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<div class=media-desc><strong>Diabetes</strong><p>Diabetes is on the rise worldwide, and is a serious, lifelong disease that can lead to heart disease, stroke, and lasting nerve, eye and foot problems. Let's talk about diabetes and the difference between the three types of diabetes. So, what exactly is diabetes and where does it come from? An organ in your body called the pancreas produces insulin, a hormone that controls the levels of your blood sugar. When you have too little insulin in your body, or when insulin doesn't work right in your body, you can have diabetes, the condition where you have abnormally high glucose or sugar levels in your blood. Normally when you eat food, glucose enters your bloodstream. Glucose is your body's source of fuel. Your pancreas makes insulin to move glucose from your bloodstream into muscle, fat, and liver cells, where your body turns it into energy. People with diabetes have too much blood sugar because their body cannot move glucose into fat, liver, and muscle cells to be changed into and stored for energy. There are three major types of diabetes. Type 1 diabetes happens when the body makes little or no insulin. It usually is diagnosed in children, teens, or young adults. But about 80% of people with diabetes have what's called Type 2 diabetes. This disease often occurs in middle adulthood, but young adults, teens, and now even children are now being diagnosed with it linked to high obesity rates. In Type 2 diabetes, your fat, liver, and muscle cells do not respond to insulin appropriately. Another type of diabetes is called gestational diabetes. It's when high blood sugar develops during pregnancy in a woman who had not had diabetes beforehand. Gestational diabetes usually goes away after the baby is born. But, still pay attention. These women are at a higher risk of type 2 diabetes over the next 5 years without a change in lifestyle. If you doctor suspects you have diabetes, you will probably have a hemoglobin A1c test. This is an average of your blood sugar levels over 3 months. You have pre-diabetes if your A1c is 5.7% to 6.4%. Anything at 6.5% or higher indicates you have diabetes. Type 2 diabetes is a wake up call to focus on diet and exercise to try to control your blood sugar and prevent problems. If you do not control your blood sugar, you could develop eye problems, have problems with sores and infections in your feet, have high blood pressure and cholesterol problems, and have kidney, heart, and problems with other essential organs. People with Type 1 diabetes need to take insulin every day, usually injected under the skin using a needle. Some people may be able to use a pump that delivers insulin to their body all the time. People with Type 2 diabetes may be able to manage their blood sugar through diet and exercise. But if not, they will need to take one or more drugs to lower their blood sugar levels. The good news is, people with any type of diabetes, who maintain good control over their blood sugar, cholesterol, and blood pressure, have a lower risk of kidney disease, eye disease, nervous system problems, heart attack, and stroke, and can live, a long and healthy life.</p></div><div class=media-desc><strong>Type 1 diabetes</strong><p>Your body is a fuel-burning machine, and the main fuel it burns is sugar, also known as glucose. In people who have diabetes, though, the body doesn't effectively store and use sugar for energy. As a result, sugar builds up in the blood, where it can lead to serious problems like blindness and nerve damage. Let's talk about a kind of diabetes known as type 1 diabetes. Unlike type 2 diabetes, which is often caused by obesity, type 1 diabetes is an autoimmune disease. That means your immune system, which normally protects your body, turns against you. In this case, the immune system attacks the cells in the pancreas that produce insulin. Insulin is a hormone that moves sugar into cells. There it's stored until your body needs it for energy. Without enough insulin, sugar can't move into your cells, so it builds up in your bloodstream. How do you know that you have Type 1 diabetes? The first signs are usually that you feel very thirsty or tired. You may lose weight without having planned to, or feel numbness or tingling in your hands or feet. If your blood sugar has already gotten very high, your body can't use sugar for energy, so it uses fat instead. This leads to a condition called diabetic ketoacidosis. Your breath will smell fruity, like you've just eaten a fruit salad. Your breathing will get faster, and you may feel sick to your stomach. Your doctor will test your blood sugar level to find out if you have type 1 diabetes. The test may be done when you haven't eaten anything, this is called a fasting blood glucose test. When you have type 1 diabetes, you need to take insulin to replace what your body isn't making. Insulin is only available as an injection, so you'll have to learn how to give yourself a shot each day or wear a pump that delivers insulin to your body continuously. Managing diabetes also means watching your diet so you don't get too much or too little sugar at once. You also need to check your blood sugar levels regularly, and keep track of them over time. Type 1 diabetes is a lifelong disease, but it's one you can control, and live with. The key to staying healthy with diabetes is partnering with your team of doctors. Test your blood sugar at home, and have your doctor check your A1c levels at least every 3 to 6 months. This test shows how well you're controlling your blood sugar over time. Also visit your doctor for regular cholesterol, blood pressure, and kidney tests. See an eye doctor at least once a year, and a dentist every 6 months. Also check your feet every day for skin sores that you might not be able to feel because of nerve damage. And see a podiatrist or your regular doctor for a foot exam twice a year. If you're having any symptoms like fatigue, frequent urination, blurred vision, foot sores, numbness or tingling, or a fast heartbeat, call your doctor right away.</p></div><div class=media-desc><strong>Low blood sugar symptoms</strong><p>Symptoms such as weakness, feeling tired, shaking, sweating, headache, hunger, nervousness and irritability are signs that a persons blood sugar is getting dangerously low. A person showing any of these symptoms should check their blood sugar. If the level is low (70 mg/dL), a sugar-containing food should be eaten right away.</p></div><div class=media-desc><strong>Type 2 diabetes</strong><p>Over the past several years, our collective diets have grown unhealthier, and our waistlines have expanded as a result. Doing so, we're putting ourselves at risk for a number of diseases, including type 2 diabetes. Diabetes is serious stuff, if it's not treated, it can lead to some pretty dangerous complications, including nerve and kidney damage. The good news is you can often avoid type 2 diabetes and its complications. You need sugar, or glucose, to keep your body running. Normally when you eat, your pancreas releases a hormone called insulin, which moves the sugar from food out of your blood and into your cells, where it can either be used for energy, or stored. But if you have type 2 diabetes, this system doesn't work as well as it should, in part because your cells have a harder time responding to insulin. As a result, sugar builds up in your blood. Why is that a problem? Well, that excess sugar can damage organs like your eyes and kidneys, and it can lead to complications like nerve damage and heart disease. Diabetes complications could leave you blind, lead to amputation of your toes or feet, and maybe even kill you. You can help prevent diabetes complications by keeping good control over your blood sugar, but first you need to know that you have type 2 diabetes. Sometimes it can be hard to tell because you may not have any symptoms at first. Being very thirsty, tired, or having to go to the bathroom a lot may be pretty good clues that you might have developed diabetes. Blurry vision might also be a clue. Your doctor can confirm it with a blood test. Once you know that you have diabetes, it's your job to keep it under control. You'll need to check your blood sugar at home and talk to your doctor about how to lower it with diet, exercise, and possibly medicine. To avoid serious complications, you'll need to see not just one doctor, but a team of health care professionals. That includes a podiatrist to check your feet, an ophthalmologist to check your eyes, and a dentist for cleanings and exams. Because type 2 diabetes increases your risk for heart disease, you'll also need to see your primary care doctor regularly to have your blood pressure, cholesterol, and triglycerides checked, and to make sure your kidneys are working as well as they should. Like any other disease, it's better to avoid getting type 2 diabetes then to have to treat it. If you're at risk because you're overweight or over age 45, ask your doctor for a blood sugar test at your next check-up. If you have already developed diabetes, you can help avoid complications by staying on top of your health, checking your blood sugars, eating a healthy diet, exercising, and seeing all of your specialists on schedule. Make your doctor a partner in your care. Call right away if you have any problems, like numbness or tingling in your legs or feet, blurry vision, extreme thirst, weakness, or fatigue.</p></div><div class=media-desc><strong>Glucose in blood</strong><p>After being diagnosed with diabetes, the first goals are to eliminate the symptoms and stabilize your blood glucose levels. The ongoing goals are to prevent long-term complications and prolong your life. The primary treatment for type 2 diabetes is exercise and diet.</p></div><div class=media-desc><strong>Islets of Langerhans</strong><p>Islets of Langerhans contain beta cells and are located within the pancreas. Beta cells produce insulin which is needed to metabolize glucose within the body.</p></div><div class=media-desc><strong>HbA1c</strong><p>If you have diabetes, it's important to keep tight control of your blood sugar. The Hemoglobin A1c test, or HbA1C test, is one way to find out if you are in control. Hemoglobin is an important part of the red blood cell. Red blood cells live about three months. During the life of a red blood cell, sugar molecules, also floating around in your blood, tend to want to stick to the hemoglobin of your red blood cells. Identifying these sugar molecules allows us to get an approximate three-month average of how high persons blood sugars have been. The HbA1c test helps us diagnose a patient suspected of having diabetes and monitors the blood sugar of a diabetic patient. Now, how do we screen for diabetes? If your doctor suspects you have diabetes, your physician will order this simple blood test. A normal HbA1c level is less than 6.0%, which is a three month blood sugar average of around 126 milligrams per deciliter, written like this in your lab results. (126 mg/dl). A HgbA1c level of 5.7 to 6.4% means you are pre-diabetic or borderline-diabetic. If your HgbA1C is 6.5% or higher, you are considered to be a diabetic. That correlates roughly to a 3-month blood sugar average of 140. So, if you are a diabetic, what level should your HbA1c be? Through a combination of a good diabetic diet that controls for carbohydrates, proteins, fats and calories, the American Diabetes Association currently recommends a HbA1C goal of less than 7%. I should also point out that the American Association of Clinical Endocrinologists recommends an even stricter control of diabetes - with a recommended goal of less than 6.5%. What we do know is diabetes causes permanent and irreversible damage to the nerves, blood vessels and body organs, like your eyes, kidneys, heart and also your feet. So, it's critical to get and keep your diabetes under good control to avoid serious long-term health problems. People often ask -- How often should a hemoglobin A1C test be done IF you are a diabetic? Since the HbA1c Test reflects 3 months of control, I recommend getting checked every 3 months to let you, and your doctor know how you're doing. Remember, if you have diabetes, keeping good control of your blood sugar reduces your risk for long-term health problems, like Eye, heart, kidney problems, and even stroke. See your doctor for HbA1c tests every 3 months; you'll be glad you did.</p></div><div class=media-desc><strong>Food and insulin release</strong><p>Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood.</p></div><div class=media-desc><strong>Glucose test</strong><p>A person with diabetes constantly manages their blood's sugar (glucose) levels. After a blood sample is taken and tested, it is determined whether the glucose levels are low or high. If glucose levels are too low carbohydrates are ingested. If glucose in the blood is too high, the appropriate amount of insulin is administered into the body such as through an insulin pump.</p></div><div class=media-desc><strong>Physical exam frequency</strong><p>When you feel perfectly fine, the last thing you want to think about is going to the doctor. But that's exactly when you should be thinking about getting a physical exam. Regular physicals, as well as certain tests and vaccinations can be powerful ways to protect health. Let's talk about physical exams. You might feel well on the outside, but it's hard to know exactly what's going on inside your body. Many conditions that threaten your health don't have any symptoms. For example, you might have no idea that you have high blood pressure or high cholesterol, until they make you really sick. How often you need to see your doctor and what tests you get depends on your age and gender. Regular physicals are important for keeping tabs on your health. Plan to see your doctor once every 1 to 5 years, depending on what conditions you have. After age 65, you'll visit the doctor at least once a year. At each physical, your height and weight will be checked and your hearing will be tested. Your doctor should ask whether you've experienced depression, and about your use of alcohol and tobacco. Get your blood pressure checked once every two years, once a year if you're over 65. Look for blood pressure screenings at health fairs or drug stores in your area, or visit your doctor. If you have a health condition like diabetes, heart disease, or kidney problems, you may need to check your blood pressure more often. If your blood pressure is high, you should also have your blood sugar levels tested for diabetes. Men who are over 34 and women over 45 need a cholesterol test once every 5 years. People with certain health conditions may need to have their cholesterol checked more often. Everyone between ages 45 and 75 should be screened for colon cancer. You can have a colonoscopy every 10 years, a stool test every year, or a flexible sigmoidoscopy every 5 years. Women need a Pap smear to check for cervical cancer once every 2 to 3 years. They should also have a mammogram to check for breast cancer every 1 to 2 years, depending on their risks. Because bones can become brittle with age, women over 65 need to have a bone density scan. Younger women and men should talk to their doctor about whether they need this test, based on their risks. To keep your teeth strong and healthy, visit your dentist once a year for a cleaning and exam. Also see an eye doctor for an exam every 2 years, especially if you have glaucoma or another vision problem. One of the best ways to avoid unexpected doctor's visits is to get the vaccines that are right for you. Vaccines aren't just a kids issue. Many adults benefit from a flu vaccine each fall or early winter to protect them for the whole season. Once every 10 years, get a Tdap vaccine, which protects against tetanus, diphtheria, and acellular pertussis. Older adults may also need to get vaccinated against pneumonia and shingles. Getting regular physicals when you aren't sick can help you stay on top of your health. Being proactive will let you and your doctor prevent and find potential problems before you have a chance to get sick.</p></div><div class=media-desc><strong>Insulin pump</strong><p>The catheter at the end of the insulin pump is inserted through a needle into the abdominal fat of a person with diabetes. Dosage instructions are entered into the pump's small computer and the appropriate amount of insulin is then injected into the body in a calculated, controlled manner. </p></div><div class=media-desc><strong>Type I diabetes</strong><p>In response to high levels of glucose in the blood, the insulin-producing cells in the pancreas secrete the hormone insulin. Type I diabetes occurs when these cells are destroyed by the body's own immune system.</p></div><div class=media-desc><strong>Diabetes - retinal conditions</strong><p>Diabetes may affect the retina by causing the formation of whitish patches called exudates. Other indications may include tiny enlargements of the blood vessels, resulting in microaneurysms and hemorrhages. </p></div><div class=media-desc><strong>Diabetic blood circulation in foot</strong><p>People with diabetes are at risk for blood vessel injury, which may be severe enough to cause tissue damage in the legs and feet.</p></div><div class=media-desc><strong>Stroke</strong><p>When blood flow to an area of your brain stops, it's serious. It's called a stroke, and will often cause permanent, debilitating damage to your brain and change your life. Let's talk about strokes. If blood flow to your brain is stopped for longer than a few seconds, your brain can't get blood and oxygen. Brain cells die, causing permanent damage. There are two types, ischemic stroke and hemorrhagic stroke. Ischemic stroke happens when a blood clot forms in a very small artery, or when a blood clot breaks off from another artery and lodges in your brain. Hemorrhagic strokes can happen when a blood vessel in your brain becomes weak and bursts open. High blood pressure is the number one risk factor for strokes. People with atrial fibrillation, when your heart rhythm is fast and irregular, diabetes, a family history of stroke, and high cholesterol are most at risk. You are also at risk for stroke if you are older than age 55. Other risk factors include being overweight, drinking too much alcohol, eating too much salt, and smoking. Symptoms of a stroke usually develop suddenly, without warning. You may have a severe headache that starts suddenly, especially when you are lying flat, often when you awake from sleep. Your alertness may suddenly change. You may notice changes in your hearing, your sense of taste, and your sense of touch. You may feel clumsy or confused or have trouble swallowing or writing. So, how are strokes treated? A stroke is a medical emergency. Immediate treatment might save your life and reduce disability. Call your local emergency number -- or have someone call for you -- at the first sign of a stroke. Most of the time, someone having a stroke should be in the hospital within three hours after symptoms first begin. If a doctor suspects you've had a stroke, the doctor will check for problems with your vision, movement, feeling, reflexes, and your ability to understand and speak. You may have several tests to check for blocked or narrowed arteries. If the stroke is caused by a blood clot, you'll be given a clot-busting drug to dissolve the clot. Treatment depends on how bad your stroke is and what caused it. But you will probably need to stay in the hospital for a few days. Besides clot-busting drugs, called thrombolytics, you may need blood thinners, medicine to control high blood pressure, and surgery to unclog one of your carotid arteries-which carry blood to the brain. After your stroke, treatment will focus on helping you recover as much function as possible, and preventing future strokes. Most people need stroke rehabilitation therapy. If you can return home, you may need help making safety changes in your home and to help you with using the bathroom, cooking, dressing, and moving around your home. After a stroke, some people have trouble speaking or communicating with others, and a speech therapist might help. Depending on the severity of the stroke, you may have trouble with thinking and memory, problems with your muscles, joints, and nerves, trouble going to the bathroom, and difficulty swallowing and eating. Therapies and support for you and your family are available to help with each of these problems. Your treatment will also focus on preventing another stroke. You may need to be on several medications to help prevent this. And, eating healthy and controlling problems like diabetes and high blood pressure can be very important.</p></div><div class=media-desc><strong>Fasting plasma glucose test</strong><p>The fasting plasma glucose test is the simplest and fastest way to measure blood glucose and diagnose diabetes. Fasting means that you have had nothing to eat or drink (except water) for 8 to 12 hours before the test. You are diagnosed with diabetes if your blood glucose level is 126 mg/dl or greater on two separate tests.</p></div><div class=media-desc><strong>Gestational Diabetes</strong><p>Gestational diabetes is defined as glucose intolerance during pregnancy. During your pregnancy, hormonal changes can cause the body to be less sensitive to the effect of insulin. These changes can lead to high blood sugar and diabetes. High blood sugar levels in pregnancy are dangerous for both mother and baby.</p></div><div class=media-desc><strong>Childhood obesity</strong><p>You may have heard of the childhood obesity epidemic. But is it real? And if it is real, how important is it? And the answer is yes, it's very real. Up until about 1988, kids' weights in the United States were pretty constant over the years. But since 1988, they've been skyrocketing. And that's important for a few reasons. One of them is that what ever our weight is today, people tend to gain weight gradually over time. So if you're already overweight as a child that sets you up to be really overweight as an adult. And all the more so as a child because when kids, before puberty especially, are putting on extra weight, they tend to make new fat cells. Where as adults, when they're getting overweight, tend to have the fat cells they already have get larger. People who make more fat cells during childhood find it easier to gain even more weight as an adult and harder to lose weight. So kids are setting habits in their metabolism and even the structure of their bodies as a child. Childhood obesity is a big problem. But it's not just because of the way fat looks. It's a health problem as well. In fact a ticking time bomb. When I started in pediatrics not that long ago, it was rare to see some of the common conditions of middle age in children. Things like high blood pressure, or abnormal blood sugar, waist size over 40 inches, abnormal cholesterol. Those things were really rare in kids. But in a recent study, about two-thirds of American high schools students already had at least one of those. Two-thirds. They use to call something juvenile diabetes and there was adult onset diabetes, the kind that you get often from being overweight. Well now, what use to be adult onset diabetes, type 2 diabetes, is more common by age 9 because of the obesity epidemic. It is a ticking time bomb. The good news is that it's never easier than today to start to make a difference in a child's life.</p></div><div class=media-desc><strong>Diabetic retinopathy</strong><p>Diabetes causes an excessive amount of glucose to remain in the blood stream which may cause damage to the blood vessels. Within the eye the damaged vessels may leak blood and fluid into the surrounding tissues and cause vision problems. </p></div>
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