Introduction
Is a metabolic disease characterized by hyperglycemia (high levels of circulating glucose) due to deranged actions and / or production of the glucose level regulating hormone, insulin. Most of the clinical features and sequelae of diabetes are due to this persistently elevated level of glucose.
A strong association between modern life style and diabetes is cited by most scientific studies.
Epidemiology
The association of type Ii diabetes and corporeal inactivity was first noted in populations who migrated from rural areas to cities and were suddenly exposed a more modern life style. A case in study is that of the Japanese living in Hawaii who have an increased risk than those living in Hiroshima. Thus, lifestyle seems to contribute more than genetics.
A study from the University of Pennsylvania complete that there is a 6% lower risk of diabetes if the weekly ingestion of calories is reduced by 500 Kcal. Other study suggests that there is a direct dose-response association between corporeal action and discount of risk for diabetes.
Types of Diabetes
Type I Diabetes Mellitus
This is characterized by absolute inability of the body to produce insulin. Pancreatic Beta cell destruction due to an autoimmune mechanism is universally approved cause of type I diabetes mellitus.
Type Ii Diabetes Mellitus
This is characterized by relative insufficiency of insulin and/ or resistance to the actions of insulin. This is the more tasteless type and affects individuals in the middle age and is dependent to a large extent on factors like race, diet and obesity.
Diagnosis of Diabetes
Fasting glucose levels of > or = 126 mg/dL (7. 0 mmol/L)
Ogtt: 2 hour plasma glucose > or = 200 mg/dL (11. 1 mmol/L)
Clinical Features
1. Polyuria
2. Polydipsia
3. Polyphagia
4. Unexplained loss of weight
5. Hypertension, coronary heart disease and stroke occur more commonly in diabetics than general population
6. Diabetic nephropathy: changes in the kidneys affecting renal function; causing end stage renal disease
7. Diabetic retinopathy: changes in the retinal arteries causing blindness
8. Diabetic neuropathy: causing damage to the peripheral motor sensory nerves and autonomic nerves; is the major cause of non-traumatic, lower limb amputations.
Management of type Ii diabetes
Is 3 fold:
1. Daily exercise
Exercise should form the basis of stoppage as well as rehabilitation of borderline cased of type Ii diabetes. Resistance training by expanding the muscle mass has a lot of definite effects in diabetes effects. Increased muscle blood flow, potential of muscle as well as mass leads to better discharge of glucose from blood without too much dependency on insulin. Furthermore, decreased abdominal fat leads to better control of insulin secretion. Exercise also causes increased insulin sensitivity in the liver and thereby reduces production of new glucose.
2. Diet
Diet containing involved carbohydrates and protein in aggregate with daily Exercise will effectively control blood glucose levels within general and also prevents the more serious sequelae. Also, ingestion of small meals straight through the day and low glycemic index foods are also good strategies.
3. Drugs
Oral hypoglycemic drugs are prescribed to keep the blood sugar levels within general limits; classified into three categories:
1. Insulin Secretogogues: cause secretion of insulin from the pancreas
2. Insulin Sensitizers: increase the sensitivity of tissue to insulin
3. Alpha-glucosidase inhibitors: delay the rate of carbohydrate absorption and digestion and thus effectively control insulin levels and thereby glucose levels.
Borderline Diabetes:Diabetes: connection With Diet and practice
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