Managing Diabetes 2
Topics from the book,
by Stephen Gislason MD
Diabetes and Vascular Disease
Eating and Weight Management
Get Started on a Solution
About the Negative Consequences of DiabetesBefore considering the bad news about Diabetes 2, the reader should understand that diabetes 2 and all its complications is an optional disease process. Each person who has or is heading for diabetes 2 has choices. The only logical conclusion is that wrong food and too little exercise will lead you down a path of misery and progressive deterioration.
Diabetes 2 is really a name for an evolving complex of metabolic derangement's that contribute to chronic and disabling illnesses. While elevated levels of sugar in the body seem to be the leading edge of the emerging disaster, changes in fat metabolism, liver and kidney function and then circulation impairment add to a cascade of dysfunction. 75% of the early deaths in diabetics are caused by coronary artery disease.
According to the National Diabetes Information Clearinghouse (a service of the National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Public Health Service.): "Diabetes is widely recognized as one of the leading causes of death and disability contributing to the deaths in the USA alone of more than 169,000 persons in 1992. Its toll increases every year. Diabetes is associated with long-term complications that affect every part of the body. The main horrors are Liver Disease (NAFDL and NASH), blindness, heart disease, strokes, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes. Diabetes cost the United States $92 billion. Indirect costs, including disability payments, time lost from work, and premature death, totaled $47 billion; medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $45 billion. Each year the cost goes up."
A collection of metabolic problems is found in patients with type 2 Diabetes. This metabolic syndrome involves insulin resistance, gout, hypertension, android (visceral) obesity, hypertension, hypertriglyceridemia, hyperapobetalipoproteinemia and low concentrations of the protective blood fat, HDL. These metabolic problems are all risk factors for liver disease, atherosclerosis, coronary artery disease and strokes.
The disturbing fact is that most diabetics will go on to develop one or more chronic microvascular and neuropathic complications. These problems include retinopathy, neuropathy, nephropathy (also called the "triopathies") and cardiovascular disease.
Sustained high blood sugar is known to result in changes in cellular metabolism and causes cumulative long-term changes in macromolecules, generally described as advanced glycation end-products (AGEs). Potential pathogenic mechanisms include the accumulation of fructose and sorbitol and the modification of proteins by glycation.
Nathan (Harvard Medical School, Diabetes Clinic) stated that: Diabetes 2 may be the most rapidly growing chronic disease in the world. Its long-term complications, including retinopathy, nephropathy, neuropathy, and accelerated macrovascular disease cause major morbidity and mortality... pathogenic mechanisms include the accumulation of sorbitol and other biochemical changes in tissues with aldose reductase, and the modification of proteins by glycation.
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