Friday, November 26, 2010

Diabetes - The Chronic Killer

Diabetes mellitus or DM is a disease affecting multi-organ systems due to the abnormal insulin production, improper insulin usage or even both. It is a very serious health problem throughout the world effecting thousands of people.A survey conducted in United States showed that almost 6.2% of the population suffers from this disease. It is a matter of great issue that almost one -third of the population is unaware of the disease.
Incidence

Diabetes is actually the fifth leading cause of deaths in the country of United States. And the real incidence is expected to have a steady increase in the coming years. Diabetes has a very important role in leading to heart disease, adult blindness, stroke, non traumatic amputation of lower limb etc. it is found that diabetic people do have a risk of almost two fold to develop coronary artery disease and that too with more than 65% suffering from high blood pressure.
Diabetes - a short review
Diabetes mellitus are of mainly three types, they include type 1 diabetes mellitus, type ii diabetes mellitus, gestational diabetes and also secondary diabetes. Gestational diabetes as its name refers to deals with the diabetic episode during pregnancy or during the gestational period. It will subside once after delivery. Secondary diabetes is another form of diabetes where diabetes will occur secondary to other diseases, for instance chronic hypertension.
Type I diabetes mellitus or juvenile diabetes
It is known as juvenile diabetes since it is more common among the juveniles or young people below 30 years of age. It is insulin dependent diabetes with a peak onset during the age group of 11 to 13. Type I diabetes is caused due to the progressive destruction of pancreatic beta cells that occurs by the auto immune mechanism. Clinical symptoms include increased frequency in urination or polyuria, excessive thirst or polydipsia, increased hunger or polyphagia, weight loss, fatigue etc are seen. Ketoacidosis is a very serious complication seen in children due to diabetes and is often life threatening and may lead to metabolic acidosis.
Type II diabetes mellitus
Over 90% of diabetes mellitus is type ii diabetes.here the pancreas continues to produce insulin,but this amount of insulin is either poorly used up by tissues or is either inadequate for bodily needs. There are mainly three abnormalities or factors leading to type ii diabetes mellitus. One of them is insulin resistence, where insulin receptors are either minimal in number or will remain unresponsive. Another factor is the poor ability of pancreas to produce insulin. The final factor comes with inappropriate glucose production by the liver.
Risks related to diabetes
When we analyze the analyze risk group for developing diabetes mellitus, a condition that requires primary importance is impaired glucose tolerance or IGT. It is a disease condition caused by the mild alteration of beta cell function. Here the blood glucose level is usually high but not to a level to be called as a case of diabetes. But most people with impaired tolerance for glucose have a high risk for developing type ii diabetes within the next 10 years.
Another important risk related to diabetes is insulin resistance syndrome, also known by the name syndrome x,it is in fact a cluster of abnormalities which will act in a synergistic manner so a stop increase the risk of cardiovascular disease. It is usually charactracterised by increase insulin levels, high amount of triglycerides, hypotension.
Once identified, then complete cure of the disease is not so easy though proper measures can help you to control diabetes in a very effective way. Though there are many environmental as well as genetic factors involved in causing diabetes, exercises. Balanced diet, adequate rest and sleep and a stress less life could help you to keep away from diabetes or to stop diabetes.
There are a lot of management measures for diabetes control. It chiefly includes nutritional therapy, exercise therapy, oral anti-glycemic agents, insulin treatment etc. therefore a collaborative management is usually preferred for treating diabetes mellitus. Nutritional therapy is one of the main management for diabetes mellitus.
Diabetic diet
Diabetic diet management is one of the main components of the collaborative management. Some of the general guidelines for diabetic diet include the following.
  • Fiber rich diet: Always include the fiber rich food in the diet as it could increase the bulk of your stomach and can add on to your satisfaction.
  • Restrict sodium intake up to even 2400mg/dl.
  • Include whole grains, fresh fruits and vegetables in the diet.
  • There is an alternative mode of planning the diabetic diet which is considered as one of the convenient method. This often referred as plate method. The most important advantage of this method is that here the patient itself could visualize the amount of starch, vegetables, and whatever food filled in the nine inch plate.
  • For lunch and the dinner, half of the plate is to be filled with non starchy vegetables, one fourth with starch and another one fourth with any non vegetarian items up to 2-4 oz. A single glass of milk with low fat and a small piece of fresh fruits could complete the meals.
  • When we look on to the breakfast, the plate has to be filled with starch around half and another one forth with optional proteins.
  • This plate method is found to be very useful as it could owe about 1200-1400 cal/day, which adds on to an appropriate balanced diet plan.
Nutritional therapy can do much to control diabetes. But there is a small variation in the diet plans of patient s with type I diabetes and type ii diabetes. When we consider total calories, type I diabetic people needs increased calorie intake because it commonly occur in young people and therefore for the proper maintenance and restoration of tissues, diet with good calorific value is important. While in the case of type ii people, this is often restricted for obese or overweight people.
Effect of diet is very much crucial in type I diabetes as not only food control but also insulin therapy is also a must in type I diabetes. Uniform timing for meals is considered very strict in the case of type I diabetes mellitus because of the multi doses of insulin's but this is just desirable for type II diabetes mellitus. If needed, intermittent snack can be taken for diabetic patients with type I form, though it is not much recommended for type II diabetes. Usually the frequent snack is not recommended for type diabetic people.
It should very seriously note that diet teaching should not only focus on the patients but also to his family and caregivers. It is most suitable to give adequate teaching to the person who is cooking and serving. But still, the ultimate responsibility to maintain their blood glucose fall on to the patients. Try to avoid alcohol also since it could again worsen your body and health by causing hyper glyceridemia. Besides all these, regular exercises, strict drug regime, periodic screening etc should be done to control diabetes and its effects. Diabetes if monitored and maintained in a very appropriate way, it could be effectively controlled.

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