Types of Diabetes

This post is for educational purposes and not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for specific advice relating to your personal medical condition.

TYPE 1 DIABETES

Type 1 diabetes occurs because the insulin-producing cells (called beta cells) of the pancreas are damaged. People with type 1 diabetes produce little or no insulin, so sugar cannot get into the body's cells for use as energy. This causes blood glucose to rise. People with type 1 diabetes MUST use insulin injections to control their blood glucose.
The damage to insulinproducing cells in type 1 diabetes occurs over a period of years. However, the symptoms of type 1 diabetes may occur over a period of days to weeks. Type 1 is the most common form of diabetes in people less than 20 years old, but it can occur at any age.

TYPE 2 DIABETES

Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin. However, the insulin produced is either not enough or doesn't work properly in the body. When there is not enough insulin or the insulin is not used as it should be, glucose cannot get into the body's cells for use as energy. This causes blood glucose to rise.
Type 2 diabetes is most common in people over age 40 who are overweight. Some people with type 2 diabetes can manage it by controlling their weight, watching their diet and exercising regularly. Others may also need to take an oral glucose-lowering medication or insulin injections.

GESTATIONAL DIABETES

Gestational diabetes is a high blood glucose level that is discovered during pregnancy. As pregnancy progresses, the developing baby has an increased need for glucose. Hormone changes during pregnancy also affect the action of insulin, resulting in high blood glucose levels.
Pregnant women who have an increased risk of developing gestational diabetes are those who are over 25 years old, are above their normal body weight, have a family history of diabetes and are either Hispanic, African-American, Native American or Asian.
Usually, blood glucose levels return to normal after childbirth. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.

Diabetes Risk Factors

Although the causes of diabetes are unknown, the following risk factors may increase your chance of developing diabetes:

A family history of diabetes: If a parent or sibling in your family has diabetes, your risk of developing diabetes increases.
Race or ethnic background: The risk of diabetes is increased in Hispanics, African-Americans, Native Americans and Asians.
Being overweight: If you are 20 percent or more over your desired body weight, you increase the risk of developing diabetes.

What is Diabetes?

This post is for educational purposes and not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for specific advice relating to your personal medical condition.

Diabetes Mellitus is a disease that prevents your body from properly using the energy from the food
you eat.

Diabetes occurs when either:

The pancreas (an organ behind your stomach) produces little insulin or no insulin at all.

-Or-

The pancreas makes insulin, but the insulin made does not work as it should. This condition is called insulin resistance.

Insulin is a naturally occurring hormone produced by the beta cells of the pancreas that helps the body use glucose for energy.

To understand diabetes better, it helps to know more about how the body uses food for energy. Your body is made up of millions of cells. To make energy, the cells need food in a very simple form. When you eat or drink, much of your food is broken down into a simple sugar called glucose. Glucose (sugar) provides the energy your body needs for daily activities.

The blood vessels and blood are the highways that transport glucose from where it is either taken in (the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is stored (fat). Glucose cannot go into the cells by itself. The pancreas releases a substance called insulin into the blood, which serves as the helper
or the "key"- that lets glucose into the cells for use as energy.

When glucose leaves the bloodstream and enters the cells, the blood glucose level is lowered.

Compare the human body to a car. To start a car you must turn the key to move the gas to the engine. Without insulin, or the "key," glucose cannot get into the body's cells for use as energy. This causes glucose to rise. Too much glucose in the blood is called "high blood sugar" or diabetes.

Recipes: Broiled Shrimp with Chili Sauce Barra Vieja

SERVING SIZE: 1/6 of recipe, SERVES: 6

Chili Sauce

6 dried New Mexico chilis
1/2 tsp ground cumin 3 ancho chilis
1/2 tsp dried marjoram
3 cloves garlic, peeled, bashed
1/2 tsp dried oregano and chopped
1/8 tsp ground cloves
2/3 cup chopped onion
1/4 tsp salt
4 Italian plum tomatoes, such as 1 Tbsp white distilled vinegar Roma, quartered
1 Tbsp molasses

Yogurt Mayonnaise

1/2 cup yogurt cheese (page 475)
1 pinch of powdered saffron
1 Tbsp fresh lime juice
1/4 tsp salt

Other Ingredients

24 cherry tomatoes
6 medium shrimp (about 2 ounces or 55 g each)
1 bunch watercress, thoroughly washed

Garnish

1 tsp mild chili powder
6 corn tortillas
1 Tbsp chopped fresh cilantro

Vegetarian Option

12 oz baby carrots (2 1/4 inch apiece)

Replace the shrimp with baby carrots (you could call them "garden prawns"), steamed for 6 to 8 minutes, or until tender but still crisp. Coat the carrots with 1/2 cup of the chili sauce and serve over watercress and tomatoes.


1. To prepare the New Mexico and ancho chilis, remove the stems and slice the chilis open lengthwise. Remove the seeds and pulp with the tip of a knife blade or a small spoon. Put the chilis in a saucepan with 1 cup of water and bring to a boil. Turn off the heat, cover, and let soak for 10 minutes.

2. While the chilis are soaking, make the yogurt mayonnaise. Whisk together the yogurt cheese, lime juice, saffron, and salt. Cover and set aside.

3. To finish the chili sauce, strain the soaked chilis, reserving the liquid. Transfer the chilis to a food processor or blender. Add the garlic, onion, tomatoes, cumin, marjoram, oregano, cloves, salt, vinegar, and molasses. Pulse, then blend until smooth, about 4 minutes. Transfer the sauce to a small saucepan. Rinse the processor bowl or blender jar with 1 cup of the pepper-soaking liquid and stir into the sauce. Bring to a boil over medium heat, then lower heat and simmer for 15 minutes.

4. Meanwhile, warm a medium frying pan over medium-high heat. Cook the cherry tomatoes until lightly browned on the outside. Transfer the tomatoes to a plate and gently mash with a fork. Remove most of the seeds.

5. Preheat the broiler.

6. Peel the shrimp, leaving the tail shell attached. Slit each shrimp lengthwise down the center, being careful not to cut all the way through. Remove the sand-filled vein and open the shrimp out flat, like a butterfly. Weave a toothpick through the thickest part of the meat, so that the two halves of the shrimp remain flat. Brush each shrimp generously on both sides with the chili sauce. Place the shrimp on a broiler pan and broil for 3 minutes on each side. Serve immediately.

7. To serve, divide the watercress among small salad plates. Arrange
3 crushed tomatoes and one shrimp on top of the watercress. Spoon a little chili sauce over each shrimp and top with a dollop of yogurt mayonnaise. Dust with mild chili powder and garnish with the chopped cilantro and hot tortillas.

Per serving: 172 calories, 2 g fat, 0 g saturated fat, 0% of calories from saturated fat, 23 g carbohydrate, 3 g dietary fiber
Exchanges: 1 Starch, 1 Very Lean Meat, 2 Vegetable

Vegetarian
Per serving: 135 calories, I g fat, 0 g saturated fat, 0% of calories from saturated fat, 27 g carbohydrate, 4 g dietary fiber
Exchanges: 1 Starch, 3 Vegetable

Exercise guidelines for Diabetics

Exercise is very important in managing diabetes. Combining diet, exercise and medication (when prescribed) will help control your weight and blood glucose levels.

Benefits of exercise

• Improves your body's use of insulin
• Helps burn excess body fat, helping to decrease and control weight
• Improves muscle strength
• Increases bone density and strength
• Decreases blood pressure
• Helps protect against heart and blood vessel disease (by lowering cholesterol)
• Improves circulation and reduces your risk of a heart attack
• Increases energy level and enhances work capacity
• Reduces stress, promotes relaxation, and releases tension and anxiety
• Improves physical appearance
• May raise HDL or 'good' cholesterol

How exercise Affects Blood Glucose Levels

Insulin is released when the concentration of glucose in the body increases, such as after eating. Insulin stimulates muscle and fat cells to absorb the glucose they use as fuel for their activities.

Muscles store excess glucose in the form of a starch called glycogen. During exercise, muscles use stored glycogen as the first source of energy. Your body burns glycogen for energy during short bursts of exercise, such as a quick sprint to catch the bus. As the exercise continues, your muscles take up glucose at almost 20 times the normal rate.

In a person whose blood glucose is controlled, exercise may lower blood glucose levels. In the person whose blood glucose is poorly controlled (particularity for people with type 1 diabetes) exercise may increase glucose levels.

Is Blood Glucose Ever Too High to Exercise?

Yes. In some cases, you should hold off on exercising if your blood glucose is very high. The American Diabetes Association offers this basic guideline: if you find that your blood glucose level is high8 just before exercise [300 mg/dl (milligrams of glucose per deciliter of blood) or higher], you should consult with your health care team and wait until your blood glucose is under control before exercising.

General Exercise Guidelines and Precautions

• Check with your doctor before you begin an exercise program. Tell your doctor what kind of exercise you want to do so adjustments can be made to your medication schedule or meal plan, if necessary.
  
• Start slowly and gradually increase your endurance.
  
• Choose an activity that you enjoy-you'll be more likely to stick with a program if you enjoy the activity. Make exercise a lifetime commitment.
  
• Exercise at least three to four times per week for 20-40 minutes each session. Ideally, you should exercise every day.
  
• Wear good shoes and practice good foot care.
  
• Consider a water exercise program. Some other exercise options include walking, riding a stationary bicycle, swimming or muscle stretching.
  
• A good exercise program should include a 5-10 minute warmup and 15 to 30 minutes of continuous aerobic exercise (walking, biking) or muscle stretching exercises, followed by a 5-minute cool down.
  
• To reduce the risk for hypoglycemia, the best time to exercise is ½ to 1 hour after eating.
  
• Follow a regular routine of exercising, eating your meals and taking your medications at the same time each day.
  
• Prolonged or strenuous exercise can stimulate the production of adrenaline and other hormones that ca counteract the effects of insulin and cause blood glucose to rise. If you are participation in strenuous exercise (exercising at your maximum capacity) or prolonged exercise (lasting for several hours or more), your insulin and/or oral diabetic medication may need to be changed. Talk to your health care provider about how to adjust your medication.
  
• Be careful exercising when your medication is reaching its peak effect.
  
• Do not ignore pain-discontinue any exercise that causes unexpected pain. If you continue to perform the activity while you are in pain, you mayu cause unnecessary stress or damage to your joints.
  
• Drink water before, during, and after exercise to prevent dehydration.
  Test your blood glucose before and after you exercise. If your blood glucose is 120 mg/dl or higher before exercising, do not exercise.
  
• If you are taking insulin or an oral diabetes medication, always carry a sugar source with you while exercising.
  
• Exercise with someone who knows what to do if you have a low blood glucose reaction.
  Wear a medical identification tag or carry an identification card that states you have diabetes.