Do you have diabetes? Are you struggling to live with diabetes? Are you looking for information online about diabetes? Are you unsure as to what types of foods you should now be eating to help keep a check on your glucose levels? If you have answered yes to any of these questions this article may well be of interest and benefit to you.

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person’s blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

Major Types of Diabetes

Type 1 diabetes
Results from the body’s failure to produce insulin, the hormone that “unlocks” the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.

Medications for Type 2 Diabetes

Sulfonylureas:
- GLUCOTROL XL (Glipizide)
- AMARYL (Glimepiride)

Meglitinides:
- PRANDIN (Repaglinide)
- STARLIX (Nateglinide)

Biguanides:
- GLUCOPHAGE (Metformin)

Thiazolidinediones:
- ACTOS (Pioglitazone)
- ACTOPLUS MET (Pioglitazone/Metformin)
- AVANDIA (Rosiglitazone)
- AVANDAMET (Rosiglitazone/Metformin)

Other medications:
- KARELA and DIABECON

Gestational diabetes
Gestational diabetes affects about 4% of all pregnant women – about 135,000 cases in the United States each year.

Pre-diabetes
Pre-diabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 54 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes.

Additional Information

Recently Diagnosed
You or someone you love has just been diagnosed with diabetes — chances are you have a million questions running through your head. This area of our Web site can help ease your fears and teach you more about living with diabetes or caring for someone with diabetes, and connect you with others affected by diabetes who will listen and share their own experiences.

Diabetes Symptoms
Often diabetes goes undiagnosed because many of its symptoms seem so harmless. Learn what they are in this section.

Diabetes Risk Test
More than 20 million Americans have diabetes — nearly one in three does not know it! Take our diabetes risk test to see if you are at risk for having diabetes. Diabetes is more common in African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders.

Diabetes Myths
Find the truth about some of the most common myths about diabetes.

The Genetics of Diabetes
You’ve probably wondered how you got diabetes. You may worry that your children will get it too. Unlike some traits, diabetes does not seem to be inherited in a simple pattern. Yet clearly, some people are born more likely to get diabetes than others.

NEW YORK (Reuters Health) – People with type 2 diabetes who need insulin to control their blood glucose levels can choose either human insulin or a structurally similar synthetic version to do the job, a study shows.

“There is no difference between premixed human insulin and premixed insulin analogues,” Dr. Rehan Qayyum from Johns Hopkins Hospital, Baltimore, told Reuters Health.

Qayyum and colleagues reviewed clinical studies of the effectiveness and safety of premixed insulin analogues compared with other anti-diabetes agents in adults with type 2 diabetes.

Premixed insulin analogues provided tighter glucose control than long-acting insulin and non-insulin agents, according to the investigators’ report in the Annals of Internal Medicine. Premixed insulin analogues were comparable to premixed human insulin in lowering A1C levels, an indicator of relatively long-term glucose control.
The occurrence of episodes of too-low glucose levels, i.e., hypoglycemia, was similar with premixed insulin analogues and with premixed human insulin.

“I have found in my previous comparative research that the benefits of new treatments and interventions are often exaggerated by industry and academia (unfortunately),” Qayyum added.

“Studies with longer follow-up are needed to determine whether the effects observed early in treatment are sustainable long-term,” the team concludes.

SOURCE: Annals of Internal Medicine, online September 15, 2008.

High liver fat levels are common in type 2 diabetes patients and contribute to heart disease risk.

The study included 77 diabetic women and men who were divided into two groups. For six months, one group did three 45-minute sessions of moderate aerobic exercise (bicycling, running on a treadmill, or brisk walking) and three 20-minute sessions of weightlifting per week. The other group didn’t do any formal aerobic fitness or gym classes.
MRI scans showed that people in the exercise group had lower levels of liver fat by the end of the study (5.6 percent) than those in the non-exercise group (8.5 percent).

The exercise group also had better fitness and less body weight and fat than those in the non-exercise group. Those who did the aerobic/weightlifting program: had 13 percent higher averages for peak oxygen uptake levels during treadmill testing; were 7 percent stronger; had 6 percent lower body fat and body weight; and had 2-inch smaller waistlines (an average of 39 inches vs. 41 inches).

“The benefits in improved fitness and fatness are clear, and physicians should really have all people with type 2 diabetes actively engaged in an exercise program,” lead investigator Kerry Stewart, a professor of medicine and director of clinical and research exercise physiology at the Johns Hopkins School of Medicine and its Heart and Vascular Institute, said in a Hopkins news release.

The findings were presented Sept. 18 at the American Association of Cardiovascular and Pulmonary Rehabilitation annual meeting, in Indianapolis.

“People with type 2 diabetes have added reason to be active and to exercise, not just because it is good for health, but also because our study results pinpoint a key benefit to trimming the fatty liver that complicates their illness and which could accelerate heart disease and liver failure,” Stewart said.

About 14 million Americans have type 2 diabetes.

MONDAY, April 7 (HealthDay News) — Use of the antipsychotic medication olanzapine may put a person at an increased risk for heart disease and type 2 diabetes, new findings show.

A team of French researchers studying the drug’s effect on male rats found that, after consuming olanzapine over several weeks, the rodents’ blood sugar levels rose significantly compared to rats not on the drug. This was especially noticeable after the rats ate meals with glucose in them. The rats consuming olanzapine did not gain weight or increase their food intake; however, the proportion of fat stored in their abdominal cavity was notably higher.

These changes are increased risk factors of metabolic syndrome, which puts an individual at greater risk of heart disease and type 2 diabetes.

“Based on these findings, we concluded that male rats treated with olanzapine experienced an early disruption of energy metabolism. This was a result of the fat tissue we observed and the impairment in blood sugar regulation which are both associated with metabolic syndrome and subsequent risk of diabetes,” senior study author Dominique Hermier, of the Department of Human Nutrition, INRA, in Paris, said in a prepared statement.

The study was to be presented Monday at the Experimental Biology annual meeting, in San Diego.

Olanzapine is a part of the second generation of antipsychotics known as atypical antipsychotics being used to treat schizophrenia. These newer medicines have proven as effective as their predecessors in treating the delusions and hallucinations that accompany psychotic mental illness and even more effective in combating other symptoms, such as apathy. Side effects, though, include weight gain and a greater chance for developing metabolic syndrome. Physicians fear these side effects may cause their patients to stop taking their medicine.

“Atypical medications like olanzapine are of tremendous value in treating individuals with certain kinds of mental illness. Our hope is that through discoveries such as this one, such life-enhancing medicines can be further optimized,” Hermier said.

TUESDAY, April 1 (HealthDay News) — The controversial diabetes drug Avandia appears to slow the progression of atherosclerosis in diabetic patients who have undergone cardiac bypass surgery, thus protecting them from new cardiac problems, according to the results of a small study.

Avandia (rosiglitazone) has been associated with increased risk of heart attack and heart failure among patients receiving the drug. In November, the U.S. Food and Drug Administration, while calling the evidence for heart attack inconclusive, agreed to keep the drug on the market, but with a black box warning about the heart attack risk.

In the new study, which included almost 100 patients taking Avandia, the study authors said they found the drug was safe and had no more cardiovascular risks than a placebo.

The VICTORY (Vein Coronary Atherosclerosis and Rosiglitazone After Bypass Surgery) study included 193 patients with type 2 diabetes who had undergone cardiac bypass surgery. They were randomly assigned to receive Avandia or a placebo. The trial was paid for by GlaxoSmithKline, the maker of Avandia.

The researchers found that after one year, patients taking Avandia had better blood sugar control, compared with those on a placebo. In addition, patients taking Avandia showed improved cholesterol levels, fewer signs of inflammation of blood vessels, and lower blood pressure than those patients taking a dummy pill.

Also, there was no significant difference in cardiovascular events between the two groups, the researchers noted.

“The enrollment of high-risk cardiovascular patients with type 2 diabetes in a placebo-controlled trial with rosiglitazone was found to have an acceptable safety profile,” the researchers concluded.

The findings were presented Tuesday at the American College of Cardiology annual meeting, in Chicago. The presenter was Dr. Olivier F. Bertrand, assistant professor at Laval University in Quebec City, Canada.

Despite the study findings, one heart expert said the results were insignificant and didn’t really show that Avandia was safe.

“How exactly can they establish the safety of rosiglitazone in a short-term study with less than 100 patients receiving the drug?” asked Dr. Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation, who was the first to report the risk of heart attack associated with Avandia. “This was an intravascular ultrasound study, not a morbidity-mortality study.”

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, agreed with Nissen that the study was too small to make any valid claims about the safety of Avandia.

“This study with only 193 patients is too small to draw any conclusions regarding the potential benefits and risk of rosiglitazone in this patient population,” he said.

Dr. Paul Aftring, senior director of metabolic research at GlaxoSmithKline, said, “We recognize the limitation of the size of this study, but the safety data were very reassuring. They are consistent with other data in high-risk populations.”

The safety data of any trial is never defined by a population of less than 100 patients, Aftring said. “But the longer-term data in longer-term studies in high-risk populations is actually quite reassuring,” he added.

Aftring noted that the current labeling of Avandia says that the drug should be used with caution in high-risk populations. “Victory adds to the knowledge base that in well-managed populations, careful use of rosiglitazone is appropriate, and there are no safety issues,” he said.

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