Diabetes Discussion

About Diabetes Discussion

This site contains information from government publications about diabetes that have been reformatted and reorganized. There are numerous links to the original documents.

The goal is to make the information easier to find and to allow the sharing of information between users.

This is a very big undertaking and you can help me help others. Please add your comments or questions to any topic that concerns you. If you know of additional resources please include links to them.

I am especially looking for:

Experiences of diabetes patients
Experiences of family members of diabetes patients
Experiences of caregivers experienced with diabetes
Experiences of physicians experienced with diabetes
Experiences of researchers experienced with diabetes

Information about specific diabetes products
Information about specific diabetes treatments
Information about specific diabetes medications
Information about hospitals specializing in the detection and treatment of diabetes
Information about clinics specializing in the treatment of diabetes
Information about physicians specializing in the treatment of diabetes

If possible please include:

Links to diabetes websites
Links to diabetes blogs
Links to diabetes news articles
Links to diabetes research articles

Drug protects kidneys of people with diabetes

NEW YORK (Reuters Health) - Kidney damage is a constant danger for people with diabetes, especially when their blood pressure is high. Now European researchers report that the addition of a drug, spironolactone, to standard blood pressure-lowering therapy for such patients helps reduce both blood pressure and the amount of albumin protein in urine, a measure of kidney impairment.

Dr. Kaspar Rossing of Steno Diabetes Center in Gentofte, Denmark, and colleagues note in the medical journal Diabetes Care that two types of antihypertensive drugs -- ACE inhibitors and angiotensin receptor blockers (ARBs) -- have protective effects on the kidneys in diabetics who already have kidney damage.

These drugs work by controlling the release of a hormone called aldosterone. While they're effective initially, aldosterone levels may subsequently rise once more in almost 40 percent of patients, resulting in greater urinary protein levels and a faster decline in kidney function.

full story>>>

FDA panel backs diabetes drug

SILVER SPRING, Md. (Reuters) - An experimental diabetes pill to lower blood sugar and certain blood fats won support on Friday from U.S. advisers despite concerns that it might contribute to heart failure.

full story>>>

FDA Panel Greenlights Diabetes Inhaler

September 9, 2005

Relief could be at hand for millions of diabetics who must be injected daily with insulin. A Food and Drug Administration advisory panel has recommended approval of a new insulin delivery system in which the substance would be inhaled rather than injected with needles.

full story>>

Cellular energy rate down with diabetes

NEW HAVEN, Conn., Aug 25, 2005 (United Press International via COMTEX) -- The rate of insulin-stimulated energy production is reduced in the muscles of lean, healthy young U.S. adults who have already developed insulin resistance.

Diabetes is a disorder of metabolism—the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

Diabetes-N-More

Diabetes-N-More is a great collection of information.  It features well written summaries of news articles.

“The Cure” for Type 1? islet cell transplantation

Diabetes Mine has a great discussion of islet cell transpantation as a possible cure for type 1 diabetes.

This looks to be the first completely successful islet cell transplantation. Previous patients escaped from hypoglycemia but continued to require insulin in small doses.

Diabetes Mine

This is a great blog from a recently diagnosed diabetic.

Noninvasive Blood Glucose Monitors

Noninvasive monitors check blood glucose levels without puncturing the skin for a blood sample.

Your Guide to Diabetes: Type 1 and Type 2

This guide will help you learn how to take care of your diabetes and how to prevent some of the serious problems that diabetes can cause.

Where to Get More Help With Your Diabetes

People who can help you with diabetes.

Organizations that can help you with diabetes.

Why It's Important to Take Care of Your Diabetes

Taking care of your diabetes every day will help keep your blood glucose in your target range and help prevent other health problems that diabetes can cause over the years. This part of the guide describes those problems. We tell you about them not to scare you, but to help you understand what you can do to keep them from happening.

When Your Blood Glucose Is Too High or Too Low

Sometimes, no matter how hard you try to keep your blood glucose in your target range, it's too high or too low. Blood glucose that's too high or too low can make you very sick. Here's how to handle these emergencies.

What Is Diabetes?

The signs of diabetes are

being very thirsty
urinating often
feeling very hungry or tired
losing weight without trying
having sores that heal slowly
having dry, itchy skin
losing the feeling in your feet or having tingling in your feet
having blurry eyesight

You may have had one or more of these signs before you found out you had diabetes. Or you may have had no signs at all. A blood test to check your glucose levels will show if you have pre-diabetes or diabetes.

Taking Care of Your Diabetes at Special Times

Diabetes is part of your life. It's very important to take care of it when you're sick, when you're at school or work, when you travel, or when you're pregnant or thinking about having a baby. Here are some tips to help you take care of your diabetes at these times.

Pancreatic Islet Transplantation

The pancreas, an organ about the size of a hand, is located behind the lower part of the stomach. It makes insulin and enzymes that help the body digest and use food. Spread all over the pancreas are clusters of cells called the islets of Langerhans. Islets are made up of two types of cells: alpha cells, which make glucagon, a hormone that raises the level of glucose (sugar) in the blood, and beta cells, which make insulin.

In an experimental procedure called islet transplantation, islets are taken from a donor pancreas and transferred into another person. Once implanted, the beta cells in these islets begin to make and release insulin. Researchers hope that islet transplantation will help people with type 1 diabetes live without daily injections of insulin.

Insulin Resistance and Pre-Diabetes

Insulin resistance is a silent condition that increases the chances of developing diabetes and heart disease. Learning about insulin resistance is the first step you can take toward making lifestyle changes that will help you prevent diabetes and other health problems.

Hypoglycemia

Hypoglycemia, also called low blood sugar, occurs when your blood glucose (blood sugar) level drops too low to provide enough energy for your body's activities. In adults or children older than 10 years, hypoglycemia is uncommon except as a side effect of diabetes treatment, but it can result from other medications or diseases, hormone or enzyme deficiencies, or tumors.

Glucose Meters & Diabetes Management

When people with diabetes can control their blood sugar (glucose), they are more likely to stay healthy. People with diabetes use two kinds of management devices: glucose meters and other diabetes management tests. Glucose meters help people with diabetes check their blood sugar at home, school, work, and play. Other blood and urine tests reveal trends in diabetes management and help identify diabetes complications.

Gestational Diabetes Discussion

Gestational (jes-TAY-shun-ul) diabetes is diabetes that is found for the first time when a woman is pregnant. Out of every 100 pregnant women in the United States, three to eight get gestational diabetes. Diabetes means that your blood glucose (also called blood sugar) is too high. Your body uses glucose for energy. But too much glucose in your blood can be harmful. When you are pregnant, too much glucose is not good for your baby.

Financial Help for Diabetes Care

Diabetes treatment is expensive. According to the American Diabetes Association, people who have this disease spend an average of $13,243 a year on health care expenses. Many people who have diabetes need help paying some of the bills. It's a good idea to start by looking for an insurance plan that covers as many diabetes-related expenses as possible. A variety of governmental and nongovernmental programs exist to help, depending on whether you qualify.

How to Control Your Diabetes

If you have just found out that you have diabetes you may be upset and need some help. Even if you have lived with diabetes for a while you may want to do more to take care of yourself.

What I need to know about Physical Activity and Diabetes

How can I take care of my diabetes?

Diabetes means that your blood glucose (also called blood sugar) is too high. Your body uses glucose for energy. But having too much glucose in your blood can hurt you. When you take care of your diabetes, you'll feel better. You'll reduce your risk for problems with your kidneys, eyes, nerves, feet and legs, and teeth. You'll also lower your risk for a heart attack or a stroke. You can take care of your diabetes by

being physically active
following a healthy meal plan
taking medicines (if prescribed by your doctor)

What I need to know about Eating and Diabetes

Whether you have type 1 or type 2 diabetes, what, when, and how much you eat all affect your blood glucose. Blood glucose is the main sugar found in the blood and the body's main source of energy.

If you have diabetes (or impaired glucose tolerance), your blood glucose can go too high if you eat too much. If your blood glucose goes too high, you can get sick.

Your blood glucose can also go too high or drop too low if you don't take the right amount of diabetes medicine.

If your blood glucose stays high too much of the time, you can get heart, eye, foot, kidney, and other problems. You can also have problems if your blood glucose gets too low (hypoglycemia).

Keeping your blood glucose at a healthy level will prevent or slow down diabetes problems. Ask your doctor or diabetes teacher what a healthy blood glucose level is for you.

Diabetes Research and Training Centers

The Diabetes Research and Training Center (DRTC) program was established in 1977 by the Diabetes Research and Education Act (Public Law 91-354) in response to a recommendation by the National Commission on Diabetes. Currently, six DRTCs are supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The DRTCs, which carry out basic and clinical research, are located at major academic institutions.

Diabetes in Hispanic Americans

Diabetes in Hispanic Americans is a serious health challenge because of the increased prevalence of diabetes in this population, the greater number of risk factors for diabetes in Hispanics, the greater incidence of several diabetes complications, and the growing number of people of Hispanic ethnicity in the United States.

Diagnosis of Diabetes

Anyone 45 years old or older should consider getting tested for diabetes.

People develop diabetes because the pancreas does not make enough insulin or because the cells in the muscles, liver, and fat do not use insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over the years, high blood glucose, also called hyperglycemia, damages nerves and blood vessels, which can lead to complications such as heart disease and stroke, kidney disease, blindness, nerve problems, gum infections, and amputation.

Alternative Devices for Taking Insulin

Many people who take insulin to manage their diabetes inject the insulin with a needle and syringe that delivers insulin just under the skin. Several other devices for taking insulin are available, and new approaches are under development.

Alternative Devices for Taking Insulin

Diabetes Control and Complications Trial (DCCT)

The DCCT is a clinical study conducted from 1983 to 1993 by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The study showed that keeping blood glucose levels as close to normal as possible slows the onset and progression of eye, kidney, and nerve diseases caused by diabetes. In fact, it demonstrated that any sustained lowering of blood glucose helps, even if the person has a history of poor control.

The largest, most comprehensive diabetes study ever conducted, the DCCT involved 1,441 volunteers with type 1 diabetes and 29 medical centers in the United States and Canada. Volunteers had diabetes for at least 1 year but no longer than 15 years. They also were required to have no, or only early signs of, diabetic eye disease.

The study compared the effects of two treatment regimens—standard therapy and intensive control—on the complications of diabetes. Volunteers were randomly assigned to each treatment group.

Diabetes Prevention Series

Prevent Diabetes Problems

Too much glucose (sugar) in the blood for a long time can cause diabetes problems. This high blood glucose (also called blood sugar) can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.

Prevent Diabetes Problems: Keep Your Teeth and Gums Healthy

This site is about the tooth and gum problems caused by diabetes. You will learn what you can do each day and during each year to stay healthy and prevent diabetes problems.

Prevent Diabetes Problems: Keep Your Nervous System Healthy

What can I do to prevent diabetes from damaging my nervous system?

Research has shown that people who kept their blood glucose close to normal were able to lower their risk of nerve damage.

Here is what you can do to prevent nerve damage:

Keep your blood glucose as close to normal as you can.
Limit the amount of alcohol you drink.
Don't smoke.
Take care of your feet (see "What can I do to take care of my feet?" ).
Tell your doctor about any problems you have with
- your hands, arms, feet, and legs
- your stomach, bowels, or bladder
Also tell your doctor if you
- have problems when you have sex
- cannot always tell when your blood glucose is too low
- feel dizzy when you go from lying down to sitting or standing

Prevent Diabetes Problems: Keep Your Kidneys Healthy

When kidneys are working well, the tiny filters in your kidneys, the glomeruli, keep protein inside your body. You need the protein to stay healthy.

High blood glucose and high blood pressure damage the kidneys' filters. When the kidneys are damaged, the protein leaks out of the kidneys into the urine. Damaged kidneys do not do a good job of cleaning out waste and extra fluids. So not enough waste and fluids go out of the body as urine. Instead, they build up in your blood.

An early sign of kidney damage is when your kidneys leak small amounts of a protein called albumin (al-BYOO-min) into the urine.

With more damage, the kidneys leak more and more protein. This problem is called proteinuria (PRO-tee-NOOR-ee-uh). More and more wastes build up in the blood. This damage gets worse until the kidneys fail.

Diabetic nephropathy (neh-FROP-uh-thee) is the medical term for kidney problems caused by diabetes.

	No protein is leaking from the healthy kidney.
	Protein is leaking from the unhealthy kidney.

Prevent Diabetes Problems: Keep Your Heart and Blood Vessels Healthy

This site is about heart and blood vessel problems caused by diabetes. You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems.

Prevent Diabetes Problems: Keep Your Feet and Skin Healthy

How can diabetes hurt my feet?

High blood glucose from diabetes causes two problems that can hurt your feet:

1. Nerve damage. One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy (ne-ROP-uh-thee). It can lead to a large sore or infection.

2. Poor blood flow. The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral (puh-RIF-uh-rul) vascular disease. Smoking when you have diabetes makes blood flow problems much worse.

How can diabetes hurt my skin?

Diabetes can hurt your skin in two ways:

1. If your blood glucose is high, your body loses fluid. With less fluid in your body, your skin can get dry. Dry skin can be itchy, causing you to scratch and make it sore. Also, dry skin can crack. Cracks allow germs to enter and cause infection. If your blood glucose is high, it feeds germs and makes infections worse. Skin can get dry on your legs, feet, elbows, and other places on your body.

2. Nerve damage can decrease the amount you sweat. Sweating helps keep your skin soft and moist. Decreased sweating in your feet and legs can cause dry skin.

Diabetes and Eye Health

This site is about eye problems caused by diabetes. You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems.

High blood glucose can cause eye problems.

Keep Your Diabetes Under Control

Taking care of diabetes is a team effort between you and your health care team (doctor, diabetes nurse educator, diabetes dietitian educator, pharmacist, and others). You are the most important member of the team. Take charge of your diabetes by learning what to do for good diabetes care.

There are other things that you can do either each day or one or more times a year to prevent diabetes problems. For example, to keep your feet healthy, check them each day. Ask your health care team whether you should take an aspirin every day to lower your risk for heart disease. To keep your eyes healthy, visit an eye doctor once a year for a complete eye examination that includes using drops in your eyes to dilate the pupils.

Once a year, your urine should be tested for protein. Also once a year, your health care provider should do a complete foot exam. See Things to Do Every Day for Good Diabetes Care for what you can do each day to stay healthy with diabetes. See Things for Your Health Care Provider to Look at Every Time You Have a Checkup for other things to check for good diabetes care.

Children and Diabetes

About 206,000 young people under 20 years of age have diabetes. As obesity rates in children continue to soar, type 2 diabetes, a disease that used to be seen primarily in adults over age 45, is becoming more common in young people. Children with diabetes and their families, health care providers, and school personnel face unique challenges when dealing with diabetes. Learn more about type 1 and type 2 diabetes in young people and how to help them manage the disease and ensure their health and well-being.

Sexual and Urologic Problems of Diabetes

Troublesome bladder symptoms and changes in sexual function are common health problems as people age. Having diabetes can mean early onset and increased severity of these problems. Sexual and urologic complications of diabetes are related to the nerve damage diabetes can cause. Men may have difficulty with erections or ejaculation. Women may have problems with sexual response and vaginal lubrication. Urinary tract infections and bladder problems occur more often in people with diabetes. By keeping your diabetes under control, you can lower your risk of sexual and urologic problems.

Diabetic Neuropathies: Nerve Damage of Diabetes

Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, have damage to nerves throughout the body. Neuropathies lead to numbness and sometimes pain and weakness in the hands, arms, feet, and legs. Problems may also occur in every organ system, including the digestive tract, heart, and sex organs. People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater the risk.

An estimated 50 percent of those with diabetes have some form of neuropathy, but not all with neuropathy have symptoms. The highest rates of neuropathy are among people who have had the disease for at least 25 years.

Diabetic neuropathy also appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40. The most common type is peripheral neuropathy, also called distal symmetric neuropathy, which affects the arms and legs.

Diabetes in Asian and Pacific Islander Americans

Diabetes mellitus poses a rapidly growing health challenge to Asian and Pacific Islander Americans in the United States. In 1997, the Asian and Pacific Islander American (APIA) population was estimated to be about 10 million, almost a 50 percent increase since the 1990 Census and representing about 3.8 percent of the total U.S. population.

Prevalence data for Asian and Pacific Islander Americans are limited, but studies have shown that some groups within this population are at increased risk for developing type 2 diabetes compared with non-Hispanic white people in the United States.

Diabetes in American Indians and Alaska Natives

Diabetes mellitus is one of the most serious health challenges facing American Indians and Alaska Natives in the United States today. The disease is very common in many tribes, and morbidity and mortality from diabetes can be severe.

This population includes all people who derive their origins from any of the original peoples of North America and who continue to maintain cultural identification through tribal affiliations or community recognition. Great diversity in culture, language, location, lifestyles, and genetic heritage exists among American Indians and Alaska Natives. More than 500 Native American tribal organizations, with many differences in language and culture, exist in the United States.

In 1990, the U.S. Bureau of the Census used self-identification to classify people as part of this group. The American Indian and Alaska Native population was estimated at about 2 million.¹ Between the 1980 and the 1990 census, a 38 percent increase occurred in the number of people who identified themselves as American Indians or Alaska Natives. This increase reflects an actual rise in the number of people who identify themselves as part of this group, as well as improvements in counting methodology. In 1990, more than half of the American Indian and Alaska Native population lived in the following seven States: Alaska, Arizona, California, New Mexico, North Carolina, Oklahoma, and Washington. The 1990 census in Alaska showed a total of 85,698 self-identified Alaska Natives. Alaska Natives include three main population groups: Eskimo, Indian, and Aleut.² Within these three groups are further divisions based on geographic location and linguistic and cultural differences.

Within the estimated 2 million self-identified American Indians, about 1.2 million live on 33 reservations served by the Indian Health Service (IHS).¹ Increasingly, tribal organizations are contracting directly with the Federal Government to operate health care facilities on reservations. The following data on American Indians are drawn primarily from information about American Indians living on reservations, not from American Indians living outside the reservations.

Am I at Risk for Type 2 Diabetes?

iabetes is a disease in which blood glucose levels are above normal. People with diabetes have problems converting food to energy. After a meal, food is broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use the hormone insulin, made in the pancreas, to help them process blood glucose into energy.

People develop type 2 diabetes because the cells in the muscles, liver, and fat do not use insulin properly. Eventually, the pancreas cannot make enough insulin for the body's needs. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation.

Complementary and Alternative Medical Therapies for Diabetes

The National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, defines complementary and alternative medicine as a "group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine." Complementary medicine is used with conventional therapy, whereas alternative medicine is used instead of conventional medicine.

Some people with diabetes use complementary or alternative therapies to treat diabetes. Although some of these therapies may be effective, others can be ineffective or even harmful. Patients who use complementary and alternative medicine need to let their health care providers know what they are doing.

Some complementary and alternative medicine therapies are discussed below. For more information, talk with your health care provider.