High Cholesterol : Risk Factors

The FDA has ordered a warning label be put on the diabetes drugs Avandia and Actos due to evidence from studies that the medications may increase the risk of heart attack or death from cardiovascular disease.

Could a baby be diabetic from birth? Leann M. Lesperance, M.D., Ph.D., is a lecturer on the Harvard Medical School faculty and a clinical assistant professor at SUNY-Upstate Medical University. She practices pediatrics in Binghamton, New York. She also holds a doctorate in medical engineering and is a research assistant professor in the Department of Bioengineering at Binghamton University.

Diabetes mellitus is a chronic disease in which the body is not able to correctly process glucose for cell energy due to either an insufficient amount of the hormone insulin or a physical resistance to the insulin the body does produce. Without proper treatment through medication and/or lifestyle changes, the high blood glucose (or blood sugar) levels caused by diabetes can cause long-term damage to organ systems throughout the body.

Diabetes mellitus describes a group of diseases in which there is an elevated level of the sugar glucose, the body's main source of energy for cellular functions, in the blood. The level of glucose, as well as other "fuel" molecules, is increased due to a disorder in the production or function of the hormone insulin. A range of health problems occurs primarily due to the damaging effects of elevated levels of glucose on blood vessels.

A serious disorder caused by an absence of or insufficient amount of insulin in the bloodstream. Insulin is a hormone produced by the pancreas in varying amounts, depending on the concentration of glucose (sugar). When the pancreas is unable to secrete enough insulin to maintain a normal concentration of glucose in the blood, the blood-glucose concentration becomes elevated. Large amounts of glucose are then excreted in the urine. Insulin allows glucose to be absorbed by the liver and fat cells, where it is stored as glycogen. In times of stress, exercise, or an emergency, the glycogen is reconverted back to glucose. It also sends glucose to the muscle cells where it is then converted to energy. More than 12 million Americans are affected by diabetes. There is a 5-6% increase in the number of those affected each year by the disease, primarily due to the population's increased rate of longevity. A rising rate of obesity, a prime cause for incidences of diabetes over the age of 40, also contributes to the increasing frequency of diabetes. It is estimated that for each reported new case of diabetes, there is an unreported one because symptoms of the early stages of adult diabetes tend to go unrecognized. Symptoms usually progress from mild to severe as the disease progresses. Approximately 300,000 deaths each year are attributed to diabetes. Its prevalence increases with age, from about 0.2% in persons under 17 years of age to about 10% in persons aged 65 years and over. Females have a higher rate of incidence for the disease, while higher income groups in the United States show a lesser incidence than lower income groups. The incident rate is markedly different among ethnic groups; it is 20% higher in non-Caucasians than in Caucasians. However, for reasons as yet unknown, the rate of diabetes in ethnic groups such as Native Americans, Latin Americans, and Asian Americans is especially high and continues to rise. There are two forms of diabetes mellitus. Type I is called insulin-dependent and type II, non-insulin-dependent. (In June 1997, an Expert Committee of the American Diabetes Association recommended changing the categories of diabetes to Type 1 [formerly Type I-indulin-dependent diabetes mellitus] and Type 2 [formerly Type Il-non-insulin-dependent diabetes mellitus]. This essay uses the conventional terminology, which was widely used at the time of publication.) Insulin-dependent diabetes (type I) generally starts in childhood, affects approximately 700,000 Americans, and is characterized by severe insulin deficiency. It is probably due to the destruction of the insulin-secreting cells of the pancreas, which is often caused by an autoimmune disorder. Without insulin, the person develops ketoacidosis, a condition where high levels of ketone bodies are present in the blood. When the body is deprived of glucose, which can occur as a result of insulin deprivation or fasting, the body begins to break down fat for fuel. Ketones are the result of this lipid metabolism. The resulting lowered blood pH value leads to the acidosis. Ketoacidosis is a serious condition and can lead to confusion, unconsciousness, and death if not treated. It can be diagnosed by urine tests which detect ketones in the urine. Untreated or uncontrolled diabetes will lead to ketosis, but fasting or starvation also produces ketones. Other symptoms of ketoacidosis include vomiting, abdominal pain, loss of appetite, and nausea. A very high blood glucose level in insulin-dependent diabetes can also lead to heart failure and coma. Genetics plays a major role in Type I diabetes. There is also some evidence that children infected with certain viruses—rubella and coxsackie B in particular—may be susceptible to the disease. Diabetes in newborns can result from low birth weight as well as genetic predisposition. Some infants experience temporary diabetes, which may recur later in life. Non-insulin-dependent diabetes (type II) usually occurs in people over

Diabetes mellitus is a condition that occurs when either the pancreas does not produce enough insulin or the body's cells stop responding to the insulin that is produced. In either case, glucose in the blood cannot be absorbed or used by the cells of the body.

Gestational diabetes is a condition that occurs during pregnancy . Like other forms of diabetes, gestational diabetes involves a defect in the way the body processes and uses sugars (glucose) in the diet. Gestational diabetes, however, has a number of characteristics that are different from other forms of diabetes.

Diabetes is the Greek term for "passing through," a phrase used to describe multiple diseases characterized by excessive urination. There are multiple forms of diabetes. The most frequently described is diabetes mellitus, a chronic disorder involving the body's use of blood glucose (blood sugar) and the synthesis, or utility, of the hormone insulin. However, not all forms of diabetes involve glucose or insulin.

Diabetes mellitus is a common metabolic disorder resulting from defects in insulin action, insulin production, or both. Insulin, a hormone secreted by the pancreas, helps the body use and store glucose produced during the digestion of food. Characterized by hyperglycemia , symptoms of diabetes include frequent urination, increased thirst, dehydration , weight loss, blurred vision, fatigue , and, occasionally, coma. Uncontrolled hyperglycemia over time damages the eyes, nerves, blood vessels, kidneys, and heart, causing organ dysfunction and failure. A number of risk factors are attributed to the incidence of diabetes, including family history, age, ethnicity, and social group characteristics, as well as behavioral , lifestyle, psychological , and clinical factors. The World Health Organization estimates that 150 million people had diabetes worldwide in 2002. This number is projected to double by the year 2025. Much of this increase will occur in developing countries and will be due to population growth, aging, unhealthful diets, obesity , and sedentary lifestyles. In the United States, diabetes is the sixth leading cause of death. While 6.2 percent of the population has diabetes, an estimated 5.9 million people are unaware they have the disease. In addition, about 19 percent of all deaths in the United States for those age twenty-five and older are due to diabetes-related complications. The prevalence of diabetes varies by age, gender, race, and ethnicity. In the United States, about 0.19 percent of the population less than twenty years of age (151,000 people) have diabetes, versus 8.6 percent of the population twenty years of age and older. In addition, adults sixty-five and older account for 40 percent of those with diabetes, despite composing only 12 percent of the population. Considerable variations also exist in the prevalence of diabetes among various racial and ethnic groups. For example, 7.8 percent of non-Hispanic whites, 13 percent of non-Hispanic blacks, 10.2 percent of Hispanic/Latino Americans, and 15.1 percent of American Indians and Alaskan Natives have diabetes. Among Asian Americans and Pacific The standard method of measuring blood glucose level is called a fingerstick, which is a small blood sample taken from the fingertip. Diabetics must monitor their blood glucose levels daily in order to avoid dire complications such as kidney disease, blindness, stroke, and poor blood circulation. [Photograph by Tom Stewart. Corbis. Reproduced by permission.] Islanders, the rate of diabetes varies substantially and is estimated at 15 to 20 percent. The prevalence of diabetes is comparable for males and females—8.3 and 8.9 percent respectively. Nevertheless, the disease is more devastating and more difficult to control among women, especially African-American and non-Hispanic white women. In fact, the risk for death is greater among young people (3.6 times greater for people from 25 to 44 years of age) and women (2.7 times greater for women ages 45 to 64 than men of the same age).

What causes diabetes? Scientists aren't sure, but heredity, obesity, lack of exercise and other factors play a part.

Meal planning and blood sugar monitoring. Medicines and multiple injections. The day-in and day-out requirements of diabetes management can overwhelm those with this chronic disease.

"If you do have diabetes, educate yourself and start managing your illness," Ms. LaBelle says.

Diabetes affects the body in many complex ways, and having a team to help you stay as healthy and vital as possible, for as long as possible, is key.

If managing diabetes seems like a full-time job, keep in mind it’s a task that can’t be taken lightly. Diabetes is the fifth-leading cause of death by disease in the United States.

Having pre-diabetes means that you are likely to develop full-blown diabetes within 10 years. But lifestyle changes can prevent that from happening.

Did you know that if you have diabetes, you have a two to four times greater risk for heart disease and stroke than people without diabetes?

Diabetes is a chronic (lifelong) and progressive condition, but it can be managed. With help from your family, your friends, and your healthcare team, you can learn to take care of yourself and stay healthy.

The only way to be sure your blood sugar stays within a normal range is to check it. You will most likely be asked to check your blood sugar at home one or more times a day. Your healthcare provider will teach you how.

Your blood sugar will most likely return to normal after delivery. But gestational diabetes is a warning sign that you are at risk for getting diabetes later in life. You're also more likely to have gestational diabetes with your next pregnancy.

Diabetes occurs when there are high levels of glucose (sugar) in the blood. All three types of diabetes involve problems with insulin, a hormone that removes glucose from the blood and allows it to enter the body's cells. (The cells use it for energy.) If your body is unable to make or use insulin properly, you have a high blood glucose level.

Living with diabetes means making many changes in your life, and these changes may seem overwhelming. When you feel down, reach out to your family and friends, and to your healthcare team. Here are a list of other resources.

The diabetes food pyramid is a tool to help you eat a wide range of healthy foods. You can use it to plan low-fat meals and snacks that include carbohydrates and protein.

When you have diabetes, your body needs special care. This care helps you stay healthy and prevent complications. Exercise and healthy eating are a part of this. You can also protect yourself by taking special care of your feet and skin.

Taking care of yourself means developing a routine for things like meals, exercising, and taking medication. But sometimes this routine is disrupted when you travel. Your healthcare team can help you work out a plan to prepare for unexpected situations.

Simple and small movements can get you started exercising. You don’t need to join a gym to start moving. Make it easy on yourself and you will be able to make exercising a habit. Slow, gentle, and easy is the way to begin to make exercising part of your life.

Once you become more active, you may be ready to increase the pace. Choose an exercise you enjoy. Just be sure to warm up, cool down, and stay safe. And learn when it’s time to stop exercising.

Managing diabetes means developing a routine for things like meals, exercise, and taking medication. It also means making changes in some of your activities, such as driving, to help keep you and those around you safe.

Is it OK for people with diabetes to drink alcohol? This is something only you and your health care provider can answer.

The stress of illness or injury can cause blood sugar to rise and make insulin less effective. This can lead to serious problems, including diabetic coma. That’s why it’s important to know what to do when illness strikes.

Among the many types of blood pressure medications available, some have a tendency to increase blood sugar levels, but this does not necessarily lead to a higher risk of diabetes.

The American Diabetes Association has set a standard for measuring blood sugar that expresses the information in two different forms, corresponding to the way the reading is given in medical tests and also in home testting.

Most people with diabetes eventually develop some form of heart disease, but this is not inevitable. Focusing on improving health through diet, exercise, weight loss, and lowering blood pressure and cholesterol can help prevent heart disease.

People with diabetes or high blood pressure are at greater risk for eye disease. Taking pills containing plant sterols and stanols may lower cholesterol as effectively as eating foods fortified with the plant matter.

Many people with diabetes suffer from one of the numerous potential complications of the disease, but following a proper diet, getting exercise, and paying attention to risk factors can help prevent further problems.

Recommendations for eating eggs for those with diabetes. Q. My husband has type 2 diabetes and has started eating two eggs about three times a week. He’s looking to fill up on low-carb foods he likes. But I’ve read that eggs may not be a good idea for people with diabetes. Should he cut back?