Diabetes and HGH Diabetes and HGH By R. Drysdale | Diabetes | Rating: The term diabetes HGH is as confusing as the available information on the connection between the two. Diabetes is, of course, a well known disease. Those who suffer from diabetes have high blood sugar levels, either because they cannot produce enough insulin, (a hormone that regulates cell uptake of glucose), or because their cells have become resistant to insulin's effects. Human growth hormone (HGH) is not the same hormone; however, it does play a role in the regulation of blood sugar. The effects of human growth hormone on blood sugar levels are complex and the long term risks of abnormal HGH levels in adults, with respect to diabetes, are not well understood. To unravel the facts about the relationship between diabetes HGH and insulin, it's important to understand some basic facts. HGH is produced by the pituitary while insulin is produced by the pancreas. Among other things, HGH acts on cells in the liver to stimulate the production of insulin-like growth factor-I (IGF-I) - don't let the name confuse you: this is not insulin. IGF-I, like HGH acts on a number of cells in the body.

High levels of IGF-I decrease the uptake of insulin by body cells and the metabolism of glucose in the liver. High levels of IGF-I also decrease production of HGH, which will in turn lead to decreased IGF-I. Logically, it would seem that a deficiency of human growth hormone should result in low blood sugar levels rather than high while, in diabetes HGH therapy should make things worse. As in many metabolic processes, it's just not that simple. Some sources report that hypoglycemia (low blood sugar) is a symptom of adult growth hormone deficiency, while others report that the onset of diabetes is a side effect of growth hormone therapy, even in those who have a deficiency (as opposed to people using HGH for anti aging purposes). Meanwhile, increased insulin sensitivity (increased uptake of glucose by cells) resulting in hypoglycemia is also seen in some people receiving growth hormone injections. In children, the onset of diabetes can be a side effect of HGH treatment. In most patients who have experienced the diabetes HGH treatment combination, but have not had diabetes in the past, discontinuing the hormone treatments has resulted in blood sugar levels returning to normal.

Critics point out that the use of growth hormone treatment for anti aging, when no conventional deficiency exists, has only been a practice in the last decade or so. There have not been any studies carried out over a sufficiently long period of time to determine whether there are permanent effects on blood sugar regulation. One thing seems clear: until we know more, people with established blood sugar abnormalities should probably stay away from human growth hormone therapy for anti aging. R. Drysdale You & Your Hormones | Endocrine conditions | Diabetes mellitus You & Your Hormones Email article to a friend | Last updated: February 19, 2015 Diabetes mellitus is a very common disorder caused by high levels of sugar in the bloodstream. It affects a large number of people, with many more people remaining undiagnosed. Type 1 diabetes: the pancreas (upper centre) cannot make insulin as the insulin-producing cells have been destroyed by the body's immune system. Therefore, sugar (white) cannot be stored as glycogen in muscle (lower left) and fat cells (lower right).

Alternative names for diabetes mellitus Diabetes; type 2 diabetes; type 1 diabetes; sugar diabetes; T2DM, T1DM; insulin -dependent diabetes mellitus; IDDM; juvenile-onset diabetes. What is diabetes mellitus? Diabetes mellitus is a condition in which the body does not produce enough of the hormone insulin, resulting in high levels of sugar in the bloodstream. There are many different types of diabetes; the most common are type 1 and type 2 diabetes which are covered in this article. Gestational diabetes occurs during the second half of pregnancy and is covered in a separate article. Diabetes mellitus is linked with an increased risk of heart attacks, strokes, poor blood circulation to the legs and damage to the eyes, feet and kidneys . Early diagnosis and strict control of blood sugar, blood pressure and cholesterol levels can help to prevent or delay these complications associated with diabetes. Maintaining a healthy lifestyle (regular exercise, not smoking and eating healthily) is important in reducing the risk of developing diabetes. What causes diabetes mellitus? Insulin is a hormone produced by the beta cells within the pancreas in response to the intake of food.

The role of insulin is to lower blood sugar (glucose) levels by allowing cells in the muscle, liver and fat to take up sugar from the bloodstream that has been absorbed from food and store it away as energy. In type 1 diabetes (or insulin-dependent diabetes mellitus), the insulin-producing cells are destroyed and the body is not able to produce insulin naturally. This means that sugar is not stored away but is constantly released from energy stores giving rise to high sugar levels in the blood. This in turn causes dehydration and thirst (because the high glucose ‘spills over’ into the urine and pulls water out of the body at the same time). To exacerbate the problem, because the body is not making insulin it ‘thinks’ that it is starving so does everything it can to release even more stores of energy into the bloodstream. So, if left untreated, patients become increasingly unwell, lose weight, and develop a condition called diabetic ketoacidosis, which is due to the excessive release of acidic energy stores and causes severe changes to how energy is used and stored in the body.

In ‘type 2 diabetes’ (accounting for 90% of all diabetes) the beta cells do not stop making insulin completely, but the insulin produced does not work properly so it struggles to store the sugar found in the blood. As a consequence, the pancreas has to produce more insulin to compensate for this reduction in insulin function. This is called insulin resistance and is commonly linked to obesity . This type of diabetes is seen more commonly over the age of 40 years but can occur at any age. What are the signs and symptoms of diabetes mellitus? There are a range of different symptoms in people with diabetes. They may feel thirsty, pass a large amount of urine, wake up overnight to pass urine, lose weight and have blurred vision. Patients are vulnerable to infections such as thrush and may present with this. Particularly in type 2 diabetes, patients may not be aware of their diabetes for several years and a diagnosis may only be made when they seek treatment for diabetes-related complications such as feet, eye or kidney problems. Some patients may become severely ill and be taken into hospital with an infection and/or very high blood sugar levels. How common is diabetes mellitus? Diabetes mellitus is a public health problem around the world.

As of 2010, it was estimated to affect 285 million (6.4%) of the worldwide population, with this number predicted to rise to 438 million (7.7% ) by 2030. There are a further 344 million people with pre-diabetes (at risk of developing diabetes). This number is projected to increase to 472 million by 2030. In the UK, there is estimated to be between 2 and 3 million people with diabetes. Type 2 diabetes accounts for more than 90% of all patients with diabetes. Is diabetes mellitus inherited? This depends on the type of diabetes. Type 2 diabetes, and to a lesser extent type 1 diabetes, may run in families. If a parent has diabetes, their children will not necessarily get it but they are at an increased risk. In type 2 diabetes, lifestyle factors such as being overweight (obesity) and lack of exercise can significantly increase your risk of developing diabetes. Some rarer types of diabetes mellitus may be inherited. How is diabetes mellitus diagnosed?

A urine sample is taken and tested for sugar; sugar is not normally found in urine but if blood sugar levels are high (as in diabetes), some can spill over through the kidneys and into the urine. If sugar is found in the urine, the diagnosis of diabetes can be confirmed by taking a blood sample after fasting. However, a normal fasting sugar test on its own does not exclude diabetes, as in the early stages of type 2 diabetes fasting sugar may still be normal. In this case, a specialised test called a glucose tolerance test may need to be carried out in which a patient is given a sugary drink with blood samples taken before and two hours after the drink. How is diabetes mellitus treated? The aim of treatment in diabetes is to Reduce circulating glucose to as normal a level as possible, Avoid the acute symptoms of diabetes such as thirst, and Avoid the long-term complications of diabetes such as eye, nerve and kidney damage. While glucose control is the prime aim of treatment, other factors such as blood pressure and blood cholesterol levels are also very important in the management of diabetes and the prevention of long-term health consequences. Type 1 diabetes is always treated with insulin, a life-saving treatment.

Patients will need to take medication several times a day for the rest of their lives. Patients will usually learn how to self-administer this. Insulin is usually given through injections under the skin. Patients normally require two to four injections a day. An increasing number of patients with type 1 diabetes are being treated with ‘insulin pumps’ which provide a continuous supply of insulin. Patients need to ensure that their blood glucose levels are kept as normal as possible so that delicate tissues in the body (especially blood vessels in the eyes, kidneys and peripheral nerves) are not chronically damaged by high glucose levels over a long period of time. To achieve this, patients need to measure their glucose regularly and learn how to adjust their insulin doses in order to optimise their glucose levels (diabetes control). Good diabetes control helps to minimise the risk of long-term diabetes complications, as well as short-term symptoms (such as thirst). Patients with type 2 diabetes can still make insulin, but not enough to control their glucose levels. Type 2 diabetes is therefore initially treated with a combination of lifestyle changes (diet and exercise) which reduce the need for insulin and therefore lower glucose levels.

If this is insufficient to achieve good glucose control, a range of tablets are available such as metformin, which, like diet and exercise, reduces insulin requirements, and sulphonylureas (eg gliclazide) which stimulate insulin secretion. If these measures are not effective, a range of new medications are available such as those raising the levels of incretins, natural hormones, which stimulate insulin production. In many patients, particularly after several years of treatment, insulin production is so low or so insufficient compared with the patient's needs that patients with type 2 diabetes have to be treated with insulin injections, either alone or in combination with tablets. Are there any side-effects to the treatment? Insulin treatment can cause weight gain and low blood sugar. In addition, there may be discomfort at the injection site. There are several types of tablets used to treat diabetes and they have different side-effects. The most common are diarrhoea, nausea, weight-gain and low blood sugar. Some patients may also experience some sexual dysfunction. However, not all patients will experience some or any of these side-effects and patients should discuss any concerns with their doctor. What are the longer-term implications of diabetes mellitus?

Having diabetes requires life-long treatment and follow-up by health professionals. Diabetes can be linked to damage of the eyes, kidneys and feet. It is also associated with increased risk of strokes, heart attacks and poor blood circulation to the legs. Medical care aims to minimise these risks by controlling diabetes, blood pressure and cholesterol and screening for possible complications caused by the diabetes. Maintaining a healthy lifestyle with regular exercise and a healthy diet helps with glucose control and managing diabetes in the long-term. With careful monitoring and appropriate treatment, diabetes patients can lead full and active lives. Women with diabetes who are planning to start a family should discuss this with their doctor as good glucose control is important both prior to conception and throughout pregnancy. Adult Growth Hormone Deficiency - Cedars-Sinai Adult Growth Hormone Deficiency Print Even after we stop growing, adults still need growth hormone. Growth hormone is a protein made by the pituitary gland and released into the blood. Growth hormone plays a role in healthy muscle, how our bodies collect fat (especially around the stomach area), the ratio of high density to low density lipoproteins in our cholesterol levels and bone density. In addition, growth hormone is needed for normal brain function.

Symptoms A person who has too little adult growth hormone will have symptoms that include: A higher level of body fat, especially around the waist Anxiety and depression Decreased sexual function and interest Fatigue Feelings of being isolated from other people Greater sensitivity to heat and cold Less muscle (lean body mass) Less strength, stamina and ability to exercise without taking a rest Reduced bone density and a tendency to have more bone fractures as they get older Changes in the make up of the blood cholesterol. People with adult growth hormone deficiency have higher than normal levels of low-density lipoproteins in comparison to their high density lipoproteins. They also tend to have higher triglyceride levels. (Triglycerides are another type of fat that circulates in the blood and contributes to blocked blood vessels.) Causes and Risk Factors A lack of growth hormone is usually caused by damage to the pituitary gland or the hypothalamus, a part of the brain that controls the pituitary gland. The damage may be due to a tumor; to surgery or radiation used to treat the tumor; or to problems with the blood supply to the pituitary gland. In some cases, the lack of growth hormone is due to an injury to the pituitary gland.

A lack of growth hormone can appear either in childhood or in adulthood. Diagnosis If a person has had surgery, an injury or a history of pituitary disorders, a doctor or endocrinologist (a specially trained physician who focuses on the health of hormone-secreting glands) will check for adult growth hormone deficiency. If there is a known disorder or problem with the pituitary gland, the doctor will probably order a magnetic resonance imaging (MRI) scan before any treatment is done. This allows the doctor to more accurately monitor how treatment is affecting the tumor. Growth hormone in adults is absorbed quickly by tissues from the blood as it circulates. As a result of this, a blood test given to a healthy persons will show low levels of growth hormone. Endocrinologists instead check the pituitary gland's response when it is stimulated to produce growth hormone. These growth hormone stimulation tests are done in an outpatient setting and take about two to three hours. You will be asked not to eat before the test. Treatments Once adult growth hormone deficiency has been confirmed, the doctor will prescribe daily doses of growth hormones. The hormone is injected into the patient's body; this can be done either by the patient or by a member of his or her family.

Every four to eight weeks, the patient will return to the doctor for monitoring and a blood test to help the doctor decided if more hormone is needed or less. If the person is getting too much growth hormone, he or she will have muscle or joint pain, swelling (fluid retention) and pain or numbness in the hands from carpal tunnel syndrome. If such symptoms appear, the doctor will lower the amount of growth hormone being given. If the deficiency of growth hormone is due to a pituitary tumor, the doctor will monitor the tumor with MRIs every year. Currently, it is not known whether the growth hormone will cause tumors that remain in the pituitary gland to grow. Finally, blood cholesterol and bone density will be monitored. With treatment of adult growth hormone deficiency, both of these measures should show signs of improvement. Growth hormone therapy should not be given to people who have active cancer or tumors. It also should not be given to people who are seriously ill as a result of complications from open heart or abdominal surgery, who have multiple injuries from a major accident or who are have breathing problems. Taking growth hormone will not cause an adult to begin growing again.

Taking growth hormone can affect the way the body uses insulin, so it is important for anyone who has diabetes to keep their doctors informed and to be vigilant about monitoring blood sugar levels. Growth Hormone Deficiency Symptoms Growth Hormone Deficiency Symptoms Symptoms of growth hormone deficiency can depend on your age. An adult with growth hormone deficiency can have different symptoms than a child with growth hormone deficiency. This article walks you through growth hormone deficiency symptoms in both children and adults. Growth Hormone Deficiency Symptoms in Children The most common symptom of growth hormone deficiency in children is that a child is significantly shorter than children his or her age. However, a child with this condition can have normal body proportions. Children with growth hormone deficiency typically grow less than 2 inches per year.

(Children with normal levels of growth hormone grow about 2 ½ inches a year from age 1 until they hit puberty—when they can grow up to 4 inches a year.) Here are some other growth hormone deficiency symptoms in children: Child's face may appear younger than children who are the same age Delayed puberty—but sometimes a child won't go through puberty Increased fat around the face and stomach Mild to moderate chubbiness Sluggish hair growth Growth Hormone Deficiency Symptoms in Adults Symptoms of growth hormone deficiency in adults can vary, and many adults who have this condition can experience a combination of the symptoms below. Anxiety and/or depression Decrease in sexual function and interest Decreased muscle mass and strength Difficult to concentration and lack of memory Dry, thin skin High levels of LDL (the "bad") cholesterol Insulin resistance Reduced bone density, making you more susceptible to developing osteoporosis Sensitivity to heat and cold Very low energy levels Weight gain, especially around the waist Understanding Growth Hormone Deficiency It's important to understand that not everyone with growth hormone deficiency will have the same symptoms. Some people will only have 1 or 2 symptoms, while others can have multiple symptoms.

Fortunately, certain tests and exams can help your doctor diagnose you with growth hormone deficiency. Find out what tests you need for your doctor to make an accurate growth hormone deficiency diagnosis . Talk to your doctor (or your child's doctor) right away if you or your child is experiencing any of the growth hormone deficiency symptoms listed above. Updated on: 12/05/14 Sources Adult growth hormone deficiency. Cedars-Sinai Medical Center Web site. Accessed May 13, 2011. Growth hormone deficiency. Health Guide. New York Times Web site. Published September 13, 2009. Accessed May 13, 2011. Growth hormone deficiency - children. MedlinePlus Web site. Update July 26, 2010. Accessed May 13, 2011. About Growth Hormone Deficiency Send me updates for the following endocrine topics to my inbox. Growth Hormone Deficiency Patient Guide to Treating High Cholesterol and Diabetes Diabetic hyperlipidemia sounds a bit intimidating, doesn’t it?

As we always do here on EndocrineWeb, we’re going to break down that concept for you, and that’s why we’ve put together this Patient Guide to Treating High Cholesterol and Diabetes. Patient Guide to Insulin The purpose of the Patient Guide to Insulin is to educate patients, parents, and caregivers about insulin treatment of diabetes. By reviewing this information, you’re taking an important step to learn about diabetes and how insulin controls the disease to help you live a healthier life. Patient Guide to Osteoporosis Prevention If you are like many people, you may think that osteoporosis—a condition marked by low bone mineral density, which leads to lowered bone strength and a heightened risk of fractures—is something you will not have to worry about until later in life. Patient Guide to Easy Diabetic Recipes Need some new ideas for what to eat? We've put together 5 delicious—and diabetes-friendly—recipes. Breakfast, lunch, dinner—even an afternoon snack and a yummy dessert. This Patients' Guide will help you eat well all day long with our easy diabetic recipes. Thyroid Cancer Guide A neck lump or nodule is the most common symptom of thyroid cancer.

You may feel a lump, notice one side of your neck appears to be different, or your doctor may find it during a routine examination. If the tumor is large, it may cause neck or facial pain, shortness of breath, difficulty swallowing, cough unrelated to a cold, hoarseness or voice change. Diabetes | University of Maryland Medical Center In some cases, symptoms may mimic type 1 diabetes and appear more abruptly, such as: Excessive urination and thirst Yeast infections Whole body itching Coma. In severe cases, high blood glucose may affect water distribution in brain cells, causing a state of deep unconsciousness, or coma. Causes Both type 1 and type 2 diabetes are caused by the absence, insufficient production, or lack of response by cells in the body to the hormone insulin. Insulin is a key regulator of the body's metabolism. After meals, food is digested in the stomach and intestines. Sugar (glucose) molecules are absorbed directly into the bloodstream, and blood glucose levels rise. Under normal circumstances, the rise in blood glucose levels signals specific cells in the pancreas, called beta cells, to secrete insulin into the bloodstream.

Insulin, in turn, enables glucose to enter cells in the body that may be burned for energy or stored for future use. In type 1 diabetes, the beta cells of the pancreas produce little or no insulin, the hormone that allows glucose to enter body cells. Once glucose enters a cell, it is used as fuel. Without adequate insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy despite high levels in the bloodstream, leading to increased hunger. In addition, the high levels of glucose in the blood cause the patient to urinate more, which leads to excessive thirst. Within 5 to 10 years after diagnosis, the insulin-producing beta cells of the pancreas are completely destroyed, and no more insulin is produced. The exact cause of type 1 diabetes is not known. Each year more than 13,000 young people are diagnosed with type 1 diabetes. New cases are less common among adults older than 20. Type 2 diabetes usually develops in older, overweight individuals who become resistant to the effects of insulin over time.

When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin but, for unknown reasons, the body cannot use the insulin effectively. This is called insulin resistance. This means that the insulin produced by your pancreas cannot connect with fat and muscle cells to let glucose inside and produce energy. This causes hyperglycemia (high blood glucose). To compensate, the pancreas produces more insulin. The cells sense this flood of insulin and become even more resistant, resulting in a vicious cycle of high glucose levels and often high insulin levels. Inflammation is also common among those with type 2 diabetes. Inflammatory markers (chemicals in the body that lead to inflammation), such as interleukin-6 (Il-6) and C-reactive protein, have been found to be increased in those with type 2 diabetes. Type 2 diabetes usually occurs gradually. Most people with type 2 diabetes are overweight at the time of diagnosis. However, the disease can also develop in lean people, especially the elderly.

Risk Factors Type 1 diabetes Family history of type 1 diabetes Mother who had pre-eclampsia (a condition characterized by a sharp increase in blood pressure during the third trimester of pregnancy) Family history of autoimmune diseases, including Hashimoto's thyroiditis, Graves disease, myasthenia gravis, Addison disease, or pernicious anemia Viral infections during infancy, including mumps, rubella, and coxsackie Child of an older mother Northern European or Mediterranean descent Lack of breastfeeding and consumption of cow's milk during infancy (although the theory is controversial and not widely accepted) Type 2 diabetes Family history of type 2 diabetes (one quarter to one third of all individuals with type 2 diabetes have a family history of the condition) Age older than 45 years Excess body fat, particularly around the waist Sedentary lifestyle and high-fat, high-calorie diet Abnormal levels of cholesterol or triglycerides in the blood High blood pressure History of gestational diabetes or polycystic ovarian syndrome (a hormonal disorder that causes women to have irregular or no menstruation) African American, Hispanic American, or Native American (particularly Pima tribe in Arizona) descent Low birth weight or a mother's malnutrition in pregnancy (this

 may cause metabolic disturbances in a fetus that lead to diabetes later in the child's life) Depression is associated with a 60% increased risk of type 2 diabetes Diagnosis According to the American Diabetes Association, all pregnant women should be screened for gestational diabetes during their third trimester.

People who are 45 years or older should have their blood glucose levels checked every 3 years. Those who have a high risk of developing diabetes (such as people with a family history of the disease) should be tested more often. Different types of tests are used to diagnose diabetes: Random plasma glucose level, fasting plasma glucose level, and oral glucose tolerance test. If the fasting glucose level is 100 to 125 mg/dL, the individual has a form of pre-diabetes called impaired fasting glucose (IFG), meaning that the individual is more likely to develop type 2 diabetes but does not have the condition yet. A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that the individual has diabetes. Other diagnostic tests for diabetes include fructosamine testing and hemoglobin A1c. The American Diabetes Association (ADA) recommends A1c as the best test to find out if an individual's blood sugar is under control over time. The test should be performed every 3 months for insulin-treated patients, during treatment changes, or when blood glucose is elevated. For stable patients on oral agents, health care professionals recommended testing A1c at least twice per year.

The ADA currently recommends an A1c goal of less than 7%. Studies have reported that there is a 10% decrease in relative risk of microvascular complications (injuries to the small blood vessels throughout the body), such as diabetic nephropathy (kidney disease) or diabetic neuropathy (nerve damage), for every 1% reduction in hemoglobin A1c. Many nutritionally-oriented physicians look for a much lower A1c as the goal for their patients. People with diabetes must closely monitor their blood sugar and see their doctor regularly. Self monitoring of blood glucose is done by checking the glucose content of a drop of blood. Regular testing tells you how well diet, medication, and exercise are working together to control your diabetes. Dieticians can also be an integral part of care. Preventive Care Type 1 diabetes There is no proven way to prevent type 1 diabetes. However, research conducted in Finland suggests that adequate amounts of vitamin D, particularly in the first year of life, may decrease one's chances of developing type 1 diabetes within the first 30 years of life.

In northern Finland (where the annual exposure to sunlight is very limited) researchers followed 10,000 infants for up to 30 years. Those given at least 2,000 IU of vitamin D per day (generally from cod liver oil) for the first year of life were significantly less likely to develop type 1 diabetes over 30 years than infants who were given less than that. Other studies have confirmed that doses of 2,000 IU or higher of vitamin D may have a strong protective effect against type 1 diabetes. For this reason, caretakers of infants and children at increased risk for type 1 diabetes might wish to consider supplementation. Experts suggest supplementing these individuals at the high end of current U.S. recommendations for vitamin D, which is 200 to 1,000 IU. Type 2 diabetes Considerable evidence from population based studies suggests that type 2 diabetes is highly preventable, particularly through exercise and weight management. Individuals who are physically inactive or overweight are much more likely to develop type 2 diabetes.

Similarly, people who move from a non-Westernized country to a Westernized country (such as the United States, where more people are overweight and live sedentary lives) increase their risk for type 2 diabetes. Studies suggest that you do not need vigorous physical activity to lower your risk of diabetes; moderate, regular exercise, such as walking for 30 minutes most days of the week, is enough. In general, lifestyle changes recommended to treat diabetes may help prevent the condition as well. Treatment Approach The goal of diabetes treatment is to achieve and maintain healthy blood glucose levels. A major study called the Diabetes Control and Complications Trial (DCCT) found that people with diabetes who kept their blood glucose levels close to normal reduced their risk of developing major complications from the condition.

People with diabetes can use the following therapies to help manage their blood glucose levels and to prevent complications: Lifestyle changes, such as a well-balanced diet and regular exercise Medications, particularly insulin for individuals with type 1 diabetes and some people with type 2 diabetes Supplements, including fiber and chromium Relaxation techniques Acupuncture for pain from nerve damage Bariatric surgery, for people who are overweight and obese to help manage blood glucose levels Lifestyle People with diabetes can improve significantly from lifestyle changes, particularly diet and exercise. People with type 2 diabetes may even eliminate the need for medications when they make appropriate lifestyle changes. Diet The ADA recommends that people with diabetes consume a healthy, low-fat diet, rich in grains, fruits, and vegetables. A healthy diet typically includes 10 to 20% of daily calories from protein, such as poultry, fish, dairy, and vegetable sources. People with diabetes who also have kidney disease should work with their health care providers to limit protein intake to 10% of daily calories. A low-fat diet typically includes 30% or less of daily calories from fat, less than 10% from saturated fats and up to 10% from polyunsaturated fats (such as fats from fish).

Carbohydrates tend to have the greatest effect on blood glucose. The balance between the amount of carbohydrate eaten and the available insulin determines how much the blood glucose level goes up after meals or snacks. To help control blood glucose, people should watch how many carbohydrate servings they eat each day. Foods that contain a high amount of carbohydrates include grains, pasta, and rice; breads, crackers, and cereals; starchy vegetables, including potatoes, corn, peas, and winter squash; legumes such as beans, peas, and lentils; fruits and fruit juices; milk and yogurt; and sweets and desserts. Non-starchy vegetables, such as spinach, kale, broccoli, salad greens, and green beans, are very low in carbohydrates. Carbohydrate counting can ensure that the right amount of carbohydrate is eaten at each meal and snack. A dietitian can help each person work out a dietary plan that is right for them. In addition, weight loss should be part of the plan for those with type 2 diabetes. Moderate weight loss (achieved by reducing calories by 250 to 500 per day and exercising regularly) controls not only blood sugars, but also blood pressure and cholesterol.

People with diabetes who eat healthy, well-balanced diets do not need to take extra vitamins or minerals to treat their condition. Exercise Exercise plays an important role in both the prevention and management of diabetes because it lowers blood sugar and helps insulin work more efficiently in the body. Exercise also enhances cardiovascular fitness by improving blood flow and increasing the heart's pumping power, promoting weight loss and lowering blood pressure. However, exercise has the most value when it's done regularly, at least 3 to 4 sessions per week for 30 to 60 minutes per session. As little as 20 minutes of walking, 3 times a week, has a proven beneficial effect. People with type 2 diabetes who exercise regularly have been shown to lose weight and gain better control over their blood pressure, thereby reducing their risk for cardiovascular disease (a major complication of diabetes). Studies have also shown that people with type 1 diabetes who exercise regularly reduce their need for insulin injections. Despite the benefits of exercise, many people have difficulty sticking with an exercise program for a long period of time. Health care providers can help develop suitable routines, as well as strategies that may improve adherence to such routines.

Anyone with long-standing diabetes should have a thorough screening before starting an exercise program and receive careful monitoring from a doctor. Medications Medications for diabetes must always be used in combination with lifestyle changes, particularly diet and exercise, to improve the symptoms of diabetes. Medications include insulin, oral sulfonylureas (like glimepiride, glyburide, and tolazamide), biguanides (Metformin), alpha-glucosidase inhibitors (such as acarbose), thiazolidinediones (such as rosiglitazone) and meglitinides (including repaglinide and nateglinide). A new agent in the fight against diabetes, exenatide (Byetta), is an injectable drug that reduces the level of sugar (glucose) in the blood. In clinical studies, patients treated with exenatide achieved lower blood glucose levels and lost weight. Exenatide was approved by the U.S. Food and Drug Administration in May 2005. Several other agents are under investigation including sodium-glucose co-transporter 2 inhibitors, G-protein-coupled receptor agonists, and the balanced dual perpexisome proliferator-activated receptor agents.

Nutrition and Dietary Supplements Considerable research has been conducted on the relationship between diabetes and specific nutrients and dietary supplements. Dietary supplements may increase the effects of blood sugar-lowering medications, including insulin. When considering the use of supplements or making dietary changes, be sure to discuss these changes with your health care provider to ensure safety and appropriateness. Supplements with Blood Sugar Lowering Effects Chromium. Found in a variety of foods and supplements, including liver, brewer's yeast, cheese, meats, fish, fruits, vegetables, and whole grains, chromium appears to enhance the body's sensitivity to insulin. Researchers believe that chromium helps insulin pull glucose from the bloodstream into the cells for energy. The benefit of chromium supplements for diabetes has been studied and debated for years. While some studies show no beneficial effects of chromium use for people with diabetes, other studies have shown that chromium supplements may reduce blood glucose levels in individuals with type 2 diabetes and reduce the need for insulin in those with type 1 diabetes. Most Americans get at least 50 mcg of chromium in their diets each day. The National Research Council estimates that intakes of 50 to 200 mcg per day are safe and effective.

Clinical studies showing improved blood sugar control for those with diabetes have used doses of chromium picolinate ranging from 200 to 1,000 mcg per day. However, until human studies of long-term safety are conducted with higher doses, it is best to use 200 mcg or less per day. Chromium may interact negatively with insulin and thyroid medicines. Speak with your doctor if you have a history of kidney or liver disease, or are being treated for a psychiatric disorder. Magnesium. Several clinical studies have demonstrated a strong association between low levels of magnesium in the blood and type 2 diabetes. However, researchers are still unclear about the cause and effect in that association. They are investigating whether low magnesium levels worsen blood sugar control in people with type 2 diabetes or whether diabetes causes magnesium deficiencies. Some experts believe that low magnesium levels worsen blood sugar control and that foods rich in magnesium (such as whole grains, green leafy vegetables, bananas, legumes, nuts, and seeds) or magnesium supplements may promote healthy blood glucose levels. At least one small study suggests that taking magnesium supplements may improve the action of insulin and decrease blood sugar levels, particularly in the elderly.

People with severe heart disease or kidney disease should not take magnesium supplements. People with diabetes should talk with their health care provider about whether it is safe and appropriate to take magnesium supplements. Magnesium can interact with some medications. Magnesium may lower blood pressure and cardiac output, and potentially interact with some cardiac medications. Excess magnesium can cause diarrhea. Fiber. Studies suggest that a high-fiber diet may help: Prevent development of type 2 diabetes Lower average glucose and insulin levels in people who already have type 2 diabetes Improve cholesterol and triglyceride levels in those with diabetes In a large-scale study of nurses in the United States, women who consumed the most whole grain foods in their diets were nearly 40% less likely to develop diabetes than women who consumed the least. People with irritable bowel syndrome, inflammatory bowel disease, or other digestive issues should speak with their doctor before adding fiber to their diet. Studies have also shown that cholesterol levels improved in people with type 2 diabetes after they took supplements of a soluble fiber known as psyllium (Plantago psyllium). Beta-glucan is a soluble fiber derived from the cell walls of algae, bacteria, fungi, yeast, and plants. It is commonly used for its cholesterol-lowering effects.

There are several human trials supporting the use of beta-glucan for glycemic (blood sugar) control. Vanadium. Vanadium is an essential trace mineral present in the soil and in many foods. It appears to mimic the action of insulin and, in a number of human studies, vanadyl sulfate (a form of vanadium) has increased insulin sensitivity in those with type 2 diabetes. Animal studies and some small human studies also suggest that vanadium may lower blood glucose to normal levels (reducing the need for insulin) in people with diabetes. One preliminary clinical study found that people with diabetes using insulin who were given vanadium were able to lower their dose of insulin. Vanadium may slow blood clotting, so people who take blood-thinning medication such as warfarin (Coumadin) and aspirin should check with their doctor before adding vanadium supplements to their regimen. People with a history of kidney issues should speak with their doctor before using vanadium supplements. Melatonin. Melatonin is a natural hormone secreted in the brain. Studies link low melatonin secretion with an increased risk of developing type 2 diabetes. Melatonin can cause sleepiness and potentially interact with some psychiatric medications and medications used to treat insomnia.

Antioxidants Antioxidants such as beta-carotene and vitamin C are scavengers of free radicals, unstable and potentially damaging molecules generated by normal chemical reactions in the body. Free radicals are unstable because they lack one electron. In an attempt to replace this missing electron, the free radical molecules react with neighboring molecules in a process called oxidation. Some studies suggest that people with diabetes have elevated levels of free radicals and lower levels of antioxidants. Preliminary clinical studies show that the following antioxidants may improve diabetes (by returning blood glucose levels to the normal range) and reduce the risk of associated complications: Vitamin E Quercetin Two additional substances that show preliminary evidence to possibly help control blood sugar include: Biotin (a B-complex vitamin). Possibly helpful for type 2 diabetes; brewer's yeast is a good source of biotin. Vitamin B6. Possibly helpful for both type 1 and type 2 diabetes. Supplements with Cardiovascular Effects Since insulin resistance is often associated with cardiovascular disease, people with diabetes may benefit from nutrients that help manage elevated blood lipid levels, high blood pressure, or heart failure.

Although the following supplements have been shown to improve cardiovascular health, there is some concern that they may raise blood glucose levels, and they may interact with certain medications. People with diabetes interested in trying the following supplements should first consult with their health care providers: Coenzyme Q10 (CoQ10) Niacin Omega-3 fatty acids Although clinical studies have not shown that either CoQ10 or omega-3 fatty acid supplements raise blood sugar levels, people with diabetes should discuss the safety and appropriateness of using these, or any supplements, with their health care provider or pharmacist, particularly if they are taking other medications. CoQ10 can potentially increase the clotting tendency of blood while omega-3 fatty acids can potentially decrease it. Niacin in certain amounts can potentially damage the liver. Work with your physician to find the types and amounts of supplements that are right for you. In addition, the following antioxidants have been shown to improve cholesterol levels in people with type 2 diabetes.

Work with your doctor to see if these are appropriate for you as they can potentially interact with other medications and may potentially worsen other medical conditions: Beta-carotene Vitamin C (1000 mg per day) Vitamin E (800 IU per day) Several clinical studies have also found that elevated manganese levels may help protect against LDL oxidation (a process that contributes to the development of plaque in the arteries). Herbs People have long used plant-based medicines in the treatment of diabetes. For instance, the plant extract guanidine, which lowers blood glucose, prompted the development and use of biguanides, a commonly used oral medication for diabetes. Other herbs may have a role in the management or prevention of diabetes. Always talk to your health care provider about any herbs you consider using. Some herbs may interact with medications and some may lower your blood sugar. When combined with blood sugar-lowering medications, some herbs can bring your blood sugar to a dangerously low level. Herbs that may have a role in the management or prevention of diabetes include: Bitter melon (Momordica charantia). Bitter melon has traditionally been used as a remedy for lowering blood glucose in patients with diabetes.

Preliminary clinical studies have indicated that bitter melon may decrease serum glucose levels. Bitter melon can be extremely dangerous to take when pregnant. Fenugreek seeds (Trigonella foenum graecum). Fenugreek seeds, a spice found in many curry preparations, are high in fiber and have been shown to regulate glucose and improve lipid levels in both animals and humans. In two small studies of people with either type 1 or type 2 diabetes, fenugreek seed powder lowered blood glucose and improved levels of blood cholesterol and triglycerides, among other beneficial effects. Fenugreek may interact with blood-thinning medications, such as warfarin (Coumadin). Gymnema (Gymnema sylvestre). Preliminary human research reports that gymnema may be beneficial in patients with type 1 or type 2 diabetes when it is added to diabetes drugs being taken by mouth or to insulin. Gymnema may alter the ability to detect sweet tastes. Cinnamon (Cinnamomum zeylanicum).

In a clinical study of 60 people with type 2 diabetes, intake of 1, 3, or 6 grams of cinnamon per day reduced glucose, triglyceride, LDL cholesterol, and total cholesterol levels. Other clinical studies have found similar results. As a result, experts claim that cinnamon may play an important role in regulating blood sugar in people with diabetes. American ginseng (Panax quinquefolium). Although both Asian (Panax ginseng) and American (Panax quinquefolium) ginseng appear to lower blood glucose levels, only American ginseng has been studied scientifically. Several clinical studies report a blood sugar-lowering effect of American ginseng (Panax quinquefolium) in individuals with type 2 diabetes, both on fasting blood glucose and on postprandial glucose levels. One clinical study found that people with type 2 diabetes who take American ginseng before or together with a glucose meal experience a reduction in glucose levels after they consume the meal. American ginseng may not be appropriate for people with autoimmune disease, and may interact with several medications, including blood-thinning medications, such as warfarin (Coumadin), among others.

People with a history of hormone-sensitive cancers should only use ginseng under the guidance of their physician. Acupuncture Some researchers speculate that acupuncture may trigger the release of natural painkillers and reduce the debilitating symptoms of a complication of diabetes known as neuropathy (nerve damage). In one clinical study of people with diabetes suffering from chronic, painful neuropathy, acupuncture reduced pain and improved sleep in 77% of the participants and eliminated the need for pain medications in 32% of the participants. Given these findings, acupuncture may be a reasonable option for people with diabetes who have neuropathy, and either find no symptom relief, or develop side effects from conventional drug treatment. Mind-Body Medicine Stressful life events can worsen diabetes in several ways. For example, stress stimulates the nervous and endocrine systems in ways that increase blood glucose levels and disrupt healthful behaviors (increasing the chances that an individual may consume excess calories and limit his or her physical activity, a pattern that leads to elevated blood glucose). It makes sense then to consider stress management as part of the treatment and prevention of diabetes.

Clinical studies have reported that people with diabetes who participate in biofeedback sessions (a technique that increases awareness and control of the body's response to stress) are more likely to reach target blood glucose levels than those who do not receive biofeedback. Although other studies have produced conflicting results, researchers and clinicians agree that long-term stress is likely to worsen diabetes and that biofeedback, tai chi, yoga, and other forms of relaxation may help motivate people with diabetes to change their habits to manage their condition. Other Considerations Pregnancy Women of child-bearing age who have diabetes should consult an endocrine specialist about the benefits of managing glucose levels before trying to conceive. About 4% of all pregnant women in the United States are diagnosed with gestational diabetes. Risk factors for developing diabetes while pregnant include: Modest weight gain prior to pregnancy (11 to 22 pounds or more) Family history of diabetes African American, Hispanic American, or Asian ancestry Age older than 50 at conception Normalizing glucose levels in women with gestational diabetes reduces their risk of complications, such as having an overweight baby, birth trauma, or the need for cesarean section.

If the mother's glucose levels are uncontrolled, an infant can be stillborn or suffer from complications, including defects of the brain or central nervous system, an abnormally large body or organs, heart or kidney abnormalities, asphyxia, respiratory distress, and heart failure. If dietary restrictions fail to improve glucose levels, a woman with gestational diabetes may need insulin. Women should not take oral diabetes medications during pregnancy. Women who develop gestational diabetes may experience the condition again in subsequent pregnancies. Gestational diabetes also increases the risk for developing type 2 diabetes later in life. Depressive symptoms are associated with an increased risk of diabetes. The association cannot be explained by the use of antidepressant drugs or being overweight. Depression is an important risk factor for diabetes. Prognosis and Complications People who maintain tight control over their blood glucose levels can prevent or delay the development of long-term complications from diabetes. Type 1 diabetes generally has more complications than type 2 diabetes.

Long-term complications of diabetes may include: Heart disease and stroke Vitamin D and Diabetes - Types, Effects, Deficiency & Health Benefits Vitamin D and Diabetes Tweet Vitamin D and Diabetes Vitamin D can be found in foods such as nuts, oily fish, eggs, powdered milk and some fortified cereals Vitamin D is a fat-soluble vitamin that plays a number of important roles in the body, including maintaining the health of your bones , teeth and joints , and assisting immune system function. This underrated vitamin is found in certain foods but is also produced by the body in response to exposure to the sun. When the sun’s ultraviolet-B (UVB) rays are exposed to bare skin, the body converts a cholesterol derivative into Vitamin D. In fact, it’s now known that every cell and tissue within the body has a Vitamin D protein receptor. However, most of us in the UK and other Western countries are deficient in Vitamin D, including many patients with Type 2 diabetes , due to limited sunlight exposure caused by a number of factors, including more time spent at home, in the office or the car, shorter days in winter, sunscreen use in summer and fears of skin cancer.

Vitamin D deficiency The signs of Vitamin D deficiency can range from bone pain and muscle weakness to depression and weakened immune system, while longer-term deficiency can result in obesity, high blood pressure , psoriasis , osteoporosis , chronic fatigue, Alzheimer’s disease , cancer and type 2 diabetes . Exposing your skin to the sun for 15-20 minutes each day can help increase your body’s own production of vitamin D and thus reduce your risk of diabetes and other serious medical conditions. Alternatively, you can get your daily intake of vitamin D through dietary supplements and foods such as nuts, oily fish, eggs, powdered milk and some fortified cereals. Effects on diabetes Vitamin D is believed to help improve the body’s sensitivity to insulin – the hormone responsible for regulating blood sugar levels – and thus reduce the risk of insulin resistance , which is often a precursor to type 2 diabetes. Some scientists also believe this vitamin may help regulate the production of insulin in the pancreas. Vitamin D levels should ideally be between 20-56 ng/ml (50-140 nmol/l)*, with anything below 20 ng/ml considered deficient.

However, it is now known that raising the amount of vitamin D in your body to around 60-80 ng/ml can help keep blood glucose levels under control, which is vital for people with diabetes. *Note; the correct level of vitamin D varies from person to person. The only way to be sure that your vitamin D levels are where they should be is to request a 25-hydroxyvitamin D, or 25(OH)D, blood test from your GP. Ideally your blood level of 25 OH D should be 60ng/ml. Other health benefits As well as assisting glycemic control, increasing your levels of vitamin D can also: Aid weight loss – studies have shown that good vitamin D status helps to reduce parathyroid hormone (PTH) levels, which in the long-term may promote weight loss and reduce risk of obesity, which is a major risk factor for type 2 diabetes. Regulate appetite – vitamin D can increase your body’s levels of the hormone leptin, which controls body fat storage and triggers the sensation of satiety, giving the feeling of having eaten enough and thus lowering hunger levels.

Reduce belly fat - an increase in vitamin D can help lower levels of cortisol, a stress hormone produced in the adrenal glands. Cortisol is involved in a number of important functions, including the body's response to stress and regulation of blood pressure. But higher and more prolonged levels of the hormone in the blood can lead to increased abdominal (or visceral ) fat, which is linked to various health conditions including diabetes type 2. Types of vitamin D Vitamin D question There are two forms of this vitamin; vitamin D2 and vitamin D3. Vitamin D2 is a synthetic version called ergocalciferol, which has a shorter shelf life, while vitamin D3 (also known as cholecalciferol) is the same as the vitamin D that is produced by the body following exposure to UVB rays. Studies have shown that vitamin D3 appears to be more than three times as effective as vitamin D2, but most products that include the words “good source of vitamin D” or “fortified with vitamin D” on their labels contain the hugely inferior vitamin D2. So when shopping for vitamin D-rich foods or supplements, make sure you check which ‘type’ of vitamin D each product contains. Where can I buy vitamin D supplements?

Single vitamin D supplements or vitamin drops containing vitamin D (for use by young children) are available at most UK pharmacies, supermarkets and health food retailers like Holland and Barrett. Most multivitamins provide a daily dosage of 400 International Units (IU), although some manufacturers have begun to offer products with 1,000, 2,000 and even 5,000 IU per day - considerably more than the UK recommendations of 400 units. *Note; before increasing your intake of vitamin D, consult with your doctor first to make sure the dose you intend to take is safe and won’t interact with your standard diabetes medication . Explore Vitamin D

Question: What hormone do diabetics suffer a deficiency of?
Answer: Insulin