Juvenile Diabetes

Juvenile diabetes is an autoimmune disorder which can be due to environmental trigger or virus, which hampers the function of beta cell. Once the beta cells are destroyed the body is unable to produce insulin. It is also believed that Type 1 diabetes results from an infectious or toxic insult to a child, whose immune system is predisposed to develop an aggressive autoimmune response either against molecules of the B cell or against altered pancreatic B antigens, resembling a viral protein. A child with diabetic siblings is more prone to develop juvenile diabetes than the child from a totally unaffected family. It is considered to be a more hereditary problem than excess eating or being obese. Pancreas produces the exact amount of insulin, to breakdown the sugar produced in the body. The juvenile diabetic lack the production of insulin so, sugar builds up high in the blood, overflows into the urine and passes from the body unused. It is estimated that about 10-15% in United States are suffering with juvenile diabetes. Approximately 35 American children are diagnosed with juvenile diabetes every day.

Symptoms of Juvenile Diabetes

Juvenile Diabetes Cure

Diagnosis of Juvenile Diabetes

Obesity and Diabetes

Diabetes is spreading worldwide as an epidemic. Diabetes is a disorder in which the body cells fail to take up glucose from the blood. Wasting of tissues is seen as glucose-starved cells are forced to consume their own proteins. Diabetes is the cause of blindness, kidney failure and amputation in adults. Individuals with diabetes lack the ability to use the hormone insulin.

As we start eating food, our body starts producing insulin. The insulin signal attaches to a special receptor on the cell surface, to make the cell turn-on its own glucose transporting machinery. It had been observed that type 2 diabetics have normal or even elevated levels of insulin in their body with normal insulin receptor, but due to some unknown reason the binding of insulin to the cell receptors does not starts the glucose transporting machinery, which it is supposed to do. Special proteins called IRS (insulin receptor substrate) are inside the cell. In type 2 diabetes something is interfering with the action of the IRS protein and it is also estimated that about 80% of those who develop type 2 diabetes are obese. When insulin attaches to the receptor protein, the receptor responds by adding a chemical called a phosphate group onto the IRS molecules by which the IRS molecules turn into action. Once activated, they start variety of processes, including an enzyme that turns on the glucose transporter machinery.

Overweight and obesity are both labels for series of weight, greater than what is generally considered healthy for an individual. BMI ranges for children and teens above a normal weight have different labels (at risk of overweight and overweight). Excess body weight is implicated as a risk factor for many disorders including heart disease, cancer, diabetes, female infertility, prostate enlargement, uterine fibroids, gallstone and gestational diabetes etc. The location of fat deposits in the body leads to different risks associated with it. Increased abdominal fat can be estimated by waist size.

Dozens of controlled clinical trials had been carried out to determine the fasting insulin levels and effect of weight loss on fasting blood glucose. They found:

• Weight loss produced by lifestyle modification declines blood glucose levels and HbA1c in type 2 diabetics.
• Glucose tolerance in overweight individuals will improve due to decrease in abdominal fat with impaired glucose tolerance.
• Glucose tolerance improves in overweight individuals due to increased cardio respiratory fitness with impaired glucose tolerance or diabetes.

Diabetic Weight Loss

Hypoglycemia

Glucose is an important fuel for the body to produce energy. The glucose used by the body as a fuel is released from the metabolism of carbohydrates. After meal, glucose starts producing and it is circulated to different body cells through the circulating blood. The cells require insulin to take up glucose inside the membrane and generate energy. When there is inadequate production of insulin, glucose metabolism is slowed down and less glucose is circulated in the blood. This condition is termed as Hypoglycemia. It happens to every diabetic patient from time to time and the severity differs from case to case. Although you are taking good care of diabetes, hypoglycemia may result as it is mostly an insulin reaction which in turn depends on number of factors at a time. As blood sugar begins to fall the counter regulatory hormone like glucagon, another hormone stimulates break down of glycogen and releases glucose, causing blood glucose level to rise. For diabetes, glucagon response to hypoglycemia is impaired, which makes it tough for the body to revert back the normal blood glucose level. Hypoglycemia can occur in people with diabetes who take certain medications to keep their blood glucose levels in control. Hypoglycemia is mild and it can be easily treated by drinking or eating something with carbohydrate. But left untreated, hypoglycemia can lead to loss of consciousness. Although it can happen suddenly, hypoglycemia can usually be treated quickly, bringing your blood glucose level back to normal. Hypoglycemia is a problem for every diabetic so it is important to learn its causes, signs, symptoms, diagnosis and prevention in order to cope up with it as soon as possible.

Hypoglycemia Symptoms

Causes of Hypoglycemia

Treating Hypoglycemia

Diabetic Ketoacidosis

Diabetic Ketoacidosis is a condition in which the body cells are unable to get glucose for producing energy. It is a state of absolute or relative insulin deficiency aggravated by hyperglycemia, dehydration, and acidosis-producing derangements in intermediary metabolism. Due to insufficiency of insulin, the cells cannot use glucose. To avoid starvation the body begins to break down fat, for energy. The constant break down of fat, releases fatty acids and ketone bodies causing chemical imbalance (metabolic imbalance) called Diabetic Ketoacidosis. Diabetic Ketoacidosis (DKA) and its Pathophysiology In the absence of insulin, an anabolic hormone the cells of muscle, liver and other body parts are unable to take up glucose. Counter regulatory hormones, such as glucagon, growth hormone, and catecholamine; boosts triglyceride breakdown into free fatty acids and gluconeogenesis. Beta-oxidation of these free fatty acids leads production of ketone bodies. Metabolism in DKA shifts from carbohydrate metabolism to fat breakdown. Diabetic Ketoacidosis include a metabolic acidosis as the ketone bodies, produced by beta-oxidation of free fatty acids to deplete extra cellular and cellular acid buffers. The hyperglycemia-induced osmotic diuresis depletes sodium, potassium, phosphates, and water (i.e.10% of total body fluids). Moderate or large amounts of ketones in your urine are dangerous. They upset the chemical balance of the blood. Following are the reasons for moderate or large amounts of ketones in the body: Insufficiency of insulin (inborn error) Due to improper injection Body does not produce insulin (flu or any infection) Body needs more insulin No enough food or skipping of meals When blood glucose levels fall too low

Diabetic Ketoacidosis Symptoms

Diabetic Ketoacidosis Causes

Diagnosis of Ketoacidosis

Diabetic Ketoacidosis Treatment

Prevention

Glycosuria

Clinical diagnosis of the diabetes require some of the laboratory tests, glycosuria (finding glucose in the urine) is one of the significant test for detecting frank diabetes. Those who are non diabetic, for them glycosuria can occur for the short term due to emotional stress, pain, hyperthyroidism, alimentary hyperglycemia or meningitis. It can also occur when there is insufficiency of insulin and if a substantial amount of food with high sugar is consumed.

Glycosuria is a condition in which glucose or simple sugar is detected in the urine despite of normal blood sugar level. The normally functioning kidneys absorb and reabsorb the extra blood sugar till renal threshold, with the help of millions of micro tubules – Nephron (filtering unit of kidney). The renal threshold is a concentration level above which all simple sugar is not absorbed in the blood, hence extra glucose is excreted by the kidneys in the urine. Renal threshold of normal kidney is around 10mmol/L. In few cases, when drugs are being used for a longer span of time, it may alter the threshold level of kidney. The amount of glucose not reabsorbed by the kidneys is usually less than 0.1%. Adults excrete about 65 mg of glucose per day. The relationship between glycosuria and the renal threshold are explained in the diagram given below.

In renal glycosuria glucose is abnormally eliminated in the urine due to improper action of the nephron.

The renal glycosuria occurs only when there are abnormally functioning kidneys, due some dent in the kidneys or as an autosomal recessive trait.

Glycosuria Causes

Diabetes and Insulin

The failure to make insulin or insufficiency of insulin is termed as Diabetes mellitus. Insulin is a natural hormone which controls the level of the sugar glucose in the blood. Insulin allows cells to use glucose for energy. Cells cannot utilize glucose without insulin. Excess glucose builds up in the bloodstream, increasing the risk of diabetes. Glucose is the body's primary source of fuel. Insulin enables the body cells to take glucose from the bloodstream. The cells might use glucose for production of energy if required, or it is sent to the liver to preserve it, in the form of glycogen. Functions of Insulin In addition to its role of regulating glucose metabolism, insulin also Stimulates lipogenesis Diminishes lipolysis Increases amino acid transport into cells Modulates transcription Altering the cell content of numerous mRNAs Stimulates growth DNA synthesis Cell replication

Structure of Insulin

Insulin Synthesis

Types of Insulin

Insulin Regimens

Diabetes Insulin Classification

Diabetes and Insulin Analogs

Insulin Injection Devices

Diabetes Treatment and Insulin Problems

Diabetes Diet

Diet plays a significant role in controlling the diabetes. The diabetic diet may be used alone or else in combination with insulin doses or with oral hypoglycemic drugs. Main objective of diabetic diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood sugar levels in blood. The diet plan for a diabetic is based on height, weight, age, sex, physical activity and nature of diabetes. While planning diet, the dietician has to consider complications such as high blood pressure, high cholesterol levels. With respect to the above factors, a dietician will assess calories to be given, like scheming the carbohydrates, proteins, fats, type of carbohydrate, amount of fiber and so on. Exchange meal plan is a diet program which balances the amount of carbohydrate that we intake per day. Glucose is a sugar released from carbohydrate so if we want to control blood sugar we have to limit the consumption of simple carbohydrate. Carbohydrate foods are given as value per portion, known as the exchange. This plan helps us to decide on the type of food to be taken, the amount of food and also the time to eat. You can plan for more flexible meal as you get more knowledge about the diet of a diabetic, may be like the counting carbohydrate meal plan or constant carbohydrate. But there is no common diet that works for everyone. Nor is there any particular diet that works perfectly for any diabetic over a long period. While planning diabetes diet we should adhere to certain important factors, they are as follows: Fiber should be at least 40 gm / day Instead of 3 heavy meals, we should go for 4-5 small mid intervals Replace bakery products and fast foods by simple whole cooked cereals, and don't eat carbohydrates 2 hours before bedtime Consume fresh fruit and vegetables at least 5 exchange/ day Diabetics must always need to take care of thier diet and also about the food they eat. Care has to be taken because all foods contain not only carbohydrate, but also some energy value. Protein and fat available in the food are converted to glucose in the body. This glucose has some effect on the blood sugar level which has to be taken care. Furthermore there is no need that you have to eat only bland boring diet. Instead you have to eat more fruits, vegetables and whole grains. It means that to select foods that are high in nutrition and low in calories and fat.

Diabetes Care

Diabetic Diet Dos

Diabetic Diet Donts