All Types Of Diabetes!!

Though most people know only type 1 and type 2 diabetes, there are other minor variants of diabetes.

Type 1 diabetes :

* It’s genetic inheritance – Risk increases 20 – 50% if an identical twin is affected. More common with certain class II HLAs.

 * Complete dependency on insulin treatment – Most of the patients need insulin in their daily life. The dose should be adjusted according to their demands, exercise and other stress factors.

* Young age onset – Around puberty.

* Autoimmune destruction of beta cells in pancreas (Body defense cells called lymphocytes destroy own body cells) – Lymphocytes of the patient are sensitized to his/her own beta cells destroying them.

* Development of ketoacidosis – Most serious complication of type 1 diabetes. As most patients depend on exogenous insulin for their blood sugar control, there should be fine balance between the demand and the supply. If there is more demand for insulin (like surgeries,exercise, pregnancy) and less supply (like missing insulin injections), they easily prone to high glucose levels and ketosis.

Type 2 diabetes :

* It’s genetic inheritance – 50 – 90% of risk if an identical twin is involved.

* Insulin resistance – Main pathology behind this type of diabetes. There are many genetic defects in insulin receptors that causes insulin resistance.

* Partial insulin deficiency – Still some insulin secretion will be preserved, atleast in most of the patients. Beta cell mass is reduced to 50% of normal at the time of diagnosis.

* Age over 40 years

* No autoimmunity – No role for autoimmunity as in type 1 diabetes.

* Development of Hyperosmolar nonketotic coma instead of ketoacidosis – This complication is common in type 2 than type 1. Due to hyperglycemia and impaired water intake in elderly diabetics.

* Insulin treatment sometimes – Usually oral antidiabetic drugs are given to control blood glucose. Some of these drugs enhances the insulin secretion from beta cells. Insulin is last resort if diet, exercise, oral drugs fail.

* Often obese – Central obesity appears to trigger the disease in persons who are genetically susceptible.

Maturity onset diabetes of the Young (MODY) :

* Primary defect is impaired glucose induced secretion of insulin.

* Age is usually less than 25 years.

* This is inherited by a mechanism called autosomal dominance.

* No autoimmunity (as in type 1)

* No insulin resistance (as in type 2)

* No obesity (as in type 2)

MODY is different category. It won’t lead to type 2 diabetes in old age.

Gestational diabetes :

Placenta in preganancy produces anti-insulin hormones that counteract the actions of insulin. So pregnant woman can not maintain normal glucose levels in blood exhibiting glucose tolerance. Fortunately, the condition disappears once the baby was delivered.

Risk factors are obesity, happens when more than 30 years of age, positive family history, unexplained still birth, polyhydromnios (excess amniotic fluid)

Other types of diabetes (secondary causes):

* Diabetes associated with insulin gene or insulin receptor genes.

* Pancreatic diseases like chronic pancreatitis, cystic fibrosis,hemochromatosis.

* Endocrine disorders like acromegaly, cushing’s syndrome, hyperthyroidsm.

* Exogenous administration of glucocorticoids.

[tags]gestational diabetes, mody, type 1 diabetes, type 2 diabetes, diabetes, diabetic[/tags]

What is Gestational Diabetes?

A pregnant woman is unable to maintain normal fasting blood sugar levels and also blood sugar levels after glucose challenge test. Interestingly blood sugar levels comes to normal levels after the baby was born. So it is short lived condition. It generally developed in second half of pregnancy.

Risk Factors:

* Obesity

* Positive family history of diabetes

* Unexplained still birth

* Polyhydromnios (excess amniotic fluid)

Reason Of Gestational Diabetes:

Normally insulin secreted by the pancreas controls blood sugar by pushing the excess glucose in to cells. But in pregnancy placenta produces hormones (human placental lactogen, placental insulinase, cortisol, progesterone) that counteract the actions of insulin. They increase blood glucose and make tissue resistant to insulin action. Once baby was born and placenta was delivered, these hormones action wanes out with in few days and blood glucose comes to normal.

Diagnose Gestational Diabetes:

Screening for gestational diabetes is routinely done on all pregnant woman as a part of regular checkups. If the pregnant woman has risk factors, early testing is required.

First screening test will be done : by 1 hour – 50 gram – oral glucose tolerance test. If the pregnant woman has blood glucose less than 140 mg/dl, it is considered normal. If the values are more than that then pregnant woman needs another test to confirm the diagnosis : 3 hour – 100 gram – oral glucose tolerance test.For this test patient need to be on overnight fasting. And three glucose values are obtained after the test. So total four values – one fasting and three after intake of glucose. If any two of four values are abnormal, then it is diagnostic of gestational diabetes.

Complications:

For the baby -

* Low blood sugar because of persistent insulin in baby’s blood

* Large babies due to excess growth result to excess insulin

* Low calcium levels in baby

* Jaundice due to liver immaturity

* Respiratory problems due to delayed lung maturation

For the mother -

* Big babies and difficult delivery

* Loss of blood after delivery due to uterine agony

Management Of Gestation Diabetes:

It is necessary to do home glucose monitoring at least four times a day. Also in some patients insulin therapy is required where they have to be given an extra dose of insulin. Diet of pregnant woman should be rich in whole grains, vegetables, low fats and nutritious. Regular exercise under the doctors guidance is a must like moderate aerobic exercises, walking, cycling are advised.

Women with overt diabetes have increased risk of fetal anomalies. These can be reduced by maintaining normal blood glucose levels starting three months prior to discontinuing the oral contraceptives or planning to conceive. Also Folic acid supplementation should started three months prior to conception.

[tags]diabetes, diabetic, diabetic pregnancy, gestational diabetes[/tags]

Gestational Diabetes Diet

Gestational Diabetes Diet Good For Mother And Child:

It is not unusual during pregnancy, to develop diabetes , result to the massive hormone changes going on in the body. Developing diabetes when pregnant and having no previous history of diabetes is termed gestational diabetes. Diet become increasing important if the mother-to-be plans to give birth to a healthy baby and not following an appropriate gestational diabetes diet can lead to problems at birth and after.

Additionally, a women with gestational diabetes generally lose the symptoms after birth and are removed from diabetes treatment, but it may remain as a risk factor for the future and will need to be monitored on a regular basis. With a gestational diabetes diet, one of the primary considerations is the intake of simple carbohydrates. The body metabolizes carbohydrates into glucose, which in the fuel the body needs to function. Insulin is produced by the body to help the glucose get into the body’s cells where it provides energy.

With a gestational diabetes diet, the amount of simple carbohydrates and sugar are limited to prevent the build up of sugar in the bloodstream where it can cause a host of health problems for the mother as well as the infant. In most cases a pregnant woman with gestational diabetes will give birth to a healthy infant, provided they follow a gestational diabetes diet as well as get plenty of exercise and watch their weight.

Surprises In Diets:

For many people, milk is a staple in their diet, believing they need it to help the infant during pregnancy. The reality is that lactose found in milk is processed into glucose quickly in the body and many gestational diabetes diet plans limit the amount of milk. We do not have to totally eliminate all carbohydrates, as the body still needs glucose to operate, but it is important to eat the right carbohydrates that do not turn into sugar too quickly.

High fiber foods and complex carbohydrates, such as peas and many legumes along with whole grain breads are good for a gestational diabetes diet, as they take longer to break down into glucose providing a steady supply of fuel instead of a quick burst that cannot be processed with a shortening supply of insulin.

Many doctors suggest a gestational diabetes diet with a specified amount of carbohydrate servings according to the needs of the individual patient. Many of the foods such as juice and many fruits that are generally believed to be good during pregnancy, may be greatly reduced or eliminated on a gestational diabetes diet.

[tags]diabetic diet, gestational diabetes, diabetic, diabetes[/tags]

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