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February 10, 2012

Diabetes Prevention (cont.)

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Is gestational diabetes a risk for developing type 2 diabetes later in life?

The simple answer is yes.

The risk for type 2 diabetes is higher in women who have had gestational diabetes (diabetes of pregnancy). In general, type 2 diabetes will occur in about 40% of women with gestational diabetes over the following 10 years. This number increases to the 50% range if obesity is present.

There are currently efforts underway to see if treating women with gestational diabetes (using lifestyle, and medications such as thiazolidinediones) can change the course of development of type 2 diabetes. The results appear promising, and further work is being done to identify who will potentially respond to treatment.

Are certain dietary patterns associated with the development of type 2 diabetes?

Diet becomes a critical issue when dealing with disease processes. A study looking at dietary factors as a contributor to disease processes must take a number of things into account. For example - is it the food itself, or the weight gain associated with its consumption that is the risk? Is it the food, or the age/lifestyle of those consuming it that is the risk? While cinnamon, coffee, and fenugreek seeds are among the many food products that some feel are associated with development/prevention of diabetes, none of these have truly been fully scientifically evaluated. The food patterns mentioned below have been adequately studied, and the results are independent of weight, age, physical activity, and family history. Therefore, with these nutritional topics, it truly looks like the results are related to the specific foods themselves.

A "Western" diet vs. a "healthy" diet

In a study of over 42,000 men, diets high in red meat, processed meat, high fat dairy products, and sweets, were associated with an increased risk of diabetes by almost two times that of those eating a "healthy" diet. Again, this is independent of weight gain and other factors mentioned previously.

Dairy foods

The data on dairy products seems to vary, depending if the person is obese or not. In obese individuals, the more dairy consumed, the lower the risk for the metabolic syndrome. Specifically, those consuming more than 35 servings of diary a week had a much lower risk compared to those consuming less than 10 servings a week. Interestingly, this association is not as strong in lean individuals.

Sugar

Sugar consumption alone has not been associated with the development of type 2 diabetes. There is of course, weight gain associated with sugar consumption. However, after adjusting for weight gain and other variables, there appears to be a relationship between drinking sugar-laden beverages and the development of type 2 diabetes. Women who drink one or more of these drinks a day have almost twice the risk of developing diabetes than women who drink one a month or less.



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  • Related Diseases & Conditions

    • Diabetes (Type 1 and Type 2)
      • Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
    • Stroke
      • A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
    • Hypoglycemia
      • Hypoglycemia is a syndrome caused by low blood sugar. Symptoms of hypoglycemia include palpitations, trembling, intense hunger, sweating, nervousness, and weakness. Consuming lifesavers, table sugar, soda, and juice are good treatment options for hypoglycemia.
    • Insulin Resistance
      • Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
    • Heart Disease
      • Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
    • Obesity
      • Obesity is the state of being well above one's normal weight. A person has traditionally been considered to be obese if they are more than 20 percent over their ideal weight. That ideal weight must take into account the person's height, age, sex, and build.
    • Diabetes Treatment
      • The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
    • Metabolic Syndrome
      • The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
    • Turner Syndrome
      • Turner syndrome is an inherited chromosomal condition affecting women. Women with Turner syndrome do not have ovarian function, and features of the syndrome include webbed neck, lymphedema of the hands and feet, heart defects, kidney problems, and skeletal abnormalities. The X chromosome is related to Turner syndrome. Treatment focuses on the symptoms of the syndrome.
    • Renal Artery Stenosis
      • Renal artery stenosis is a narrowing of the diameter of the renal arteries. When the renal arteries narrow, the result is restricted blood flow to the kidneys, which may lead to impaired kidney function and high blood pressure (referred to as renovascular hypertension (RVHT). Renal artery stenosis can occur in one or both kidneys. The primary cause of renal artery stenosis is atherosclerosis. Risk factors for renal artery stenosis include high blood pressure, high cholesterol levels, age, cigarette smoking, and diabetes. Symptoms of renal artery stenosis include high blood pressure that does not respond to treatment, severe high blood pressure in individuals younger than 30 or greater than 50 years of age. Renal artery stenosis is diagnosed with imaging and functional tests. Treatment for renal artery stenosis include medication or surgery.
    • Preeclampsia (Pregnancy Induced Hypertension)
      • Preeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
    • Diabetic Diet
      • A diabetic diet, or diabetes diet helps keep blood glucose levels in the target range for patients. Exercise and medication may also help stabilize blood glucose levels. Keeping track of when you take your diabetic medicine, keeping track of food choices, eating the proper amount of fruits, vegetables, carbohydrates, and fats will also help maintain proper blood glucose levels.
    • Diabetes and Foot Problems
      • Diabetes-related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
    • Prader-Willi Syndrome
      • Prader-Willi syndrome is a condition characterized by severe floppiness (hypotonia), poor growth, delayed development, and poor feeding problems in early infancy later followed in infancy by excessive eating that may lead to extreme obesity. The genitals in both females and males are underdeveloped and most are infertile. Prader-Willi syndrome is related to chromosome 15.
    • Diabetes and Kidney Disease
      • In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
    • Diabetic Home Care and Monitoring
      • Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
    • Stroke Prevention
      • Stroke is the third leading killer in the United States. Some of the warning signs of stroke include sudden confusion, trouble seeing with one or both eyes, dizziness, loss of balance, and more. Stroke prevention and reatable risk factors for stroke include lowering high blood pressure, quit smoking, heart disease, diabetes control and prevention.
    • Healthy Living & Disease Prevention
      • The importance of a healthy lifestyle in disease prevention is widely understood and most people know that lifestyle changes and choices can be critical to good health. Yet, few practice healthy behaviors that constitute healthy living.
    • High Cholesterol: Frequently Asked Questions
      • Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
    • Disease Prevention in Women
      • Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests are commonly available through your general doctor. Some specialized tests may be available elsewhere.
    • Diabetes: Caring for Your Diabetes at Special Times
      • Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in situations such as illness, work, school, travel, or a natural disaster.
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