By Dr Romy Sutrisna, Medical Advisor & Snr Wellness Consultant

Do You Know?
In United States, a total of 1.6 million new cases of diabetes were diagnosed in people ages 20 years or older in 2007 and about 186,300 people younger than 20 years have diabetes. This represents 0.2 percent of all people in this age group. WHO estimates that more than 180 million people worldwide have diabetes (2000) . Diabetes is one of the top 10 causes of death bringing about 5% of all deaths globally each year.

What is Diabetes?
Diabetes is a group of diseases marked by high levels of blood glucose, also called blood sugar, resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.

Type 1 diabetes previously known as insulin-dependent diabetes mellitus (IDDM) or juvenileonset diabetes. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adultonset diabetes. In adults, type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity.

Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy.

Can We Prevent or Delay Diabetes? Well, progression to diabetes among those with pre-diabetes is not inevitable but studies have shown that people with pre-diabetes who lose weight and increase their physical activity can prevent or delay diabetes and even return their blood glucose levels to normal. Lifestyle modification can also reduced the development of diabetes by 58 percent over 3 years. The reduction was even greater, 71 percent, among adults ages 60 years or older. Research has found that lifestyle modifications are more cost-effective than medications.

What are the symptoms of Diabetes and how can we know if we have risk of Diabetes?
If you experience symptoms such as increased thirst, frequent urination, extreme hunger, unintentional weight loss, fatigue, slow-healing sores or frequent infections, then you may consider seeking consult to your physician. Symptoms of diabetes and a random plasma sugar of 200 mg/dl or greater indicates that you may have diabetes. Blood glucose of 126 mg/dl or greater after an overnight fastthat has been confirmed with a repeat test- may also indicate that you have diabetes.

So, what is the treatment for Diabetes?
Diabetes can lead to serious complications, such as blindness, kidney damage, cardiovascular disease, and lower-limb amputations, but people with diabetes can lower the occurrence of these and other diabetes complications by controlling blood glucose, blood pressure, and blood lipids. People with type 2 diabetes can control their blood glucose by following a healthy meal plan and exercise program, losing excess weight, and taking oral medication such as biguanide and sulfonylureas. Some people with type 2 diabetes may also need insulin to control their blood glucose, but people with type 1 diabetes must have insulin delivered by injection or a pump. Many people with diabetes also need to take medications to control their cholesterol and blood pressure. Self-management education or training is a key step in improving health outcomes and quality of life. It focuses on self-care behaviors, such as healthy eating, being active, and monitoring blood glucose. It is a collaborative process in which diabetes councilor help people with or at risk for diabetes gain the knowledge and problem-solving and coping skills needed to successfully self-manage the disease and its related conditions.

At last but not least, from Nutritional Medicine point of view, minerals like Chromium can work closely with insulin to help facilitate the uptake of glucose into cells. References: 1. "All About Diabetes"". American Diabetes Association. 2009-07-01. 2. Department of Medicine, Washington University, St.Louis, USA. The Washington Manual of Medical Therapeutics. 31st.Edition. 3. World Health Organization, Department of Noncommunicable Disease Surveillance (1999). "Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. 4. Guyton&Hall. Medical Physiology, 2006 edition. Elsevier Saunders.