Blood glucose monitoring – wikipedia, the free encyclopedia, Blood glucose monitoring is a way of testing the concentration of glucose in the blood (glycemia). Ioh symptoms of hyperglycemia (high blood sugar), Ioh diabetes: symptoms of hyperglycemia, diabetic ketoacidosis (dka), causes, treatment, prevention of low blood sugar.
Diabetes recovery by age-dependent conversion of, Total or near-total loss of insulin-producing [bgr]-cells occurs in type 1 diabetes.
Embryonic stem cells in trial for diabetes, As san diego’s viacyte was in the midst of launching the first fda-approved embryonic stem (es) cell clinical trial for diabetes last week, boston’s harvard. Understanding Hemoglobin A1C levels plays an important part in monitoring the development of diabetes. If testing reveals your Hemoglobin A1C levels are high there are proactive steps you can take to reduce your A1C numbers and possibly reverse the diabetes process. Increasingly, people are having direct access to their pathology test results and with the introduction of the Australian Government's My Health Record this is expected to become even more commonplace.
Name and address of doctor or health practitioner to whom your results will be sentPatient's name and identifiers used to link the results to the correct personDate this report was printed. The abnormal results in this report are clearly marked in red and have a letter after them to show whether they are high (H) or low (L). The results show a low haemoglobin, low haematocrit, low RCC (red cell count) and low MCV (mean cell volume) all of which are typical of iron deficiency anaemia and which would have been caused by the heavy periods.
If you look at the reference ranges you will see that these results are only just outside the limits and both of them are normal on the other two occasions tested. The results show a steady improvement in control of the diabetes with the final HbA1c in the non-diabetic range. These lab reports clearly mark abnormal results by printing them in a different colour and following them with an indicator showing whether they are high or low.
If in doubt, talk to your doctor as results need to be interpreted in the context of all the other information available. The final destination of a journey is not, after all, the last item on the agenda, but rather some understanding, however simple or provisional, of what one has seen. Summer’s rich bounty of fresh fruits and vegetables together with its heat, humidity and more leisurely pace invite us each year to lighten up and adopt healthier habits. Dietary changes give the body a chance for “housekeeping.” Cleansing foods allow the system to expel toxins and set healing in motion. Far Eastern philosophy suggests that true healing requires reaction: Reactions signal the body’s attempts to discharge toxins, both physical and emotional, that stand in the way of healing.
AlcoholTension, inability to relax2 to 5 days or more depending on level prior consumption. DairyMucus discharge through the skin, sinuses, mucous membranes, lungs, sex organsStarting up to 3 months after the food is stopped, for a year or two. Possible discharges include boils, pimples, rashes, body odors, nasal and vaginal discharges, coating on the tongue. For chronic conditions, symptoms may appear in reverse order: Known as “retracing,” someone who in early childhood contracted chicken pox and later bronchitis may experience a period of coughing associated with bronchitis, and later a skin rash resembling chicken pox.
If the summer season inspires you to make positive changes in your life, have patience, knowing that healing may bring a few ups and downs on the way to establishing a firmer foundation for better health.
In these modern times, with the plethora of blood-sugar-related diseases, we need tools like GI and GL to help us understand ways to control blood sugar. The self-testing, graphic approach to food testing developed in the balance of the newsletter is a less scientific but a more dynamic way to explore postprandial (post-meal) blood glucose levels (BGLs).
GI measures the blood glucose impact of foods eaten in isolation, yet we rarely consume foods this way. GI readings vary with the individual—blood sugar and insulin reactions are more extreme for diabetics, for example (See Charts 2A and 2B). GIs are calculated in the science lab as the day’s first meal after a 12-hour fast and using a fixed serving that includes 50 grams of carbohydrate.  Most of our daily calories, however, are consumed in combination and throughout the day, when our blood sugar is affected by other foods that we have eaten earlier, as well as by our level of activity. Of the following numbered charts, the first three are based upon scientific research journal articles (Charts 1, 2A, 2B), while the last four (Charts 3-6) are constructed from my own self-testing of foods4 using a simple blood glucose monitor. Chart 1:  Blood Sugar Curves of White Bread Compared to Bread with Added Fiber, Sourdough, and Vinegar. Chart 3:  Instant Oatmeal, Whole Oats (Soaked and Not Soaked), and Whole Oats Combined with a Protein and Fat. To fully appreciate the impact of two back-to-back carbohydrate breakfasts please notice that the scale used for Chart 6 is twice that of Charts 3-5. Resetting the Table–to Control Blood Sugar (For a discussion of other strategies, see April 2011).
Ramekins filled with condiments like nuts and seeds (GI=0).  Nuts and seeds provide healthy fats, fiber, vitamins, minerals, and antioxidants, while they slow digestion and curb blood sugar.
Sourdough bread or whole-grain bread with whole kernels; butter from grass-fed cows and organic nut and seed butters such as tahini and pumpkin seed butter. A pitcher of water and glasses for all—sometimes we mistake hunger for what is in fact thirst.  You might flavor the water with a little lemon juice or other flavoring. Because 12-hour fasting, pre-meal blood sugar reading can vary, all data points at time zero prior to the first morning meal were indexed to zero in order to illustrate the change from a neutral starting point. I use the label “traditional” carbohydrates, just as we call unrefined fats, “traditional” fats. As a sequel to my April and May 2011 newsletters on blood sugar and metabolic stress, this a short June piece on the liver.
A well-functioning liver is vital to good health because of the many important functions it performs in the body.
Over the past weeks in researching blood sugar and reading the lead article in the Spring 2011 Weston A. Our modern diet that relies upon refined carbohydrates and refined vegetable oils—so often consumed in convenience foods—takes a heavy toll on the liver. Current research suggests that fatty liver disease is not just a disease troubling alcoholics. Refined carbohydrates such as sugar and high fructose corn syrup (HFCS), especially when consumed as soft drinks. Simple accumulation of fat within the liver generally proceeds without producing any overt symptoms, but it is not necessarily harmless.
The totality of the evidence suggests that the initial accumulation of fat in the liver is triggered by nutritional imbalance…fatty liver seems to occur as a result of too much energy flowing through the liver without sufficient nutrients to process it.
The key culprits, then, are nutrient-poor refined foods, choline deficiency and polyunsaturated oils. The key to keep in mind when the goal is to cut out sugar (and calories), limit red meats, which set up cravings for sugar.
Counter-intuitive perhaps, but this is why “junk-food” vegetarians (who rely upon a diet of sugar and refined carbohydrates) often crave sugar. The vital force energy of whole foods satisfies and the creative process of preparation provides its own form of gratification. Baking at high heat is a natural way to convert the carbohydrate energy of vegetables and grains into delectable sweet treats.
Have plenty of sweet substitutes like roasted parsnips, sweet potatoes, winter squashes, dried fruits, and perhaps some bananas, dates, and figs on hand. Raw carrots help raise blood sugar effectively but less dramatically than sugar, and for a longer time interval. The best natural sweeteners, with the greatest nutritive value and lowest sugar content (compared to sugar’s 99%), are amasake (40%), brown rice and barley malt (50%), and maple syrup and molasses (both at 65%). Refining strips 99% of sugar’s Magnesium, 98% of its Zinc, and 93% of its Chromium and Manganese, 88% of Cobalt, and 83% of its Copper (Elson Haas). This article aims to outline specific strategies to address pain, inflammation, and chronic disease.  But the greater question remains: why is inflammation so pervasive today? A second idea to remember is that we need both stable saturated fats like butter and coconut oil for the structural integrity of cell walls, as well as omega-3s and omega-6 fats for the flexibility of cell membranes.  Unsaturated omega-3 and omega-6 fats are needed for cells to carry out highly sophisticated neurological and electrical communication functions. Realistically, to eliminate inflammatory foods means that we need to know where our food comes from.  This is the very best way to eliminate pro-inflammatory vegetable oils and trans fats that are hidden in prepared foods—as well as inflammatory refined sugars and white flour products. If inflammation helped our forebears to survive in a hostile world, why is it now seen as such a health threat?  The answer again comes from the science lab.  Research tells us that our modern diet and inactive lifestyle are the two factors most to blame for silent inflammation and chronic disease. The shift that has happened in just a few decades away from grass-fed animal products and other foods with healthy omega-3 fats toward processed foods rich in inflammatory omega-6 refined vegetable oils:  Today, we consume 25 times more pro-inflammatory refined liquid vegetable oils than a century ago, but only a third as much stable, nutrient-dense butter.
The transition over the same period away from whole grains and other antioxidant-rich whole foods toward sugars and refined flour products that provide calories but are stripped of vital nutrients.  It is really the simple matter of refined products…oils, sugars, and grains…both “crowding out” the traditional whole foods that we are genetically programmed to eat, as well as the massive quantities of fractured products in the modern diet that overwhelm the modest levels of good nutrition that we still take in.
Both type 1 and type 2 diabetes share one central feature: elevated blood sugar (glucose) levels due to absolute or relative insufficiencies of insulin, a hormone produced by the pancreas.
During and immediately after a meal, digestion breaks carbohydrates down into sugar molecules (of which glucose is one) and proteins into amino acids. Right after the meal, glucose and amino acids are absorbed directly into the bloodstream, and blood glucose levels rise sharply. The rise in blood glucose levels signals important cells in the pancreas, called beta cells, to secrete insulin, which pours into the bloodstream.
When insulin levels are high, the liver stops producing glucose and stores it in other forms until the body needs it again. About 2 - 4 hours after a meal both blood glucose and insulin are at low levels, with insulin being slightly higher. Without insulin to move glucose into cells, blood glucose levels become excessively high, a condition known as hyperglycemia.
Weakness, weight loss, frequent urination, and excessive hunger and thirst are among the initial symptoms. About 5% of pregnant women develop a form of type 2 diabetes, usually temporary, in their third trimester called gestational diabetes. Type 1 diabetes is usually a progressive autoimmune disease, in which the beta cells that produce insulin are slowly destroyed by the body's own immune system. Researchers have found at least 18 genetic locations, labeled IDDM1 - IDDM18, that are related to type 1 diabetes. Most people who develop type 1 diabetes, however, do not have a family history of the disease. Some research suggests that viral infections may trigger the disease in genetically susceptible individuals.
Conditions that damage or destroy the pancreas, such as pancreatitis, pancreatic surgery, or certain industrial chemicals can cause diabetes.
Type 1 diabetes can occur at any age but usually appears between infancy and the late 30s, most typically in childhood or adolescence.
Children with type 1 diabetes may also be restless, apathetic, and have trouble functioning at school.
The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes, or if the tests are normal in people who have symptoms or risk factors for diabetes. Patients who have the FPG and OGTT tests must not eat for at least 8 hours prior to the test.
The results of a blood glucose test tell the patient and doctor how well the diabetes is controlled for only the day of the test.
Once a blood sugar molecule sticks to a hemoglobin molecule, which are found in every red blood cell, it never lets go (a process called glycation). Therefore, an elevated hemoglobin A1c level tells the doctor and the patient how well controlled the patients diabetes has been over the last 3 months or so.
Measuring glycosylated hemoglobin is not generally used for making an initial diagnosis of diabetes, since a normal level does not rule out diabetes. Elevated levels of glycosylated hemoglobin are strongly associated with most if not all of the complications of diabetes. Type 1 diabetes is characterized by the presence of a variety of antibodies that attack the islet cells.
Cardiac exercise testing should be considered for adult patients with any symptoms or electrocardiogram findings, or before starting an exercise program. Protect the heart and aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure. Healthy eating habits, along with good control of blood glucose, are the basic goals, and several good dietary methods are available to meet them.
Protein should provide 12 - 20% of daily calories, although this may vary depending on a patient’s individual health requirements.
To avoid hypoglycemia, patients should inject insulin in sites away from the muscles they use the most during exercise. Before exercising, avoid alcohol and if possible certain drugs, including beta blockers, which make it difficult to recognize symptoms of hypoglycemia. Insulin-dependent athletes may need to decrease insulin doses or take in more carbohydrates, especially in the form of pre-exercise snacks.
Patients with diabetes and high blood pressure need an individualized approach to drug treatment, based on their particular health profile. Angiotensin-converting enzyme (ACE) inhibitors reduce the production of angiotensin, a chemical that causes arteries to narrow.
Calcium-channel blockers (CCBs) decrease the contractions of the heart and widen blood vessels. Nearly all patients who have diabetes and high blood pressure should take an ACE inhibitor (or ARB) as part of their regimen for treating their hypertension.
The primary safety concern with statins has involved myopathy, an uncommon condition that can cause muscle damage and, in some cases, muscle and joint pain. Although lowering LDL cholesterol is beneficial, statins are not as effective as other medications -- such as niacin and fibrates -- in addressing HDL and triglyceride imbalances.
Fibrates, such as gemfibrozil (Lopid) and fenofibrate (Tricor), are usually the second choice after statins. In virtually all cases, wound care requires debridement, which is the removal of injured tissue until only healthy tissue remains. Administering hyperbaric oxygen (oxygen given at high pressure) is showing promise in promoting healing. Total-contact casting (TCC) uses a cast that is designed to match the exact contour of the foot and distribute weight along the entire length of the foot. Nonprescription analgesics, such as aspirin, acetaminophen, and non-steroidal anti-inflammatory drugs (NSAIDs). Topical medications, particularly capsaicin (the active ingredient in hot peppers), are applied to the skin to relieve minor local pain.
Tricyclic antidepressants, such as amitriptyline (Elavil) or doxepin (Sinequan), are effective in reducing pain from neuropathy in many patients.
Duloxetine (Cymbalta), a serotonin and norepinephrine reuptake inhibitor, is approved for treatment of pain associated with diabetic peripheral neuropathy.
Anti-seizure drugs used for peripheral neuropathy pain relief include gabapentin (Neurontin), pregabalin (Lyrica), carbamazepine (Tegretol), and valproate (Depakote).
Although not proven to be beneficial, patients may also try transcutaneous electrostimulation (TENS), a treatment that involves administering mild electrical pulses to painful areas. Tight control of blood sugar and blood pressure is essential for preventing the onset of kidney disease. ACE inhibitors are the best class of blood pressure medications for delaying kidney disease and slowing disease progression in patients with type 1 diabetes.
For patients with diabetes who have microalbuminuria, the American Diabetes Association strongly recommends ACE inhibitors or ARBs. A doctor may recommend a low-protein diet for patients whose kidney disease is progressing despite tight blood sugar and blood pressure control.
Intensive blood sugar control during pregnancy can reduce the risk for health complications for both mothers and babies.
To prevent birth defects that affect the heart and nervous system, women with diabetes should take a higher dose of folic acid from the time of conception up to week 12 of pregnancy. Women with diabetes should have an eye examination during pregnancy and up to a year afterward. Many patients experience significant weight gain from insulin administration, which may have adverse effects on blood pressure and cholesterol levels. A diet plan that compensates for insulin administration and supplies healthy foods is extremely important. The goal of intensive insulin therapy is to keep blood glucose levels as close to normal as possible. Table 1:Glucose Goals for Patients with Diabetes Standard insulin therapy usually consists of one or two daily insulin injections, one daily blood sugar test, and visits to the health care team every 3 months.
Insulin requirements vary depending on many non-nutritional situations during the day, including exercise and sleep. The patient must also maintain a good diet plan and should visit the health care team of doctors, nurses, and dietitians once a month.
Because of the higher risk for hypoglycemia in children, doctors recommend that intensive treatment be used very cautiously in children under 13 and not at all in very young children. The catheter at the end of the insulin pump is inserted through a needle into the abdominal fat of a person with diabetes. Learning to use the pump can be complicated, although over time most patients find the devices are fairly easy to use. Insulin pumps are more expensive than insulin shots and occasionally have some complications, such as blockage in the device or skin irritation at the infusion site. Pramlintide (Symlin) is a new type of injectable drug that can help control postprandial hyperglycemia, the sudden increase in blood sugar after a meal. Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) are of concern for patients who take insulin.
Different goals may be required for specific individuals, including pregnant women, very old and very young people, and those with accompanying serious medical conditions. Home monitors are about 10 - 15% less accurate than laboratory monitors, and many do not meet the standards of the American Diabetes Association.
To monitor the amount of glucose within the blood a person with diabetes should test their blood regularly.
Continuous glucose monitoring systems (CGMS) use a needle-like sensor inserted under the skin of the abdomen to monitor glucose levels every 5 minutes. GlucoWatch is a battery-powered wristwatch-like device that measures glucose by sending tiny electric currents through the skin, a technique called reverse iontophoresis. Hemoglobin A1c (also called HbA1c , HA1c, or A1C) is measured periodically every 2 - 3 months, or at least twice a year, to determine the average blood-sugar level over the lifespan of the red blood cell.
Some research has suggested that children (particularly thin children) are at higher risk for hypoglycemia because the injection goes into muscle tissue. Patients who intensively control their blood sugar should monitor blood levels as often as possible, four times or more per day.
In adults, it is particularly critical to monitor blood glucose levels before driving, when hypoglycemia can be very hazardous.
Patients who are at risk for hypoglycemia should always carry hard candy, juice, sugar packets, or commercially available glucose substitutes. If the patient is helpless (but not unconscious), family or friends should administer three to five pieces of hard candy, two to three packets of sugar, half a cup (four ounces) of fruit juice, or a commercially available glucose solution. If there is inadequate response within 15 minutes, the patient should receive additional sugar by mouth and may need emergency medical treatment, possibly including an intravenous glucose solution. Family members and friends can learn to inject glucagon, a hormone, which, in contrast to insulin, raises blood glucose. Patients with type 1 diabetes should always wear a medical alert ID bracelet or necklace that states that they have diabetes and take insulin. Patients should inspect their feet daily and watch for changes in color or texture, odor, and firm or hardened areas, which may indicate infection and potential ulcers.
When washing the feet, the water should be warm (not hot) and the feet and areas between the toes should be thoroughly dried afterward. Gently use pumice to remove corns and calluses (patients should not use medicated pads or try to shave the corns or calluses themselves).
Intensive control of blood glucose and keeping glycosylated hemoglobin (HbA1c) levels below 7%.
Diabetic ketoacidosis (DKA) is a life-threatening complication caused by insulin deficiency.
The process is usually triggered in insulin-deficient patients by a stressful event, most often pneumonia or urinary tract infections.
Severely low insulin levels cause excessive amounts of glucose in the bloodstream (hyperglycemia).
These fatty acids are converted into chemicals called ketone bodies, which are toxic at high levels.
Cerebral edema, or brain swelling, is a rare but very dangerous complication that occurs in 1% of ketoacidosis cases and results in coma, brain damage, or death in many cases.
Other serious complications from DKA include aspiration pneumonia and adult respiratory distress syndrome. If the condition persists, coma and eventually death may occur, although over the past 20 years, death from DKA has decreased to about 2% of all cases. Life-saving treatment uses rapid replacement of fluids with a salt (saline) solution followed by low-dose insulin and potassium replacement.
Patients with type 1 diabetes are 10 times more at risk for heart disease than healthy patients. Both type 1 and 2 diabetes accelerate the progression of atherosclerosis (hardening of the arteries).
In type 1 diabetes, high blood pressure (hypertension) usually develops if the kidneys become damaged.
Impaired nerve function (neuropathy) associated with diabetes also causes heart abnormalities.
Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Diabetic nephropathy, the leading cause of end-stage renal disease (ESRD), occurs in about 20 - 40% of patients with diabetes.
Diabetes is responsible for more than half of all lower limb amputations performed in the U.S.
People with diabetes who are overweight, smokers, and have a long history of diabetes tend to be at most risk. In general, foot ulcers develop from infections, such as those resulting from blood vessel injury. Charcot foot is initially treated with strict immobilization of the foot and ankle; some centers use a cast that allows the patient to move and still protects the foot. Diabetes accounts for thousands of new cases of blindness annually and is the leading cause of new cases of blindness in adults ages 20 - 74.
The early and more common type of this disorder is called nonproliferative or background retinopathy.
If the capillaries become blocked and blood flow is cut off, soft, "woolly" areas may develop in the retina's nerve layer. Type 1 diabetes is associated with a slightly reduced bone density, putting patients at risk for osteoporosis and possibly fractures. Women with diabetes should also be aware that certain types of medication can affect their blood glucose levels. It is also important for women to closely monitor their blood sugar levels during pregnancy. Major advances in islet-cell transplantation are allowing more patients to come off insulin or reduce their use of it.
As soon as there are sufficient numbers of islets available for transplantation, the patient is given intravenous antibiotics and oral vitamins E, B6, and A. Once the islets have been isolated, they are injected directly in a major vein in the patient's liver. Specific drugs, such as tacrolimus, sirolimus, or rapamycin (Rapamume), are used to suppress the immune system.


This procedure is still investigational but has helped some patients with severe type 1 diabetes to become free of insulin injections. A major obstacle for the islet cell transplantation is the need for two or more donor pancreases to supply sufficient islet cells. Whole pancreas transplants and double transplants of pancreases and kidneys are proving to have a good long-term success rate for some patients with type 1 diabetes. Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Tamborlane WV, Beck RW, Bode BW, Buckingham B, Chase HP, et al. SEARCH for Diabetes in Youth Study Group, Liese AD, D'Agostino RB, Hamman RF, Kilgo PD, Lawrence JM, et al. Writing Group for the SEARCH for Diabetes in Youth Study Group , Dabelea D, Bell RA, D'Agostino RB, Imperatore G, Johansen JM, et al. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
Homeostasis- all of these items above must interact to create a balanced internal environment within living organisms.
Intestinal juices and digestive enzymes break food down into small enough sizes for absorption.
Pancreas- manufactures and secretes pancreatic digestive enzymes to break down food and pancreatic juice (pH 8) to ___________ it. Carbon dioxide, the by product of chemical ____________ is removed from our blood into the lungs. Sweat glands sweat out wastes like salt, nitrogenous waste and water from the _______ of your skin. Each sweat gland is surrounded by small _________ vessels that transfer the waste to your sweat gland through your pores to your skin. The liver converts _______ amino acids in our bloodstream into other compounds the body can use. Microscopic webs of small blood vessels called ____________ filter back the water and nutrients.
Testing urine proves if substances like ______ have been in a person's system recently.Finding certain substances in the urine, like ________, can indicate a problem like diabetes. Veins - thin walled vessels without muscle, moves blood ______ _________ the heart, one-way valves prevent ______ flow.
Capillaries- microscopic blood vessels only ____ _______ thick, oxygen and carbon dioxide _______ across the capillaries and body tissues.
The muscles of the heart contract and pump blood ________ ________ the heart (through the aorta) and to the tissues of the body. Blood rich in oxygen flows in the pulminary ________ from the LUNG into the ________ atrium of the heart.
Your heart beats when the _____________ (sinoatrial node located in the right atrium) sends an impulse that causes muscle contractions to occur. The miniumum blood pressure is when the ventricles are _________ called diastolic pressure.
High blood pressure- makes the heart work harder and can lead to many problems such as ____________ of the blood vessels and heart muscle.
Atherosclerosis occurs when fatty plaque deposits _______ _____ on the walls of blood vessels. If this condition occurs in the coronary arteries, it can ___________ the flow of blood that supplies the heart with oxygen and nutrients. The part of the heart that isn't getting the supply of ___________ it needs can start to die, causing a heart attack.
Without oxygen, cells in your brain ________ causing permanent damage such as ________ immobility.
Cardiovascular diseases can be prevented through the avoidance of smoking, regular ___________, keeping your blood pressure low and balanced _________. Hemophilia is a genetic disorder that causes defected clotting factor proteins, leading to the inability to clot blood. Blood is composed of 55% plasma and 45% red blood cells, __________ blood cells and platelets. Plasma is made up primarily of ________, but also contains salts, nutrients, hormones, and many other substances.
Sickle cell anemia is a genetic disease where the red blood cells are crescent shaped and can't carry oxygen. When the air enters the lungs, it travels through the bronchi to clusters of microscopic air ______ called alveoli wrapped in capillaries. The diaphragm is a _________ located underneath the heart and lungs that contracts to pull air into the lungs and relaxes to force air out of the lungs. Emphysema is when your lungs lose their ___________, making it extremely difficult to breathe. Nerves allows organisms to detect and respond to stimuli by transmitting ___________ impulses cell to cell. These receptor sites play an important role in allowing cells and organs to ____________ with one another. A hormone is a chemical __________ with a specific shape that travels through the bloodstream influencing another target cell or target organ. Upon reaching the cell the hormone is targeted for, the hormone activates a ______ within a cell to make a necessary compound.
The pituitary gland at the base of the brain makes __________ hormone, thyroid and follicle stimulating hormones. Adrenal glands above the kidneys secrete ___________ to increase heartbeat and blood clotting rates. The Islets of Langerhans in the pancreas secretes _________ to absorb sugar from the blood vessels by storing it as glycogen in the ________. Any change in nerve or hormone signals will change the communication between cells and organs in an organism and thus may cause problems for organisma€™s stability and ability to maintain ____________. Feedback is when a change in one quantity causes a change in a second quantity which then causes a change in the __________ quantity. Negative feedback is when the change caused by the feedback is _________ to the initial change. Excessive sugar in the blood is caused by a deficiency of _________ produced by the islets of Langerhans in the pancreas. The immune response is the defensive reaction of the body to foreign substances or organisms.
Smoking, _________, and over consumption of alcoholic beverages would be a few examples of poor personal choices which may have immediate or long term consequences for our health. Immunity describes the ability of an organism to ______ foreign organisms or invaders which enter its body.
The immune system is designed to protect against microscopic organisms (bacteria, viruses) and foreign substances which enter an organism from outside its body. An antigen is any foreign substance which _________ the body of an organism, while a pathogen is a living antigen (such as viruses or bacteria) which invade an organism. Many different kinds of white blood cells exist which are able to help the body fight foreign invaders in various ways. Release of ____________- proteins that attach to the surface proteins of pathogens, deactivating them. When organisms are exposed to disease, they make specific antibodies which destroy that antigen during their first exposure to it. This first exposure to a disease and our making of __________ in reaction to this to defend ourselves is sometimes called the primary immune response.
This means that if we ever are exposed to that same particular disease antigen again, our immune system has a memory and will make _________ so rapidly in response to another exposure that we will not get the disease. Vaccinations use ______ or weakened microbes or parts of them to stimulate the primary immune response or first production of antibodies.
Using dead or weakened microbes has the advantage of not making the organism sick as they would become if they caught and recovered from a disease. Because the vaccine has stimulated the immune system, the organism will now have a _________ to subsequent exposures to that disease causing antigen. In allergies, the body's immune system produces chemicals in response to normally ________ substances which do not trouble other individuals.
In auto-immune diseases, the body's immune system for usually unknown reasons may attack and destroy some its ______ cells. Some viral diseases damage the immune system which leaves it unable to cope with many antigens and other infectious agents.
Exposure of cells to certain chemicals and radiation appears to increase the chance of mutations and thus cancer. Biological research is constantly ongoing to find knowledge about diagnosing, preventing, treating, controlling and curing diseases in plants and animals. The human genome project has provided a great deal of information of the genetic basis of many diseases.
When giving blood transfusions, it is important to consider the importance of the blood type of the recipient and donor. All pathology reports contains certain compulsory information that is essential for interpreting your results.
It is important that you only use the reference range on the report from the lab that performed the analysis and not from any other source as reference ranges may differ between laboratories for some tests.
In summer, we naturally rotate away from heavy anabolic “build-up” foods such as animal proteins and fats to more catabolic, cleansing fruits and vegetables. But, healing often brings reactions, so when we launch into a healthier dietary or lifestyle program, we need to expect reactions and read them as positive signs of healing.
Giving up sugar, coffee, alcohol, dairy, meats or fats each has a set of associated reactions, outlined below.
Toxic experiences and traumas, perhaps dating to early childhood, also come with their own unique set of physical and emotional reactions; these are signs of a more prolonged and complex healing process.
Reactions feel similar to the original disease or emotional trauma but usually appear in a diminished form. Pain may occur in the internal organs, particularly the liver, under the right side of the rib cage.
First outlined by Constantine Hering (1800-1880) and known as Hering’s Law of Cure, such symptoms are used to this day in the field of homeopathy. Medications that affect the liver or kidneys can appear as redness or rashes on the legs or ankles.
The second factor—the postwar shift from traditional to refined carbohydrates—is largely due to the growing role of the commercial food industry and processed, convenience foods.  Convenience foods must have a long shelf-life, so food companies rely upon refined flours and oils, which do not go rancid. Visual pictures of postprandial blood sugar behavior, while less scientific than GI measurements, are nevertheless powerful learning tools, providing a real flavor for how our body reacts when we eat different kinds of foods. This chart illustrates the second meal effect– that what we eat at one meal affects postprandial blood sugar behavior at the next. What we do to our children when we give them a sugary cereal or a Pop-tart for breakfast extends beyond this first meal to affect their blood sugar, hunger, concentration, and desire to overeat throughout the rest of the day. One of the best herbs and spices to moderate blood sugar.  It can be sprinkled on hot cereals and desserts such as puddings, custards, and stewed fruits.
Among its jobs, the liver helps to regulate blood sugar and the burning of fat; and, it processes and helps the body discard many toxins—drugs, pesticides, food additives and chemicals, environmental toxins, caffeine, alcohol, and toxic metals. Refined carbohydrates and omega-6 vegetable oils such as corn, soy, and canola provide concentrated, inflammatory, empty calories but without the fiber (to slow and assist digestion) and essential neutralizing phytonutrient cofactors to allow the liver to do its job well.
Nonalcoholic fatty liver disease affects more than 70 million Americans and is fostered by the modern American diet.
These high-glycemic carbohydrates tax the liver because of the speed with which the liver is forced to deal with the rapid-metabolizing calories and because they lack the nutritional co-factors required by the liver for their processing.
Choline, found in egg yolks, liver, and organ meats, is necessary for the proper transport of fats from the liver. The disease begins with the accumulation of fat within the cells of the liver, but can progress to inflammation, the development of scar tissue, and in some cases death from liver failure or cancer.
The liver regulates blood glucose and blood cholesterol levels, plays a critical role in burning fat for fuel, helps eliminate excess nitrogen, contributes to the metabolism of endocrine hormones, stores vitamin A, protects against infections, and detoxifies drugs and environmental toxins. Indeed, fatty liver disease increases the risk of cardiovascular disease three-fold in men, fourteen-fold in women, and seven- to ten-fold in type one diabetics. Similar studies have shown that 45 percent of type-one diabetics and 70-85 percent of type-two diabetics have fatty liver. The accumulation of delicate fats, especially polyunsaturated fatty acids (PUFAs) [like corn, soy, safflower, and canola oils]increases the vulnerability of the liver to oxidative and inflammatory insults in the form of infections, toxins, or poor metabolism. What they all have in common is that they are ancestral diets, rich in nutrient-dense foods that we are well-adapted to…The emergence of fatty liver as a silent epidemic in the modern era is a call to nourish our livers with age-old traditional wisdom as we pursue the vibrant health of our ancestors. Do we give sufficient thought to how convenience foods combine with drugs and medications compound, creating an ever greater toxic load for the liver? Try to read labels and think of the factors in your present lifestyle that might be placing an unnecessary load on your liver. Besides lack of sleep, stress and emotional upheaval are also big factors that can send us to the cookie jar.
Without eating animal protein to counterbalance and buffer this expansive energy, they set in motion a blood sugar roller-coaster of “sugar-insulin-sugar,” along with insatiable cravings for more and more sugar-charged treats. Roasting root vegetables caramelizes their natural sweet starches into sugars, concentrating and intensifying their natural sweetness. Try radishes (at the end of the meal), lemon juice and water, or spices like cinnamon to satisfy the sweet tooth. Rice syrup and barley malt are less disruptive to the mineral balance of the body, along with maple syrup which is indigenous to the Northeast.
BackgroundThe two major forms of diabetes are type 1, previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, and type 2, previously called non-insulin-dependent diabetes mellitus (NIDDM) or maturity-onset diabetes. Here, insulin and other hormones direct whether glucose will be burned for energy or stored for future use.
In addition to secreting digestive enzymes, the pancreas secretes the hormones insulin and glucagon into the bloodstream. In type 2 diabetes, the body does not respond properly to insulin, a condition known as insulin resistance. It is unknown what first starts this cascade of immune events, but evidence suggests that both a genetic predisposition and environmental factors, such as a viral infection, are involved. The IDDM1 region contains the HLA genes that encode proteins called major histocompatibility complex.
The odds of inheriting the disease are only 10% if a first-degree relative has diabetes, and even in identical twins, one twin has only a 33% chance of having type 1 diabetes if the other has it.
Over the past 40 years, a major increase in the incidence of type 1 diabetes has been reported in certain European countries, and the incidence has tripled in the U.S. Certain drugs can also cause temporary diabetes, including corticosteroids, beta blockers, and phenytoin.
SymptomsThe process that destroys the insulin-producing beta cells can be long and insidious. Widespread screening of patients to identify those at higher risk for diabetes type 1 is not recommended. The oral glucose tolerance test (OGTT) is more complex than the FPG and may overdiagnose diabetes in people who do not have it.
This test examines blood levels of glycosylated hemoglobin, also known as hemoglobin A1c (HbA1c).
If a patient with diabetes has elevated blood glucose on many days, more blood glucose molecules will stick to the hemoglobin molecule.
These antibodies are referred to as autoantibodies because they attack the body''s own cells -- not a foreign invader.
The earliest manifestation of kidney disease is microalbuminuria, in which tiny amounts (30 - 300 mg per day) of protein called albumin are found in the urine.
The American Diabetes Association recommends that patients with type 1 diabetes have an annual comprehensive eye exam, with dilation, to check for signs of retina disease (retinopathy). All patients should be screened for nerve damage (neuropathy), including a comprehensive foot exam. People with type 1 diabetes must coordinate calorie intake with medication or insulin administration, exercise, and other variables to control blood glucose levels.
People with diabetes, whether type 1 or 2, are at risk for a number of medical complications, including heart and kidney disease. It increases sensitivity to insulin, lowers blood pressure, improves cholesterol levels, and decreases body fat. These include weight reduction (when needed), following the Dietary Approaches to Stop Hypertension (DASH) diet, smoking cessation, limiting alcohol intake, and limiting salt intake to no more than 1,500 mg of sodium per day. Strict control of blood pressure is critical for preventing complications of diabetes and has proven to improve survival rates.
They include atorvastatin (Lipitor), lovastatin (Mevacor and generics), pravastatin (Pravachol), simvastatin (Zocor and generics), fluvastatin (Lescol), and rosuvastatin (Crestor). Niacin has the most favorable effect on raising HDL and lowering triglycerides of all the cholesterol drugs. Taking a daily aspirin reduces the risk for blood clotting and may help protect against heart attacks.
Fortunately, severe and even moderate vision loss is largely preventable with tight control of blood glucose levels. Patients with severe diabetic retinopathy or macular edema (swelling of the retina) should see an eye specialist who is experienced in the management and treatment of diabetic retinopathy.
In some cases, hospitalization and intravenous antibiotics for up to 28 days may be needed for severe foot ulcers. Debridement may be accomplished using chemical (enzymes), surgical, or mechanical (irrigation) means. Felted foam uses a multi-layered foam pad over the bottom of the foot with an opening over the ulcer. It is generally reserved for patients with severe, full thickness diabetic foot ulcers that have not responded to other treatments, particularly when gangrene or an abscess is present. Alternative treatments -- such as hypnosis, biofeedback, relaxation techniques, and acupuncture -- have also been reported to help some patients manage pain.
Neuropathy also impacts other functions, and treatments are needed to reduce their effects. Studies indicate that phosphodiesterase type 5 (PDE-5) drugs, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), are safe and effective, at least in the short term, for many patients with diabetes. Strict control of these two conditions produces a reduction in new cases of nephropathy and a delay in progression of the disease. Microalbuminuria is an accumulation of protein in the blood, which can signal the onset of kidney disease (nephropathy). Protein-restricted diets can help slow disease progression and delay the onset of end-stage renal disease (kidney failure).
Doctors recommend that pregnant women with pre-existing diabetes monitor their blood sugar levels up to 8 times daily. TreatmentInsulin is essential for strict control of blood glucose levels in type 1 diabetes. It is important to manage heart disease risk factors that might develop as a result of insulin treatment. The basal component of the treatment attempts to provide a steady amount of background insulin throughout the day. Meals require a boost (a bolus) of insulin to regulate the sudden rise in glucose levels after a meal. Injections of insulin under the skin ensure that it is absorbed slowly by the body for a long-lasting effect. Insulin is available in several forms, including: standard, intermediate, long-acting, and rapid-acting. Insulin lispro (Humalog) and insulin aspart (Novo Rapid, Novolog) lower blood sugar very quickly, usually within 5 minutes after injection. Regular insulin begins to act 30 minutes after injection, reaches its peak at 2 - 4 hours, and lasts about 6 hours.
Regimens generally include combinations of short and longer-acting insulins to help match the natural cycle.
An insulin pump can improve blood glucose control and quality of life with fewer hypoglycemic episodes than multiple injections. Some are worn externally and are programmed to deliver insulin through a catheter in the skin or the abdomen. Studies indicate that even very young children (ages 2 - 7 years) can successfully use insulin pumps and that the pumps may help improve blood sugar control. Dosage instructions are entered into the pump's small computer, and the appropriate amount of insulin is then injected into the body in a calculated, controlled manner.
In spite of early reports of a higher risk for ketoacidosis with pumps, more recent studies have found no higher risk. Pramlintide is injected before meals and can help lower blood sugar levels in the 3 hours after meals. Side effects may include nausea, vomiting, abdominal pain, headache, fatigue, and dizziness. Most doctors believe, however, that they are accurate enough to indicate when blood sugar is too low. While fingerprick self-testing provides information on blood glucose for that day, the HbA1c test shows how well blood sugar has been controlled over the period of several months. These tests should always be performed during illness or stressful situations, when diabetes is likely to go out of control. Pinching the skin so that only fat (and not muscle) tissue is gathered or using shorter needles may help. For example, taking a fast-acting insulin (insulin lispro) before the evening meal may be particularly helpful in preventing hypoglycemia at bedtime or during the night. This approach can help prevent complications due to vascular (blood vessel) abnormalities and nerve damage (neuropathy) that can cause major damage to organs, including the eyes, kidneys, and heart.
Blood glucose control helps the heart, but it is also very important that people with diabetes control blood pressure, cholesterol levels, and other factors associated with heart disease. Other triggers include alcohol abuse, physical injury, pulmonary embolism, heart attacks, or other illnesses.
Among young patients, the youngest children and boys of any age are at higher risk for hypoglycemia. Hypoglycemia unawareness is a condition in which people become accustomed to hypoglycemic symptoms. Mild symptoms usually occur at moderately low and easily correctable levels of blood glucose.
Heart attacks account for 60% of deaths in patients with diabetes, while strokes account for 25% of such deaths. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. With this condition, the tiny filters in the kidney (called glomeruli) become damaged and leak protein into the urine. Patients with ESRD have 13 times the risk of death compared to other patients with type 1 diabetes. It is a common complication that affects nearly half of people with type 1 or type 2 diabetes after 25 years.
Studies show that tight control of blood glucose levels delays the onset and slows progression of neuropathy. People who have the disease for more than 20 years and are insulin-dependent are at the highest risk. Numbness from nerve damage, which is common in diabetes, compounds the danger since the patient may not be aware of injuries.


Charcot foot or Charcot joint (medically referred to as neuropathic arthropathy) occurs in up to 2.5% of people with diabetes. When the acute phase has passed, patients usually need lifelong protection of the foot using a brace initially and custom footwear. Patients with no signs of retinal damage or low risk factors for retinopathy may only require screening every 2 - 3 years. People with diabetes face a higher risk for influenza and its complications, including pneumonia, possibly because the disorder neutralizes the effects of protective proteins on the surface of the lungs. Women with diabetes face a significantly higher risk for urinary tract infections, which are likely to be more complicated and difficult to treat than in the general population. Depression, in turn, may increase the risk for hyperglycemia and complications of diabetes.
The changes in estrogen and other hormonal levels that occur during perimenopause can cause major fluctuations in blood glucose levels. Up to a third of young women with type 1 diabetes have eating disorders and under-use insulin to lose weight.
Two or three organs are usually needed in order to supply enough islet cells to have any effect on insulin production. This generally requires multiple pancreas donors in order to achieve complete independence from insulin therapy. However, many of these insulin-independent patients needed to resume insulin injections within 2 years. Unfortunately, there are not enough pancreases available to make this procedure feasible for even 1% of patients. The operations help to prevent further kidney damage, and long-term studies indicate that they may even eventually reverse some existing damage. Kidney damage caused by diabetes most often involves thickening and hardening of the internal kidney structures. Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Our bodies have the ability to detect slight changes internally or externally and make changes to correct any deviations. When it contracts (with each heart _______) it pumps the oxygenated blood into arteries that carry blood to _____ __________.
After the blood flows into the right ventricle, it is pumped to the ________ through the pulminary arteries.
Hemoglobin is a protein located on red blood cells that binds to oxygen in the lungs and transports it to the tissues where the oxygen gets released.
When you are ________, the number of white blood cells in the blood increases to help fight infection. This causes clotting factors to be released, which can produce ____________ filaments called fibrins. The amount of hemoglobin A1C levels in your body reflects the last several weeks of blood sugar levels.
Individual pathology laboratories often add their own information and they can vary in the way it is presented. See Reference ranges and what they mean for more information about how these are calculated and why they differ between laboratories. If you have enough tests done it is very likely that one or more results will fall just outside the reference range by chance. The results are followed by information provided by the laboratory to assist with interpretation of the results.
Sometimes if treatment is too strict, blood sugar levels may fall to very low levels at times and this is potentially dangerous. There will however, always be some indicator of abnormality, most commonly an H for high or L for low but some labs may use other marks such as # or * signs to indicate the result is outside the reference range. Healing reactions present an opportunity to go back through everything not previously resolved in life. If the reaction is an emotional discharge of anger, the feeling may remind a person of anger earlier in life, even though the present anger may be “caused” by different circumstances.
Thus, it is the liver that bears the brunt of many of our modern dietary and lifestyle habits. The speed with which empty calories are consumed—particularly from the sugar and high fructose corn syrup (HFCS) in soft drinks—exerts an enormously heavy burden on the liver. As in the case of refined carbohydrates, processing strips refined oils of their natural protective antioxidants. Fatty liver is thus a dangerous silent epidemic, and… it is likely caused by the overabundance of calorie-rich, nutrient-poor refined foods and the banishment of traditional sources of choline like liver and egg yolks from the modern American menu. Moreover, even in the absence of diabetes and obesity, those with the lowest insulin sensitivity have the highest accumulation of liver fat. In the second, inflammation, the proliferation of fibrous connective tissue (fibrosis), and eventually the formation of scar tissue (cirrhosis) ensue. These insults launch the progression from the first stage of simple fat accumulation to the second stage of inflammation. Other strategies to support the liver include consuming fresh, organic (to avoid pesticides) fruits and vegetables and organic animal proteins rich in choline, while avoiding sugar, HFCS, refined vegetable oils and other refined, processed foods. Layer upon layer, toxins that burden the liver are everywhere—from synthetic prescription drugs, over-to-counter medications such as Tylenol and Nyquil, caffeine, alcohol, food additives and food colorings, pesticides in foods, and chemicals in cleaning agents. If you do not eat them already, try some cleansing bitter greens and think of shopping for fresh, organic food at a local farmers’ market.
When we eat meat, which is concentrated protein and fat, we crave concentrated carbohydrates like sugar.
Because carbohydrate and protein metabolism are inter-related, when we eat a lot of sugar and other concentrated sweets, our body needs to be anchored by additional concentrated animal protein and fats in order to stabilize blood sugar. Ironically, “like” craves “like:” Contractive foods (chips) do send us for expansive opposites (a Coke), but this safeguard relationship does not hold so well for expansive foods.
Carbohydrate digestion begins in the mouth and the true essence of whole foods is tapped only when we sit down long enough to chew well and enjoy our food. Foods all have an associated temperature, so you can choose warming sweet potatoes, oats, or the heat of lamb in the cold winter months; or cooling melon and pears, salad greens, tempeh, and barley in the hot summer months. Through the magic of heat and stable saturated fats, we can alter a pungent onion into sweet velvety smoothness.
The release of insulin into the blood lowers the level of blood glucose (simple sugars from food) by enhancing glucose to enter the body cells, where it is metabolized.
After delivery, blood sugar (glucose) levels generally return to normal, although 25% of these women develop type 2 diabetes within 15 years.
Children are more likely to inherit the disease from a father with type 1 diabetes than from a mother with the disorder.
Epidemics of Coxsackie virus, as well as mumps and congenital rubella, have been associated with incidence of type 1 diabetes. At the point when insulin production bottoms out, however, type 1 diabetes usually appears suddenly and progresses quickly.
Some doctors recommend it as a follow-up after FPG, if the latter test results are normal but the patient has symptoms or risk factors of diabetes. Blood tests for these autoantibodies can help differentiate between type 1 and type 2 diabetes. Testing should be performed yearly and perhaps every other year for patients with good lipid control and no evidence of heart disease.
Microalbuminuria is also a marker for other complications involving blood vessel abnormalities, including heart attack and stroke. Patients who lose sensation in their feet should have a foot exam every 3 - 6 months to check for ulcers or infections. Patients should meet with a professional dietitian to plan an individualized diet within the general guidelines that takes into consideration their own health needs. On the other hand, studies suggest that more than one-third of women with diabetes omit or underuse insulin in order to lose weight.
People with diabetes and risk factors for myopathy should be monitored for muscle symptoms.
Combining a statin with one of these drugs may be helpful for people with diabetes who have heart disease, low HDL, and near-normal LDL levels.
However, some patients who take high-dose niacin can experience increased blood glucose levels.
It can help relieve pain but has significant side effects, including nausea, constipation, and headache.
Unfortunately, tricyclics may cause heart rhythm problems, so patients at risk need to be monitored carefully.
If diabetes affects the nerves in the autonomic nervous system, then abnormalities of blood pressure control and bowel and bladder function may occur.
Typical side effects are minimal but may include headache, flushing, and upper respiratory tract and flu-like symptoms.
However, patients with end-stage renal disease who are on dialysis generally need higher amounts of protein. Patients on dialysis usually need injections of erythropoiesis-stimulating drugs to increase red blood cell counts and control anemia. This includes checking your blood glucose before each meal, 1 - 2 hours after a meal, at bedtime, and possibly during the night.
Tight blood glucose control is the best way to prevent major complications in type 1 diabetes, including those that affect the kidneys, eyes, nerve pathways, and blood vessels. Insulin glargine matches parts of natural insulin and maintains stable activity for more than 24 hours. For example, one approach in patients who are intensively controlling their glucose levels uses 3 injections of insulin, which includes a mixture of regular insulin and NPH at dinner.
The patient and doctor must determine the amount of insulin used -- it is not automatically calculated.
Pramlintide is used in addition to insulin for patients who take insulin regularly but still need better blood sugar control.
Patients with type 1 diabetes have an increased risk of severe low blood sugar (hypoglycemia) that may occur within 3 hours following a pramlintide injection. The patient should also undergo yearly urine tests for microalbuminuria (small amounts of protein in the urine), a risk factor for future kidney disease. It may also occur in a person with type 1 diabetes who is not consistent with insulin therapy, or who has an acute illness or infection that makes their diabetes difficult to control.
The most serious consequences of neuropathy occur in the legs and feet and pose a risk for ulcers and, in unusually severe cases, amputation. Patients with diabetes should be aware of other warning signs of a heart attack, including sudden fatigue, sweating, shortness of breath, nausea, and vomiting. The consequences of both poor circulation and peripheral neuropathy make this a common and serious problem for all patients with diabetes. About 85% of amputations start with foot ulcers, which develop in about 12% of people with diabetes. Related conditions that put people at risk include peripheral neuropathy, peripheral artery disease, foot deformities, and a history of ulcers.
Early changes appear similar to an infection, with the foot becoming swollen, red, and warm. People with diabetes are also at higher risk for developing cataracts and certain types of glaucoma. The two primary abnormalities that occur are a weakening of the blood vessels in the retina and the obstruction in the capillaries -- probably from very tiny blood clots.
Patients beginning a new or vigorous exercise program should have their eyes examined, as well as all patients planning pregnancy.
Everyone with diabetes should have annual influenza vaccinations and a vaccination against pneumococcal pneumonia. In terms of sexual health, diabetes may cause decreased vaginal lubrication, which can lead to pain or discomfort during intercourse.
Long-term use (more than 2 years) of birth control pills may increase the risk of health complications. Studies indicate that high blood sugar levels (hyperglycemia) can affect the developing fetus during the critical first 6 weeks of organ development. Women with diabetes also face an increased risk of premature menopause, which can lead to higher risk of heart disease.
Adolescents with diabetes are at higher risk than adults for ketoacidosis resulting from noncompliance. Researchers are continuing to work on refining the Edmonton protocol so that its benefits can be more sustainable and long lasting. Researchers are looking for alternative approaches including the use of umbilical cord cells, embryonic or adult stem cells, bone marrow transplantation, and other types of cellular therapies. There is some evidence that heart disease and diabetic neuropathy improve after pancreas transplantation (although not retinopathy). This type of sustained glucose testing gives a longer term view of your body’s insulin resistance levels and its ability to process glucose. This is why diabetes and obesity often go hand-in-hand (90% of diabetics are either overweight or obese). David Ludwig regarding high-glycemic foods and overeating, cited in the Recommended Reading section at the conclusion of this newsletter. Meanwhile, summer provides antidotes to detoxify and de-stress the liver with its vast array of rainbow-colored fresh, nutrient-dense vegetables and fruits. It is the calorie load, the speed, and the lack of nutritional cofactors needed by the liver to effectively process toxins that underlie the current epidemic of fatty liver disease. So, too, will eating hearty meals early in the day, with a light supper consumed at least several hours before bedtime time.
Have you ever noticed how much better you feel when you pair a glass of wine (an expansive sugar) with adequate protein and fats to avoid a hangover? Whole plant foods such as grains, beans, and vegetables become sweeter the longer they are chewed, so chewing well can go a long way toward satisfying cravings for sweets. They are wonderful experiments, but we owe ourselves to take note as if on a real adventure, and make sure we pay attention afterward to how we feel. If blood glucose levels get too low, the pancreas secretes glucagon to stimulate the release of glucose from the liver. New advances in genetic research are identifying other genetic components of type 1 diabetes.
Risk FactorsType 1 diabetes is much less common than type 2 diabetes consisting of only 5 - 10% of all cases of diabetes. Eating disorders have become a serious problem within the general population and are especially dangerous in patients with diabetes. Because patients with diabetes may have silent heart disease, they should always check with their doctors before undertaking vigorous exercise. Although combinations of statins and fibrates or niacin increase the risk of myopathy, both combinations are considered safe if used with extra care. Moderate doses of niacin can control lipids without causing serious blood glucose problems. Erythromycin, domperidone (Motilium), or metoclopramide (Reglan) may be used to relieve delayed stomach emptying caused by neuropathy. However, these drugs -- darbepoetin alfa (Aranesp) and epoetin alfa (Epogen and Procrit) -- can increase the risk of blood clots, stroke, heart attack, and heart failure in patients with end-stage kidney disease when they are given at higher than recommended doses. Intensive insulin treatment in early diabetes may even help preserve any residual insulin secretion for at least 2 years. Insulin glargine now offers the most consistent insulin activity level, but other intermediate and long-acting forms may be beneficial when administered twice a day.
This rapid action reduces the risk for hypoglycemic events after eating (postprandial hypoglycemia). Lente (insulin zinc) is another intermediate insulin that peaks 4 - 12 hours and lasts up to 18 hours. Another approach uses 4 injections, including a separate short-acting form at dinner and NPH at bedtime, which may pose a lower risk for nighttime hypoglycemia than the 3-injection regimen.
Newer, prefilled pens (Humulin Pen, Humalog) are disposable and allow the patient to dial in the correct amount. They work by administering a small amount of insulin continuously (the basal rate) and a higher dose (a bolus dose) when food is eaten. This requires an initial learning period, including understanding insulin needs over the course of the day and in different situations and knowledge of carbohydrate counting. Home tests are available for measuring A1C but they tend not to be as accurate as the laboratory tests ordered by doctors. Shoes with a rocker sole reduce pressure under the heel and front of the foot and may be particularly helpful. Longer survival rates are probably due to improvements in monitoring and tighter control of blood glucose.
Other contributing factors are lack of health insurance and intentionally reducing insulin doses in order to lose weight, which occurs with adolescent girls in an effort to keep weight down. It affects about 25% of patients who use insulin, nearly always people with type 1 diabetes. Urine tests showing microalbuminuria (small amounts of protein in the urine) are important markers for kidney damage. Symptoms of kidney failure may include swelling in the feet and ankles, itching, fatigue, and pale skin color.
Peripheral neuropathy usually starts in the fingers and toes and moves up to the arms and legs (called a stocking-glove distribution).
Lowering triglycerides, losing weight, reducing blood pressure, and quitting smoking may help prevent the onset of neuropathy.
If these processes affect the central portion of the retina, swelling may occur, causing reduced or blurred vision. In this more severe condition, new abnormal blood vessels form and grow on the surface of the retina. Therefore, it is important that women with pre-existing diabetes (both type 1 and type 2) who are planning on becoming pregnant strive to maintain good glucose control for 3 - 6 months before pregnancy.
Young people who do not control glucose are also at high risk for permanent damage in small vessels, such as those in the eyes.
These studies are still in very early stages, but researchers predict that there will be major advances in these fields in the coming years. However, this procedure has significant surgical and postsurgical complications in patients with diabetes. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.
It is these nutrient-laden whole foods that provide the liver with the tools—vitamins, minerals, and micronutrients—needed to convert toxins for their safe elimination from the body.
Nevertheless, like type 2 diabetes, the incidence of type 1 diabetes among children and adolescents has been rising over the past few decades.
A doctor uses the results from a creatinine blood test to calculate the glomerular filtration rate (GFR). Patients with diabetes should monitor their carbohydrate intake either through carbohydrate counting or meal planning exchange lists. Limit trans-fats (hydrogenated fat found in snack foods, fried foods, and commercially baked goods) to less than 1% of total calories. Some evidence suggests that they contribute to about 20% of cases of recurrent ketoacidosis in young women. Short-acting insulin delivered continuously using a pump is proving to a very good way to provide basal rates of insulin.
Optimal timing for administering this insulin is about 15 minutes before a meal, but it can also be taken immediately after a meal (but within 30 minutes).
The older Minimed system measures glucose over a 72-hour period and has wireless communication between the monitor and an insulin pump.
About a quarter of the time, the results differ significantly from actual fingerstick tests, however. Usually the condition is manageable, but, occasionally, it can be severe or even life threatening, particularly if the patient fails to recognize the symptoms, especially while continuing to take insulin or other hypoglycemic drugs. In such cases, hypoglycemia appears suddenly, without warning, and can escalate to a severe level. The outlook of end-stage renal disease has greatly improved during the last four decades for patients with type 1 diabetes, and fewer people with type 1 diabetes are developing ESRD. The bones may crack, splinter, and erode, and the joints may shift, change shape, and become unstable. One 10-year study reported that survival rate at 10 years was 76%, and two-thirds of the patients had both pancreas and kidney function.
Because summer also brings a more leisurely pace of living, there is perhaps no better time to alter dietary and lifestyle habits for a healthier liver. The rich minerals in meat help the body metabolize these concentrated calories so it does not have to tap into its mineral stores stockpiled in tissues, bones, and teeth. While type 2 diabetes has been increasing among African-American and Hispanic adolescents, the highest rates of type 1 diabetes are found among Caucasian youth. The GFR is an indicator of kidney function; it estimates how well the kidneys are cleaning the blood. Ketoacidosis is a significant complication of insulin depletion and can be life threatening. Ultralente insulin peaks at 10 hours and lasts up to 20 hours but varies greatly in activity from day to day. Even a single recent episode of hypoglycemia may make it more difficult to detect the next episode.
It typically develops in people who have neuropathy to the extent that they cannot feel sensation in the foot and are not aware of an existing injury. Major hemorrhage or retinal detachment can result, causing severe visual loss or blindness. Any duplication or distribution of the information contained herein is strictly prohibited. Unlike alcohol, our body does not react to sugar with the same hangover warning, but the imbalance is there nonetheless, through a surge in insulin, along with dehydration, depletion,1 and cravings.
With vigilant monitoring and by rigorously avoiding low blood glucose levels, patients can often regain the ability to sense the symptoms. Instead of resting an injured foot or seeking medical help, the patient often continues normal activity, causing further damage.
Doctors generally recommend transplants in cases of end-stage kidney failure or when diabetes poses more of a threat to the patient's life than the transplant itself. Late-night eating prevents the liver from doing its job efficiently and well (see November 2010 newsletter, The Body Clock).
However, even very careful testing may fail to detect a problem, particularly one that occurs during sleep.



2-hour postprandial blood sugar chart 2014
How low blood sugar for a seizure
Fasting sugar 7.2 update


Comments

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    Author: Dj_Dance
  2. 07.05.2014 at 23:40:25


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    Author: blero