Diabetes Overview

The Diabetes Myth: While usually referred to as a “group of diseases”, all types of diabetes are NOT DISEASES. Rather, all diabetics suffer from a “single symptom” and that symptom is “high blood glucose”.

Diabetes is the state of having excessive glucose in the blood due to inadequate insulin production or the body’s cells are not responding properly to absorb glucose produced by the body.

In the USA, Diabetes is ranked as the 7th highest killer in the USA.

Diabetes is significantly under-reported as a cause of death. Studies have shown that only 35% to 40% of people with diabetes that died had diabetes listed on the death certificate. Only 10% to 15% had diabetes listed as an underlying cause of death.

When you consider that most diabetics have heart disease (#1 killer) or cancer (#2 killer) on their death certificates and NOT diabetes which was the underlying cause … Diabetes is probably more like the #3 or #4 killer.

Approximately 120 million people in the USA are “diabetic” or “prediabetic”.

As of 2014, an estimated 387 million people have diabetes worldwide, with Type 2 diabetes making up about 90% of the cases. The number of people with diabetes is expected to rise to 592 million by 2035.

The Center for Disease Control (CDC) has stated “one in three born in 2000 and the years since will get diabetes”

Data from the National Diabetes Statistics Report, 2014 (released June 10, 2014)

  • $245 billion USD Total costs of diagnosed diabetes in the United States in 2012
  • $176 billion for direct medical costs 
  • $69 billion in reduced productivity

The global economic cost of diabetes in 2014 was estimated to be $612 billion USD.

Medical expenses for people with diagnosed diabetes are 2.3 times higher than what expenses would be in the absence of diabetes.

Diabetes at least doubles a person’s risk of death.

Top Ten Countries – While diabetes affects people in countries all around the world, it tends to be more prevalent in certain countries. According to figures from the International Diabetes Foundation, the top ten countries with the highest rate of diabetes are as follows, starting with the highest rate of the disease:

  1. China
  2. India
  3. USA
  4. Brazil
  5. Russia
  6. Mexico 
  7. Indonesia
  8. Egypt 
  9. Japan 
  10. Pakistan

The two underlying causes of the single diabetes symptom of high blood glucose (high blood sugar) are:

  1. Abnormal metabolism of blood sugar because the pancreas does not produce enough insulin
  2. The cells of the body are not responding properly to insulin produced by the pancreas.

Diabetes is diagnosed by high blood sugar levels in the blood over a prolonged period.

Other signs of high blood sugar include frequent urination, increased thirst, and increased hunger.

If left untreated, diabetes can cause many complications. Acute complications include:

  • Diabetic Ketoacidosis Coma
  • Nonketotic Hyperosmolar Coma
  • Death

Serious long-term complications include:

  • Heart disease and Stroke – Death from heart disease and stroke is three times higher for diabetics
  • High Blood Pressure – 75% of diabetics have high blood pressure (130/80 or higher)
  • Kidney Disease – Diabetes is the leading cause of kidney failure
  • Nervous System Damage – Most diabetics develop nervous system damage such as reduced feeling in the feet, erectile dysfunction, and impaired digestion
  • Foot ulcers
  • Amputation – Diabetes is the leading cause of limb amputations
  • Damage to The Eyes – Diabetes is the leading cause of blindness in adults
  • Cancer – Diabetes dramatically increases the risk for cancer. Diabetes doubles the risk of liver, pancreas, and endometrial cancer. It increases the risk of colorectal, breast, and bladder cancer by 20% to 50%.

Types of Diabetes:

Prediabetes 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. It is preventable and reversible with lifestyle changes.

Type 2 diabetes is diagnosed when a person’s blood glucose levels are consistently high enough to become health threatening and require intervention. It is the dominant form of diabetes and it has reached epidemic proportions worldwide. Type 2 diabetes represents the majority of diabetes cases at about 90%. It is preventable and reversible with lifestyle changes.

Type 1 diabetes primarily results from an autoimmune reaction that destroys insulin producing beta cells in the pancreas. This results in failure of the pancreas to produce enough insulin to carry blood glucose to the body’s cells or complete failure to produce insulin. Type 1 is also caused by decreased insulin sensitivity of the body’s cells. Approximately 5% of diabetes cases in North America and Europe are from Type 1. People with Type1 where the pancreas is still producing some amounts of insulin may be able to regenerate the pancreas through lifestyle changes to regain normal blood sugar levels.

Latent Autoimmune Diabetes of Adults (LADA) is a condition in which Type 1 diabetes develops in adults. Adults with LADA are often misdiagnosed as having Type 2, based on age rather than normal causes of Type 2. People with LADA may be able to recover to normal blood sugar levels through lifestyle changes.

Gestational diabetes occurs when a pregnant women without a previous history of diabetes develops high blood sugar levels. Gestational diabetes resembles Type 2 diabetes in several respects with a combination of relatively inadequate insulin secretion and cellular responsiveness. It occurs in as many as 10% of all pregnancies and may improve. It usually resolves after the birth of the baby. 

However, after birth, approximately 5% to 10% of women with gestational diabetes develop diabetes, most commonly Type 2. Gestational diabetes is treatable with lifestyle changes, but requires careful medical supervision of a diabetes knowledgeable doctor throughout the pregnancy.

Overview of the main symptoms of diabetes

The classic initial symptoms of untreated diabetes are:

  • Lethargy
  • Stupor
  • Weight loss
  • Polyurea (Frequent Urination) – The body attempts to get rid of excess glucose by diluting the high blood sugar. It draws water out of the cells into the bloodstream and gets rid of it through urination.
  • Polydipsia (increased thirst)
  • Polyphagia (increased hunger)
  • Kussmaul breathing (deep and labored breathing)
  • Smell of acetone on the breath

Several other signs and symptoms can mark the onset of diabetes, although they are not specific to the disease. In addition to the ones above, they include:

  • Blurry vision that can progress to blindness
  • Headache
  • Chronic Fatigue
  • Slow healing of cuts
  • Itchy skin
  • Nausea
  • Vomiting
  • Abdominal pain

The common clinical tests used to diagnose diabetes are measures of blood glucose levels:

Fasting Plasma Glucose (FPG) test measures the amount of glucose in the blood after fasting. Prediabetes is diagnosed if the fasting blood glucose level is between 100 and 125 mg/dl. Diabetes is diagnosed if the fasting blood glucose level rises to 126 mg/dl or above.

Oral glucose Tolerance Test (OGTT) is used to measure insulin response to high glucose levels. During this test, patients are given glucose, and the rise in blood glucose levels is measured. Prediabetes is diagnosed if the glucose level rises to between 140 and 199 mg/dl. Diabetes is diagnosed if blood glucose levels rise to 200 mg/dl or higher.

HbA1c Test is also helpful in diagnosing less severe cases of diabetes. From this test, clinicians can estimate the average blood glucose level during the preceding two to four months. Normally 4 to 6 percent of hemoglobin is glycosylated, which corresponds to average blood glucose between 60 and 120 mg/dl. Mild hyperglycemia increases HbA1c to 8 to 10 percent (or 180 to 240 mg/dl), while severe hyperglycemia increases HbA1c values up to 20 percent. For diabetics, a healthy HbA1c level is less than 7 percent, which corresponds to an average blood glucose level of 150 mg/dl or less.

A diabetes test result, in the absence of definitive high blood sugar, should be confirmed by a repeat of any of the above methods on a different day. It is preferable to measure a fasting plasma glucose level because of the ease of measurement. There is a considerable time commitment for oral glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test.

Diabetes is diagnosed by persistent high blood sugar demonstrating any one of the following:

Fasting Plasma Glucose Level

  • 70-90 mg/dl = Normal
  • 91-100 mg/dl = Not ideal 
  • 101-125 mg/dl = Prediabetic 
  • 126 mg/dl or above = Diabetic

Plasma glucose ≥ 200 mg/dl two hours after a 75 g oral glucose load as in a glucose tolerance test = Diabetic

Symptoms of high blood sugar and casual plasma glucose ≥ 200 mg/dl = Diabetic

Glycated Hemoglobin (HbA1C) ≥ 6.5 DCCT % = Diabetic

As little as five pounds of excess fat on a body can interfere with insulin’s ability to deliver glucose to the body’s cells. Excess body fat interferes with the action of insulin in in multiple ways:

Insulin also works less effectively when we eat fatty foods, overeat, or eat low-nutrient foods.

IMPORTANT NOTE: Giving overweight diabetic people more insulin makes them sicker by promoting more weight gain and causing them to become even more diabetic.

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