Mens Health Blog. Medical Blog

Diabetes has been around for a long time. The ancient Egyptians recognized the disease, and so did the Romans, who even developed some crude treatments for it. In ancient India, “physicians” recommended exercise as a treatment for the condition we know as diabetes. Amazingly, in modern time we strongly recommend that same exercise programme.
The name of the disease comes from the Greek word “diabetes”, which means to siphon or flow through, and the Latin word “mellitus”, which means honey or sweet.
In Europe during mediaeval times, physicians diagnosed diabetes by tasting the urine of the afflicted patient. If the urine was sweet, the physicians confirmed the diagnosis. Unfortunately, these physicians could not effectively treat the disease.

Definitions
Diabetes mellitus refers to the condition that results in an above-normal level of glucose in the blood, which sometimes spills over through the kidneys into the urine.
There are two major types of diabetes mellitus:
• Type I diabetes, in which the person does not produce any insulin and thus is dependent on injections of insulin to sustain life and to regulate blood glucose levels.
Type I diabetes usually occurs in children and adolescents but has been known to occur in adults. About ten per cent of all persons with diabetes have Type I. The onset of Type I diabetes is rapid, has characteristic symptoms, and often is dramatic.
• Type II diabetes, in which the person may not produce enough insulin or may be resistant to the action of the insulin produced. This person may be able to regulate blood glucose levels by diet and exercise alone; by diet, exercise and an oral anti-diabetes drug; or by diet, exercise and insulin injections.
Type II diabetes usually occurs in adults over the age of forty, those who have a family history of diabetes, those who are overweight or obese, and women who have given birth to babies weighing over four kilograms. It is possible that a woman who gives birth to a big baby had diabetes during her pregnancy (called gestational diabetes), which may not have been diagnosed.
About ninety per cent of all persons with diabetes have Type II. About eighty-five per cent of people with Type II are overweight or obese.
The onset of Type II diabetes is gradual and often without symptoms. A blood test ordered at the time of a routine physical examination often is the only way for a person to detect that he or she has this disease.
More than half of the people with Type II diabetes don’t even know they have the disease.
Since you have just been diagnosed as having Type II diabetes, you should consider yourself to be quite lucky. You’re fortunate because you can do something to control this disease and make your life happier, healthier and perhaps even longer.
*5/210/5*

Diabetes is the sugar disease. Diabetics have too much sugar circulating because their pancreases do not make enough insulin, a vital hormone. Insulin prepares your body’s cells to absorb sugar (glucose) for energy. In the absence of insulin, the sugar piles up in the blood system.
The sugar does its damage to the body’s many enzymes. These chemicals carry out the intricate chemistry of the body. Some researchers believe that an overabundance of sugar in the blood allows the excess glucose to stick to enzyme molecules. An enzyme molecule coated with sugar will stick to other sugar-coated molecules. When that happens, the clumped enzymes fail to do their jobs.
Such a chemical catastrophe can shutdown many organs of the body, especially the kidneys, eyes, and nerves. In turn, battered nerves can lead to sexual impotence, severe leg pains, and blindness.
For at least three decades, diabetes experts argued about the need for keeping the blood sugar levels low and close to normal -the same level as non-diabetics achieve without injecting insulin. Pioneering diabetes specialists tried it out on a few patients to see whether low sugar levels could be won with injections of synthetic insulin, diet control, and exercise.
Diabetes patients found the new approach arduous. The system called for sufferers to measure their sugar blood levels four or more times a day. Fortunately, in the 1980s, electronics manufacturers were able to create a blood sugar machine no bigger than a pack of cigarettes. It worked beautifully.
The patient had to stick a sharp needle into one of his fingers. A drop of blood formed on the digit. The patient transferred the red liquid to a small paper stick. He then put the blood-soaked rod into the machine. In about a minute, the sugar reading came up on a small screen.
Depending on the number on the screen, a diabetic could inject more insulin, do some exercise, or have something to eat. It seemed like a thankless and difficult task. But enough diabetics did it to encourage the doctors to do a 10-year study on what is now called “tight control.”
“I can think of no other disease where patients can play a more active, direct role in their own care and its outcome,” says Dr. Phillip Gorden, director of the National Institute of Diabetes and Digestive and Kidney Diseases. The institute financed the research. Self-management was the key, and the massive experiment was on its way. It was called the Diabetes Control and Complications Trial (DCCT). It involved 1,421 patients and cost $160 million. Half the patients, chosen at random, followed the standard treatment. They used the sugar machine to check their blood sugars once a day and took one or two insulin injections daily.
The other half, the experimental group, strived for tight control -blood sugars in the normal range. They measured their blood four or more times daily, taking at least three injections of insulin a day. For some patients who found four injections a day too difficult, doctors prescribed insulin pumps, which deliver a fixed amount of insulin below the skin.
The idea was not to take more insulin but to deliver it in a way that more closely mimics the body’s release of the hormone and to adjust the insulin doses -and sometimes diet and exercise -when sugars are too high or too low. This required working closely with diabetes educators and dietitians.
The result: The tightly controlled group had a 76 percent lower incidence of diabetic eye disease than the other group, 60 percent less nerve damage, and up to 56 percent fewer kidney problems.
Until now, doctors were not certain what caused the complications.  Some held to the theory that the crippling effects of diabetes came from defects in body tissues that were part of the basic disease process. Others said it was from the abnormally high blood sugar levels. Dr. Oscar B. Crofford of Vanderbilt University, chairperson of the study, says, “The DCCT proved for the first time that complications of diabetes can be prevented by such intensive diabetes therapy.”
The culprit was the abnormally high sugar level.
The DCCT study involved only Type I diabetics. It’s the Type II diabetics whose sometimes “casual” approach to diabetes puts them in jeopardy. Dr. James Gavin III of the Howard Hughes Medical Institute in Chevy Chase, Maryland, says, “There is no such thing as ‘a little touch of sugar.’ Diabetes is serious – whether you take insulin or not. And the DCCT shows us clearly that, to prevent complications, it’s important for all people with diabetes to bring their blood sugars close to normal.”
Diabetes specialists hope that tight control will also prevent heart attacks and stroke, both of which are very common with diabetes.
Tracy Sankstone, a receptionist at the Mayo Clinic in Rochester, Minnesota, developed diabetes at age 2. She was the first patient in the experimental group of the DCCT, which began in 1983. She reports, “Doing four blood tests and four or more shots a day was tough in the beginning, but I’m used to it now. I feel great, I don’t have any complications – and I don’t want to get them.”
*8/266/5*