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INTRODUCTION

TYPE 1 DIABETES
TYPE 2 DIABETES
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DIAGNOSIS AND TREATMENT
CURRENT RESEARCH


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Non insulin dependent diabetes mellitus

School risk for diabetes children

 The health of many children with type 1 diabetes is threatened due to poor care in primary schools, say campaigners.

 Diabetes UK claims 6,500 pupils in England are not covered by school medication policies which ensure they get insulin injections when needed.

 This means parents often need to visit during the school day to administer injections.

 The charity wants ministers to force school inspectors to keep checks on the care of children with diabetes.

 Thousands of children in the UK have type I diabetes, caused by the sudden loss of insulin-producing cells in the pancreas.

 Most are wholly dependent on regular blood testing and insulin injections to avoid severe complications - which can include diabetic coma and even death.

 In the long term, poor control of diabetes can increase the risk of heart disease, stroke, kidney failure and amputation.

 There is already evidence that blood glucose levels are poorly managed, with research in 2007 suggesting that only one in five children had their levels properly under control.

 Injection regimes are a particular problem at younger ages, when children do not have the skills or confidence to carry out testing and injections.

 Diabetes UK says its research suggests only 16% of primary schools in England have medication policies which allow them to administer insulin.

 Toilet trauma

 This can mean that treatment regimes are changed to fit around school hours, or that children are not cared for properly in school.

 The charity said that parents had told it of instances in which children had to inject insulin in school toilets, or, in one case, wait outside the gates for the arrival of a nurse.

 Douglas Smallwood, its chief executive, said: "It is unacceptable for medication regimes to be changed to fit around school hours.

 "Children must have the most appropriate treatment for their diabetes and be properly supported in managing their condition.

 "Where parents have to step in to give insulin injections during school hours, we hear all too often that they are unable to work because they have to go into school every day - this can put heartbreaking strain on families both financially and emotionally."

 He said that the government needed to strengthen legislation to include the well-being of children with long-term conditions - and to make sure that school inspections included the presence or absence of a medication policy.

 A spokesman for the Department for Children, Schools and Families, said there was no legal duty on schools to administer medicines, but most assisted on a voluntary basis.

 In Scotland, a similar survey suggested just one in ten primary schools had a policy on giving medication and were prepared to follow it.


Chamomile tea 'may ease diabetes'

 Drinking chamomile tea daily may help prevent the complications of type 2 diabetes, such as loss of vision and nerve and kidney damage, a study says.

 UK and Japanese researchers fed a chamomile extract to diabetic rats.

 The extract appeared to cut blood sugar levels and block activity of an enzyme associated with the development of diabetic complications.

 Charity Diabetes UK cautioned against patients acting on the findings until further research had been carried out.

 However, researchers say the Journal of Agricultural and Food Chemistry study raises hope of a new anti-diabetes drug.

 Cases of type 2 diabetes, many of which are linked to obesity, are on the increase throughout the developed world.

 Chamomile, also known as manzanilla, has been used for years as a medicinal cure-all to treat a variety of medical problems including stress, colds and menstrual cramps.

 Researchers from University of Toyama, led by Atsushi Kato, fed chamomile extract to a group of diabetic rats for 21 days and compared the results with a group of control animals on a normal diet.

 Enzyme inhibition

 Blood glucose levels - high levels of which are a sign of diabetes - were significantly lower in the animals fed the extract, which appeared to inhibit production of the sugar in the liver.

 Tests also showed reduced activity of an enzyme called aldose reductase in tissue samples from the extract group.

 This enzyme helps change glucose into a sugar alcohol called sorbitol.

 In people with type 2 diabetes, the activity of aldose reductase increases as glucose levels rise in the blood.

 However, sorbitol does not move easily across cell membranes and it can collect in excess quantity, particularly in eye and nerve cells, where it can cause serious damage.

 Dr Victoria King, of the charity Diabetes UK, said: "More research would be needed before we can come to any firm conclusions about the role chamomile tea plays in fighting diabetes-related complications.

 "Diabetes UK wouldn't recommend people with diabetes increase their chamomile tea intake just yet.

 "Eating a healthy balanced diet, taking regular physical activity and adhering to any prescribed medicines remain key ways to effectively control blood glucose levels, blood pressure and blood fats.

 "Good diabetes management will help reduce the risk of serious complications such as heart disease, stroke and blindness."


Broccoli may undo diabetes damage

 Eating broccoli could reverse the damage caused by diabetes to heart blood vessels, research suggests.

 A University of Warwick team believe the key is a compound found in the vegetable, called sulforaphane.

 It encourages production of enzymes which protect the blood vessels, and a reduction in high levels of molecules which cause significant cell damage.

 Brassica vegetables such as broccoli have previously been linked to a lower risk of heart attacks and strokes.

 People with diabetes are up to five times more likely to develop cardiovascular diseases such as heart attacks and strokes; both are linked to damaged blood vessels.

 The Warwick team, whose work is reported in the journal Diabetes, tested the effects of sulforaphane on blood vessel cells damaged by high glucose levels (hyperglycaemia), which are associated with diabetes.

 They recorded a 73% reduction of molecules in the body called Reactive Oxygen Species (ROS).

 Hyperglycaemia can cause levels of ROS to increase three-fold and such high levels can damage human cells.

 The researchers also found that sulforaphane activated a protein in the body called nrf2, which protects cells and tissues from damage by activating protective antioxidant and detoxifying enzymes.

 Countering vascular disease

 Lead researcher Professor Paul Thornalley said: "Our study suggests that compounds such as sulforaphane from broccoli may help counter processes linked to the development of vascular disease in diabetes.

 "In future, it will be important to test if eating a diet rich in brassica vegetables has health benefits for diabetic patients. We expect that it will."

 Dr Iain Frame, director of research at the charity Diabetes UK, stressed that research carried out on cells in the lab was a long way from the real life situation.

 However, he said: "It is encouraging to see that Professor Thornalley and his team have identified a potentially important substance that may protect and repair blood vessels from the damaging effects of diabetes.

 "It also may help add some scientific weight to the argument that eating broccoli is good for you."


Hospital rise for child diabetes

 The number of children in England needing emergency hospital care for complications of diabetes has risen, figures show.

 Last year, 3,317 were admitted to hospital with the potentially coma-inducing complication diabetic ketoacidosis compared to 2,617 in 2002.

 Patient group Diabetes UK claimed that cuts in NHS services were partly to blame for this trend.

 The Department of Health said it was committed to improving services.

 Diabetic ketoacidosis can be the first obvious sign of unchecked diabetes in a child, with symptoms such as sluggishness and fatigue, weight loss, stomach pain and vomiting.

 If not treated quickly, these symptoms can worsen and eventually lead to coma and death.

 Once diagnosed, children with type I diabetes use insulin injections to manage their blood sugar levels - but if they are very poorly-controlled, ketoacidosis can arise again.

 The steady rise in the number of cases since 2002 was revealed in a Parliamentary answer.

 Douglas Smallwood, the chief executive of Diabetes UK, said that parents needed to be better educated in the tell-tale signs and more needs to be spent on specialist diabetes services aimed at children.

 He said: "The number of children being rushed to AE with such a life-threatening complication is shocking.

 "In other research, specialist diabetes staff have reported that cuts in diabetes services results in increased emergency hospital admissions.

 "With increased awareness and more investment, the number could be dramatically reduced."

 The charity said while the figures were just based on hospital admission in England, the problem was likely to be UK-wide.

'Vital support'

 But Professor Peter Hindmarsh, from the Institute of Child Health, who leads a committee asked by the government to look at the care of children with diabetes, said the reasons were more complex.

 "There are an increasing number of people being diagnosed with diabetes - probably because of greater awareness - and people tend to stay in hospital at this point.

 "However, the shortage of specialist care might have something to do with; we haven't got enough people on the ground to deliver the service."

 A spokesman for the Department of Health acknowledged that it was vital that children and young people with diabetes had access to support from a specialist team.

 "The government has recognised that the quality of diabetes care for children and young people can be variable and we set up a working group to establish what needed to be done to improve this."


Experts paint a depressing future for Australian diabetics

 New research presented at an international conference has predicted that almost a third of Australians with diabetes will die from the disease in the next decade.

 The alarming prediction is the first to forecast the mortality and morbidity in Australia because of type two diabetes, and it presents a depressing picture.

 Taken from a nationally-representative sample of diabetics, it has been revealed that 13 per cent will die in the next five years and 31 per cent would be dead within a decade, 1 in 5 will have a heart attack by 2018, and 1 in 12 will suffer stroke or other complications like amputation, blindness and renal failure.

 Associate Professor Danny Liew, a clinical pharmacologist at St Vincent's Hospital in Melbourne, says the figures are compelling and unexpected and the outlook for diabetics is not good.

 Professor Liew also says worse is to come because more people in the future will develop diabetes to add to the 700,000 Australians already diagnosed with the type two diabetes.

 Type two diabetes is very much a lifestyle form of the condition triggered by poor diet, lack of exercise and weight gain.

 Experts say a diabetic crisis is looming as a growing number of Australians of all ages carry the dual lifestyle conditions.

 Professor Liew and his colleagues were able to build a predictive model to assess the health outlook for diabetics using data from the nation's largest diabetes study, AusDiab.

 The model to assess the health outlook for diabetics used a sample of 825 people who were older and had a range of complications such as obesity, high cholesterol and high blood pressure.

 Professor Liew says how typical the model is of the diabetes population, is hard to assess but it is close, and the dangers of those risks are clear and the burden of the disease is high.

 Experts say while the numbers developing diabetes were on the rise, death rates overall were decreasing but the situation is still bad and the complications remain a major burden.

 It is estimated that type two diabetes costs an average of $5,350 per person a year to treat, from $4,000 in the early-stage disease to almost $10,000 for people with common, diabetes-related complications.

 The research was presented at the American Diabetes Association meeting in San Francisco.



Diabetes Mellitus, disease in which the pancreas produces little or no insulin, a hormone that helps the body’s tissues absorb glucose (sugar) so it can be used as a source of energy. The condition may also develop if muscle, fat, and liver cells respond poorly to insulin. In people with diabetes, glucose levels build up in the blood and urine, causing excessive urination, thirst, hunger, and problems with fat and protein metabolism. Diabetes mellitus differs from the less common diabetes insipidus, which is caused by lack of the hormone vasopressin that controls the amount of urine secreted.

In the United States, about 17 million people (6 percent of the population) suffer from diabetes mellitus. Every year, about 1 million people learn they have the disease. Diabetes mellitus kills over 400,000 U.S. residents each year, and it is the sixth leading cause of all deaths caused by disease. In Canada, more than 2.2 million residents (7 percent of the population) have diabetes mellitus, and the disease contributes to more than 25,000 deaths a year.

Diabetes is most common in adults over 45 years of age; in people who are overweight or physically inactive; in individuals who have an immediate family member with diabetes; and in people of African, Hispanic, and Native American descent. The highest rate of diabetes in the world occurs in Native Americans. More women than men have been diagnosed with the disease.



This light micrograph of a section of the human pancreas shows one of the islets of Langerhans, center, a group of modified glandular cells. These cells secrete insulin, a hormone that helps the body metabolize sugars, fats, and starches. The blue and white lines in the islets of Langerhans are blood vessels that carry the insulin to the rest of the body. Insulin deficiency causes diabetes mellitus, a disease that affects at least 10 million people in the United States (Blood diabetes diabetic insulin jds sugar testing, Non insulin dependent diabetes mellitus).

In diabetes mellitus low insulin levels prevent cells from absorbing glucose. As a result, glucose builds up in the blood. When glucose-laden blood passes through the kidneys, the organs that remove blood impurities, the kidneys cannot absorb all of the excess glucose. This excess glucose spills into the urine, accompanied by water and electrolytes—ions required by cells to regulate the electric charge and flow of water molecules across the cell membrane. This causes frequent urination to get rid of the additional water drawn into the urine; excessive thirst to trigger replacement of lost water; and hunger to replace the glucose lost in urination. Additional symptoms may include blurred vision, dramatic weight loss, irritability, weakness and fatigue, and nausea and vomiting (Blood diabetes diabetic insulin jds sugar testing, Non insulin dependent diabetes mellitus).

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