Diabetes is a silent killer!
It is at epidemic levels in the US because of an increase among older Americans, and the increase of obesity and sedentary lifestyles. Children are being diagnosed with type 2 diabetes at an alarming rate. About 2,200 people are diagnosed with diabetes each day. About one-third of people who have diabetes are NOT aware they have the disease.

Many people find out about their diabetes when they develop one of its life-threatening complications:

• Blindness. Diabetes is the leading cause of new cases of blindness in people between the ages of 20 and 74 years.
• Kidney disease. Diabetes is the leading cause of end-stage renal disease, accounting for about 40% of new cases.
• Nerve and amputations. Diabetes is the most frequent cause of non-traumatic lower limb amputations. About 60 to 70% of people with diabetes have mild to serve forms of diabetic nerve damage, which in severe forms, can lead to amputations.

Heart disease and stroke. People with diabetes are 2 to 4 times more likely to have heart disease, which is present in 75% of diabetes-related deaths. People with diabetes are 2 to 4 times more likely to suffer a stroke.

What is Blood Glucose?
When normal people eat food their bodies turn it into sugar (glucose). This glucose is normally used for fuel. A hormone that is made in the pancreas called insulin helps the glucose in blood get into the cells to be used as fuel. Elevated blood glucose means there is too much glucose in the blood. People who have diabetes or impaired fasting glucose have elevated blood glucose levels because of their inability to use insulin properly. This is often referred to as insulin resistance.

• Normal glucose = Less than 110 mg/dL
• Impaired fasting glucose = 110 to 125 mg/dL
• Diabetes = 126 mg/dL or higher

Impaired Fasting Glucose
Impaired fasting glucose is an intermediate stage between normal glucose and diabetes and is often called pre-diabetes. It is important to treat impaired fasting glucose to try to prevent its conversion into diabetes.

What problems can Impaired Fasting Glucose Cause?
Impaired fasting glucose is a risk factor for developing diabetes and cardiovascular disease. A low HDL cholesterol, elevated triglyceride, increased LDL cholesterol, and hypertension often are associated with impaired glucose, diabetes, and insulin resistance. Excess weight especially in the abdomen, a diet high in saturated fatty acids and excess calories, physical inactivity, aging, and genetic factors all contribute to cardiovascular disease.

Types of Diabetes
Type 1 diabetes (insulin-dependent) is when the body stops producing insulin. This form of diabetes usually develops in children or young adults. Type 2 diabetes is the most common form of the disease and accounts for about 90 to 95% of all cases.

In type 2 diabetes the body produces insulin but not enough to properly help glucose get into the cell. Elevated blood glucose develops slowly in type 2 diabetes and is often not detected in its early stages and can remain undiagnosed for many years. Most people with type 2 diabetes are obese which contributes to their inability to use insulin properly. People who are not obese and have type 2 diabetes may have an increased percentage of body fat distributed in the abdominal region.

Risk Factors for Type 2 Diabetes

• People who are overweight
• People who do not exercise regularly
• Age 45 years or older
• Family history of diabetes
• Obesity which is a body mass index of 27 and higher
• Certain racial and ethnic groups (for example African-Americans, Hispanic Americans, Native Americans, Asian-Americans, Pacific Islanders)
• Impaired fasting glucose or impaired glucose tolerance
• High blood pressure (higher than 140/90 mmHg in adults)
• HDL-cholesterol less than 35 mg/dL and/or triglycerides 250 mg/dL or higher
• History of gestational diabetes or delivery of babies over 9 lbs or more

Diet for Controlling Blood Glucose and Diabetes
Weight loss and regular aerobic activity will help people with impaired fasting glucose stop the progression to diabetes. Losing weight helps the body use insulin better. Sometimes losing 10 to 20 pounds is enough to help bring blood glucose levels down to normal again.

• Calories
  Achieving and maintaining your reasonable weight will help control blood glucose.
• Saturated fat
  Less than 10% of calories.
• Polyunsaturated fat
  No more than 10% of calories.
• Monounsaturated fats and carbohydrates
  60 to 70% of calories.
• Cholesterol
  No more than 300 mg daily.
• Dietary Fiber
  20 to 35 grams from both soluble and insoluble food sources.
• Sodium
  No more than 3,000 mg per day; less for people with high blood pressure.
• Alcohol
  For people who drink, no more than 2 drinks per day for men and no more than 1 drink per day for women.

Diabetes Care, Volume 23 Supplement 1. January 2000. S20-S23. www.diabetes.org

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