Diabetes is a disease affecting the manner in which the body

handles digested carbohydrates. If neglected, diabetes can

cause extremely severe health complications, ranging from

blindness to kidney failure.

Around eight percent of the population in the United States has

diabetes. This means that around sixteen million people have

been diagnosed with the disease, based only on national

statistics. The American Diabetes Association estimates that

diabetes accounts for 178,000 deaths, as well as 54,000

amputees, and 12,000-24,000 cases of blindness annually.

Blindness is twenty-five times even more common among diabetic

patients in comparison with nondiabetics. If current trends

continue, by the year 2010 complications of diabetes will

exceed both heart disease and cancer as the leading cause of

death in America.

Diabetics have a high level of blood glucose. Blood sugar level

is regulated by insulin, a hormone secreted by the pancreas,

which releases it in response to carbohydrate consumption.

Insulin causes the cells of the body to absorb glucose from the

blood. The glucose then serves as fuel for cellular functions.

Traditional diagnostic standards for diabetes have been fasting

plasma glucose levels greater than 140 mg/dL on 2 occasions and

plasma glucose greater than 200 mg/dL following a 75-gram

glucose load. However, even more recently, the American

Diabetes Association lowered the criteria for a diabetes

diagnosis to fasting plasma glucose levels equal to or higher

than 126 mg/dL. Fasting plasma levels outside the normal limit

demand further testing, usually by repeating the fasting plasma

glucose check and (if indicated) initiating an oral glucose

tolerance test.

The many symptoms of diabetes include excessive urination,

excessive thirst and hunger, sudden weight loss, blurred

vision, delay in healing of wounds, dry and itchy skin,

repeated infections, fatigue and headache. While suggestive of

diabetes, these symptoms can also be caused by other factors,

and therefore anyone with symptoms suspicious of the disease

should be tested.

There are 2 different varieties of diabetes.

Type I Diabetes (juvenile diabetes, also known as

insulin-dependent diabetes): The cause of type I diabetes

starts with pancreatic inability to make insulin. This causes

5-10% of cases of diabetes. The pancreatic Islet of Langerhans

cells, which secrete the hormone, are destroyed by the

patient's own immune system, probably because it mistakes them

for a virus. Viral infections are believed to be the trigger

that sets off this auto-immune disease. Type I diabetes is most

prevelant in the caucasian population and has a hereditary

component.

If untreated, Type I or juvenile diabetes can lead to death

within two to three months of the onset, as the cells of the

body starve because they no longer receive the hormonal prompt

to absorb glucose. While a great majority of Type I diabetics

are young (hence the term Juvenile Diabetes), the condition can

develop at any age. Autoimmune diabetes is diagnosed by an

immunological assay which shows the presence of

anti-insulin/anti-islet-cell antibodies.

Type II Diabetes (non insulin dependent diabetes, also known as

adult onset diabetes): This diabetes is a consequence of body

tissues becoming resistant to the effects of insulin. It

accounts for 90-95% of cases. In many cases the pancreas is

producing a plentiful amount of insulin, however the cells of

the body have become unresponsive to its effect due to the

chronically high level of the hormone. Finally the pancreas

will exhaust its over-active secretion of the hormone, and

insulin levels fall to beneath normal.

A tendency towards Type II diabetes is hereditary, although it

is unlikely to develop in normal-weight individuals eating a

low- or even moderate-carbohydrate diet. Obese, sedentary

individuals who eat poor-quality diets built around refined

starch, which constantly activates pancreatic insulin

secretion, are prone to develop insulin resistance. Native

peoples like North American Aboriginals, whose traditional

diets never included refined starch and sugar until these items

were introduced by Europeans, have very high rates of diabetes,

five times the rate of caucasians. Blacks and hispanics are

also at higher risk of the disease. Though Type II diabetes

isn't as immediately disastrous as Type I, it can lead to

health complications after many years and cause serious

disability and shortened lifespan. As with Type I diabetes, the

condition develops primarily in a certain age group, in this

case patients over forty (which is why it's typically termed

Adult Onset Diabetes); however, with the rise in childhood and

teenage obesity, this condition is being seen for the first

time in school children as well.

If treatment is neglected, both Type I and Type II diabetes can

lead to life-threatening complications like kidney damage

(nephropathy), heart disease, nerve damage (neuropathy),

retinal damage and blindness(retinopathy), and hypoglycemia

(drastic reduction in glucose levels). Diabetes damages blood

vessels, especially smaller end-arteries, leading to very

severe and premature atherosclerosis. Diabetics are prone to

foot problems because neuropathy, which afflicts about ten

percent of patients, causes their feet to lose sensation. Foot

injuries, common in day-to-day living, go unnoticed, and these

injuries cannot heal because of atherosclerotic blockage of the

microscopic arteries in the foot. Gangrene and subsequent

amputation of toes, feet or even legs is the result for many

elderly patients with poorly-controlled diabetes. Usually these

sequelae are seen sooner in Type I than Type II diabetes,

because Type II patients have a small amount of their own

insulin production left to buffer changes in blood sugar

levels.

Type I diabetes is a severe disease and there is no known

permanent cure for it. Nonetheless, the symptoms can be

controlled by strict dietary monitering and insulin injections.

Implanted pumps which release insulin immediately in response to

changes in blood glucose are in the testing stages.

In theory, since it induced by diet, Type II diabetes should be

preventable and manageable by dietary changes alone. However, as

so often happens, clinical theory is defeated by human nature in

this case, as many diabetics (and many obese people without

diabetes) find it personally impossible to lose weight or even

stick to a diet free of starchy, sugary junk food. So Type II

diabetes is frequently treated with drugs which restore the

body's response to its own insulin, and in a few cases

injections of insulin.

Please note that this article isn't a subsitute for medical

advice. If you suspect you have diabetes or even are in a high

risk demographic group, please see your doctor.