SUFFERER FROM DIABETES should become as well acquainted as possible with their problem. Many false ideas about this disease are prevalent and as a result, mismanagement is too often seen. There is much that is not understood about it, but the basic facts are simple and should serve as a guide to every patient.
Doctors are anxious to teach basic facts to a diabetic, especially those facts having to do with home-administered therapy, for they know they cannot watch him constantly and check on his diet and habits day after day. Volumes have been written but basically, all of them deal with a few important principles that should guide any diabetic on how to live a healthy, useful, and happy life.
What is Diabetes?
Normally the bloodstream contains 100 to 120 mg. of sugar per 100 ccs. of blood. When insulin is insufficiently produced this amount may increase to 300 or 400 or even higher. When sugars are not oxidized as they normally should be, fats also are incompletely oxidized. As a result, diacetic acid and acetone are produced. These substances absorbed into the blood cause one to go into a coma. READ the Basics
Diagnosis of Diabetes
Usually, a diabetic condition can be correctly diagnosed by doing a simple urinalysis, but this does not always reveal the presence of the disease. The absence of sugar in the urine is no absolute proof that one does not have diabetes.
The positive test is done by studying the blood sugar level and the way the body handles sugar. If an examination of blood sugar done under fasting conditions reveals a level of 70 to 120, one is considered normal. A very good screening test is also being done nowadays, which consists of doing a blood-sugar test 2 hours after administering 100 grams of carbohydrate. A reading of 150 or less is. Good evidence that the patient does not have diabetes.
Some symptoms that may cause one to suspect diabetes are a passage of large amounts of urine, increased thirst, excessive appetite and loss of weight and strength. Others are itching of the skin, infections that do. Not heal disturbances of vision, numbness and tingling and neuritic pain, especially in the legs.
Treatment of Diabetes
The doctor will observe his patient and adjust the dosage so that the body can take care of the sugars eaten. Since insulin is digested. If given by mouth it must be given by injection. There is a tablet, However, that can be taken by mouth but it is useful only for mild adult cases.
We must emphasize that diabetes cannot be cured. That is, we have no way of causing the pancreas to secrete more insulin. The treatment indicated above merely controls the condition for the day. For this reason, a person taking insulin should'plan on taking it as long as he lives. To the new diabetic, this may sound discouraging but after one has taken it for a time. It becomes the least of his worries.
Often a diabetic is told in tones indicating alarm, "If you start taking insulin you have to keep on."True! But unless you start, your health will degenerate rapidly and your life expectancy will be greatly shortened. It is possible, however, for overweight persons who succeed in reducing their weight to normal to cut down their insulin dosage or to transfer to tablets. Sometimes such cases can be controlled on diet alone.
Complications of Diabetes
Precautions of Diabetes
Besides making sure that his diabetes is kept under good control, the patient should be extremely careful not to injure his feet He should wear shoes or sandals and be careful not to trim the toe-nails too close or injure the skin, while. trimming them.
While there are exceptions, most diabetics have decreased resistance to infection. For this reason, they should wash all cuts and bruises with soap and water and cover them with sterile bandages. If these are not readily available, freshly laundered white strips of cloth may be used.
Under no circumstances should the patient allow anyone to talk him out of taking his medicine or adhering to his special diet. He should take no stock in cures offered by untrained people. He must stay on the programme prescribed by his doctor year in and year out and report regularly to him for
The Factor of Heredity of Diabetes
Diabetes is transmitted as a recessive characteristic. That is, it tends to disappear from the family tree if non-diabetic blood is introduced. The incidence of diabetes can be expected from the following indicated marriages: Union of two diabetics: All offspring will eventually develop diabetes if they live long enough.
Union of a diabetic with a non-diabetic from a diabetic family: One half of the offspring will develop diabetes.
Union of two non-diabetics from diabetic families: One-fourth of the offspring will develop diabetes.
Union of a diabetic with a non-diabetic from a non-diabetic family: None of the offspring should develop diabetes.
It is to be noted that occasionally diabetes will appear in families where no diabetes has been previously known.
In view of the above facts, it is well to inform young people of the possibilities of heredity in this disease.
The actual cause of diabetes is unknown, but heredity and obesity are the two main factors contributing to its development in the body. The only thing you can do about heredity is to pick out a different grandmother and grandfather!
Obviously, that is fraught with great difficulty; so you may be stopped on this one. But when it comes to obesity there is something you can do, even though it may tax your patience and ingenuity.
I had a patient some years ago who was 50 pounds overweight. He was told many times to get down to business and lose this excess. He passed off each order with a smile and did nothing about it. One day he came in with numbness of the feet and a chronic sore on the ball of the foot. When examined he was found to be diabetic. He has put one insulin and a strict diet, with the result that he lost the 50 pounds we had been asking him to get rid of.
One day as he contemplated the many times he had been asked to reduce he exclaimed, "If there was only a way to impress a fellow with the importance of losing weight!"He was one who found out for himself but at what cost! Are you going to take his word for it or are you
going to find out the hard way also?
Exercise in Diabetes
An important observation in connection with exercise has been made by those who care for diabetic children. School children for whom insulin has been prescribed do not need it on the days when they do not attend school. On those days they run about and use up their carbohydrates without help.
A parallel observation, also quite common, is that those who have sedentary work, (i. e. Those who do not get exercise in their work) usually are the ones who have diabetes. They sit around and put on weight. They often have good appetites and eat of the fat of the land. Every diabetic (and we might
add every good person also) should get daily exercise. It should be as vigorous as the individual can tolerate.
Diet in Diabetes
In the light of the foregoing facts, the diabetic, and for that matter everyone else, should adopt a diet that will bring him to his ideal weight and hold him there. It should be a diet that also contains all the essential elements in proper proportions for health. In many areas of Southern Asia, there is far too much use made of fried foods, butter, Margarine, sugar, and polished rice. The use of fats should be definitely restricted, as should also the use of sugar, and this includes honey.
Saturated fats are now known to contribute to hardening of the arteries and since diabetes also contributes to the same it is doubly important that they should not be used by a diabetic patient. Saturated fats come from animal sources and unsaturated fats from vegetable sources. Even the latter should be used cautiously, for they may also contribute to an increase in weight. It is customary in some places to serve very sweet drinks. Some even mix sugar with milk. This is a bad combination and should be avoided.
The amount of protein needed in the body was once estimated to be about 120 grams a day but now half of that quantity is considered adequate. Recent investigations have shown that it is very possible to get adequate protein if a variety of vegetarian foods is eaten. Such a diet, supplemented with milk, assures one of good nutrition. It provides the further advantage of eliminating or greatly reducing the intake of animal fat.
A recent study of vegetarians in California revealed that they suffered less coronary disease than non-vegetarians, and that heart attacks among them, if any, occurred on an average of 15 years later in life. For those who choose such a diet, we suggest vegetarian foods that are high in protein. Such foods fall into three groups :
- those high in fats,
- those high in carbohydrates, and
- those high in neither.
It should be added that meat is stimulating and gives a sense of Satisfaction. When it is left off abruptly one may experience a let-down feeling. The reason behind this has relevance for
this study on diabetes and its related emphasis on diet. For a while after adopting a vegetarian diet, a former non-vegetarian may experience a temporary protein deficit; that is, he will lose more protein than he takes in.
The body then has to make an adjustment, acting to conserve the amino acids of which proteins are made. It is this effort on the part of the body to compensate that causes the let-down feeling. After a while, the system will become accustomed to the new diet, and the protein deficit, with its accompanying emotional reaction, will not be felt anymore.
Canned fruit or fresh fruit makes a good dessert for the diabetic. The canned fruit should be the kind put up without sugar, and if sweetening is necessary one can use sucaryl (Abbott). Unfortunately, most desserts are high in fats and carbohydrates, so one must be careful about them. It is well for us to get away from desiring very sweet foods and juices, Sugar should never be added to milk even for the non-diabetic,
Suggestive diets are not mathematically accurate, so if you compare the values in any one chart with various other authorities they will vary. No one can nor should measure everything he eats with the accuracy of a chemist.
One should, however, educate himself to know the amount of food he can take and then test periodically to see if he is "spilling"sugar. If so, the size of the helping should be cut down. No particular item of food should be left off entirely unless it is especially bad in causing sugar to appear in the urine.
If after cutting down a reasonable amount one still has excess sugar in the urine, he should see his physician to make an adjustment. The amount of food eaten should be enough to satisfy one and cause him to reach and maintain his ideal weight as nearly as possible.
SOURCES: • American Diabetes Association: "Statistics About Diabetes," "Type 1 Diabetes," "Type 2," "Diagnosing Diabetes and Learning About Prediabetes." • U.S. National Library of Medicine: "Diabetes in Children and Teens." • Cleveland Clinic: "Diabetes Learning Module," "Preventing Diabetes Complications." • National Diabetes Information Clearinghouse: "Causes of Diabetes." • International Diabetes Federation: "Prevention," "Complications of Diabetes." • Harvard T.H. Chan School of Public Health: "Simple Steps to Preventing Diabetes." • National Institute of Diabetes and Digestive and Kidney Diseases: "Am I at risk for type 2 diabetes?" • Joslin Diabetes Center: "Common Questions About Type 2 Diabetes." • Carolinas HealthCare System: "Yeast Infections and Diabetes: What You Should Know."
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