Tuesday, October 30, 2007

NATURO THERAPY FOR DIABETES

Description

Results from insufficient production of insulin by pancreas, leading to high levels of glucose in the blood and poor absorption of glucose by tissues. Is generally divided into two categories: Type I, called insulin dependent or juvenile diabetes, and Type II called non-insulin dependent or adult onset diabetes. A person is regarded as having Diabetes Mellitus if their Blood Sugar concentration is greater than 140 mg per deciliter after an overnight fast.

Prevalence
Approximately 6% of the population of the Western world is afflicted with one of the forms of Diabetes Mellitus.
In the USA, Diabetes Mellitus is the sixth most common cause of death.

Substances that Alleviate Diabetes Mellitus

Amino Acids
Alpha-Ketoglutarate (Pyridoxine Alpha-Ketoglutarate (PAK) form - 1,800 mg per day) enhances the therapeutic effectiveness of Insulin and Phenformin in Diabetes Mellitus patients - both Diabetes Mellitus Type 1 and Diabetes Mellitus Type 2.

Carnitine helps to prevent Diabetes Mellitus, lowers elevated Triglycerides and Cholesterol in Diabetes Mellitus patients and helps to alleviate the Pain associated with (diabetic) Neuropathy in Diabetes Mellitus patients.

N-Acetyl-Cysteine (NAC) helps to prevent (diabetic) Neuropathy in Diabetes Mellitus patients.

Carbohydrates
Arabinoxylans (10,000 mg per day) improve Blood Sugar control in Diabetes Mellitus patients.

Cellulose helps to lower Blood Sugar levels in Diabetes Mellitus patients.

Glucomannans help to lower Blood Sugar levels in Diabetes Mellitus patients.

Gums help to lower Blood Sugar levels in Diabetes Mellitus patients:

- Guar Gum helps to normalize Blood Sugar levels in Diabetes Mellitus patients.

Inulin helps to lower elevated Blood Sugar levels in Diabetes Mellitus patients.

Lignin alleviates Diabetes Mellitus.

Enzymes
Diabetes Mellitus patients are generally found to have abnormally low Glucokinase activity.

Hormones
Supplemental Dehydroepiandrosterone (DHEA) lowers the requirement for exogenous Insulin in Diabetes Mellitus patients.

Immune System Chemicals
Diabetes Mellitus patients are usually found to produce insufficient quantities of endogenous Interferon Alpha.

Lipids
Conjugated Linoleic Acid (CLA) helps to lower elevated Blood Sugar levels (which is particularly beneficial for Diabetes Mellitus patients).

Gamma-Linolenic Acid (480 mg per day) alleviates the symptoms of (diabetic) Neuropathy:

- Diabetes Mellitus patients have an impairment in their ability to convert Linoleic Acid to Gamma-Linolenic Acid (GLA) - this occurs because Diabetes Mellitus patients are unable to manufacture the Delta-6 Desaturase Enzyme which normally converts dietary Linoleic Acid to GLA.

Series 1 Prostaglandins alleviate Diabetes Mellitus (by improving the effectiveness of Insulin):

- Diabetes Mellitus patients are often found to have sub-optimal production of Prostaglandin E1 (PGE1).

Minerals
Calcium AEP reduces the requirement for exogenous Insulin in Diabetes Mellitus patients, counteracts the Autoimmune abnormality that is associated with Diabetes Mellitus Type 1 and helps to normalize Blood Sugar levels in Diabetes Mellitus Type 2 patients.


Diabetes Mellitus can occur as a result of Chromium deficiency and supplemental Chromium exerts numerous beneficial effects on Diabetes Mellitus patients:

- Chromium lowers elevated serum Triglycerides levels in Diabetes Mellitus patients.

Copper deficiency can cause Glucose intolerance (which is implicit in Diabetes Mellitus). Many Diabetes Mellitus patients are found to be deficient in Copper.

Magnesium helps to prevent Diabetes Mellitus and to keep Diabetes Mellitus under control (most Diabetes Mellitus patients are found to be deficient in Magnesium).

Manganese (5 - 15 mg per day) is beneficial in the treatment of Diabetes Mellitus (due to its ability to activate the enzymes involved in the process of glycolysis) and Diabetes Mellitus patients are generally found to have approximately 50% of the levels of Manganese of normal, healthy persons.

Potassium alleviates Diabetes Mellitus (by facilitating the conversion of Glucose to Glycogen).

Selenium helps to lower elevated Blood Sugar levels in Diabetes Mellitus patients.

Zinc supplementation counteracts the inability of Diabetes Mellitus patients to absorb Zinc and their tendency to excrete excessive quantities of Zinc. It also improves/regulates Insulin function in Diabetes Mellitus patients.

Peptides
Glutathione helps to prevent some of the complications associated with Diabetes Mellitus (including (diabetic) Nephropathy and (diabetic) Neuropathy (due to the Antioxidant effects of Glutathione).

Pharmaceutical Drugs
Anti-Diabetic Pharmaceutical Drugs are employed by orthodox medicine to treat Diabetes Mellitus:

- Exogenous, pharmaceutical Insulin is administered in the treatment of Diabetes Mellitus.

- Metformin is utilized in the treatment of Diabetes Mellitus - it increases the sensitivity of the Muscles to Insulin and Glucose (i.e. it counteracts Insulin Resistance).

Polyphenols
Silymarin (200 - 800 mg per day) reduces Blood Sugar levels, Insulin levels, Glycosuria and Glycosylated Hemoglobin levels in Diabetes Mellitus patients.

Quercetin helps to prevent many of the complications that arise from Diabetes Mellitus (by suppressing the Aldose Reductase enzyme).

- Quercetin helps to prevent Cataracts in Diabetes Mellitus patients.

Proteins
Charantin (a constituent of Bitter Melon) potently lowers Blood Sugar levels in Diabetes Mellitus patients.

Polypeptide-P (a constituent of Bitter Melon) alleviates Diabetes Mellitus (due to its ability to substitute for Insulin within the body).

Quinones
Coenzyme Q10 alleviates Diabetes Mellitus:

- 8% of Diabetes Mellitus patients are deficient in Coenzyme Q10.
- Coenzyme Q10 reduces Blood Sugar levels by at least 20% in 36% of Diabetes Mellitus patients and reduces Blood Sugar levels by at least 30% in 31% of patients.
- Many of the complications associated with Diabetes Mellitus are exacerbated in the presence of Coenzyme Q10 deficiency.

Smart Drugs
Aminoguanidine prevents the Cross-Linking of the body's endogenous Proteins with Glucose which is greatly accelerated in Diabetes Mellitus patients and which leads to many of the complications inherent in this disease:

- Aminoguanidine helps to prevent (diabetic) Nephropathy in Diabetes Mellitus patients.
- Aminoguanidine helps to prevent (diabetic) Neuropathy in Diabetes Mellitus patients.
- Aminoguanidine helps to prevent (diabetic) Retinopathy in Diabetes Mellitus patients.

Sulphuric Compounds
Allyl Propyl Disulfide (APDS) - found in Onions - helps Diabetes Mellitus patients to lower their Blood Sugar levels:

- APDS competes with Insulin for breakdown sites in the Liver, thereby increasing Insulin's lifespan.

Methylsulfonylmethane (MSM) (2,000 mg per day) may alleviate Diabetes Mellitus (by facilitating the endogenous production of Insulin and by decreasing Insulin Resistance).

Vitamins
Biotin lowers fasting Blood Sugar levels and improves overall control of Blood Sugar levels in Diabetes Mellitus patients (partly due to Biotin enhancing the activity of the Glucokinase enzyme which is usually low in Diabetes Mellitus patients). Biotin also helps to prevent and treat (diabetic) Neuropathy in Diabetes Mellitus patients.

Inositol (1,000 mg per day) improves Nerve function, improves the function of Myelin Sheaths and alleviates (diabetic) Neuropathy in Diabetes Mellitus patients.

Lipoic Acid prevents and alleviates many of the detrimental side effects that occur as a result of Diabetes Mellitus (both Type 1 and Type 2):

- Lipoic Acid reduces the incidence of Cataracts in Diabetes Mellitus patients.

- Lipoic Acid prevents the Kidney damage (diabetic Nephropathy) that is a common side effect of Diabetes Mellitus.

- Lipoic Acid prevents the (diabetic) Neuropathy that is a common side effect of Diabetes Mellitus.

Most Diabetes Mellitus patients are found to be deficient in Vitamin B6.

Vitamin C reduces the Insulin requirements of Diabetes Mellitus patients and lowers elevated Sorbitol levels in Diabetes Mellitus patients:

- Vitamin C inhibits the activity of Aldose Reductase in Diabetes Mellitus patients.

Many of the complications associated with (both forms of) Diabetes Mellitus are exacerbated in the presence of Vitamin E deficiency.

Foods/Herbs that Alleviate Diabetes Mellitus

Herbs
Agrimony helps to prevent some cases of Diabetes Mellitus and lowers elevated Blood Sugar levels in Diabetes Mellitus patients.

Alfalfa alleviates the symptoms of Diabetes Mellitus.

Aloe vera (1 tablespoon of juice derived from the pulp of Aloe vera leaves consumed orally) reduces Blood Sugar levels and Triglycerides levels in Diabetes Mellitus patients.

American Ginseng helps to lower elevated Blood Sugar levels in Diabetes Mellitus patients.

Banaba Leaf lowers Blood Sugar levels in Diabetes Mellitus patients (due to the Colosilic Acid content of Banaba Leaf facilitating the transportation of Glucose into Cells, resulting in lowered Blood Sugar levels).

Bilberry helps to prevent Retinopathy developing in Diabetes Mellitus patients (due to the Anthocyanosides content of Bilberries).

Blue Cohosh reputedly alleviates Diabetes Mellitus (according to anecdotal reports).

Caterpillar Fungus lowers elevated Blood Sugar levels in Diabetes Mellitus patients (due to the CS-OHEP and CS-F30 Polysaccharides content of Caterpillar Fungus).

Cat’s Claw may alleviate Diabetes Mellitus.

Dandelion alleviates Diabetes Mellitus.

Essiac (a mixture of Herbs - primarily Sheep Sorrel) reputedly allows Diabetes Mellitus patients to discontinue supplemental Insulin treatment (by vastly improving the function of the Pancreas) (according to anecdotal reports).

Goat’s Rue lowers elevated Blood Sugar levels in Diabetes Mellitus patients.

Goldenseal reputedly alleviates Diabetes Mellitus.

Gymnema Sylvestre (a form of Red Algae) alleviates and prevents the onset of Diabetes Mellitus (Types 1 and 2) (by repairing and regenerating the Beta Cells that are located within the Islets of Langerhans of the Pancreas which are responsible for the production and secretion of Insulin):

- Gymnema Sylvestre reduces elevated Blood Sugar (Glucose) levels in Diabetes Mellitus patients.

- Many Diabetes Mellitus patients are able to withdraw from using Pharmaceutical Drugs after GS supplementation.

Indian Gooseberry helps to lower elevated Blood Sugar levels in Diabetes Mellitus patients.

Korean Ginseng lowers serum Blood Sugar levels in Diabetes Mellitus patients.

Milk Thistle reduces Blood Sugar levels, Insulin levels, Glycosuria and Glycosylated Hemoglobin levels in Diabetes Mellitus patients (due to the Silymarin content of Milk Thistle).

Neem (leaf extract consumed orally) lowers Blood Sugar levels in Diabetes Mellitus patients (both Diabetes Mellitus Type 1 and Diabetes Mellitus Type 2 patients).

Olive Leaf improves the condition of Diabetes Mellitus patients.

Rehmannia lowers elevated Blood Sugar levels in Diabetes Mellitus patients (by increasing Glucokinase levels).

Schizandra may be useful for the treatment of Diabetes Mellitus (it may lower Blood Sugar levels).

Stevia lowers elevated Blood Sugar levels in Diabetes Mellitus patients:

- In one study on humans, 6 - 8 hours after the ingestion of Stevia by hospitalized patients, mean Blood Sugar levels dropped by 35%.

Legumes
Legumes are excellent Insulin regulators and can sometimes eliminate the need for Diabetes Mellitus patients to receive Insulin injections (due to the high Polysaccharides content of Legumes):

- Kidney Beans are beneficial for Diabetes Mellitus patients (due to the Lectins content of Kidney Beans which influence Insulin levels).

- Lentils effectively regulate Blood Sugar levels in Diabetes Mellitus patients (due to the Polysaccharides in Lentils).

Oils (Dietary Oils)
Evening Primrose Oil (4,800 mg per day) alleviates the symptoms of diabetic Neuropathy (due to the Gamma-Linolenic Acid (GLA) content of Evening Primrose Oil).

Flax Seed Oil alleviates Diabetes Mellitus by lowering Insulin requirements.

Seeds
Fenugreek Seeds lower Blood Sugar levels in Diabetes Mellitus patients.

Vegetables
Asparagus (juice) reputedly alleviates Diabetes Mellitus (according to anecdotal reports).

Bitter Melon (unripened) alleviates Diabetes Mellitus (due to the Blood Sugar lowering capabilities of Charantin and the ability of Polypeptide-P to substitute for Insulin within the body):

- Human studies have demonstrated that Bitter Melon lowers Blood Sugar levels more effectively than the pharmaceutical drug - Tolbutamide.

Celery (juice) reputedly alleviates Diabetes Mellitus (according to anecdotal reports).

Garlic alleviates Diabetes Mellitus by lowering Blood Sugar levels.

Globe Artichoke improves the metabolic function of Diabetes Mellitus patients (due to the Inulin in Globe Artichoke improving Blood Sugar control).

Jerusalem Artichoke potently regulates Blood Sugar levels in Diabetes Mellitus patients (due to the Inulin content of Jerusalem Artichoke).

Onions exert significant Blood Sugar-lowering actions in Diabetes Mellitus patients (mainly due to the Allyl Propyl Disulfide content of Onions retarding the degradation of Insulin):

- Onions are as effective as the Pharmaceutical Drugs, Tolbutamide and Phenformin, in lowering Blood Sugar levels in Diabetes Mellitus patients.

Spinach alleviates Diabetes Mellitus.

Yeasts
Brewer’s Yeast (9 grams per day) normalizes Blood Sugar levels, improves Glucose tolerance and improves Insulin sensitivity in Diabetes Mellitus patients (primarily due to the Chromium content of Brewer’s Yeast).

Substances that can Cause Diabetes Mellitus

Food Additives

Aspartame may cause Diabetes Mellitus.

Proteins
Elevated Glycosylated Hemoglobin levels increase the risk of Diabetes Mellitus Type 2. Glycosylated Hemoglobin levels are recognized as a screening and diagnostic test for Diabetes Mellitus Type 2. research

These Substances are Toxic for Diabetes Mellitus patients

Amino Acids
Diabetics should avoid Arginine supplementation (due to Arginine's Insulin-raising effect).

Diabetics should not consume Cysteine supplements.

Carbohydrates
Fructose can cause elevated serum Triglyceride levels in Diabetes Mellitus patients.

Excessive endogenous production of Sorbitol (by conversion of endogenous Glucose by the Aldose Reductase enzyme) is responsible for several of the complications associated with Diabetes Mellitus.

Food Additives
Aspartame exacerbates the side effects (e.g. Cataracts, Diabetic Neuropathy; Diabetic Retinopathy) of Diabetes Mellitus.

Ketone Bodies
Excessive quantities of Acetoacetic Acid are manufactured by Diabetes Mellitus patients.

Lipids
Excessive consumption of Long-Chain Saturated Fatty Acids can cause Diabetes Mellitus.

Trans-Fatty Acids increase the Insulin response of Diabetes Mellitus patients.

Neurotransmitters
Excessive production (or consumption) of Phenylethylamine (PEA) increases the body's Blood Sugar levels.

Pharmaceutical Drugs
Diabetes Mellitus patients should not use Galanthamine.

Long-term usage of Pharmaceutical Corticosteroids increases the risk of developing Diabetes Mellitus.

Smart Drugs
Propranolol should not be used by Diabetes Mellitus patients except under the guidance of a Physician.

Diabetes Mellitus patients Should Avoid these Foods/Herbs

Herbs
Diabetes Mellitus patients should not consume Ephedra.

Side Effects of Diabetes Mellitus

Cardiovascular System
Diabetes Mellitus can cause Microangiopermeability (leaking Capillaries).

Diabetes Mellitus increases the risk of Stroke.

Excretory System
Diabetes Mellitus increases the risk of Kidney disease (Nephropathy) - Kidney malfunction in Diabetes Mellitus patients is known as Diabetic Nephropathy. 10% to 21% of Diabetes Mellitus patients develop diabetic Nephropathy.

Eyes/Vision
Diabetes Mellitus is the leading cause of Blindness in persons aged 20 to 74. This occurs as a result of the progression of diabetic Retinopathy.

Diabetes Mellitus patients have a three to four times higher risk of developing Cataracts compared to the general population.

Diabetes Mellitus is the leading cause of Macular Edema. Macular Edema caused by Diabetes Mellitus is known as diabetic Macular Edema (DME) and occurs when the retinal Blood Vessels of diabetics deteriorate, causing leakage. Approximately 40% of Diabetes Mellitus patients are afflicted with diabetic Macular Edema.

Diabetes Mellitus patients are at greater risk of developing Retinopathy (diabetic Retinopathy).

Immune System
Diabetes Mellitus patients are more prone to Infections.

Metabolism
Diabetes Mellitus can cause Acidosis (through accumulation of Acetoacetic Acid and loss of Potassium, Sodium and Ketone Bodies via the Urine).

Diabetes Mellitus greatly accelerates the rate of Cross-Linking of the body's endogenous Proteins with Glucose - this accelerated Cross-
Linking is responsible for the majority of the complications associated with Diabetes Mellitus.

Diabetes Mellitus patients may not be able to manufacture the Delta-6-Desaturase enzyme.

Diabetes Mellitus causes Fatigue.

Diabetes Mellitus can cause Glycosuria (i.e. Sugar in the Urine).

Diabetes Mellitus interferes with Vitamin A absorption:

- Diabetics are unable to convert Beta-Carotene into Vitamin A.

Musculoskeletal System
Gangrene can occur as a result of Diabetes Mellitus (Diabetes Mellitus-induced Gangrene is known as Diabetic Gangrene and occurs as a result of poor Blood Circulation from Diabetes Mellitus-induced Atherosclerosis).

Diabetes Mellitus patients are prone to Plantar Ulcers (known as Diabetic Plantar Ulcers).

Nervous System
Diabetes Mellitus patients have an increased risk of Depression (due to Insulin’s probable role in the prevention of Depression).

Neuralgia can occur as a side effect of Diabetes Mellitus.

Neuropathy can occur as a side effect of Diabetes Mellitus (Neuropathy that occurs in conjunction with Diabetes Mellitus is known as Diabetic Neuropathy).

Sexual System
Diabetes Mellitus increases the risk of Male Impotence, mainly due to diabetic neuropathy.

Diabetes Mellitus increases the risk of Vaginitis in females.

Diabetes Mellitus Increases Levels of these Potentially Toxic Substances

Aldehydes
Diabetes Mellitus patients generally exhibit elevated Malondialdehyde levels.

Enzymes
Diabetes Mellitus patients have elevated levels of Glutamate Dehydrogenase.

The elevated Blood Sugar that is associated with Diabetes Mellitus enhances the activity of Protein Kinase C (a known activator of some forms of Cancer).

These Ailments Exacerbate Diabetes Mellitus

Oral Health
Periodontal Disease can exacerbate Diabetes Mellitus (due to the Detrimental Bacteria that enter the bloodstream during advanced Periodontal Disease).

Suggested Products

Product

Dosage

Comments

Optimum D - 270 Caps

6 capsules per day

Multivitamin formula designed to support those with diabetes or with a family history of diabetes.

GluControl - 90 Caps

3-6 caps per day

Improves glucose tolerance, restores hypothalamic and muscle insulin receptor-cell sensitivity, normalizes high blood sugar levels without causing hypoglycemia.

AGEBlock™ (Anti Glycation formula) - 90 Caps

1 capsule 2 times per day

Add to maximum dose of GluControl.

Vitamin B3 (Niacinamide), 500 mg 180 Caps

1000... mg per day

Lowers blood sugar, may also reduce blood cholesterol and triglycerides in diabetics. Regenerates pancreatic cells

Lipoic Acid Caps 500 mg - 90 Caps

500-1000 gm per day

Powerful antioxidant. May prevent free radical damage caused by diabetes.

Taurine, L-Taurine, 600 mg - 100 Caps

500 mg 2-3 times per day

Diabetics are known to have lower levels of taurine.

Vitamin C (Ascorbic Acid Caps) 750 mg - 200 Caps

1000... mg per day

Diabetics may have impaired cellular uptake of Vitamin C. Vitamin C inhibits glycosylation of proteins.

E-Team - 60 Caps

One to three capsules per day

Tocotrienols, 572 mg - 30 Softgels

1 capsules daily in the morning.

GLA (Gamma Linolenic Acid) - 60 softgel caps

2-6 capsules per day


AYURVEDIC TREATMENT FOR DIABETIC

According to ayurveda, diabetes is a metabolic kapha type of disorder in which diminished functioning of agni leads to a tendency toward high blood sugar. (Ayurveda recognizes 24 forms of the disease commonly classified under Prameha - 4 are due to Vata dosha, 6 are due to Pitta dosha, and 10 are caused by Kapha dosha. The main causes of these diseases are fat, urine, and Kapha buildups due to foods, liquids, lifestyle and others.)

Ayurvedic practitioners attack diabetes using a multiprong approach. First, they address diet modification, eliminating sugar and simple carbohydrates, and emphasizing complex carbohydrates. Protein is limited, since excessive intake can damage the kidneys. Fat is also limited because there is often a deficiency of pancreatic enzymes, making fat digestion difficult. Since many diabetics have autoantibodies, a cleansing program is instituted. Panchakarma is typically used for this purpose. This begins with herbal massages and an herbal steam sauna, followed by fasting to cleanse the body. This is followed by an herbal purge for the liver, pancreas, and spleen. Colon therapy is next, first to cleanse the digestive tract and then to reconstitute the system.


Ayurvedic practitioners also use several herbal preparations for diabetics. Exercise is another cornerstone of ayurvedic treatment of diabetes. Yoga and breathing exercises are traditionally used.

Herbs

The most important herbs for all doshas are shilajit, gudmar turmeric, neem, amalaki, guggul, and arjuna. Turmeric with aloe vera gel (1 to 3 gms./.035 to .1 oz) is best used during the early stages of diabetes for regulating pancreas and liver functions.


1. Juice of bitter melon or bitter gourd (Momordica dioica, Roxb., Karela), or Rose apple (Eugenia Jambos, Linn., Jambu) or two tender leaves of Bilva (Aegle Marmelos, Corr., Bael fruit) and Neem (Melia azadirachta, Ravipriya, or Indian Lilac) may be taken on empty stomach daily. Juice of Jambu should be taken in an ounce quantity twice daily, and that of Karela in 1-1/2 ounce dose daily. Shilajit (Swertia Decussata Nimmo.) is another useful medicine (250 mg as a single dose) should be taken, twice daily with juice of stone apple.


2. Use turmeric. Fill some 00-size capsules with turmeric, and take 2 capsules 3 times a day, a few minutes before meals. Continue this program for up to a month, and then reevaluate your condition. Clinical observation suggests that a person who is insulin dependent will experience a markedly diminished requirement for insulin; the diabetes can often be brought under control.


3. Take 1/2 teaspoon of ground bay leaf and 1/2 teaspoon turmeric, mixed in 1 tablespoon aloe vera gel. Take the mixture twice a day before lunch and dinner.


4. The ayurveda preparation Vasanta Kusumakar Ras, is very good but is extremely costly. Take two grains daily with a tsp. of cream or honey. In certain cases, the said medicine brings down sugar lever quite quickly, hence sugar-levels should be carefully monitored. When sugar has touched its normal range, the dose should be tapered in a graduated manner, and added with 500 mg pill of Chandraprabhavati which is called a 'Poor man's remedy.'


5. Mix and grind seeds of Fenugreek (Methi) 100 gm, turmeric 50gm, Dakhni Mirch (white pepper). Take one teaspoon of this powder with a glass of milk twice daily. Alternately, immerse and soak one teaspoon of fenugreek seed in water. Take this in the morning, with water or with milk.


6. Take twice daily, with powder of rose apple stones (powder of Jambu or Jamun-ki-Guthali).


7. Include decoctions of triphala, fenugreek, musta, arjuna, sandalwood, lodhra, ajwan, gokshura, vidanga, guduchi, haritaki, and chitrak. These may be taken with a small amount of ghee. Gudmar and shilajit are excellent.


8. Amalaki Churna (500mg), Haldi Powder (Turmeric Powder) 500mg and Naag Bhasma (125mg) should be taken with honey, twice daily ( A 12-hourly dose ).

Diet


Follow the kapha-pacifying diet. Avoid excess intake of sweets, carbohydrates, and dairy products. Take more fresh vegetables and bitter herbs. Other useful foods include: roasted or fried barley, corn flour, light, bitter vegetables, barley porridge, ghee, rice, and herbs like gokshura, gudmar, triphala, musta, cardamom, fenugreek, or coriander, mixed with honey. Triphala with amalaki juice can also be used to heal prameha. Barley is the main food to heal urinary diseases. Other ayurvedic methods to heal prameha (diabetes) include strenuous exercises, oil massage, steam, sitz or waist bath, and sprinkling of water and ointment. Dry ginger, cardamom, and sandalwood may be used in baths or taken orally. Gudmar is the best herb for digesting sugar in the pancreas. A combination of gudmar and shilajit is an excellent remedy for diabetes that is often prescribed by Ayurvedic practitioners.

bullet


Eliminate all objects that contain sugar from diet, like wheat, rice, potato, sugar, sugar cane and its juice, jaggery , sweet fruits.

bullet


Reduce fats, especially butter and ghee from diet.

bullet

Take barley soaked in a triphala decoction overnight, then mixed with honey and eaten several times a day.

bullet


Orange, and lemon, may be taken as and when needed.

bullet


Take bitter melon, in any form, without any fear, and Jamun and powder of its seed.

bullet


Take plenty of green vegetables, black gram, soy, fish etc.


Copper Water


Put one cup of water into a copper vessel at night, and drink the water in the morning.

Exercise

bullet

Take morning and evening walk

bullet

Do Pranayama

bullet

Do yoga asanas

Herbs for Diabetes

Since antiquity, diabetes has been treated with plant medicines. Recent scientific investigation has confirmed the efficacy of many of these preparations, some of which are remarkably effective. Only those herbs that appear most effective, are relatively non-toxic and have substantial documentation of efficacy are covered here.

Pterocarpus marsupium (Indian Kino, Malabar Kino, Pitasara, Venga)

The tree is the source of the Kino of the European pharmacopeas. The gum-resin looks like dried blood (Dragon's blood), much used in Indian medicine. This herb has a long history of use in India as a treatment for diabetes. The flavonoid, (-)-epicatechin, extracted from the bark of this plant has been shown to prevent alloxan-induced beta cell damage in rats.

Both epicatechin and a crude alcohol extract of Pterocarpus marsupium have actually been shown to regenerate functional pancreatic beta cells. No other drug or natural agent has been shown to generate this activity.

Bitter Melon (Momordica charantia)

Bitter melon, also known as balsam pear, is a tropical vegetable widely cultivated in Asia, Africa and South America, and has been used extensively in folk medicine as a remedy for diabetes. The blood sugar lowering action of the fresh juice or extract of the unripe fruit has been clearly established in both experimental and clinical studies.

Bitter melon is composed of several compounds with confirmed anti-diabetic properties. Charantin, extracted by alcohol, is a hypoglycaemic agent composed of mixed steroids that is more potent than the drug tolbutamide which is often used in the treatment of diabetes. Momordica also contains an insulin-like polypeptide, polypeptide-P, which lowers blood sugar levels when injected subcutaneously into type 1 diabetic patients. The oral administration of 50-60 ml of the juice has shown good results in clinical trials.

Excessively high doses of bitter melon juice can cause abdominal pain and diarrhea. Small children or anyone with hypoglycemia should not take bitter melon, since this herb could theoretically trigger or worsen low blood sugar, or hypoglycemia. Furthermore, diabetics taking hypoglycemic drugs (such as chlorpropamide, glyburide, or phenformin) or insulin should use bitter melon with caution, as it may potentiate the effectiveness of the drugs, leading to severe hypoglycemia.

Gymnema Sylvestre (Gurmar, Meshasringi, Cherukurinja)

Gymnema assists the pancreas in the production of insulin in Type 2 diabetes. Gymnema also improves the ability of insulin to lower blood sugar in both Type 1 and Type 2 diabetes. It decreases cravings for sweet. This herb can be an excellent substitute for oral blood sugar-lowering drugs in Type 2 diabetes. Some people take 500 mg per day of gymnema extract.


Onion and Garlic ( Allium cepa and Allium sativum)

Onion and garlic have significant blood sugar lowering action. The principal active ingredients are believed to be allyl propyl disulphide (APDS) and diallyl disulphide oxide (allicin), although other constitutents such as flavonoids may play a role as well.

Experimental and clinical evidence suggests that APDS lowers glucose levels by competing with insulin for insulin-inactivating sites in the liver. This results in an increase of free insulin. APDS administered in doses of 125 mg/ kg to fasting humans was found to cause a marked fall in blood glucose levels and an increase in serum insulin. Allicin doses of 100 mg/kg produced a similar effect.

Onion extract was found to reduce blood sugar levels during oral and intravenous glucose tolerance. The effect improved as the dosage was increased; however, beneficial effects were observed even for low levels that used in the diet (eg., 25 to 200 grams). The effects were similar in both raw and boiled onion extracts. Onions affect the hepatic metabolism of glucose and/or increases the release of insulin, and/or prevent insulin's destruction.

The additional benefit of the use of garlic and onions are their beneficial cardiovascular effects. They are found to lower lipid levels, inhibit platelet aggregation and are antihypertensive. So, liberal use of onion and garlic are recommended for diabetic patients.

Fenugreek (Trigonella foenum-graecum)

Experimental and clinical studies have demonstrated the antidiabetic properties of fenugreek seeds. The active ingredient responsible for the antidiabetic properties of fenugreek is in the defatted portion of the seed that contains the alkaloid trogonelline, nicotinic acid and coumarin.

Blueberry leaves (Vaccinium myrtillus)

A decoction of the leaves of the blueberry has a long history of folk use in the treatment of diabetes. The compound myrtillin (an anthocyanoside) is apparently the most active ingredient. Upon injection it is somewhat weaker than insulin, but is less toxic, even at 50 times the 1 g per day therapeutic dose. A single dose can produce beneficial effects lasting several weeks.

Blueberry anthocyanosides also increase capillary integrity, inhibit free-radical damage and improve the tone of the vascular system. In Europe, it is used as an anti-haemorrhagic agent in the treatment of eye diseases including diabetic retinopathy.

Asian Ginseng

Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes. It has been shown to enhance the release of insulin from the pancreas and to increase the number of insulin receptors. It also has a direct blood sugar-lowering effect.
A recent study found that 200 mg of ginseng extract per day improved blood sugar control as well as energy levels in Type 2 diabetes (NIDDM).

Bilberry

Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy.

Stevia

Stevia has been used traditionally to treat diabetes. Early reports suggested that stevia might have beneficial effects on glucose tolerance (and therefore potentially help with diabetes), although not all reports have confirmed this. Even if stevia did not have direct antidiabetic effects, its use as a sweetener could reduce intake of sugars in such patients.

Ginkgo Biloba

Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy.

Cinnamon - Triples insulin's efficiency

Barberry - One of the mildest and best liver tonics known.
Dosage: tincture, 10-30 drops; standard decoction or 3-9 g.

Herbal Combinations

For all pancreatic problems:
1 part uva ursi
1 part goldenseal
1 part elecampane
2 parts dandelion root
2 parts cedar berries
1 part fennel part ginger

Monday, October 29, 2007

ACUPUNTURE

Acupuncture Treatments for Diabetes

Diabetes Mellitus (Type II) Non-Insulin Dependent Diabetes - the translation means "wasting, thirsting disease."

Initial symptoms of Type II diabetes include thirst, hunger, weight loss and frequent, copious urination. The copious urination is usually the first symptom as the body tries to flush the excess sugars out of the blood. However, here in the west, many people find out that they are diabetic before they reach the symptomatic stage. In the chronic stages obesity is prevalent along with boils, peripheral neuropathy, retinitis, dry tongue and pruritis vulvae (vaginal yeast.)

The type II person may or may not use insulin. The onset of the disease may be related to diet, stress, obesity, food allergies and even viral infections. These factors can escalate an existing condition as well. The onset is usually abrupt in children and slow in adults. "It's almost a law that any person 30% overweight for 30 years will become a (Type II) diabetic." [2]

Type I diabetics have antibodies to their pancreatic cells and are insulin dependent for survival. There may be a genetic link to a specific tissue type.

Type III is gestational diabetes and only reaches clinical stages during pregnancy. It normally goes away after the pregnancy ends.

Traditional Chinese Medicine (TCM) theory states that the disease (Type II) begins in adults with chronic Stomach Heat and Spleen Deficiency. The heat damages stomach fluids. Left untreated the Yin deficiency can involve, and damage, other organs such as the lungs and kidneys. Because of this, it is classified as upper, middle and lower wasting and is related to the lungs, spleen and kidneys respectively with the predominate symptom being either great thirst, great hunger or great urination or lumbar pain respectively.

Acupuncture and herbal treatments are planned to focus on the individual's specific symptoms. There are numerous herbal substances that will lower and stabilize blood sugar. Therefore, herbal therapy takes precedence over acupuncture, which is supplemental for this disease. Dietary therapy is also a must for successful treatment. Ear acupuncture, Cutaneous acupuncture, Moxabustion might also be included in a treatment program.

TREATMENT



Diabetes Treatment

Self-Care at Home

If you have diabetes, you would be wise to make healthful lifestyle choices in diet, exercise, and other health habits. These will help to improve glycemic (blood sugar) control and prevent or minimize complications of diabetes.

Diet: A healthy diet is key to controlling blood sugar levels and preventing diabetes complications.

  • If you are obese and have had difficulty losing weight on your own, talk to your health care provider. He or she can recommend a dietitian or a weight modification program to help you reach your goal.

  • Eat a consistent, well-balanced diet that is high in fiber, low in saturated fat, and low in concentrated sweets.

  • A consistent diet that includes roughly the same number of calories at about the same times of day helps your health care provider prescribe the correct dose of medication or insulin.

  • It will also help to keep your blood sugar at a relatively even level and avoid excessively low or high blood sugar levels, which can be dangerous and even life threatening.
Exercise: Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure, blindness, and leg ulcers.
  • As little as 20 minutes of walking 3 times a week has a proven beneficial effect. Any exercise is beneficial; no matter how light or how long, some exercise is better than no exercise.

  • If you have complications of diabetes (eye, kidney, or nerve problems), you may be limited both in type of exercise and amount of exercise you can safely do without worsening your condition. Consult with your health care provider before starting any exercise program.
Alcohol use: Moderate or eliminate your consumption of alcohol. Try to have no more than 7 alcoholic drinks in a week and never more than 2-3 in an evening. One drink is considered 1.5 ounces of liquor, 6 ounces of wine, or 12 ounces of beer. Excessive alcohol use is a known risk factor for type 2 diabetes. Alcohol consumption can cause low or high blood sugar levels, nerve pain called neuritis, and increase in triglycerides, which is a type of fat in our blood.

Smoking: If you have diabetes, and you smoke cigarettes or use any other form of tobacco, you are raising your risks markedly for nearly all of the complications of diabetes. Smoking damages blood vessels and contributes to heart disease, stroke, and poor circulation in the limbs. If you need help quitting, talk to your health care provider.

Self-monitored blood glucose: Check your blood sugar levels frequently, at least before meals and at bedtime, and record the results in a logbook.

  • This log should also include your insulin or oral medication doses and times, when and what you ate, when and for how long you exercised, and any significant events of the day such as high or low blood sugar levels and how you treated the problem.

  • Better equipment now available makes testing your blood sugar levels less painful and less complicated than ever. Your daily blood sugar diary is invaluable to your health care provider in seeing how you are responding to medications, diet, and exercise in the treatment of your diabetes.

  • Medicare now pays for diabetic testing supplies, as do many private insurers and Medicaid.

Medical Treatment

The treatment of diabetes is highly individualized, depending on the type of diabetes, whether you have other active medical problems, whether you have complications of diabetes, and your age and general health at time of diagnosis.

  • Your health care provider will set goals for lifestyle changes, blood sugar control, and treatment.

  • Together, you will devise a plan to help you meet those goals.
Education about diabetes and its treatment is essential in all types of diabetes.
  • When you are first diagnosed with diabetes, your diabetes care team will spend a lot of time with you, teaching you about your condition, your treatment, and everything you need to know to care for yourself on a daily basis.

  • Your diabetes care team includes your health care provider and his or her staff. It may include specialists in foot care, neurology, kidney diseases, and eye diseases. A professional dietitian and a diabetes educator also may be part of the team.
Your care team will see you at appropriate intervals to monitor your progress with your goals.

Type 1 diabetes

Treatment of diabetes almost always involves the daily injection of insulin, usually a combination of short-acting insulin such as regular or Lispro or Aspart insulin and a longer acting insulin such as NPH, lente, glargine, detemir, or ultralente insulins.

  • Insulin must be given as an injection. If taken by mouth, insulin would be destroyed in the stomach before it could get into the blood where it is needed.

  • Most people with type 1 diabetes give these injections to themselves. Even if someone else usually gives you your injections, it is important that you know how to do it in case the other person is not available.

  • A trained professional will show you how to store and inject the insulin. Usually this is a nurse who works with the health care provider or a diabetes educator.

  • Insulin is usually given in 2 or 3 injections per day, generally around mealtimes. Dosage is individual and is tailored by the health care provider. Longer acting insulins are typically administered 1 or 2 times per day.

  • Some people have their insulin administered by continuous infusion pumps to provide adequate blood glucose control. Supplemental mealtime insulin is programed into the pump by the individual as recommended by his or her health care provider.
  • It is very important to eat if you have taken insulin, as the insulin will lower your blood sugar regardless of whether you have eaten. If you take insulin without eating, you could have hypoglycemia. This is called an insulin reaction.

  • There is an adjustment period while you learn how insulin affects you and how to time your mealtimes and exercise times with your insulin injections to keep your blood sugar level as even as possible.

  • Keeping accurate records of your blood sugar levels and insulin dosages is crucial in helping your health care provider take care of your diabetes.

  • Eating a consistent, healthy diet appropriate for your size and weight is essential in controlling your blood sugar level.
Type 2 diabetes

Depending on how elevated your blood sugar and glycosylated hemoglobin are at the time of your diagnosis, you may be given a chance to lower your blood sugar level without medication.

  • The best way to do this is to lose weight if you are obese and begin an exercise program.

  • This will generally be tried for 3-6 months, and then your blood sugar and glycosylated hemoglobin will be rechecked. If they remain high, you will be started on an oral medication, usually a sulfonylurea or biguanide (Metformin), to help control your blood sugar level.

  • Even if you are on medication, it is still important to eat a healthy diet, lose weight if you are overweight, and engage in moderate physical activity as often as possible.

  • Your health care provider will monitor your progress on medication very carefully at first. It is important to get just the right dose of the right medication to get your blood sugar level in the recommended range with the fewest side effects.

  • Your doctor may decide to combine two types of medications to get your blood sugar level under control.

  • Gradually, even people with type 2 diabetes may require insulin injections to control their blood sugar levels.

  • It is becoming more common for people with type 2 diabetes to take a combination of oral medication and insulin injections to control blood sugar levels.

DIAGNOSIS

The following tests are used for diagnosis:
  • A fasting plasma glucose test measures your blood glucose after you have gone at least 8 hours without eating. This test is used to detect diabetes or pre-diabetes.
  • An oral glucose tolerance test measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes or pre-diabetes.
  • In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes.

Positive test results should be confirmed by repeating the fasting plasma glucose test or the oral glucose tolerance test on a different day.

Fasting Plasma Glucose (FPG) Test

The FPG is the preferred test for diagnosing diabetes due to convenience and is most reliable when done in the morning. Results and their meaning are shown in table 1. If your fasting glucose level is 100 to 125 mg/dL, you have a form of pre-diabetes called impaired fasting glucose (IFG), meaning that you are more likely to develop type 2 diabetes but do not have it yet. A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes.

Table 1. Fasting Plasma Glucose Test

Plasma Glucose Result (mg/dL)

Diagnosis

99 and below

Normal

100 to 125

Pre-diabetes
(impaired fasting glucose)

126 and above

Diabetes*

*Confirmed by repeating the test on a different day.

Oral Glucose Tolerance Test (OGTT)

Research has shown that the OGTT is more sensitive than the FPG test for diagnosing pre-diabetes, but it is less convenient to administer. The OGTT requires you to fast for at least 8 hours before the test. Your plasma glucose is measured immediately before and 2 hours after you drink a liquid containing 75 grams of glucose dissolved in water. Results and what they mean are shown in table 2. If your blood glucose level is between 140 and 199 mg/dL 2 hours after drinking the liquid, you have a form of pre-diabetes called impaired glucose tolerance or IGT, meaning that you are more likely to develop type 2 diabetes but do not have it yet. A 2-hour glucose level of 200 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes.

Table 2. Oral Glucose Tolerance Test

2-Hour Plasma Glucose Result (mg/dL)

Diagnosis

139 and below

Normal

140 to 199

Pre-diabetes
(impaired glucose tolerance)

200 and above

Diabetes*

*Confirmed by repeating the test on a different day.

Gestational diabetes is also diagnosed based on plasma glucose values measured during the OGTT. Blood glucose levels are checked four times during the test. If your blood glucose levels are above normal at least twice during the test, you have gestational diabetes. Table 3 shows the above-normal results for the OGTT for gestational diabetes.

Table 3. Gestational Diabetes: Above-Normal
Results for the Oral Glucose Tolerance Test

When

Plasma Glucose Result (mg/dL)

Fasting

95 or higher

At 1 hour

180 or higher

At 2 hours

155 or higher

At 3 hours

140 or higher

Note: Some laboratories use other numbers for this test.

Random Plasma Glucose Test

A random blood glucose level of 200 mg/dL or more, plus presence of the following symptoms, can mean that you have diabetes:

  • increased urination
  • increased thirst
  • unexplained weight loss

Other symptoms include fatigue, blurred vision, increased hunger, and sores that do not heal. Your doctor will check your blood glucose level on another day using the FPG or the OGTT to confirm the diagnosis.

SIGNS AND SYMPTOMS

The symptoms of diabetes progress according to the range and duration of high blood sugar levels. The symptoms usually start mild (e.g. poorly healing skin rashes), and then progress to the more severe symptoms (e.g. excessive thirst and urination), and then finally to the dangerous life-threatening conditions of HHNS or DKA. The progression of symptoms is usually slow over years for Type 2 diabetes and rapid over weeks or months for Type 1 diabetes. People with Type 2 diabetes often are undiagnosed long enough that they start to get symptoms of the complications of diabetes, such as kidney and foot problems.

The list of signs and symptoms mentioned in various sources for Diabetes includes the 64 symptoms listed below:

* No early symptoms - many people have Type 2 diabetes without knowing it

* Early mild symptoms - from moderate blood sugars (which are still dangerous and lead to serious complications):

o Abscess

o Skin rashes

o Skin infections

o Athlete's foot

o Poor skin healing

o Urinary tract infections

o Candida

o Thrush

o Dry itchy skin

o Flaky skin

o Skin ulcers

o Skin boils

o Peripheral neuropathy

o Paresthesias

o Foot tingling

o Foot numbness

o Hand tingling

o Hand numbness

o Blurred vision

o Sexual problems

o Erectile failure

o Unusual vaginal dryness

o Premature menopause

o Absent periods

o Poor healing - any type of difficulty healing of minor infections, injury or after surgery.

o Weight loss

o Weight gain

o Drowsiness

o Malaise

* Later more extreme symptoms when blood sugars get higher:

o Excessive thirst

o Excessive urination

o Dehydration

o Bed wetting - in children

o Excessive hunger

o Tiredness

o Weight loss

o Severe blurred vision

o Muscle cramps

o Muscle aches

o Headaches

o Irritability

o Tiredness

o Fatigue

o Muscle weakness

o Acne - often worsens from diabetes and improves once sugars controlled

o Sexual problems

+ Erectile failure

+ Unusual vaginal dryness

o Absent menstrual periods

o Persistent fungal skin infections

+ Athlete's foot

+ Tinea

+ Thrush (Candida)

* Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) - a very severe life-threatening complication of high blood sugars

* Diabetic Ketoacidosis (DKA) - a very severe life-threatening complication of high blood sugars, requiring emergency treatment, which has very severe symptoms:

o Nausea

o Vomiting

o Sweet-smelling fruity acetone breath

o Breathing difficulty

o Rapid Pulse

o Abdominal pain - usually in children


Note that Diabetes symptoms usually refers to various symptoms known to a patient, but the phrase Diabetes signs may refer to those signs only noticable by a doctor.


More ways to research these symptoms: To research other symptoms use the symptom center, or to research causes of more than one symptom in combination, try our multi-symptom search.

GENETIC FACTOR

Diabetes means just one thing - a high blood sugar level. While there are many conditions and problems associated with diabetes, such as obesity and heart problems, the disease itself is defined only by plasma glucose levels. Diabetes is a disease of glucose metabolism. Many people with diabetes have no clinical symptoms. The diagnosis of diabetes is based on one of two tests:the fasting plasma glucose test or an oral glucose tolerance test. It is important to remember that diabetes is not defined by obesity or its complications; nor is it defined by a urine test.

Diabetes is defined by the blood glucose level after undergoing a fasting plasma glucose test or an oral glucose tolerance test. Medical professionals recognize three strata associated with diabetes: people who are not diabetic; those with Impaired Glucose Tolerance (IGT); and those with diabetes.

There are three types of diabetes:

  • Type I is insulin dependent and often called juvenile onset diabetes.
  • Type II is non-insulin dependent, and often called adult onset.
  • Gestational diabetes.

In Type I, the pancreas does not make enough insulin. Without taking insulin, the affected person will die; when given insulin, the affected person will live. People afflicted with Type I diabetes develop antibodies and auto-immunity to pancreatic insulin-producing b-cells. Studies have shown that concordance in twins for Type I is minimal, therefore the inheritance factor of Type I is small. Researchers believe that a combination of environmental factors and, probably, viral antigens are responsible for Type I diabetes. This type is intensively managed by controlling the blood sugar. Type I diabetes has a much smaller economic impact as compared to Type II.

Type II diabetes is 10 times more prevalent in America than Type I and it's economic impact is much greater. It is one of the most common chronic conditions in the United States. Since, at the beginning, there are no obvious symptoms,many Type II cases are not diagnosed. Those with the disease don't have an absolute deficiency of insulin since their pancreas does make some.

Type II diabetes is associated with obesity and with aging. It is a lifestyle-dependent disease, and has a strong genetic component (concordance in twins is 80-90%). The problem seems not so much in insulin production,but that when the insulin reaches its target cells, it doesn't work correctly.Most Type II diabetes patients initially have high insulin levels along with high blood sugar. However, since sugar signals the pancreas to release insulin,Type II diabetics eventually become resistant to that signal and the endocrine-pancreas soon will not make enough insulin. These people end up managing the disease with insulin and they need much higher doses because they are resistant to it.

When a person takes in a high load of sugar, the sugar stimulates the pancreas to release insulin. The targets for insulin are muscle, fat, and liver cells.These cells have insulin receptor sites on the outside of the cell membrane.For most people, when insulin has bound to the receptors, a cascade of events begins, which leads to sugar being transported from the blood into the interior of the cell. In Type II diabetics, even when insulin is present on the cell membrane, the process doesn't work. The glucose is never taken up into the cell and remains in the bloodstream.

The liver is responsible for glucose production and insulin is the regulatory agent of production. A high blood sugar content causes the pancreas to release insulin, and the insulin should signal the liver to stop making sugars. But, in diabetics, there's resistance to that signal and the liver keeps producing glucose. Hyperglycemia leads to glucose toxicity.

It is not high blood sugar that is the disease process of diabetes, but complications from the high blood sugar. Standard complications for many diabetics are: retinopathy (blindness); neuropathy (nerve damage) which leads to foot ulcers, gangrene, and amputations; kidney damage, which leads to dialysis; and cardiovascular disease. A major problem faced by doctors is that some people with high blood sugar feel fine; it's hard to treat diseases that are asymptomatic since most people don't want to take a pill for something that they don't feel bad about.

Type II Diabetes -- Genetic Factors


Normally, genetic studies are conducted by a classical linkage analysis using an LOD (Logarithm of Odds) score. This type of pedigreed, generational study works well if the disease is an autosomal dominant, recessive disorder. A study of this kind focuses on a particular gene locus to see if it tracks or co-segregates with the disease.

The problem with diabetes is that, even if the exact same mutation caused it in everyone, it would look different from person to person and family to family, depending on environmental influences, the genetic background it's laid upon, and modifier genes. Its expression would be variable.Furthermore, studies have shown that diabetes is not simple; it's genetically complex, involving multiple genes, and multiple gene-environment interactions.

Since classical linkage analysis doesn't work very well when studying genes in a mixed population, geneticists are moving to sib-pair analysis, called IBD - Identity by Descent. Siblings share 50% of their genes. If a gene locus has no association with a disease, it would be predicted that the siblings would share the locus 50% of the time.

One new, and somewhat controversial, method of studying the genetic component of diabetes is an Admixture Linkage Analysis. In this method, researchers view the admixed population as an F1 cross. If a disease is linked to a chromosomal locus in a genetically distinct population, it will stay in linkage association for multiple generations, until it finally sorts out through recombination. Since it's been 15 generations or so since the Europeans came over and admixed with the Native American population, now is the perfect time to do this kind of linkage analysis. The idea is that since DNA is inherited as a block, a gene locus and a marker will stay in association longer, the closer they are on the chromosome - if they are far away, the marker will fall out and they will no longer be linked.

NEW CLASSIFICATION

The new classification system identifies four types of diabetes mellitus: type 1, type 2, "other specific types" and gestational diabetes. Arabic numerals are specifically used in the new system to minimize the occasional confusion of type "II" as the number "11." Each of the types of diabetes mellitus identified extends across a clinical continuum of hyperglycemia and insulin requirements.

Type 1 diabetes mellitus (formerly called type I, IDDM or juvenile diabetes) is characterized by beta cell destruction caused by an autoimmune process, usually leading to absolute insulin deficiency.2,7 The onset is usually acute, developing over a period of a few days to weeks. Over 95 percent of persons with type 1 diabetes mellitus develop the disease before the age of 25, with an equal incidence in both sexes and an increased prevalence in the white population. A family history of type 1 diabetes mellitus, gluten enteropathy (celiac disease) or other endocrine disease is often found. Most of these patients have the "immune-mediated form" of type 1 diabetes mellitus with islet cell antibodies and often have other autoimmune disorders such as Hashimoto's thyroiditis, Addison's disease, vitiligo or pernicious anemia. A few patients, usually those of African or Asian origin, have no antibodies but have a similar clinical presentation; consequently, they are included in this classification and their disease is called the "idiopathic form" of type 1 diabetes mellitus.

Type 2 diabetes mellitus (formerly called NIDDM, type II or adult-onset) is characterized by insulin resistance in peripheral tissue and an insulin secretory defect of the beta cell.2,7 This is the most common form of diabetes mellitus and is highly associated with a family history of diabetes, older age, obesity and lack of exercise. It is more common in women, especially women with a history of gestational diabetes, and in blacks, Hispanics and Native Americans. Insulin resistance and hyperinsulinemia eventually lead to impaired glucose tolerance. Defective beta cells become exhausted, further fueling the cycle of glucose intolerance and hyperglycemia. The etiology of type 2 diabetes mellitus is multifactorial and probably genetically based, but it also has strong behavioral components.

Types of diabetes mellitus of various known etiologies are grouped together to form the classification called "other specific types." This group includes persons with genetic defects of beta-cell function (this type of diabetes was formerly called MODY or maturity-onset diabetes in youth) or with defects of insulin action; persons with diseases of the exocrine pancreas, such as pancreatitis or cystic fibrosis; persons with dysfunction associated with other endocrinopathies (e.g., acromegaly); and persons with pancreatic dysfunction caused by drugs, chemicals or infections.

EPIDEMIOLOGY

About 90% of patients with diabetes mellitus have Type 2 diabetes. An estimated 150 million people worldwide have Type 2 diabetes, and this number is expected to double within the next 20 years. Most of the increase will stem from developing and threshold countries such as India and China. In the USA, where the prevalence of diabetes is high, it is estimated that one in three people will develop Type 2 diabetes.

TYPES OF DIABETIC

Types:

There are three types of Diabetes:

Type 1 diabetes

Type 1 diabetes is an autoimmune disease. In genetically susceptible individuals, an inflammation of pancreatic beta cells is triggered, most likely by a viral infection. Because beta cells are the only ones able to produce and secrete insulin, complete insulin deficiency ensues. As a result, all Type 1 diabetic patients require insulin replacement therapy. The only exception is during the 'honeymoon period' that some patients experience shortly after diagnosis and initial treatment, owing to some residual insulin secretion early in the progress of the disease.

Type 2 diabetes

Type 2 diabetes is a prime example of a disease caused by a combination of genetic and environmental factors. The genetic influence is greater than for Type 1 diabetes: the identical twin of a Type 2 diabetic patient is almost certain to develop the disease. On the other hand, lifestyle factors such as diet and exercise are also important determinants; in times of scarce food supply, for instance, the incidence of Type 2 diabetes is very low.

A good example of the interplay of genetics and lifestyle are the Pima Indians. Those living in Mexico have a diabetes prevalence of about 8%, whereas those who have emigrated to the USA, where the lifestyle is more sedentary and access to energy-dense (fatty) food is easier, have a diabetes prevalence of about 50%.

he most important risk factor for Type 2 diabetes is obesity. Epidemiological studies have shown that, compared to lean individuals, very obese men and women (body mass index >35) have a 60- and 90-fold increased probability of developing Type 2 diabetes, respectively (see figure). In terms of genetics, Type 2 diabetes is a multifactorial disease for which no single gene is responsible.

In contrast to patients with overt Type 2 diabetes, patients with pre-diabetes (characterised by insulin resistance) do not exhibit hyperglycaemia when fasting. However, after a challenge like an oral glucose tolerance test (oGTT), during which 75 grams of glucose are ingested, patients exhibit pathologically high glucose levels (see Table 1). These patients, therefore, are characterised as having impaired glucose tolerance.

For a limited period, pancreatic beta cells are able to produce enough insulin to overcome the insulin resistance, so many pre-diabetic patients actually have elevated plasma insulin levels. However, in most patients, the rate of beta-cell death exceeds that of beta-cell formation in the pancreas, resulting in fewer insulin-producing beta cells. When the insulin-producing capacity of the pancreas is overtaken by the increased demand caused by insulin resistance, the patient develops overt Type 2 diabetes.

Three main factors contribute to hyperglycaemia:

  1. Insulin resistance in the muscle tissue, causing the muscles to take up less glucose from the blood.
  2. Impaired insulin secretion by the pancreas.
  3. Increased glucose production by the liver as a consequence of hepatic insulin resistance.

In the last few years, it has been demonstrated that adipose (fat) tissue and the central nervous system also play important roles in the pathogenesis of Type 2 diabetes.


DIABETIC

Introduction:
Diabetes prevents your body from turning your food into energy. Instead glucose stays in your bloodstream, and left untreated can result in a range of complications.

If you have recently been diagnosed as diabetic, don't worry. With proper treatment and care, you will lead a normal and happy life. You may need to make a few changes in your lifestyle - but then, if you are like me, you probably had plans to do that anyway and just never got round to it.