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Food as Medicine - Diabetes

DK PublishingDK Publishing 2/07/2014 DKBooks
Photo: Control your child’s eating - Children who snack on fatty foods, such as chips, and have a low level of activity are at risk of becoming overweight and developing diabetes. © Provided by DKBooks Control your child’s eating - Children who snack on fatty foods, such as chips, and have a low level of activity are at risk of becoming overweight and developing diabetes.

Meeting with a dietitian - Your doctor can refer you to a dietitian who will help you manage your diabetes, suggest menu plans, and teach you how to count carbohydrates.

Photo: Meeting with a dietitian - Your doctor can refer you to a dietitian who will help you manage your diabetes, suggest menu plans, and teach you how to count carbohydrates. © Provided by DKBooks Meeting with a dietitian - Your doctor can refer you to a dietitian who will help you manage your diabetes, suggest menu plans, and teach you how to count carbohydrates.

Control your child’s eating - Children who snack on fatty foods, such as chips, and have a low level of activity are at risk of becoming overweight and developing diabetes.

Diabetes

Nutrition plays a vital role in the treatment of this chronic illness.

Diabetes is a condition that affects how the body uses carbohydrates for energy. It is diagnosed when the concentration of glucose in the blood is abnormally high (more than 126mg/dL).


Role of insulin

The body’s main source of energy comes from carbohydrates, which are turned into glucose in the body. For glucose in the bloodstream to be able to enter into body cells, the hormone insulin, produced by the pancreas, is required.

Sometimes, the body cannot make enough insulin or use the insulin it does make effectively—this is known as insulin resistance—which causes blood glucose levels to rise. The reasons why insulin resistance develops are becoming more defined. It is now known that genetics, diet, and level of physical activity are all involved.

Insufficient insulin action and the resulting high blood-glucose levels can lead to diabetes. Most of the treatments for diabetes are aimed at restoring and maintaining normal blood-glucose levels.


How common is diabetes?

One of the most common chronic diseases in North America, diabetes affects about 17 million adults in the US, and is on the rise, most likely as a result of increased rates of obesity. In addition, more than 20 million adults in the US have reduced glucose tolerance and/or insulin resistance, and may have mildly elevated blood sugar levels, which is known as prediabetes.


Type 1 diabetes

This accounts for 5–10 percent of all diagnosed cases of diabetes, and is the form that is more likely to affect children and people under 30 years of age. Type 1 diabetes, also known as insulin-dependent diabetes, is due to the destruction of the insulin-producing cells of the pancreas, thus causing insulin deficiency. It can be treated with injections of synthetic insulin.

Without sufficient insulin, people with type 1 diabetes may develop weight loss, excessive thirst and hunger, frequent need to urinate, lack of energy, nausea, vomiting, and dehydration. If it is untreated or poorly controlled type 1 diabetes can also lead to ketoacidosis.


Type 2 diabetes

The development of type 2 diabetes, or noninsulin-dependent diabetes, is strongly related to lifestyle factors. Increasing the amount of exercise you do, losing weight if necessary and maintaining a healthy weight, increasing your fiber intake, and cutting down on your fat intake (particularly saturated fats), have been shown to delay or prevent the development of type 2 diabetes in susceptible people.

Type 2 diabetes accounts for 90–95 percent of all diagnosed cases of diabetes, and is the type that usually occurs in adults over age 40 who are often overweight. It is now increasingly common in overweight adolescents, too.

People with type 2 diabetes do not need insulin injections because the pancreas continues to secrete insulin. Symptoms develop slowly and are not usually obvious. Some people may simply feel tired, but when blood-glucose levels are very high symptoms similar to type 1 diabetes can develop. Eventually about 40 percent of people who have type 2 diabetes will require insulin to maintain adequate control of their blood-glucose levels.


Gestational diabetes

This type of diabetes occurs in some women during pregnancy due to an increase in hormones, some of which may have anti-insulin properties. Women who are diagnosed with elevated blood-sugar levels in pregnancy can usually control the problem with diet and exercise, although some may have to take insulin.


Jargon buster

Ketoacidosis

When the body’s tissues cannot take up glucose from the blood, fat is broken down for energy instead. The breakdown of fat produces chemicals called ketone bodies, or ketones. When these build up to high levels, a ketoacidosis occurs. The symptoms of ketoacidosis include abdominal pain, rapid deep respiration, fruity breath odor, weakness, fatigue, confusion, stupor, and shock. It can lead to severe dehydration, coma, or even death.


Who is most at risk of diabetes?

By identifying the risk factors for diabetes you can detect it early, and prevent or delay the complications of the disease.


General risk factors

Whatever your age, if you have any of the risk factors mentioned here, ask your doctor to measure the levels of glucose in your blood.

A family history of diabetes. If anyone in your family has type 2 diabetes, you should exercise regularly and maintain a healthy weight in order to minimize your risk of developing the condition.

A body mass index (BMI) above 25 . Overweight people often suffer from insulin resistance, which is associated with type 2 diabetes because the accumulated fat cells interfere with the action of insulin.

If you are a member of a high-risk ethnic group .

You have been diagnosed with gestational diabetes during pregnancy.

You have high blood pressure.

You have HDL cholesterol levels of less than 40mg/dL (men), 50mg/dL (women), and/or a triglyceride level greater than 150mg/dL (same for men and women). This could indicate metabolic syndrome and the risk of your developing type 2 diabetes and cardiovascular disease is high.

You had borderline elevated glucose levels on previous testing (prediabetes).

You are a woman with polycystic ovarian syndrome.


Age

The risk of diabetes increases with age, and those over the age of 65 have the highest rates. At age 45, you should talk to your doctor about having your blood tested for glucose levels—even if the results are normal, you should repeat this test every three years.

Children should be screened if:

They are overweight with BMI above the 85th percentile for age and gender .

They have two or more of these risk factors: family history of type 2 diabetes, from a high-risk ethnic group, signs of insulin resistance (such as gray-brown skin pigmentation around the neck).


Gender

Women with polycystic ovarian syndrome are at increased risk. The risk of gestational diabetes is more likely in overweight women and those with a family history of diabetes. Women with a history of delivering a baby weighing more than 9lb (4kg) at birth, or a history of miscarriages or stillbirths, are also at risk. If you are at risk, your doctor will measure your blood-glucose levels during pregnancy.


Ethnicity

African–Americans, Native Americans, Hispanic people, and Asian–Americans are at higher risk of diabetes than Caucasians.


Managing diabetes

Diabetes is a chronic disease requiring important changes to your lifestyle. These include diet, physical activity, managing the condition on a daily basis, and, for many people, medications.


Dealing with your condition

Taking responsibility for your diabetes will improve your quality of life both in the short- and long-term. Achieving the best possible control of your blood sugar, cholesterol, and triglyceride levels and blood pressure can prevent or delay any complications while minimizing low-blood-sugar episodes and weight gain.

Many doctors encourage people with diabetes to self-manage their condition, with the support of their family. Some doctors, in addition to giving medical care, provide their own nutrition and physical-activity programs, and you may even find that your doctor or clinic can put you in contact with dietitians, nurses, and diabetes educators, who can help you deal with living with diabetes.


Monitoring blood sugar

People with diabetes can easily and quickly monitor blood-sugar levels with a simple finger stick or blood-glucose meter. By monitoring your blood-sugar levels daily, you can determine what effect your food choices and physical activity have on your levels. These results can help you modify your diet and make adjustments to help you achieve as close to normal blood-sugar levels as possible. If you have type 1 or type 2 diabetes and are taking insulin, it is best to monitor your blood sugar three or four times a day. If you have type 2 diabetes and are taking oral medications, it may be necessary to monitor your blood sugar only a few times a week.

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