About Diabetes

What is Diabetes Mellitus

Diabetes mellitus or diabetes is a very common disease. The number of diabetes patients is increasing and it is ticking every second. Diabetes is a disease caused due by disturbed metabolism and increased blood sugar levels. The increased blood sugar causes abnormal effects of insulin and the inadequate secretion of insulin.

Diabetes Facts/ Diabetes Information

The following section gives information on diabetes- its history, statistics etc.
Diabetes was discovered in 1552 BC although it had existed long before. Since then, many Greek and French physicians had researched this disease. In the 1870s, a French physician discovered the connection between diabetes and diet and this was how diet plans for diabetes came into being.

In the period between 1920 and 23, Dr Banting, Prof. Macleod and Dr.Collip discovered the nature, effect and use of insulin. They were awarded the Nobel Prize for this groundbreaking work. In the 1940s it was discovered that disorders in organs such as kidney, skin, heart etc are related to diabetes. In 1955, the manufacture of oral hypoglycemic drugs started. Diabetes was analyzed and divided into Type 1 and Type 2 in the year 1959. Diabetes Researches still continues, scientists trying to discover new cures and medicines.

Diabetes Statistics

According to the ADA, there are almost 20.8 million diabetic patients in the US. Almost every 21 second, someone is diagnosed with diabetes.

Causes of Diabetes

Humans obtain their energy sources from the food they eat, whether they are animal products or plant products. Energy that the sun produces is captured by plants and photosynthesized into sugar sources. When humans eat plant products, they digest these complex sugars, and break them down into simpler forms of sugar, like glucose. Glucose is needed by the body’s billions of cells to produce energy. In order for glucose to be absorbed effectively in the cellular level, the pancreas produces the hormone insulin. Some of the glucose that is not used is converted to glycogen, and can be harnessed by the body for reserve energy sources for future use. When the pancreas has difficulty producing the right amounts of insulin, or sometimes no insulin at all, the person experiences diabetes. In this condition, the amounts of glucose in the blood remain unabsorbed and unused by the cells. Glucose is said to spill over into the urine, and is excreted without serving its purpose. In this regard, the person is unable to get the energy he needs from his food sources.

Types of Diabetes

The WHO has classified three major types of diabetes. They are type1, type2, and gestational diabetes which occur during pregnancy. All the three types have similar symptoms but the causes are different. Any form of diabetes is due to the inefficiency of the beta cells of the pancreas to generate sufficient quantity of insulin. But the cause for this is different in each type of diabetes.

Type One Diabetes

In type 1 inability to generate sufficient quantities of insulin is because of the auto immune destruction of the beta cells. Type i diabetes is insulin dependent, meaning the patient needs to be regularly administered with insulin shots to compensate for the lack of the hormone in the body. This should be done on a daily basis, and in some cases, it is a lifelong condition.

Type Two Diabetes

Type 2 diabetes is due to the insulin resistance. The pancreas is able to secrete enough insulin or even the normal levels of it, but the insulin is unable to act on the glucose as it should. This causes need for high insulin levels that the pancreatic beta cells cannot meet. Around 90 to 95 percent of diabetic patients fall under type ii diabetes, which is also known as non-insulin dependent. This condition is often associated with obesity and the usual onset starts at age forty and above. This can be treated by dietary diabetes supplements, and oral insulin sources. A person can manage this type of diabetes by constant exercising and weight management.

Symptoms of Diabetes

How can a person find out if he or she is diabetic? Sources say when a person is excessively thirsty, always hungry, urinates more frequently than usual, and is often fatigued, he or she may have diabetes.

Type 1 Diabetes Symptom

The development of the diabetes symptoms is quite rapid in the case of type 1 diabetes, especially in the case of children.
1) Nausea - Since type 1 diabetes inhibits production of insulin, body cells lack the glucose needed for producing ATP (Adenosin Triphosphate. This results in nausea and vomiting.
2) Fatigue
3) Considerable Weight Loss despite normal eating habits - this happens because the body starts breaking fat and muscle tissues in order to gain energy.
4) Dehydration.

Type 2 Diabetes Symptoms

In case of type2, diabetic symptoms might show very slowly or would be completely absent. Usually these signs of diabetes are found in type 2 only if that diabetes is not controlled at all.

1. Increased Fatigue: Due to insulin resistance, the body uses its reserve fat for energy. Fat, when broken down, uses more energy when compared to glucose. The result is that that body goes into negative calorie effect, resulting in fatigue.
2. Polydipsia : With the increase in the concentration of glucose in blood, the body tries to dilute it and as a result we feel thirsty.
3. Polyuria: With the increase in the concentration of glucose in blood, the body tries to get rid of it by excreting it by means of urinating. This leads to increased urine production and also dehydration.
4. Polyphegia: In type 2 diabetes, the body tries to produce more insulin. Since insulin stimulates hunger, a person feels more hungry.
5. Weight Fluctuation: Due to the above conditions, a person might gain more weight or even lose weight.
6. Vision Problems: Some times, body fluid is pulled out of tissues including the eye lenses, resulting in problems of the lenses to focus which leads to blurry vision. This condition is called Hyperosmolar Hyperglycemia Nonketotic Syndrome.
7. Irritability: Inefficient supply of glucose to the body organs such as the brain, makes the patients feel tired and uneasy and thus irritated.
8. Infections and Problem Healing Wounds: WBC (White Blood Corpuscles- please see our section on blood for more information) are part of the human immune system. High blood sugar inhibits the production of these blood cells. A reduction in the number of white blood cells makes a person more open to the infections and more likely to get infected because the immune system offers little resistance to the disease. Also as diabetes grows old, the blood vessels thicken, thereby affecting proper blood circulation.

Pre Diabetes

It is an intermediary stage between diabetic and normal stage. It is a stage where the blood sugar is higher than normal but not high enough to qualify as type 2 diabetes. The person has normal glucose tolerance but has an increased risk of developing diabetes.
It is also known as Borderline Diabetes, Chemical Diabetes, Touch of Diabetes. It is important to have information about this since this is a serious condition and person can seek appropriate treatment by intervention and lifestyle changes, before one becomes diabetic. Pre diabetes normally takes a long time to finally transform into diabetes and there are better chances to revert back to normal at this stage, if proper measures are taken.

Pre Diabetes Symptoms

The symptoms of pre diabetes may be the same as in case of diabetes but they are not continuous, instead they erupt occasionally

• Thirsty

• Tingling sensations in feet and fingers

• Increase in appetite

• Increase in Urination

• Irritability

• More Infections or more vulnerability towards infectious diseases.

• Blurred vision

• Itching of Skin

Pre-Diabetes Risk Factors

Some people are at increased risk of pre diabetes-

• Overweight

• Family history of pre-diabetes

• Waist hip ratio - The person with 'fat tire'

• Depression or stress

Diet for Diabetes

Proper diet is an important part of controlling diabetes. A person might follow a diabetic diet either alone of even while he/she is taking doses of insulin or oral hypoglycemic drugs. The purpose of a diabetic diet is not to cure diabetes but to maintain ideal body weight and controlling blood sugar level while at the same time provide necessary nutritional benefits. A diabetes diet is developed taking into account the patients height, weight, age, sex, the amount of physical activity he/she performs, nature of diabetes and other medical conditions such as high blood pressure, high cholesterol levels etc. Using these parameters, the dietician determines the amount of carbohydrates, proteins, fats, type of carbohydrate or amount of fiber that the patient should intake.

Its important to understand that there is no common diet that works for everyone. Also there is no particular diet that works over a long period of time. But one should adhere to the some important factors while planning the diet:

• Consume at least 40gm of fiber every day.

• Do not have heavy meals, instead have small meals with sufficient time gap between each meal. Do not skip meals and avoid snack unless you have been advised to. Eat you meals at the prescribed hour. Your doctor decides this depending on the time and form of insulin injection.

• Eat more of simple whole cooked cereals instead of bakery and fast foods.

• Don't eat carbohydrates 2 hours before bedtime.

• Consume lots of fresh fruit and vegetables.

• Use less oil for cooking. Avoid fried and fatty foods.

• Avoid eating packages, ready to eat foods, sweetened drinks, esp. those that do not provide any health benefits.

• Watch you weight.

• If your lipid levels are high, lipid-lowering drugs might be needed.

• Keep a check on your hemoglobin and proteins in blood. If necessary, consult with your doctor for suitable diet changes.

Diabetic foods must be very carefully chosen - this is because all foods contain some amount of carbohydrate and also some energy values. For example: protein and fats found in foods are finally converted to glucose in the body and this glucose also effects the blood sugar levels. Therefore, extra care must be taken while selecting diabetes foods. Also it is not necessary that one should follow only a bland diet, but instead select foods that are high in nutrition but low in fats and calories. One should ideally eat a lot of fruits and vegetable and whole grains of course after consultation with your dietician.

Diet Management During Diabetes

Food mainly contains carbohydrates, protein and fats. Foods rich in carbohydrates are:

1. cereals
2. Protein rich food:
meat, fish, lentils etc
3. Fats rich food:
cream, milk, oil, nuts etc.

Fats is rich in calories, 1 gm of fat contains 9 calories. On the other hand, only 4 calories are provided by 1gm carbohydrate or 1 gm protein. The human body digests carbohydrates much more easily than it digests fats and proteins. Thus, carbohydrates digestion and increased production of glucose by the liver, are responsible for the quick rise in blood glucose after a meal. For people with no diabetes, this high blood sugar levels comes down to normal levels within 2 hours. However, if one is suffering from diabetes, the glucose levels are much higher and the time taken for this to return to normal is nearly 3 to 4 hours.

Diabetes Care

The following tips will help you with Diabetes Control

• Do not have heavy meals, instead have small meals with sufficient time gap between each meal.

• Do not over eat.

• Do not skip meals and avoid snack unless you have been advised to. Eat you meals at the prescribed hour. Your doctor decides this depending on the time and form of insulin injection.

• Do not eat immediately after a workout.

• Drink lots of unsweetened fluids.

• Avoid bakery and fast foods.

• Don't eat carbohydrates 2 hours before bedtime.

• Consume lots of fresh fruit and vegetables.

• Sprouts are good for diabetes.

• Use less oil for cooking. Avoid fried and fatty foods.

• Avoid eating packages, ready to eat foods, sweetened drinks, esp. those that do not provide any health benefits.

• Watch you weight. Check your blood sugar levels regularly.

• Regularly check the functions of other body organs such as liver, kidney et.

• Exercise regularly.

• Take your medicines regularly.

• Avoid smoking and alcohol.

Gestational Diabetes

Gestational Diabetes is a type of diabetes that affects pregnant women. In gestational diabetes the hormones produced during pregnancy causes insulin resistance causing type 2 diabetes. However in this case it resumes to normal after the delivery of the child while that is not the case with the other two types. The gestational diabetes might be a transient variety but if it is not treated then it can aggravate and can damage the fetus or the health of mother. About 4% of all pregnant women get Gestational Diabetes. In the United States, an estimated 135,000 cases of Gestational Diabetes are registered every year.

Certain hormones produced during pregnancy, which assist in the development of the placenta and in the growth of the baby some times also blocks the affect of the mother's insulin on her body. As a result, the mother might need up to three times more insulin for it to effectively work on the glucose. If not treated, glucose builds up to high levels in the blood. This condition is called hyperglycemia.

Why there is a need to take care of gestational diabetes? Gestational diabetes normally affects women late in their pregnancy. It affects the baby too. Due to Gestational Diabetes, the insulin does not cross the placenta while other nutrients including glucose pass through. This extra blood glucose results in the baby having increased blood sugar levels. This forces the baby's pancreas to produce more insulin to get rid of the extra glucose. Also since the baby now gets more energy than is required, this surplus energy is stored in the baby's body as fat. This can lead to the condition called Macrosomia or “Fat” baby. At birth such babies have difficulty breathing or may even develop hypoglycemia or diabetes shock.

Types of Gestational Diabetes

There are 2 types of gestational diabetes:

Type A1: A proper diet is sufficient to maintain normal glucose levels.
Type A2: Insulin or other medications along with changes in diet are required.

Gestational diabetes is also classified into different forms of diabetes which existed prior to pregnancy:

Type B: onset at age 20 or older or with duration of less than 10 years.
Type C: onset at age 10-19 or duration of 1-19 years.
Type D: onset before age 10 or duration greater than 20 years.
Type F: diabetic nephropathy.
Type R: diabetic retinopathy.
Type H: diabetes with ischemic heart disease.
Type T: diabetes requiring kidney transplant.

Symptoms of Gestational Diabetes

In case of Gestational Diabetes, the symptoms might be completely absent some times. If present the are similar to the symptoms of type 2 diabetes.

Gestational Diabetes – Risk of Diabetes in Future

If a woman has had Gestational Diabetes once, the probability that she might get it again is high. Also there is a link between Gestational Diabetes and type 2 diabetes, since both involve insulin resistance. Some of the Risk factors for gestational diabetes are:

• A family history of type 2 diabetes

• The woman's age - the older the mother is at the time of pregnancy, the higher the risk

• Obesity, lack of exercise.

• Previous incidents of G diabetes

• A previous pregnancy that resulted in a child with a birth weight of 9 pounds or more.

• Pre Diabetic, glucose intolerance or impaired fasting glucose

Gestational Diabetes Test

During pregnancy some standard tests are carried out for Gestational Diabetes. Usually if you are at high risk of Gestational Diabetes, the blood glucose levels may be checked at the first visit to the doctor. If the results are normal , you will be screened again between 24 to 28 months of pregnancy. You might have one or more of the following tests, depending on the initial test results and your risk level. The following are the different types of diabetes testing:

Fasting blood glucose or random blood glucose test: If you fasting blood sugar level is > 126 mg/dl or random blood sugar level is > 200 mg/dl. You might be suggested by the doctor to go for further confirmatory tests.

Screening glucose challenge test: This test is performed between 26-28 weeks of pregnancy and is a is a preliminary screening test, . This test diagnoses the existence of diabetes by studying whether or not the body is using glucose. This test is now a standard test performed during the second trimester of pregnancy.

Oral glucose tolerance test (OGTT): Women with a high risk of Gestational Diabetes and recommended this test. The glucose challenge test is performed on the person by studying her blood samples drawn 1 hour after she has had a 50grams glucose drink. If the blood sugar levels are higher than 140 mg/dl she might have Gestational Diabetes and this requires further confirmatory tests called 3-hour oral glucose tolerance test (OGTT). According to American Diabetes Association, the following values are considered to be abnormal for the OGTT:

• Fasting Blood Glucose Level=95 mg/dl

• 1 Hour Blood Glucose Level=180 mg/dl

• 2 Hour Blood Glucose Level=155 mg/dl

• 3 Hour Blood Glucose Level=140 mg/dl

Treatment for Gestational Diabetes

Gestational diabetes can harm you and your baby, so you need to consider about it seriously and start caring at once. The main aim of gestational diabetes treatment is to keep blood glucose levels equal to those of normal pregnant women. It needs a planned meal and scheduled physical activity, even blood glucose testing and insulin injections if required. If gestational diabetes is taken care off properly, reduces the risk of a cesarean section birth that high weight babies may require.

Gestational Diabetes can harm both the mother and the baby. It is therefore necessary to start taking remedial action immediately. The main aim of Gestational Diabetes is to keep the blood sugar levels normal or within a targeted range. Women with Gestational Diabetes can have healthy babies of they following the simple guidelines laid down by the doctor.

• Each women should have a gestational diabetes diet plan designed specifically for her need.

• Regular check up of blood sugar level and keeping it under control.

• Follow a healthy diet.

• Get regular, moderate exercises and physical activity.

• Watch your weight.

• Track you blood sugar levels, physical activities and food habits. This can help gauge the effectiveness of the treatment and make changes if required.

• Take your medicines on time

Diabetes Complications

Once we have crossed the reversible stage of pre diabetes and enter diabetes stage certain changes start developing in our body. These changes occur due to high blood sugar with instability in the hormones as well as blood vessels and nerves. When these changes become permanent in the body it develops into serious Diabetes Complications and body indicates these changes by steady symptoms.

Symptoms of the Diabetes Complications

• Diabetic retinopathy shows symptoms of pain in your eyes and may even result in loss of vision.

• Renal (kidney) disease shows symptoms of swelling (edema) in the feet and legs. It then passes over total body and as the disease progresses, blood pressure also increases.

• Tingling, burning, numbness, tightness, shooting or stabbing pain in the hands, feet or other parts of your body, especially at night.

• Digestive problems also occur if, the nerves controlling internal organs gets damaged (autonomic neuropathy).

• You may have scanty or profuse sweating, difficulty of sensing when your bladder is full, when there is a low blood sugar, increased sexual problems, weakness, dizziness, and fainting.

• Chest pain (angina) or shortness of breath dizziness or light headache, shoulder or stomach pain, fast heartbeat. You might not show any symptoms until having a heart attack or stroke.

Once a person is afflicted with diabetes (moved past the pre diabetic stage), certain bodily changes start developing due to the high sugar levels in blood accompanied by hormonal instability and changes in blood vessels and nerves. Once these changes become permanent, the body starts showing symptoms of serious Diabetic Complications. The following are the complications one might get;

Diabetic Retinopathy

Diabetic retinopathy affects the eye, leading even to blindness. It affects the micro vessels supplying blood to the retina of the eye, thereby obstructing the flow of oxygen to the cells of the retina. The retina is a light-sensitive inner layer of the eye with three types of photoreceptor cells. Two of these photoreceptor cells, called rods and cones (detecting color), send image forming signals through the optic nerve to the brain, which converts these into a some thing we recognize and send this back to the eyes. This is how we see things around us. High blood glucose creates problems in passing light through the retina and thus leading to improper vision.

The early stage of Diabetic Retinopathy is called non proliferate diabetic retinopathy. The distorted and blurred vision, marking this stage, is due to diabetic macular edema. The macula is a central part of the retina , which is rich in cones. Diabetic Macular Edema is swelling of the retina caused by leakage of fluids from the macula. As macular edema progresses it causes blurring in the middle or on the side of the visual field. On the other hand, proliferative diabetic retinopathy, is the later or advanced stages of Diabetic Retinopathy. In this stage, the blood vessels become weak and finally break, causing leakage of blood into the vitreous of the eye. This leads to the formation of floating spots in the eye. It is not necessary that both the eye get equally affected. As this progresses, the retina is totally destroyed and detached from the back of the eye. This causes blindness in the patient.

Other complications may be

Cataract :- cataract is caused by a thin, misty layer appearing in the eye, lading to unclear vision.
Glaucoma :- High blood pressure on the optic nerve damages it creating unclear vision.

Diabetes Eye Care

A diabetic patient must get regular eye checkups in order to detect any of the above mentioned complication at the earliest possible stage. Also the patient should monitor and maintain the blood sugar levels.

Diabetic Neuropathy

Nerves depend on multiple tiny vessels that carry nutrients and oxygen to keep each and every segment of these very long nerves intact. Damage to one small segment can result in loss of feeling, pain or burning sensations that bother the foot and leg.

Feet:- Diabetes can decrease blood supply to the foot and gradually damages the nerves which carry sensation. A second micro vascular disease is diabetic foot or diabetic peripheral neuropathy or distal symmetric neuropathy. Neuropathy is the common complication of diabetes, due to high blood sugar, chemical changes occur in the nerves. It always starts in the feet as they are the longest nerves and fed with longest blood vessels of the body. Generally it is seen in the obese people, with high blood sugar levels and age more than 40 years. Neuropathy can develop within a span of first few years and it affects approximately 60% of diabetics. Signs and symptoms of Diabetic Neuropathy

• Decrease or no sweating i.e. dry scaly skin with callus formation.

• Numbness, tingling, and some sort of burning sensation.

• Weakness and loss of reflexes.

• Decrease sensation to the slight change in temperature.

Diabetic should take care of their feet especially the area between toes, and should not ignore if there is any kind of blisters, ulcer, redness or soreness, formation of callus etc. If any suspicion or doubt arises for the foot then it should be followed by immediate physical examination. The clinical examination will show the sensation in the feet and determine if it is normal or diminished.
Blood flow may be improved with good sources of vitamin E intake along with blood pressure medicine (ACE inhibitors). Although amputations are common with diabetes, about half can be prevented with simple steps that protect the feet.

Diabetic Nephropathy

Diabetic Nephropathy affects the kidney. The consistent High blood sugar levels damages the kidney.

The filed of medicine that studies kidneys and its associated diseases is called nephrology. Kidneys have many biological functions. Foremost amongst these is to regulate body fluids by secreting necessary minerals and filtering the waste which is finally excreted along with water in the form of urine. The Kidneys help maintain the ph levels in blood, sustain electrolyte balance and also releases certain important hormones. When the kidneys are damaged, it affects these important functions. If detected in the initial stages, when the damage is not very severe, the condition can be treated or controlled with diet and medications. However, as the condition worsens, instead of just waste, necessary nutrients such as protein molecules which are present in blood, are excreted with urine. This condition is called microalbuminuria and with its progress, larger and larger amounts of protein is thrown out with urine, leaving the body starving for protein.

Symptoms of Kidney Disease

1. Loss of appetite
2. Tiredness or fatigue
3. Nausea and vomiting.

Diabetic Nephropathy Tests

1. A simple urine test is sufficient to diagnose Diabetic Nephropathy.

If a person has Type 1 diabetes, he/she should take this test within the fourth year of diabetes diagnosis.
If a person has Type 2 diabetes, it is advisable to take this test at the time of diagnosis itself.
In both cases, tests should be carried out on a regular basis.

Treatment

1. Control diet
2. Exercise regularly
3. Regular medication for blood pressure control- ACE inhibitor or ARB (angiotension receptor blocker ).

The medicines help control the amount of protein excreted with urine and also inhibit the progress of Diabetic Nephropathy and other kidney related disorders.

Diabetes Myonecrosis is a type of gangrene (a necrosis or cell death disorder characterized by decay of body issues.) It is caused by Clostridium bacteria may develop at the time diabetes is diagnosed or even before. The bacterium produces toxins, leading to diabetic mastopathy. Diabetic mastopathy normally affects women with Type 1 diabetes but might also affect women with Type 2 diabetes, especially pre- menopausal women.

Preventing Diabetic Nephropathy

• Blood sugar levels must be maintained within normal range.

• Modify Diet if necessary, take proper and timely medications.

• Maintain healthy blood pressure levels.

• Take the urine tests and be cautious of urinary tract infections

Diabetes , Heart Disease and Stroke

It has been noted that a person with diabetes is more likely to suffer from heart diseases or strokes. In fact a middle aged person with diabetes is more likely to have a heart attack than people without diabetes but with known heart disease complications and more aged than you are. Coronary artery disease (CAD) is the most common heart disease that accompanies diabetes. This happens due to the clogging up or narrowing of arteries supplying blood to the heart, due to fat deposits. This is called atherosclerosis. This kind of plaque is formed from cholesterol, calcium etc, which float in blood and therefore inside arteries including the coronary arteries. For more information on heart disease, please refer our section on it.

But how is diabetes related to cholesterol and heart disease? People with type 2 diabetes have low HDL cholesterol (for more information on this please refer our section on Cholesterol) and increased triglyceride levels. These two together increases the risk of atherosclerosis. High Blood sugar also damages the blood vessel and nerves by changing hormones and cells. Such damaged blood vessels build up plaque and thereby increase the heart disease risks. Damage to blood vessels causes diabetes complications we have mentioned above. Other risk factors include HBP, smoking, lack of exercise and physical activity etc. For more information on heart disease, please refer our section on it.

Diabetes Treatments/ Diabetes Cure

Until now diabetes is considered to be a chronic disease which means that it cannot be cured. But you can manage this to remain under normal conditions, once you take off those restrictions or the medications it will pop out. Usually it is done by controlling the diet by taking food with less sugar content and carbohydrates. There are many diabetic drugs which increase the insulin production in pancreas. The most effective method found is injecting artificial insulin to the patient. But on a regular basis this is not advised as it may have complications on a long term. In the case of type1 diabetes they can cure it by transplanting the pancreas or the kidney and medically assured that they are insulin independent. The future developments include exogenous beta cell replacement, which was a success in humans and mice. However there is a belief that it can be prevented by excess intake of sugar based food.

Diabetes Medications

If natural remedies for diabetes are not enough to control blood sugar levels, one has to take diabetic medicines. Some common diabetic medications are:
1. Insulin- this is taken via a injection or pump.

Type 2 diabetes drugs include:

1. Sulfonylureas
2. Biguanides
3. Alpha glucosidase Inhibitors
4. Thiazolidinediones
5. Meglitinides

Diabetes Control/ Diabetes Management

Managing diabetes is not a rare task. Many families and individuals are still able to live normal lives with diabetes. Medical technology has helped developed home kits and tools that help monitor blood sugar levels. Also, complementary and alternative medical practices propose the use of herbal remedies to help alleviate diabetes in many patients. However, a doctor should first be consulted before attempting to use herbal medicines.

1. Its important to understand that irrespective of the nature of the treatment, urine sugar tests are not sufficient and a reliable indicator of diabetes control. One needs to have regular blood tests. Over the years, most diabetic patients acquire an increase in the renal threshold of glucose (spillage of glucose in urine). Again if one has urinary tract infection, the sugar in the urine is devoured by bacteria, thus making
urine test for sugar unreliable.
2. If you are taking tests your self, for example the capillary blood glucose test using a hand held glucometer, make sure you know the correct instructions for usage. Ask your doctor/nurse for a demo the first time.
3. Stick to your diet plan, exercise regularly and take your medication (tablets/insulin injections) on time.
4. If one is obese and has diabetes, the person should watch his diet, try to control/reduce weight, and get regular physical activity.
5. Maintain your glucose levels.

Prevent Diabetes

The following tips will help diabetes prevention

1. Eat a balanced diet.
2. Exercise regularly
3. In case of doubt, consult your doctor immediately.