Check your LADA

This is the story of me and my LADA.  No, not the car: LADA is “Latent Autoimmune Diabetes of Adults”.  It isn’t very well known.  Sometimes it’s called Type 1.5, or adult-onset Type 1.  It’s something that people need to be more aware of, because a lot of people diagnosed with Type 2 diabetes, actually are suffering from LADA.  Which is unfortunate, because the treatment is different, and the right treatment might make a real difference if you’re diagnosed with LADA early enough.  I was very lucky (or maybe just pushy), but I was diagnosed with LADA five years ago, and my condition is still stable.  Here’s the story.

About six years ago, I had a couple of routine fasting blood sugar test that were above 100 mg/dl (5.6 mmol/L).  No big worry.  My BMI was fine, my lipids fine.  Next routine test: 110.  My GP wasn’t too happy and sent me for a glucose tolerance test – the one where you drink a cup of vilely sweet water and they measure your blood glucose at 30 minute intervals.  Crucially, I also asked for them to measure not just glucose, but also insulin levels.  My glucose curve was “pre-diabetic”, and my GP would have been happy to diagnose Impaired Glucose Tolerance; except that my insulin levels were low, and also late (i.e. the insulin didn’t start to rise straight after the drink).  I was lucky enough to contact a top diabetes endocrinologist and he agreed to see me.  A regular doctor who sees plenty of new IGT cases each day might just have rubber stamped me “Type 2 pre-diabetic”.  Fortunately, there are also doctors who see the whole range of presentations of diabetes, and are familiar with the subtle complexities of the disorder.

After taking a detailed history, and looking at my test results, he explained it to me like this.  “You’re a young man [I was 41], and you’re healthy.  You want to lead a long healthy life.  One day, your pancreas will stop producing insulin, and you’ll have to control your blood sugar all by yourself.  That could happen when you’re 42, or it could happen when you’re 60.  That’s partly up to you…  If you don’t mind taking medication, even though you feel fine, and if you control your diet like you’re diabetic, you can put this off 5, maybe 10 or even 20 years.”

Now as we know, in Type 1 diabetes, you don’t produce insulin, whereas in Type 2, you can’t use the insulin that you make (eventually, poor blood glucose control means that you lose the ability to produce insulin also in Type 2).  The difference between regular “juvenile” Type 1 and LADA is that the loss of the ability to produce insulin takes a lot longer – many years – so that it doesn’t appear until adulthood.  As the insulin-producing cells in the pancreas begin to die off, you start to show impaired glucose tolerance and higher fasting blood sugar.  Of course, most people who develop glucose intolerance as adults are automatically diagnosed with “pre” (Type 2) diabetes.  They are advised to change their lifestyle, and maybe take medication like metformin to lower the blood glucose.

But here’s the LADA catch.  Your pancreas is still producing insulin, albeit not enough.  Slowly, the insulin producing cells are dying off from the stress – they’re working flat out and not keeping up with the amount of insulin your body needs.

 One day – and it will inevitably happen one day – your body won’t be able to produce any more insulin, and you need to treat it like full Type 1 diabetes.  But by looking after your pancreas, giving it an easier time, a bit of a rest, you might be able prolong the life of those beta cell and put off that day when you need to go on a pump, or regular insulin injections.  So that’s why some doctors propose small doses of insulin to relieve the pancreas and hopefully to keep insulin capacity going for as long as possible.

For me, it was an easy choice. Once I started looking at my glucose levels at home, it became clear how much my pancreas was struggling.  I was regularly peaking at over 300 mg/dl  (16.7 mmol/L) after meals, even though my fasting glucose was steady around 110.  So I started with small doses of insulin: just 3 units of Lantus daily.  That’s enough to keep the postprandial peaks under control, and give my pancreas the holiday it needs.  Five years on, and my fasting glucose is still 110.  Another interesting benefit of the low-dose insulin treatment is that it gives you the opportunity to get used to controlling blood sugar, at a time when it’s not that critical to get the control right.  I’m not going to go into DKA because of a peak of 300, and any hypos I get are going to be mild.  So it’s good training for later life – not to mention the getting used to a diabetic diet.

I know people who were suddenly diagnosed with full-blown Type 1 diabetes in middle age.  They were probably LADA for years, but never knew it until their pancreas shut down completely.  Perhaps with a low dose insulin treatment they could have put off that day by a few more years.  In fairness, not all doctors are convinced that insulin treatment improves the prognosis for LADA, but I for one am happy to take the chance.

So if you’re an adult with impaired glucose tolerance, not obese, and with no family history of Type 2 diabetes, I recommend you ask your doctor to be tested for LADA.  There’s more information on this link: here

diabetes 1

How to Tell if You Have Diabetes

from wikiHow - The How to Manual That You Can Edit
If you believe that you may have diabetes, consult a medical professional immediately.
There are 2 main types of diabetes.  Type 1, (your body does not produce insulin) sometimes known as juvenile diabetes which is more commonly diagnosed in children but can present at any age. Type 2, (your body does not absorb insulin correctly) sometimes known as adult-onset diabetes, is often subtle and may be due to aging or obesity. Type 2 diabetes is growing in children and teens as well. General signs that warrant further investigation are:

 Steps

1.   Check to see if you have one or many of the following symptoms:
   
   
   • Seek urgent medical attention if you have a fruity smell on your breath. This is a symptom of Ketoacidosis (ketones are a by product of when your body uses fat for energy)caused by severe hyperglycemia (high blood sugars), and requires urgent medical attention. Diabetics who miss their insulin dose, even without ketoacidosis, can have fruity breath. It's a warning sign not to be ignored.
     
   • Excessive thirst
     
   • Excessive hunger
     
   • Frequent urination (you wake 3 or more times in the night to urinate)
     
   • Unexplained significant weight loss
     
   • Fatigue (particularly after eating)
     
   • Feeling irritable
     
   • Wounds that don't heal or heal slowly
     
   • Frequent or lingering infections
     
   • Leg cramps (usually occurring as the undiagnosed disease worsens and mostly during the night)
     
   • Blurred or other changes in vision
     
   
   
2. If you have some or all of the symptoms above, get tested by a physician. Your primary care physician can perform 2 different tests to check your blood glucose test. Normally, a blood test is used to check for diabetes, but a urine test can also be performed.
   
   
   • Normal blood glucose levels are between 90 and 120.
     
   • If you're borderline diabetic, your levels will be between 121 and 130.
     
   • If your levels are above 130, you're considered diabetic.
     
   
   
3. Treat diabetes. To treat diabetes, you may need to take insulin injections or pills daily, watch your diet and exercise.
   
   
   • Sometimes, the only thing needed is diet and exercise.
     
   • You'll be asked to cut back on sugar and carbohydrates, and exercise for about 30 minutes a day.
     
   
   

 Video

 Tips

• Risk factors for developing type 2 diabetes include being overweight or obese; being African-American, Hispanic-American, Asian-American, Native-American, or of Pacific-Islander descent; having a family history of diabetes; having a history of gestational diabetes. If you have one or more of these risk factors, talk to your doctor about getting a fasting plasma glucose test.[1]
  
• The onset of hyperglycemia is known when a person’s glucose level goes beyond the ideal level, and although it can occur on its own, it is highly considered as the major symptom of Diabetes Mellitus. In fact, it is known to be the primary cause of several complications associated with diabetes. If left untreated, hyperglycemia can lead to more serious health issues, such as nerve damage (neuropathy), kidney damage or failure, blindness, and severe circulation problems resulting in difficult-to-treat infections that can progress into gangrene necessitating amputation (particularly in the lower extremities).
  
• Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin.
  
• Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency.
  
• Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.[2]
  
• Blood glucose indicators normally used are the blood glucose levels and the A1c. The blood glucose levels near 70 to 120 mg/dl before meals and under 140 mg/dl at 2 hours after eating are considered in the normal range.
  
• To explain what an A1c is, think in simple terms. Sugar sticks, and when it's around for a long time, it's harder to get it off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar sticks to these cells, it gives us an idea of how much sugar has been around for the preceding three months. In most labs, the normal range is 4-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it's less than 7.0%. The benefits of measuring A1c is that is gives a more reasonable view of what's happening over the course of time (3 months), and the value does not bounce as much as finger stick blood sugar measurements.
  
• To explain the normal correlation between A1c and average blood sugar levels is as follows. An A1c of 6 = a three month average blood glucose level of 135. An A1c of 7 = 170, an A1c of 8 = 205, an A1c of 9 = 240, an A1c of 10 = 275, an A1c of 11 = 301, an A1c 12 of 345.
  
• [3]
  

 Warnings

• Seek urgent medical attention if you have a fruity smell on your breath. This is a symptom of diabetic ketoacidosis that can be fatal if left untreated.
  
• It is extremely important to consult with a medical professional immediately if you are exhibiting any of these symptoms; undiagnosed diabetes mellitus (Type 1 or Type 2) can progress to diabetic ketoacidosis (DKA), which rapidly progresses into possible organ failure or death.
  

 Related wikiHows

• How to Give Glucose to a Diabetic
  
• How to Control Diabetes
  
• How to Improve Your Health as a Diabetic
  
• How to Find a Fibromyalgia Doctor
  
• How to Live With Arthritis
  
• How to Cope With Having Lupus
  

 Sources and Citations

• http://www.dlife.com/dLife/do/ShowContent/type2_information/diagnosis/diagnosis.html
  
• http://www.emedicinehealth.com/articles/17044-3.asp
  
• http://ndep.nih.gov/diabetes/diabetes.htm
  
• http://www.fda.gov/diabetes/glucose.html
  
• http://www.cdc.gov/nccdphp/publications/aag/ddt.htm
  
• http://www.diabetes.org/nutrition-and-recipes/nutrition/overview.jsp
  

1. ↑ http://www.dlife.com/dLife/do/ShowContent/type2_information/diagnosis/diagnosis.html
2. ↑ http://en.wikipedia.org/wiki/Diabetes_mellitus
3. ↑ http://www.medicinenet.com/hemoglobin_a1c_test/article.htm

Article provided by wikiHow, a wiki how-to manual. Please edit this article and find author credits at the original wikiHow article on How to Tell if You Have Diabetes.  All content on wikiHow can be shared under a Creative Commons license.

How to Avoid Diabetes

from wikiHow - The How to Manual That You Can Edit
                   
In the past 30 years, the prevalence of Diabetes Type 2 has skyrocketed to the point where it is now viewed as an epidemic in the western world. From being a once fairly mild and rare ailment of the elderly to becoming a chronic disease, diabetes mellitus affects people of every age, race, and background, and is now a major modern cause of premature death in many countries around the world, with someone dying from Diabetes Type 2 every 10 seconds worldwide.[1]
Being the leading cause of kidney failure, lower limb amputation, and blindness in developed countries, as well as increasing the likelihood of death from heart disease,[1] diabetes mellitus is a modern-day scourge. Its gradual debilitating effects destroy quality of life well before causing untimely death. And what is of greatest concern is that most cases of Diabetes Type 2 are preventable. While Type 1 Diabetes is generally a hereditary disease, this article focuses on the ways in which you can seek to avoid Type 2 Diabetes, a disease which can often be prevented with appropriate attention to the risk factors.

 Steps

1. Note the different types of diabetes. Diabetes affects the way that blood sugar (glucose) is processed in your body. An essential energy source, glucose is present in the bloodstream after consuming food. Insulin, produced by the pancreas, takes the glucose out of the blood and distributes it to the liver cells, muscles, and fat, where it is turned into usable energy for the body. There are two types of diabetes: Type 1 and Type 2. Approximately 10 percent of people with diabetes have Type 1, while Type 2 is more prevalent. In brief, the background to the types of diabetes is as follows:[2]
   
   
   • Type 1 diabetes: This condition involves destruction of more than 90 percent of the insulin-producing cells of the pancreas, causing the pancreas to cease making insulin or to make very little. Type 1 diabetes tends to occur prior to the age of 30 and it may involve an environmental factor, as well as a genetic predisposition.[2]
     
   • Type 2 diabetes: While the pancreas continues to produce insulin, or even higher levels of insulin, the body develops a resistance to the insulin, causing scarcity of insulin for the body's needs and blood sugar levels remain permanently too high. While this type of diabetes can occur in children and adolescents, it usually begins in people over 30 and becomes more common as people age. It tends to run in families and around 15 percent of people over 70 have diabetes Type 2.[2] Type 2 symptoms may not show symptoms for years or even decades before being diagnosed.
     
   • Gestational diabetes develops during pregnancy. Left untreated, serious side effects can injure the mother and affect the unborn child. Having gestational diabetes, that resolves after delivery, increases your chances of developing Type 2 Diabetes in some point of your life and getting gestational diabetes in a next pregnancy. It also increase the chances of getting cardiovascular diseases after 15 to 20 years from 1.5 to 7.8 times!
     
   • Other specific types of diabetes resulting from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses may account for 1 percent to 2 percent of all diagnosed cases of diabetes.[3] Diabetes insipidus is not related to blood sugar levels.[2] It is a relatively rare disease and is not covered in this article.
     
   
   
2. Be concerned. Understanding how Type 2 diabetes impacts your life is an important part of motivating you to want to try and avoid getting it. There are numerous complications associated with diabetes, and some of these occur quickly after the onset of diabetes, while others are progressive. The types of complications that arise with diabetes include lowered blood supply to the skin and nerves, atherosclerosis (an increase of fatty substances in the blood), heart failure, strokes, leg cramps when walking, poor vision, renal (kidney) failure, nerve damage, skin breakdown, angina, strokes, etc.
   
   
   • Over-consumption of fructose and other simple sugars is a major concern in relation to developing diabetes Type 2. However, the specific kind does not matter as they all have the same effects on the body. [4]
     
   
   
3. Pay special attention to any risk factors for diabetes that apply to your life. There are several key risk factors that increase the potential for you to suffer from diabetes, and while some of them are not under your control (such as age and genetics), others are (such as food intake and exercise). The risk factors for Type 2 diabetes include:
   
   
   • Obesity – based on body mass index, a BMI over 29 increases your odds of diabetes to one in four.[5]
     
   • Older than age 45. Note that pre-menopausal women are probably helped by the levels of estrogen, which helps to clear away fatty acids that cause insulin resistance, and helps insulin absorb glucose more rapidly.[6]
     
   • Having a parent, sibling, grandparent, aunts and uncles, etc., who has or did have Type 2 diabetes. This can indicate a family gene predisposing you to diabetes.[5]
     
   • A diagnosis of heart disease or high cholesterol. Cardiovascular risks include high blood pressure, low HDL cholesterol, and high LDL cholesterol, and a study showed that one in four people in Europe suffering from these risk factors were also pre-diabetes.[5]
     
   • People of Hispanic, African American, Native American, Asian, or Pacific Islander descent are at almost double the risk of white Americans.[5][3]
     
   • Up to 40 percent of women who experienced gestational diabetes are at risk of developing diabetes Type 2 later in life.[3]
     
   • A low birth weight increases your chances of developing diabetes by 23 percent for babies 5.5 pounds and by 76 percent for babies under 5 pounds.[5]
     
   • Diet high in sugar,[7] cholesterol, and processed food.
     
   • Irregular or no exercise - less than 3 times per week.[8]
     
   
   
4. Act early. High blood sugar can be corrected before lasting damage sets in.[9] If you have the risk factors associated with diabetes, it is important to get regular screening tests – simple urine and blood tests – and to respond by controlling your lifestyle factors. If tests reveal that you have "pre-diabetes" (metabolic syndrome), it means that you have an increased chance of being diagnosed with Type 2 diabetes in the future. While such a diagnosis can be frightening, it's also an opportunity to take back your health and to slow, reverse, or avoid Type 2 diabetes through lifestyle changes.
   
   
   • Pre-diabetes exists where your blood glucose is higher than normal. It's a key indicator of metabolic breakdown taking place, leading to Type 2 diabetes.[10]
     
   • Pre-diabetes is reversible. Left ignored, the American Diabetes Association warns that your odds for getting Type 2 diabetes within a decade are almost 100 percent.[11]
     
   • The CDC recommends that anyone aged 45 or over should be tested for diabetes if you're overweight.[8]
     
   
   
5. Change your dietary habits. A diet rich in sugar-laden foods, as well as foods high in cholesterol, increases your risk for pre-diabetes and Type 2 diabetes development. In order to improve your chances of reversing high-normal blood sugar (pre-diabetes) and restoring full body health, there are some dietary solutions that you can implement from today. The following dietary suggestions focus on do's and don'ts.
   
   
   • Increase your daily servings of fruit and vegetables. Aim for seven to nine daily servings of fruit and vegetables.[12] They can be fresh, frozen, or dried, but it is preferable to error on the side of as much fresh produce as possible.[13] Try to reduce your intake of canned vegetables because they have higher salt content.
     
     
     • Eat dark green veggies (for example, broccoli, spinach, Brussels sprouts).
       
     • Orange veggies (for example, carrots, sweet potatoes, pumpkin, winter squash).
       
     • Beans and peas (for example, black beans, garbanzo beans, kidney beans, pinto beans, split peas, lentils).
       
     
     
   • Eat good carbohydrates. Skip the pastries, cakes, fries, and other processed carbs. Fill up instead on carbohydrates that are healthy – fruits, vegetables, whole grain cereals and breads. Look for choices with good fiber content; fiber has been shown to lower blood sugar by acting as a "mop" slowing down the digestive process and the speed with which glucose enters the bloodstream.[12]
     
     
     • Eat whole grains, whole grain rice, breakfast cereals with 100 percent whole grain content, whole grain pasta, etc.
       
     • Eat whole-wheat bread, bagels, pita bread, and tortillas.
       
     
     
   • Stop drinking sugar.[14] Quench your thirst with water most of the time. If you're worried about its quality, purchase a filter. Sodas, soft drinks, fruit juice, cordial, fruit drinks, flavored water, energy drinks, etc., are all sources of invisible sugar that your body does not need. Leave these drinks for treats only and rely on drinking water, dairy milk, or unsweetened soy, oat, nut, etc., milks. Soda water and sparkling mineral water are free of sugar; a few drops of lemon or orange juice freshly squeezed can be sufficient to flavor these drinks pleasantly. Coffee and tea are also OK in moderation, without sugar. Persevere; your body will crave sweetened drinks initially until you wean yourself from the habit.
     
   • Stop snacking on sugar.[15] Sugar resides in many snacks from the obvious cakes, pastries, candies, and chocolate, to the less obvious fruit bars and sweetened yogurts. Sugar is cheap and it satisfies cravings, provides a quick pick-me-up for after-lunch crashes, and is serves a never-ending need for fast energy fixes. Do you have a cookie or sweet snack with every coffee? These soon add up. Don't stock up on sugary treats and don't reach for them when you feel like a lift. Leave fruit, vegetable pieces, nuts, and other healthy items within reach instead.
     
     
     • Watch out for sugary breakfast cereals. Prefer cereals with less sugar and that are 100 percent wholegrain. Or substitute with oatmeal, amaranth, or other grain-based sugarless options. Try making your own muesli.
       
     
     
   • Eat less fat. Consume less than 30 percent of your daily calories as fat, and only 10 percent of that as saturated.[12] Avoid trans-fats as much as possible.[13] Trim fat off meat, eat lean cuts of meat, and use more monounsaturated oils, such as olive oil.
     
   • Keep treats for special occasions. The constant availability of sweet and fatty food is the equivalent of a permanent feast. Many of us have lost the ability to restrain ourselves from eating sweet and fatty treats and have absorbed them into our diets on a daily basis. In the past, human beings could only enjoy such a vast array of treats on special occasions such as feasts and celebratory occasions. The delayed gratification involved in waiting for such occasions increased the sweetness and delectable taste of the treats; nowadays, it's almost a taken-for-granted solution to every hiccup during the day – "Someone said my work sucked! I need chocolate!". While we can't change the crazy pace of our workplace and lives (yet), we can stand up for our personal health by not using food as the stress crutch it has become, and by leaving treats to true special occasions for savoring.
     
   
   
6. Lose weight. If you're changing your eating habits to healthier ones as a lifestyle choice, you'll lose weight with a lot less effort than if you focus on the deprivation-thinking of a "diet". Eat healthy and exercise well, and the weight will start to remove itself. Keep in mind the goal of being healthy lifelong, and the fact that even extremely overweight people have lowered their diabetes risk by 70 percent just by losing 5 percent of their total weight.[12]
   
   
   • Take it easy. "Diets" tend to fail because they're short term and we want to reach an "end" point. A lifestyle eating change is for good and involves gradually cutting out the foods that increase health risks, while increasing the healthier foods. As it is gradual, your body becomes more attuned to healthier food and you'll start enjoying it a lot more without the added flavorings, processing, sugar, fats, and salt.
     
   
   
7. Exercise regularly to avoid diabetes. It has been shown by the Diabetes Prevention Program (DPP) that people who lost 5 to 7 percent of their body weight and exercised for a half hour each day 5 days a week cut their risk of developing by 58 percent; this contrasts with only 31 percent reduced risk for people who relied merely on medication.[16][8] Whatever your weight, exercise is an important part of keeping healthy. Excessive body fat hinders the breakdown of and use of glucose essential for energy. The great news is that a mere 30 minutes of exercise per day, using activities that raise the heart rate for a suitable length of time, is one vital way of helping you to avoid diabetes and to maintain a healthy weight.
   
   
   • Take walks during your lunch break. If you can walk half an hour each lunch for 5 days a week, you'll be keeping yourself fit and healthy.
     
   • Avoid the rush hour by exercising near your work after knock-off time. Go home a little later, exercised, and unstressed because the traffic levels have eased.
     
   • Get a dog or start walking your existing dog - dogs make it easier to exercise and are a form of responsibility that obliged you to get out.
     
   • Walk to your local shops rather than taking the car. Unless you've got heavy packages to carry, walking locally makes good sense. It's a good opportunity to go with a friend or family member too, and to have a chat. Conversing while walking makes the walk seem shorter.
     
   • Renew the songs on your iPod or MP3 player. Give yourself a great excuse to walk or run while listening to your music selection.
     
   
   
8. Return for testing. After 6 months to a year of improving your diet and exercise habits, return for a test to see how your blood sugar levels have changed.
   
   
   • Always keep monitoring up with your doctor. Follow your doctor's advice.
     
   • If you need help, consider speaking to a registered dietitian who can assist you with developing a meal plan.
     
   • Consider seeing a psychologist if you have underlying emotional issues that cause you to consume too much or to eat an unhealthy diet.
     
   
   

 Video

While this video talks about diet and exercise after being diagnosed with diabetes to keep your blood sugar low, the advice is the same for pre-diabetics.

 Tips

• Regularly schedule appointments in advance with your doctor to monitor your urine and blood if you are at risk for diabetes. Set automatic reminders on your phone or online calendar to ensure you keep your appointments.
  
• It has been noted that breast-fed babies are less likely than bottle-fed babies to develop diabetes Type 1.[17]
  
• "Diabetes mellitus" means "honey-sweet diabetes", referring to the high levels of sugar in the patient's urine.[18]
  
• A study in the Netherlands showed that men eating a diet high in potatoes, fish, vegetables, and legumes appear to have a lower risk for diabetes.[19] Despite the unfair bad rap that potatoes often get, when cooked and eaten without added fats, they are considered healthy because they're high in complex carbohydrates, which have to be broken down into simple sugars before they can be absorbed into the bloodstream, a factor that keeps blood sugar levels stable.
  

 Warnings

• Untreated diabetes can lead to heart disease and eventual death. If you discover that you have any risk factors for diabetes or testing determines you have pre-diabetes, make the lifestyle changes to reverse the condition and avoid a diabetes diagnosis.
  

 Things You'll Need

• Healthy food choices
  
• Quality healthy food cookbooks for recipe ideas
  

 Related wikiHows

• How to Avoid a Stroke
  
• How to Eat Healthy
  
• How to Be Healthy
  
• How to Live a Healthy Lifestyle
  
• How to Live a Healthier Life
  
• How to Prevent Type 2 Diabetes
  
• How to Manage Type 2 Diabetes
  
• How to Protects Yourself Against Diabetes
  

 Sources and Citations

• CDC, http://www.cdc.gov/diabetes/consumer/learn.htm – research source
  
• http://www.diabetes.org/diabetes-basics/prevention/ http://www.diabetes.org/diabetes-basics/prevention/ – research source
  
• http://www.nlm.nih.gov/medlineplus/ency/article/002072.htm http://www.nlm.nih.gov/medlineplus/ency/article/002072.htm – research source
  
• http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/index.htm http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/index.htm – research source
  

1. ↑ 1.0 1.1 David Gillespie, Sweet Poison: Why Sugar Makes You Fat, p. 118, (2008), ISBN 978-0-670-07247-7
2. ↑ 2.0 2.1 2.2 2.3 The Merck Manual of Medical Information, Diabetes Mellitus, p. 962, (2003), ISBN 978-0-7434-7733-8
3. ↑ 3.0 3.1 3.2 CDC, Diabetes & Me, http://www.cdc.gov/diabetes/consumer/learn.htm
4. ↑ Melanson, K.; et al. (2006). "Eating Rate and Satiation.". Obesity Society (NAASO) 2006 Annual Meeting, October 20–24,Hynes Convention Center, Boston, Massachusetts.
5. ↑ 5.0 5.1 5.2 5.3 5.4 Ann Fittante, Prevention's The Sugar Solution, p. 264, (2007), ISBN 1-59486-693-7
6. ↑ David Gillespie, Sweet Poison: Why Sugar Makes You Fat, p. 117, (2008), ISBN 978-0-670-07247-7
7. ↑ David Gillespie, Sweet Poison: Why Sugar Makes You Fat, p. 117, (2008), ISBN 978-0-670-07247-7
8. ↑ 8.0 8.1 8.2 CDC, Prevent Diabetes, http://www.cdc.gov/diabetes/consumer/prevent.htm
9. ↑ Ann Fittante, Prevention's The Sugar Solution, p. 11, (2007), ISBN 1-59486-693-7
10. ↑ Ann Fittante, Prevention's The Sugar Solution, p. 263, (2007), ISBN 1-59486-693-7
11. ↑ Ann Fittante, Prevention's The Sugar Solution, p. 262, (2007), ISBN 1-59486-693-7
12. ↑ 12.0 12.1 12.2 12.3 Ann Fittante, Prevention's The Sugar Solution, p. 269, (2007), ISBN 1-59486-693-7
13. ↑ 13.0 13.1 CDC, Eat Right, http://www.cdc.gov/diabetes/consumer/eatright.htm
14. ↑ David Gillespie, Sweet Poison: Why Sugar Makes You Fat, pp. 151-152, (2008), ISBN 978-0-670-07247-7
15. ↑ David Gillespie, Sweet Poison: Why Sugar Makes You Fat, pp. 156-157, (2008), ISBN 978-0-670-07247-7
16. ↑ Ann Fittante, Prevention's The Sugar Solution, pp. 11-12, (2007), ISBN 1-59486-693-7
17. ↑ Reader's Digest, Curing Everyday Ailments the Natural Way, Diabetes, p. 163, (2000), ISBN 1-876689-78-1
18. ↑ Reader's Digest, Curing Everyday Ailments the Natural Way, Diabetes, p. 162, (2000), ISBN 1-876689-78-1
19. ↑ Selene Yeager, The Doctors Book of Food Remedies", p. 524, (2007), ISBN 1-59486-753-4

Article provided by wikiHow, a wiki how-to manual. Please edit this article and find author credits at the original wikiHow article on How to Avoid Diabetes.  All content on wikiHow can be shared under a Creative Commons license.

Diabetes Affects Hearing Loss, Especially in Women

(HealthNewsDigest.com) - DETROIT – Having diabetes may cause women to experience a greater degree of hearing loss as they age, especially if the metabolic disorder is not well controlled with medication, according to a new study from Henry Ford Hospital in Detroit.

Women between the ages of 60 and 75 with well-controlled diabetes had better hearing than women with poorly controlled diabetes, with similar hearing levels to non-diabetic women of the same age.

The study also shows significantly worse hearing in all women younger than 60 with diabetes, even if it is well controlled.

Men, however, had worse hearing loss across the board compared to women in the study, regardless of their age or whether or not they had diabetes.

“A certain degree of hearing loss is a normal part of the aging process for all of us, but it is often accelerated in patients with diabetes, especially if blood-glucose levels are not being controlled with medication and diet,” says Derek J. Handzo, D.O., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.

“Our study really points to importance of patients controlling their diabetes, especially as they age, based on the impact it may have on hearing loss.”

The study will be presented Jan. 26 in Miami Beach at the annual Triological Society’s Combined Sections Meeting.

According to the American Diabetes Association, nearly 26 million people in the U.S. have diabetes, and another 34.5 million have some degree of hearing loss. Signs of hearing loss include difficulty hearing background noises or hearing conversations in large groups, as well as regularly needing to turn up the volume on a radio or TV.

While the association between diabetes and hearing loss has previously been studied, Henry Ford researchers sought to learn more about hearing differences among patients with well-controlled diabetes, poorly controlled diabetes, and those who do not have diabetes.

The Henry Ford research team reviewed records for 990 patients that had audiograms performed between 2000 and 2008 at the hospital. Patients were categorized by gender, age (younger than 60 years old, between 60-75 years old and older than 75 years old), and if they had diabetes. Those with diabetes were divided into two groups: well-controlled or poorly controlled, as determined by the American Diabetes Association guidelines that use HbA1C blood levels.

Dr. Handzo notes that previous studies about diabetes and hearing loss have not focused on blood-glucose levels, nor did they include such a diverse population based on age and gender.

The Henry Ford team looked at patients’ pure tone average, a measurement that determines hearing level at certain frequency, and speech recognition at different ages. The team evaluated pure tone average ranges that focus on the frequency at which most people speak and the very high frequencies used in music and alarms.

Women between the ages of 60 and 75 with poorly controlled diabetes had significantly worse hearing than those whose diabetes was well-controlled and the control group. Among the women younger than 60, those with diabetes – regardless of whether or not it was being controlled – had worse hearing than non-diabetic women.

For the men in the study, there was no significant difference in hearing between those with diabetes that well-controlled or poorly controlled, as well as those who did not have diabetes.

“Younger males in general have worse hearing, enough so to possibly mask any impact diabetes may have on hearing. But our findings really call for future research to determine the possible role gender plays in hearing loss,” says Dr. Handzo.

My sister died because she didn't take diabetes seriously

When Yolanda Acuna Ocana was diagnosed with type 1 diabetes, her family was almost relieved.

She was 14 and had been suffering from inexplicable weight loss, constant thirst and tiredness, and they were grateful for a diagnosis. 

Now — sadly — they feel very differently about diabetes. 

Last April, aged just 39, Yolanda died as a result of the disease, leaving behind a loving husband and devoted family.

Yolanda Acuna Ocana (left) with her sister Nicky Dixon. The effects of her missed doses of insulin were becoming apparent by her late 20s

‘No one expects diabetes to kill someone so young in this day and age,’ says Yolanda’s sister, Nicky Dixon, 38, a company director from Surbiton, Surrey.

People often think diabetes, type 1 or type  2, is not a serious condition, says Dr Jeremy Allgrove, a paediatric endocrinologist at Barts and the London NHS Trust.

‘But if you don’t look after yourself, it’s a killer.’ 

 

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The figures are stark: type 1 diabetes reduces life expectancy on average by 20 years. 

The condition is caused by the body attacking the cells of the pancreas responsible for making insulin. 

Insulin helps the body break down glucose from food and turn it into energy; without it, blood sugar levels become dangerously high, causing damage to blood vessels.

Around 300,000 Britons have the condition. It can run in families, but experts believe the condition is usually triggered, possibly by some sort of virus.

'She bitterly regretted not having taken her insulin properly,' said Nicky of her sister who died last April

Unlike type 2 diabetes, type 1 is characterised by insulin dependence — once diagnosed, a patient must inject themselves daily for the rest of their life. 

The problem is that many people don’t take their insulin as they should, with potentially fatal consequences.

Yolanda was supposed to inject herself seven times a day, but when she left home for university at 18, she reduced her intake because the jabs were causing her to put on weight. 

This growing trend has even been given a name: diabulimia.

‘We were out one night when she suddenly passed out,’ Nicky recalls.

‘I called an ambulance and when she came round she admitted to me what she had been doing. 

'She’d put on a stone-and-a-half since starting on insulin. She found the weight and having diabetes hard to deal with.

‘I told her she would make herself ill — but she was young and not thinking about what her health when she was older.’

One in three women under 30 with type 1 diabetes deliberately misses doses of insulin, according to charity Diabetes UK. 

‘A symptom of undiagnosed type 1 diabetes is weight loss — but once that person goes onto insulin they put on weight, and that can be hard to handle,’ says Cathy Moulton, clinical adviser at the charity.

Not taking adequate insulin leads to long-term health problems.

When the body cannot access sugars from food, it starts to break down fat and protein, leading to by-products called ketones, which are toxic to the body. 

This can lead to complications including blindness and kidney failure.

It can also cause nerve damage known as neuropathy, where the patient loses sensation in their feet, putting them at risk of amputation because wounds won’t heal. 

High blood sugar also furs up the arteries, increasing the risk of stroke or a heart attack — the leading cause of death among type 1 diabetics.

‘If you stop taking insulin, symptoms are likely to develop within a few hours,’ says Dr Allgrove, adding that patients can, like Yolanda, simply pass out as a result of high blood glucose and the ketones.

‘Diabetes requires round-the-clock dedication, every day.’

The effects of Yolanda’s missed doses were becoming apparent by her late 20s.

She developed problems with her kidneys and suffered diabetic retinopathy (damage to the retina in the eye caused by high blood sugar) for which she needed laser surgery.

‘She also developed neuropathy,’ recalls Nicky. ‘Once she went to a chiropodist who found she had a piece of glass wedged into her foot, but she hadn’t noticed.’

Yolanda married in her mid-20s and dreamed of having a family, but her failure to take her diabetes seriously thwarted this. 

‘If you look after yourself, fertility and pregnancy should be relatively normal,’ says Dr Allgrove. 

However, although Yolanda had started taking her insulin properly by her 30s, she was told she was too ill to have children. 

‘Her kidneys were starting to fail and she needed a transplant. Getting pregnant would have pushed her body into full-blown kidney failure,’ says Nicky.

Yolanda was put on the waiting list for new kidneys and a new pancreas in 2005.

‘When the call came two months later to say there was a donor available, she was in New Zealand attending her father-in-law’s funeral,’ says Nicky. 

‘It was devastating for her.’

She got a call about a second donor in February 2010, but the donor organs were unsuitable. 

By July that year, it was not just her kidneys and eyes causing her problems. A blister on her big toe developed into a diabetic ulcer.

Minor injuries can lead to  more serious medical problems for diabetics because poor blood circulation means wounds do not heal well. Yolanda was warned her foot might need to be amputated.

‘She was devastated, screaming: “Please don’t let them do it”,’ recalls Nicky. ‘So the doctors just cut away the affected tissue.’

Within months, Yolanda’s kidneys failed. She also suffered a deep-vein thrombosis in her leg and developed cataracts which reduced her vision.

Nicky says: ‘She bitterly regretted not having taken her insulin properly. 

'She once told me she wished she could go back in time and do things differently.’

The family still hoped Yolanda would have a transplant, but last Easter she had a series of heart attacks and ended up on life-support. After a week, her family agreed to turn off the machine.

‘We all felt numb,’ Nicky says. ‘Yolanda had been so full of life; at no point did we ever consider she would die.’

Losing her sister has been a warning to Nicky, who was also diagnosed with type 1 diabetes at the age of 21.

‘What happened to Yo makes me even more careful,’ she says. ‘I eat well and exercise and never forget to inject myself.’

Despite this, she does suffer from diabetic retinopathy, and some days feels incredibly tired. 

However, she is training for the London marathon in April, which she will run in her sister’ memory.

‘I want to raise awareness of diabetes and the need for people to sign up for donor cards,’ Nicky says. 

‘Had a donor become available to Yolanda, she might still be here today. 

‘Most of all, though, I’m doing this so that people won’t forget my sister.’