Diabetes is a condition characterized by elevated blood glucose levels due to the body's inability to utilize glucose effectively, leading to serious health risks. There are different types of diabetes: Type 1 (less common, no insulin production) and Type 2 (more common, insulin resistance), with various risk factors and symptoms. Treatment involves lifestyle modifications, regular monitoring, and often medication to manage blood sugar levels, with an emphasis on preventing complications associated with uncontrolled diabetes.

1. DIABETES 101
YOUR COMPLETE GUIDE
YK Singh [Date] [Course title]

2. What is diabetes?
Diabetes is a disease where your blood glucose (sugar) levels are above normal.
It results from the inability of the glucose to get into your cells. As a result, your
cells are starving for their food (glucose). It would be like a starving person
surrounded by tables of wonderful food, but their mouth has been sewn closed
and they can't eat.
About 17 million Americans are believed to have diabetes and one-third of those
patients don't even know they have it. Diabetes can cause serious health
complications including heart disease, blindness, kidney failure, and lower-
extremity amputations. Diabetes is the 6th leading cause of death in the US. And
most diabetics develop heart disease. In fact, just having diabetes carries the
same risk of having a heart attack as someone who has already had such an
event. Therefore, it is very important for patients that have diabetes to also have
a physician that closely monitors and treats their cholesterol levels as well as
their blood pressure. Additionally, any use of tobacco products multiplies the
risks and should be stopped
Are there different kinds of diabetes?
Certainly. But the basic features of the disease are same. In any form of diabetes
there is some underlying reason why your body is not able to utilize glucose
(sugar) for energy, and that causes the levels of glucose (sugar) in your blood
build up above normal. There are three areas that are important for you to
understand in diabetes. First, the cells in your body which use the glucose are
important as they must be able to remove sugar from the blood and put it inside
the cell as a fuel. Secondly, the insulin which is made by your pancreas (an organ
near your stomach) is important to allow the sugar to enter the cell (the key to
unlock the door to enter), and lastly, glucose which is broken down from your
food or from muscle and liver from a storage form of glucose called glycogen.
Now if you think of the disease diabetes as involving a locking gas cap on your
car, it will be easier to understand.
If you understand how a locking gas cap works, then you can understand how
diabetes works. All of the cells in your body have a locking gas cap on them.
Insulin is the key to the locking gas cap, and glucose would be the fuel for the

3. car. In one form of diabetes, the body totally quits making insulin (keys) so you
can't get glucose (fuel) into your cells. In other forms of diabetes, your body
makes some insulin (keys) but not much as your body needs. Therefore, only a
few of the cells can be unlocked and opened to put the glucose (fuel) inside.
Another thing that happens is that some of the locks on the cells become rusty
and won't work properly. So even if you have insulin (keys) you can't get the cells
to open. This is called insulin resistance. If the cells won't open, you can't get
glucose (fuel) inside the cell for energy. The result of all of this is excess glucose
in your blood.
Types of Diabetes.
Type 1 diabetes is usually diagnosed in children and young adults and only
accounts for 5-10% of diabetes patients. In type 1 diabetes the pancreas doesn't
make any insulin (keys) at all.
Type 2 diabetes is the most common form of the disease. It accounts for 90-95%
of all the cases of diabetes. In type 2 diabetes, either your body doesn't make
enough insulin (keys), or the cells in your body ignore the insulin (the lock is rusty
and doesn't work) so they can't utilize glucose like they are supposed to. When
your cells ignore the insulin, as mentioned above, it is often referred to as insulin
resistance.
Other types of diabetes which only account for a small number of the cases of
diabetes include gestational diabetes, which is a type of diabetes that only
pregnant women get. If not treated, it can cause problems for mothers and
babies and usually disappears when the pregnancy is over. Other types of
diabetes resulting from specific genetic syndromes, surgery, drugs, malnutrition,
infections, and other illnesses may account for 1% to 2% of all cases of diabetes.
How do you get diabetes?
There are risk factors that increase your chance of developing diabetes. Risk
factors for type 2 diabetes include older age, obesity, family history of diabetes,
prior history of gestational diabetes, impaired glucose tolerance, physical
inactivity, and race/ethnicity. Risk factors are less well defined for type 1
diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental
factors are involved in developing this type of diabetes.

4. What are the symptoms of diabetes?
People who think they might have diabetes must visit a physician for a diagnosis.
They might have SOME or NONE of the following symptoms: frequent urination,
excessive thirst, unexplained weight loss, extreme hunger, sudden vision
changes, tingling or numbness in hands or feet, feeling very tired much of the
time, very dry skin, sores that are slow to heal, more infections than usual.
Nausea, vomiting, or stomach pains may accompany some of these symptoms
in the abrupt onset of type 1 diabetes.
Glucose is sugar! So, all I have to do is avoid sweets, right?
It is not that simple. The truth is, most food, and all of the carbohydrates you
eat, are broken down into its simplest structure, glucose. As food arrives in your
stomach, the acid starts to break the food down immediately. Proteins are
broken down for their amino acids, and carbohydrates for their glucose. Once
your gastrointestinal system breaks your food down into something your body
can utilize, the blood picks it up and carries it to your cells to for energy. In
healthy people, the blood picks up the glucose absorbed from the GI tract and
sends a signal to your pancreas (an organ near your stomach) to make and
release insulin. Remember, in Type 2 diabetes your body doesn't make enough
insulin (keys), or some of your cells ignoring the insulin that is there. (The locks
are rusty and won't work) In both situations, your cells don't get the glucose they
need for energy and they are starving while all the extra glucose is just floating
around in your blood and can't be used. The worst part is, when all that extra
glucose is floating around in your blood, it is causing damage to your blood
vessels and organs and that damage increase your risk of heart disease. That is
why it is very important to keep your blood glucose levels as close to normal as
possible. When the glucose levels get really high, the glucose starts to leak out
into your urine.
How do you treat diabetes?
There are several things you need to do to help control your diabetes. For type
1 diabetes, Healthy eating, physical activity, and insulin injections are the basic
therapies. The amount of insulin taken must be balanced with food intake and

5. daily activities. For patients with type 1 diabetes, blood glucose levels must be
closely monitored through frequent blood glucose testing.
For type 2 diabetes, healthy eating, physical activity, and blood glucose testing
are the basic therapies. In addition, many people with type 2 diabetes require
oral medication, insulin, or both to control their blood glucose levels. Some of
the oral medications work by stimulating your pancreas to make more insulin
(keys). Other oral medicines work to make the rusty locks start working again.
In a sense they are kind of like WD-40 for the rusty locks on the cells. It fixes the
lock on the cells so the insulin (keys) can open the cell to allow the glucose (fuel)
inside. Once the glucose (fuel) is allowed inside the cells, your blood sugar levels
will drop back down to normal.
What medicine am I going to have to take for my diabetes?
There are many different types of medications that your doctor may prescribe
for diabetes; however, these prescriptions can cause certain nutritional
deficiencies that may increase your risk for chronic degenerative diseases.
NutraMD Diabetes Essential Nutrients® supplement was designed to work with
your diabetic medications by replacing lost nutrients reducing the risk of
dangerous side effects, and promote better health
The main classes of diabetic medications include sulfonylureas, biguanides, and
thiazolidinediones.
Sulfonylureas include the following medications:
Orinase ,Tolinase, Diabinese, Glipizide, Glyburide, Amaryl, Prandin, Strarlix
The main function of sulfonylureas is to increase insulin production in the beta
cells of the pancreas. Sulfonylureas can interfere with the body's normal
metabolism of Coenzyme Q10. Because CoQ10 is necessary to make energy in
all tissues of the body, this effect may decrease your body's natural ability to
utilize or "burn up" sugars and may even reduce the ability of the pancreas to
produce insulin over time.

6. Biguanides include the following medications:
Glucophage (Metformin)
Glucovance (metformin + glyburide)
The main functions of biguanides are to lower the production of glucose by the
liver thereby reducing blood glucose levels. Your doctor may prescribe this type
of medicine in combination with sulfonylureas insulin, or a class of drugs known
as thiazolidinediones. Unfortunately, biguanides have been shown to deplete
vitamin B-12, folic acid and Coenzyme Q10 (CoQ10). A few of the problems
which may arise from deficiencies of folate and vitamin B-12 include the
following: Heart disease, stroke, anemia, arthritis, joint pain, muscle pain, and
neuropathies (nerve damage). Because diabetes increases your risk for heart
disease, stroke, and neuropathy, it is especially important to prevent nutritional
deficiencies which may add to these risk factors. Therefore, to reduce potential
side effects of nutrient deficiencies you should take NutraMD Diabetes Essential
Nutrients® supplement as long as you are on your diabetic medication.
Because both medication types listed above can deplete CoQ10, it is important
to understand some of the symptoms of a deficiency. CoQ10 deficiency has been
linked to the following diseases and symptoms: Congestive heart failure, high
blood pressure, rhabdomyolysis (muscle break down), muscle and joint pain,
and fatigue. Therefore, to achieve maximum benefit from the diabetes
medications and minimize potential side effects of nutrient deficiencies, you
should complement your prescription medication by taking NutraMD Diabetes
Essential Nutrients® supplement. By doing this, you will balance the risk/benefit
ratio further in your favor.
In summary, diabetic medications prescribed by your doctor are necessary to
treat your condition; however, you should also be aware that the long term
potential nutritional side effects may be just as big a risk factor for your health
as the disease you set out to treat in the first place. Put the odds in your favor
and maintain your health with NutraMD Diabetes Essential Nutrients®
supplement

7. How do I know I am keeping my blood sugar under control?
Frequent blood tests are used to monitor your blood sugar. Most patients with
diabetes should have a home blood monitoring kit. Some doctors ask their
patients to check their blood sugar as frequently at 6 times a day, though this is
an extreme. The more information you have about your blood sugar levels, the
easier it will be for you to control it. People with diabetes must take
responsibility for their day-to-day care and keep blood glucose levels from going
too low or too high.
When your blood sugar is too high, your doctor refers to it as hyperglycemia.
When your blood sugar is too high, you may not experience any symptoms, but
the high levels of glucose in your blood is causing damage to your blood vessels
and organs. That is why it is important to have your body utilize the sugar
properly and get it out of your bloodstream.
When your blood sugar is too low, your doctor refers to it as hypoglycemia.
Having low blood sugar can be very dangerous and patients taking medication
for diabetes should watch for symptoms of low blood sugar. It is also important
that your monitor your blood sugar regularly to avoid both low as well as high
blood sugar. It is important that you keep your blood sugar as close to normal
as possible at all times.
How does my doctor know if I am keeping my blood sugar under
control?
Some patients are may not follow the proper diet and exercise except for the
days leading up to a blood test in the doctor's office. They want to look like they
are doing a good job controlling their blood sugar. This way their fasting blood
glucose test results will be good for the doctor. But there is a test that will show
your doctor the real picture over the past 3 months or so. It is called the
hemoglobin A1C (HbA1C) test. Hemoglobin is the part of your blood, or red cells,
that carries oxygen to your cells. Glucose sticks to the hemoglobin in your red
cells of the blood as they emerge from the bone marrow where they are made.
The amount of sugar on the red cell is proportionate to the blood sugar level at
the moment the red cell goes into circulation and remains at that level for the
life of the red cell. So, if there has been a lot of extra glucose in your blood, there

8. will be a lot of glucose stuck all over your hemoglobin. Since the average lifespan
of the hemoglobin in your blood is 90-100 days, a HbA1C test shows a doctor
how well you have been controlling your blood sugar over the last 3 months.
This test is a check on the overall sugar control, not just the fasting blood sugar.
So, it is important to control your blood sugar at all times, and not just before
visiting the doctor. The most important reason to control your blood sugar is so
that you can live a longer, healthier life without complications that can be
caused by not controlling your diabetes.
What happens if I do not control my diabetes?
The complications of diabetes can be devastating. Both forms of diabetes
ultimately lead to high blood sugar levels, a condition called hyperglycemia. The
damage that hyperglycemia causes to your body is extensive and includes:
Damage to the retina from diabetes (diabetic retinopathy) is a leading
cause of blindness.
Diabetes predisposes people to high blood pressure and high cholesterol
and triglyceride levels. These independently and together with
hyperglycemia increase the risk of heart disease, kidney disease, and
other blood vessel complications.
Damage to the nerves in the autonomic nervous system can lead to
paralysis of the stomach (gastroparesis), chronic diarrhea, and an inability
to control heart rate and blood pressure with posture changes.
Damage to the kidneys from diabetes (diabetic nephropathy) is a leading
cause of kidney failure.
Damage to the nerves from diabetes (diabetic neuropathy) is a leading
cause of lack of normal sensation in the foot, which can lead to wounds
and ulcers, and all too frequently to foot and leg amputations.
Diabetes accelerates atherosclerosis or "hardening of the arteries", and
the formation of fatty plaques inside the arteries, which can lead to
blockages or a clot (thrombus), which can then lead to heart attack,
stroke, and decreased circulation in the arms and legs (peripheral vascular
disease).

9. Hypoglycemia, or low blood sugar, occurs from time to time in most people with
diabetes. It results from taking too much diabetes medication or insulin, missing
a meal, doing more exercise than usual, drinking too much alcohol, or taking
certain medications for other conditions. It is very important to recognize
hypoglycemia and be prepared to treat it at all times. Headache, feeling dizzy,
poor concentration, tremors of hands, and sweating are common symptoms of
hypoglycemia. You can faint or have a seizure if blood sugar level gets too low.
Diabetic ketoacidosis is a serious condition in which uncontrolled hyperglycemia
(usually due to complete lack of insulin or a relative deficiency of insulin) over
time creates a buildup in the blood of acidic waste products called ketones. High
levels of ketones can be very harmful. This typically happens to people with type
1 diabetes who do not have good blood glucose control. Diabetic ketoacidosis
can be precipitated by infection, stress, trauma, missing medications like insulin,
or medical emergencies like stroke and heart attack.
Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in
which the blood sugar level gets very high. The body tries to get rid of the excess
blood sugar by eliminating it in the urine. This increases the amount of urine
significantly and often leads to dehydration so severe that it can cause seizures,
coma, even death. This syndrome typically occurs in people with type 2 diabetes
who are not controlling their blood sugar levels or have become dehydrated or
have stress, injury, stroke, or medications like steroids.
My doctor says I have pre-diabetes. What is that?
Pre-diabetes is a common condition related to diabetes. In people with pre-
diabetes, the blood sugar level is higher than normal but not high enough to be
considered diabetes. Pre-diabetes increases your risk of getting type 2 diabetes
and of having heart disease or a stroke. Pre-diabetes can be reversed without
insulin or medication by losing a modest amount of weight and increasing your
physical activity. This can prevent, or at least delay, onset of type 2 diabetes.
When associated with certain other abnormalities, it is also called the metabolic
syndrome.
What are normal blood glucose levels? The amount of glucose (sugar) in your
blood changes throughout the day and night. Your levels will vary depending

10. upon when, what and how much you have eaten, and whether or not you have
exercised. The American Diabetes Association categories for normal blood sugar
levels are the following, based on how your glucose levels are tested:
A fasting blood glucose test: This test is performed after you have fasted (no
food or liquids other than water) for eight hours. A normal fasting blood glucose
level is less than 100 mg/dl. A diagnosis of diabetes is made if your blood glucose
reading is 126 mg/dl or higher. (In 1997, the American Diabetes Association
lowered the level at which diabetes is diagnosed to 126 mg/dl from 140 mg/dl.)
A "random" blood glucose test can be taken at any time. A normal blood glucose
range is in the low to mid 100s. A diagnosis of diabetes is made if your blood
glucose reading is 200 mg/dl or higher and you have symptoms of disease such
as fatigue, excessive urination, excessive thirst or unplanned weight loss.
Another test called the oral glucose tolerance test may be performed instead.
For this test, you will be asked, after fasting overnight, to drink a sugar-water
solution. Your blood glucose levels will then be tested over several hours. In a
person without diabetes, glucose levels rise and then fall quickly after drinking
the solution. In a person with diabetes, blood glucose levels rise higher than
normal and do not fall as quickly
A normal blood glucose reading two hours after drinking the solution is less than
140 mg/dl, and all readings between the start of the test until two hours after
the start are less than 200 mg/dl. Diabetes is diagnosed if your blood glucose
levels are 200 mg/dl or higher.
What else do I need to do if I have diabetes?
People with diabetes should see a health care provider who will monitor their
diabetes control and help them learn to manage their diabetes. In addition,
people with diabetes may see endocrinologists, who may specialize in diabetes
care; ophthalmologists for eye examinations; podiatrists for routine foot care;
and dietitians and diabetes educators who teach the skills needed for daily
diabetes management.
Diabetes, and its precursor, the metabolic syndrome, can lead to a multitude of
problems if not adequately controlled. These include vascular diseases that

11. result in heart attack and stroke, kidney damage leading to kidney failure,
damage to nerves (neuropathy), retinal damage leading to blindness, high blood
pressure, and various metabolic defects such as high triglycerides or high
cholesterol. It is therefore crucial to control the diabetes as well as all the other
risk factors for artery diseases that cause heart attack and stroke.
To do this, your doctor will insist on a good diet and regular exercise.
Medications are added to lower the blood sugar, and if these are inadequate,
insulin or other injectable medication will be required. The medications that
treat diabetes may cause depletion of folic acid, which in turn can cause a high
homocysteine, which is a risk factor for artery disease that underlies heart attack
and stroke.
Learn how to control and manage your diet to reduce the symptoms of diabetes
and maintain a healthy lifestyle to ensure the possible risks of developing this
illness. For more information visit https://bit.ly/37bPXQx