Diabetic retinopathy is the leading cause of blindness in the developed world. Its ability to cause the disease of blood vessels of the retina is the primary cause for blindness in both type 1 and type 2 diabetes patients. It's time to take action and save your eyes! Introduction Diabetes Mellitus has more than what meets the eye - causing one to lose his or her sight. Almost all type 1 diabetes patients and 60% of type 2 diabetes patients have a certain degree of diabetic eye disease within twenty years of onset of the disease. On a more alarming note, a study by Wisconsin Epidemiologic Study of Diabetic Retinopathy showed that 3.6% of type I diabetics and 1.6% of type 2 diabetes patients were legally blind.
What is diabetic retinopathy?
To the public, Diabetes Mellitus usually brings with it images of amputated limbs, people with kidney failure undergoing dialysis and even the occasional heart attack. Sadly, the message of the complications of diabetic retinopathy has not been brought into focus. The primary reason could be because of the myriad of complicated terms that patients find hard to digest. In simple terms, diabetic retinopathy is basically the disease of the retina - the photographic film at the back of the eye that a person's visual images are focused upon. The macula is a particular spot on this 'film' that is responsible for our central vision. On the 'film' itself are many small vessels that deliver nutrients to it. Diabetes, being a disease of blood vessels, attacks the very walls of the vessels on the retina and causes the leakage of proteins and fats from these vessels. The end result? Thickening of the wall of the retina and the macula, as what is termed medically, Macular Edema. This can lead to the loss of our central vision and the distortion of the images focused upon the retina. Other complications include bleeding into the retina (retinal haemorrhages), formation of abnormal vessels (microaneurysms and venous beading) and, on a more serious note, formation of new blood vessels leading to bleeding into the vitreous jelly and detachment of the retina from the wall.
Screening for diabetic retinopathy
The dire consequences of complacency are enough to scare one into action. How does one get started? Firstly, it is recommended that for type 1 diabetes patients, first time screening of the eye should be done within three to five years of diagnosis of disease. For type 2 diabetes patients, screening should be done at the time of diagnosis. The urgency is because many of these diabetes patients would have already had diabetes for six to seven years but have not had prior knowledge of it. Screening of the eye involves taking photographs of the fundus of the eye and subsequent yearly follow-ups to record any progression of the disease. This can be done at the regular outpatient polyclinics or at the general practitioner's clinics with the appropriate facilities.
When do I need to see the eye specialist?
So when does the diabetes patient see the ophthalmologist? Diabetic retinopathy is basically classified into non-proliferative and proliferative type. The former is divided into mild, moderate and severe depending on the classification of the retinal picture. Referral to the ophthalmologist has to be made once the diagnosis of severe non-proliferative type or the proliferative type is made. This is to allow for the early intervention of laser to halt the progression of the disease before it bourgeons into more serious complications. In addition, if the patient complains of sudden onset of worsening of vision and is found to have more serious complications like bleeding into the vitreous or even detachment of the retina, urgent referral to the ophthalmologist has to be made for surgery. However, if the disease has already reached this stage, the visual prognosis would likely remain poor even with surgical interventions. Take action before it is too late.
Do I need to be follow-up regularly?
The story does not end here. Even with the intervention of laser and surgery, it is still crucial for the patient to continue follow-ups to monitor disease progression. For the mild to moderate type of non-proliferative diabetic retinopathy, it is recommended to have follow-up every six to 12 monthly but for the severe type, it is recommended to have one to four monthly follow-ups. For the proliferative type, urgent laser treatment is needed. Always ask your family doctor for his or her recommendations for the duration of follow-up according to the clinical guidelines.
Take charge
You need to take charge and be responsible in ensuring that there is adequate and good control of the blood sugar level and blood pressure. Studies have shown that poor control of these two factors could worsen the progression of diabetic eye disease. In diabetes patients with hypertension, it is recommended by the UKPDS study to have tight control blood pressure below 130/80mmHg to prevent diabetic complications.
Save your Eyes
Diabetes is a battle that can be fought if the proper armour is used. The same is true for diabetic eye disease. Armed with the above information, the patient and the physician can work hand in hand to prevent vision impairment. The message to the diabetic patient is clear - save your sight before it is too late.
Read more about how many have fought and won with dbethics. Read it at www.dbethics.com; www.springwell.biz
Friday, October 3, 2008
Oh No I have Diabetes !
What goes on in your head and heart when you find out you have diabetes? Is it the end of the road? After weeks of constantly feeling tired and thirsty, being plagued by mood swings and poor sleep, you muster enough courage to see a doctor and he gives you the bad news - you have diabetes. You try to make sense of the slew of instructions about medication, diet, blood testing regime and lifestyle changes. Before you can catch your breath, you are due to see the dietitian and diabetes nurse educator.
How did you feel? Lost? Confused? Overwhelmed? Angry? Disbelieving? Guilty? Afraid? How else can you feel? After all, you have just been told that you are stuck with an incurable illness for life. Rest assured, these emotions are natural - it's called "grief".
WHAT IS THIS GRIEF? Grief is a natural response to loss. We grieve for the loss of a loved one or precious item. We experience grief when we lose our health and even a certain way of life. You may have felt as if some part of you died when you found out you had diabetes. Your future seems so uncertain. You mourn for the loss of being "normal". With all the changes (insulin, oral medications, home glucose monitoring) needed now, life dust isn't the same. You may also resent the food restrictions.
Such negative feelings are all part of the bereavement process. Grief is not necessarily a bad thing. It usually opens our eyes and changes our attitudes. While grief is normal, incomplete recovery from loss can have a lifelong effect on a person's capacity for happiness.
It is important to work through the different stages of grief. Elizabeth Kubler-Ross identified the different stages of grieving using an abstract model. The stages are, however, not as neatly experienced as they are described. People seldom move from one stage to another in a straight line. You may find yourself in more than one stage at a time. You may also find yourself moving back and forth between stages or be stuck in one.
Denial - the initial reaction
You may initially refuse to believe what you heard from your doctor. Did you perhaps request more blood tests? Did you seek a second opinion? Perhaps you have chosen to disregard your doctor's advice and refused to take your medicine or make lifestyle changes.
Anger - reality sets in
As the reality of diabetes takes root, feelings of anger. and a sense of unfairness may begin to surface. You resent your loved ones and blame them for this disease. You may be angry with yourself or even God for "giving" you diabetes.
Bargaining - your head takes over
At this point, reason and logic take over. You realise that this disease is not going away. So what do you do now? You try to delay taking medicine by losing weight or becoming more conscientious in controlling your diet.
Depression - the full impact sinks in
When realisation finally sinks, you feel the full force of how serious your condition is and how much change you need to make. You feel very heavy hearted and depressed. It is common for newly diagnosed diabetics to feel depressed, overwhelmed, hopeless and helpless.
Acceptance - at peace with yourself
This is the ultimate stage where we hope to be. It means that you are finally dealing with the reality of diabetes. The condition is now part of your daily living. You have a sense of hope and a positive frame of mind.
HOW TO HANDLE IT
Have a good support network
• Identify some people whom you trust to help you
• Let them know that you may need their moral support
• Surround yourself with people who care and whom you feel comfortable with.
Don't be afraid to ask for help
• To ask for help does not mean that you are incapable or weak
• Let yourself be helped by your friends and loved ones. It is okay to ask for help every now and then
Talk
• Do not keep things bottled up inside
• Stress is bad for you and may worsen your diabetes
Permit yourself to feel
• Let yourself feel sad, angry or even cry
• It will be better to let it out than fight your emotions
WHEN TO SEEK PROFESSIONAL HELP?
• When your sadness is starting to interfere with your daily routine
• When you neglect taking care of yourself and your health.
• If you feel that you are unable to cope with your grief alone anymore
Seb Thiam is a health volunteer passionate to help those who have diabetes Type 1 and 2 control their blood glucose level. After seeing many who suffered from complications of Diabetes including a relative who died of it at age 30. He would like to Unite To Fight Diabetes with those who are equally interested in this subject.
Check out how celebrities fight diabetes and win at www.dbethics.com
www.springwell.biz
How did you feel? Lost? Confused? Overwhelmed? Angry? Disbelieving? Guilty? Afraid? How else can you feel? After all, you have just been told that you are stuck with an incurable illness for life. Rest assured, these emotions are natural - it's called "grief".
WHAT IS THIS GRIEF? Grief is a natural response to loss. We grieve for the loss of a loved one or precious item. We experience grief when we lose our health and even a certain way of life. You may have felt as if some part of you died when you found out you had diabetes. Your future seems so uncertain. You mourn for the loss of being "normal". With all the changes (insulin, oral medications, home glucose monitoring) needed now, life dust isn't the same. You may also resent the food restrictions.
Such negative feelings are all part of the bereavement process. Grief is not necessarily a bad thing. It usually opens our eyes and changes our attitudes. While grief is normal, incomplete recovery from loss can have a lifelong effect on a person's capacity for happiness.
It is important to work through the different stages of grief. Elizabeth Kubler-Ross identified the different stages of grieving using an abstract model. The stages are, however, not as neatly experienced as they are described. People seldom move from one stage to another in a straight line. You may find yourself in more than one stage at a time. You may also find yourself moving back and forth between stages or be stuck in one.
Denial - the initial reaction
You may initially refuse to believe what you heard from your doctor. Did you perhaps request more blood tests? Did you seek a second opinion? Perhaps you have chosen to disregard your doctor's advice and refused to take your medicine or make lifestyle changes.
Anger - reality sets in
As the reality of diabetes takes root, feelings of anger. and a sense of unfairness may begin to surface. You resent your loved ones and blame them for this disease. You may be angry with yourself or even God for "giving" you diabetes.
Bargaining - your head takes over
At this point, reason and logic take over. You realise that this disease is not going away. So what do you do now? You try to delay taking medicine by losing weight or becoming more conscientious in controlling your diet.
Depression - the full impact sinks in
When realisation finally sinks, you feel the full force of how serious your condition is and how much change you need to make. You feel very heavy hearted and depressed. It is common for newly diagnosed diabetics to feel depressed, overwhelmed, hopeless and helpless.
Acceptance - at peace with yourself
This is the ultimate stage where we hope to be. It means that you are finally dealing with the reality of diabetes. The condition is now part of your daily living. You have a sense of hope and a positive frame of mind.
HOW TO HANDLE IT
Have a good support network
• Identify some people whom you trust to help you
• Let them know that you may need their moral support
• Surround yourself with people who care and whom you feel comfortable with.
Don't be afraid to ask for help
• To ask for help does not mean that you are incapable or weak
• Let yourself be helped by your friends and loved ones. It is okay to ask for help every now and then
Talk
• Do not keep things bottled up inside
• Stress is bad for you and may worsen your diabetes
Permit yourself to feel
• Let yourself feel sad, angry or even cry
• It will be better to let it out than fight your emotions
WHEN TO SEEK PROFESSIONAL HELP?
• When your sadness is starting to interfere with your daily routine
• When you neglect taking care of yourself and your health.
• If you feel that you are unable to cope with your grief alone anymore
Seb Thiam is a health volunteer passionate to help those who have diabetes Type 1 and 2 control their blood glucose level. After seeing many who suffered from complications of Diabetes including a relative who died of it at age 30. He would like to Unite To Fight Diabetes with those who are equally interested in this subject.
Check out how celebrities fight diabetes and win at www.dbethics.com
www.springwell.biz
Wednesday, April 23, 2008
Higher Incidence among Asia Indians !
Researchers Look for Explanation Behind High Incidence of Diabetes Among Asian Indians
18 April 2008
The incidence of type 2 diabetes is rising, especially in urbanized parts of the world where sedentary lifestyles and obesity abound. In addition to weight and inactivity, race puts some people at increased risk for developing type 2 diabetes.
The incidence of diabetes is rapidly increasing globally, and Asian Indians have the highest prevalence. An estimated 32 million Asian Indians have been diagnosed with this condition, and some expert expect this number to double over the next 30 years.
In a study published in the March issue of Diabetes, Mayo researchers examined whether Asian Indians have observable differences in the way their cells convert nutrient fuel to available energy and whether these differences may increase the risk for diabetes.
"We know that Asian Indians are highly susceptible to this condition, and they often acquire the disease at an earlier age and at lower body mass index than people of European origin," explains Mayo endocrinologist K. Sreekumaran Nair, M.D., Ph.D., the study's lead researcher. "The question we asked is whether any metabolic differences between Asian Indians and Americans of Northern European origin can explain the higher incidence of diabetes in Indians."
Once known as adult-onset or non-insulin-dependent diabetes, type 2 diabetes is a chronic condition that affects the way the body utilizes sugar (glucose). People with type 2 diabetes don't produce enough insulin -- a hormone that regulates the absorption of sugar into cells -- and their cells resist the effects of insulin (insulin-resistant). While death rates due to heart attack, stroke and even cancer are decreasing, deaths related to diabetes are increasing. Type 2 diabetes is the leading cause of cardiovascular deaths, kidney failure, blindness, sexual dysfunction and many other chronic complications.
Mayo researchers studied 13 diabetic Indians, 13 nondiabetic Indians, and 13 nondiabetic northeast Americans of European descent who were matched for gender, age and body mass to Indian study participants. Study participants were fed the same diet and underwent tests for insulin resistance and muscle biopsy to see whether differences occurred at the cellular level among the different study subject groups.
The study yielded a number of interesting findings. Researchers observed that the Indian subjects, irrespective of their diabetic status, had a greater degree of insulin resistance than the American subjects of Northern European origin, even though the study subjects were not obese, a condition commonly associated with insulin resistance. Earlier research has established that people with insulin resistance typically have poorly functioning muscle mitochondria.
Mitochondria are the part of cells responsible for converting energy from nutrients to ATP (adenosine triphosphate), the chemical form of cellular energy that the body uses for almost all functions.
"Our study showed that the Indian diabetic and nondiabetic subjects with insulin resistance actually had mitochondrial function that was higher than those observed in the Northern European American subjects," says Dr. Nair.
Dr. Nair hypothesizes that key to understanding this difference may lie in an examination of how populations adapt as they become more urbanized. Urban societies typically move away from lifestyles that involve a higher level of physical activity and diets dominated by low-calorie foods.
"The higher capacity to produce ATP that the Indian subjects displayed may have been an adaptive advantage for the generations that preceded them, when energy content of their diet was lower. But today, this trait may be a disadvantage given the higher energy content of their current diets," explains Dr. Nair.
Dr. Nair and his team are hopeful that the information gained from this study will have a substantial impact on understanding the cause of the global epidemic in diabetes.
"Our findings have potential to help determine the energy requirements of different populations and what role this plays in the onset of diabetes" says Dr. Nair.
18 April 2008
The incidence of type 2 diabetes is rising, especially in urbanized parts of the world where sedentary lifestyles and obesity abound. In addition to weight and inactivity, race puts some people at increased risk for developing type 2 diabetes.
The incidence of diabetes is rapidly increasing globally, and Asian Indians have the highest prevalence. An estimated 32 million Asian Indians have been diagnosed with this condition, and some expert expect this number to double over the next 30 years.
In a study published in the March issue of Diabetes, Mayo researchers examined whether Asian Indians have observable differences in the way their cells convert nutrient fuel to available energy and whether these differences may increase the risk for diabetes.
"We know that Asian Indians are highly susceptible to this condition, and they often acquire the disease at an earlier age and at lower body mass index than people of European origin," explains Mayo endocrinologist K. Sreekumaran Nair, M.D., Ph.D., the study's lead researcher. "The question we asked is whether any metabolic differences between Asian Indians and Americans of Northern European origin can explain the higher incidence of diabetes in Indians."
Once known as adult-onset or non-insulin-dependent diabetes, type 2 diabetes is a chronic condition that affects the way the body utilizes sugar (glucose). People with type 2 diabetes don't produce enough insulin -- a hormone that regulates the absorption of sugar into cells -- and their cells resist the effects of insulin (insulin-resistant). While death rates due to heart attack, stroke and even cancer are decreasing, deaths related to diabetes are increasing. Type 2 diabetes is the leading cause of cardiovascular deaths, kidney failure, blindness, sexual dysfunction and many other chronic complications.
Mayo researchers studied 13 diabetic Indians, 13 nondiabetic Indians, and 13 nondiabetic northeast Americans of European descent who were matched for gender, age and body mass to Indian study participants. Study participants were fed the same diet and underwent tests for insulin resistance and muscle biopsy to see whether differences occurred at the cellular level among the different study subject groups.
The study yielded a number of interesting findings. Researchers observed that the Indian subjects, irrespective of their diabetic status, had a greater degree of insulin resistance than the American subjects of Northern European origin, even though the study subjects were not obese, a condition commonly associated with insulin resistance. Earlier research has established that people with insulin resistance typically have poorly functioning muscle mitochondria.
Mitochondria are the part of cells responsible for converting energy from nutrients to ATP (adenosine triphosphate), the chemical form of cellular energy that the body uses for almost all functions.
"Our study showed that the Indian diabetic and nondiabetic subjects with insulin resistance actually had mitochondrial function that was higher than those observed in the Northern European American subjects," says Dr. Nair.
Dr. Nair hypothesizes that key to understanding this difference may lie in an examination of how populations adapt as they become more urbanized. Urban societies typically move away from lifestyles that involve a higher level of physical activity and diets dominated by low-calorie foods.
"The higher capacity to produce ATP that the Indian subjects displayed may have been an adaptive advantage for the generations that preceded them, when energy content of their diet was lower. But today, this trait may be a disadvantage given the higher energy content of their current diets," explains Dr. Nair.
Dr. Nair and his team are hopeful that the information gained from this study will have a substantial impact on understanding the cause of the global epidemic in diabetes.
"Our findings have potential to help determine the energy requirements of different populations and what role this plays in the onset of diabetes" says Dr. Nair.
Friday, April 18, 2008
Dbethics can help reduce costs of treating Diabetes
The global diabetes epidemic has devastating human, social and economic effects. The largest costs of diabetes worldwide are its devastating effects on families and national economies.
Impact on families and people with diabetes
Diabetes is expected to cause 3.8 million deaths worldwide in 2007, about 6% of total global mortality, about the same as HIV/AIDS. Using World Health Organization (WHO) figures on years of life lost per person dying of diabetes, this translates into more than 25 million years of life lost each year.
The International Diabetes Federation (IDF) estimates that the equivalent of an additional 23 million years of life are lost to the disability and to reduced quality of life caused by the preventable complications of diabetes.
People living with diabetes and their families feel the impact of diabetes most directly. They feel the often crushing expenses of diabetes treatments as costs are not subsidized, and family income is frequently reduced when diabetes interferes with work.
It is often the case that caring for diabetes steals valuable time from education, paid work and leisure. In many countries, individuals and families fear and experience the disability, reduced quality of life, and the lost years of life that untreated diabetes brings.
*
People with diabetes face the near certainty, in many countries the stark reality, of premature death.
*
Type 1 diabetes is particularly costly in terms of mortality in poor countries, where many children die because access to life-saving insulin is not subsidized by governments (who instead tax it heavily), and is often not available at any price.
*
Studies recently carried out in Zambia, Mali and Mozambique highlight a stark reality: a person requiring insulin for survival in Zambia will live an average of 11 years; a person in Mali can expect to live for 30 months; in Mozambique a person requiring insulin will be dead within 12 months.
*
In the poorest countries, people with diabetes and their families bear almost the entire cost of whatever medical care they can afford.
*
In Latin America, families pay 40-60% of diabetes care costs out of their own pockets.
*
In India, for example, the poorest people with diabetes spend an average of 25% of their income on private care. Most of this money is used to stay alive by avoiding fatally high blood sugar levels.
With many successful story Dbethics has helped to reduce the costs of treating diabetes.
see many real life changing experiences in www.springwell.biz; www.dbethics.com
Impact on families and people with diabetes
Diabetes is expected to cause 3.8 million deaths worldwide in 2007, about 6% of total global mortality, about the same as HIV/AIDS. Using World Health Organization (WHO) figures on years of life lost per person dying of diabetes, this translates into more than 25 million years of life lost each year.
The International Diabetes Federation (IDF) estimates that the equivalent of an additional 23 million years of life are lost to the disability and to reduced quality of life caused by the preventable complications of diabetes.
People living with diabetes and their families feel the impact of diabetes most directly. They feel the often crushing expenses of diabetes treatments as costs are not subsidized, and family income is frequently reduced when diabetes interferes with work.
It is often the case that caring for diabetes steals valuable time from education, paid work and leisure. In many countries, individuals and families fear and experience the disability, reduced quality of life, and the lost years of life that untreated diabetes brings.
*
People with diabetes face the near certainty, in many countries the stark reality, of premature death.
*
Type 1 diabetes is particularly costly in terms of mortality in poor countries, where many children die because access to life-saving insulin is not subsidized by governments (who instead tax it heavily), and is often not available at any price.
*
Studies recently carried out in Zambia, Mali and Mozambique highlight a stark reality: a person requiring insulin for survival in Zambia will live an average of 11 years; a person in Mali can expect to live for 30 months; in Mozambique a person requiring insulin will be dead within 12 months.
*
In the poorest countries, people with diabetes and their families bear almost the entire cost of whatever medical care they can afford.
*
In Latin America, families pay 40-60% of diabetes care costs out of their own pockets.
*
In India, for example, the poorest people with diabetes spend an average of 25% of their income on private care. Most of this money is used to stay alive by avoiding fatally high blood sugar levels.
With many successful story Dbethics has helped to reduce the costs of treating diabetes.
see many real life changing experiences in www.springwell.biz; www.dbethics.com
Tuesday, April 15, 2008
Diabetes in Pregnancy can be cured with Dbethics
Diabetes is a disorder of carbohydrate metabolism that requires immediate changes in lifestyle. In its chronic forms, diabetes is associated with long-term vascular complications, including retinopathy, nephropathy, neuropathy and vascular disease. Approximately 650,000 women give birth in England and Wales each year, and 2–5% of pregnancies involve women with diabetes. Approximately 87.5% of pregnancies complicated by diabetes are estimated to be due to gestational diabetes (which may or may not resolve after pregnancy), with 7.5% being due to type 1 diabetes and the remaining 5% being due to type 2 diabetes. The prevalence of type 1 and type 2 diabetes is increasing. In particular, type 2 diabetes is increasing in certain minority ethnic groups (including people of African, black Caribbean, South Asian, Middle Eastern and Chinese family origin).
Diabetes in pregnancy is associated with risks to the woman and to the developing fetus. Miscarriage, pre-eclampsia and preterm labour are more common in women with pre-existing diabetes. In addition, diabetic retinopathy can worsen rapidly during pregnancy. Stillbirth, congenital malformations, macrosomia, birth injury, perinatal mortality and postnatal adaptation problems (such as hypoglycaemia) are more common in babies born to women with pre-existing diabetes.
This clinical guideline contains recommendations for the management of diabetes and its complications in women who wish to conceive and those who are already pregnant. The guideline builds on existing clinical guidelines for routine care during the antenatal, intrapartum and postnatal periods. It focuses on areas where additional or different care should be offered to women with diabetes and their newborn babies.
Where the evidence supports it, the guideline makes separate recommendations for women with pre-existing diabetes (type 1 diabetes, type 2 diabetes and other forms of diabetes, such as maturity onset diabetes of the young) and gestational diabetes. The term 'women' is used in the guideline to refer to all females of childbearing age, including young women who have not yet transferred from paediatric to adult services.
The guideline will assume that prescribers will use a drug’s summary of product characteristics to inform their decisions for individual women.
Insulin aspart has marketing authorisation specifically for pregnant women. At the time of publication (March 2008), none of the other drugs recommended in the guideline have UK marketing authorisation specifically for pregnant women. Informed consent should be obtained and documented.
Woman- and baby-centred care
This guideline offers best practice advice on the care of women with diabetes who are planning to become pregnant, or who are already pregnant, and their newborn babies.
Treatment and care should take into account women’s needs and preferences. Women with diabetes should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If women do not have the capacity to make decisions, healthcare professionals should follow the Department of Health guidelines – ‘Reference guide to consent for examination or treatment’ (2001) (available from www.dh.gov.uk). Healthcare professionals should also follow a code of practice accompanying the Mental Capacity Act (summary available from www.publicguardian.gov.uk).
Good communication between healthcare professionals and women is essential. It should be supported by evidence-based written information tailored to the woman's needs. Treatment and care, and the information women are given about it, should be culturally appropriate. It should also be accessible to women with additional needs such as physical, sensory or learning disabilities, and to women who do not speak or read English.
Care of young women in transition between paediatric and adult services should be planned and managed according to the best practice guidance described in ‘Transition: getting it right for young people’ (available from www.dh.gov.uk). Adult and paediatric healthcare teams should work jointly to provide care for young women with diabetes.
Key priorities for implementation
Pre-conception care
• Women with diabetes who are planning to become pregnant should be informed that establishing good glycaemic control before conception and continuing this throughout pregnancy will reduce the risk of miscarriage, congenital malformation, stillbirth and neonatal death. It is important to explain that risks can be reduced but not eliminated.
• The importance of avoiding unplanned pregnancy should be an essential component of diabetes education from adolescence for women with diabetes.
• Women with diabetes who are planning to become pregnant should be offered pre-conception care and advice before discontinuing contraception.
Antenatal care
• If it is safely achievable, women with diabetes should aim to keep fasting blood glucose between 3.5 and 5.9 mmol/litre and 1-hour postprandial blood glucose below 7.8 mmol/litre during pregnancy.
• Women with insulin-treated diabetes should be advised of the risks of hypoglycaemia and hypoglycaemia unawareness in pregnancy, particularly in the first trimester.
• During pregnancy, women who are suspected of having diabetic ketoacidosis should be admitted immediately for level 2 critical care , where they can receive both medical and obstetric care.
• Women with diabetes should be offered antenatal examination of the four-chamber view of the fetal heart and outflow tracts at 18–20 weeks
More diabetes news in www.dbethics.com
www.springwell.biz
Diabetes in pregnancy is associated with risks to the woman and to the developing fetus. Miscarriage, pre-eclampsia and preterm labour are more common in women with pre-existing diabetes. In addition, diabetic retinopathy can worsen rapidly during pregnancy. Stillbirth, congenital malformations, macrosomia, birth injury, perinatal mortality and postnatal adaptation problems (such as hypoglycaemia) are more common in babies born to women with pre-existing diabetes.
This clinical guideline contains recommendations for the management of diabetes and its complications in women who wish to conceive and those who are already pregnant. The guideline builds on existing clinical guidelines for routine care during the antenatal, intrapartum and postnatal periods. It focuses on areas where additional or different care should be offered to women with diabetes and their newborn babies.
Where the evidence supports it, the guideline makes separate recommendations for women with pre-existing diabetes (type 1 diabetes, type 2 diabetes and other forms of diabetes, such as maturity onset diabetes of the young) and gestational diabetes. The term 'women' is used in the guideline to refer to all females of childbearing age, including young women who have not yet transferred from paediatric to adult services.
The guideline will assume that prescribers will use a drug’s summary of product characteristics to inform their decisions for individual women.
Insulin aspart has marketing authorisation specifically for pregnant women. At the time of publication (March 2008), none of the other drugs recommended in the guideline have UK marketing authorisation specifically for pregnant women. Informed consent should be obtained and documented.
Woman- and baby-centred care
This guideline offers best practice advice on the care of women with diabetes who are planning to become pregnant, or who are already pregnant, and their newborn babies.
Treatment and care should take into account women’s needs and preferences. Women with diabetes should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If women do not have the capacity to make decisions, healthcare professionals should follow the Department of Health guidelines – ‘Reference guide to consent for examination or treatment’ (2001) (available from www.dh.gov.uk). Healthcare professionals should also follow a code of practice accompanying the Mental Capacity Act (summary available from www.publicguardian.gov.uk).
Good communication between healthcare professionals and women is essential. It should be supported by evidence-based written information tailored to the woman's needs. Treatment and care, and the information women are given about it, should be culturally appropriate. It should also be accessible to women with additional needs such as physical, sensory or learning disabilities, and to women who do not speak or read English.
Care of young women in transition between paediatric and adult services should be planned and managed according to the best practice guidance described in ‘Transition: getting it right for young people’ (available from www.dh.gov.uk). Adult and paediatric healthcare teams should work jointly to provide care for young women with diabetes.
Key priorities for implementation
Pre-conception care
• Women with diabetes who are planning to become pregnant should be informed that establishing good glycaemic control before conception and continuing this throughout pregnancy will reduce the risk of miscarriage, congenital malformation, stillbirth and neonatal death. It is important to explain that risks can be reduced but not eliminated.
• The importance of avoiding unplanned pregnancy should be an essential component of diabetes education from adolescence for women with diabetes.
• Women with diabetes who are planning to become pregnant should be offered pre-conception care and advice before discontinuing contraception.
Antenatal care
• If it is safely achievable, women with diabetes should aim to keep fasting blood glucose between 3.5 and 5.9 mmol/litre and 1-hour postprandial blood glucose below 7.8 mmol/litre during pregnancy.
• Women with insulin-treated diabetes should be advised of the risks of hypoglycaemia and hypoglycaemia unawareness in pregnancy, particularly in the first trimester.
• During pregnancy, women who are suspected of having diabetic ketoacidosis should be admitted immediately for level 2 critical care , where they can receive both medical and obstetric care.
• Women with diabetes should be offered antenatal examination of the four-chamber view of the fetal heart and outflow tracts at 18–20 weeks
More diabetes news in www.dbethics.com
www.springwell.biz
Roy Partridge a Champion Sailor who travelled the world
Roy, a type one diabetic since the age of 14, decided to make a Mirror dinghy from kit form.
Having built the boat, he then had to learn to sail it as he had no previous experience of sailing.
On one of his first outings he managed to snag the main sail sheet and capsized the boat.
He persevered with the sailing, built many more boats, learnt how to fine tune the sails and rigging, and years later became Area, National, European and World Champion.
He was invited by the Mirror Class Associations from around the world to share his sailing knowledge, which he did with enthusiasm and pleasure. He went to such places as Barbados, Canada and South Africa.
He wrote a book called Sailing the Mirror which was considered the “class bible” for many years and is still selling today around the world.
*His diabetic routine was an injection of long-acting Actrapid and short-acting soluble insulin a.m. He was meticulous with his diet.
In the boat he would take Mars Bars in case his blood sugar should drop too low.
He never managed to eat them because he was too involved in the racing. He did have Dextro tablets that he would eat even when they were wet and soggy. He always ate a large sandwich before going out on the water.
Menna, his wife would often be seen at the waters edge with food for Roy when the boats came in after a race.
Among his joint achievements was 59 years of marriage. We know, but for the love care and devotion that our mother gave him, he would not have lived as long as he did. He died aged 82.
Zena Healy (nee Partridge)
Diabetes.uk
More testimonies in www.springwell.biz
www.dbethics.com
Having built the boat, he then had to learn to sail it as he had no previous experience of sailing.
On one of his first outings he managed to snag the main sail sheet and capsized the boat.
He persevered with the sailing, built many more boats, learnt how to fine tune the sails and rigging, and years later became Area, National, European and World Champion.
He was invited by the Mirror Class Associations from around the world to share his sailing knowledge, which he did with enthusiasm and pleasure. He went to such places as Barbados, Canada and South Africa.
He wrote a book called Sailing the Mirror which was considered the “class bible” for many years and is still selling today around the world.
*His diabetic routine was an injection of long-acting Actrapid and short-acting soluble insulin a.m. He was meticulous with his diet.
In the boat he would take Mars Bars in case his blood sugar should drop too low.
He never managed to eat them because he was too involved in the racing. He did have Dextro tablets that he would eat even when they were wet and soggy. He always ate a large sandwich before going out on the water.
Menna, his wife would often be seen at the waters edge with food for Roy when the boats came in after a race.
Among his joint achievements was 59 years of marriage. We know, but for the love care and devotion that our mother gave him, he would not have lived as long as he did. He died aged 82.
Zena Healy (nee Partridge)
Diabetes.uk
More testimonies in www.springwell.biz
www.dbethics.com
Friday, February 22, 2008
Could this help overcome Insulin Resistance in Diabetes ?
Yes, it can.
Complex Carbohydrates and Insulin Resistance
One of the biggest mistakes that weight loss failures make is cutting out carbs altogether. An example of this flawed ideology is the Atkins diet. Clinical studies have proven that the low-carb, high fat diet has a negative impact on the health of your heart and blood.
But bringing back the carbs can cause problems too. Did you know that many of the carbs we eat every day may cause a condition called insulin resistance? With the extra carbs adding the extra pounds and inches to your body, the insulin hormone runs into a big problem: It can’t help you process fuel, fats, or sugars. When you reach this condition, your body stores even more fat than it should be, mostly around your stomach and hips.
So how do we keep the delicious carbohydrate-filled foods without adding inches and developing insulin resistance? If you’re dedicated to losing weight and achieving health for the rest of your life, this solution is for you! You must understand that thre are two types of carbohydrates; good and bad. Good carbohydrates include non-processed foods like fruits, vegetables, and whole grains. Bad carbohydrates include those such as white bread, chips, snacks and other baked or fried foods that have been mechanically processed.
What are the good carbohydrates?
These are the carbs we should focus on eating. They come in more natural forms such as whole grain wheat bread, fruit like strawberries and peaches, and vegetables such as carrots, green beans or squash.
What are the bad carbs?
If you want to keep the healthiest blood chemistry, try hard to avoid eating these foods. Some of the foods with “bad” carbohydrates include those such as white bread, chips, snacks and other baked or fried foods that have been mechanically processed. These carbs bad for you because during processing, much or all of the dietary fiber is removed from them, and your body cannot process these new complex carbs with efficiency.
Many take Dbethics with proper diet and has manage to control their blood sugar level to normal. The question is Could Dbethics be the cure many has asked after they have managed to overcome insulin resistance and reduced their blood sugar level to normal after taking Dbethics for 3 - 6 months.
Check it out for yourself at www.springwell.biz
www.dbethics.com; www.curediabetes2.com
Complex Carbohydrates and Insulin Resistance
One of the biggest mistakes that weight loss failures make is cutting out carbs altogether. An example of this flawed ideology is the Atkins diet. Clinical studies have proven that the low-carb, high fat diet has a negative impact on the health of your heart and blood.
But bringing back the carbs can cause problems too. Did you know that many of the carbs we eat every day may cause a condition called insulin resistance? With the extra carbs adding the extra pounds and inches to your body, the insulin hormone runs into a big problem: It can’t help you process fuel, fats, or sugars. When you reach this condition, your body stores even more fat than it should be, mostly around your stomach and hips.
So how do we keep the delicious carbohydrate-filled foods without adding inches and developing insulin resistance? If you’re dedicated to losing weight and achieving health for the rest of your life, this solution is for you! You must understand that thre are two types of carbohydrates; good and bad. Good carbohydrates include non-processed foods like fruits, vegetables, and whole grains. Bad carbohydrates include those such as white bread, chips, snacks and other baked or fried foods that have been mechanically processed.
What are the good carbohydrates?
These are the carbs we should focus on eating. They come in more natural forms such as whole grain wheat bread, fruit like strawberries and peaches, and vegetables such as carrots, green beans or squash.
What are the bad carbs?
If you want to keep the healthiest blood chemistry, try hard to avoid eating these foods. Some of the foods with “bad” carbohydrates include those such as white bread, chips, snacks and other baked or fried foods that have been mechanically processed. These carbs bad for you because during processing, much or all of the dietary fiber is removed from them, and your body cannot process these new complex carbs with efficiency.
Many take Dbethics with proper diet and has manage to control their blood sugar level to normal. The question is Could Dbethics be the cure many has asked after they have managed to overcome insulin resistance and reduced their blood sugar level to normal after taking Dbethics for 3 - 6 months.
Check it out for yourself at www.springwell.biz
www.dbethics.com; www.curediabetes2.com
Wednesday, February 6, 2008
Everyday recipes for Diabetes
Catering for people with diabetes
The information on this page is intended to illustrate how you can best cater for people with diabetes, whether they are coming for dinner, or to stay for a few days. The information is about people with diabetes in general but it is important to remember that everyone with diabetes has individual dietary requirements and treatment plan - and some people may like to stray a little from their usual eating habits when away from home. Just like everyone else, the occasional high fat or high sugar food can be included as part of a healthy diet. It may therefore be an idea to have a chat with the person with diabetes before they come, to see if they have any specific needs, or to discuss the meal(s) you have planned.
What to provide, meal by meal
Breakfast
Include the following in the choices available:
* High fibre cereals such as Branflakes, Fruit and Fibre, no added sugar muesli, Shredded Wheat, Weetabix, porridge.
* Low fat spread or polyunsaturated/monounsaturated margarine as well as butter.
* Semi-skimmed/skimmed milk as well as full cream milk.
* Unsweetened fruit juice.
* Fruit, eg grapefruit in natural juice and not syrup.
* Reduced sugar jam/marmalade or pure fruit spreads as well as ordinary versions (NOT ‘diabetic’ jams).
* Artificial sweeteners, eg Canderel, Hermesetas or Sweetex as well as sugar for tea and coffee. Granulated artificial sweeteners can be used for cereals and for use in recipes, eg Canderel Spoonful.
* A selection of wholemeal and granary breads or rolls as well as white.
* If cooked breakfasts are planned, food should be grilled not fried where possible.
Main meals
Have plenty of starchy carbohydrate foods available. If possible let the person with diabetes help themselves as they will know how much they will need (buffets are often a good idea to allow this). It’s a good idea to have bread already on the table as people requiring insulin may have given their insulin injection and therefore will need some carbohydrate within half an hour of their injection.
* Have a variety of dishes from which people can choose.
* People with diabetes need meals including carbohydrates, such as potatoes, pasta or rice.
* Try to provide low fat/low calorie options, eg new potatoes as well as fried.
* Provide extra vegetables and salad.
* Serve butter, mayonnaise or dressings separately so that people can choose whether to have it or not.
* Provide vegetarian options.
* Serve cream and rich sauces separately so that people can choose whether to add it or not.
* Provide low sugar desserts, ice-cream, fresh fruit or low fat yogurts as an alternative choice to ordinary.
* Water should be available on the table.
Snacks
People with diabetes are encouraged to spread their food intake evenly throughout the day for good blood glucose control and snacks mid morning, mid afternoon and bedtime may be part of their eating plan.
Suitable snacks are:
* Fruit – fresh or dried.
* Plain biscuits, eg garibaldi, rich tea, gingernuts, digestives, hob nobs.
* Bread or toast, muffins, crumpets, teabreads, plain or fruit cakes and cereals.
* Low fat yogurt.
Drinks
It is important that a selection of sugar-free drinks and mixers, such as diet cola and slimline tonic, are available. You will use more of these sugar-free drinks than you would usually.
Proper diet and moderate physical movement and exercise with help from Dbethics a plant based supplement developed by Swiss scientists have helped many reduced their blood glucose safely without side effects. Many have been able to reduce their medications gradually too. Read how Dbethics can help you at www.springwell.biz
www.dbethics.com;and friendly bloggers www.diabfree.blogspot.com
www.curediabetes2.com
The information on this page is intended to illustrate how you can best cater for people with diabetes, whether they are coming for dinner, or to stay for a few days. The information is about people with diabetes in general but it is important to remember that everyone with diabetes has individual dietary requirements and treatment plan - and some people may like to stray a little from their usual eating habits when away from home. Just like everyone else, the occasional high fat or high sugar food can be included as part of a healthy diet. It may therefore be an idea to have a chat with the person with diabetes before they come, to see if they have any specific needs, or to discuss the meal(s) you have planned.
What to provide, meal by meal
Breakfast
Include the following in the choices available:
* High fibre cereals such as Branflakes, Fruit and Fibre, no added sugar muesli, Shredded Wheat, Weetabix, porridge.
* Low fat spread or polyunsaturated/monounsaturated margarine as well as butter.
* Semi-skimmed/skimmed milk as well as full cream milk.
* Unsweetened fruit juice.
* Fruit, eg grapefruit in natural juice and not syrup.
* Reduced sugar jam/marmalade or pure fruit spreads as well as ordinary versions (NOT ‘diabetic’ jams).
* Artificial sweeteners, eg Canderel, Hermesetas or Sweetex as well as sugar for tea and coffee. Granulated artificial sweeteners can be used for cereals and for use in recipes, eg Canderel Spoonful.
* A selection of wholemeal and granary breads or rolls as well as white.
* If cooked breakfasts are planned, food should be grilled not fried where possible.
Main meals
Have plenty of starchy carbohydrate foods available. If possible let the person with diabetes help themselves as they will know how much they will need (buffets are often a good idea to allow this). It’s a good idea to have bread already on the table as people requiring insulin may have given their insulin injection and therefore will need some carbohydrate within half an hour of their injection.
* Have a variety of dishes from which people can choose.
* People with diabetes need meals including carbohydrates, such as potatoes, pasta or rice.
* Try to provide low fat/low calorie options, eg new potatoes as well as fried.
* Provide extra vegetables and salad.
* Serve butter, mayonnaise or dressings separately so that people can choose whether to have it or not.
* Provide vegetarian options.
* Serve cream and rich sauces separately so that people can choose whether to add it or not.
* Provide low sugar desserts, ice-cream, fresh fruit or low fat yogurts as an alternative choice to ordinary.
* Water should be available on the table.
Snacks
People with diabetes are encouraged to spread their food intake evenly throughout the day for good blood glucose control and snacks mid morning, mid afternoon and bedtime may be part of their eating plan.
Suitable snacks are:
* Fruit – fresh or dried.
* Plain biscuits, eg garibaldi, rich tea, gingernuts, digestives, hob nobs.
* Bread or toast, muffins, crumpets, teabreads, plain or fruit cakes and cereals.
* Low fat yogurt.
Drinks
It is important that a selection of sugar-free drinks and mixers, such as diet cola and slimline tonic, are available. You will use more of these sugar-free drinks than you would usually.
Proper diet and moderate physical movement and exercise with help from Dbethics a plant based supplement developed by Swiss scientists have helped many reduced their blood glucose safely without side effects. Many have been able to reduce their medications gradually too. Read how Dbethics can help you at www.springwell.biz
www.dbethics.com;and friendly bloggers www.diabfree.blogspot.com
www.curediabetes2.com
Step out to Fight Diabetes !
IF 21 MILLION PEOPLE IN US CAN GET DIABETES 200 CITIES CAN GET RID OF IT
(Let's unite to fight Diabetes)
There's no doubt that diabetes is going to affect your life.
When she was diagnosed with diabetes at age 8, Leslie Oxford wasted no time diving in help find a cure. Read more...
Visit the American Diabetes Association
There's something stronger than America's fastest growing disease: The people who are doing something about it.
Step Out to Fight Diabetes, formerly America's Walk for Diabetes, is about changing the face of diabetes in our country—by raising funds to help find a cure and by walking a few miles to bring a greater awareness to this devastating disease.
Step Out is a whirlwind day packed with energy, fun, support for others and a perfect amount of selfless dedication. Anyone can take part in Step Out—your participation isn't measured by your dexterity or the speed you walk, but by the level of your enthusiasm and your commitment to ending diabetes.
Gather your friends and family to walk and raise funds for Step Out to Fight Diabetes in your city. Together, we can crush this epidemic.
Register or Request More Information online, or by calling your local American Diabetes Association office at 1-888-DIABETES.
Find out how Dbethics have helped many reduced their Blood Glucose with side effects
http://www.springwell.biz; www.dbethics.com
(Let's unite to fight Diabetes)
There's no doubt that diabetes is going to affect your life.
When she was diagnosed with diabetes at age 8, Leslie Oxford wasted no time diving in help find a cure. Read more...
Visit the American Diabetes Association
There's something stronger than America's fastest growing disease: The people who are doing something about it.
Step Out to Fight Diabetes, formerly America's Walk for Diabetes, is about changing the face of diabetes in our country—by raising funds to help find a cure and by walking a few miles to bring a greater awareness to this devastating disease.
Step Out is a whirlwind day packed with energy, fun, support for others and a perfect amount of selfless dedication. Anyone can take part in Step Out—your participation isn't measured by your dexterity or the speed you walk, but by the level of your enthusiasm and your commitment to ending diabetes.
Gather your friends and family to walk and raise funds for Step Out to Fight Diabetes in your city. Together, we can crush this epidemic.
Register or Request More Information online, or by calling your local American Diabetes Association office at 1-888-DIABETES.
Find out how Dbethics have helped many reduced their Blood Glucose with side effects
http://www.springwell.biz; www.dbethics.com
How I manage to reduce my blood glucose level
There was infection due to the shots I took. It was very painful and I went to the Hospital for help. I was not given medication for this. I am glad to receive a trial pack of Dbethics from the kind lady at the Springwell’s counter in the Hospital. On that day my fasting sugar level was 13.6. After four days on Dbethics, it dropped to 6.2 and in another two days it further reduce to 5.6 and is now normal. The swelling and sores in my abdomen has subsided. I was very happy with the results of Dbethics after only 1 week. It has helped me in increasing the productivity in my work and reduced my stress. I was also less thirsty. There was better bowel movement and I have not heard of complaints of the stench in the washroom after my use. I was very thankful and have decided to purchase three months supply of Dbethics. (-Arna Jelon)
read also in http://www.springwell.biz; www.dbethics.com
www.curediabetes2.com
read also in http://www.springwell.biz; www.dbethics.com
www.curediabetes2.com
Saturday, February 2, 2008
Girls with big breasts have bigger chance of developing diabetes
Girls with big breasts have a 68 percent higher chance of developing diabetes by middle age than their small-breasted counterparts, according to a new study by Canadian scientists.
The decade-long study to find the link between big breasts and diabetes development among nurses in the US shows that those with bigger breasts at the age of 20 are at a higher risk of developing the disease in later years.
Joel Ray, professor of medicine at the University of Toronto and a clinician-scientist at the local St Michael's Hospital, said this was "the broad conclusion" of his research team on the basis on this study.
"Our findings are based on data from the Nurses Health Study II project in 14 American states. In a nutshell, 92,102 nurses were studied for link between their breast size and their chances of developing diabetes by the age of 35. The bigger their breasts are at the age of 20, the bigger their chances of developing diabetes," Ray said.
However, Ray was quick to add that the breast size could be one of the factors, apart from smoking, family history, diet and ethnicity that trigger diabetes in women.
"Obesity remains a big factor. Obese women tend to have larger breasts, thereby becoming more prone to diabetes," he said.
From these findings, he said, it will be interesting to study how breast fat influences insulin resistance.
Ray emphasised that their research was preliminary at this stage and should not be taken at its face value.
Women should not think about breast surgeries to minimise their chances of developing diabetes.
"It is an interesting possibility that needs to be studied before we can say anything," he said.
During the study, he said, it was found that nurses with a family history of diabetes or those who smoked were more prone to developing the disease.
"Out of 92,102 nurses in the decade-long study, 1,844 developed diabetes."
The study, published in the Canadian Medical Association Journal, also showed that big-breasted nurses reported being heavier than others at young ages of five and 10, and entering puberty earlier. Ray said there is a definite link between early puberty among fat girls, insulin resistance and their predisposition to diabetes.
Breast tissue is extremely sensitive to hormones. Since insulin is a hormone, there is resistance to it by breast tissue, he said. A bigger breast means more insulin resistance and more chances of diabetes.
More diabetes articles at http://www.springwell.biz
http://www.dbethics.com
http://springwellswizerland.blogspot.com/
http://diabfree.blogspot.com/
http://natureshealthyliving.blogspot.com/
http://breakthroughindiabetes.blogspot.com/
www.curediabetes2.com
The decade-long study to find the link between big breasts and diabetes development among nurses in the US shows that those with bigger breasts at the age of 20 are at a higher risk of developing the disease in later years.
Joel Ray, professor of medicine at the University of Toronto and a clinician-scientist at the local St Michael's Hospital, said this was "the broad conclusion" of his research team on the basis on this study.
"Our findings are based on data from the Nurses Health Study II project in 14 American states. In a nutshell, 92,102 nurses were studied for link between their breast size and their chances of developing diabetes by the age of 35. The bigger their breasts are at the age of 20, the bigger their chances of developing diabetes," Ray said.
However, Ray was quick to add that the breast size could be one of the factors, apart from smoking, family history, diet and ethnicity that trigger diabetes in women.
"Obesity remains a big factor. Obese women tend to have larger breasts, thereby becoming more prone to diabetes," he said.
From these findings, he said, it will be interesting to study how breast fat influences insulin resistance.
Ray emphasised that their research was preliminary at this stage and should not be taken at its face value.
Women should not think about breast surgeries to minimise their chances of developing diabetes.
"It is an interesting possibility that needs to be studied before we can say anything," he said.
During the study, he said, it was found that nurses with a family history of diabetes or those who smoked were more prone to developing the disease.
"Out of 92,102 nurses in the decade-long study, 1,844 developed diabetes."
The study, published in the Canadian Medical Association Journal, also showed that big-breasted nurses reported being heavier than others at young ages of five and 10, and entering puberty earlier. Ray said there is a definite link between early puberty among fat girls, insulin resistance and their predisposition to diabetes.
Breast tissue is extremely sensitive to hormones. Since insulin is a hormone, there is resistance to it by breast tissue, he said. A bigger breast means more insulin resistance and more chances of diabetes.
More diabetes articles at http://www.springwell.biz
http://www.dbethics.com
http://springwellswizerland.blogspot.com/
http://diabfree.blogspot.com/
http://natureshealthyliving.blogspot.com/
http://breakthroughindiabetes.blogspot.com/
www.curediabetes2.com
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