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    What is it?
    Causes and Types
    Symptoms and

    Who's at Risk?
    Western Treatments
    Traditional Chinese

    Diet and Diabetes
    Blood Glucose Test

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Diabetes mellitus is characterized by chronic elevation of blood glucose levels, a condition called hyperglycaemia. There are two major forms of the disease. Type I, insulin-dependent diabetes mellitus (IDDM), formerly referred to as juvenile-onset diabetes, usually develops in childhood. IDDM stems from an inability of the pancreas to produce insulin because the diabetic person's immune system produces antibodies that destroy the insulin-producing beta cells. Because the body is no longer able to produce insulin, daily injections of insulin are required. Diet plays no part in causing IDDM, although breastfeeding may offer some protection against it developing. Diabetes of this kind is difficult to cure. Even so, following a good diet with adequate starch and fiber can often make possible a reduction in insulin intake by about one-third, as well as reduce the incidence and severity of diabetic complications. In susceptible individuals it can be sparked by viral infections such as a previous attack of mumps or German measles.

Type II, non-insulin-dependent diabetes mellitus (NIDDM), which was once called adult-onset diabetes, tends to be much more common among older people. It usually occurs after 40 years of age and becomes more common with increasing age. NIDDM arises from either sluggish pancreatic secretion of insulin or a resistance to insulin by the body's tissues; sometimes both factors are involved. It is linked to genetics and obesity, notably upper-body obesity. In this case, enough insulin is produced, but its utilization in the cells of the body is simply blocked by the effects of a diet rich in fats. Eating refined white sugar and other simple sugars also contributes to diabetes because in excess, these sugars convert to fat in the body.

People with NIDDM can control blood glucose levels through diet and exercise and, if necessary, by taking oral medications. Severe diabetics need insulin injections if other methods fail to control their condition. The injected insulin is extracted from the pancreas of pigs, sheep, and oxen. By the early 1980s certain strains of bacteria had been genetically modified to produce human insulin.

Despite their former classifications as juvenile or adult, either type of diabetes can occur at any age. NIDDM is by far the most common type of diabetes, accounting for about 90 percent of all cases, affecting some 15 percent of the population over the age of 50. It is essential for both groups of diabetics to eat regularly to prevent low blood sugar levels. Some insulin-treated diabetics need to eat every 2 or 3 hours and may also require snacks between meals.

In treating diabetes mellitus a complication of having blood sugar below normal levels often occurs. This condition is called hypoglycaemia, which could also develop from the same kind of dietary extremes that cause hyperglycaemia. But instead of a diabetic shortage of insulin, an excess is produced. In time, if insulin overproduction continues, the pancreas becomes overworked and loses its ability to produce sufficient and/or effective insulin.

Even brief falls in blood glucose levels can produce severe brain dysfunction. In healthy individuals, an intricate gluco-regulatory system acts rapidly to counter hypoglycemia by reducing insulin production (insulin is important in the mechanism that removes glucose from the bloodstream) and mobilizing energy reserves from the fat and liver. When this regulatory system does not operate, as in IDDM, disproportionately large amounts of insulin in the blood result in sudden drastic falls in circulating glucose.

Fasting hypoglycaemia can be a life-threatening problem; it occurs most often in diabetic patients who have accidentally overdosed on insulin by mistiming their therapy, missing meals, or exercising without compensating for increased glucose use. The condition also occurs in otherwise healthy individuals with insulin-producing tumors or as a late complication of starvation or other metabolic disorders. The symptoms of hypoglycaemia result from energy starvation in the central nervous system and include mental impairment, confusion, lethargy, and seizures; in severe cases, hypoglycaemia causes coma and death. Diagnosis is based on the concurrence of these neurological symptoms, low levels of circulating glucose, and the alleviation of the patient's symptoms upon the rapid oral or intravenous administration of glucose, which is the usual treatment for the condition.

Gestational diabetes is an ephemeral condition associated with pregnancy. In this situation, blood glucose levels increase during pregnancy but usually return to normal after delivery. However, gestational diabetes is recognized as a risk for developing NIDDM diabetes later in life.

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