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DIABETES TYPES- PRECAUTION TO BE TAKEN: Apples, pears, apricots, blueberries, kiwifruit, pomegranates, and avocados are very good but you have to eat it Moderately, also Test before and after Bananas, dates, grapes, watermelon, and oranges dried fruits, have a lot of SugarAlso Cactus is really good for type 2 diabetics. Unless you are consuming large quantities of fruit, then eating fruit is not really that big of an issue. Fruit has so much good stuff in it that you can overlook the "bad" sugar it has. You may find that certain fruit causes sugar to skyrocket and if that's the case then that item should be strictly limited. Fiber rich foods are general safe for diabetics to eat because they tend to have a lower glycemic index (GI) Fruits high in fiber include: apples(2.5%), pears (2.1%), apricots (2.1%), blueberries (2.7%), kiwifruit (2.1%), pomegranates (3.4%), and avocados (6.7%). Apples have added benefits for people with diabetes. Raw apples contain high amounts of pectin which has been shown to improve glycemic control in diabetics, reducing insulin. Diabetic people can eat fiber-rich fruits like watermelon, strawberries, papaya, plums, muskmelon, etc. These fruits help to control blood sugar, levels. Due to their law glycaemic index, they promote a gradual increase in the blood sugar level which is highly beneficial to diabetics. Fresh lime also helps a lot by providing vitamins and minerals to the diabetic, person. But on the other hand all fruit juices should be restricted because they contain too much sugar and moreover because plenty of fruit is required to make one glass of juice. Juice does not add any fiber to person’s diet but instead raises the blood sugar level simultaneously. Fruits like mango, custard apple, chickoo, banana and grapes should be strictly avoided as they have high sugar content. Dry fruits are not allowed for diabetes because they contain high level of fat and concentrated source of energy. Dates are not at all good for diabetics. They are rich in calories and should be avoided by diabetics and obese. Dried dates are a good source of calcium and iron. What Fruits Can A Diabetic Eat? A bowl of fruit Diabetics often ask whether it is safe for them to eat large quantities of fruit. Many people suffering from diabetes avoid eating fruit because they are worried about the high sugar content found in most fruits. Fortunately, there are many fruits a diabetic can enjoy which do not significantly affect blood glucose levels. Good Fruits For Diabetics Fiber rich foods are general safe for diabetics to eat because they tend to have a lower glycemic index (GI) and therefore do not spike blood sugar levels to the same extent as high GI foods. This is because fiber slows down the absorption of sugar into the blood stream. Fiber rich fruits tend to be fruits with edible skins and seeds as it is these parts of the fruit that are highest in fiber. Fruits high in fiber include (fiber content in brackets): apples(2.5%), pears (2.1%), apricots (2.1%), blueberries (2.7%), kiwifruit (2.1%), pomegranates (3.4%), and avocados (6.7%). The avocado is not only high in fiber, but is also a rich source of monounsaturated fat. The American Diabetes Association (ADA) recommends a diet high in monounsaturated fat as it can help reduce the risk of cardiovascular disease which is more common in diabetics than the general population. There is also some evidence that a diet rich in monounsaturated fat can improve glycemic control. Fruits high in fructose, and those with high fructose to glucose ratios are also beneficial to diabetics because fructose does not require insulin to metabolize and therefore can be enjoyed by insulin resistant diabetics. High fructose fruits include apples, pears, guavas, and mangoes, - all of which have fructose to glucose ratios greater than 2. Along with high fiber and fructose levels, apples have added benefits for people with diabetes. Raw apples contain high amounts of pectin which has been shown to improve glycemic control in diabetics, reducing insulin requirements by up to 50% in some cases. Grapefruit is another fruit which may be beneficial for diabetics. Grapefruit can promote weight loss which in turn helps reduce insulin resistance. According to the Scripps institute, grapefruit may also help control insulin levels when consumed during meal times. Bad Fruits For Diabetics Fruits with high amounts of glucose should be eaten only in small amounts as they can spike blood glucose levels however most can still be enjoyed as part of a healthy diabetic meal plan. High sugar fruits include bananas, dates, grapes, watermelon, and oranges. Likewise, fruit juices tend to be stripped of the pulpy fibrous parts of the fruit and therefore tend to be very low in fiber and very high in sugar. Many fruit juices manufacturers also add sugar to their fruit juices to the extent that some fruit juices have higher sugar levels than carbonated sodas. Dried fruits tend to have a significant effect blood sugar levels due to their high sugar content. Canned fruits in syrup also tend to be high in sugar and therefore should be eaten in moderation or drained of the syrup before consuming. Many fruits are also available canned in their own juices rather than in syrup. These should be used in preference to fruits canned in syrup. For most of us, eating a sensible diet means five basic changes We should eat less fat. We should eat less sugar. We should eat more fibre. We should eat more fruits and vegetables. We should avoid hunger by filling up with good food. (1) Eat less Fat Fat is not our friend, so we must except it in small quantities. Fat contains more than twice the calories of other nutrients. Person should switch the low fat diary products. He should eat less red meat like beef, lamb and pork. Twice a week is enough. Person should also switch to fish, turkey, chicken, pork steak, etc. Foods to be avoided should a like high fat foods such as Fried breakfasts, pastries, cream, butter, mayonnaise, fries, chocolate, Candy, biscuits, cookies etc. (2) Eat Less Sugar Sugar is also not human being friend. Processed sugar is relatively high in calories. In addition, it’s almost valueless as a food. It provides us mainly with no nutrients, so if we stopped eating it tomorrow we would not be any less nourished. Person should reduce the amount of sugar in tea or coffee. There should be no addition of sugar in cereal. Person should avoid non-diet soft drinks. Instead enjoy diet drinks or fruit juice. He should start reading food labels and choose brands with less sugar. (3) Eat More Fibre Fibres contains fewer calories than fat or sugar, so it is an ideal slimming food. It also fills us up, so we feel nice and satisfied. It also helps to protect against a number of digestive complaints like constipation as well as diabetes and gall stones. High fibre diet includes whole meal bread potatoes, pasta, brown rice, beans, peas, leafy green vegetables, sweet corn, oat bran. (4) Eat more fruits and vegetables They are best friend of diabetic people. Ideally, patient should eat 4-5 helpings of fruit everyday. Whatever you do, Don’t just park your fruit in a fruit bowl and expect to eat it. Be more creative. You will eat a lot more fruit if you are. Ideally, person should eat 3-4 helpings of vegetables every day. They should make homemade soup because it is quick, easy and even green vegetables taste delicious. Person’s should eat more salads. They should remember, salad is not just a lettuce-leaf. It includes onions, tomatoes, cucumber, sweet-corn, radishes, chopped carrot and chopped cabbage. Patients should move away from meat. They should stop making meat the centerpiece of their main meals. They should eat small quantities of it and eat more vegetables, instead. (5) Avoid Hunger Hunger is definitely the Enemy No. 1 of human beings. Hunger is easily the biggest Diet-Killer. It is because hunger makes us miserable. We give up dieting and go back to the biscuits/cookies. Unfortunately, most slimness still think that dieting means eating small portions-that’s why most of them give up dieting and stays fat. REGULAR EXERCISE: Regular exercise is especially important for a person with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than diabetics who not exercise regularly. Exercise, generally helps control blood glucose levels because exercising muscle cells use more sugar and oxygen than those at rest. Exercise also helps insulin to work better. There are two main types of exercise i.e. Aerobic and Anaerobic. Aerobic Exercise: It is steady exercise over a period of time that causes our body to use more oxygen. It makes our heart and lungs stronger, lowers blood lipids, lowers blood pressure, and used up blood sugar. Aerobic exercises includes walking briskly, cycling, dancing, swimming, Jogging, cross-country skiing, some team sports etc. Anaerobic Exercise : It consists of short bursts of energy that work one part of the body at a time, such as weight lifting. It builds muscles but does not strengthen the heart and lungs. It uses small amounts of blood sugar, but not enough to have much effect on overall blood sugar levels. Both types of exercises are beneficial. While aerobic exercise works to lower blood sugar better, the benefits of anaerobic activities such as weight training are important too. For maximum benefit, aerobic exercise should be done 3 to 5 minutes a week, for 20-30 minutes each time. If a person is taking insulin them it is easier to balance his blood glucose levels if he exercise at the same time of day. How Regular Exercise Controls Blood Sugar : Regular Exercise is of great value in patients suffering from both Type-1 and Type-2 diabetes. Sometimes, it may seem easier to pop a pill or even take a shot than to put on your walking shoes and hit the trail. But the truth is that exercise, in combination with a healthy diet, is one of the best things; the person can do to take care of himself, if he/she is suffering from diabetes. Due to exercise, the glucose is metabolised in the body and thus normal blood sugar level is maintained. Exercise increases the body efficiency, because it increases the tissue sensitivity to Insulin in patients suffering from Type-2 Diabetes. Here more amount of glucose is forced out of the blood stream and into the cells where it is utilized for the production of energy. Hence, this condition reduces the level of glucose in the blood. It has been known that, exercise also increases the demand of muscles for glucose. If the muscles are exercising or in the working order then require more glucose the muscles those are not in working order. Hence, this condition also lowers the blood sugar level. In addition, to all this, the exercise burns calories which therefore helps in lose weight or maintain a healthy weight. And it is said that in a healthy weight individual, the blood sugar level remains in normal range, particularly in Type-2 diabetes. Exercise can improve circulation, especially in the arms and legs, where people with diabetes can have problems. Exercise can possibly reduce the amount of medication we need to treat diabetes or even eliminate the need for medication. Exercise also provides us relief from stress, which is the major contributing factor in raising blood sugar levels. Moreover, exercises reduce weight in case of the obese person. If there is extra body weight then unnecessary strain is put on beta cells, they needed to overwork, and hence the function of Beta cells is impaired for whole life. In some people, exercise combined with a meal plan, can control Type-2 Diabetes without the need for medications. EXERCISE, HYPERTENSION AND DIABETES Exercise, helps in reducing the high blood pressure. A high blood pressure can lead to a heart attack or stroke. So, an exercise helps in lowering the risk for heart diseases. With all these good things going for it, it’s mind boggling that only a few people get enough exercise or leisure-time physical activity to benefit. Hypertension is more commonly prevalent in a diabetic than in a non-diabetic. It is present in more than 50% of patient with Non insulin dependent diabetes mellitus and may or may not be accompanied by renal damage. Hypertension is a major risk factor for the development of macro/micro vascular disease in diabetics. Although increased cardiovascular risk has been demonstrated in adult diabetic subject with pressure slightly greater than 130/80 mm Hg. The decision to treat mildly elevated levels of blood pressure must rest on clinical grounds in each individual. Isolated systolic hypertension is more common in a diabetic than a non-diabetic and is a risk factor for micro vascular disease, but treatment should be individualised. In diabetics, the high blood pressure may be due to secondary causes, which must be carefully considered and ruled out. Primary Measures for management of hypertension in diabetics include, Regular Exercise, weight optimization, Cessation of smoking and dietary salt restriction. The drugs to be given to diabetics for hypertension must be carefully thought about because many anti hypertensive drugs shows side effects in diabetic individuals. EXERCISE, CHOLESTEROL AND DIABETES Exercise can help reduce the cholesterol of diabetics. Hence, by lowering the cholesterol level in diabetics, the risk for heart disease like heart attack or stroke is also reduced in them. Exercise lowers the elevated blood cholesterol by increasing the amount of high-density lipoproteins (HDLs), which are mainly responsible for removing cholesterol from the blood stream. Exercise also reduces the triglycerides and bad type of low-density lipoproteins in the blood and thus lowers the blood pressure, which in turn minimizes or decreases the risk of heat attacks in diabetics. Atherosclerosis is also prevented by Exercise in Diabetic people. No hardening of arteries occurs, if a diabetic person performs regular exercise. Nowadays, cholesterol has become the number one public health issue nationwide. The US National Institute of Health has described high cholesterol as an epidemic. This really no surprise because it has been observed that heart disease kills many people every year and the elevated cholesterol level is the main causative factor in them. In order, to prevent this the National Institute of Health has given certain Cholesterol treatment guidelines. By following the preventive programs the preventive programs or getting proper treatment, the patients cholesterol level decreases considerably and thereby reducing the occurrence of more serious diseases. Statins are the family of drugs most commonly used to treat high cholesterol. But there are certain controversies in using them. Such as Statins and their herbal source and red rice yeast may cause muscle damage and in some cases it may be fatal even. SELECTING YOUR EXERCISE It is people is out of shape or have been recently diagnosed as having diabetes, and then he/she should see his doctor before starting an exercise program. Doctor can best guide about the type of exercises that are good for him depending on how well the diabetes is controlled. Moreover, doctor can choose an enjoyable physical activity that is perfect for his current fitness level. Before making choice of an exercise program for the patient doctor should check the sensation in patient’s feet. He should check patient’s feet for any cut; sores, bruises, blisters, or any provide tips to the patient that is about the best care of his feet. Doctor should advise to the patient, the use of special shoes, if required. While choosing an exercise, person should keep in mind that it should put undue stress on his feet. Hence, exercises like walking, swimming or bicycling must be the appropriate choices. Person should try to avoid activities like running or jumping that could injure his feet. Patient should remember to warm up and cool down before and after exercising and he/she should always wear comfortable footwear. During walking or jogging, person should be very sure that his shoes fit well and are designed for the activity, which the person is performing. Person should be alert for blisters. Person should wear and shoes for a bit of each day until they are comfortable and are not as likely to cause blisters. Person should always remember to wear soaks. Diabetics should choose light exercises. They should not choose strenuous exercise as it may elevate blood pressure in them. If a patient has foot problem, then he should choose swimming or biking rather than jogging because it is easier on the foot. After making final choice of the exercise, the person should begin the exercising activity, slowly with a low impact. Such as if a person has to do walking then he should start with five minutes and add a bit of time each day. Exercises like diving, parachuting and mountain climbing are not recommended for people with diabetes. Because, during performing these exercises, hypoglycaemia can occur which can lead to serious complications. WHY WALKING WINS Diabetics can cut down their risk of dying prematurely by just getting up and walking. These have been found by several researchers. Their study found that the diabetic people who walked at least two hours a week had nearly a 40 percent reduction in death from all causes. Many studies have shown the health benefits of regular physical exercises including a decrease in the risk of developing diabetes. But little research has been done on the effect of exercise on people who already have the disease. In this study investigators from the Centers for Diseases Central and Prevention looked at nearly 3,000 adults with diabetes. All were questioned about their exercise habits through surveys administered in the community. Participants were followed for eight years. When compared with individuals who did not exercise, those who reported at least two hours a week of walking had a 39 percent lower death rate overall and a 34 percent lower death from cardio vascular causes. Even better results were seen for those who walked three to four hours a week. Therefore, these findings support the current recommendations that brisk walking on a regular basis is key health behaviour for persons suffering from Type-2 Diabetes mellitus. This regular daily walk will prevent the deposition of fat and maintain normal blood circulation particularly in the extremities. HOW OFTEN SHOULD A PERSON EXERCISE Person should try to exercise at the same time every day and for the same duration. This will help him controlling his blood sugar. It is mainly recommended to exercise at least three times a week for about 30 to 45 minutes. But if a person does not have at least 30 minutes to exercise then they should break their routine into shorter intervals. They could perform exercise for 10-15 minutes in the morning before going for job. Then they should take a 10-15 minutes walk at lunch time. Then again they can perform exercise for 10-15 minutes in the evening. HOW MUCH EXERCISE It has been noted that a sedentary life style increases the chances of becoming overweight and developing a large number of chronic diseases. Exercise or regular physical activity helps many of the body’s systems function better and keeps a host of diseases at bay. The physical exercises improve the chances of living longer and living healthier. It also prevents developing heart diseases or developing certain cancers like that of colon and breast cancer. It also prevents and helps in controlling Type-2 diabetes. Despite of all such beneficial effects, the person should fix up the time for exercise. He should not overexert himself. Hence, Regularity, intensity and duration of exercise are very important. It is recommended half an hour of continuous aerobic exercise. During this exercise, the heart goes up for a few minutes and a drop of sweat appear. This is all what is generally required. Person should stop exercising at once, if he feels any sort of discomforts like pain in the chest, neck or any other body part. PRECAUTIONS No doubt, exercises are very good for people suffering with diabetes but certain precautions should be taken during performing them. Straining or overexertion during exercising should be avoided. If after stopping the exercise, the breathing and pulse rate do not come to normal then it proves that the person has got overstrained and this may lead to a condition known as hypoglycaemia that is reduction in blood sugar level. During exercising, person should not wear tight clothes. He should wear loose, comfortable clothes and the types of clothes he wear should suit the weather. In summers, generally lightweight and light coloured clothes are preferred. If a person is exercising then care should be taken that he is having his regular meals, that is sufficient quantity of carbohydrates are provided in his diet. Otherwise, hypoglycaemia may occur. Patient should not keep on exercising continuously, in a condition if he finds blisters or cuts in his feet. Exercise should be immediately stopped until the healing of feet occurs. LISTEN TO YOUR BODY: WHEN NOT TO EXERCISE If the person’s blood sugar level is above 300 mg/dl, then he/she should not exercise. Due to exercise the blood glucose level may be raised. It is because when the person performs exercise, then he liver releases the glucose, which has been stored in it in the form of glycogen. If a person is ill or suffering from any infection, then also exercising should be stopped, till the person gets well. It is because during sick condition, the blood sugar levels are already very difficult to control and further exercises may worsen the condition. The presence of ketone, in the urine, also indicates that one should not perform exercise. It is because when we exercise, we usually burn glucose and fat. So when fats are burned in order to provide energy, they release certain by products like ketones. Enough insulin in our blood means that little quantity of ketone can be used as fuel. But when there is less amount of insulin, then ketones get deposited up and they are excreted into urine. Hence, presence of ketone in urine indicates that our body does not have sufficient quantity of insulin maintain the blood sugar level under normal range. If the person, experiences, tingling or pain or numbness in his legs then also he should stop exercising. During certain, climatic changes like in extreme, hot or cold weather, there is increased chance of diabetics for developing hypoglycemia and moreover, due to cold weather in diabetics skin cracks may occur due to impaired circulation and neuropathy. If the patient feels dizziness, nausea or short of breath then he should not exercise. Moreover if he/she suffers from the problem of blurred vision then also they should stop exercising. TYPE 1 DIABETES MELLITUS : It is also called Insulin Dependent Diabetes (IDDM) or Juvenile Diabetes. Although, it may occur at any age, but it usually develops in childhood or adolescence, before the age of 25. Equal incidences are seen in both sexes. But there are increased incidences in white population. This type of diabetes accounts for 10-15% of all cases of Diabetes mellitus. This type of Diabetes is acute in onset and progresses rapidly. Type 1 Diabetes is caused by complete deficiency of Insulin resulting from Beta cell destruction. It can be explained on the basis of three basic factors: (i) Genetic susceptibility: * A family history of Type 1 Diabetes mellitus is often found. * Moreover, it has been seen in identical turns, that if one twin has Type 1 diabetes, there is 50% chance of the second twin developing diabetes. * Majority of the cases of Type 1 diabetes has been seen in individuals with HLA-D Phenotypes (HLA-DR3 and HLA-DR4). (ii) Auto Immunity: * The islet cell antibodies, sometimes instead of providing immunity to the pancreas, acts against it and destroys the insulin producing Beta cells of Pancreas. Thereby leading to raised glucose level and thus diabetes mellitus. * There may be Insulitis i.e. infiltration of lymphocytes around the Pancreatic islets further leading to loss of most of the Beta Cells. * Type 1 Diabetes may also be associated with other autoimmune diseases such as Hashimoto’s thyroiditis. Addison’s disease as pernicious anaemia. (iii) Environmental Factors: It may be: * Viral infections such as –congenital Rubella, Mumps, Measles and coxsackie B virus may lead to the onset of Type 1 Diabetes. The type 1 of diabetes mellitus is a serious adolescent disease in the advanced parts of the world such as in Europe and in America. This type of diabetes affects mainly people who are in their early childhood or adolescence, though it may occur in an older age also. It is quite acute right from its onset, but it advances with growing age. Once diabetes mellitus type 1 sets in, there is no complete cure for it, and the person must learn to live with the condition. However, there are many remedies, especially in Ayurveda, through which diabetes mellitus type 1 can be kept under control. TYPES OF DIABETES: (1) TYPE 1 DIABETES MELLITUS (2) TYPE 2 DIABETES MELLITUS (3) GESTATIONAL DIABETES MELLITUS-GDM (4) OTHER TYPES (1) DIABETES MELLITUS TYPE 1 IN DETAIL: What is Diabetes Mellitus Type 1? Diabetes mellitus type 1 is insulin dependent diabetes mellitus. It is also known as IDDM for this reason. It is characterized by the absence of insulin, or its inefficacy in properly utilizing the glucose content in the human bloodstream. Due to this, the level of blood sugar rises, which is voided through the urination. This type of diabetes mellitus is commonly found in the younger generation. Even preadolescent are affected by it. Hence, diabetes mellitus type 1 is also known as juvenile diabetes. That said, diabetes mellitus type 1 is not restricted to adolescents only. It can even affect middle-aged people. Causes of Diabetes Mellitus Type 1 Diabetes mellitus type 1 is classified as an autoimmune disorder. An autoimmune disorder is one in which the body attacks itself. In case of diabetes mellitus type 1, the cells of the pancreas are attacked. The pancreas is responsible for the production of insulin, which controls the blood sugar level. The Onset of Diabetes Mellitus Type 1 Very little is known to medical science about how the diabetes mellitus type 1 sets in. It begins quite suddenly, and without any apparent stimulating factor. Once it sets in, it rapidly advances and shows complications. Diabetes mellitus type 1 is a largely fatal disease. It is indeed very difficult to diagnose diabetes mellitus type 1, since it affects the younger generation who are very ignorant about such a condition. For this reason, the disease is mostly brought into light only when it is too late. Diabetes mellitus type 1 can get seriously complicated and that too very fast. Recent research is providing evidence that the diabetes mellitus type 1 is caused due to an infection of the Coxsackie virus. Another indication is the consumption of cow’s milk in children. Some children have a resistance to cow’s milk, which could trigger the autoimmune system of the body to release antibodies. This could be a cause of the diabetes mellitus type 1, but it has not yet been studied enough. Why is Diabetes Mellitus Type 1 Different? There are many ways in which diabetes mellitus type 1 differs from the other forms of diabetes. Firstly, diabetes mellitus type 1 affects children and adolescents. The people who suffer from diabetes mellitus type 1 are not necessarily obese and do not have a hyperglycemic dietary pattern. In this manner, diabetes mellitus type 1 is not a dietary disease at all. It cannot be controlled by sticking to a particular dietary pattern. It is also found that diabetes mellitus type 1 does not have a genetic disposition. Unlike other forms of diabetes mellitus, a family member having diabetes mellitus type 1 does not affect the chances of the other members having it in any way. Diabetes mellitus type 1 does not depend on the lifestyle a person leads. It has equal chances of occurring in people who lead active as well as sedentary lifestyles. The Prevalence of Diabetes Mellitus Type 1 Diabetes mellitus type 1 is more prevalent in the European and the American continents. It is known to affect every 1 in 500 children below the age of 10 years and every 1 in 200 teenagers. On an average every 15 of 100,000 people suffer from diabetes mellitus type 1, i.e. it affects 3% of the total adolescent population of the world. Hence, diabetes mellitus type 1 has a very prolific growth rate, though it is not as widely known. Conventional Treatment Methods Diabetes mellitus type 1 is not curable as of today, but attempts are being made on several counts to control the disease. Insulin injections are the most popular way to cope with the disease. Another way to increase the insulin amount in the body is to regenerate the cells of the pancreas so that they are more able to produce insulin in the body. A very different approach is being developed in recent times, which is based on genetic engineering. The cells are being genetically engineered to remain resistant to autoimmune disorders or to secrete normal amounts of insulin. Perhaps the most drastic conventional method to treat diabetes mellitus type 1 is to replace the pancreas or to introduce an artificial pancreas into the body. None of these methods, though, are assured treatment methods for diabetes mellitus type 1. * Exposure to cow’s milk rather then material milk in infancy may lead to development of type 1 DM. It is because the albumin from cow’s milk may react with islet cells of pancreas, leading to their destruction. * Geography also plays an important role, as the incidences of Type 1 DM are mainly high in Finland and Sardinia (2) TYPE 2 DIABETES MELLITUS: This type of Diabetes is also known as Adult onset Diabetes. Non-insulin dependent Diabetes Mellitus (NIDDM), Maturity onset diabetes. It is more common and constituents 80-90% of all cases of diabetes. It usually occurs in adults over 40 years of age. But now a day few cases are observed in teen years also. Many people with Type 2 diabetes do not known they have it, although it is a serious condition. Generally, when the diagnosis is made, patient is asymptomatic. Routine urine or blood test shows the presence of high glucose levels in the blood or urine. The onset of symptoms in type 2 are slow and does not progresses rapidly. The main cause of Type 2 Diabetes mellitus is insufficient Insulin secretion by Beta Cells due to their destruction. Due to lack of insulin, there is raised blood sugar level and finally diabetes” type 2 diabetes mellitus also occur due to development of Insulin Resistance where the cells of the body mainly fat and muscle cells does not accept the insulin. The liver of such patients also produces glucose through a process called gluconeogenesis, which further worsens the controlling of glucose level. Type 2 diabetes is more prevalent because of faulty eating habit, increasing obesity end failure to exercise. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes. The chance to become 2 diabetes doubles for every 20% increase form normal body weight. Heredity and Genetic factors play a major role in development of Type-2 Diabetes. In Europe and North America about 80% of all diabetes have Type-2 Diabetes have Type 2 Diabetes mellitus. TYPE 2 IN DETAILS: Out of the different types of diabetes mellitus, the diabetes mellitus type 2 is the less dangerous one. It is also the more common type, constituting about 80 to 90% of the total diabetes cases in the world. Diabetes mellitus type 2 is easier to cure than the type 1 and another plus point is that diabetes mellitus type 2 patients respond much better to oral medication than diabetes mellitus type 1. What is Diabetes Mellitus Type 2 Diabetes mellitus type 2 is popularly known as non insulin-dependent diabetes or adult onset diabetes. This is a condition in which the blood is incapable to utilize glucose efficiently, due to which its amount builds up in the blood. The urine of the person contains a large amount of glucose, which is the characteristic symptom of diabetes mellitus. Unlike diabetes mellitus type 1, the type 2 develops quite gradually and is very difficult to diagnose in its earlier stages. It may or may not show the typical diabetic symptoms, which could quite easily be confused for some other ailment. Causes of Diabetes Mellitus Type 2 Diabetes mellitus type 2 is not an autoimmune disease like the type 1. In this type of diabetes mellitus, the body is not attacking itself. Diabetes mellitus type 2 is caused due to malfunctioning of the pancreas, which is incapable of producing the required volume of insulin. The pancreas does produce some insulin, but it is insufficient to meet the total requirements of the body in utilizing glucose. Another important cause of diabetes mellitus type 2 is not related to the pancreas at all. In some persons, the cells of the muscles and the tissues may become resistant to insulin, due to which they will not be able to assimilate glucose properly. In both of the above cases, the glucose remains in the blood and gives rise to diabetes mellitus type 2. Obesity is a prime precipitating factor for the disease. In people who are overweight, the sensitivity of the receptor cells to insulin decreases. This leads to glucose retention, and hence, diabetes mellitus type 2. The Onset of Diabetes Mellitus Type 2 Currently, the etiology, i.e. origin of diabetes mellitus type 2 is not known. It is not known how this form of diabetes takes root. Some factors are strongly indicated, such as genetic defects, resistance to drugs, trauma and surgery and other patho-physiological problems. But, scientists classify such diabetes mellitus cases as secondary diabetes mellitus and are yet unable to pinpoint a particular source of origin of diabetes mellitus type 2. Special Features of Diabetes Mellitus Type 2 There are some special features of diabetes mellitus type 2 which makes it a unique form of the disease. The following are the more obvious distinguishing features of the disease:* Diabetes mellitus type 2 is found in the adult population, especially those who have excess weight problems. * Diabetes mellitus type 2 is not due to a total absence of insulin; on the other hand, it occurs because the pancreas is not able to utilize the insulin. So, it is a functional disorder rather than a deficiency. * Since the pancreas is capable of producing insulin, it is easier to increase its concentration in the body. Consequently, diabetes mellitus type 2 is easier to treat and it responds well to oral medication. * Diabetes mellitus type 2 is a hereditary problem. If there is a close relative having the diseases, then the vulnerability is high. The vulnerability is higher with close relatives and risk decreases as the relations become more and more distant. The Prevalence of Diabetes Mellitus Type 2 Diabetes mellitus type 2 is the commonest form of diabetes affecting the human population. If a person above the age of 20 years develops diabetes mellitus, then there are 90 to 95% chances that it is a case of diabetes mellitus type 2. Non-insulin deficient diabetes is found to occur more in overweight people. Almost all patients of diabetes mellitus type 2 have problems of obesity. It is also found that diabetes mellitus type 2 is more common with people who have eating problems. People who eat at irregular times, eat unhygienic food or junk food, eat voraciously, etc. have much higher chances of getting this type of diabetes. This is very much compounded if the person is also leading a sedentary lifestyle. People who lead an active life will never become victims of diabetes mellitus type 2. Conventional Treatment Methods of Diabetes Mellitus Type 2 The treatment of diabetes mellitus type 2 includes the injections of insulin as well as the use of antibiotics. The first step is to chalk out a weight loss and a glucose-level monitoring program. A strict dietary regimen is developed which intends to bring down the glucose level at an optimal level and then to maintain it at that point. Weight loss is necessary to reduce obesity and to stimulate the cells of the muscles and tissues to utilize insulin in a better way. Antibiotics commonly prescribed for patients of diabetes mellitus type 2 are sulfonylureas, biguanides, thiazolidinediones, meglitinides and a-glucosidase inhibitors. Insulin therapy is used only if the antibiotics fail to show any results. But the most important aspect in the treatment of diabetes mellitus type 2 is to enrich the overall quality of the person’s life. Several changes in lifestyle are necessary, such as leading an active life, eating a healthy diet and keeping oneself free of mental stress. (3) GESTATIONAL DIABETES MELLITUS-GDM: Gestational Diabetes mellitus (GDM) is defined as any degree of glucose intolerance, with the onset of pregnancy. Women who develop Type –1 diabetes mellitus during pregnancy and women with undiagnosed a symptomatic type –2 diabetes mellitus that is discovered Gestational Diabetes Mellitus. Women with diabetes mellitus before pregnancy are said to have “Pregestational Diabetes”. Many women who have developed gestational diabetes may have controlled glucose level during the first half of the pregnancy and develop insulin deficiency during the latter half of the pregnancy, leading to hyper-glycaemia. Gestational Diabetes Mellitus is a complication in approximately 4% of all pregnancies in the United States. Mother with Gestational diabetes mellitus have increased rate of caesarian delivery and chronic hypertension “High blood Glucose levels in early pregnancy may deprive the embryo of oxygen and lead to Birth Defects, especially of the heart and spinal cord. Maintaining blood glucose control continues to be important throughout the pregnancy, but it is particularly important during the first eight weeks, when an embryo’s organs are farming. (4) OTHER TYPES DIABETES: Diabetes mellitus is a very commonly known disease. Almost everyone around is aware that this disease is caused due to the presence of excess glucose in the blood due to the incapability of the pancreas to produce insulin. The two most famously known types of diabetes mellitus are the diabetes mellitus type 1, which is also known as insulin-dependent diabetes, and the diabetes mellitus type 2, which is also known as non insulin-dependent diabetes. However, some more kinds of diabetes caused due to various other reasons. This article elucidates those lesser-known forms of diabetes mellitus. The list given below is actually a list of diabetes mellitus conditions that are caused in varying conditions of the body. Their symptoms and even treatment methods may be alike, but they differ in their causes. Gestational Diabetes Gestational diabetes is caused in women undergoing pregnancy. It is brought on by hormonal changes that occur in the bodies of women owing to prenatal conditions. Insulin secreted by the pancreas is also a hormone. An increase in the other hormones may cause a decrease in the production of insulin, which may lead to gestational diabetes. Gestational diabetes is mostly temporary and a self-treating type of diabetes mellitus. It occurs when the woman is in her second half of pregnancy, especially in the third trimester, and continues up to childbirth. Once the birth has taken place, the symptoms of gestational diabetes reduce, and the condition automatically gets cured. Almost all pregnant women are screened for conditions of gestational diabetes so that the condition can be detected early and precautions may be taken to prevent complications in both the woman as well as the baby. Attempts are made at controlling blood sugar level through medication and through diet. Gestational diabetes is not very common. It affects only about 2 to 5% of all pregnant women. Malnutrition Related Diabetes Mellitus This is a comparatively recently classified form of diabetes mellitus. It is a form of diabetes mellitus caused due to a severe malnutrition. It is rampant in underdeveloped and developing countries like South Asian and African countries. Several people from such countries are lacking in the requisite nutrition due to poverty or ignorance about food. Insulin is required to break down carbohydrates, especially glucose, from the food that we consume. But if the person is starving, then there is nothing that the insulin can act upon. In a way, the insulin produced by the body is ‘wasted’. The human body has a mechanism called as feedback control in which it understands what hormones are not being used, and it slowly declines their production. Due to the non-utilization of insulin, the body slowly reduces its production. As a result, malnutrition related diabetes mellitus sets in over time. Malnutrition related diabetes mellitus can be treated with injections of insulin. There is no complete cure, but with a proper diet and insulin supplementation, the situation can be controlled to a healthy limit. Diabetes Mellitus due to Hormonal Imbalances Hormonal changes are one of the prime causes of diabetes mellitus of any form. This is because insulin itself is a hormone, and an increase in any other hormone will directly reduce the quantity of production of insulin. Some hormones directly affect the amount of insulin in the blood. Examples of such insulin-retarding hormones are growth hormones, thyroid hormones, pancreatic hormone glucagons, etc. In the presence of interfering hormones, insulin’s functions are affected and diabetes mellitus sets in. However, the symptoms of diabetes mellitus related to hormonal imbalances are strictly personal and so the same techniques of treatment cannot be applied to each patient. Pancreas Related Diabetes Mellitus Pancreas is the root organ where diabetes mellitus originates. The insulin hormone required for the regulation of blood sugar levels is produced in the beta cells of the islets of Langerhans of the pancreas. Hence, any abnormality with the pancreas will tamper with the production of insulin, and hence, the proper utilization of sugar from the blood. The result will be diabetes mellitus. There are many problems with the pancreas causing diabetes mellitus. Pancreas related diabetes mellitus can be caused due to infections of the pancreas, tumors in or around the pancreatic region, obstructions due to any foreign entities between the pancreas and the other organs, removal of pancreas for some reason, etc. Pancreas related diabetes mellitus is not dependent on age. It is also not influenced by the ordinary diabetes mellitus triggering conditions such as diet, lifestyle, age, heredity, etc. Liver Related Diabetes Mellitus It has been found recently that liver complications can also lead to diabetes mellitus, quite akin to pancreas problems. The symptoms and treatment patterns of liver related and pancreas related diabetes mellitus run on similar lines. Diabetes Mellitus due to External Factors A type of diabetes mellitus can develop in people who are used to taking certain kinds of antibiotics. Toxins consumed, knowingly or unknowingly, can destroy the capacity of the pancreas in producing insulin. This results in the formation of diabetes mellitus. To diagnose GDM, a 50 gm glucose-screening test should be performed at 24-28 weeks of gestation known as Glucose Tolerance Test (GTT). By them, the placenta begins to make the hormones that lead to insulin resistance. The screening test measures the blood sugar response to glucose consumed in a drink. Untreated gestational diabetes can lead to problems for both the mother and the child. It can lead to Fat baby syndrome or Microsomatia, in which the baby’s body produces extra fat.