American Diabetes Association Complete Guide to Diabetes. American Diabetes Association

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СКАЧАТЬ our borders. In 2010, the International Diabetes Federation estimated that 285 million people worldwide have diabetes and more than 430 million people will have diabetes by 2030. Diabetes deaths are likely to double between 2005 and 2030, according to the World Health Organization (WHO). As you may expect, the United States has some of the highest rates of diabetes. But it’s still not at the top of the list.

      Five Countries with the Highest Rates of Diabetes in 2000

      • India

      • China

      • United States

      • Indonesia

      • Japan

      The WHO and other groups, such as the International Diabetes Federation, are working to raise awareness and help prevent and control diabetes worldwide. For example, the International Diabetes Federation’s Life for a Child Program helps supply children with diabetes with insulin and other equipment throughout the world. The Federation also supplies grants to fund research on diabetes prevention and treatment.

      World Diabetes Day

      The United Nations passed a Diabetes Resolution in 2006 declaring November 14th as World Diabetes Day and encouraging member states to develop policies to prevent and treat diabetes.

Early History of Diabetes

      As much as diabetes is widespread, it is also age old. Diabetes is one of the oldest known diseases in the world. In fact, people wrote down early descriptions of the disorder before they really understood what it was. References to diabetes can be found in some of the oldest surviving medical writings in the world.

      Early References to Diabetes

      • An early Egyptian medical text written around 1550 BCE describes a condition of “passing too much urine.”

      • The Greek physician Aretaeus, who lived in the second century CE, gave diabetes its name from a Greek word meaning “siphon” or “pass through.” Aretaeus observed that his patients’ bodies appeared to “melt down” into urine.

      • People observed early on that the urine from people with diabetes was very sweet. In fact, one way to diagnose diabetes was to pour urine near an anthill. If the ants were attracted to the urine, it meant that the urine contained sugar.

      • By the 18th century, physicians added the Latin term mellitus (honey-sweet) to diabetes, which describes its sugary taste.

      Up Next

      In the next few chapters, you’ll find out a lot more about the science of diabetes. We’ve come a long way from pouring urine on anthills! One of the most important scientific discoveries in diabetes was glucose. Chapter 2 gets down to the basics of glucose and its role in diabetes.

CHAPTER 2

      Glucose Facts

      • What Is Glucose?

      • How Glucose Works

      • Glucose Tests

      It sounds like a technical term, but glucose is just a fancy name for sugar. Your health care provider tested the glucose in your blood when he or she diagnosed you with diabetes. Perhaps it was the first time you heard the term. In any case, you’ll probably hear it a lot more.

      Glucose is probably the most important term you’ll need to understand for managing your diabetes. In this chapter, we’ll discuss what it is and how it affects your diabetes. We’ll also cover the tests that measure glucose in your blood.

What Is Glucose?

      Glucose is a simple sugar in your blood and your body’s main source of energy. It is called blood glucose or sometimes blood sugar. It comes primarily from carbohydrates in many of the foods that you eat, including sugary treats like cupcakes, starchy things like vegetables, and grains like breakfast cereal.

How Glucose Works

      The purpose of glucose is to provide energy. The key to providing energy is eating food. Yes, food!

      When people eat certain foods, their bodies break them down into simple sugars called glucose. Glucose goes into their bloodstream, where it travels to all of the cells in their body. Cells use this glucose for energy to do all the big and small jobs that keep the body humming. To operate at peak performance, your body needs to keep blood glucose levels within a normal range. If you have too little glucose, you run out of energy; too much, and the extra glucose will be stored and cause weight gain. In people with diabetes, excess glucose stays in the blood and may also damage different parts of the body, such as blood vessels and nerves.

      The optimal, “normal” range of blood glucose is measured using a plasma glucose test. A normal fasting glucose level is 70–99 milligrams per 1 deciliter of blood, which is abbreviated as 70–99 mg/dl. Fasting means that you haven’t eaten for at least eight hours before the test.

      But how does the human body regulate glucose levels? This feat requires a delicate balance of hormones and stored glucose.

      Pancreas

      The pancreas is an organ that does not get much attention—unless it stops doing its job. It is an important player in your digestive system, and it sits right behind your stomach.

      The pancreas secretes many hormones, including two very important hormones for regulating glucose: insulin and glucagon. These hormones are made by cells in the pancreas known as the islets of Langerhans. Within the islets of Langerhans, alpha cells produce glucagon and beta cells produce insulin.

      Islets of Langerhans

      The islets of Langerhans are named for the German physician Paul Langerhans, who first described them in 1869 while still a medical student. He presented a thesis that described these cells as looking different than other cells in the pancreas. However, Langerhans could not determine what these cells did.

      Insulin and Glucagon

      Insulin and glucagon are two important hormones that help keep your blood glucose on target. Insulin helps move glucose (energy) to your cells and glucagon helps raise blood glucose.

      Insulin is the “special key” to make sure glucose effectively gets to cells. Insulin also prevents the liver from making too much glucose when you are not eating. The pancreas needs to produce the right amount of insulin to move glucose from the bloodstream to cells. It releases insulin in response to rising blood glucose levels during snacks and meals. It also releases a small, steady stream of insulin throughout the day. This keeps your liver from making too much glucose between meals or overnight.

      Conversely, the pancreas produces glucagon to raise blood glucose levels СКАЧАТЬ