GUIDE TO DIABETES.

1}.TREATMENT TO YOUR HEALTH-
Being diagnosed with diabetes means that looking after your health has become even more important. This section of the Guide to diabetes includes information about medications, your lifestyle, monitoring your health and complementary therapies.
2}.EATING WELL-
Balancing your diet when you are diagnosed with diabetes can be challenging. Although the food choices you make and your eating habits are important in helping you manage your diabetes, you should be able to continue enjoying a wide variety of foods as part of healthy eating.

Eating a balanced diet, managing your weight, and following a healthy lifestyle, together with taking any prescribed medication and monitoring where appropriate will benefit your health enormously.

Remember, in the long run it is better to make small changes that you feel you can stick to rather than completely altering your diet and not sticking to it.

Taking steps to balance your diet will help you control your:

A}.blood glucose levels
B}.blood fats – cholesterol and triglycerides
C}.blood pressure
It will also help regulate your weight. If you are overweight losing weight will help you control your diabetes and will also reduce your risk of heart disease, high blood pressure and stroke.

You are sure to have lots of questions about your diet. A registered dietitian will be able to answer your questions. Diabetes UK recommends that everyone with diabetes should see a registered dietitian at diagnosis, and then have regular reviews for specific advice on their eating habits
3}.



KEEPING ACTIVE-Being active is good for all of us but is especially important for people with diabetes. Physical activity, combined with healthy eating and any diabetes medication that you might be taking, will help you to manage your diabetes and prevent long-term diabetes complications.

Everyday fitness
Activity made easy...
Being more physically active often conjures up images of gym memberships, long distance runs and aerobics in a leotard, yet this need not be the case. The great news is that you can become more active by making small changes to your lifestyle.

This section of the website offers you a chance to think about what:

makes being more active important to you
might be getting in the way of you taking the plunge
changes you can make to your daily routine.
It lays out the long-term aim for activity levels, providing you with lots of ideas and top tips for being more active.

... Plus info for the seriously sporty
There is also information for the more serious sports people amongst you.

Don't be afraid to ask
If you have any concerns at all about becoming more active, never be afraid to ask for advice – your diabetes team is there to help.
4}.SMOKING-
If you have been diagnosed with diabetes, giving up smoking is one of the most positive things you can do to both improve your health and reduce your risks of the long-term complications associated with the condition.

This section of the website explains about the damage smoking does to people with diabetes, the benefits of giving up and ideas on how to get the support you need to stop smoking
SMOKING AND DIABETES-
Almost everybody is aware of the dangerous link that smoking has with diseases such as cancer, but are you conscious of its connection with diabetes?

Cigarettes contain more than 4000 chemical compounds and at least 400 toxic substances.

Everyone risks damaging their health through smoking a cigarette, pipe or cigar, but for people with diabetes the risk may be even greater. If you have diabetes you already have an increased chance of developing cardiovascular disease, such as a heart attack, stroke or circulatory problems in the legs. Combine this with smoking (which can also double your risk of complications) and you make the chances of developing these diseases even higher.

Smoking ...

... when you have diabetes can make it more likely that you will develop neuropathy (nerve damage), nephropathy (kidney damage) and retinopathy (eye damage).
... decreases the amount of oxygen reaching the tissues of the body, which can lead to a heart attack or stroke.
... increases your LDL (low density ‘bad’ lipids) cholesterol level and lowers HDL (high density ‘good’ lipoproteins). This can make blood cells stick together, which can attract cholesterol and fats to stick to the artery walls making it more difficult for blood to circulate. This can damage and constrict (narrow) the blood vessels of the body (known as atherosclerosis) or cause a clot to form and possibly break away to travel round the body leading to a heart attack, stroke, peripheral vascular disease or worsening of foot and leg ulcers.
... increases your blood pressure by releasing adrenaline which causes blood vessels to constrict and the heart to beat faster.
... raises blood glucose levels. This is probably due to the nicotine and other products involved in smoking which may cause insulin resistance (whereby insulin doesn’t work properly) and stimulate stress hormones that can increase glucose levels.
So, like maintaining good blood glucose control, eating well, taking regular exercise and keeping to a healthy weight, giving up smoking is one of the most beneficial things you can do for your future health.
SUPPORT TO QUIT-
Giving up can be hard, but you don’t have to carry the burden of quitting on your own. It has been shown that you are more likely to quit if you get the right support. Whichever method you choose, there are clear benefits from quitting and plenty of support to help you. So what’s stopping you from stopping?

Stop Smoking Services
One way to get support is to use a Stop Smoking Service. These can offer you free advice specific to your individual needs together with meetings, which may be on a one-to-one basis or group sessions.

NHS Smoking Helpline
Tel: 0800 169 0 169
www.givingupsmoking.co.uk

QUIT
0800 00 22 00
www.quit.org.uk

There are also treatments available that can help you to stop smoking.

Nicotine replacement therapies
Nicotine replacement therapies (NRTs) are available on prescription as well as over the counter.

Nicotine is a drug that affects the areas of the brain which produce ‘feel good’ chemicals. NRTs help you to withdraw from this addiction without all the other harmful chemicals in a cigarette.

NRTs are available in a number of different forms, such as patches, gum, nasal spray, lozenges, microtabs and inhalators. A trained healthcare professional will help you to choose the one which suits best your smoking habits and lifestyle and will keep in close touch with you as you slowly decrease the amount you use (usually over a period of 12 weeks).

NRT is not licensed for use in children but individual clinicians may use it for a young person over the age of 12.

Prescription drugs
Prescription drugs are usually offered to smokers who have tried other methods.
There are two options at present but it must be remembered that your doctor may know of medical reasons why you could not be prescribed it.

Zyban
Zyban (Buproprion) which is taken for a maximum of 8 weeks. It works by reducing the craving for nicotine. The dosage has to be carefully followed and if the attempt to stop smoking is unsuccessful, further treatment will not be funded for 6 months.

Champix
Champix (Varenicline) which is taken for 12 weeks. It works by mimicking the effect of nicotine in the body and blocking the feel-good effect if a smoker does have a cigarette. The dosage must be carefully followed. A maintenance dose may be given for a further 12 weeks after completing the initial course.

Neither of these tablets can be used for people under 18 years old.

Other therapies
Other therapies that may work for some people but don’t have clinical tests to prove their effectiveness include acupuncture, hypnotherapy and laser treatment.
5}.MANAGING YOUR WEIGHT-
A healthy lifestyle is something everyone is recommended to follow but sometimes seems difficult to achieve. Being overweight can seriously affect your health but often people have their own reasons for losing weight. Making realistic long term changes to your lifestyle can bring huge rewards. Whether you want to be able to fit in to last summer’s clothes, play in the park with your grandchildren or to run for the bus without feeling out of puff, losing weight and keeping it off is well worth the effort.

But why is losing weight important?


One of the reasons for the increase in diabetes over the years is the increase in the number of people who are overweight. In fact more than four out of five people diagnosed with diabetes are overweight. We can’t ignore this fact that people who are overweight are at greater risk of developing Type 2 diabetes.
For people with diabetes there are major health benefits from losing weight. Being overweight makes diabetes control more difficult as excess weight makes it hard for the body to use insulin properly (insulin resistance), whether the insulin is being injected or being made by the body. Insulin resistance is especially associated with excess fat around the waist and people from South Asian communities have a greater health risk associated with being overweight.

If you are overweight, losing weight will help to control

-blood glucose levels
-blood fats – cholesterol and triglycerides
-blood pressure.
-Losing weight will also:


-reduce your risk of heart disease,
-improve your mobility
-reduce joint damage
-reduce tiredness
-help relieve stress
-help improve your self-esteem.

CAN TOO MUCH SUGAR CAUSE DIABETES FOR YOU?

Diabetes is one of those diseases we all 'sort of' know about — something to do with sugar, right?
Well, if you 'sort of' know that much, here are some facts you should know for sure: diabetes can lead to blindness, heart attack, stroke and its incidence has tripled in the last ten years — there's a new case diagnosed every seven minutes.

So it affects millions of us.

But the good news is, for most people, it's largely preventable. But how?

Our reporter, Dr Andrew Rochford, is going to put a commonly held belief about diabetes to the test. Andrew is going to over indulge his sweet tooth — and it's all in the name of medical research.


test
Sugar is often associated with Australia's fastest growing chronic disease — diabetes. But what we want to know is can too much sugar in your diet actually cause diabetes?

Essentially, diabetes is related to elevated blood sugar levels, so the logic goes, eat more sugar, get diabetes.
Associate Professor Maarten Kamp is a diabetes expert at the Gold Coast hospital: "Currently more than 1.2 million Aussies have diabetes and only half of those are diagnosed, so half the people with diabetes are unaware of it. There's a further two million or so people who are at risk of developing diabetes, having a condition we call pre-diabetes."


It's forecast that by 2010, 1.8 million Australians will have diabetes. That will put them at risk of heart disease, strokes, kidney failure, blindness, nerve damage and a whole host of other nasties.
Here's how diabetes happens:

To get the energy we need to survive, our body converts some of the food we eat into sugars, also known as glucose. At the same time, our pancreas is creating a hormone called insulin, which acts like a key, binding to cells and allowing them to absorb that glucose. But people with diabetes don't produce enough insulin, or that insulin doesn't work properly, so it's like they've lost the key — the cell door stays locked and the glucose stays in your blood.

"And that means that whilst there is plenty of glucose in the blood, too much glucose, and that's what's damaging, and isn't getting into the cells properly where it's needed to provide energy for the body," says Professor Kamp.

Andrew also needs to declare a personal interest: "My dad has diabetes and we've had some scary times with this illness. Diabetics have to keep a careful balance between insulin and glucose in his body. So my dad has to inject insulin four times a day. If he gets the balance wrong, then he can fall into a coma — called a hypo."


"Unfortunately the diabetes has put a lot of strain on my wife and children particularly when I have hypos in the middle of the night and four and five-year-old kids see their father being carted down the stairs by ambulance men. Andrew unfortunately has seen that on a couple of occasions and I'm sure he's not too happy about it," says Michael Rochford.
Fortunately those attacks, which can be fatal, are rare.


There are two types of diabetes, Andrew's dad is a Type 1:
"Type 1 diabetes is predominantly caused by being at risk with having inherited genes that place people at risk and we think it's then set off by particular types of infections. It's not absolutely clear what causes Type 1 diabetes," says Professor Kamp.

But most people with diabetes, nearly 90 percent of sufferers are Type 2.

"Type 2 diabetes again people have a predisposition to it, genetic predisposition, but it largely develops as a result of overweight, inactivity, over-nutrition that we see in our society nowadays," says the Professor.

Type 2 diabetes usually starts around age 45, but a recent report showed children in Australia are now suffering from the disease.

Which brings us back to our test…

First Andrew has his normal insulin and glucose levels recorded through a blood test. Then comes the good part — a pig-out in a lolly shop.

Andrew: "It's a tough gig, but I'm up to the challenge … If a sugar overdose can cause diabetes, all this lot ought to do the trick … Finally a test I can enjoy — guilt-free."



It sounds logical — the more you eat, the higher the levels, so after Andrew has binged for 24 hours he heads off to have his blood sugar levels tested again. Remember, the body absorbs sugar, by producing insulin, which unlocks the cell doors. A non-diabetic person produces enough insulin to cope with as much glucose as we throw at it, and keep the blood sugar normal.

So what do Andrew's results say?
"Now on the day when I had the high sugar diet — the diet we should all avoid — my blood sugar stayed the same, which you'd expect from someone without diabetes. But my insulin level was through the roof, my pancreas was working overtime to try and maintain my blood sugar at that level," says Andrew.

But his system did cope — despite the binge, his blood sugar level stayed normal, and that means eating sugar is not a direct cause of diabetes.



But if Andrew kept that high-sugar diet up, he could develop insulin resistance and he'd certainly put on weight, which is a major problem.
"Obesity is a very important factor in contributing to diabetes it's certainly the main factor that's contributing to the epidemic of diabetes that we have," says Professor Kamp.

So how do you know if you have diabetes?

Some of the symptoms include:


Fatigue
Passing urine frequently
Constant thirst
Infections that are slow to heal
If you are diabetic or at risk of it, diet is one area you can really take control of to improve your situation.


Chef Peter Howard has done just that. Food is Peter's passion, but as he himself admits, he loved it just a bit too much: "Always eating, always drinking, not really caring what I was eating and not really caring what I was drinking just as long it was a lot of both."
But all that's changed since he was diagnosed with Type 2 diabetes.


Diabetes can't be cured but Peter is controlling his condition with diet and exercise — so far he doesn't need insulin shots. He now walks every day and does weights and crunches and he's lost 15 kilos.
What did Peter have to cut out of his diet?

"Mostly fats, I loved deep fried things so the fats had to go. Sugars … I loved sweet things, absolutely loved sweet things, just adored them so they just had to go and I think actually the amount was the thing as well, and the constancy. So now I do eat very, very well and I eat a lot, but I eat a lot of really good food and what I'm always looking for is food that's high in fibre."

He's so passionate about living better, Peter's even brought out his own cookbook with recipes for good health.

The plain truth is we're sitting on an obesity time bomb that could explode into a massive diabetes epidemic. But we can change the future by changing how we eat right now.

So there are many causes of diabetes but we're happy to report that sugar isn't one of them. But does that mean you can stay in a lolly shop and gorge yourself? No, because if you eat too much sugar then you'll put on weight and obesity is a risk factor.

So all the fun aside, diabetes isn't a laughing matter — you can protect yourself with a healthy diet and regular exercise and if diabetes runs in the family or you have any concerns go and see your doctor.



Why do people normally inject insulin instead of taking a pill? Because if they swallowed it, digestive enzymes would destroy it before the body could use it.

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It sounds logical — the more you eat, the higher the levels, so after Andrew has binged for 24 hours he heads off to have his blood sugar levels tested again. Remember, the body absorbs sugar, by producing insulin, which unlocks the cell doors. A non-diabetic person produces enough insulin to cope with as much glucose as we throw at it, and keep the blood sugar normal.

So what do Andrew's results say?
"Now on the day when I had the high sugar diet — the diet we should all avoid — my blood sugar stayed the same, which you'd expect from someone without diabetes. But my insulin level was through the roof, my pancreas was working overtime to try and maintain my blood sugar at that level," says Andrew.

But his system did cope — despite the binge, his blood sugar level stayed normal, and that means eating sugar is not a direct cause of diabetes.