Diabetes Type II in Adults

Diabetes Type II in Adults

CONFRONTING a DREAD DISEASE

Insulin is a hormone released by the pancreas to bring glucose to the cells so the body can use it for energy (University of Maryland Medical Center 2008). If this does not happen, the body has nothing to use for its functions. Diabetes develops. There are many types of diabetes. The most common are type 1 insulin-dependent, type 2 non-insulin-dependent and gestational diabetes. Type 2 is lifelong and characterized by high sugar levels trapped in the blood instead of flowing into the cells. This type develops when the body does not respond correctly to insulin. It is often accompanied by obesity and insulin resistance. Because the cells are not getting the needed insulin, the pancreas produces more and more until sugar levels build up abnormally in the blood. This condition is called hyperglycemia. It often occurs with insulin resistance, because fat impedes the body's ability to take up insulin. Type 2 develops gradually. While it often does in overweight persons at the time of diagnosis, it can also develop in underweight or lean persons, especially the elderly (University of Maryland Medical Center).

Major risk factors in Type 2 diabetes are family history and genetics, low activity, poor diet and excess body weight, particularly around the wait (University of Maryland Medical Center 2008). It has been observed to occur more among African-Americans and Native Americans. Those who are 45 years old and older and suffer from glucose intolerance, high blood pressure, with HDL cholesterol less than 35 mg/dL or triglyceride higher than 250 mg/dL and a history of gestational diabetes (University of Maryland Medical Center).

The American Diabetes Association recommended that adults 45 years and older should be tested for diabetes as age is a major risk factor (National Diabetes Information Clearinghouse 2000). If they the glucose reading turns out normal, the test should be repeated at three-year intervals. Those less than 45 years old should be tested if they are high-risk. Other risk groups are those whose weight is 20% more than the ideal or with a body mass index of 27 more; who have a parent or sibling with diabetes; American-Indians, Asian-Americans; Hispanic-American and Pacific Islander Americans; women who give birth to a baby weighing more than 9 pounds or have diabetes while pregnant; blood pressure of 140/90 or more; abnormal blood lipid levels; and glucose intolerance (National Diabetes Information Clearinghouse).

Statistics showed the importance of promoting knowledge and awareness about Type 2 Diabetes (Nathan 2004). It is the leading cause of blindness, end-stage kidney disease and lower-limb amputations in the U.S. alone. Records bared that 30 to 70% of those with the disease also suffer from nerve damage, which is often severe. Approximately 14 million Americans are afflicted with this Type and around half of them are not aware of it. In addition, more than 600 new cases are diagnosed with the disease every year. Cases have increased three times since 1960. Experts said that Type 2 diabetes is likely to develop in those who are over 40 years old, obese, with a family history, live a sedentary lifestyle and from specific racial strains. The increase in the incidence of Type 2 diabetes also increases the risk for a stroke or heart disease two times. These are among the justifications for a sustained health promotion program on the disease (Nathan).

Further statistics said that roughly 2,000 new cases of Type 2 diabetes are diagnosed on a daily basis (Simmons 2001). This figure meant an increase in incidence in the past 40 years. One in every five persons over 65 has the disease. An increasing number of children and adolescents have been diagnosed with this disease in addition to adults. Obesity appeared to be the leading cause. Afflicted women stand at an increased risk of heart disease, stroke, kidney failure, blindness, neuropathy, amputation, periodontal disease and even dementia. Inadequately controlled blood sugar levels raise their risk of developing one or more of these conditions. And the longer they have been ailing, the greater the risk. Contend with statistics on overweight and the American lifestyle and eating habits. Roughly 33% of Americans are overweight and 23% are obese. Popular American meals are processed, packaged and full of fats and sugar. Americans rely or choose fatty and high-caloric fast foods for their meals on account of a busy lifestyle without the needed time to prepare nutritious foods. In addition, there is less time for physical activity to counteract the unnecessary calories (Simmons).

Diabetes specialists estimated that metformin and acarbose would be more effective in combating Type 2 diabetes and with fewer complications (Nathan 2004). Previous treatments reduce blood sugar by injecting or taking insulin into the system. This is to increase the rate of the tissues taking in glucose from the blood and converting it into energy. The drug is sulfonylurea. Metformin, a biguanide, has been around for more than a decade in Europe and Canada. A large multi-center study conducted on August 31, 1995 showed that the drug could lower blood glucose as effectively as sulfonylurea. It also showed that the drug could increase HDL and significantly reduce overall cholesterol levels, triglycerides and LDL. It reduces the liver's capacity to produce glucose. It is better than insulin and sulfonylureas, which can cause hypoglycemia and metformin almost never does. Sulfonylureas can cause weight gain, but metformin induces weight loss in some cases. The sulfonylureas stimulate the pancreas to produce insulin but the pancreas stops functioning after a few years. Metforming tends to remain effective longer. Metformin's side effects include transient nausea and diarrhea. It is the preferred drug by those who are unable to control their blood glucose levels through diet and exercise. Diet and exercise are the first measures for Type 2. If this would not work, Metformin should be used with a sulfonylurea or insulin. Metformin is, however, prescribed with caution to those with impaired kidney function as it might cause lactic acidosis. It is likewise not recommended for heavy drinkers and those who have kidney and liver diseases or congestive heart failure (Nathan).

Acarbose is a boon to Type 2 patients with postprandial hyperglycemia (Nathan 2004). This condition is a steep rise in glucose after eating, common among those in the early stages and those who have harbored the disease for years. The pancreas has turned sluggish in secreting insulin in reaction to a meal. The drug is an alpha-glucosidase inhibitor, which inhibits an enzyme, so that less glucose enters the bloodstream. This allows more time for the pancreas to secrete enough insulin. But the undigested carbohydrate ferments in the large intestines. Flatulence can result. Comparing effects, acarbose may not be as powerful as Metformin and the sulfonylureas. But it is preferred by those whose blood sugar rises steeply despite other treatments (Nathan).

These new drugs are found better than the sulfonylureas (Nathan 2004). They may not reduce blood glucose levels in 10-20% of patients even at the highest recommended doses. Some patients obtain good results at first, but the results cease in 5-10% of them in the succeeding years. When this happens, patients can only move back to insulin. Insulin therapy in itself does not sufficiently control blood glucose levels. Doctors and patients choose not to use high doses. Yet body tissues in Type 2 diabetes respond only to large doses (Nathan).

An increase in the incidence of type 2 diabetes has been observed (Rynk 2002). Lifestyle appears to be strongly linked to it. Statistics said that approximately 95% of diabetes cases in the U.S. are Type 2 or adult-onset diabetes. A study conducted at the Normal J. Arnold School of Public Health in Columbia, South Carolina, found that exercise and weight loss matched the action of medications at almost twice as much. The respondents from the region included 45% non-Whites, who had higher risk of Type II diabetes. These were African-Americans, Hispanics, Native Americans and Asian-Pacific Islanders. Many of them had a family history of diabetes who wanted to find benefit from the study for themselves and their families. It aimed at losing weight, reducing dietary fat to 25% of calories and raise activity level to 30 minutes at most days of the week. The results were so favorable that the study ended a year earlier. The first step taken during the investigation was to treat the diabetes through medications, including insulin directly. Copies of the vegan diet were distributed. The second step was a 30-minute walk each day whether outdoor or indoor. The researchers found that those who followed the simple advice experienced a dramatic change in their diabetes. Medications were reduced or discontinued. Some of them had weight loss, a reduction in cholesterol and sugar levels and in some, weight loss even made the diabetes disappear. They assured the respondents that weight loss did not have to be large to recognize the benefit of the diet and exercise regimen (Rynk, Rooney 2007).

A lot of the burden of diabetes happens after 60 and this is why most of those stricken do not bother losing weight at this age (Rynk 2002). Yet they gained tremendous benefits from the diabetes prevention program. It reduced the risks at 71% by choosing a moderate lifestyle. Good health could allow 20 more years to those over 65. It showed that lifestyle intervention dramatically decreased the risks of diabetes. Regular exercise was an important component of the management of Type II diabetes. It kept the weight down. The lack of exercise brought the weight up. Overweight and de-conditioning, in turn, made it harder to exercise. The type of exercises depended on the health condition or issues of the patient. Those who are somehow healthy could start walking but not too fast to talk with someone walking with them. The walk could be five to 10 minutes on flat ground increasing to 45 minutes on hilly ground at a faster pace. Those who found it hard to walk, such as those with arthritis in the hips or knees, could try water aerobics. The physical therapist could prepare an individualized plan for patients. Otherwise, an exercise bike, an elliptical trainer or rowing machine were suggested as more convenient substitute for walking. The American Diabetes recommended that patients check their blood sugar level before, during and after exercise. This would tell them how exercise was improving or affecting their condition. Those already doing steady exercise could do this once a month to make sure their blood sugar was under control. It would be good practice to avoid developing hypoglycemia. A healthy diet, moderate weight loss and exercise can enable the patient to control his or her condition. Those on medication could further reduce the amount of medication or even eliminate it entirely. And those without Type 2 could make themselves fit enough to prevent it (Rynk).

The specter of increased body mass or abdominal obesity is the threat of developing Type 2 diabetes or cardiovascular diseased conditions (Simmons 2001). A waistline of more than 40 inches for men and more than 35 inches for women should sound an alarm. Just losing 10 pounds or 10% of body weight can already significantly decrease that risk and that threat or at least lower blood sugar levels. Diet and exercise will address the need of the hour to lose and maintain weight as well as improve insulin sensitivity. Diet consists of the type of food, the amount, the time and the place of the meal. Proper foods must be whole and unadulterated rather than processed or white. Whole and processed foods contain the necessary nutrients. It is important that the person or patient with Type 2 diabetes eats only a portion size in order to ward off or fight obesity. Average meals at fast food restaurants contain as many as 2,000 calories. This is higher than the allowed total calories a day without the snacks. And with little or no exercise, it should be little wonder why obesity has been plaguing American society. The time and place of meals also matter in diet. Many eat without control before TV sets or computers because their attention is set on other things. They do not recognize the body's signal of satisfaction to stop eating. This results in overeating and obesity (Simmons).

Experts outlined tips on proper diet. Eating should be the only activity during meals (Simmons 2001). Meals should not be skipped to avoid indulgent eating at a later time. Only portion sizes should be eaten to avoid overweight. Snacks too should be healthful. Chewing should be slow in order to help digestion, encourage eating pleasure and wait for the body's signal of fullness and satiety. Dinners should not be beyond 7pm. A woman who wants to lose weight should consume no less than 1,200 calories a day. Weight loss can be achieved by cutting down total calorie intake by 300 to 500 a day. The Food Pyramid includes a 1,600-calorie diet recommended for sedentary women and older adults. A healthy diet also considers the composition of nutrients. The total daily caloric consumption should be 15% protein, 50-60% carbohydrates and 25 to 35% fats. Experts also recommend 20-30 grams of fiber daily. This can come from enriched whole grain foods, such as cereals, breads and breakfast bars. A six-year study conducted on 35,000 women showed that high and regular intake of whole grains, cereal fiber and dietary magnesium significantly prevented diabetes. A separate study compared the intake of whole grains and that of refined grain products. It found that whole grain products could decrease the risk of diabetes in women. Water-soluble fiber helps lower blood sugar. It reduces the absorption of carbohydrates and causes the blood sugar to rise slowly rather than rapidly with simple carbohydrates in fruit juices. Water-soluble fiber can be found in oat bran, nuts, apples, pears and most vegetables (Simmons).

Exercise, on the other hand, helps improve glycemic control and prevent the development of Type 2 diabetes (Simmons 2001). A nurses' health study concluded that even moderate physical activity substantially reduced the risk of the disease. The American Diabetes Association recommends 20 to 45 aerobic exercise at least thrice a week. But the National Institutes of Health strongly prompts at least 30 minutes of exercise on most days of the week. The Surgeon General suggested walking 10,000 steps a day. Cars should be parked farther from the front door at working places, the malls or grocery store to encourage more walking. People should walk more than ride. They should take the stairs instead of the elevator. Walking before or after dinner can release stress, encourage bonding and keep weight down. Chores should be done more with the hand than with convenience devices. The conclusion in all studies about exercise and Type 2 diabetes has been that proper dietary habits, exercise and relaxation in combination will help prevent and improve the condition and its consequences (Simmons).

Type II diabetes is considered a nutritional disorder by some experts. With the alarming increase in the incidence of the disease worldwide, some patients have turned to natural ingredients for cure (Furey 2005). Natural ingredients also avoid long-term risks associated with synthetic drugs or medications. One of those natural ingredients was the pycnogenol extract from the bark of French maritime pine tree, a natural antioxidant. A study conducted by the American Diabetes Association showed that a regimen of diet and exercise could significantly lower glucose levels when supplemented by Pycnogenol at a dose between 50 and 100 mg. The natural extract appeared to assert metabolic control in patients with mild Type 2. Other clinical studies also showed the Pycnogenol could help prevent cardiovascular disease and diabetic retinopathy. There was solid evidence that it effectively reduces high blood pressure, platelet aggregation, LDL cholesterol and improves circulation. Experts were convinced that Pycnogenol should be a basic component in a diabetes health regimen, considering that heart infarction and stroke are the current-day leading causes of death (Furey).

Earlier studies conducted on 1,000 diabetic patients demonstrated the Pycnogenol could seal leaky capillaries in the eye and stop the loss of vision (Furey 2005). Diabetic retinopathy ultimately leads to blindness. The Maritime pine tree grows in the coast of southwest France. Its ingredients are procynidins, bioflavonoids and organic acids, which have been shown to provide natural health benefits. The bark has been subjected to investigations for the last 35 years. These studies insured its safety and effectiveness. It is now available in synthetic form in more than 400 dietary supplements and as multivitamins and health products worldwide. It is manufactured by Natural Health Science Inc. For Horphag Research (Furey).

An investigation was recently conducted on 60 Type 2 diabetes patients not on insulin therapy who received different doses of cinnamon therapy for 40 days (Gaby 2007). In all cases, cinnamon significantly reduced the respondents' serum glucose, triglyceride, LDL-cholesterol and total cholesterol levels. The result of the investigation showed that 1 gram of cinnamon supplementation can improve glucose and lipid levels in patients with Type 2 diabetes. Two other studies were conducted on cinnamon. One showed that cinnamon to be less effective than what the first study suggested. The third study showed that cinnamon was not beneficial. The differences in the results have not been explained. Nonetheless, cinnamon appeared to remain safe and Type 2 patients could try it (Gaby).

Another boon to Type 2 sufferers was the VAP cholesterol test (Snyders 2008). It helps physicians determine the most effective cholesterol and heart disease risk-reducing treatments. It provides valuable and life-saving information for the purpose. Through its use, for example, researchers in the Diabetes and Combined Lipid Therapy Regimen found that the combination of statin therapy with a fibrate would be the most effective way to contain the risk in those with diabetes and mixed dyslipidemia. The VAP test provides direct measurements of LDL, HDL and their subclasses, risk factors, and precise calculations for LDL components. The Chief Medical Officer of Atherotech, manufacturer of VAP test, said that it has been used in more than 100 clinical trials. He saw its continued use as a valuable analytical research instrument. It will be most important to use with diabetics in obtaining accurate information to assess, manage and reduce heart disease risk in Type 2 diabetes patients (Snyders).