Having Diabetes is no child’s play.

You might think that it’s only a matter of having a problem with your pancreas and your body’s inability to use glucose floating in your blood stream, but that’s not the full story.

Having Diabetes is so much more, there are so many other organs and systems that are affected by diabetes and we will be discussing a few. It is very important to know what diabetes is about and what you are facing in future, as failure to do so is like jumping into the ocean with a weight tied around your neck…… you will surely not survive.

Living with Diabetes is a challenge; it’s about lifestyle changes, about keeping away from the wrong things and about monitoring your glucose every day making sure you are maintaining healthy glucose levels.

Even if you do all of the above, it is not guaranteed that you will be in the lifeboat and not in the sea. Staying inside the lifeboat is a whole different mission, but you can get there with the right information and education.

As said, having diabetes makes you susceptible to so many other conditions, and they will surely be on your way. Here is just a very short version to introduce you to some of your competitors that you will be facing.

Diabetes associated conditions:

Diabetic Cardiovascular disease:

We kick off by looking at our vascular system and the changes that diabetes causes to this system. Diabetes causes major structural changes in the arteries and veins of your body like atherosclerosis and thickening of capillary basement membranes. This can cause an obstruction to blood flow which can lead to high blood pressure, peripheral vascular diseases or a total blockage which will cause a stroke, a heart attack or ischemia.

Diabetic Neuropathy:

As already discussed diabetes can cause changes in the blood vessels which supplies all areas of our body with oxygen, nutrients and water. These structural changes will also affect the nervous system and causes deterioration or loss of nerve function.

Diabetic neuropathy can manifest with no symptoms while the sufferer may also have symptoms such as pain, tingling, or numbness-loss of feeling-in the hands, arms, feet, and legs. According to research, about 60-70% of all diabetics have some form of diabetic neuropathy.

Diabetic Ketoacidosis:

Diabetic ketoacidosis is a is a life-threatening complication in patients with diabetes mellitus. If you do not have enough insulin in your body, you run the risk of developing this condition and urgent medical intervention is needed to prevent a sufferer from falling into a coma or even death.

Since you do not have enough insulin in your body, your glucose levels will increase and your body needs to get rid of the excess glucose by excreting it in the urine. When the glucose is excreted, so is a large amount of water causing the sufferer to become dehydrated.

Since the body does not have any glucose to use for energy, it starts burning fat and protein from muscle tissue in an attempt to generate energy. This is an extremely unhealthy way of generating energy as the liver becomes involved in fat burning. The by-product of this process is ketones. The ketones build up and your blood becomes acidic…… and this is VERY bad indeed. This will cause your blood to become a toxic environment for all your other organs.

Your body will try to counter this acidic environment by shifting electrolytes and this will cause your body to lose potassium and retain sodium.

Potassium affects your heart rhythm and if you lose potassium this will cause severe arrhythmias. Potassium is also needed by the brain for vital functions, and if there is a deficiency of potassium for the brain to use, you run the risk of a coma. Untreated diabetic ketoacidosis can result in coma or death……

Diabetic Ketoacidosis is serious business, but you can avoid it if you are aware of the risks.

Diabetic Retinopathy:

One of the most severe long term effects of diabetes in my opinion must be Retinopathy. As changes in the vascular system occur, the eyes are not spared. Diabetes causes long term changes to the capillaries in the retina of the eye which also decreases blood flow to vital areas of the eye…. just like with neuropathy where the nerves are affected.

The structural changes can cause a high blood pressure in the eyes. This can cause damage to the veins and causes the veins to leak. When the vessels leak, it can leak in the white area (vitreous humour) of the eye causing an increase in pressure of the eye ball or into the macula which is the most light-sensitive part of the retina with highly specialized cells. This can cause the sufferer to see floaters.

The sufferer may also see double vision when the nerves affected is the nerves controlling the eye muscles. Usually Retinopathy only manifests after 10 years of being diabetic, but do not wait until then to start treatment or take corrective measures. Make sure that you visit your optometrist at least once a year for a dilated eye exam. During this exam the optometrist can see how your diabetes is progressing and monitor any eye problems.

If you experience any of these signs, see your eye doctor immediately.

Diabetic Nephropathy:

As the eyes, nerves, heart and other body systems are not spared, so is the kidneys affected by diabetes. As previously discussed, diabetes causes structural changes to the cardiovascular system which in turn causes high blood pressure. This high blood pressure also causes damage to the tiny blood vessels in the kidneys which will prevent the kidneys from functioning normally. This is called kidney failure.

Not all sufferers of diabetes get kidney damage and doctors do not understand yet why only some people are affected and some don’t. Out of a 100 people, as many as 40 will get kidney damage.

There are no symptoms in the early stages. So it’s important to have regular urine tests to find kidney damage early. The first sign of kidney damage is the trace of a small amount of protein in the urine. This can be detected by a simple urine test. Sometimes early kidney damage can be reversed if detected in time.

Diabetic Hypoglycemia:

People with diabetes runs a risk of having a very low blood sugar and develop a condition called hypoglycemia. This is when the body does not have any glucose left to burn to be used as fuel for cells.

Diabetics experiencing hypoglycemia can have a variety of symptoms which may include feeling weak, drowsiness, hunger, dizziness, paleness, headache, irritability and trembling.

Diabetics can bring on hypoglycemic attacks by missing or delaying meals, drinking too much alcohol, exercising too much or taking too much insulin in comparison to food. This can be easily corrected by eating food that is known for increasing the glucose level in the blood.

As you can see diabetes is a very unforgiving disease and it’s best to be prepared for it. As Sir Francis Bacon said: “Knowledge is power” and if you know what to expect, you know how to prevent it.

Increasing severity of hypertriglyceridemia is associated with a rise in cardiovascular disease (CVD) risk, show results from the ICARIA study.

The researchers also found that the major predictor of mild hypertriglyceridemia was obesity, and that the major predictor of moderate and severe hypertriglyceridemia was diabetes.

“There is a paucity of studies that show the presence of different grades of hypertriglyceridemia, its relationship with environmental factors and comorbidities that increase vascular risk, and its relationship with vascular disease itself,” say researchers Pedro Valdivielso (University of Málaga, Spain) and colleagues.

They therefore carried out the cross-sectional ICARIA (Ibermutuamur CArdiovascular RIsk Assessment) study involving 594,701 Spanish workers from across the country. Data collected included: age, gender, general anthropometric measurements, lipids, and vascular risk factors. Cardiovascular risk was also calculated using the Framingham and European SCORE models.

Hypertriglyceridemia was diagnosed when triglyceride levels exceeded 1.69 mmol/l (150 mg/dl). The authors further classified individuals as having mild (1.69??”4.50 mmol/l; 150??”399 mg/dl), moderate (4.51??”11.28 mmol/l; 400??”999 mg/dl), or severe (more than 11.28 mmol/l; 1000 mg/dl) hypertriglyceridemia.

Writing in the journal Atherosclerosis, the researchers report that in this representative population sample the prevalence of mild, moderate, and severe hypertriglyceridemia was 16% (n=95,673), 1.1% (n=7081), and 0.03% (n=224), respectively.

Risk factors associated with having high triglyceride levels were male gender, older age, obesity, presence of Type 1 or Type 2 diabetes, increased alcohol consumption, and vascular disease.

Compared with individuals with normal triglyceride levels, participants with mild, moderate, and severe hypertriglyceridemia had a 1.16-, 1.66-, and 4.41-fold increased risk for CVD, respectively.

Valdivielso and co-workers found that the major independent predictor for mild hypertriglyceridemia was obesity (body mass index over 30 kg/m²), which increased risk 2.42-fold.

Conversely, the major predictor for moderate and severe hypertriglyceridemia was the presence of diabetes, which increased risk 3.64- and 7.35-fold, respectively.

The authors conclude that their results indicate that “preventive programs for hypertriglyceridemia and associated vascular disease should consider obesity-diabetes control as their first objective.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

US researchers report that teenagers and young adults who are obese or have Type 2 diabetes have increased carotid artery intima-media thickness (IMT) and stiffness.

“Because this damage is progressive and has started so early, this may be the first generation that has a shorter life expectancy than their parents,” remarked lead researcher Elaine Urbina (Cincinnati Children’s Hospital, Ohio).

Urbina and colleagues performed non-invasive ultrasound imaging of the carotid arteries in 446 young people aged between 10 and 24 years, of whom 136 were obese, 128 had Type 2 diabetes, and 182 were lean and did not have diabetes.

Adolescents and young people are developing Type 2 diabetes at an alarming rate, so much so that the condition is no longer referred to as adult-onset diabetes, Urbina noted.

The team’s results, reported in the journal Circulation, showed that individuals with Type 2 diabetes had significantly increased carotid IMT compared with lean participants for all carotid segments. They also had significantly greater carotid IMT than obese participants for the carotid artery and bulb, but not the internal carotid artery, where both Type 2 diabetes and obese groups had greater carotid IMT than the lean group (all p?0.05).

Further investigation showed that carotid artery stiffness was greater in both the Type 2 diabetes group and the obesity group compared with the lean group, as calculated by the Young elastic modulus and the beta stiffness index.

Although the participants with Type 2 diabetes and those with obesity were more likely than the lean individuals to have other cardiovascular risk factors, and risk factors correlated with both carotid IMT and stiffness, group was an independent predictor of common carotid artery IMT and for beta stiffness index. Thus additional effects of Type 2 diabetes and obesity likely influence changes to carotid structure and function not entirely explained by traditional risk factors.

However, as it is not yet possible to routinely take carotid artery measurements, children who are obese or have Type 2 diabetes should be tested for such traditional risk factors and treated accordingly, said Urbina.

“Our objective is to identify youths who will need more aggressive therapy,” she said. “Some kids need to go right onto medication, while others can be treated with lifestyle changes.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract