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Diabetes can be a real threat to the cardiovascular system. It comes on slowly and can wreak havoc with the bodies systems before the individual knows that they even have diabetes. Diabetes can cause harm not only to the cardiovascular system but the eyes, the nerves, the kidneys, and impede the healing process. A clinical sign that someone may have diabetes is that they may have a difficult time healing from the slightest of skin injuries. People that have diabetes are at a two to four fold increase to developing heart disease or having a stroke. The advantage that pre-menopausal women have over men is diminished when they have diabetes. (1)

According to Christopher Saudek, M.D professor of medicine at Johns Hopkins University in Baltimoore and past president of The American Diabetes Association (ADA), having diabetes is such a strong risk factor for heart disease that it is equivalent to already having had a heart attack. Just why diabetes causes heart disease on such a destructive is unknown. Dr. Robert H. Eckel, M.K., professor of medicine at the University of Colorado Denver and past president of the American Heart Association., says it is a complicated connection.

From a physics standpoint, it can be seen that the heart is muscle and one that is reposonispible for pumping blood to the entire body. Since muscles need glucose to move and expend energy, it can be inferred what when there is a problem with he functioning of glucose iin the body, there will also be a problem with the heart as well.

There are those people that are insulin resistant. This implies that their bodies do not respond to insulin like other people. Insulin is responsible for putting sugar or glucose back into the cells instead of having it run rampant throughout the system. “Insulin resistance leads to vascular dysfunction, which indicate that there is an altering of the function of the blood vessels to respond normally to the bodies hormonal signals that tell veins to expand and or contract,” notes, David M. Nathan, M.D. , professor medicine at Harvard Medical School and director of the Massachusetts general hospital Diabetes Center. It also leads to systemic, inflammation, as measured by levels of C=reactive protein and inflammatory cytokines. In this scenario, when type 2 diabetes develops there is a system of cascading events that effects many systems and causing such untoward effects such as high blood pressure, kidney disease, and heart disease.

Given as such wide spread evidence on the effects of diabetes on the cardiovascular system and other body functions, the reality of taking precautionary health measures becomes important. An estimated two out of every three adults with diabetes have hypertension. Diabetic dyslipidemia requires frequent blood work so that the individual knows what their levels of good cholesterol (LDL) and bad cholesterol (HDL) are. When the two are out of sync, a condition called atherosclerotic heat disease can occur. These people are usually candidates for heart bypass surgery, since their arteries become clogged.

In summary, those people with diabetes should take an active role in controlling their disease process. They can do this by getting regular fasting blood glucose levels and having their HDL and LDL tested. Normal values of these cholesterol levels are as follows; total cholesterol should be under 200; LDL under 200 and HDL above 50 for women, 40 for men, and triglycerides below 150. if your LDL, HDL and triglyceride levels are also at desirable levels and you have no other risk factors for heart disease, total blood cholesterol below 200 mg/dL puts you at relatively low risk of coronary heart disease. Even with a low risk, however, it is still smart to eat a health diet, avoid tobacco smoke and try to exercise daily… Have your cholesterol levels checked every five years or as your doctor recommends, and get regular fasting blood glucose levels. This preventative health maintenance should help increase your lifespan and provide many healthy and fulfilling years.

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Diabetes mellitus is a chronic disease in which patients present with absolute or relative insulin deficiency. It effects about 6% of western populations and is a major contributing factor for heart attacks, strokes, kidney failure and peripheral vascular disease. Diabetes mellitus is also the leading cause of new blindness.

1. Types of Diabetes
There are four forms of the disease, classified as: types 1 and 2, gestational and other specific types.

a. Type 1 Diabetes
In people with type 1 diabetes the pancreas is not producing insulin, so blood glucose levels are higher than normal. People with this form of diabetes require daily insulin therapy to survive. This form is further split into idiopathic diabetes and immune mediated diabetes.

Type 1 accounts for around 10% to 15% of all people with diabetes. It is one of the most serious and common chronic diseases of childhood, with about half of the people with this form of diabetes developing the disease before age 18. It is also known as insulin dependent diabetes mellitus (IDDM) or juvenile-onset diabetes.

b. Type 2 Diabetes
Type 2 diabetes is marked by reduced levels of insulin (insulin deficiency) and/or the inability of the body to use insulin properly (insulin resistance). This form of the disease is most common among people aged 40 years and over and accounts for 85% to 90% of all people with diabetes. Most people with type 2 diabetes are obese.

c. Gestational Diabetes
Gestational diabetes occurs during pregnancy in about 3% to 8% of females not previously diagnosed with diabetes. It is a temporary form of diabetes and usually disappears after the baby is born. However, it is a marker of much greater risk of developing Type 2 diabetes later in life. Screening tests for gestational diabetes are usually performed around the 24th-28th week of pregnancy.

d. Other Specific Diabetes Types
This includes people who have diabetes as a result of a genetic defect, or exposure to certain drugs or chemicals.

2. Causes of Diabetes Mellitus
Diabetes is caused by resistance to, or deficient production of, the hormone insulin, which helps glucose move from the blood into the cells.

In type 1 immune mediated diabetes, pancreatic beta cell destruction results in failure to release insulin and ineffective transport of glucose. There is no known cause for idiopathic diabetes.

In type 2 diabetes, the beta cells release insulin but, receptors are insulin resistant and glucose transport is variable and inefficient. Some people may have conditions that can cause diabetes, such as Cushing’s syndrome, pancreatitis or liver disease.

Risk factors for type 2 diabetes include;

a. Obesity
b. History of Gestational diabetes
c. Lack of physical activity
d. Hypertension
e. Age 45+
f. Ethnic groupings other than anglo-saxon
g. Low HDL cholesterol levels
h. Impaired glucose tolerance
i. Family history

3. Signs and Symptoms of Diabetes
Symptoms of diabetes include; dehydration, unexplained weight loss, excessive thirst, frequent need to urinate, fatigue, lethargy, severe irritation and itching, excessive hunger, blurred vision, skin and urinary infections and vaginitis.

4. Diagnosis
Diabetes or impaired glucose tolerance may be detected on routine blood tests as part of a general health check up or investigation for other symptoms or diseases. Diabetes tests check blood glucose levels.

Fasting blood glucose levels are classified as:
Normal: less than 100 mg/dl
Prediabetes: 100 to 125 mg/dl
Diabetes: greater than 125mg/dl

Because symptoms can be mild, diabetes is often detected when a person suffers a problem that is caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing or a foot ulcer, certain eye problems, certain fungal infections, or delivering a baby with macrosomia or hypoglycemia.

5. Diabetes Treatment
Effective treatment endeavors to normalize blood glucose and reduce complications using insulin replacement, diet and exercise. For those with very mild diabetes, diet plus weight loss plus exercise may be enough to keep blood glucose within reasonable levels.

Dietary changes should focus on the ideas of weight loss and blood sugar regulation by keeping the blood sugar levels relatively stable throughout the day, avoiding big peaks or troughs.

The principal treatment of type 1 diabetes, even from its earliest stages, is replacement of insulin combined with careful monitoring of blood glucose levels using blood testing monitors.

Type 2 diabetes may require oral anti-diabetic drugs to stimulate body insulin production and increase insulin sensitivity. Various forms of natural supplements for diabetes treatment have also been postulated as effective.

People with unstable diabetes, or those requiring many injections a day, may benefit from an insulin pump which is worn on the body and delivers a continuous infusion of insulin via a needle implanted into the body.

Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy. Even though it may be transient, untreated gestational diabetes can damage the health of the fetus or the mother.

Treatment for all forms of diabetes need not significantly impair normal activities, if sufficient patient training, awareness, appropriate care, discipline in testing and dosing of insulin is taken

6. Complications
Diabetes mellitus is the most common cause of adult kidney failure worldwide in the developed world. If undetected or poorly controlled, diabetes can lead to blindness, kidney failure, lower limb amputation, heart attack, stroke and impotence.

Dick Aronson has a background of over 35 years in various facets of the Healthcare industry. He set up and ran clinical trials in more than 20 countries and he has also founded a number of small private health related businesses. Dick now runs a number of informative health websites Go to Health Innovations Online and he has a herbal health store at Visit the Herbal Health Store

Gestational diabetes is a rapidly-growing problem among mothers today, probably due to the relative overweight of modern moms as well as the relative age of mothers. Women who are inclined to be diabetic or who are older are both more likely to get this troublesome disease. This is not quite the same as full-blown diabetes, though some of the symptoms are the same. However, it can cause some very special problems in both mother and baby.

Treating gestational diabetes requires you to follow several directions:

- Eat 6 small meals per day, throughout the day.
- Eat a very balanced diet, following the new modified FDA food pyramid
- Know what your portion sizes are
- Always start the day with a high-protein, high-carb breakfast; no juice or sugars
- Check your blood sugar regularly, as the doctor suggested
- Exercise
- Be mentally prepared if your doctor tells you it’s time for insulin shots

What Causes Gestational Diabetes?

Gestational diabetes is triggered by the placenta, which is an organ in itself, producing hormones that make your body more resistant to insulin so that you need more. If your pancreas cannot keep up with the increased demand, instead of the glucose you ingest being processed properly by insulin, it remains in the bloodstream. This can cause a number of problems, from high-birthweight babies forcing C-sections to respiratory distress syndrome in the baby to a much increased chance of preeclampsia in the mother. Left untreated, both mother and baby are at risk of death.

It is critical to treat gestational diabetes yourself with diet and exercise, no matter what medications the doctor also offers you. The ideal way to treat gestational diabetes is to self-regulate your sugar level by being very careful of what you eat and when.

Eating For Gestational Diabetes

Use a basic carbohydrate counting reference sheet. Your doctor may have given you one; if he did not, you can order them from the American Diabetes Association. This will tell you which foods are carbs, proteins, and fats, and help you select appropriate serving sizes. It will also help you follow the USDA food pyramid. Make sure, too, that you always read food labels.

When is not so complicated. Eat six times a day, including within an hour of getting up and within an hour of going to bed. If you have trouble eating smaller portions, prepare three regular meals and eat half of them at a time. Eat the same number of carbohydrate servings at each meal. And start your day with a meal including one protein and one complex carbohydrate (for instance, one egg and a slice of wheat toast).

Other Gestational Diabetes Treatments

Make sure that you also exercise every day. This doesn’t have to be fancy. You can just spend a half hour strolling through your neighborhood, or swim for a little while, or whatever you enjoy. The key is just to do it every day, not to slack off because you don’t feel well. You’re pregnant! You’re going to feel bad from time to time.

Finally, make sure you treat your diabetes exactly the way your doctor recommends: by testing every day, coming to every appointment, saving your urine (yuck, but necessary), and learning to give yourself shots if worst comes to worst. Just remember that everything you do is for the sake of your baby’s health.

Please consider participating in our free Diabetes Community. A lot of people
put a lot of hard work into this site. You can meet new friends and talk about
your experiences at our Diabetes
Day Forum or you can learn more about what causes diabetes.

Diabetic ketoacidosis or (DKA) is a complication of diabetes. When the individual’s blood sugar gets very high and they are profoundly deficient in insulin, the body becomes unable to utilize blood sugar efficiently.

The body then begins to burn fat stores for food. As these fat stores are burned, a by product is released called Ketones. It is ketones that are responsible for lowering the body’s pH level below 7.35. Metabolic acidosis occurs when the pH of the body drops below 7.35. The body attempts to excrete the ketones via the kidneys, causing ketones to be released in the urine, a term called ketonuria. However along with the negative ketones, the body’s positively charged electrolytes are also excreted. This leads to an electrolyte imbalance. The body continues to burn other glucose stores in the body such as proteins, causing nitrogen losses.

Now the body has depletion in electrolytes. This can cause nausea and vomiting, depleting more electrolytes. The individual is now in a severe hyperglycemic state and is hypovolemic as well. If these conditions are left untreated, the person can go into hypovolemic shock, become comatose and die.

Outward signs and symptoms of DKA include the following; eyeballs are soft and appear sunken, skin turgor is poor, (Dehydration of tissues can be tested by pinching the skin fold on the sternum. If the skin stays in one place or does not loose its shape rapidly, then dehydration can be assumed.), the person is very pale, cold, clammy, and exhibits deep rapid respirations, an effort the body makes to eliminate excess carbon dioxide. The individual may also exhibit severe abdominal pain and tachycardia, (heart rate greater than 100 beats per minute.) Diagnostic laboratory findings from arterial blood gases would indicate a pH less than 7.35, blood glucose level greater than 250 mg/dL, serum bicarbonate level less than 15 mEq/L, as well as ketones in the urine.

Interventions must be immediate to prevent irreversible destruction to the body’s organs and prevent coma or death. Ensure a patent airway, and begin to administer oxygen via nasal cannula or mask. Establish an intravenous access with a large bore needle (18 to 20 gauge). Begin fluid stabilization with 0.9 Normal Saline. This is an isotonic fluid, compatible with the body’s pH. The purpose of using an isotonic infusion initially is to re-establish blood pressure which was low and to increase urinary out put to 30-60ml/hr. When urinary output is less than 30 ml/hr, kidney failure can rapidly occur. Fluids should continue for one hour or until stabilization occurs. Next begin insulin infusion with a drip rate or 0.1U/kg/hr. During this time it is important to monitor the person’s vital signs every fifteen minutes until stable or for at least one hours after treatment begins. If necessary, potassium should be administered to correct for hypokalemia, and sodium bicarbonate to correct for metabolic acidosis, if the pH is less than 7.0. The person should also have electrocardiogram leads placed on chest to monitor heart rhythms.

When the diabetic is at home and feels these bodily signs and symptoms beginning to occur, they should take the following steps; call 911, check their blood sugar, administer insulin per sliding scale, drink an electrolytic fluid, (i.e., sports fluids), breath into a paper bag, use oxygen if available, lie down, raise feet level with the heart and wait for the ambulance.

Preventative measures to avoid DKA include consistent control of blood sugar with administration of insulin per protocol. The diabetic should avoid too much food intake, and avoid taking too much or too little insulin. Stressful life situations can also cause elevations in glucose levels. Therefore the diabetic should prepare to check their blood sugar more often during times of stress and administer insulin as prescribed.

Understanding the complications of diabetes can help the diabetic take the necessary actions to prevent DKA from occurring and help them live a healthy life.

References:

1. Lewis, Heiitkemper, Dirkesen, Medical Surgical Nursing 6th ed., Copyright 2006, Mosby, St. Louis., pages 1273 -1278.
2. www.defeatdiabetes.org/support_groups
3. www.accu-chek.com
4. www.Type2Diabetes-Info.com
5. www.ChildrensDiabetesFdn.org
6. www.diabetesinmichigan.org
7. www.diabetesmonitor.com

Pass the Nursing Entrance Test the first time with our guide at Nurses Learning Center. Written by a Professor of Education for nurses, the guide has over 600 pages with details answers to every question.

There is a solution to three of the four biggest influences on diabetes and the life of a diabetic. This disease can be prevented or at least controlled by taking a proactive stance on your life.

First and foremost is diet. Food has the most direct impact on blood sugar levels so always use your doctors guidelines to create their meal plans.

Get ready for 5-6 well balanced meals a day, ever adding up micro nutritional values to ensure balance and control of your blood sugar. How many grams of protein, carbohydrates, and fat that every meal contains should always be on your mind, but the end substantiates the means.

Once you learn how to run your body on the exact amount of fuel it needs, you can lose weight and gain muscle simultaneously. If you cut down on the calories but still get the right balance right between protein, carbs, and fats; you can just get lean and healthy.

Believe me I know what I am talking about; I lost 150 pounds 10 years ago. I have been able to keep it off because I developed a new eating lifestyle, I do not go on diets.

Second is exercise. Your exercise regimen should have three components stretching, cardiovascular, and weight lifting. There are two very important roles of stretching in the life of the diabetic.

First is increased blood flow to the extremities to prevent diabetic neuropathy and allow the movement of pharmaceuticals. The second is injury prevention.

Stretching before and after your workout is the best way to prevent injury and insure that the maximum amount of muscle fibers are exposed to stress. Do a quick warm-up walk, if time allows, before you start your stretches. The increased blood flow to your bone, muscles, and connective tissue will give you
an increase range of motion (ROM) on your stretches right off the bat.

While doing your cardiovascular training you burn fat most efficiently when your heart rate is at the correct level for your age group, typically just shy of heavy breathing in a healthy adult. If you perform your cardiovascular training at a higher heart rate, heavy breathing, your body will start to burn muscle as its primary energy source.

This is why runners carry very little muscle even though they get a tremendous workout every day, because they work over the optimal heart rate. The most important aspect of weight training is the metabolic boost you receive from an increase in muscle mass. Your body has to work hard to sustain muscle; thus your metabolism goes up to bring more oxygen and nutrients to your muscles.

The third major impact comes from stress. Stress is physical and it affects ever part of our being, mental and physical. Please do the best you can to keep to yourself happy.

Everyone knows by now that stress in our daily lives manifests itself physically. Bills, work, family, disease, etc. The more stressed you are, the more likely you are to increase your risk of making your diabetes worse.

Do your best to stay in control of your stress by the use of any technique you like, yoga, walking, working out, time with the family, hitting a punching bag; what ever makes you happy.

The fourth is heredity; if you have a family history of diabetes, you MUST alter your life to beat the odds or at least gain further control of your life. You can not change your family history, but you can control everything else that impacts your diabetes.

The reality of diabetes cannot be neglected. My hope for you is that following the suggestions and guidelines that your doctors and I set out will allow you to gain the highest possible level of diabetes control.

Take an active roll in your life; do not except the fact that this disease is going to completely control your life.

Many of my clients have been cleared by their doctors to at least decrease the level of pharmaceutical control factors. Every less blood sugar test and shot will make your life better. You need to get yourself to that point.

Control the disease, do not let it control you!

Melford Bibens is an ACE certified personal trainer. He lost 150lbs in 1996 through a self-engineered fitness and nutritional program and has kept the weight off for more than ten years.

He is the author of
, a comprehensive guide to preventing or controlling diabetes.

So, you are a diabetic. If you have just been recently diagnosed, then there is much to learn. Be careful where you get your information. The doctor should be your first source. Your doctor should prepare you with literature and other teaching material, as well as give you referrals to help groups. Being a diabetic doesn’t mean your life is going to change. It does mean that you will have to make important decisions about your health maintenance.

If your diagnoses requires that you take oral hypoglycemics then you need to know how they work, when to take them, and the signs and symptoms of hypoglycemia and hyperglycemia. For those who are required to take injections of insulin, they must learn how to give themselves injections, and take their blood glucose level. The best idea is to take it slow. All of this information may seem overwhelming at the beginning. No one expects you to know everything. Most of all be patient with yourself.

It is important to understand why you have diabetes. Diabetes whether Type I or Type II has been determined to have certain genetic links. Genetically speaking, Type I Diabetes risk to offspring from the mother is 1%-3%, risk to offspring of diabetic fathers is 4 %-6%, with identical twin concordance between 30%-50%. (1) In regards to Type II Diabetes the genetic predisposition of risk to first degree relatives is 10%-15% and identical twin concordance can exceed 90%. (1)

In Type I Diabetes the autoimmune system of the individual gradually destroys the beta cells within the pancreas. Signs and symptoms of diabetes do not begin to manifest until 80%-90% of the beta cells are destroyed. Beta cells are important because they are responsible for the production of insulin. Insulin is a hormone that controls the amount of glucose in the blood stream at any particular time. For instance, when a person indulges in a meal that is high in sugar content, there will be large amounts of circulating glucose in the blood. To protect the body from excessive amounts of glucose, there is cascade of hormonal signals that stimulate the pancreas to produce insulin and put the unused glucose back into the cell where it will stay until the body requires it. High glucose levels can put the person in danger of diabetic ketoacidosis. Excessively low levels of blood glucose can be just as dangerous as in hypoglycemia. The acceptable range of blood glucose levels considered optimum range between 90-120 mg/dl. The diagnoses of diabetes require blood tests for confirmation. Usually one of the following blood tests are done;

1. Fasting Plasma glucose level exceeding 126 mg/dl

2. Random, or casual, plasma glucose exceeding 200mg/dl, with the inclusion of the signs and symptoms of Type I Diabetes.

3. Two hour Oral Glucose Tolerance Test level exceeding 200mg/dl using a glucose load of 75mg.

Type II Diabetes is by far the most prevalent in those people diagnosed with diabetes. Also, certain populations have a predisposition to diabetes more so than others. Native Americans, Hispanics and African Americans appear to have higher rates of Type II diabetes than their non-Hispanic white counterparts.

The signs and symptoms of diabetes can differ depending on whether the person is Type I or Type II. For Type I diabetics, the symptoms include, polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger) as well as weight loss, weakness and fatigue. The signs and symptoms of Type II Diabetes are not as obvious as Type I. In Type II Diabetics, the onset is later in life. Also, their pancreas is still producing some endogenous insulin. Therefore, their symptoms are not as detectable. Symptoms include, delayed wound healing, peripheral neuropathy (decreased sensation or pain in extremities), fatigue and visual changes. or Diabetes, just like hypertension is a disease that must be treated for life. Diabetics who take proper care of themselves can live long healthy lives into their nineties.

Pass the Nursing Entrance Test the first time with our guide at Nurses Learning Center. Written by a Professor of Education for nurses, the guide has over 600 pages with details answers to every question.