Guide for treatment of diabetes

For couples trying to conceive , uncontrollable diabetes can create a variety of serious problems. There are a number of things a diabetic woman should do before becoming pregnant to ensure a healthy conception, birth and baby. A woman suffering from diabetes should give careful consideration to her overall health and welfare before trying to become pregnant and always follow the advice of her physician.

For a diabetic woman that wants to conceive a baby, the first step is consulting with a healthcare provider. A physician will determine if the diabetes is controlled well enough for the woman to discontinue using birth control. The urine and blood will be checked in order to determine if renal function is healthy, in order to prevent any type of kidney-related complications should the woman become pregnant.

Other things a physician will check on a diabetic woman considering pregnancy include cholesterol and triglyceride levels, an eye examination and weight. If a woman has passed all of the testing, a physician may refer her to a genetic specialist, as well as a preconception counselor to make sure she understands everything entailed by becoming pregnant. If there is any type of situation which would prevent conception, the physician might refer the woman to see a fertility specialist as well.

If a woman is overweight and diabetic, she should lose weight before becoming pregnant or trying to conceive. By losing weight, a woman prevents any hypertension complications or other high blood pressure related problems which could result from becoming pregnant. If a woman smokes or drinks alcohol, these habits will need to be discontinued before trying to become pregnant in order to ensure a healthy pregnancy and childbirth.

Before becoming pregnant, a diabetic woman should also discuss prenatal vitamins. Adding folic acid supplements to the diet of a female will dramatically decrease the risks of neural tube defects in a developing fetus. A physician will want to discuss whether prescription prenatal vitamins or over-the-counter will work sufficiently for a diabetic female.

Uncontrollable diabetes can hinder couples that are trying to get pregnant and by checking the blood sugar on a regular basis, a woman can keep her levels within healthy parameters. Good blood sugar control before becoming pregnant will have a direct impact on a woman being able to conceive and determines what the outcome will be if a female becomes pregnant. Other important things which should also be considered are dietary requirements and any medication adjustments. With time and careful planning a diabetic woman can conceive, enjoy a healthy pregnancy and give birth to the child she has always wanted.

There are so many names used to describe this new epidemic… insulin resistance, diabesity, adult onset diabetes, type 2 diabetes. Whichever name is used… all have the same issues.

Type 2 diabetes is the leading chronic condition this century. Do you know from 1983 to 2009 the number of people with type 2 diabetes worldwide increased from 35 million to 240 million? This is higher than the number of people affected by the HIV virus!

Don’t you think we should be wondering why this is happening? Why are you putting yourself at risk for this condition and its associated complications, why are you cutting your life short?

Although type 2 diabetes is more than high blood sugar levels; it involves all of the following which are almost always traceable to excessive levels of sugar in your blood stream for many years. High blood sugar levels gradually damages your blood vessels and nervous system

Type 2 diabetes affects both your small and large blood vessels. Nearly all type 2 diabetics have:

Cardiovascular Disease: Approximately one third have known heart disease. If your heart stops beating or if major blood vessels clog, you could die. Strokes are a major killer… stroke is up to four times more likely if you have type 2 diabetes. Heart attacks are a prime cause of death in middle-aged people with type 2 diabetes. A recent study showed that up to 50% of heart attack victims had high blood sugar levels at the time of their heart attack.

High Blood Pressure: Seventy-five per cent of people with type 2 diabetes have high blood pressure. Your blood pressure is a prime indicator of your heart health. Fats as well as high blood sugars cause your blood vessels to constrict… usually your health care provider will treat you and keep your blood pressure at 130/80 mmHG or less.

Blindness, kidney failure, nervous system damage, gum disease, dementia and cancer are all outcomes of uncontrolled blood sugar levels.

What is your approach to treating your type 2 diabetes? Is it to take anti-diabetic drugs or insulin? Do you take anti-hypertensives to lower your blood pressure? Statins to reduce your cholesterol level? Do you realize this is treating the symptoms rather than the cause? High blood sugar levels are symptoms of a metabolic process that is out of whack… lowering your blood sugar levels with drugs does not deal with the issues that caused the high blood sugars in the beginning.

The core of treatment for type 2 diabetes and all it encompasses, is the food you eat… what you eat affects your weight, your blood pressure, your blood sugar and cholesterol levels. These may all drop significantly with a weight loss of 10 to 15 pounds (4.5 to 7 kgs). Add 150 minutes a week of physical activity to your treatment plan and you are well on your way to preventing damage to your blood vessels and getting to the real reason you developed type 2 diabetes.

Diabetes mellitus results from either hypo-secretion or hypo-activity of insulin. After a meal, when insulin is either absent or deficient, blood glucose levels remain high because glucose is unable to enter most tissue cells. Insulin is needed for uptake by cells to happen.

Ordinarily, when blood glucose levels rise, hypoglycemic hormones are not released, but when hyperglycemia becomes excessive, you start to feel nauseated. The nausea causes your body to enter the “flight-fright-frolic” response. This is a series of changes brought about by the autonomic nervous system and prolonged by certain members of your endocrine system. The results are inappropriate because they normally occur in the hypoglycemic or fasting state to make glucose available. The nausea triggers glycogenolysis, a breakdown of glycogen, lipolysis, a breakdown of fat and gluconeogenesis when the liver creates glucose. These cause the already high glucose levels to soar even higher and excess glucose begins to leave the body in the urine which is called glucosuria.

When simple sugars, such as glucose, cannot be used as cellular fuel, more fats are mobilized and broken down for fuel. The fats produce a high fatty acid level in the blood, a condition called lipidemia or lipemia. The presence of acids in the blood increases a persons free H+ ion count which results in a lower than normal pH. This is referred to as acidosis. In severe cases of diabetes, blood levels of fatty acids and their metabolites (acetoacetic acid, acetone and others) rise dramatically. The metabolites, collectively called ketones or ketone bodies, are organic acids. They work to push down your pH even more. Your acidosis becomes more severe. Since this is due to ketones the acidosis is renamed ketoacidosis. Excess ketones spill over into the urine from the kidneys. This is called ketonuria.

Severe ketoacidosis is life threatening. One of the very good reasons to see a Diabetologist if you suspect you are starting to lose control of your condition. The severe swings in the pH of the body is a disruption of your normal homeostasis.

The severe ketoacidosis causes the nervous system to initiate rapid deep breathing (hyperpnea) to blow off carbon dioxide from the blood with the net result of temporarily increasing your pH (buffers the blood). If ketoacidosis continues unchecked it will disrupt heart activity and oxygen transport, severely depress the nervous system which leads to coma and death

Researchers have long noted that shift workers — folks like nurses, security personnel and others on the night shift — are extremely prone to developing metabolic syndrome, a pre-diabetic condition marked by insulin resistance, weight gain around the middle and high cholesterol levels. But why? Do they tend to simply eat too many snacks as they try to stay alert at night or is it related to disruption of the circadian clock, the body’s internal master clock in the brain that’s set by light exposure? Turns out, according to new research by scientists at the Salk Institute, there’s probably another crucial factor: not only is what you eat important to health but when you eat appears to be crucial to weight control and healthy metabolism.

In experiments with mice, researchers at the Salk Institute for Biological Studies discovered there’s a daily waxing and waning of thousands of genes in the liver, the organ that’s the body’s metabolic clearinghouse. And this revving up and slowing down is primarily controlled not just by food intake and not by the body’s circadian clock, as was previously assumed.

“If feeding time determines the activity of a large number of genes completely independent of the circadian clock, when you eat and fast each day will have a huge impact on your metabolism,” said the study’s leader Satchidananda (Satchin) Panda, Ph.D., an assistant professor in the Salk Institute’s Regulatory Biology Laboratory, in a press statement.

The Salk researchers’ findings, which are set for publication in an upcoming issue of the Proceedings of the National Academy of Sciences, could explain why shift workers are at an unusually high risk for metabolic syndrome, diabetes, high cholesterol levels and obesity. “We believe that it is not shift work per se that wreaks havoc with the body’s metabolism but changing shifts and weekends, when workers switch back to a regular day-night cycle,” Dr. Panda explained.

The new research involved putting mice on a strict feeding schedule. They could eat during an 8 hour period but they had to fast for the next 16 hours. The result? The scientists found that genes that encode enzymes the body needs to break down sugars soar immediately after a meal, while the activity of genes which encode enzymes needed to break down fat increases the most during fasting. Bottom line: a clearly defined daily feeding schedule causes healthy regulation of the enzymes needed for metabolism and optimizes burning of sugar and fat.

“The liver oscillator in particular helps the organism to adapt to a daily pattern of food availability by temporally tuning the activity of thousands of genes regulating metabolism and physiology,” Dr. Panda said in the statement to the press. “This regulation is very important, since the absence of a robust circadian clock predisposes the organism to various metabolic dysfunctions and diseases.”

In fact, the more defined fasting and feeding periods are, the more robust the regulation. Dr. Panda has tried the scheduled eating himself. He quit eating between 8 pm and 8 am and reported he feels great eating this way. “I even lost weight, although I eat whatever I want during the day,” he noted.