What is Diabetes?
Diabetes is a general term for an endocrine disease that is characterized by excessive urination and thirst. Many Americans suffer from this disease, as well as the limitations to one's lifestyle that accompany it. The two most commonly known forms are diabetes mellitus and diabetes insipidus.
Diabetes mellitus is a pancreatic disease primarily affecting carbohydrate metabolism. In this condition, the pancreas is unable to secrete sufficient insulin to maintain a normal blood glucose level. This results in abnormally high levels of blood sugar, causing the symptoms of thirst, hunger, emaciation, and weakness. The imperfect combustion of fats may ensue, resulting in ketosis-- high levels of ketones in the body. Difficult breathing, heart problems, and even coma may occur in the complicated stages of diabetes.
Diabetes insipidus is a condition associated with the kidney's inability to conserve water. It is caused by the failure of the hypothalamus to release anti-diuretic hormone, resulting in the passage of large amounts of urine. This is often accompanied by a voracious appetite, loss of strength, and emaciation.
Who is Diabetic?
Diabetes mellitus is far more prevalent than diabetes insipidus. It affects more than 10 million people in the United States and causes over 30,000 deaths each year; it contributes to an additional 100,000 deaths annually. Diabetes is costly for Americans-- over 18 billion dollars are spent every year to treat the disease. Its prevalence increases with age from affecting approximately .1% of the population under 17 years of age to reaching approximately 8% of persons over age 65.
The non-insulin, dependent type of diabetes usually occurs in obese people who are age 40 or older. They have higher than normal amounts of insulin in their blood but are resistant to the action of this blood sugar regulating hormone.
How is Diabetes Diagnosed?
A variety of methods, including Glucose Tolerance Tests, have been used to diagnose diabetes mellitus. The most reliable of these methods detects a blood glucose concentration greater than 140 milligrams per deciliter (normal is considered to be between 70-100 mg/dl) after an overnight fast.
How is Diabetes Treated?
After the isolation of insulin by Frederick Banting and Charles Best in 1921, incidence of death from ketoacidosis and diabetic coma decreased dramatically. The prolonged life span, however, revealed long-term complications such as kidney failure, eye disease, blindness, heart disease, gastrointestinal and nervous system disorders. Elevated blood glucose levels are believed to be at the root of these disorders. Thus, the objective of treatment for the diabetic is to restore blood glucose to normal levels.
In obese, non-insulin dependent individuals with diabetes, the treatment of choice is weight loss. If this plan is not successful, oral, blood sugar-reducing medicines are required. These hypoglycemic agents act primarily by stimulating the patient's pancreas to secrete additional insulin.
Is There a "Diabetic Diet"?
It is apparent that there are as many "diabetic diets" as there are persons with diabetes. Any dietary program is complicated by the fact that the same food may be eaten by different people and produce different responses in blood sugar levels. On-going research which investigates a food's ability to raise glucose levels (also known as glycemic index) indicates that the response is dependent upon the proportions of carbohydrate, protein and fat. For example, some individuals will spike a high blood glucose level when juice is ingested alone. However, the same juice may be better tolerated if taken with a meal which includes more protein and fat.