You might have heard of insulin in connection with the disease known as diabetes. Still, you might be curious about insulin—what it means for the body and what can happen if the body does not produce enough of it. In addition, chances are you know little about the history of insulin and how science’s knowledge of insulin has changed over the years.

To begin with, knowledge about insulin is a relatively new phenomenon. Berlin medical student Paul Langerhans first discovered insulin in 1869. Using a microscope, Langerhans noticed a heap of cells in the pancreas which later became known as the Islets of Langerhans. Later, scientists surmised that these cells produce insulin, which regulates carbohydrate metabolism. In January of 1922, Leonard Thompson, a 14-year-old diabetic, received the first insulin injection. Because the extract was impure, Thompson experienced a severe allergic reaction. As a result, doctors cancelled future insulin injections for Thompson. However, in later years, researchers were able to perfect insulin injections, making them the primary means of treating diabetes.

In addition to its role in metabolism, insulin controls the storage and release of fat, the cellular uptake of amino acids and electrolytes, and affects small vessel muscle tone. In fact, the concentration of insulin can affect the entire body. This is why diabetics can suffer a variety of side-effects, including blindness and slow healing of wounds. Those who suffer from type 1 diabetes require insulin injections in order to survive, while type 2 diabetes patients may need insulin if other medication and dietary changes are ineffective in controlling blood glucose levels.

At this point, it is not possible to take insulin orally. Instead, insulin is administered through syringes with needles, or insulin pens with needles. However, there are a number of problems associated with insulin as a treatment for diabetes. For instance, it can be difficult to determine the appropriate dose of insulin. The dosage, as well as the timing of the dosage, must often be adjusted, based upon eating habits, exercise routines, or the additional stress of illness. Insulin injections can be a nuisance for patients and, if the patient makes a mistake in terms of dosage, they can actually be dangerous.

Still, when it is used appropriately, insulin can help restore the body’s metabolism to normal levels. As a result, through proper administration of insulin, athletes and artists can perform at their optimal level without difficulty. For instance, Olympic swimmer Gary Hall Jr. is an example of a diabetic who has been helped by insulin, while David Crosby of the singing group Crosby, Stills & Nash has also benefited from insulin injections.

In the year 2004, the former spouse of an international track star maintained that the athlete had used insulin to energize the body. The report promoted the idea that the hormone insulin could be utilized like a steroid in enhancing the body’s functions. However, researchers say that insulin does not have the same effects as steroids. They say that eight decades of steroid use do not indicate that insulin could be used as a performance-enhancing drug for those who are not diabetics. While insulin can help to alleviate fatigue for those with diabetes, it does not have the same chemical composition as a steroid. Therefore, doctors say that the use of insulin by non-diabetics is, in fact, dangerous.

Proper use of insulin is essential for those with type 1 diabetes. It can enable them to lead a normal, productive life. However, while insulin is a legitimate treatment for diabetes, it is not a cure. Research is now underway to try to make diabetes a disease of the past and to make insulin injections unnecessary.

Type 1 diabetes, or Insulin Dependent Diabetes Mellitus (IDDM), is a disease characterized by “auto-destruction” of the pancreatic beta cells that produce insulin. Overtime, your body silently destroys these cells creating an insulin deficiency. IDDM appears to stem from an inherited defect in the immune system, triggered by some environmental stimuli. The exact cause of the disease is still unknown; however, scientists have isolated a few factors that may be related to development of the disease. The purpose of this review is to provide insight on where research is headed and what we already know about the progression of IDDM.

Genetics Recent mapping of the human genome has opened many areas to explore in the field of diabetes research. Animal models and large population studies have led to some possible genetic links. The major histocompatibility complex (MHC) on chromosome 6 is a regulator of immune response because it recognizes “self” and “not-self” things in the body. If something is seen as foreign, the MHC will stimulate antibody production. Genes encoded on the MHC are associated with IDDM, particularly the human leukocyte antigen (HLA) class II alleles, DQ and DR (1). Although the HLA-DQ locus appears to be the best single marker for susceptibility among Caucasians, at least 40% of family-related diabetes cases have combinations of both DQ and DR alleles (2,3). DQ and DR alleles are almost always found together on a chromosome and the risk is associated with them not being in equilibrium. Many combinations have been documented, some showing both increased and decreased susceptibility, however it has been difficult to determine the contribution of HLA-DQ independent of DR. The insulin gene region at chromosome 11 is also associated with IDDM risk.

Studies conducted in the 1970’s established an HLA association and contribution of IDDM while comparing siblings with the disease (4,5,6). When comparing the relationship between family members, results are inconsistent. Current estimates suggest that HLA is 40-50% related to genes passed down by family members (7,5). The risk of developing IDDM for a twin of someone who already has the disease is about 70%, and this rises depending on the specific HLA alleles that the twins share (8). When comparing the risk of developing the disease for first-degree relatives vs. the US population, the risk is 1/20 and 1/300, respectively (1). Research in the area of HLA has been extremely difficult. Definitive answers cannot be drawn because not everyone holding these “susceptible” genes develops IDDM. Actually, less than 10% of genetically susceptible individuals progress to diabetes, implying that other factors are responsible for progression of the disease. Researchers have explored these other factors, particularly environmental factors such as early introduction of cow’s milk, dysregulation of the gut immune system, viral infections, drinking water and a number of others.

Cow’s Milk Several population studies have found a link between exposure to cow’s milk and increased risk for IDDM in genetically susceptible individuals. A few studies have also shown an increased risk for infants exposed to cow’s milk or cow’s milk based formulas within the first 3 months, and also later in life. It has been found that infants fed cow’s milk had increased levels of bovine insulin anti-bodies compared to those that were breast-fed (9,10,11). Bovine insulin is found in the milk of cows. The antibodies binding to bovine insulin appear to cross-react with human insulin (9,10). Bovine insulin is considered immunogenic because it differs from human insulin by 3 amino acids.

Insulin-specific antibodies (ISA), those specific for IDDM, and increased T cell levels from exposure to cow’s milk have been found in those carrying diabetes associated HLA risk alleles. Of all the studies to date however, levels of insulin binding antibodies seem to decrease as the child approaches 9-18 months. This suggests that the infant is building a tolerance to dietary antigens (12). However, Vaarala et al. discovered that infants who developed ISA’s, also had increased levels of bovine insulin antibodies, suggesting that insulin specific immune responses in children prone to develop autoimmunity cannot be prevented (12). Other studies have found bovine insulin antibody levels to decrease when human insulin was presented in the body.

Early weaning (2-3 months) from breast milk has been shown to increase the risk for IDDM. Maternal milk contains colostrum, a light fluid that contains a variety of protective factors for the infant. Infants have an immature and easily penetrable gut system allowing food, in this case cow’s milk, to easily cross into the bloodstream. The gut system works in one of two ways: it will either accept (build tolerance to) or reject (develop immunity to) food and its dietary components (13). Several cow’s milk proteins have been shown to be related to IDDM such as bovine albumin, beta-lactoglobulin, and beta casein (14,15,16)

A study by Karjalainen et al. in 1992 was conducted to assess whether bovine serum albumin (BSA) was a trigger for IDDM (14). Researchers measured the levels of anti-BSA and anti-ABBOS (specific part of the albumin protein) antibodies in the serum of children with newly diagnosed IDDM, children without IDDM, and blood donors’ (14). Antibodies that react to the ABBOS also react with a beta cell surface protein that may represent a target for autoimmune attack (14). All children in the study with IDDM had the highest amount of both antibodies, especially ABBOS, compared to the children without IDDM and blood donors’ (14). Antibody levels declined after one or two years of exposure to cow’s milk (14). This suggests that albumin has a section that is capable of reacting with “beta-cell specific surface proteins”, which could contribute to islet cell dysfunction because of molecular mimicry (14). What is molecular mimicry?

When an antigen is present in the body, T cells latch onto a short segment, consisting of about 10 amino acids. T cells then present the antigen to macrophages that engulf it and break it down into smaller protein fragments. The macrophages bring the fragments to the cell surface where capable T cells can bind to it. This activates the T cells, leading to stimulation in other areas to attack all proteins with similar amino acid segments. Bovine serum albumin has a short amino acid sequence similar to a beta cell surface receptor ICA69 (17) and beta casein shares a similar sequence with a glucose transporter. If molecular mimicry occurs here, then presentation of BSA or beta casein in the body would lead to autoimmune destruction.

Contrary to Karjalainen et al.’s study, Vaarala et al. found no association with BSA, but did find an increased risk for newly diagnosed IDDM with beta-lactoglobulin, another cow’s milk protein (15). A study conducted by Cavallo et al. found an association with increased risk of newly diagnosed IDDM with beta casein, another milk protein (16). However, no differences were noted with BSA and other proteins assessed (16). Despite these conflicting results, it does appear that some form of “cross-reactivity” may occur with cow’s milk proteins and islet-cell antigens, leading to “auto-attack” of the beta cells.

The role of cow’s milk related to IDDM is not clear. The hypothesis of molecular mimicry has been questioned. Few studies have found a link between cellular immunity to BSA and IDDM. A recent study found that reactivities to beta casein were similar between newly diagnosed individuals with IDDM, their immediate relatives without the disease, and non-related healthy subjects. One confounding factor of the previous study was the lack of appropriately matched subjects, because researchers failed to use HLA matched relatives. Also, when comparing breast-feeding vs. cow milk formula, it is unclear at what point there is an increased risk, as well as the actual amount needed to induce an immune response. Despite all of the evidence presented here, exposure to cow’s milk and risk for IDDM is only suggestive because the exact cause is unknown (18).

Viral Infections Viral infections have been considered to be “more” responsible for diabetes development, than milk proteins. Identifying the exact virus responsible has been extremely daunting for several reasons. Individuals are exposed to many viral infections within their lifetime. Although IDDM is primarily a juvenile disease, by the time the disease is diagnosed, children have been exposed to many viruses. Thus, pinpointing the exact one would be every difficult, if not impossible to link. Another problem is that immunological damage often occurs after the virus is gone, leaving no trace of the virus responsible. However, large population studies, as well as human and mice studies, have led to some possible viruses responsible.

Coxsackie B Virus Coxsackie B virus is an enterovirus, a virus part of a group of picornaviruses, related to those that cause polio. Several studies have found that after or with exposure to Coxsackie B that individuals developed IDDM. Also, large population studies have found antibodies against the virus in children with newly diagnosed IDDM. Coxsackie B viruses have been isolated from the pancreas in children who have developed IDDM very rapidly. Plus, inducing certain mouse strains with the virus has caused these mice to develop the disease.

Molecular mimicry has been postulated in the case of Coxsackie B virus. The virus increases the expression of an enzyme GAD in the pancreas. GAD is a highly potent autoantigen of the autoimmune response in humans and mice models. Coxsackie B and GAD share a similar sequence that may lead to cross reactivity.

Other, but not limited to, factors that may be responsible for Coxsackie B and IDDM are altered immune system regulation because of viral infection, altered memory of the T cells causing them to forget which are “self” and “not self” in the presence of viral infection, and persistent infection of the beta cells because of viral antigens expressed within them.

Although this all sounds promising, several other studies have not found conflicting results such as no difference in Coxsackie B antibodies between those with IDDM and those without it, along with no differences in prevalence and amount of antibodies responsible.

Rubella Virus About 12-20% of fetal infected individuals with rubella will develop diabetes within 5-20 years (19,20). In some adults, development of diabetes has occurred after infection with rubella. Although this poses a threat to genetically susceptible individuals, vaccination programs have decreased the amount of rubella cases.

Cytomegalovirus (CMV) There have been individual case reports of children developing IDDM after exposure to CMV. There have been recent studies done showing that newly diagnosed individuals with IDDM were recently exposed to CMV. It has been suggested that molecular mimicry may be partly responsible because CMV proteins share a resemblance with a protein in the islet cells of the pancreas. Pak et al. discovered that about 20% of individuals with IDDM have CMV DNA in the islet cells (21). Despite all this evidence however, a large Swedish study found no correlation between CMV infection and risk for IDDM (22). Besides all of this, vaccinations against the virus have lowered the prevalence of CMV infections.

It started basically just like any other day. You couldn’t tell from its beginning what it would bring, and how it would come so close to damaging our lives irreparably. That’s how life is when you have a diabetic in your midst; particularly one who doesn’t take care of his diet, and who doesn’t follow doctor’s orders.

In retrospect, it’s hard to imagine that a tiny incident, over in a matter of seconds, almost rendered my husband a permanent invalid, but for the grace of God . . .

The Event

So what was this event? My husband, a diabetic of fifteen years, and very poorly controlled, was touring his latest building site. He suddenly noticed that there was a piece of wood attached to the sole of his foot. As he has a degree of peripheral neuropathy, he felt no pain, but knew he must have stepped on a nail. Since he was in a hurry to go to a meeting, he pulled the plank away from his foot, finished arrangements with his workmen, and took off.

That was in the late afternoon. Around eleven O’clock that night, he came home tired and hungry. I fed him, and as we were chatting, he casually mentioned what had happened on the building site earlier. He showed me the small puncture mark, which at that point in time wasn’t even pink, never mind red. I was horrified and told him he should go to the emergency room there and then. He laughed at me. “What for?” he asked.

He went on like this for a few days.

Crisis Point

Eventually he was getting impatient at me for nagging. I was distraught. In the end, and most predictably, infection set in. On the advice of a doctor friend (who he spoke with on the phone), he got himself some strong antibiotics. By this time, five days after the event, it was too late. The antibiotics didn’t stand a chance against the raging infection that rapidly took hold. By the next morning he could hardly stand, and needed someone to help him walk.

Aggressive Medicine

He gave in and went to the hospital. Even I was surprised at the speed with which they admitted him. They began intravenous antibiotics immediately. We all stood by with baited breath. The first type didn’t seem to be doing anything, so the doctors (by this time there were three or four on his case), decided to try a stronger one. When I stood by on the second morning, I could see the concern on the doctors’ faces. They were trying to keep his morale high, as of course this is essential to any patient. On the third day they decided to perform surgery to clean out the wound and try and give the antibiotics a better chance of beating the infection. By this time we were on our fourth different type of antibiotics.

Truth Dawns

My husband, previously oblivious to his plight, smiling and cheerful, and highly attentive to visitors, was beginning to see that this could all go horribly wrong. I knew exactly what the score was, and every time they brought in a new, stronger type of antibiotic, I would grab the vial to read its name. I knew that when we reached Vancomycin, we would have reached the end of the line.

Immediately upon admission, the endocrinologist insisted that my husband follow the special diet that was written for him. The reason this was so critical is that if blood sugars are high, the infection (any infection) actually feeds on the glucose in the blood and grows stronger. This is, in a nutshell, why infections of any kind are so devastating to diabetics. Besides, this was a wonderful opportunity; they’d been trying to bring his blood sugars under control for years, and now he was just where they wanted him!

Almost anyone can be afflicted with diabetes. It is a medical disorder that affects the blood sugar level of a person resulting to different complications. Amazingly, while diabetes can be prevented or slowed down, there are lots of people in America who has this disorder, around 25 million of them.

The human body generates insulin, a fluid that has the main task of maintaining the sugar level in our blood. With diabetes, there is not enough insulin that is generated to do its job. As the sugar levels increase in our blood, many complications arise.

Diabetics experience symptoms such as urinating frequently, increased fluid intake and feeling thirsty all the time. The body also feels exhausted and tired frequently and the vision is altered. The breath of a diabetic also experiences a change in odor; a distinct “acetone” smell can be noticed.

Diabetes is blamed on a couple of reasons. This may include having the disease through genetics. Parents or family members that have a history of diabetes would likely have another in the gene pool that would have this disorder.

Other causes rely heavily on a person’s lifestyle and eating habits. If a person is fat and lacks exercise, there is a great chance that he would have diabetes. Excess intake of sweets and carbohydrate-packed foods can also lead to diabetes.

Diabetes has different types and has different treatments. But generally, doctors would recommend a diabetic to get lots of exercise and to avoid sweets, candies, excessive meat intake, eggs, milk and fatty foods. Alcohol and smoking is also a big no-no. A doctor can recommend a full list of what you can eat as well as the recommended amount and quantity.

Diabetes has become a major health threat to the whole world; indeed, the greatest increase will be contributed by India, which has already been declared by the World Health Organization (WHO) as the country with the largest number of diabetics in the world. Diabetes is frequently not diagnosed until complications appear, and approximately one third of all people with diabetes may be undiagnosed, though diagnosed many people are not aware of their condition.

Late detection of diabetes often means that at the time of diagnosis complications have already damaging the eyes, kidneys and nerves. These complications are costly in the physical, financial and psychosocial sense. Early detection and treatment of diabetes may not only improve glycemic control, but also improves blood pressure and lipids. Who should be screened? In general all adults should be screened at regular intervals

• Family history of diabetes (i.e., parents or siblings with diabetes)
• Overweight (Body Mass Index >25 kg/m2)
• Age >45 years
• Previously identified impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
• Hypertension (>140/90 mmHg)
• Hyperlipidemia (HDL - <35 mg/dL or triglyceride level >250 mg/dL or both)
• History of gestational diabetes or delivery of a baby over 9 lb (4.1 kg) (ADA -Diabetes Care 2004)

What are the Screening test for Diabetes

Fasting Plasma Glucose: The fasting plasma glucose (FPG) test is the standard test for diabetes. It is a simple blood test taken after eight hours of fasting. The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes.

Oral Glucose Tolerance Test: The glucose tolerance test may be more accurate than the FPG in certain groups (e.g., women with a history of gestational diabetes). The test uses the following procedures: I) after an overnight fast Fasting Plasma Glucose test is performed. ii) After this test a person receives 75 g of glucose (100 g for pregnant women) blood samples are taken every half an hour {(fasting-30mts-60mts-90mts-120mts-(five times)} to measure the blood glucose. It not only helps in detecting diabetes but also help to detect the pre-diabetic status, Impaired Fasting Glucose (IFG) & Impaired Glucose Tolerance (IGT))

Is it important to detect pre-diabetic stage? Yes! Because it is “preventable” Criteria for the diagnosis of diabetes mellitus
Normal DIABETES
Symptoms of diabetes + Random plasma glucose <140 mg/dl ≥ 200 mg/dl
Fasting plasma glucose (FPG) NFG IFG ≥ 126 mg/dl

<100 mg/dl

100 – 125 mg/dl

Oral Glucose Tolerance Test (OGTT)
(WHO, 2004) NGT IGT ≥200 mg/dl
<140 mg/dl 140–199 mg/dl

What is the test for diabetic who is on treatment to detect the control of blood sugar? Test for Glycosylated Haemoglobin: Tests for blood levels of glycosylated hemoglobin, also known as hemoglobin A1C (HbA1c) are useful for determining the severity of diabetes. A glycosylated hemoglobin level of 1% above normal range (5%) identifies diabetes in 98% of patients. The test is not affected by food intake so it can be taken at any time. It shows average blood sugar control of 2-3 months. HbA1c - < 7, should be screened six months once.

What are the routine screening tests for Diabetes Complications? : All patients with a diagnosis of diabetes should receive routine screening for diabetes complications.

Screening for Heart diseases

• Blood pressure check up, regular at every visit for Hypertension (High blood pressure) - should be <130-80 mm/hg,
• Lipids test (Bad cholesterol(LDL),Low good cholesterol(HDL)& ,high triglyceride) , Check-up : six months once-Should be LDL <100,TGL <150 &HDL >40
• An electrocardiogram (ECG), that provides information about the status of heart
• Chest X ray, information about the lungs and shape of the heart and vascular system (aorta and blood vessels)
• Carotid Intima-media Thickness (IMT), marker of early atherosclerosis

Diabetic Nephropathy (Kidney Damage): Person with diabetes are several times more prone to kidney disease than the general population. The earliest manifestation of kidney damage is microalbuminuria, (tiny amounts of protein called albumin are found in the urine). Symptoms include Protein in the urine, High blood pressure, burning during urination, frequent urination, puffiness and swelling around the eyes, hand & feet, excessive itching, nausea, vomiting & weakness.

About 20% of type 2 patients show evidence of microalbuminuria upon diagnosis of diabetes, however, only a small percentage of type-2 diabetics eventually develops kidney disease. Microalbuminuria typically shows up in type 2 diabetics who have high blood pressure. Normal: <30;

Microalbuminuria: 30-299 (earliest stage) Macroalbuminuria: ≥300 (progression to End Stage Renal Disease (ESRD)) screening test: Microalbuminuria, Protein (urine) Creatinine, urea (blood) Diabetic Neuropathy: (Nerve damage) All patients should be examined for loss of sensation (neuropathy). The symptoms of neuropathy depend on which nerves and what part of the body is affected. It include: numbness or insensitivity to pain or temperature; tingling, burning, or pricking; sharp pains or cramps; sensitivity to touch; loss of balance and coordination. Symptoms can get worse at night.

Peripheral neuropathy affects the feet and hands and autonomic neuropathy affects the internal organs. Neuropathy is diagnosed by the use of very simple devices like Biothesiometer & Monofilament test, performed by trained technicians. These tests are very simple and in-expensive. ABR index < 0.8 indicates normal.

Diabetic Foot examination: Foot problems are important cause of morbidity in diabetic people and they should be examined for reduced blood flow towards limb (legs & feet). Foot problems such as ulceration, infections, necrosis, gangrene and amputation are quite common. These can be diagnosed through a simple device like monofilament (10gm) - to check the foot sensation and Emed pressure measurement system – to check the amount of pressure at various parts of the feet and to predict the changes of getting callus in the feet & Jerk is observed in the ankle & knee using Knee hammer. These test are performed by trained nurses and qualified podiatrist

Diabetic Vasculopathy: When the arteries & veins are affected due to diabetes it is known diabetic Vasculopathy. It shows reduced blood flow towards the limbs. It is examined by Doppler test, which record the blood pressure and arterial pulsations in the upper & lower limb and Ankle Brachial Index ABI is measured. This test is Simple, quiet and non-invasive assessment. The vascular system is performed by doctors and trained technicians. ABI index <0.9 indicates normal.

Diabetes-Retinopathy (related eye): Of many complications of diabetes, blindness is perhaps the most feared. Diabetic subjects are twice to develop eye problems and 60% of those having diabetes for >15yrs will develop diabetic retinopathy in their lifetime. Who are more prone to Diabetic retinopathy? : Uncontrolled blood sugar, longstanding diabetes, Hypertension with diabetes & Genetic predisposition.

What are the stages of retinopathy? : Mild non proliferative diabetic retinopathy (NPDR), Moderate-non proliferative diabetic retinopathy, severe retinopathy, Maculopathy and Proliferative diabetic retinopathy. Treatment: Retinopathy can be treated through laser photocoagulation. Screening test: Patients with diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist right from the day of diagnosis of diabetes and every year thereafter. Early detection, timely treatment, appropriate screening and care reduce the risk of vision loss & 90% of diabetes related blindness

An individual may get diabetes when the pancreas can no longer secrete the needed hormones that produce insulin. The insulin maintains the glucose in the blood to be normal. Low insulin means that the level of glucose, which is sugar in the blood, may get high and may lead to diabetes.

The autoimmune reaction is a type 1 diabetes where the cells in the pancreas organ that produces the needed insulin are destroyed. This results to the total loss of insulin in the hormones. This happens because the body has its own hormones that protects and destroys its own pancreas cells.

Although there is no scientific proof why this occurrence in the pancreas happens, some studies have some theories that may possibly be related in this kind of reaction. Some say that this happens when there is exposure of a newly born to a cow’s milk, the infection from viruses and bacteria, and the exposure from food-borne chemical toxins. There is not enough evidence yet to prove some theories that may trigger the cause of diabetes.

The type 2 diabetes is said to progress when there is lack of insulin that is needed to maintain the blood sugar in the body. Another reason is believed to be that the needed insulin not be effective effective to control the blood sugar because of abnormalities in composition. The last reason is said to be that the receptors in cells no longer respond and fail to stimulate the organ that produces the needed insulin.

An individual is likely developing the type 2 diabetes when a person is overweight or obese. The increase of age of an individual is also considered a factor in acquiring this type of diabetes. Some few cases that may lead in this type of diabetes may include when a woman is having her pregnancy, or when a person have some intakes of medicines and drugs. In addition, any sickness or infectious decease that can alter the pancreas production of insulin.

There are some basic treatments for diabetes. These ways can serve an individual its important role in treating diabetes. Here are some ways on how a person can treat diabetes problems.

1. An individual must work thoroughly in obtaining his ideal body weight. Every individual must have a regular exercise and physical endurance tests. People who suffer from diabetes are recommended to be physically fit if possible. Exercises for the lungs and heart may help the person lessen the sugar that causes diabetes.

2. An individual must follow a diabetic diet program. Not being on the proper diet can be a great factor in acquiring type 2 diabetes. It is recommended that a person must lose weight if he is an overweight person. It is advisable that a person must be conscious of the food that he takes. Eat foods that do not have sugar content.

3. The option of the individual to have medication and seek the help of a doctor. Every diabetes patients that have type1 and type 2 diabetes can take insulin daily to sustain the insulin production of the pancreas. There is also the new insulin pump that continuously provides the much-needed insulin. There are also new medications that treat diabetes like the synthetic human insulin, Sulfonylurea drugs, Biguanides, Thiazolidinediones, Meglitinides, Alpha-glucosidase, and other drug combinations.

Diabetes can be prevented with the proper awareness and information regarding this illness. What is important is that a person must have a healthy diet and regular exercise to have a healthy body. Responsibility and discipline is needed to help oneself in overcoming this disease.

Root vegetables and fruits are rich sources of vitamins, minerals, phytochemicals and fiber. Many studies show that diabetics who do not eat fruit and root vegetables, such as potatoes, carrots or beets, are at increased risk for heart attacks and strokes. Recent studies from Oxford University in England and Arizona State University show that diabetics should eat fruits and root vegetables with other foods to slow the rise in blood sugar that can cause cell damage (European Journal of Clinical Nutrition, January 2006; Journal of the American Dietetic Association, December, 2005).

Diabetics are at high risk for heart attacks, strokes, blindness, deafness, kidney failure and damage to virtually every tissue in their bodies. These serious side effects are caused by blood sugar levels rising too high after meals. When you eat food, it passes into the stomach where the pyloric sphincter closes and prevents food from entering the intestines. The stomach squeezes and mixes its contents and only when solid food is converted to a thick soup does the pyloric sphincter open and permit food to pass into the intestines, where sugar is absorbed immediately to cause a high rise in blood sugar. If you eat nuts along with the potatoes or fruits, the fat in the nuts keeps other foods eaten with them in the stomach for a longer period of time and therefore blood sugar levels do not rise as quickly. Any slowly-digested foods that contain fats or protein will have the same effect, so eat your fruits and root vegetables with other foods, not alone as snacks.

People with diabetes 2 have beta cell dysfunction, the cells that make and release insulin, and a decreased beta cell mass due to apoptosis – death of beta cells. This has highlighted the role of incretin hormones GIP and GLP-1 in beta cell function, growth and development.

The incretins are peptide hormones secreted by specific cells located in the small intestine in response to food intake. In the pancreas, incretin hormones act to increase glucose-dependent insulin secretion from beta cells and are essential for maintaining after meal glucose control.

There are observations to be noted in people with diabetes 2 before any diagnosis of an abnormal glucose is made. The disorder begins far sooner than the abnormal glucose indicates.

• The rapid release of insulin is completely absent at the time of diagnosis of diabetes 2.
• Total beta cell function and mass is half normal at time of diagnosis.

The remainder of the natural history of diabetes 2 is now well understood.

• Total beta cells, beta cell mass in people with diabetes 2, decreases linearly for the first 10 years if no intervention occurs.
• L-arginine still produces insulin response during this time.
• Glyburide and other sulfonylureas also produce a normal insulin response.

Apoptosis occurs at an increased rate in this stage of diabetes 2. There are treatments used to treat the high glucose that can decrease the life of the beta cell. These medications include the following.

• Starlix, Prandin and Glyburide
Byetta, fondly referred to as “lizard spit”, seems to reverse all of these negative diabetes 2 processes and treatments quite handily. It is quite similar to GLP-1 having been altered slightly to be able to patent the molecule. There are other unique features that make it quite safe. It acts to,
• Increase first phase insulin response
• Increase late phase and total insulin production.
• It inhibits glucagon release
• It lowers its power as glucose goes to normal thus decreasing the chance of hypoglycemia.

Additionally it increases important regulation of beta cell gene expression for the following.

• Glukinase – aids release of glycogen from liver
• Insulin production
• Glucose transporters – decreasing insulin resistance

Finally, Byetta will increase beta cell mass through replication of beta cell and decreased apoptosis.

It appears that Byetta will reverse the natural decline of the Islands of Langerhans where the beta cells reside and add a few more things that give the reversal a “soft landing” that makes it quite safe. The decrease in apoptosis and increase in beta cell mass mark this product as an exceptional advance in the care of patients with diabetes 2. We now are using Byetta in many people with type 1 with very good preliminary results.

This doesn’t even take into consideration the intangibles such as decreased fatigue, increased muscle strength and diminished abdominal fat patients love perhaps most of all.

A recent study from Washington University in St Louis may explain why more than 75 percent of diabetics die of heart disease (Journal for the American College of Cardiology, February 7, 2006). The heart muscle of diabetics uses a much higher percentage of fat for energy than that of non-diabetics, to markedly increase risk for heart attacks.

The energy source for heart muscle is mostly sugar and fat, and to a lesser degree, protein. Muscles need far more oxygen to process fat than to process sugar. The blood supply to heart muscle comes from large arteries on the outside of the heart. Diabetics have narrowed arteries because high blood sugar levels cause plaques to form and reduce the diameter of the coronary arteries. The increased need for blood flow from burning fat and the decreased blood flow from narrowed arteries put diabetics at very high risk for heart attacks, heart failure and sudden death. The increased use of oxygen increases blood levels of oxidants that further damage the inner linings of arteries.

Another study from Sweden shows that many people discover that they are diabetic only after they have had a heart attack. Researchers recorded blood sugar levels in men who had had heart attacks and then did sugar tolerance tests at discharge and three months later. They found that 35 percent had diabetic sugar tolerance tests at hospital discharge and 40 percent had impaired sugar tolerance tests three months later (Lancet, Volume 359, 2002).

Therefore, 40 percent of people who have heart attacks are diabetic, even though they may not know it. Many of the diabetics had normal HBA1C blood tests, the standard test to measure diabetic control. Furthermore, the patients who were unknown diabetics had a much higher rate of sudden death from their heart attacks than those who were not diabetic. The authors recommend that all people with heart attacks be tested for diabetes

An exciting study from Yale shows that intense exercise is far more effective in preventing and controlling diabetes than exercising at a leisurely pace (Journal of Applied Physiology, January 2006). That means that the diabetic who exercises hard enough to sweat and raises his heart rate above 80 percent of its maximum will be far less likely to suffer heart attacks, strokes, blindness, deafness, kidney failure and all the other terrible consequences of uncontrolled diabetes.

Inactive, healthy, non-obese women over 72 years of age were started in training programs of hard (80 percent of aerobic capacity), moderate (65 percent) and easy (50 percent). All three groups did the same amount of work, burning 300 calories per session. The intense group had a great improvement in their ability to use sugar and suppress fat formation, while the low intensity group had little benefit.

That means that intense exercise can help to both prevent and treat diabetes. The most tissue damage occurs immediately after eating when blood sugar levels rise the highest. After you eat, sugar goes from the intestines into the bloodstream. The only places that sugar can be stored are in your muscles and liver. When your muscles are not exercised, they are full of sugar and sugar has no place to go after it enters your bloodstream. On the other hand, when your muscles are exercised, they empty their stored sugar. Then when you eat, sugar can go from the intestines into the bloodstream and then immediately into the muscles, preventing a high rise in blood sugar.

The important news from this study is that the more intensely you exercise, the greater the protection from developing diabetes and the better the control of your diabetes if you already have it. A word of caution: 75 percent of diabetics die from heart disease and some people can suffer heart attacks during intense exercise, so check with your doctor first.

Glyconutrients are eight immune sugars the body uses for cell to cell communication. These sugars are not used by the body as a source of energy/fuel as are other carbohydrates. Without proper cell to cell communication, the immune system cannot determine which cells to attack or which cells to leave alone, which cells are healthy or which cells are unhealthy. When the immune system attacks healthy cells, it is called AutoImmune Disorders. When the immune system fails to attack unhealthy cells, sickness and disease sets in the body. As you read this, much research is being done on glyconutrients. Science has established that glyconutrients are not a diet option but a requirement for everyone, called by many “the missing link” to good health.

Alarming evidence shows that many common diseases are caused by a single dietary deficiency missing in our diets. Among the missing ingredients are antioxidants, phytonutrients and gloconutrients. Why? Most people already know the answer but do not know what to do about it. “The nutrients are no longer in the foods that we eat daily because of soil depletion and green harvesting.”

Take glyconutrients for an example, only two of the eight known glyconutrieints are found commonly in today’s foods. Science has shown that we need all eight of these living sugars to stay healthy.

To explain in a simple way why everyone needs glyconutrients, take for example a typewriter, what if all of the vowels were missing from the keyboard, it would be impossible to communicate a written message that makes sense. This is exactly what is happening in the body when even one of these essential glyconutrients is missing from the diet. The immune system does not get the message to destroy damaged cells or leave healthy cells alone. The immune system can defend the body if it has all of the nutrition needed and knows when and where to attack.

The eight essential immune sugars are: xylose, fucose, galactose, glucose, mannose, N-acetylglucosamine, N-acetylgalactosamine and N-acetylneuraminic acid (sialic acid)

Some other benefits in taking glyconutrients are: build resistance to disease, increase over all health and vitality, alleviate allergy symptoms, slow down the aging process, decrease inflammation, increase natural killer cells and macrophages and improve blood sugar disorders.

A final word about glyconutrients and stem cells. Stem cells are produced in bone marrow and travel through the body repairing damage tissues. Studies show that those taking glyconutrients for one week had an increase in stem cells by the trillions. Glyconutrients have the answer that stem cell researchers are still seeking. Maybe they should look at glyconutrients for their answers.

Typical signs of diabetes mellitus for example are increasing thirst and hunger. Dropping weight for no obvious reason does not always mean to be some serious health problem, but can also be a possible symptom for diabetes. Patients then seem to suffer from starvation.

This diabetes mellitus starvation actually happens on two levels. On the one hand you really run into starving for you obvious drop weight, even if you try to eat enough and provide your body with enough energy. Why you actually drop weight is due to the "starvation of your cells". What does that mean?

When suffering from diabetes mellitus, your pancreas does not produce proper amounts of insulin. Insulin is a hormone with many functions, the most important being the "key" to open the cells for glucose. Glucose on the other hand provides the cells with energy.

Without insulin the cells cannot be opened for needed energy, which means they are literally starving. If your cells do not get enough energy, your body reacts and you start to feel hungry. But if you eat more food, insulin is still missing and so your blood sugar level will increase. To reduce this again, sugar is filtered by your kidneys and is excreted via urine. Therefore increased urination is another sign of a possible diabetes disease.

Because your cells are not fed with energy, your body thinks you are starving (do not eat) and therefore needs to get the energy for physical activities from somewhere else. Body fat and muscles are then used to provide needed energy. This is why you start to drop weight for no obvious reason

Prologue and Rationale

When the level of blood glucose rises above normal it gives rise to a condition called diabetes. The food we eat gets converted into glucose or fat in our body to provide energy for work. The organ lying near the stomach known as pancreas secretes a hormone, insulin that helps the glucose to get stored in the body cells. When pancreas are not able to produce insulin in required amounts or is not able to use insulin the glucose is not able to get store in the cells, as a result the sugar gets stored in the blood causing diabetes. The cases of diabetes are much higher these days as compare to the past. It occurs in all age groups but the most common sufferers are obese people in middle or older age. The most commonly used screening tests are the determination of the fasting blood glucose level and the blood glucose level tested two hours after a meal. The normal fasting blood sugar content is 80-120mg.per 100 ml of blood, this can go up to a level of 160 mg. per 100 ml of blood two hours after meals. Anything above these levels can be termed as diabetic levels.

Types of diabetes

· Type 1 diabetes

In this type 1 diabetes the body stops producing insulin or produces less to regulate the level of blood glucose. It was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile onset diabetes. The people suffering from types 1 diabetes require insulin treatment daily to sustain life.

· Type 2 diabetes

In this type of diabetes the pancreas secrete insulin but the body is not able to use the insulin. This condition is also referred to as insulin resistance. This insulin resistance results in type 2 diabetes when enough amounts of insulin is not secreted to cope up with the higher demands. It was previously known as non-insulin dependent mellitus (NIDDM) or adult onset diabetes. It doesn’t occur in younger people. It can be controlled with proper diet, weight loss and exercise.

· Gestational diabetes

It usually occurs during the second half of pregnancy. It can cause problems for the mother and babies if proper medication is not done. It disappears after the delivery. The women who suffer from this diabetes in pregnancy have more chances to suffer from type 2 diabetes in the later years of life.

Symptoms

The various symptoms of diabetes are:
· Dry skin
· Slow recovery from an injury
· Frequent urination
· Fatigue
· Blurred vision
· Excessive thirst and hunger
· Sudden weight loss
· Intense hunger
· Weak appearance
· Numbness of hands and feet
· Stomach pains

Causes

Systematic overeating and obesity mainly cause diabetes. This overeating is just not if sugar and refined carbohydrates but also high intake of proteins and fats. Grief, worry and anxiety are also the causes of diabetes that affects the metabolism and cause sugar to appear in the urine. It may also be caused due to some disorders like cancer, tuberculosis and cerebral disease. Diabetes is a heredity disease, which can affect many generations. It can also be caused due to many nutritional deficiencies and use of certain medicines for longer period of time.

If you think you are doomed to become diabetic because it "runs in your family," take heart.

You inherit a susceptibility to Type II diabetes; you do not inherit diabetes. One of three Americans will become diabetic, with women more likely to develop diabetes than men.

Risk factors for developing diabetes include: a family history of diabetes; storing fat primarily in the belly; high triglycerides; low HDL (good) cholesterol; blood sugar higher than 200 thirty minutes after a meal; fasting blood sugar above 110; excess hair on the face or body (in women); or diabetes during pregnancy.

A person with any of these warning signs should immediately make lifestyle changes to prevent diabetes: avoid refined carbohydrates (foods made with flour, white rice, milled corn; all added sugars and drinks that contain sugar), exercise regularly, lose weight if you are overweight, and keep your weight controlled for the rest of your life. If you do this you will be at low risk for developing diabetes, even if you have the genes that make you susceptible.

The authors of one study showed that the average person who is diagnosed with diabetes at age 40 will die 11.6 year earlier than a non-diabetic and that he or she will be severely incapacitated with one or more side effects of diabetes 18.6 years before a non-diabetic becomes disabled by similar health problems. Anyone who has watched a loved one progress through the horrible consequences of uncontrolled diabetes should be strongly motivated to make the lifestyle changes that help you avoid ever becoming diabetic.

There are plenty of joggers who do not believe there is much value in treadmills. But they are wrong because there is a long list of advantages - they offer a safe and regular running surface and they tell you exactly what distance you have covered. A treadmill run is never disrupted by the weather, you can run safely at night and you cannot get attacked or be in an auto wreck.

Therefore treadmill running does have some benefits. However we also need to know what are the disadvantages of this type of running and how can they be overcome. The problems with treadmill running fall into 2 groups: 1. relying on treadmill running may bring problems if you are following a training program. 2. problems that can be overcome if you purchase the right treadmill.

The first problem, the impact treadmill training will have on your overall fitness program, depends on your fitness aim. So if it is purely to become fit then stay there, you will find the treadmill a winner. Running offers a fine cardio workout, and though it is not equally effective on all parts of the body it helps your legs (of course) and your back, chest, stomach and arms. Some folk will want to complement the running with Pilates, swimming, weights or whatever. Another bonus for runners is that it is one of the exercises that works your bones - good for keeping osteoporosis at bay. If running is not yet in your sights, running machines are great for walking on as well.

If your fitness goal is a running race - a fun run, a marathon or a shorter event - then the running machine should only be part of the running you do. For road racing we need to practice on the road so that we become accustomed to the different stresses and strains this causes. Anyone who only runs on a machine will not be comfortable on the road. Yet the treadmill helps in many situations, like if the only time you can train some days is after dark and you do not want to run around at night on your own. If you want to use the treadmill to train for outside running then set the incline feature to 1% - this helps get your striding right for outside conditions.

The rest of the problems we will encounter are to do with buying the wrong kind of machine. Buy a treadmill that is good enough to last for a long time - many people under buy thinking that they can trade up later. The trouble with this tactic is that many of the cheaper models are so bad that you will be quickly discouraged.

You want to buy a product from an experienced running machine company. Do not neglect the motor, but do not simply buy the largest motor your money can buy - 2 HP is plenty if it is quality and bigger motors that come cheaper may have shortcomings like poor cooling systems that lead to failure.

Something else to consider is the size of the belt on the treadmill. Some come up very short which means the area you have to run on is quite tight. Running on short belts is difficult, so go for one with a longer belt. You should also look at the electrics. Look for something that is simple and straightforward to use. And to be certain make sure you try a couple before you buy, then you can make you purchase online or at a store.

Recently, I've had a lot of requests for an alternative to health insurance for diabetics. The case of one gentleman, in particular, has lingered on my mind.

The man who I will refer to as "Bob" has what is called Type II, or Late Onset Diabetes. My own dad has this condition as well, so I am aware of the tremendous health struggles and monetary cost that can come as a result.

One fortunate thing for Daddy is that he was well covered with health insurance long before he became ill. Bob was not so lucky. He had no type of coverage at all when he received the surprise diagnosis of diabetes.

Do you know that once a doctor has made a chart note, or included a lab result in your chart, suggesting that your blood sugar is high (or that you are "pre-diabetic") your odds of being able to obtain a reasonably priced health insurance plan plummet?

That was the case with Bob, who had been "getting by" paying for his glucose meter, testing strips, and diabetic supplies out of his own pocket. This had been a burden on Bob's bank account, which was in its own state of recovery following a divorce, but he was getting back on his feet in mid January.

When I mentioned an alternative to health insurance for diabetics, Bob was relieved and thrilled, and asked me to give him a call on pay day so that he could get started. The great news about these alternatives is that they cover all ongoing medical problems, even if the doctor has written a definite diagnosis in the chart.

Sadly, when I reached Bob on his cell phone, Bob was not in a position to talk long. He had been at Bible Study the previous evening when he'd gone into insulin shock. The men in his group had responded quickly and Bob had been taken to the hospital, where he expected to remain for 2 to 3 more days to recover.

I can only imagine what the EMT, hospital, and doctor charges will add up to for such an emergency. It breaks my heart to know that because he narrowly missed getting signed up for an alternative to health insurance for diabetics, Bob will be paying the entire amount out of his own pocket.

It especially concerns me to know that there are so many diabetics (and undiagnosed folks who have the condition and may suddenly experience diabetic symptoms) who have no coverage.

Not only does diabetes require testing supplies, possible prescription medication and/or insulin; it comes with the threat of emergency hospital admission for something like insulin shock. Worse yet ... diabetes brings with it a whole host of possible serious health consequences.

My own dad has suffered numerous complications of his diabetes, even though he and my mother took the condition seriously from the beginning and altered his lifestyle accordingly. I shudder to think what would have become of my parents when my dad began having strokes, if they had not been covered with health insurance prior to his diabetes diagnosis.

You see, even if a person is able to get insurance coverage for diabetics after they are diagnosed with the condition, a traditional insurance company will generally have a lengthy waiting period before they will pay anything for diabetes treatment OR for other conditions which they can cite as possibly related to or caused by the diabetes.

If in reading the diabetes information I've provided on my website, you think that you or someone you love is at risk for having or getting diabetes, I urge you to make certain you or they have or obtain health insurance today.

I understand that many of us would have a difficult time paying for traditional health insurance - especially on short notice - however that truly would be your best course of action.

If traditional insurance coverage is out of reach, the next best option is to sign up for an inexpensive health discount program. These plans provide appreciable discounts on care associated with diabetes.

Additionally, at least one of the discount programs provides a hospital advocate to each member so that any costs over $2,500 are negotiated down to wholesale, and payment arrangements are worked out.

If you or someone you love has already been diagnosed with diabetes, it is all the more important to obtain health insurance immediately. While it may not pay toward anything related to the diabetes until a waiting period has passed, at least that waiting period could be going by now, making coverage available should any complications occur in the future.