How do I check my blood sugar level?

Follow your doctor's advice and the instructions that come with the glucose meter. In general, you will follow the steps below. Different meters work differently, so be sure to check with your doctor for advice specifically for you.

1. Wash your hands and dry them well before doing the test.
2. Use an alcohol pad to clean the area that you're going to prick. For most glucose meters, you will prick your fingertip. However, with some meters, you can also use your forearm, thigh or the fleshy part of your hand. Ask your doctor what area you should use with your meter.
3. Prick yourself with a sterile lancet to get a drop of blood. (If you prick your fingertip, it may be easier and less painful to prick it on one side, not on the pad.)
4. Place the drop of blood on the test strip.
5. Follow the instructions for inserting the test strip into your glucose meter.
6. The meter will give you a number for your blood sugar level.

Tips on blood sugar testing
* Pay attention to expiration dates for test strips.
* Use a big enough drop of blood.
* Be sure your meter is set right.
* Keep your meter clean.
* Check the batteries of your meter.
* Follow the instructions for the test carefully.
* Write down the results and show them to your doctor.


How often should I check my blood sugar level?
Check your blood sugar as often as your doctor suggests. You'll probably need to do it more often at first. You'll also check it more often when you feel sick or stressed, when you're changing your medicine or if you're pregnant. People taking insulin may need to check their levels more often. Keep track of your blood sugar levels by writing them down. You can also keep track of what you've eaten and how active you've been during the day. This will help you see how food and exercise affect your blood sugar level.

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Children with Diabetes

Type 1 diabetes is the most common form of diabetes in children: 90-95 per cent less than 16 years with diabetes have this type.
It is caused by the failure of the pancreas to produce insulin.
Type 1 diabetes is classified as an autoimmune disease, in which the immune system "attacks" one of their tissues or organs.
In type 1 diabetes, cells that produce insulin in the pancreas are destroyed.
How common?
Diabetes of the child is not common, but there are wide variations in the world:
* In England and Wales with 17 children to develop diabetes each year, 100,000
* In Scotland, the figure is 25 per 100,000
* In Finland, which is 43 per 100,000
* In Japan, it is 3 per 100,000.
The last 30 years has seen an increase in diabetes in childhood.
In Europe and America, type 2 diabetes was the first time in young people. This is probably caused in part by the growing trend of obesity in our society.
Obesity, but does not explain the increase in the number of type 1 diabetes in children - who represent the majority of new cases.
What are the causes of childhood diabetes?
As adults, the cause of childhood diabetes is not included. It is probably a combination of genes and environmental factors.
Most children who develop Type 1 do not have a family history of diabetes

What are the symptoms?
The main symptoms are the same as for adults. They tend to be more than a few weeks:
* Thirst
* Weight Loss
* Fatigue
* Frequent urination.

The symptoms that are more typical for children include:
* Tummy pains
* Headache
* Behavioral problems.

Sometimes occurs before acidosis diabetic is diagnosed diabetes, but this happens less often in the United Kingdom, thanks to better awareness of symptoms to watch.
Doctors should consider the possibility of diabetes in every child who otherwise has a history of illness or unexplained stomach pains for a few weeks.
If diabetes is diagnosed, the child must be submitted to specialists in the region in childhood diabetes.

As for the treatment of diabetes in children?
The specialized nature of the management of childhood diabetes means that most children are treated by the hospital, rather than with their doctor.
Most children with diabetes require insulin treatment. If so, the child will need a routine of insulin, which will be supplied with diabetes team.

* Most of the schemes often daily dose of fast-acting insulin during the day and the slow action of insulin during the night.
* The very young children are not normally need an injection in the night, but a necessity, because they grow.
* An increasing number of children continues to use insulin pumps.

Often, during the first year after diagnosis, the child in may only need a small dose of insulin. This is called the "honeymoon period". In addition to insulin treatment, good blood glucose and avoid "hypos" (low blood glucose attacks) is important. The reason is that many of the complications of diabetes increases with the duration of diabetes was present.

What can parents do?
Your family and the child, the medical team can help in difficult moments. Living with diabetes can put pressure on families, and access to support is crucial. May this with your doctor, hospital team or social services. To understand all aspects of diabetes and its treatment requires patience, but will benefit your child and family life.

The team from diabetes in the hospital can help in the list below.
* Learn to manage your insulin injections. Insulin is usually injected into the skin of the abdomen or thighs.
* Knowing the symptoms of hypoglycemia and diabetic acidosis, and what to do about it.
* Ensure that the glucose is always available.
* Measurement of glucose in the blood and to teach your children how to do it as soon as they are very old.
* Teach your child how to self-administer insulin injections when they are old - about the age of nine years, is typical.
* Consult your doctor on a regular basis, especially if the child is sick, for whatever reason - the treatment is likely to need to adapt.
* Inform the school and the friends on the symptoms of hypoglycemia and what to do about it.
* Contact your local association of diabetes care and support.

Diet
It is important to give your child a healthy, balanced, which is rich in fiber and carbohydrates. A healthy diet is the same for everyone, even if they do not have diabetes. As the child should eat depends on age and weight. The dietitian and parents must decide together. Desserts are no longer off limits because of "regime diabetic" is a relic of the past. Once your child is how his body responds to eat and take insulin, sweets sparingly as possible - with the appropriate dose of insulin.

Physical activity
Physical activity is important for children with diabetes, who must try to exercise every day. Physical activity reduces blood sugar, so if your child is taking insulin, which may be necessary to reduce the dose.
The reason is that the combination of excess insulin and exercise can help lower blood sugar and lead to hypos. To counter this, the child should always carry the sugar. Physical activity also affects what the child can eat. Before the child or a year of sport, more bread, fruit juices or other carbohydrates.

In the long term
A child who develops diabetes with the condition of life more than someone who develops diabetes in adulthood.
Diabetes is more common, the risk of long-term complications, such as those affecting the eyes and kidneys. You can start after puberty, but are usually a problem until later in life. Periodic reviews by the end of stage complications begin around the age of nine years. Therefore, it is carried out every year.

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In Depth: Insulin

When we eat, our bodies break food down into organic compounds, one of which is glucose.
The cells of our bodies use glucose as a source of energy for movement, growth, repair, and other functions. But before the cells can use glucose, it must move from the bloodstream into the individual cells. This process requires insulin.

Insulin is produced by the beta cells in the islets of Langerhans in the pancreas. When glucose enters our blood, the pancreas should automatically produce the right amount of insulin to move glucose into our cells. People with type 1 diabetes produce no insulin. People with type 2 diabetes do not always produce enough insulin. Delivery Devices:
Unlike many medicines, insulin cannot be taken orally. Like nearly all other proteins introduced into the gastrointestinal tract, it is reduced to fragments (even single amino acid components), whereupon all 'insulin activity' is lost. There has been some research into ways to protect insulin from the digestive tract, so that it can be administered in a pill. So far this is entirely experimental.

All insulin delivery devices inject insulin through the skin and into the fatty tissue below.
Most people inject the insulin with a syringe that delivers insulin just under the skin. Others use insulin pens, jet injectors, or insulin pumps. Several new approaches for taking insulin are under development.


Here are several conditions in which insulin disturbance is pathologic:

* Diabetes mellitus – general term referring to all states characterized by hyperglycemia.

* Insulinoma - a tumor of pancreatic beta cells producing excess of insulin or reactive hypoglycemia

* Metabolic syndrome – a poorly understood condition first called Syndrome X by Gerald Reaven, Reaven's Syndrome after Reaven, CHAOS in Australia (from the signs which seem to travel together), and sometimes prediabetes. It is currently not clear whether these signs have a single, treatable cause, or are the result of body changes leading to type 2 diabetes. It is characterized by elevated blood pressure, dyslipidemia (disturbances in blood cholesterol forms and other blood lipids), and increased waist circumference (at least in populations in much of the developed world). The basic underlying cause may be the insulin resistance of type 2 diabetes which is a diminished capacity for insulin response in some tissues (e.g., muscle, fat) to respond to insulin. Commonly, morbidities such as essential hypertension, obesity, Type 2 diabetes, and cardiovascular disease (CVD) develop.

* Polycystic ovary syndrome – a complex syndrome in women in the reproductive years where there is anovulation and androgen excess commonly displayed as hirsutism. In many cases of PCOS insulin resistance is present.

www.wikipedia.com
www.fda.gov
www.medterms.com

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Other Diabetes Medications

The first treatment for type 2 diabetes is often meal planning for blood glucose (sugar) control, weight loss, and exercising. Sometimes these measures are not enough to bring blood glucose levels down near the normal range. The next step is taking a medicine that lowers blood glucose levels.

How they work

In people with diabetes, blood glucose levels are too high. These high levels occur because glucose remains in the blood rather than entering cells, where it belongs. But for glucose to pass into a cell, insulin must be present and the cell must be "hungry" for glucose.

People with type 1 diabetes don't make insulin. For them, insulin shots are the only way to keep blood glucose levels down.

People with type 2 diabetes tend to have two problems: they don't make quite enough insulin and the cells of their bodies don't seem to take in glucose as eagerly as they should.

All diabetes pills sold today in the United States are members of five classes of drugs: sulfonylureas, meglitinides, biguanides, thiazolidinediones, and alpha-glucosidase inhibitors. These five classes of drugs work in different ways to lower blood glucose levels.

Sulfonylureas
Sulfonylureas stimulate the beta cells of the pancreas to release more insulin. Sulfonylurea drugs have been in use since the 1950s. Chlorpropamide (brand name Diabinese) is the only first-generation sulfonylurea still in use today. The second generation sulfonylureas are used in smaller doses than the first-generation drugs. There are three second-generation drugs: glipizide (brand names Glucotrol and Glucotrol XL), glyburide (Micronase, Glynase, and Diabeta), and glimepiride (Amaryl). These drugs are generally taken one to two times a day, before meals. All sulfonylurea drugs have similar effects on blood glucose levels, but they differ in side effects, how often they are taken, and interactions with other drugs.

Meglitinides
Meglitinides are drugs that also stimulate the beta cells to release insulin. Repaglinide (brand name Prandin) and nateglinide (Starlix) are meglitinides. They are taken before each of three meals.

Because sulfonylureas and meglitinides stimulate the release of insulin, it is possible to have hypoglycemia (low blood glucose levels).

You should know that alcohol and some diabetes pills may not mix. Occasionally, chlorpropamide, and other sulfonylureas, can interact with alcohol to cause vomiting, flushing, or sickness. Ask your doctor if you are concerned about any of these side effects.

Biguanides
Metformin (brand name Glucophage) is a biguanide. Biguanides lower blood glucose levels primarily by decreasing the amount of glucose produced by the liver. Metformin also helps to lower blood glucose levels by making muscle tissue more sensitive to insulin so glucose can be absorbed. It is usually taken two times a day. A side effect of metformin may be diarrhea, but this is improved when the drug is taken with food.

Thiazolidinediones
Rosiglitazone (Avandia) and pioglitazone (ACTOS) are in a group of drugs called thiazolidinediones. These drugs help insulin work better in the muscle and fat and also reduce glucose production in the liver. The first drug in this group, troglitazone (Rezulin), was removed from the market because it caused serious liver problems in a small number of people. So far rosiglitazone and pioglitazone have not shown the same problems, but users are still monitored closely for liver problems as a precaution. Both drugs appear to increase the risk for heart failure in some individuals, and there is debate about whether rosiglitazone may contribute to an increased risk for heart attacks. Both drugs are effective at reducing A1C and generally have few side effects.

DPP-4 Inhibitors
A new class of medications called DPP-4 inhibitors help improve A1C without causing hypoglycemia. They work by by preventing the breakdown of a naturally occuring compound in the body, GLP-1. GLP-1 reduces blood glucose levels in the body, but is broken down very quickly so it does not work well when injected as a drug itself. By interfering in the process that breaks down GLP-1, DPP-4 inhibitors allow it to remain active in the body longer, lowering blood glucose levels only when they are elevated. DPP-4 inhibitors do not tend to cause weight gain and tend to have a neutral or positive effect on cholesterol levels. Sitagliptin (Januvia) is currently the only DPP-4 inhibitor on the market.

Alpha-glucosidase inhibitors
Acarbose (brand name Precose) and meglitol (Glyset) are alpha-glucosidase inhibitors. These drugs help the body to lower blood glucose levels by blocking the breakdown of starches, such as bread, potatoes, and pasta in the intestine. They also slow the breakdown of some sugars, such as table sugar. Their action slows the rise in blood glucose levels after a meal. They should be taken with the first bite of a meal. These drugs may have side effects, including gas and diarrhea.

Oral combination therapy

Because the drugs listed above act in different ways to lower blood glucose levels, they may be used together. For example, a biguanide and a sulfonylurea may be used together. Many combinations can be used. Though taking more than one drug can be more costly and can increase the risk of side effects, combining oral medications can improve blood glucose control when taking only a single pill does not have the desired effects. Switching from one single pill to another is not as effective as adding another type of diabetes medicine.

http://www.diabetes.org/type-2-diabetes/oral-medications.jsp

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Diabetes Type 2: Treatments and drugs

Treatment for type 2 diabetes is a lifelong commitment of blood sugar monitoring, healthy eating, regular exercise and, sometimes, diabetes medications or insulin therapy. The goal is to keep your blood sugar level as close to normal as possible to delay or prevent complications. In fact, tight control of blood sugar levels can reduce the risk of diabetes-related heart attacks and strokes by more than 50 percent.

If managing your diabetes seems overwhelming, take it one day at a time. And remember that you're not in it alone. You'll work closely with your diabetes treatment team — doctor, diabetes educator and registered dietitian — to keep your blood sugar level as close to normal as possible.

Monitoring your blood sugar

Depending on your treatment plan, you may check and record your blood sugar level once a day or several times a week. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.

Even if you eat on a rigid schedule, the amount of sugar in your blood can change unpredictably. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to:

Food.

What and how much you eat will affect your blood sugar level. Blood sugar is typically highest one to two hours after a meal.

Physical activity.

Physical activity moves sugar from your blood into your cells. The more active you are, the lower your blood sugar level.

Medication.

Any medications you take may affect your blood sugar level, sometimes requiring changes in your diabetes treatment plan.

Illness.

During a cold or other illness, your body will produce hormones that raise your blood sugar level.

Alcohol.

Alcohol can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time.

Stress.

The hormones your body may produce in response to prolonged stress may prevent insulin from working properly.

For women, fluctuations in hormone levels.

As your hormone levels fluctuate during your menstrual cycle, so can your blood sugar level — particularly in the week before your period. Menopause may trigger fluctuations in your blood sugar level as well.

In addition to daily blood sugar monitoring, your doctor may recommend regular A1C testing to measure your average blood sugar level for the past two to three months. Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working overall. An elevated A1C level may signal the need for a change in your insulin regimen or meal plan.

Healthy eating
Contrary to popular perception, there's no diabetes diet. You won't be restricted to a lifetime of boring, bland foods. Instead, you'll need plenty of fruits, vegetables and whole grains — foods that are high in nutrition and low in fat and calories — and fewer animal products and sweets. In fact, it's the best eating plan for the entire family. Even sugary foods are OK once in a while, as long as they're included in your meal plan.

Yet understanding what and how much to eat can be a challenge. A registered dietitian can help you put together a meal plan that fits your health goals, food preferences and lifestyle. Once you've covered the basics, remember the importance of consistency. To keep your blood sugar on an even keel, try to eat the same amount of food with the same proportion of carbohydrates, proteins and fats at the same time every day.

Physical activity
Everyone needs regular aerobic exercise, and people who have type 2 diabetes are no exception. Get your doctor's OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes of aerobic exercise most days of the week. Stretching and strength training exercises are important, too. If you haven't been active for a while, start slowly and build up gradually.
Remember that physical activity lowers blood sugar. Check your blood sugar level before any activity. You might need to eat a snack before exercising to help prevent low blood sugar.

Diabetes medications and insulin therapy

Some people who have type 2 diabetes can manage their blood sugar with diet and exercise alone, but many need diabetes medications or insulin therapy.

Many oral or injected medications can be used to treat type 2 diabetes. Some diabetes medications stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells. Still others block the action of stomach enzymes that break down carbohydrates or make your tissues more sensitive to insulin.

In addition to diabetes medications, your doctor might prescribe low-dose aspirin therapy to help prevent heart and blood vessel disease.

Some people who have type 2 diabetes need insulin therapy as well. Because stomach enzymes interfere with insulin taken by mouth, insulin must be injected. Often, insulin is injected using a fine needle and syringe or an insulin pen injector — a device that looks like an ink pen, except the cartridge is filled with insulin.

An insulin pump also may be an option. The pump is a device about the size of a cell phone worn on the outside of your body. A tube connects the reservoir of insulin to a catheter that's inserted under the skin of your abdomen. The pump is programmed to dispense specific amounts of insulin automatically. It can be adjusted to deliver more or less insulin depending on meals, activity level and blood sugar level.

Many types of insulin are available, including rapid-acting insulin, long-acting insulin and intermediate options. Examples include insulin lispro (Humalog), insulin aspart (NovoLog) and insulin glargine (Lantus). Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night.

In October 2007, the manufacturer of inhaled insulin (Exubera) announced a decision to stop selling the drug because too few people are using it. If you use inhaled insulin, work with your doctor to adjust your diabetes treatment plan as soon as possible. In the meantime, it's safe to continue using inhaled insulin as directed.

The decision about which medications are best depends on many factors, including your blood sugar level and the presence of any other health problems. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways.

* http://www.mayoclinic.com/

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Type 1 Diabetes - Treatment Overview

Treatment for type 1 diabetes is a lifelong commitment of monitoring blood sugar, taking insulin, maintaining a healthy weight, eating healthy foods and exercising regularly. The goal is to keep your blood sugar level as close to normal as possible to delay or prevent complications. In fact, tight control of blood sugar levels can reduce the risk of diabetes-related heart attacks and strokes by more than 50 percent.

If managing your diabetes seems overwhelming, take it one day at a time. And remember that you're not in it alone. You'll work closely with your diabetes treatment team — doctor, diabetes educator and registered dietitian — to keep your blood sugar level as close to normal as possible.

Blood sugar monitoring

Depending on what type of insulin therapy you select or require — single dose injections, multiple dose injections or insulin pump — you may need to check and record your blood sugar level up to four or more times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
Even if you take insulin and eat on a rigid schedule, the amount of sugar in your blood can change unpredictably. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to:

Food.
What and how much you eat will affect your blood sugar level. Blood sugar is typically highest one to two hours after a meal.
Physical activity.
Physical activity moves sugar from your blood into your cells. The more active you are, the lower your blood sugar level. To compensate, you might need to lower your insulin dose before unusual physical activity.
Medication.
You need insulin to lower your blood sugar level. But any other medications you take may affect your blood sugar level as well, sometimes requiring changes in your diabetes treatment plan.
Illness.
During a cold or other illness, your body will produce hormones that raise your blood sugar level. This might require changes in your diabetes treatment plan.
Alcohol.
Alcohol can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time.
Stress.
The hormones your body may produce in response to prolonged stress may prevent insulin from working properly.
For women, fluctuations in hormone levels.
As your hormone levels fluctuate during your menstrual cycle, so can your blood sugar level — particularly in the week before your period. Menopause may trigger fluctuations in your blood sugar level as well.

In addition to daily blood sugar monitoring, your doctor may recommend regular A1C testing to measure your average blood sugar level for the past two to three months. Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working overall. An elevated A1C level may signal the need for a change in your insulin regimen or meal plan.

Insulin and other medications
Anyone who has type 1 diabetes needs insulin therapy to survive. Because stomach enzymes interfere with insulin taken by mouth, oral insulin isn't an option for lowering blood sugar. Often, insulin is injected using a fine needle and syringe or an insulin pen — a device that looks like an ink pen, except the cartridge is filled with insulin.

An insulin pump also may be an option. The pump is a device about the size of a cell phone worn on the outside of your body. A tube connects the reservoir of insulin to a catheter that's inserted under the skin of your abdomen. The pump is programmed to dispense specific amounts of insulin automatically. It can be adjusted to deliver more or less insulin depending on meals, activity level and blood sugar level.

Many types of insulin are available, including rapid-acting insulin, long-acting insulin and intermediate options. Examples include regular insulin (Humulin R, Novolin R, others), insulin isophane (Humulin N, Novolin N), insulin lispro (Humalog), insulin aspart (NovoLog) and insulin glargine (Lantus). Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night.

Sometimes other medications are prescribed as well. For example, an injection of pramlintide (Symlin) before you eat can slow the movement of food through your stomach to curb the sharp increase in blood sugar that occurs after meals. Your doctor might prescribe low-dose aspirin therapy to help prevent heart and blood vessel disease.

In October 2007, the manufacturer of inhaled insulin (Exubera) announced a decision to stop selling the drug because too few people are using it. If you use inhaled insulin, work with your doctor to adjust your diabetes treatment plan as soon as possible. In the meantime, it's safe to continue using inhaled insulin as directed.

Healthy eating
Contrary to popular perception, there's no diabetes diet. You won't be restricted to a lifetime of boring, bland foods. Instead, you'll need plenty of fruits, vegetables and whole grains — foods that are high in nutrition and low in fat and calories — and fewer animal products and sweets. In fact, it's the best eating plan for the entire family. Even sugary foods are OK once in a while, as long as they're included in your meal plan.

Yet understanding what and how much to eat can be a challenge. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle. Once you've covered the basics, remember the importance of consistency. To keep your blood sugar on an even keel, try to eat the same amount of food with the same proportion of carbohydrates, proteins and fats at the same time every day.

Physical activity
Everyone needs regular aerobic exercise, and people who have type 1 diabetes are no exception. Get your doctor's OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes of aerobic exercise most days of the week. Stretching and strength training exercises are important, too. If you haven't been active for a while, start slowly and build up gradually.

Remember that physical activity lowers blood sugar. If you begin a new activity, check your blood sugar level more often than usual for a few weeks. You might need to adjust your meal plan or insulin doses to compensate for the increased activity.

Transplantation
The only potential cure for type 1 diabetes is a pancreas transplant. Other types of transplants are being studied as well.
Pancreas transplant.
With a successful pancreas transplant, you would no longer need insulin therapy. But pancreas transplants aren't always successful — and the procedure poses serious risks. You'd need a lifetime of potent immune-suppressing drugs to prevent organ rejection. These drugs can have serious side effects, including a high risk of infection and organ injury. Because the side effects can be more dangerous than the diabetes, pancreas transplants are usually reserved for people whose diabetes can't be controlled or those who have serious complications.
Islet cell transplant.
The islet cells are special cells in the pancreas that make insulin. Researchers are experimenting with islet cell transplants, which provide new insulin-producing cells from a donor pancreas. Although this experimental procedure has met with problems in the past, new techniques and better drugs to prevent islet cell rejection may hold promise for the future.
Stem cell transplant.
In a 2007 Brazilian study, a small number of people newly diagnosed with type 1 diabetes were able to stop using insulin after being treated with stem cells made from their own blood. Although stem cell transplants — which involve shutting down the immune system and then building it up again — can be risky, the technique may one day provide an additional treatment option for type 1 diabetes.

* http://www.mayoclinic.com/

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Diabetes prevention: 5 tips for taking control

Tweaking your lifestyle could be a big step toward diabetes prevention — and it's never too late to start.

Consider these tips.
When it comes to type 2 diabetes — the most common type of diabetes — prevention is a big deal. It's especially important to make diabetes prevention a priority if you're at increased risk of diabetes, for example, if you're overweight or have a family history of the disease. In the United States alone, experts at the Centers for Disease Control and Prevention expect diabetes to affect more than 48 million people by 2050.

Tweaking your lifestyle could be a big step toward diabetes prevention — and it's never too late to start. Diabetes prevention is as basic as losing extra weight and eating more healthfully.

Consider the latest diabetes prevention tips from the American Diabetes Association.

Tip 1: Get more physical activity
There are many benefits to regular physical activity. It can help you lose weight but even if it doesn't, it's still important to get off the couch. Whether you lose weight or not, physical activity lowers blood sugar and boosts your sensitivity to insulin — which helps keep your blood sugar within a normal range.
Research shows that both aerobic exercise and resistance training can help control diabetes, but the greatest benefits come from a fitness program that includes both.
Fitness programs: 5 steps to getting started

Tip 2: Get plenty of fiber
It's rough, it's tough — and it may reduce the risk of diabetes by improving your blood sugar control. Fiber intake is also associated with a lower risk of heart disease. It may even promote weight loss by helping you feel full. Foods high in fiber include fruits, vegetables, beans, whole grains, nuts and seeds.
Dietary fiber: An essential part of a healthy diet

Tip 3: Go for whole grains
Although it's not clear why, whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains. Many foods made from whole grains come ready to eat, including various breads, pasta products and ready-to-eat cereals. Look for the word "whole" on the package and among the first few items in the ingredient list.
Whole grains: Hearty options for a healthy diet

Tip 4: Lose extra weight
If you're overweight, diabetes prevention may hinge on weight loss. Every pound you lose can improve your health. And you may be surprised by how much. In one study, overweight adults who lost a modest amount of weight — 5 percent to 10 percent of initial body weight — and exercised regularly reduced the risk of developing diabetes by 58 percent over three years.
Weight loss: 6 strategies for success

Tip 5: Skip fad diets and make healthier choices
Low-carb, low-glycemic load or other fad diets may help you lose weight at first, but their effectiveness at preventing diabetes isn't known; nor are their long-term effects. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients. Instead, think variety and portion control as part of an overall healthy-eating plan.
Food pyramid: An option for better eating

* http://www.mayoclinic.com/

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DIABETES TYPE 2

Type 2 diabetes mellitus was once called adult-onset diabetes. Now, because of the epidemic of obesity and inactivity in children, type 2 diabetes mellitus is occurring at younger and younger ages.

Although type 2 diabetes mellitus typically affects individuals older than 40 years, it has been diagnosed in children as young as 2 years of age who have a family history of diabetes.

Type 2 diabetes is characterized by peripheral insulin resistance with an insulin-secretory defect that varies in severity. For type 2 diabetes mellitus to develop, both defects must exist: all overweight individuals have insulin resistance, but only those with an inability to increase beta-cell production of insulin develop diabetes. In the progression from normal glucose tolerance to abnormal glucose tolerance, postprandial glucose levels first increase. Eventually, fasting hyperglycemia develops as inhibition of hepatic gluconeogenesis declines.

About 90% of patients who develop type 2 diabetes mellitus are obese. Because patients with type 2 diabetes mellitus retain the ability to secrete some endogenous insulin, those who are taking insulin generally do not develop DKA if it is stopped. Therefore, they are considered to require insulin but not to depend on insulin. Moreover, patients with type 2 diabetes mellitus often do not need treatment with oral antidiabetic medication or insulin if they lose weight or stop eating.

Maturity-onset diabetes of the young (MODY) is a form of type 2 diabetes mellitus that affects many generations in the same family with an onset in individuals younger than 25 years. Several types exist. Some of the genes responsible can be detected by using commercially available assays.

Causes

The major risk factors for type 2 diabetes mellitus are the following:
Age

Older than 45 years (though, as noted above, type 2 diabetes mellitus is occurring with increasing frequency in young individuals)

Obesity

Weight greater than 120% of desirable body weight (true for approximately 90% of patients with type 2 diabetes mellitus)

Family history of type 2 diabetes in a first-degree relative (eg, parent or sibling)Hispanic, Native American, African American, Asian American, or Pacific Islander descent

History of previous impaired glucose tolerance (IGT) or impaired fasting glucose (IFG)Hypertension (>140/90 mm Hg) or dyslipidemia (high-density lipoprotein [HDL] cholesterol level <40>150 mg/dL)History of GDM or of delivering a baby with a birth weight of >9 lbPolycystic ovarian syndrome (which results in insulin resistance)

Frequency

United States
In 2005, people with diabetes were estimated to account for 7% of the US population, or approximately 20.8 million people. Of these 20.8 million people, 14.6 million have a diagnosis of diabetes, and diabetes is undiagnosed in another 6.2 million. Approximately 10% have type 1 diabetes, and the rest have type 2. Additionally, an estimated 54 million people have pre-diabetes. Pre-diabetes, as defined by the American Diabetes Association, is that state in which blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes.

Mortality/Morbidity

The morbidity and mortality associated with diabetes are related to the short- and long-term complications. Complications include the following:
Hypoglycemia and hyperglycemiaIncreased risk of infectionsMicrovascular complications (eg, retinopathy, nephropathy)Neuropathic complicationsMacrovascular disease (eg, coronary artery disease, stroke)Diabetes is the major cause of blindness in adults aged 20-74 years, as well as the leading cause of nontraumatic lower-extremity amputation and end-stage renal disease (ESRD).

Race

Type 2 diabetes mellitus is more prevalent among Hispanics, Native Americans, African Americans, and Asians/Pacific Islanders than in non-Hispanic whites.

Sex

The incidence is essentially equal in women and men in all populations.

Age

Type 2 diabetes mellitus is becoming increasingly common because people are living longer, and the prevalence of diabetes increases with age.It is also seen more frequently now than before in young people, in association with the rising prevalence of childhood obesity.

Although type 2 diabetes mellitus still occurs most commonly in adults aged 40 years or older, the incidence of disease is increasing more rapidly in adolescents and young adults than in other age groups.

* http://www.mayoclinic.com/

* www.emedicine.medscape.com/article/766143-overview

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Type 1 diabetes

Type 1 diabetes often develops in children, adolescents, and young adults, so it's sometimes called "juvenile diabetes." Diabetes is not contagious. You cannot catch diabetes from someone who has it. Researchers continue to study how and why diabetes occurs in certain children and families. Although diabetes cannot be cured, it can be controlled.

About Blood Sugar Levels

A healthy pancreas produces insulin, a hormone that the body uses to change glucose in the blood into energy. Glucose in the blood comes from the food and drink a person consumes. A person with type 1 diabetes doesn't produce any insulin. Without insulin, the glucose builds up in the blood, causing high blood sugar, or hyperglycemia. Blood sugar levels that are too high and untreated for long periods of time can lead to ketoacidosis, a very serious condition. Very high blood sugars for an extended period of time can eventually lead to coma and death.
In people without diabetes, the pancreas maintains a "perfect balance" between food intake and insulin. When a person eats, the pancreas puts out the exact amount of insulin needed to turn the glucose into energy. If the per­son eats a lot, the pancreas puts out a lot of insulin. If the person eats just a little, the pancreas puts out just a little insulin.

Insulin Needs

Since people with type 1 diabetes can't produce their own insulin, they must put insulin into the blood stream through injections or an insulin pump. If people with type 1 diabetes inject too much insulin (or eat too little) they may have a hypoglycemic reaction. Hypoglyce­mia (low blood sugar) is the most common problem in children with diabetes. It can be very serious and requires imme­diate action.
People with type 1 diabetes often struggle to determine how much insulin to inject. In a simple and perfect world, this question would have an easy answer (e.g. always eat a certain amount of food and inject a certain amount of insulin). However, in reality there is no way to know how much insulin to inject with 100% accuracy. Many factors influence how much insulin people need to get to the desired "perfect balance" of glucose and insulin. These factors include foods with different absorp­tion rates as well as the effects of stress, illness, and exercise. Also, as children grow, their insulin needs change. Since determining how much insulin the body needs to "balance" the amount of glucose is really a best guess, sometimes the guess is inaccurate and high or low blood sugar results.

Difficult to Manage
Despite rigorous attention to maintaining a meal plan and exercise regimen, and always injecting the proper amount of insulin, many other factors can adversely affect efforts to tightly control blood sugar levels including: stress, hormonal changes, periods of growth, physical activity, medications, illness/infection, and fatigue.

Statistics
As many as 3 million Americans may have type 1 diabetes.
Each year more than 15,000 children are diagnosed with diabetes in the U.S. That's 40 children per day.

Warning signs of type 1 diabetes include:

extreme thirst, frequent urination, drowsiness or lethargy, increased appetite, sudden weight loss for no reason, sudden vision changes, sugar in urine, fruity odor on breath, heavy or labored breathing, stupor or unconsciousness. These may occur suddenly.

Risk of Complications
High blood sugar levels over a number of years can cause serious damage to the body's organ systems. This damage may cause complications affecting the heart, nerves, kidneys, eyes, and other parts of the body. A number of studies, however, have proven that careful monitoring and control of blood sugar levels greatly reduces the threat of these complications. Researchers are also making progress at developing new treatments and technologies to help people with diabetes stay healthy. It's important to remember that people with diabetes can lead active and productive lives, just like anyone else.

http://www.jdrf.org/

http://www.nlm.nih.gov/medlineplus/diabetestype1.html

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DIABETES

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 23.6 million children and adults in the United States, or 7.8% of the population, who have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, unfortunately, 5.7 million people (or nearly one quarter) are unaware that they have the disease.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.
In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

Major Types of Diabetes
Type 1 diabetes
Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.
Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.
Gestational diabetes
Immediately after pregnancy, 5% to 10% of women with gestational diabetes are found to have diabetes, usually, type 2.
Pre-diabetes
Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.

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