Diabetes: The problem regardless of
"There is a case of diabetes that is not critical. It is always serious. " - Anne Daly, American Diabetes Association.
"ITS blood tests reveal significant abnormalities. Must take care immediately. " The doctor's words hit like a blow Deborah. "That night I kept thinking that it must have been a laboratory error. I told myself that it was not possible that I was sick. " How many
, Deborah thought to be quite healthy, so it gave weight to the troublesome symptoms. He thought that the persistent thirst was due to taking antihistamines. He attributed the frequent urination to the fact that drinking too much water. And fatigue: Well, as parent that work does not feel exhausted?
But then a blood test confirmed that the cause of his problems was diabetes. Deborah was difficult to accept the diagnosis. "I did not talk to anyone about my illness," he says. "At night, when everyone was asleep, I was in the dark with his eyes fixed on deaf ears and crying." Learning that they have diabetes some, like Deborah, feel mixed emotions, including despair and even anger. "I went through a painful period during which refused to accept the reality," says Karen.
These are natural reactions to what seems like a practical joke. But with a little 'encouragement of diabetics are able to adapt. "The nurse helped me to accept my illness, "says Karen. "I calmed down, saying that it was normal to cry. That outburst helped me to resign. "
Why is serious
A reason diabetes has been called "a disturbance of the engine of life." When the body can not metabolize glucose, a number of vital mechanisms may stop working, sometimes with potentially lethal consequences. "You do not die directly from diabetes," says Dr. Harvey Katzeff, "people die from complications. We manage well enough to prevent complications, but not to treat them once they occur. "
There is hope for those suffering diabetes? Yes, if they understand the severity of the disease and are undergoing a treatment program. Diet and exercise
Type I diabetes is preventable, but scientists are studying the genetic risk factors to try to find a way to prevent an immune reaction. (See the sidebar "The Role of Glucose", page 8). "With the type II diabetes the situation is much better," says the book. "Many of those who might be genetically at risk, avoid manifest symptoms of the disease simply by following a balanced diet and regular exercise to stay fit and maintain their weight within normal limits. " - Diabetes-Caring for Your Emotions as Well as Your Health.
The medical journal JAMA (Journal of the American Medical Association) reported extensive research on women who emphasized the importance of physical exercise. The research found that "a short period of physical activity increases for more than 24 hours [cells], the absorption of glucose mediated by insulin. So the report concluded that "both the walking and vigorous physical activity are associated with substantial reductions in the risk of type II diabetes in women." The researchers recommend at least half an hour of moderate physical activity every day of the week or so. It can be something as simple as a walk, which, according to a handbook for people with diabetes is likely to exercise better, safer and less expensive. " - American Diabetes Association Complete Guide to Diabetes.
However, diabetics should exercise under the supervision of qualified personnel. One reason is that diabetes can damage the nervous and vascular system, compromising the blood circulation and the sense of touch. So a simple scratch to a foot could be neglected, become infected and turn into an ulcer: a serious injury if not treated immediately could lead to amputation.
However, a program of exercise can help control diabetes. "The more researchers study the benefits of regular exercise," says the manual mentioned above, "the more you experience the benefits."
Many diabetics taking insulin should supplement the diet and exercise with daily blood glucose testing and multiple injections of insulin. Because their health has improved thanks to a good diet and exercise program, some patients with type II diabetes were able, at least temporarily, to stop taking insulin. Karen, who has Type I diabetes, found that exercise increases the effectiveness of insulin that is injected. Therefore it has been reduced by 20 per cent of the daily insulin requirement.
If insulin is needed, however, there is no reason that the diabetic be discouraged. "The need to take insulin is not a failure by the patient," says Mary Ann, a registered nurse who looks after other people with diabetes. "Whatever form they suffer from diabetes, close monitoring of blood glucose minimize other health problems later." In fact, a recent study found that patients with type I diabetes who kept tight control of blood glucose has many fewer cases of retinopathy, kidney disease and diabetic neuropathy of origin. " The risk of retinopathy, for example, was reduced by 76 percent. Those with type II diabetes by controlling blood sugar have similar benefits.
To make insulin therapy easier and less traumatic, syringes and insulin pens (the unit most commonly used) are extremely thin needles that give very little discomfort. "Usually the first injection is the worst," says Mary Ann. "Then he says that most patients do not feel almost anything." Other injection methods include automatic injectors that fit into a needle into the skin painlessly, jet injectors, which literally shoot insulin through the skin using a fine spray and diatomaceous using a catheter that remains fixed for two or three days. In recent years it became increasingly using the insulin pump, more or less the size of a small phone. This programmable instrument provides a continuous infusion of insulin as needed daily, making it more convenient and accurate dosing.
We continue to learn
All in all, there is no generalized treatment for diabetes. When choosing where to undergo treatment, each individual must take several factors into account to make a decision. "Even if you are followed by a medical team," says Mary Ann, "It's up to you to decide the way forward." In fact, a trade magazine said: "Treating diabetes without systematically teach the patient self-management approach can be considered a poor and unethical." - Diabetes Care.
Most diabetics know their disease, most will be able to manage their own health and have the prospect of living longer and have healthier lives. Effective education, however, requires patience. A book says: "If you want to learn everything at once, you're probably confused and do not use the information effectively. In addition, many of the most useful information you'll need are not found in books and pamphlets. They have to do. . . with changes in blood glucose due to changes in activity. This can only be learned with time and trial. " - Diabetes-Caring for Your Emotions as Well as Your Health.
For example, with careful monitoring learn how your body reacts to stress, which can suddenly raise your blood sugar. "For 50 years, living with diabetes," says Ken, "and I learned to know the symptoms!" It's worth it "listen" to your body, because Ken is still able to play a full-time job, even if has more than 70 years.
The importance of family support
In the treatment of diabetes should not be underestimated family support. In fact, a publication notes that "the quality of family life is perhaps the most effective single factor" that helps to control diabetes in children and young adults.
is helpful for family members to learn about diabetes, perhaps taking turns in accompanying the patient to the doctor. The knowledge will help them to be helpful, important to recognize symptoms and know what to do. Ted, whose wife has type I diabetes since he was four years, said: "I can understand when your blood sugar drops too Barbara. It mutes in the middle of the conversation. Sweating profusely and gets angry for no reason. And his reactions slow down. "
Similarly, when Catherine, the wife of Ken, notes that he becomes pale and clammy and see that it behaves in a strange way, presents him with a simple mathematical problem. If he responds in a confused way, Catherine knows she has to immediately intervene to put a remedy to the situation. Both Ken and Barbara are very grateful to have a spouse who is well informed that they love and trust.
loving family members should strive to be encouraging, kind and patient, qualities that help the patient deal with the problems of life and also have a positive effect on the disease. Karen's husband assured her that he loved her, which meant a lot to her. Karen says: "Nigel told me, 'People need food and water to live, just as you need food and water, and a small dose of insulin '. Those kind words but practices were just what I needed. "
Family and friends should understand that the fluctuations in blood sugar can affect the mood of the diabetic. "When I have blood sugar issues," said a woman, I become silent, sad, upset and frustrated. So I am ashamed to act so childish. It helps me to know that others understand the reason for this attitude, which seeks to control. "
Diabetes can be managed, especially if the sufferer has cooperation from friends and family. Even Bible principles can help. In what way?
The excessive fat around the waist appears to be a greater risk of fat on her hips.
smokers are at even greater risk because the smoke is harmful to the heart and the circulatory system, and constricts blood vessels. A publication says that 95 percent of amputations due to diabetes affect smokers.
Some were helped by an oral treatment. This consists of taking drugs that stimulate the pancreas to produce more insulin, others that slow down the increase of glucose in the blood, and still others that reduce insulin resistance. (The oral treatment is not usually prescribed for diabetes type I). Currently you can not take insulin orally, because digestion breaks down the protein before it reaches the bloodstream. Neither insulin nor oral medication eliminates the need of exercise and good nutrition.
authorities on health recommended that diabetics always bring with it an identification card or a bracelet or a chain with an inscription indicating that this disease can save critical moments in their lives. A hypo, for example, can be mistaken for another disorder or even drunk.
The Role of Glucose Glucose is
the energy source of the trillions of cells in the body. To enter the cells, however, needs a "key": insulin, a hormone secreted by the pancreas. With type I diabetes the pancreas produces no insulin. With type II diabetes produces, but usually not enough. In addition, the cells are reluctant to accept the insulin that occurs a insulin resistance. In both forms of diabetes, the result is the same: cells that do not receive the necessary and dangerous levels of glucose in blood sugar.
In type I diabetes the immune system attacks the β cells of the pancreas that produce insulin. Therefore, the type I diabetes is an autoimmune disease. Among the factors that can trigger an immune response include viruses, toxic chemicals and certain drugs. Although genetic predisposition may play their part, since the type I diabetes is often found in certain families and is more common among Caucasians.
In diabetes type II, the genetic factor is even stronger, but is found primarily among non-Caucasians. Among the most affected are the Australian Aborigines and Native Americans, and they have the highest percentage in the world of type II diabetes. Researchers are studying the relationship between genetics and obesity, as well as the way excess fat seems to increase insulin resistance in individuals genetically at risk. Unlike type I, type II diabetes occurs mainly in ultraquarantenni.
The role of the pancreas The pancreas, which is about the size of a banana, is located behind the stomach. According to a book, "The healthy pancreas performs a continuous balancing action and succeeded in stabilizing the level of glucose in the blood as it secretes the proper amount of insulin gradually during the day the glucose level rises and falls." (The Unofficial Guide to Living With Diabetes) in pancreatic β cells are the source of the hormone insulin.
When β cells do not produce enough insulin, glucose accumulates in the blood, causing hyperglycemia. On the contrary, the low concentration of glucose in the blood is called hypoglycemia. Together with the pancreas, the liver helps maintain normal blood glucose level by accumulating the excess glucose as glycogen. When required by the pancreas, the liver converts glycogen back into glucose which is used by the body. The role of sugars
the belief that eating a lot of sugar causes diabetes is wrong. Medicine shows that fat, with or without sugar, increases the probability among individuals genetically at risk. However, eating too many sweets is not healthy because they contain very few nutrients and promote obesity.
Another misconception is that diabetics have a craving for sweets, while actually feel the same desire of people in general. When it is unchecked, diabetes can cause hunger, but not necessarily sweet things. People with diabetes can eat sweets, but they must take account of taking sugar in their diet plan.
Recent studies have shown that a diet rich in fructose (sugar derived from fruits and vegetables) may contribute to insulin resistance and even diabetes in animals, regardless of their weight.
Diabetes in a few words
PANCREAS
↓ ↓ ↓
healthy person with Type I Diabetes Type II diabetes
After a meal the β cells of the pancreas
In most cases, the pancreas responds
pancreas to produce insulin produces a greater quantity
content of insulin are attacked Limited
blood glucose by secreting the proper immune system
,
insulin then not produce insulin
↓ ↓ ↓
molecules Without insulin
If insulin receptors are less sensitive
molecules attach to glucose no insulin, the receptors can penetrate
"transporters
muscle cells glucose into the cells "does not
and other cells. steps to
This in turn absorb
giving rise to a blood glucose
process that allows the glucose
penetrate cells
↓ ↓ ↓
Glucose and glucose builds up
absorbed into the blood stream,
burned by preventing vital processes
muscle cells. and damaging the walls
So the blood vessels
of glucose in the blood returns to normal
KATHY Living with Diabetes is a young girl. Mind the diet and weight, makes a lot of practice and follow your doctor's instructions. He also injections insulin every day. Kathy is one of the many millions of people who have diabetes. Despite all his precautions
Kathy admits: "I never know what is the level of glucose in the blood. An afternoon can be 300. The next day, with the same program, can be 50 and I suffer from insulin shock. " Not long ago took an infection that did not heal and spent weeks in hospital.
Mae is an elderly woman. Pays no attention to diet and, as a result, weighs 23 pounds more than normal. He admits to not follow closely the requirements of your doctor. Do not you worry that your blood glucose goes over 300 and often refuses to take insulin. Although in reality take a pill for diabetes every day, it seems surprisingly unconcerned about his illness. As
seem different, both of these women have the same disease. It is called diabetes mellitus. Why is there this difference between them? More importantly, what can they do to live with their diabetes?
What is diabetes?
First of all, we need to understand what diabetes. A key factor of the disease has to do with the body's ability to produce insulin, a hormone secreted by the pancreas. Insulin allows the body to take sugar from the blood stream and bring it into the cells where it is used for energy or is stored.
However, if the body does not produce enough insulin, a little sugar will be routed to cells for energy or stored there. Instead, the sugar reaches high levels in the blood and begins to cause problems. Simply put, this is diabetes. And there are two main types, as illustrated by the case of Kathy and Mae.
In the case of Kathy, the disease is called insulin-dependent diabetes mellitus, or type I diabetes. The problem here is the inability of the pancreas to produce insulin. Recent evidence indicates that this type of diabetes can be caused, at least sometimes, by viral infections. The person who has this type of diabetes usually contracted at a young age (under 30) is usually lean to live and needs insulin injections.
In the case of Mae, the disease is called insulin-independent diabetes mellitus, or type II diabetes. It is often referred to as adult diabetes and is different from the type. The problem here is that the pancreas does not produce insulin, but that does not produce enough. Much insulin it produces is absorbed by fat cells. The pancreas can not produce enough to cope, and glucose in the blood increases. People who have this type of diabetes usually have over 30 years, are fat and can sometimes do without insulin injections. In addition it seems that their diabetes is hereditary.
Diabetes Treatment type I diabetes
Kathy, type I, is much more serious, though less common. It would appear that the solution for the type is simple, just to administer insulin. However, although insulin injections to maintain life in the diabetic can not take account of changes in insulin levels in the body needs minute by minute.
To minimize the complications of diabetes such as blindness and kidney disease, it is important to reduce the amount of glucose in the blood and urine. We must imitate the normal and frequent changes of insulin in the body. But the question is exactly how to do this. The therapy is twofold: (1) preventive care and (2) insulin.
With preventive care, we must take steps to minimize the daily variations of insulin the body needs. A vital factor is the power of the person, because that is what the digestive system into glucose in the blood. The prudent person suffering from diabetes type I soon learned that a diet should be well regulated. This includes both complex carbohydrates fats and proteins. This diet avoids sugar, honey, candy, soft drinks containing sugar and the like. These carbohydrates enter the bloodstream quickly.
This diet must be submitted to the body at regular intervals. If diabetes becomes careless, eating whatever they like at any time, has a rapid imbalance in the levels of insulin and glucose in the blood. This leaves him exposed to rapid and severe disability or long-term complications of the disease.
Exercise lowers blood sugar. So the conscientious type I diabetes in the program includes daily exercise, taking care to have a quick source of sugar (like candy) in case the exercise, who will lower your blood sugar too. This can lead to a diabetic shock. Even emotions can affect blood sugar and can cause low self-control with regard to diet. Infections and illnesses must be treated quickly, since can significantly affect the level of glucose in the blood.
However, although the patient with diabetes type I, like Kathy, take into account all these factors, it can still find it difficult to stabilize your blood sugar. So what to do?
The second main aspect of treatment is the use of insulin injections. When insulin was made available more than 60 years ago, it served to save the lives of many diabetics. And the subsequent development of an injection in the early days was considered as a great advantage.
Although daily injections are cheaper, there is some concern about the potential long-term complications such as hardening arteries. Therefore, some recommend more frequent short-acting insulin injections to keep more closely monitor the blood glucose during the course of the day. Several recent developments have made it not only possible but also practical. The control
home blood glucose has been called "the first truly significant therapeutic advance since the discovery of insulin." Using a simple portable machine, the diabetic can control his blood glucose levels several times a day. So it can adjust the dosage by themselves and you can get closer to the constant normal blood sugar levels. One
disadvantage of home monitoring is that the diabetic has to prick his finger for a blood test. But there are special tools for this, and experts say that this really is not bad. Another disadvantage is the cost of the machine. However, the expenditure should decrease with improved technology.
Other advantages include the manufacture of needles to inject insulin is not expensive to throw away after use, very sharp. They have made their insulin injections less painful. Moreover, insulin is not available now must be more chilled, so you avoid a serious inconvenience when traveling.
has now been marketed insulin which is equivalent human insulin and is often recommended to those who have been newly diagnosed type I diabetes. There are also new pressurized injection of insulin, without needle, infusion pumps and insulin. The injector pump is a portable insulin that the patient wears on his belt. It injects insulin continuously through a needle into the abdominal cavity. The infusion pumps, although in use today, is considered by many doctors quite dangerous and should be used only under the directive of a specialist.
regard to children who have type I diabetes, a recent trend has been less concerned about the diet. Some think they can relatively normal diet and then supplement that diet with any amount of insulin needed. Of course, these children should not eat many sweets, however. The real basic thing that they may live a relatively normal life seems to do a careful monitoring of blood glucose and frequent administration of insulin.
Care
In type II diabetes by the most common type II diabetes, the progress has not been just as numerous. As already noted, this is not the absolute inability of the pancreas to produce insulin. It is the inability of the pancreas to be up to the growing need of insulin by the body, usually worsened by excess weight. Although
are widely used pills, they all serve to push the pancreas to produce more insulin. But there is a limit to the 'flogging a tired horse can bear', in this case, a sick pancreas. A good diet that reduces the weight and restricts simple sugars, accompanied dall'assennato exercise, may be more useful.
If diet, exercise, abstaining from sweets not enough lower level of glucose in the blood, then they can prescribe pills. Here opinions vary. Some doctors prefer to use pills instead of insulin injections, even in type II diabetics. The pills can have side effects, and there is some doubt as to whether actually help prevent long-term complications.
In each case, all factors must be weighed by competent doctors before recommending treatment. And the diabetic must weigh the recommendations and make the final decision about what it will do.
How to live with your diabetes
Therefore, treating diabetes is to make several steps, according to the type from which you are suffering. For type II diabetes, the solution may be diet and weight loss. But one doctor said: "Realistically, my experience has shown that there is little chance that this happens. In most cases they are prepared to give my patients pills or insulin from the beginning. "
For the type I diabetes, the solution that the patient is living with the disease is not so simple. However, even here, part of the answer may not be in medical treatment but on the attitude of the individual to diabetes. It is true that the prospect of daily injections, perhaps several times a day is not pleasant, nor is the finger prick to check blood glucose. Nor is it easy to make sure that your life is organized to the point of eating similar foods each day at regular intervals at the same time, and which are properly planned exercise and physical rest.
At the same time, it was realistic in accepting the fact that at present there is no cure for diabetes. But there is a cure, although it requires discipline, it can keep diabetics alive and in reasonably good condition for far more years than without treatment. Attitudes to avoid
must avoid two completely opposite attitudes. On the one hand, people with diabetes should avoid being careless about the problem, failing to follow doctors' prescriptions wise and perhaps hoping that the problem disappears. Not disappear.
On the other hand, since the emotions cause irregular blood glucose levels, it would be counterproductive to worry too much of the problem. Will not help feed constant fear and have the constant concern for the care of diabetes with the exclusion of normal activities. Although the life of diabetics having to be adjusted, the vast majority can live a well planned.
Losing a limb: how to reduce the risk
In most cases you can avoid getting to the point of losing a limb! This is true even for those who suffer from peripheral vascular disease. As mentioned in the previous article, in many cases, these disorders are a consequence of diabetes. But often you can keep diabetes under control.
"that are prescribed or not insulin, nutrition is the foundation of therapy for diabetics, "says the Encyclopædia Britannica. Marcel Bayol, of Kings County Hospital in New York, said: "If people with diabetes are serious about their illness, are careful what they eat and remain under medical supervision, reduce the risk of losing a leg." If you have diabetes non-insulin-dependent and follows these tips can even see, over time, relief of symptoms.
Exercise is essential
Although exercise is important. It helps the body maintain normal glucose levels. Exercise helps people suffering from peripheral vascular disease to maintain strong, flexible, and properly sprayed with blood on the affected parties. The exercise also helps to reduce intermittent claudication (literally, "intermittent limp") is a disorder that affects those who suffer from peripheral vascular disease causing pain in the muscles of the calf when he walks or does exercise. In this case, however, should avoid exercises that involve effort and trauma to the legs. It is better, such as walking, cycling, rowing, swimming and water aerobics. Before starting a diet or a particular exercise program you should always consult a doctor.
Of course, anyone who takes health should definitely avoid smoking. The peripheral vascular disease are just one of many health problems that smoking creates or exacerbates. "Smoking is closely related to the amputations, especially those who smoke suffer from diabetes and peripheral vascular disease," said Dr. Bayol. How closely this correlation? A handbook for the rehabilitation of those who have lost a limb saying that "the amputations are 10 times more frequent among smokers than among non-smokers.
Care diseased limbs
The peripheral vascular disease can reduce circulation in the legs, and this in turn can undermine the vitality or sensitivity of the nerves, in which case we speak of neuropathy. At this point the legs are easily damaged, even if you do nothing but stay in bed. For example, if an electric blanket or heating pad should be overheating could cause a severe burn, as the person is unable to feel pain! For this reason, the manufacturers warn diabetics to be careful when using these devices.
diseased limbs are also more susceptible to infections. A simple scratch can cause ulcers and even gangrene. Therefore it is essential to take care of the feet, which includes wearing comfortable shoes and the right size and keep legs and feet clean and dry. Many hospitals 'clinics in the foot', which teach patients to take care of your feet. When
vascular disease has progressed to the point you need surgery, surgeons usually try to avoid amputation. An alternative procedure is balloon angioplasty. The vascular surgeon inserts a catheter in the artery with a balloon on top. The balloon is then inflated, thus expanding the artery occluded. Another possibility is a by-pass surgery: the replacement of blood vessels are very sick with others taken from another part of the body.
Barbara, now 54, suffers from insulin dependent diabetes since he was four. After giving birth to her first child began to have problems with circulation to the feet. Some doctors told her they had to be amputated. Barbara, However, he found a qualified vascular surgeon with angioplasty could improve circulation in her feet. Angioplasty worked for a while, but eventually Barbara was forced to undergo a bypass surgery, which was successful. Now Barbara has a lot of care of her feet.
Avoid trauma
Injuries are the second leading cause of loss of a limb. And they are much less selective vascular disease: they may lose any part of the body. However, having the right perspective on life can do much to reduce the risk of injury. What is being done to reduce the risks for the population in countries where many mines are scattered? In many countries were initiated by the government-sponsored programs to raise awareness about the problem of landmines. According to a report of the Secretary General of the United Nations, these programs teach the "at-risk populations. . . to minimize the risk margin even if they live or work in mined areas. "
Unfortunately, "people get used to the presence of mines and becomes irrelevant," says a UN report. "Sometimes religious factors encourage [people] to adopt a fatalistic attitude to these dangers."
Therefore being cautious and taking reasonable steps to protect the health can greatly reduce the risk of losing a limb. But what about those who have lost a limb? It can also lead a fulfilling life?
Other factors that may create or exacerbate vascular problems in the legs are wearing tight pants or other clothing, wear shoes that do not fit well or sit (especially with legs crossed) or standing for long periods.
Those who suffer from insulin-dependent diabetes (type I diabetes) to do daily insulin injections. If you have diabetes non-insulin-dependent (type II diabetes) can often control the disease with proper nutrition and exercise. In the United States, 95 percent of diabetics suffer from this form of diabetes.
For those who smoke the risk of losing a limb is much higher, especially if you suffer from vascular disease
Exercise and proper diet suitable promote the health of the circulatory system
"There is a case of diabetes that is not critical. It is always serious. " - Anne Daly, American Diabetes Association.
"ITS blood tests reveal significant abnormalities. Must take care immediately. " The doctor's words hit like a blow Deborah. "That night I kept thinking that it must have been a laboratory error. I told myself that it was not possible that I was sick. " How many
, Deborah thought to be quite healthy, so it gave weight to the troublesome symptoms. He thought that the persistent thirst was due to taking antihistamines. He attributed the frequent urination to the fact that drinking too much water. And fatigue: Well, as parent that work does not feel exhausted?
But then a blood test confirmed that the cause of his problems was diabetes. Deborah was difficult to accept the diagnosis. "I did not talk to anyone about my illness," he says. "At night, when everyone was asleep, I was in the dark with his eyes fixed on deaf ears and crying." Learning that they have diabetes some, like Deborah, feel mixed emotions, including despair and even anger. "I went through a painful period during which refused to accept the reality," says Karen.
These are natural reactions to what seems like a practical joke. But with a little 'encouragement of diabetics are able to adapt. "The nurse helped me to accept my illness, "says Karen. "I calmed down, saying that it was normal to cry. That outburst helped me to resign. "
Why is serious
A reason diabetes has been called "a disturbance of the engine of life." When the body can not metabolize glucose, a number of vital mechanisms may stop working, sometimes with potentially lethal consequences. "You do not die directly from diabetes," says Dr. Harvey Katzeff, "people die from complications. We manage well enough to prevent complications, but not to treat them once they occur. "
There is hope for those suffering diabetes? Yes, if they understand the severity of the disease and are undergoing a treatment program. Diet and exercise
Type I diabetes is preventable, but scientists are studying the genetic risk factors to try to find a way to prevent an immune reaction. (See the sidebar "The Role of Glucose", page 8). "With the type II diabetes the situation is much better," says the book. "Many of those who might be genetically at risk, avoid manifest symptoms of the disease simply by following a balanced diet and regular exercise to stay fit and maintain their weight within normal limits. " - Diabetes-Caring for Your Emotions as Well as Your Health.
The medical journal JAMA (Journal of the American Medical Association) reported extensive research on women who emphasized the importance of physical exercise. The research found that "a short period of physical activity increases for more than 24 hours [cells], the absorption of glucose mediated by insulin. So the report concluded that "both the walking and vigorous physical activity are associated with substantial reductions in the risk of type II diabetes in women." The researchers recommend at least half an hour of moderate physical activity every day of the week or so. It can be something as simple as a walk, which, according to a handbook for people with diabetes is likely to exercise better, safer and less expensive. " - American Diabetes Association Complete Guide to Diabetes.
However, diabetics should exercise under the supervision of qualified personnel. One reason is that diabetes can damage the nervous and vascular system, compromising the blood circulation and the sense of touch. So a simple scratch to a foot could be neglected, become infected and turn into an ulcer: a serious injury if not treated immediately could lead to amputation.
However, a program of exercise can help control diabetes. "The more researchers study the benefits of regular exercise," says the manual mentioned above, "the more you experience the benefits."
Many diabetics taking insulin should supplement the diet and exercise with daily blood glucose testing and multiple injections of insulin. Because their health has improved thanks to a good diet and exercise program, some patients with type II diabetes were able, at least temporarily, to stop taking insulin. Karen, who has Type I diabetes, found that exercise increases the effectiveness of insulin that is injected. Therefore it has been reduced by 20 per cent of the daily insulin requirement.
If insulin is needed, however, there is no reason that the diabetic be discouraged. "The need to take insulin is not a failure by the patient," says Mary Ann, a registered nurse who looks after other people with diabetes. "Whatever form they suffer from diabetes, close monitoring of blood glucose minimize other health problems later." In fact, a recent study found that patients with type I diabetes who kept tight control of blood glucose has many fewer cases of retinopathy, kidney disease and diabetic neuropathy of origin. " The risk of retinopathy, for example, was reduced by 76 percent. Those with type II diabetes by controlling blood sugar have similar benefits.
To make insulin therapy easier and less traumatic, syringes and insulin pens (the unit most commonly used) are extremely thin needles that give very little discomfort. "Usually the first injection is the worst," says Mary Ann. "Then he says that most patients do not feel almost anything." Other injection methods include automatic injectors that fit into a needle into the skin painlessly, jet injectors, which literally shoot insulin through the skin using a fine spray and diatomaceous using a catheter that remains fixed for two or three days. In recent years it became increasingly using the insulin pump, more or less the size of a small phone. This programmable instrument provides a continuous infusion of insulin as needed daily, making it more convenient and accurate dosing.
We continue to learn
All in all, there is no generalized treatment for diabetes. When choosing where to undergo treatment, each individual must take several factors into account to make a decision. "Even if you are followed by a medical team," says Mary Ann, "It's up to you to decide the way forward." In fact, a trade magazine said: "Treating diabetes without systematically teach the patient self-management approach can be considered a poor and unethical." - Diabetes Care.
Most diabetics know their disease, most will be able to manage their own health and have the prospect of living longer and have healthier lives. Effective education, however, requires patience. A book says: "If you want to learn everything at once, you're probably confused and do not use the information effectively. In addition, many of the most useful information you'll need are not found in books and pamphlets. They have to do. . . with changes in blood glucose due to changes in activity. This can only be learned with time and trial. " - Diabetes-Caring for Your Emotions as Well as Your Health.
For example, with careful monitoring learn how your body reacts to stress, which can suddenly raise your blood sugar. "For 50 years, living with diabetes," says Ken, "and I learned to know the symptoms!" It's worth it "listen" to your body, because Ken is still able to play a full-time job, even if has more than 70 years.
The importance of family support
In the treatment of diabetes should not be underestimated family support. In fact, a publication notes that "the quality of family life is perhaps the most effective single factor" that helps to control diabetes in children and young adults.
is helpful for family members to learn about diabetes, perhaps taking turns in accompanying the patient to the doctor. The knowledge will help them to be helpful, important to recognize symptoms and know what to do. Ted, whose wife has type I diabetes since he was four years, said: "I can understand when your blood sugar drops too Barbara. It mutes in the middle of the conversation. Sweating profusely and gets angry for no reason. And his reactions slow down. "
Similarly, when Catherine, the wife of Ken, notes that he becomes pale and clammy and see that it behaves in a strange way, presents him with a simple mathematical problem. If he responds in a confused way, Catherine knows she has to immediately intervene to put a remedy to the situation. Both Ken and Barbara are very grateful to have a spouse who is well informed that they love and trust.
loving family members should strive to be encouraging, kind and patient, qualities that help the patient deal with the problems of life and also have a positive effect on the disease. Karen's husband assured her that he loved her, which meant a lot to her. Karen says: "Nigel told me, 'People need food and water to live, just as you need food and water, and a small dose of insulin '. Those kind words but practices were just what I needed. "
Family and friends should understand that the fluctuations in blood sugar can affect the mood of the diabetic. "When I have blood sugar issues," said a woman, I become silent, sad, upset and frustrated. So I am ashamed to act so childish. It helps me to know that others understand the reason for this attitude, which seeks to control. "
Diabetes can be managed, especially if the sufferer has cooperation from friends and family. Even Bible principles can help. In what way?
The excessive fat around the waist appears to be a greater risk of fat on her hips.
smokers are at even greater risk because the smoke is harmful to the heart and the circulatory system, and constricts blood vessels. A publication says that 95 percent of amputations due to diabetes affect smokers.
Some were helped by an oral treatment. This consists of taking drugs that stimulate the pancreas to produce more insulin, others that slow down the increase of glucose in the blood, and still others that reduce insulin resistance. (The oral treatment is not usually prescribed for diabetes type I). Currently you can not take insulin orally, because digestion breaks down the protein before it reaches the bloodstream. Neither insulin nor oral medication eliminates the need of exercise and good nutrition.
authorities on health recommended that diabetics always bring with it an identification card or a bracelet or a chain with an inscription indicating that this disease can save critical moments in their lives. A hypo, for example, can be mistaken for another disorder or even drunk.
The Role of Glucose Glucose is
the energy source of the trillions of cells in the body. To enter the cells, however, needs a "key": insulin, a hormone secreted by the pancreas. With type I diabetes the pancreas produces no insulin. With type II diabetes produces, but usually not enough. In addition, the cells are reluctant to accept the insulin that occurs a insulin resistance. In both forms of diabetes, the result is the same: cells that do not receive the necessary and dangerous levels of glucose in blood sugar.
In type I diabetes the immune system attacks the β cells of the pancreas that produce insulin. Therefore, the type I diabetes is an autoimmune disease. Among the factors that can trigger an immune response include viruses, toxic chemicals and certain drugs. Although genetic predisposition may play their part, since the type I diabetes is often found in certain families and is more common among Caucasians.
In diabetes type II, the genetic factor is even stronger, but is found primarily among non-Caucasians. Among the most affected are the Australian Aborigines and Native Americans, and they have the highest percentage in the world of type II diabetes. Researchers are studying the relationship between genetics and obesity, as well as the way excess fat seems to increase insulin resistance in individuals genetically at risk. Unlike type I, type II diabetes occurs mainly in ultraquarantenni.
The role of the pancreas The pancreas, which is about the size of a banana, is located behind the stomach. According to a book, "The healthy pancreas performs a continuous balancing action and succeeded in stabilizing the level of glucose in the blood as it secretes the proper amount of insulin gradually during the day the glucose level rises and falls." (The Unofficial Guide to Living With Diabetes) in pancreatic β cells are the source of the hormone insulin.
When β cells do not produce enough insulin, glucose accumulates in the blood, causing hyperglycemia. On the contrary, the low concentration of glucose in the blood is called hypoglycemia. Together with the pancreas, the liver helps maintain normal blood glucose level by accumulating the excess glucose as glycogen. When required by the pancreas, the liver converts glycogen back into glucose which is used by the body. The role of sugars
the belief that eating a lot of sugar causes diabetes is wrong. Medicine shows that fat, with or without sugar, increases the probability among individuals genetically at risk. However, eating too many sweets is not healthy because they contain very few nutrients and promote obesity.
Another misconception is that diabetics have a craving for sweets, while actually feel the same desire of people in general. When it is unchecked, diabetes can cause hunger, but not necessarily sweet things. People with diabetes can eat sweets, but they must take account of taking sugar in their diet plan.
Recent studies have shown that a diet rich in fructose (sugar derived from fruits and vegetables) may contribute to insulin resistance and even diabetes in animals, regardless of their weight.
Diabetes in a few words
PANCREAS
↓ ↓ ↓
healthy person with Type I Diabetes Type II diabetes
After a meal the β cells of the pancreas
In most cases, the pancreas responds
pancreas to produce insulin produces a greater quantity
content of insulin are attacked Limited
blood glucose by secreting the proper immune system
,
insulin then not produce insulin
↓ ↓ ↓
molecules Without insulin
If insulin receptors are less sensitive
molecules attach to glucose no insulin, the receptors can penetrate
"transporters
muscle cells glucose into the cells "does not
and other cells. steps to
This in turn absorb
giving rise to a blood glucose
process that allows the glucose
penetrate cells
↓ ↓ ↓
Glucose and glucose builds up
absorbed into the blood stream,
burned by preventing vital processes
muscle cells. and damaging the walls
So the blood vessels
of glucose in the blood returns to normal
KATHY Living with Diabetes is a young girl. Mind the diet and weight, makes a lot of practice and follow your doctor's instructions. He also injections insulin every day. Kathy is one of the many millions of people who have diabetes. Despite all his precautions
Kathy admits: "I never know what is the level of glucose in the blood. An afternoon can be 300. The next day, with the same program, can be 50 and I suffer from insulin shock. " Not long ago took an infection that did not heal and spent weeks in hospital.
Mae is an elderly woman. Pays no attention to diet and, as a result, weighs 23 pounds more than normal. He admits to not follow closely the requirements of your doctor. Do not you worry that your blood glucose goes over 300 and often refuses to take insulin. Although in reality take a pill for diabetes every day, it seems surprisingly unconcerned about his illness. As
seem different, both of these women have the same disease. It is called diabetes mellitus. Why is there this difference between them? More importantly, what can they do to live with their diabetes?
What is diabetes?
First of all, we need to understand what diabetes. A key factor of the disease has to do with the body's ability to produce insulin, a hormone secreted by the pancreas. Insulin allows the body to take sugar from the blood stream and bring it into the cells where it is used for energy or is stored.
However, if the body does not produce enough insulin, a little sugar will be routed to cells for energy or stored there. Instead, the sugar reaches high levels in the blood and begins to cause problems. Simply put, this is diabetes. And there are two main types, as illustrated by the case of Kathy and Mae.
In the case of Kathy, the disease is called insulin-dependent diabetes mellitus, or type I diabetes. The problem here is the inability of the pancreas to produce insulin. Recent evidence indicates that this type of diabetes can be caused, at least sometimes, by viral infections. The person who has this type of diabetes usually contracted at a young age (under 30) is usually lean to live and needs insulin injections.
In the case of Mae, the disease is called insulin-independent diabetes mellitus, or type II diabetes. It is often referred to as adult diabetes and is different from the type. The problem here is that the pancreas does not produce insulin, but that does not produce enough. Much insulin it produces is absorbed by fat cells. The pancreas can not produce enough to cope, and glucose in the blood increases. People who have this type of diabetes usually have over 30 years, are fat and can sometimes do without insulin injections. In addition it seems that their diabetes is hereditary.
Diabetes Treatment type I diabetes
Kathy, type I, is much more serious, though less common. It would appear that the solution for the type is simple, just to administer insulin. However, although insulin injections to maintain life in the diabetic can not take account of changes in insulin levels in the body needs minute by minute.
To minimize the complications of diabetes such as blindness and kidney disease, it is important to reduce the amount of glucose in the blood and urine. We must imitate the normal and frequent changes of insulin in the body. But the question is exactly how to do this. The therapy is twofold: (1) preventive care and (2) insulin.
With preventive care, we must take steps to minimize the daily variations of insulin the body needs. A vital factor is the power of the person, because that is what the digestive system into glucose in the blood. The prudent person suffering from diabetes type I soon learned that a diet should be well regulated. This includes both complex carbohydrates fats and proteins. This diet avoids sugar, honey, candy, soft drinks containing sugar and the like. These carbohydrates enter the bloodstream quickly.
This diet must be submitted to the body at regular intervals. If diabetes becomes careless, eating whatever they like at any time, has a rapid imbalance in the levels of insulin and glucose in the blood. This leaves him exposed to rapid and severe disability or long-term complications of the disease.
Exercise lowers blood sugar. So the conscientious type I diabetes in the program includes daily exercise, taking care to have a quick source of sugar (like candy) in case the exercise, who will lower your blood sugar too. This can lead to a diabetic shock. Even emotions can affect blood sugar and can cause low self-control with regard to diet. Infections and illnesses must be treated quickly, since can significantly affect the level of glucose in the blood.
However, although the patient with diabetes type I, like Kathy, take into account all these factors, it can still find it difficult to stabilize your blood sugar. So what to do?
The second main aspect of treatment is the use of insulin injections. When insulin was made available more than 60 years ago, it served to save the lives of many diabetics. And the subsequent development of an injection in the early days was considered as a great advantage.
Although daily injections are cheaper, there is some concern about the potential long-term complications such as hardening arteries. Therefore, some recommend more frequent short-acting insulin injections to keep more closely monitor the blood glucose during the course of the day. Several recent developments have made it not only possible but also practical. The control
home blood glucose has been called "the first truly significant therapeutic advance since the discovery of insulin." Using a simple portable machine, the diabetic can control his blood glucose levels several times a day. So it can adjust the dosage by themselves and you can get closer to the constant normal blood sugar levels. One
disadvantage of home monitoring is that the diabetic has to prick his finger for a blood test. But there are special tools for this, and experts say that this really is not bad. Another disadvantage is the cost of the machine. However, the expenditure should decrease with improved technology.
Other advantages include the manufacture of needles to inject insulin is not expensive to throw away after use, very sharp. They have made their insulin injections less painful. Moreover, insulin is not available now must be more chilled, so you avoid a serious inconvenience when traveling.
has now been marketed insulin which is equivalent human insulin and is often recommended to those who have been newly diagnosed type I diabetes. There are also new pressurized injection of insulin, without needle, infusion pumps and insulin. The injector pump is a portable insulin that the patient wears on his belt. It injects insulin continuously through a needle into the abdominal cavity. The infusion pumps, although in use today, is considered by many doctors quite dangerous and should be used only under the directive of a specialist.
regard to children who have type I diabetes, a recent trend has been less concerned about the diet. Some think they can relatively normal diet and then supplement that diet with any amount of insulin needed. Of course, these children should not eat many sweets, however. The real basic thing that they may live a relatively normal life seems to do a careful monitoring of blood glucose and frequent administration of insulin.
Care
In type II diabetes by the most common type II diabetes, the progress has not been just as numerous. As already noted, this is not the absolute inability of the pancreas to produce insulin. It is the inability of the pancreas to be up to the growing need of insulin by the body, usually worsened by excess weight. Although
are widely used pills, they all serve to push the pancreas to produce more insulin. But there is a limit to the 'flogging a tired horse can bear', in this case, a sick pancreas. A good diet that reduces the weight and restricts simple sugars, accompanied dall'assennato exercise, may be more useful.
If diet, exercise, abstaining from sweets not enough lower level of glucose in the blood, then they can prescribe pills. Here opinions vary. Some doctors prefer to use pills instead of insulin injections, even in type II diabetics. The pills can have side effects, and there is some doubt as to whether actually help prevent long-term complications.
In each case, all factors must be weighed by competent doctors before recommending treatment. And the diabetic must weigh the recommendations and make the final decision about what it will do.
How to live with your diabetes
Therefore, treating diabetes is to make several steps, according to the type from which you are suffering. For type II diabetes, the solution may be diet and weight loss. But one doctor said: "Realistically, my experience has shown that there is little chance that this happens. In most cases they are prepared to give my patients pills or insulin from the beginning. "
For the type I diabetes, the solution that the patient is living with the disease is not so simple. However, even here, part of the answer may not be in medical treatment but on the attitude of the individual to diabetes. It is true that the prospect of daily injections, perhaps several times a day is not pleasant, nor is the finger prick to check blood glucose. Nor is it easy to make sure that your life is organized to the point of eating similar foods each day at regular intervals at the same time, and which are properly planned exercise and physical rest.
At the same time, it was realistic in accepting the fact that at present there is no cure for diabetes. But there is a cure, although it requires discipline, it can keep diabetics alive and in reasonably good condition for far more years than without treatment. Attitudes to avoid
must avoid two completely opposite attitudes. On the one hand, people with diabetes should avoid being careless about the problem, failing to follow doctors' prescriptions wise and perhaps hoping that the problem disappears. Not disappear.
On the other hand, since the emotions cause irregular blood glucose levels, it would be counterproductive to worry too much of the problem. Will not help feed constant fear and have the constant concern for the care of diabetes with the exclusion of normal activities. Although the life of diabetics having to be adjusted, the vast majority can live a well planned.
Losing a limb: how to reduce the risk
In most cases you can avoid getting to the point of losing a limb! This is true even for those who suffer from peripheral vascular disease. As mentioned in the previous article, in many cases, these disorders are a consequence of diabetes. But often you can keep diabetes under control.
"that are prescribed or not insulin, nutrition is the foundation of therapy for diabetics, "says the Encyclopædia Britannica. Marcel Bayol, of Kings County Hospital in New York, said: "If people with diabetes are serious about their illness, are careful what they eat and remain under medical supervision, reduce the risk of losing a leg." If you have diabetes non-insulin-dependent and follows these tips can even see, over time, relief of symptoms.
Exercise is essential
Although exercise is important. It helps the body maintain normal glucose levels. Exercise helps people suffering from peripheral vascular disease to maintain strong, flexible, and properly sprayed with blood on the affected parties. The exercise also helps to reduce intermittent claudication (literally, "intermittent limp") is a disorder that affects those who suffer from peripheral vascular disease causing pain in the muscles of the calf when he walks or does exercise. In this case, however, should avoid exercises that involve effort and trauma to the legs. It is better, such as walking, cycling, rowing, swimming and water aerobics. Before starting a diet or a particular exercise program you should always consult a doctor.
Of course, anyone who takes health should definitely avoid smoking. The peripheral vascular disease are just one of many health problems that smoking creates or exacerbates. "Smoking is closely related to the amputations, especially those who smoke suffer from diabetes and peripheral vascular disease," said Dr. Bayol. How closely this correlation? A handbook for the rehabilitation of those who have lost a limb saying that "the amputations are 10 times more frequent among smokers than among non-smokers.
Care diseased limbs
The peripheral vascular disease can reduce circulation in the legs, and this in turn can undermine the vitality or sensitivity of the nerves, in which case we speak of neuropathy. At this point the legs are easily damaged, even if you do nothing but stay in bed. For example, if an electric blanket or heating pad should be overheating could cause a severe burn, as the person is unable to feel pain! For this reason, the manufacturers warn diabetics to be careful when using these devices.
diseased limbs are also more susceptible to infections. A simple scratch can cause ulcers and even gangrene. Therefore it is essential to take care of the feet, which includes wearing comfortable shoes and the right size and keep legs and feet clean and dry. Many hospitals 'clinics in the foot', which teach patients to take care of your feet. When
vascular disease has progressed to the point you need surgery, surgeons usually try to avoid amputation. An alternative procedure is balloon angioplasty. The vascular surgeon inserts a catheter in the artery with a balloon on top. The balloon is then inflated, thus expanding the artery occluded. Another possibility is a by-pass surgery: the replacement of blood vessels are very sick with others taken from another part of the body.
Barbara, now 54, suffers from insulin dependent diabetes since he was four. After giving birth to her first child began to have problems with circulation to the feet. Some doctors told her they had to be amputated. Barbara, However, he found a qualified vascular surgeon with angioplasty could improve circulation in her feet. Angioplasty worked for a while, but eventually Barbara was forced to undergo a bypass surgery, which was successful. Now Barbara has a lot of care of her feet.
Avoid trauma
Injuries are the second leading cause of loss of a limb. And they are much less selective vascular disease: they may lose any part of the body. However, having the right perspective on life can do much to reduce the risk of injury. What is being done to reduce the risks for the population in countries where many mines are scattered? In many countries were initiated by the government-sponsored programs to raise awareness about the problem of landmines. According to a report of the Secretary General of the United Nations, these programs teach the "at-risk populations. . . to minimize the risk margin even if they live or work in mined areas. "
Unfortunately, "people get used to the presence of mines and becomes irrelevant," says a UN report. "Sometimes religious factors encourage [people] to adopt a fatalistic attitude to these dangers."
Therefore being cautious and taking reasonable steps to protect the health can greatly reduce the risk of losing a limb. But what about those who have lost a limb? It can also lead a fulfilling life?
Other factors that may create or exacerbate vascular problems in the legs are wearing tight pants or other clothing, wear shoes that do not fit well or sit (especially with legs crossed) or standing for long periods.
Those who suffer from insulin-dependent diabetes (type I diabetes) to do daily insulin injections. If you have diabetes non-insulin-dependent (type II diabetes) can often control the disease with proper nutrition and exercise. In the United States, 95 percent of diabetics suffer from this form of diabetes.
For those who smoke the risk of losing a limb is much higher, especially if you suffer from vascular disease
Exercise and proper diet suitable promote the health of the circulatory system
The diet for diabetes
Tips generaliIl first goal of the diet in the diabetic is to keep as much as possible within the normal range blood sugar levels, namely the level of sugar in the blood. The more stable it will be the trend of blood glucose throughout the day, the less likely it is to get sick of diabetes complications (eye, kidney and nervous). Equally important, however, according to the most recent guidelines, is to maintain a proper level of fat (lipids) in the blood to minimize the cardiovascular risks of the disease comporta.Oggi, in fact, the general dietary recommendations for both types of diabetes (type I - or juvenile or insulin-dependent - and type 2 or adult-onset diabetes or non-insulin dependent) are not very different or very different from the rules of healthy diet that all people should follow to prevent certain diseases and metabolic cardiovascolari.Il role of the dietitian can be crucial to obtain lasting results in diabetes and in the case of type I diabetes, which often involves young people, can be very important to involve family in a series of meetings of nutrition education.
Diabetes type IPoiché is common for patients with this type of diabetes are thin or underweight, we generally recommend a diet "full", that provides sufficient calories to ensure muscle mass and normal fat reserves. In practice, a diet that does not deviate much from a "normal" diet. This means taking a normal amount of sugar (carbohydrates) complexes, namely those contained in particular in cereals (bread, pasta, rice, beans, potatoes ...) which can account for up to 60 percent of total calories when foods containing carbohydrates are also rich in "fiber (whole grains, fruits, vegetables, legumes). The presence of fiber is very important because it slows the absorption of "sugar" in the gut and thus fosters a more balanced blood sugar levels after eating. Foods rich in fiber
Vegetable fibers are contained in various foods typical Italian food. The fibers are useful to the diabetic because:
make more gradual absorption of carbohydrates, avoiding too high peaks of glucose after meals;
are effective in reducing cholesterol;
have a satiating effect and thus diminish the sense of hunger.
fibers more "profitable" in those with diabetes are water soluble, contained in legumes (beans, chickpeas, lentils, peas, grass pea), vegetables (artichokes, carrots, chicory, green beans, eggplant, broccoli, mushrooms, cauliflower, tomatoes ...) and fruits. These foods should be consumed daily, even several times a day to eat soluble fibers, which are contained in plant foods and whole foods (prepared with refined flour) as wholemeal bread, pasta and biscuits integral whole, are useful because improve bowel function and prevent the absorption of cholesterol in the intestine. But they did not have a different calorie content than their counterparts without fibers. For example, there is no difference between normal and spaghetti noodles integrals in terms of power effect on blood sugar or calories.
is always good to choose foods that contain carbohydrates that are absorbed more slowly, which already have a "glycemic index" lower. For example, the bread contains carbohydrates that are absorbed quickly (GI = 100) while other foods have carbohydrates that are absorbed more slowly and thus are more "profitable" for diabetes (see below).
glycemic index of some foods (as compared to bread)
PaneBananeRiso comuneGnocchi of farinaRiso parboiledSpaghettiAranceLatteFagioliLenticchie
100 84 80 70 60 60 66 50 45 40
Contrary to the findings in the past, especially in patients of normal weight, can be eaten even small amounts of simple sugars (such as those contained in milk, fruit, ice cream, and desserts) that do not cause as once thought, big setbacks on blood glucose in type I diabetics, who among other things often take insulin before meals ready. Crucial also is the fulfillment of mealtimes and regular consumption throughout the day with small snacks (see below) to ensure supply and split adjusted basis in the insulin doses prescribed by your doctor. Finally, remember that another mainstay of treatment is represented by a regular physical activity and program: fact, regular exercise lowers blood sugar, helps control the levels of blood cholesterol, prevents grease and reduces stress. To do this it is interesting to take a look at the so-called pyramid of physical activity, useful for all, even for diabetics.
Type II diabetes
Because the patient with diabetes type II (popularly known as "diabetic food") is also often overweight, the first goal is to lose weight and not to take drugs to lower blood glucose . The weight loss is achieved primarily by adopting a healthy lifestyle, which consists of a proper diet coupled with a moderate but regular physical activity. The reduction - even partial - of the weight (for example, 5-10 percent of overweight initial) will allow to improve - or even normalize - the values \u200b\u200bof blood glucose and fat levels (cholesterol and triglycerides) levels.
The diet of the diabetic overweight does not differ from that of any patient, therefore, are overweight or obese. Therefore, in these cases, it is good:
reduce the amount of fat in the diet, especially the "saturated", that is of animal origin such as butter, cheese, red meat;
prefer complex carbohydrates, avoiding simple sugars and increase consumption fiber;
maintain a generous contribution of protein, giving preference to those of plant origin (vegetables, like beans, lentils, chickpeas, beans, fenugreek, peas) compared to those of animal origin that are often too rich too fat. In this case always prefer fish and white meats.
The following foods, however, should be significantly limited:
whole milk, cream, cream, fat cheese such as mascarpone, pecorino and provolone;
offal, fatty meats, bacon, sausage, hot dogs, salami, mortadella, neck, pate, cup sausage;
olive bread, pizza by the slice "or filling;
lard, margarine, oils, mixed seed;
sugar, jam, sweets or chewing gum, chocolate, croissants, nougat, cakes, pastries, canned fruit or dried fruit;
soft drinks (orange, coca cola drinks) and fruit juices with added sugars.
Special suggestions
Snacks important appropriately distributed meals throughout the day, never skip breakfast and with the addition of at least two light meals (based on low-fat milk or yogurt, fruit or 40 grams bread with vegetables).
AlcoolNon compelling reasons to prohibit the recruitment of small amounts of alcohol, for example 1:00 to 2:00 glasses of dry wine (11-12 degrees) with meals, if the patient is not evident in overweight. Keep in mind also that the beer has a considerable content of simple sugars (maltose) and therefore its consumption must be lower compared to wine and only during meals. It should pay particular attention to the consumption of alcohol if a patient with diabetes has elevated blood triglycerides.
FruttaSebbene fruit should be taken with caution, because of its content of simple sugars, no kind of fruit is now banned from the diet of diabetics, for which, considering the amount of fiber you can eat all kinds of fruit, including banana, considering for example that a small banana does not contain much more sugar than an apple. In any case, you can use the so-called "exchange lists" that can replace different foods in the same group known equivalences in nutrient content (see below).
List of fruits: equivalent to 10 grams of sugar 160 grams
130 Grams 100 Grams 80 Grams
AnguriaFragoleLimonePompelmo
AlbicoccaAranciaClementinaLamponeMandarinoMelogranoMirtilliNespolaPesca
AnanasCiliegieKiwiMelaMorePerePrugne
BananaCachiFichiUva
fatty essenzialiIn a disease like diabetes that with the passage of time is likely to damage the bloodstream, it can be useful to increase dietary intake of long chain fatty acids, also known as omega 3, which seem to be making some advantages over blood lipid profile, lowering triglycerides, reducing platelet aggregation, thereby increasing the flow of blood and perhaps lowering blood pressure. For this reason, we recommend eating at least twice a week the fish.
SaleNon there are specific indications on salt intake for diabetics, for whom the recommendations apply to the general population, suggesting that the amount of salt to be taken daily should not exceed 3 grams, unless this hypertension or even kidney disease (possible long-term complication of diabetes). To do this you must pay attention mainly to canned in brine, the bouillon cubes, salami, cheeses, ketchup, mayonnaise, potato chips and baked goods in general. Food
specialiPer check the blood sugar is not recommended so-called "diabetic products" which, despite having a reduced content of carbohydrate, are often - like chocolate or biscuits for diabetics - the richest in fat and therefore more calories. Aspartame and other synthetic sweeteners may reasonably be consumed in place of sugar, while it is very questionable use of fructose that has an adverse effect on the level of triglycerides in the blood.
Foods preferred
Fats All fats should be limited
* Meat Chicken, turkey, rabbit, veal and lean beef, venison, lean ham and bacon, dried beef
Dairy products and eggs *
Semi-skimmed milk, yogurt, cottage cheese, egg white fish
All kinds of boiled or baked fish, tuna in brine
fruit, vegetables and legumes
All types of vegetables, whether fresh or frozen soup, fruit fresh except one indicated next
Cereals Pasta, parboiled rice, barley
Liquorice Sweets and sweeteners, aspartame, saccharin
Drinks Tea, coffee
Other herbs, spices, mustard, pepper, vinegar, lemon juice, tomato juice
Tips generaliIl first goal of the diet in the diabetic is to keep as much as possible within the normal range blood sugar levels, namely the level of sugar in the blood. The more stable it will be the trend of blood glucose throughout the day, the less likely it is to get sick of diabetes complications (eye, kidney and nervous). Equally important, however, according to the most recent guidelines, is to maintain a proper level of fat (lipids) in the blood to minimize the cardiovascular risks of the disease comporta.Oggi, in fact, the general dietary recommendations for both types of diabetes (type I - or juvenile or insulin-dependent - and type 2 or adult-onset diabetes or non-insulin dependent) are not very different or very different from the rules of healthy diet that all people should follow to prevent certain diseases and metabolic cardiovascolari.Il role of the dietitian can be crucial to obtain lasting results in diabetes and in the case of type I diabetes, which often involves young people, can be very important to involve family in a series of meetings of nutrition education.
Diabetes type IPoiché is common for patients with this type of diabetes are thin or underweight, we generally recommend a diet "full", that provides sufficient calories to ensure muscle mass and normal fat reserves. In practice, a diet that does not deviate much from a "normal" diet. This means taking a normal amount of sugar (carbohydrates) complexes, namely those contained in particular in cereals (bread, pasta, rice, beans, potatoes ...) which can account for up to 60 percent of total calories when foods containing carbohydrates are also rich in "fiber (whole grains, fruits, vegetables, legumes). The presence of fiber is very important because it slows the absorption of "sugar" in the gut and thus fosters a more balanced blood sugar levels after eating. Foods rich in fiber
Vegetable fibers are contained in various foods typical Italian food. The fibers are useful to the diabetic because:
make more gradual absorption of carbohydrates, avoiding too high peaks of glucose after meals;
are effective in reducing cholesterol;
have a satiating effect and thus diminish the sense of hunger.
fibers more "profitable" in those with diabetes are water soluble, contained in legumes (beans, chickpeas, lentils, peas, grass pea), vegetables (artichokes, carrots, chicory, green beans, eggplant, broccoli, mushrooms, cauliflower, tomatoes ...) and fruits. These foods should be consumed daily, even several times a day to eat soluble fibers, which are contained in plant foods and whole foods (prepared with refined flour) as wholemeal bread, pasta and biscuits integral whole, are useful because improve bowel function and prevent the absorption of cholesterol in the intestine. But they did not have a different calorie content than their counterparts without fibers. For example, there is no difference between normal and spaghetti noodles integrals in terms of power effect on blood sugar or calories.
is always good to choose foods that contain carbohydrates that are absorbed more slowly, which already have a "glycemic index" lower. For example, the bread contains carbohydrates that are absorbed quickly (GI = 100) while other foods have carbohydrates that are absorbed more slowly and thus are more "profitable" for diabetes (see below).
glycemic index of some foods (as compared to bread)
PaneBananeRiso comuneGnocchi of farinaRiso parboiledSpaghettiAranceLatteFagioliLenticchie
100 84 80 70 60 60 66 50 45 40
Contrary to the findings in the past, especially in patients of normal weight, can be eaten even small amounts of simple sugars (such as those contained in milk, fruit, ice cream, and desserts) that do not cause as once thought, big setbacks on blood glucose in type I diabetics, who among other things often take insulin before meals ready. Crucial also is the fulfillment of mealtimes and regular consumption throughout the day with small snacks (see below) to ensure supply and split adjusted basis in the insulin doses prescribed by your doctor. Finally, remember that another mainstay of treatment is represented by a regular physical activity and program: fact, regular exercise lowers blood sugar, helps control the levels of blood cholesterol, prevents grease and reduces stress. To do this it is interesting to take a look at the so-called pyramid of physical activity, useful for all, even for diabetics.
Type II diabetes
Because the patient with diabetes type II (popularly known as "diabetic food") is also often overweight, the first goal is to lose weight and not to take drugs to lower blood glucose . The weight loss is achieved primarily by adopting a healthy lifestyle, which consists of a proper diet coupled with a moderate but regular physical activity. The reduction - even partial - of the weight (for example, 5-10 percent of overweight initial) will allow to improve - or even normalize - the values \u200b\u200bof blood glucose and fat levels (cholesterol and triglycerides) levels.
The diet of the diabetic overweight does not differ from that of any patient, therefore, are overweight or obese. Therefore, in these cases, it is good:
reduce the amount of fat in the diet, especially the "saturated", that is of animal origin such as butter, cheese, red meat;
prefer complex carbohydrates, avoiding simple sugars and increase consumption fiber;
maintain a generous contribution of protein, giving preference to those of plant origin (vegetables, like beans, lentils, chickpeas, beans, fenugreek, peas) compared to those of animal origin that are often too rich too fat. In this case always prefer fish and white meats.
The following foods, however, should be significantly limited:
whole milk, cream, cream, fat cheese such as mascarpone, pecorino and provolone;
offal, fatty meats, bacon, sausage, hot dogs, salami, mortadella, neck, pate, cup sausage;
olive bread, pizza by the slice "or filling;
lard, margarine, oils, mixed seed;
sugar, jam, sweets or chewing gum, chocolate, croissants, nougat, cakes, pastries, canned fruit or dried fruit;
soft drinks (orange, coca cola drinks) and fruit juices with added sugars.
Special suggestions
Snacks important appropriately distributed meals throughout the day, never skip breakfast and with the addition of at least two light meals (based on low-fat milk or yogurt, fruit or 40 grams bread with vegetables).
AlcoolNon compelling reasons to prohibit the recruitment of small amounts of alcohol, for example 1:00 to 2:00 glasses of dry wine (11-12 degrees) with meals, if the patient is not evident in overweight. Keep in mind also that the beer has a considerable content of simple sugars (maltose) and therefore its consumption must be lower compared to wine and only during meals. It should pay particular attention to the consumption of alcohol if a patient with diabetes has elevated blood triglycerides.
FruttaSebbene fruit should be taken with caution, because of its content of simple sugars, no kind of fruit is now banned from the diet of diabetics, for which, considering the amount of fiber you can eat all kinds of fruit, including banana, considering for example that a small banana does not contain much more sugar than an apple. In any case, you can use the so-called "exchange lists" that can replace different foods in the same group known equivalences in nutrient content (see below).
List of fruits: equivalent to 10 grams of sugar 160 grams
130 Grams 100 Grams 80 Grams
AnguriaFragoleLimonePompelmo
AlbicoccaAranciaClementinaLamponeMandarinoMelogranoMirtilliNespolaPesca
AnanasCiliegieKiwiMelaMorePerePrugne
BananaCachiFichiUva
fatty essenzialiIn a disease like diabetes that with the passage of time is likely to damage the bloodstream, it can be useful to increase dietary intake of long chain fatty acids, also known as omega 3, which seem to be making some advantages over blood lipid profile, lowering triglycerides, reducing platelet aggregation, thereby increasing the flow of blood and perhaps lowering blood pressure. For this reason, we recommend eating at least twice a week the fish.
SaleNon there are specific indications on salt intake for diabetics, for whom the recommendations apply to the general population, suggesting that the amount of salt to be taken daily should not exceed 3 grams, unless this hypertension or even kidney disease (possible long-term complication of diabetes). To do this you must pay attention mainly to canned in brine, the bouillon cubes, salami, cheeses, ketchup, mayonnaise, potato chips and baked goods in general. Food
specialiPer check the blood sugar is not recommended so-called "diabetic products" which, despite having a reduced content of carbohydrate, are often - like chocolate or biscuits for diabetics - the richest in fat and therefore more calories. Aspartame and other synthetic sweeteners may reasonably be consumed in place of sugar, while it is very questionable use of fructose that has an adverse effect on the level of triglycerides in the blood.
Foods preferred
Fats All fats should be limited
* Meat Chicken, turkey, rabbit, veal and lean beef, venison, lean ham and bacon, dried beef
Dairy products and eggs *
Semi-skimmed milk, yogurt, cottage cheese, egg white fish
All kinds of boiled or baked fish, tuna in brine
fruit, vegetables and legumes
All types of vegetables, whether fresh or frozen soup, fruit fresh except one indicated next
Cereals Pasta, parboiled rice, barley
Liquorice Sweets and sweeteners, aspartame, saccharin
Drinks Tea, coffee
Other herbs, spices, mustard, pepper, vinegar, lemon juice, tomato juice
To be taken in moderation
Olive oil, margarine and oils derived from sunflower, corn, soybeans, peanuts
Ham cooked pork, lamb, corned beef
Caciotte fresh Parmesan and mozzarella cheese in small amounts, fruit yogurt, 1-2 eggs per week
Fried fish, seafood
bananas, persimmons, grapes, figs
Bread and flour , rice, pasta, biscuits common, pizza, polenta, gnocchi, bread sticks, crackers
Sorbitol, fructose, honey
wine, beer, fruit juices
condiment sauces and mayonnaise, low calorie
To be taken occasionally
butter, lard, hard margarine, seed oils
offal, fatty meats, bacon, sausage, frankfurters, sausages, salami, pate, ground beef and hamburger packaged chicken with skin, neck, mortadella, coppa
Whole milk, cream, cream, mascarpone, pecorino, provolone cheese, yogurt
roe (caviar)
fruit syrup, fruit
dry bread with olive oil, stuffed pizza, flatbread
Sugar, jam, candy, cream, chocolate, nougat, biscuits, croissants, cakes, pastries
Fruit juices with added sugar, coca-cola, orange
Mayonnaise, dressings based cream or cheese
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