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Diabetes Mellitus is a chronic metabolic disorder that prevents the body from utilizing glucose completely or partially. It is characterized by raised glucose concentration in the blood. The pancreas produce a hormone insulin which controls the amount of glucose in the blood. Without insulin, the blood sugar increases as the body cannot use or store glucose. The most commonly-used screening tests are the determination of the fasting blood glucose level and the blood glucose level tested two hours after a meal. The normal fasting blood sugar content is 80-120 mg per 100 ml of blood; this can go up to a level of 160 mg per 100 ml of blood two hours after meals. Anything above these levels can be termed as diabetic levels. Diabetes is common among older, obese people.

Type 1 or insulin-dependent diabetes mellitus (IDDM) occurs when the pancreas fails to make enough insulin. It usually occurs in childhood or adolescence but can develop at any age. These patients need insulin everyday.
Type 2 or non-insulin dependant diabetes mellitus occurs when body cells become resistant to insulin. This is more common among adults, especially those who are overweight and over age 40. These people are able to control their blood sugar levels through weight control, regular exercise and a well-balanced diet. Some people require oral medications or insulin injection to lower blood sugar.
In both the types of diabetes, signs and symptoms are more likely to be similar as the blood sugar is high, either due to less production of insulin, or no production or insulin resistance. In any of the case if there is inadequate glucose in the cells, it can be identified through certain signs and symptoms. These symptoms are quickly relieved once the Diabetes is treated and also reduce the chances of developing serious health problems.
Diabetes Type 1:
In type 1, the pancreas stop producing insulin, due to autuimmune response or possibly viral attack on pancreas. In absence of insulin, body cells does not get glucose for producing ATP (Adenosin Triphosphate) units which results into primary symptom in the form of nausea and vomiting. In latter stage which leads to ketoacidosis in which body starts breaking down muscle tissue and fat for energy, there is consequently fast weight loss. Dehydration is also usually observed due to electrolyte disturbance. In advance stages even coma and death, are being witnessed.
Diabetes Type 2:
Increased fatigue : Due to inefficiency of cell to metabolise glucose, reserve fat of body is metabolised to gain energy. When fat is broken down in the body, it uses more energy as compared to glucose, hence body goes in negative calorie effect, which results in fatigue.
Polydipsia : As the concentration of glucose increases in the blood, brain receives signal for diluting it and in its counteraction we feel thirsty.
Polyuria: Increase in urine production is the result seen when excess of glucose is present in body. Body tries to get rid of the extra sugar in the blood by excreting it through the urine. This can also lead to dehydration because excreting the sugar which carries a large amount of water out of the body along with it.
Polyphegia : The hormone insulin is also responsible for stimulating hunger. In order to cope up with high sugar levels in blood, body produces insulin which leads to increased hunger.
Weight flactuation : Factors like loss of water (polyuria), glucosuria , metabolism of body fat and protein may lead to loss of weight. Few cases may show weight gain due to increased appetite.
Blurry vision : Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of eye, which affects the ability of lenses to focus resulting in blurry vision.
Irritability : It is one of the sign of high blood sugar because of the inefficient supply of glucose to brain and other body organs, which makes us feel tired and uneasy.
Infections : Certain signals from the body is given whenever there is fluctuation of blood sugar (due to suppression of immune system) by frequent infections of fungal or bacterial like skin infection or UTI (urinary tract infection).
Poor wound healing : High blood sugar resists the flourishing of WBC, (white blood cell) which are responsible for body immune system. When these cells do not function accordingly, wound healing is not at good pace. Secondly, long standing diabetes leads to thickening of blood vessels which may affect proper circulation of blood in different body parts.
It's important to also be aware of the different myths that over the years have arisen about the causes of diabetes.
Eating sweets or the wrong kind of food does not cause diabetes. However, it may cause obesity and this is associated with people developing Type 2 diabetes.
Stress does not cause diabetes, although it may be a trigger for the body turning on itself as in the case of Type 1 diabetes. It does, however, make the symptoms worse for those who already have diabetes.
Diabetes is not contagious. Someone with diabetes cannot pass it on to anyone else.
IDDM mostly results from a virally initiated autoimmune destruction of beta cells of the pancreas.
NIDDM is determined genetically and is expressed with age or other factors like obesity, diet and inactivity.
Among the several home remedies that have proved beneficial in controlling diabetes, perhaps the most important is the use of bitter gourd. It has lately been established that bitter gourd contains a hypoglycaemic or insulin-like principle, designated as 'plantinsulin', which has been found valuable in lowering the blood and urine sugar levels. It should, therefore, be included liberally in the diet of the diabetic. For better results, the diabetic should take the juice of about four or five karelas every morning on an empty stomach. The seeds can be added to food in a powdered form. Diabetics can also use bitter gourd in the form of a decoction by boiling the pieces in water or in the form of dry powder.
Indian gooseberry, with its high vitamin C content, is considered valuable in diabetes. A tablespoon of its juice, mixed with a cup of bitter gourd juice, taken daily for two months, will stimulate the islets of Langerhans, that is, the isolated group of cells that secrete the hormone insulin in the pancreas. This mixture reduces the blood sugar in diabetes.
Jambul fruit is another effective home remedy. It is regarded in traditional medicine as a specific against diabetes because of its effect on the pancreas. The fruit as such, the seeds, and fruit juice are all useful in the treatment of this disease. The seeds contain a glucoside 'jamboline' which is believed to have the power to check the pathological conversion of starch into sugar in cases of increased production of glucose. The seeds should be dried and powdered. One teaspoon of this powder should be mixed in one cup of milk or water or half a cup of curd, and taken twice daily. The inner bark of the jambul tree is also used in the treatment of diabetes. The bark is dried and burnt. It will produce an ash of white colour. This ash should be pestled in mortar, strained and bottled. The diabetic patient should be given ten grams of this ash on an empty stomach with water in the morning, and twenty grams in the afternoon, and in the evening an hour after taking meals. An equal quantity of amla powder, jamun powder, and bitter gourd powder also makes a very useful remedy for diabetes. A teaspoon of this mixture once or twice a day would be effective in checking the progress of the disease.
Grapefruit is a splendid food in the diet of a diabetic patient. If grapefruits were eaten more liberally, there would be much less diabetes. If you have sugar, use three grapefruits three times a day. If you do not have sugar, but a tendency towards it and want to prevent it, use three a day.
The seeds of fenugreek have been found effective in the treatment of diabetes. Fenugreek seeds, when given in varying doses of 25 gm to 100 gm daily, diminish reactive hyperglycaemia in diabetic patients. Levels of glucose, serum cholesterol, and triglycerides were also significantly reduced in the diabetes patients when the seeds were consumed.
Experiments have shown that the intake of water extract of Bengal gram enhances the utilization of glucose in both diabetic and normal persons. When kept on a diet which included liberal supplements of Bengal gram extract, the condition of tile patient improved considerably and his insulin requirement was reduced to about twenty units per day. Diabetes patients who are on a prescribed diet which does not severely restrict the intake of carbohydrates, but includes liberal amounts of Bengal gram extract, have shown considerable improvement in their fasting blood sugar levels, glucose tolerance, urinary excretion of sugar, and general condition.
For a milder type of diabetes, two tablespoons of germinated black gram, taken with half a cup of fresh bitter gourd juice and a teaspoon of honey, is said to be useful. It should be taken once daily for three to four months. A restriction should be placed on the intake of carbohydrates. Even in severe cases, regular use of this combination, with other precautions, is useful as a health-giving food for the prevention of various complications that may arise due to malnutrition in diabetics.
The tender leaves of the mango tree are considered useful in diabetes. An infusion is prepared by soaking 15 gm of fresh leaves in 250 ml of water overnight, and squeezing them well in the water in the moming. This filtrate should be taken every morning to control early diabetes. As an alternative, the leaves should be dried in the shade, powdered and preserved for use when necessary. Half a teaspoon of this powder should be taken twice a day.
The seeds of parslane are useful in diabetes. A teaspoon of the seeds should be taken every day with half a cup of water for three to four months. It will increase the body's own insulin and help in curing diabetes.
Besides bitter gourd, certain other vegetables have been found useful in diabetes. These include string beans, cucumber, onion, and garlic. Tea made of the pods of string beans is valuable in diabetes.
Diet plays a significant role in controlling the diabetes. The diabetic diet may be used alone or else in combination with insulin doses or with oral hypoglycemic drugs. Main objective of diabetic diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood sugar levels in blood. The diet plan for a diabetic is based on height, weight, age, sex, physical activity and nature of diabetes. While planning diet, the dietician has to consider complications such as high blood pressure, high cholesterol levels.
With respect to the above factors, a dietician will assess calories to be given, like scheming the carbohydrates, proteins, fats, type of carbohydrate, amount of fiber and so on.
Exchange meal plan is a diet program which balances the amount of carbohydrate that we intake per day. Glucose is a sugar released from carbohydrate so if we want to control blood sugar we have to limit the consumption of simple carbohydrate. Carbohydrate foods are given as value per portion, known as the exchange. This plan helps us to decide on the type of food to be taken, the amount of food and also the time to eat. You can plan for more flexible meal as you get more knowledge about the diet of a diabetic, may be like the counting carbohydrate meal plan or constant carbohydrate. But there is no common diet that works for everyone. Nor is there any particular diet that works perfectly for any diabetic over a long period. While planning diabetes diet we should adhere to certain important factors, they are as follows:
Fiber should be at least 40 gm / day
Instead of 3 heavy meals, we should go for 4-5 small mid intervals
Replace bakery products and fast foods by simple whole cooked cereals, and don't eat carbohydrates 2 hours before bedtime
Consume fresh fruit and vegetables at least 5 exchange/ day
Diabetics must always need to take care of thier diet and also about the food they eat. Care has to be taken because all foods contain not only carbohydrate, but also some energy value. Protein and fat available in the food are converted to glucose in the body. This glucose has some effect on the blood sugar level which has to be taken care. Furthermore there is no need that you have to eat only bland boring diet. Instead you have to eat more fruits, vegetables and whole grains. It means that to select foods that are high in nutrition and low in calories and fat.
-Exercise regularly, it keeps you fit and helps in controlling diabetes. Light exercise such as jogging, swimming or brisk walking are good.
-Do not walk bare feet. Decreased sensations can result in injury.
-Do not miss a meal after insulin or oral anti diabetic drugs.
-Do not change the dose of the anti-diabetic drugs, except under medical advice.
-Test urine regularly.
The main goal of nutrition for diabetics is to avoid highs & lows of blood sugar so you can feel well today and in the future. So it is important to remember these 3 points.
1) The timing of your meals & snacks is very important. Eat meals & snacks at the same time every day or as close to the same time as possible. Include a snack if you are exercising or if your blood sugar gets low. If these are happening regularly then consult your physician.
2) If you are taking insulin or a diabetic pill, always eat bed time snack. Stick to your serving size. If you eat more then what you are required to may raise your blood sugar.
Glycaemic Index:
It is found that factors other then fibre may result in a food producing relatively flat blood profiles. These foods may favorably influence blood lipids. Classification of foods in terms of their glycaemic effects may facilitate application of this information in day-to-day management. Increase in levels of plasma insulin and glucose produced by various carbohydrate containing foods vary considerably from one food to another. For example, the post-prondial blood glucose response of glucose and potato of similar value is higher than that produced by bread or rice. Many such researches are being carried out to elicit the glycaemic response must also be considered. This system may be used as a part of the exchange system. The glycaemic index provides a means of identifying starchy foods with a lower glycaemic potential. (i.e foods less likely to cause a rise in blood glucose) that may be offered on trial to diabetics.