20892-2510
301/496-5248 or 800/869-2020 (to order materials)
301/402-1065 (fax)
 

Educating People with Diabetes Kit
(Sponsored by the National Eye Institute)
2020 Vision Place, Bethesda, MD 20892
 

Office of Minority Health Resource Center
US Department of Health and Human Services
P.O. Box 37337, Washington, DC 20013-7337
800/444-MHRC (444-6472)
 

Non-Federal Government Organizations

Links to Non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at these links.

American Association of Diabetes Educators
100 West Monroe, 4th Floor, Chicago, IL 60603-1901
800/338-3633 for names of diabetes educators
312/424-2426 to order publications
 

American Diabetes Association
1660 Duke Street, Alexandria VA 22314
800/232-3472 or 703/549-1500
800/ADA-ORDER to order publications toll free
ADA's D.I.A.L. Program (Diabetes Information and Action Line)
800/342-2383 or 800/DIABETES for diabetes information
 

American Dietetic Association
National Center for Nutrition and Dietetics
216 West Jackson Boulevard, Suite 800, Chicago, IL 60606-6995
800-366-1655 Consumer Nutrition Hotline (Spanish speaker available)
800-745-0775
 

American Heart Association National Center
7272 Greenville Avenue, Dallas, TX 75231
214/373-6300
 

American Optometric Association
1505 Prince Street, Alexandria, VA 22314
800/262-3947 or 703/739-9200
 

International Diabetic Athletes Association
1647-B West Bethany Home Road, Phoenix, AZ 85015
800/898-IDAA or 602/433-2113
602/433-9331 (fax)
 

Juvenile Diabetes Foundation International
The Diabetes Research Foundation
120 Wall Street, 19th Floor, New York, NY 10005-4001
800/JDF-CURE or 800/223-1138
212/785-9595 (fax)
 

Medical Eye Care for the Nation's Disadvantaged Senior Citizens
The Foundation of the American Academy of Ophthalmology
P.O. Box 429098, San Francisco, CA 94142-9098
800/222-EYES (222-3937)

National Diabetes Information Clearinghouse
1 Information Way, Bethesda MD 20892-3560
301/654-3327 (phone); 301/907-8906 (fax)
 

• WalMart
• Walgreens

• Generic Drugs- Ask your doctor to specify that generic drugs are OK. The exceptions are few and only apply if you are already on a trade name product with a narrow therapeutic index.
   
• Ask your pharmacist if you RECEIVED the generic product - many times if a pharmacist does not have the generic drug they will give you a trade name product instead of sending you to another pharmacy which has a generic available.
   
• There are frequently differences among meds in same therapeutic category i.e 30 days of Prilosec (for reflux gastritis) the Average Wholesale Price is $119.57/20 mg caps while Prevacid which does the same thing is $112.03/30 days. Ask your pharmacist if there is a less expensive drug in that works the same way as the one you are taking.
   
• Many drugs do not increase proportionally in price as the strength increases. Example: Mevacor (a drug for elevated cholesterol) - the Average Wholesale Price is $82.32 for 60-10 mg tablets while for 60 - 20 mg tablets the cost is $145. Thus if you are taking 10 mg each day you can save by using the 20 mg tablets and cutting in half - this is a very common way you can save medication costs. If you want to do this please: 1) Check with your pharmacist to be sure cutting in half will not impact on release properties of medication 2) Let your physician know that you are cutting the tablet so he can adjust his/her records accordingly. 3)Purchase a tablet cutter from your pharmacy (at a cost of $3-$4) 4)Replace your tablet cutter as it dulls because of use.
• Maximum Amount - If you are on medication that you refill regularly -always ask the pharmacist to give you the maximum amount allowed by your prescription up to 100. Most, if not all, pharmacies charge more for 30 tablets than for 100 AND by returning every 30 days you pay an additional dispensing fee each time (not including gas, waiting in lineetc.).

• Food Therapy
• Reflexology
• Stress Management (Relaxation And Meditation)
• Vitamins And Minerals
• Yoga
• Daily Exercises And Lifestyle
• Acupuncture
• Chromium
• Vanadium
• Biofeedback
• Ginseng
• Magnesium
• Cinnamon
• Bitter Melon

The Problem With Carbohydrates And Diabetics

Food plays a vital role in the life of diabetics, especially carbohydrates and foods with trans fats. 

Carbohydrates, when broken down into the body after eating, turns into glucose or sugar.  This requires insulin (a hormone produced by the body which acts like a key) to allow this form of sugar to enter the cells to be burned by the metachondriacs, to produce energy.

In short, the more carbohydrates you eat, the more insulin you will need to burn the sugar.  This becomes a problem if your body does not produce enough insulin. 

For others who produce enough insulin, this is also a problem because this may lead to "insulin resistance" or the body's inability to burn glucose.

 According to a recent study from Harvard University, Insulin resistance   contributes  to high blood sugar levels, causing inflammation and blockage in the arteries and ,may lead to heart attacks and even death. 

Doctor Atkins, in his new book "The New Diet Revolution, shows that a diet high in protein, low complex carbohydrates and regular exercise does help to loose weight and maintain better blood sugar levels.

One down side of the high protein diet is kidney problems. Diabetics and people who have a history in their family with kidney problems need to take extra precaution. If you go on a high protein diet, you should get tested regularly to make sure that you are not spilling protein in your urine.

So far we have not found the perfect diet that works for everyone. So we strongly recommend that you talk to your doctor before starting any new diet program. . You can buy. Doctor Robert C. Atkins book here 

Studies conducted by Duke University Medical Center in North Carolina found that stress significantly increases your blood sugar levels.  This they say is caused by triggering the body's "fight or flight response system." When this happens, the blood vessels and muscles contract and get tight,  making it more difficult for blood to flow properly throughout the body.  Hence, if you are constantly under stress, your blood sugar levels will be high all the time.

An easy way to reduce this stress is to take a walk, do some deep breathing exercises, try yoga or watch some comedy on tv. You may need to buy  books on this topic at Amazon.com

Some diabetics also have reported that taking Calcium with Magnesium, about 1,000 mg per day, also helps with balancing of their blood sugar levels. 

The National Institute of Health, along with The University of California and other agencies combined to perform a seven year study using over 700 clinical trial subjects to determine the effect on nutrition and health. 

Their discovery suggests what nutritionists have known for years - a disruption in the ecology in the digestive tract may cause up to 90% of illnesses and diseases. 

The problem is that, as you get older, the body's natural digestion enzyme supply becomes depleted.  You become enzyme deficient, making you susceptible to heart disease, cancer, arthritis, diabetes and many other age related illnesses. You can buy books on Vitamins And Mineral Therapy here

Cinnamon For Diabetes

In recent studies done in the UK and the USA, cinnamon seems to be very helpful in controlling blood sugar levels in diabetics, when taken on a daily basis, either orally, nasally or as a gum.

My own experience with cinnamon is very encouraging also. I have been using cinnamon as a tea and a spread over my food. It does seem to reduce my blood sugar levels.

But cinnamon seems to be good not only for diabetes but, it is also good for the prevention of heart disease and even make you smarter, according to the researchers.

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Additional Information on Complementary and Alternative Medical Therapies for Diabetes

The National Diabetes Information Clearinghouse collects resource information on diabetes for the Combined Health Information Database (CHID). CHID is a database produced by health-related agencies of the Federal Government. This database provides titles, abstracts, and availability information for health information and health education resources.

To provide you with the most up-to-date resources, information specialists at the clearinghouse created an automatic search of CHID.

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National Diabetes Information Clearinghouse

1 Information Way
Bethesda, MD 20892–3560
Email: ndic@info.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1978, the Clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. The NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

This e-text is not copyrighted. The Clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.

NIH Publication No. 04–4552
May 2004