There has been a note of elevated levels of free fatty acids and hormones resistin and leptin and their action in increasing insulin resistance. They have also been noted in obesity patients. Whether these hormones and fatty acids have a role in diabetes or are just another part of obesity is still in research. Calpains, a type of protein have some effects in both insulin action and secretion; research is on whether diabetes is related in any way and whether calpains could render help to Type-2 Diabetics. A surge in growth hormones in overweight pubescent adolescents is also a cause of insulin resistivity. Research has also shown that irregular regulation of peptides amylin and CGRP causes alteration in blood flow, a major cause of insulin resistance. In 2001, researchers found elevated levels of IL-6 and CRP in Type-2 Diabetics. Both of these are markers for inflammation and damage due to immunological hyper-reaction; studies are still ongoing in understand the disease process of Type-2 Diabetes.

There is a Genetic side of this story which is just as complicated as obscure, with most data still in hypothesis and under research. To understand why this Monster can affect some of us more than others, it is important to know some basic facts like impairment of beta-cells and how it affects us. Some genetic suspects have also been identified.

MODY, or maturity-onset diabetes in youth is a rare genetic version of Type-2 Diabetes that develops in Caucasian teenagers and is unassociated with the obesity related variety. Research indicates that hereditary factors play a major role in Type-2 Diabetes in middle-aged Caucasians apart from the lifestyle factors.

Defective FABP2 genes may cause an unhealthy build up of fat molecules, particularly triglycerides which may lead us to links between obesity and insulin resistance in Type-2 Diabetes. Defective LpL also shows us similar possibilities in coronary disease and Type-2 Diabetes. Likewise, defective genes that monitor a molecule PPAR gamma can show us relations of high blood-pressure and Type-2 Diabetes.

Another study shows that defective genes that regulate the protective substance beta3-adrenegenic receptor in visceral fat cells in the abdomen cause high insulin resistance as well as obesity. Metabolism slowing down is a major symptom of this condition; as found in Pima Indians who have had a drastic increase in Diabetics in their population. Scientists call this the “Thrifty Gene”, once used as a survival tool in their nomadic lifestyle. When food was scarce with seasonal changes, the body made some hormonal adjustments to increase insulin resistivity and store fat. But with their nomadic, active lifestyle and scarcity gone, and with the availability of high carbohydrate and fatty foods easily; the gene once useful for surviving a famine or seasonal scarcity is adversely causing obesity and Type-2 Diabetes.

Neuropathies are Nervous system complications common to Type-2 Diabetics. There are two kinds of neuropathies; namely, Peripheral Neuropathy affecting the limbs, torso and other extremities and Autonomic Neuropathy affecting internal organs and organ systems. Neuropathies are painful are caused by major nerve damage to the affected area, simultaneously, weaknesses also develop in the traumatized area. Pain, numbness or tingling in an area indicates Peripheral Neuropathy, while Autonomic Neuropathy often takes a while in diagnosis.

The eyes of a Type-2 Diabetic often face a lot of damage in the long run. Diabetic Retinopathy is the most common eye complication faced by a Diabetic. Retinal blood vessels get blocked and cause hemorrhage in the eyes which eventually leads to blindness. The USA records an average of 16,000 cases of Diabetic Retinopathy related blindness a year. Other complications like Macular Edema which is related to Retinopathy and Glaucoma are similar fluid build-up and vision related complications. Cataract among Diabetics is twice more common than non-diabetics. However, early detection and control over blood-glucose levels have shown curability of eye-complications. Laser surgery and vitrectomy (replacing vitreous fluids of the eyes) are some common cures in dire conditions. Lifestyle regulation also works miraculously on Type-2 Diabetic eye complications.

Heart complications are often an additional package of damage this monster called Diabetes gives. Cardiovascular diseases like Atherosclerosis, Stroke, and Cardiovascular Neuropathy are common heart complications associated with Type-2 Diabetes. High blood pressure weakens the arteries while cholesterol and high blood-glucose (Hyperglycemia) cause extensive narrowing and clogging of arteries. Hypertension too is a risk often neglected by a Type-2 Diabetic.

Renal (Kidney) diseases are the most drastic and common complication of Type-2 Diabetes. With increased blood-pressure and hypertension put stress on nephrons (the body’s filters) in it’s form of Autonomic Neuropathy. Renal Failure is one of the most common causes that claim Diabetic lives. However, early detection by monitoring urine samples for abnormalities like BUN tests and albumin tests help to resolve kidney complications successfully. Renal complications can often lead to ESRD which ends in renal failure. Early diagnosis, lifestyle regulation and regular treatment help prevent the requirement for Dialysis or Kidney transplant for the Type-2 Diabetic in future.

There are various other complications that arrive with the Monster we are speaking of. Erectile Dysfunctions due to vascular complications and neuropathy are one such example. Edema in the mouth, thrush and visible skin problems like patches, blisters and itching are also Type-2 Diabetes related complications that develop. Major Musculoskeletal complications like Charcot Foot where deformity and extreme pain shows up; and circulatory complications like Carpal Tunnel Syndrome are effects of Peripheral Neuropathy very common to Type-2 Diabetics. There Complications are often interrelated, and come up from the same conditions like weakened nerves and high blood-pressure. The understanding of such common complications in depth is too vast a subject for the common person; but to be aware of possible appearance of such problems can help one prepare for this monster’s ruthless aftermath.

After these precautions and medications, the next step to Diabetic care is the long term effects and conditions prevention goals. Foot-care happens to be an important part of Diabetes treatment, as blood circulation to the feet is most adversely affected by Type-2 Diabetes. Cleaning and checking your feet regularly for sores and calluses, maintaining skin to prevent any infection is very important. Because irregular blood-glucose levels affect healing very adversely, it is very important to visit a podiatrist regularly and wearing comfortable shoes to prevent any chances of infection and trauma to the feet. Carelessness can often lead to amputation as weak blood flow and blood vessels are a part of the conditions of a Type-2 Diabetic.

Continuing care is a vital requirement for the fight against Type-2 Diabetes, for once in your system, the monster remains within you to strike at the slightest sign of carelessness. Careful blood-glucose monitoring is important, but just so important is the tri-monthly periodical tests. These tests should be done at the doctors’ or diabetes advisor’s every three months without fail:-
• Glycosylated hemoglobin (HbA1c) is a three-month average of what your blood-glucose has been. It measures glucose retained by red blood cells. A high HbA1c is an indicator of risk for future complications. The ADA recommends an HbA1c of less than 7% to avoid complications.
• Blood pressure check.
• Foot and skin examination.
• Ophthalmoscopy examination.
• Neurological examination.

Apart from these, there are also important annual tests that require close monitoring to prevent future complications and development of any emergency. These are:-
• Random microalbumin (urine test for protein).
• BUN and serum creatinine.
• Serum cholesterol, HDL, and triglycerides.
• ECG.
• Dilated retinal exam.

These are a few of the requirements and general notes to inform a Type-2 Diabetic. It is an attempt to brief you on fighting the villain called Type-2 Diabetes, this isn’t a medical excerpt. The precautions and advice your doctors and medical advisors give you are to be followed by the line.

The first risk group is people with a family history of Diabetes, especially of the first degree, i.e. parents and/or siblings who already have Type-2 Diabetes. Age is also an important factor as most middle-aged and aging people with irregular, careless lifestyles are at risk; but overweight adolescents and teenagers with inactive lifestyles and dietary callousness also tend to be in the risk zone. In both cases, whether of sedentary lives or overweight issues, family history often tends to be a major factor to developing Pre-Diabetes and later Type-2 Diabetes.

Race and Ethnicity also may cause high risk towards Type-2 Diabetes. Genetic factors in African Americans, Hispanics, Asians, Native Americans and Pacific Islanders have been identified to making these groups more risk prone. The ‘Thrifty Gene’, once a survival tool for nomadic and scarce lifestyles is now a major cause of Type-2 Diabetes and obesity because of lifestyle and dietary changes.

A history of Gestational Diabetes also leaves both mother and child or children in risk of developing Type-2 Diabetes later in life. Women carrying children over 9lbs are also majorly in the risk zone as well as the child due to hereditary factors. People born 5lbs or lower often tend to develop Type-2 Diabetes later in life.

Polycystic ovary syndrome (PCOS) is a hormonal disorder connected to abnormal ovulation and also with Type-2 Diabetes and obesity. Metabolic Syndrome, i.e. complications of various natures to do with metabolism is also closely related to Type-2 Diabetes and obesity. People who have any of these complications tend to fall into this risk group.

The common risk development factors for all these groups remain the same. Sedentary lives without sufficient calorie expenditure and physical activity, especially among the young group and middle-aged is a major cause of Type-2 Diabetes. Unhealthy diets as mentioned earlier also increase risk factors. But in our world of impersonal duties and rush of professional immediateness, when are we to note these factors aiding the Monster grow within us and our loved ones? We often fall prey not merely because we aren’t aware of the relative factors, but also because we feel too busy or ‘healthy enough’ to change before it’s too late. In the onslaught at it’s worse, this monster known as Type-2 Diabetes is a killer; a slow and steady killer who manifests into multiple complications before ending lives painfully. It is our duty to be wary and predictive because it has no cures and leads to a life-time of restrictions and medications. A stitch in time does indeed save nine, if not a few more.

Though two-thirds of Type-2 Diabetics have almost no identifiable symptoms, the most common happens to be an increase in urination. The body tries to reduce blood glucose levels by rapid and excessive urination. This leads to dehydration of the body as a lot of fluid is lost in the body’s natural response to high blood-glucose levels. Unusual thirst is the second identifiable symptom of Type-2 Diabetes which surfaces from the rapid dehydration of the body. Thus, high fluid intake is a must for the diabetic.

Since the glucose in the blood is going to waste, and glucose happens to be the basic fuel to the human body; undue tiredness and often lethargy is another common symptom of Type-2 Diabetes. Blood-glucose highs mean that the glucose isn’t used up but rather wasted in the human body. This leaves the body with an unusual tiredness and lack of energy.

Fall in weight in spite of a good food intake is another trait of a Type-2 diabetic. Food is not digested well; hence there is a waste of nutrients. The cells cannot perform well enough to synthesize other foods like proteins and fats and this leads to rapid weight loss. Contemporarily, a hike in appetite is also a noted symptom. With all the waste of essential nutrition, the body requirements aren’t satisfied. Appetite increases as the body demands more nutrition to cope with the lack of energy and nutrients. Feeling sick due to no apparent reason is often another closely associated symptom of this kind.

With a loss of nutrients, the body naturally feels weak and is susceptible to other diseases as there is a loss in immunological responses compared to a healthy body. Eye-sight failures and blurry visions are another easily detectable symptom of Type-2 Diabetes. Hypo-glycaemia or loss of glucose from the body system causes blurry vision, most common with diabetics and their weak glucose retention.

Yeast infections, thrush in the mouth and throat and genital irritation are also very common and predictable symptoms of Type-2 Diabetes. Increase of urination and low immunity causes these very uncomfortable symptoms. Often to be noted is also the collection of ants on the spot of urination due to high glucose levels in the urine. In fact, in India, people often urinate in open fields to detect high blood-glucose to see if ants are attracted to their urination spot!

There are these very minute symptoms in detecting the early signs of Type-2 Diabetes, but very often they tend to be rather vague to the layman. In aging patients, particularly, they go un-noted for long as “just age catching up” and natural. In younger adults, it is often given a blind eye in the melee of busy, crazy lives. There are various tests to diagnose Type-2 Diabetes; a medical practitioner will often test after suspecting Diabetes in a patient after seeing the said symptoms. Some common tests for Diabetes detection are:-

• Fasting blood glucose level – Diabetes is diagnosed if higher than 126 mg/dL on two occasions.
• Random (non-fasting) blood glucose level — diabetes is suspected if higher than 200 mg/dL and accompanied by the classic symptoms of increased thirst, urination, and fatigue. (This test must be confirmed with a fasting blood glucose test.)
• Oral glucose tolerance test — diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours.

The first simple step to prevention of Diabetes is weight regulation. Since overweight people and obesity patients often develop Type-2 Diabetes, watching one’s weight and maintaining a healthy BMI record is the first priority. The BMI chart can help you regulate your exercise routine to meet your needs according to calorie intake and body capabilities. Moderate activity like long walks and light exercise must be more frequent, but vigorous activity like weight-lifting is also good in controlled levels if the body can withstand the strain. It is also advisable to visit a professional fitness trainer to best suit you to your activity and exercise regime. It has often been seen that loss of even 10-20lbs can work wonders in keeping down blood-glucose and blood-pressure levels.

The very next preventive stand against the tyranny of this Monster is a Dietary reformation. The correct amounts of each food group are vital in maintaining health for a Type-2 Diabetic. In this process, a dietician is again very essential because often drug intake and multiple conditions can restrict the diet in many ways; this specialized diet must be regulated to individualistic requirements. Some common essential food-groups in Diabetic nutrition are whole grains, lean meat and plenty of fresh leafy vegetables. Low GI sugars are a must with minimum glucose intake.

With dietary reformation come dietary restrictions. Killer foods are usually sugary and fatty foods, mostly the fried fast foods with low dietary fiber, high saturated fats and high GI spikes. Avoiding alcohol and smoking are also essential for a Type-2 Diabetic. Avoiding soft drinks and processed red meat should also be a part of the agenda. In these attempts, one tries to gain the basic objectives:-

• Keeping a low blood-glucose level.
• Keeping control over blood-pressure.
• Maintaining a healthy body weight in accordance to the BMI charts.
• Maintaining low lipid profiles and a healthy cholesterol level.
• Making sure that the careful monitoring and maintenance of these objectives don’t fall behind.

Apart from dietary and activity changes to prevent the disease from affecting you, other precautions and regular check-ups are a must. Any diabetic must be extra careful of both specific and general health issues as immunological weakness is a part of the package of Type-2 Diabetes. Often, with multiple complications, careful restrictions of any drug intake to avoid drug interaction adversities and regular blood-work monitoring will be done by your medical advisor or doctor to avoid chances of emergencies.

A diabetic should be extra careful of strokes, heart-attacks and such macrovascular developments; often a low dose of aspirin is prescribed in necessary cases to maintain heart and vascular health. Blood-work should be accompanied with regular eye check-ups and renal checking to avoid eye and kidney problems common to Type-2 Diabetes. An angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) medicine is prescribed at the first sign of diabetic nephropathy, even if you do not have high blood pressure to prevent developing these conditions. Foot care is just as important because of frequent foot infections and complications in the healing process. These simple norms are a quick overview of how the Monster can be prevented from taking residence in a body; a few basic pointers on how to keep the dangers at bay. Self awareness and control over one’s own life is a must for surviving Type-2 diabetes healthily.

Once you know that you have the symptoms of diabetes and you ask you’re in diagnosing diabetes, you will be set for a random of test. The first one is a glucose test. Glucose test must be done to know the sugar present in your body.

Moreover, you also need to answer several questions to help the doctor in getting your medical record. You will be asked if what diabetes medical symptoms guide you are experiencing or if you have done glucose test in years past.

To validate the doubt that you have diabetes, you need to have two glucose tests. Diabetic people have sugar content in their body of 140 mg/dl while regular people only have 90 mg/ dl. After this test, you will be informed about your sugar level condition to determine if you are a diabetic.

The second test that will be conducted during the diabetic diagnostic test is the tolerance test of oral glucose. It is required that during this test, the person will not eat or drink for eleven hours prior to the exam.

There will sets of test. The first one, the doctor will draw blood sample from the patient and test it. After which, the patient required to drink water that contains a lot of sugar. The patient’s blood sample will be tested again after an hour to compare with the last one. For a series of 3 counts, the patient’s blood will be tested after an hour, 2 hours, and 3 hours.

A physician standard is that no person will be tested if he or she is smoking prior to the exam. This is done to ensure that the result of the test is reliable.

To get checked for high and low level of glucose in our body, we first need to understand and know the symptoms for both of these conditions. In the case of high glucose level in the blood the symptoms do not set in very early. This takes more time to detect this condition. Tiredness, thirst, blurred image are some of the symptoms. The urge to urinate frequently is seen. Vomiting is another sign along with feeling not nauseous. Falling sick is not unusual in such a condition.

High sugar in the blood is mainly caused due to high amounts of stress a person goes through. An infection is also a likely cause for it. Insufficient exercise, no taking diabetes medicine on time, and binge eating are some of the other causes of high level of glucose in the blood.

Low blood sugar symptoms vary from those of high blood sugar. You may feel hungry and confused if you suffer from this condition. Tiredness is one symptom common to both. An unusual symptom is that you start to feel sad for no apparent reason. IF the level of glucose drops by a huge margin then the patient may fall unconscious.

Drop in sugar levels in the blood is caused by excessive intake of insulin, indulging in heavy drinking, excessive exercising and skipping or delaying a meal. Taking medicines for some other condition might inadvertently cause the glucose levels in the blood to drop.

Living with high or low glucose level of blood is not a good practice. If you suffer from any of these conditions it is suggested you check with a doctor immediately. Your doctor is well equipped that can help them diagnosing diabetes and prescribe you the right medication and the proper diet plan that you need to follow to overcome either of the two conditions you may suffer from. Delaying will worsen the condition.

There are many natural remedies for Type-2 Diabetes, some scientifically proven effective and some utter quack! Careful selection of alternative medication is as absolutely necessary as understanding it’s functions.

The first magical herb for Type-2 Diabetics is Ginseng. Ginseng has many varieties according to where it is growing; but for Diabetes, the North American variety (Panax quinquefolius) is best effective. North American Ginseng acts in regulating blood-glucose levels by working on glycosylated hemogobin which are blood cells that monitor blood-glucose levels. In conducted studies, Ginseng dosages have considerably lowered blood-glucose levels, revitalized general and mental health and shown improvement on new non-insulin using Type-2 Diabetics. They have also shown consistent improvements in their HbA1C tests.

Chromium is a metal present in the human body in traces. It helps carbohydrate and fat metabolism and increasing insulin sensitivity. Also, Chromium deficiencies have been found in Type-2 Diabetics to indicate some relativity to it’s functions in patients. The information available however, isn’t conclusive. Sulfonylurea was used with a placebo against 1000 mcg of Chromium with good results relative to insulin sensitivity and body weight regulations. However, no conclusive result could be drawn on tests conducted on insulin users using a placebo and Chromium on body-mass-index, blood pressure or insulin sensitivity.

Magnesium is another mineral commonly present in leafy vegetables, nuts and whole grains that has shown efficacious positive results on Type-2 Diabetics. Since Magnesium is necessary for more than 300 biochemical reactions and muscle and nerve functions; it’s positive effects on a Diabetic are obvious. With regulated heart control, blood-pressure regulations and immunological effects, Magnesium dosages have shown consistent improvement in the blood-glucose control of test Diabetics with Type-2 Diabetes. Being naturally present in foods inclusive in a healthy diet, Magnesium is also a natural part of the plan of a Diabetic’s road to health and well-being without going through weight loss surgery.

Zinc is another metal that has convincing results on Type-2 Diabetics because it helps in storage of and retaining of insulin in the blood. Fresh oysters, chicken, ginger root, pecan, split peas, lima beans, walnuts, almonds and sardines are some important sources of Zinc.

Cinnamon is another very good natural remedy to use against Type-2 Diabetes. In tests, Cinnamon has shown statistically significant evidence of helping control fasting blood-glucose levels, triglycerides and total cholesterol. However, there was no noted change in lipid profiles or glycosylated hemoglobin. As a part of oral combination therapy, however, Cinnamon has a noted beneficial function.

Aloe Vera Gels, commonly used in curing cuts and for skin health has shown some effects in regulation of blood-glucose levels. Recent studies in Japan has shown how active phytosterol compounds in Aloe Vera Gels act on glycosylated hemoglobin levels. However, all the tests happen to be yet on animals; human testing is still to be conducted on this issue.

Natural Remedies, on the whole, can be used parallel to drugs and insulin for steady maintenance of mental and physical health of a Type-2 Diabetic. It may not be effective in a natural way to provide complete medical support or replace drugs with a natural remedy, but it can help considerably to reduce drug dependency when Natural remedies are resorted to when possible. Often, the harmful side-effects of the drug itself can be countered by such Natural Remedies.

There are five different groups of medication that are efficacious in different ways in helping Type-2 Diabetics. Doctors usually start with oral medication (pills) to begin with and only prescribe insulin shots if the patient is unreceptive to oral medication or if the conditions are severe.

Sulfonylureas have been in the market since the 1950s with first generation drugs like Chlorpropamide (Diabinese) still in the market today. Second generations include Glipizide (Glucotrol & Glucotrol XL), Glyburide (Micronase, Glynase, & Diabeta), and Glimepiride (Amaryl). These act as stimulants on the pancreatic beta-cells to increase insulin production and have similar effects of blood-glucose levels. Their usage is however different according to other drug interactions, side effects and dosage.

Meglitinides are the next drug group, but their nature of action and dosage is similar to Sulfonylureas. Meglitinides include Repaglinide (Prandin) and Nateglinide (Starlix). Sometimes, both these can cause hypoglycemia due to their action in reduction of blood-glucose. They are also known to cause adverse reactions to alcohol like nausea and vomiting.
Biguanides act in reduction of blood-glucose by reducing glucose formation in the liver. Metformin (Glucophage) is a biguanide that also helps in making muscle cells more receptive to insulin, hence glucose absorption. One noted side-effect is diarrhea, but the same can be stopped with food intake during medication.

Thiazolidinediones act on muscle tissue and fat to help insulin work better; they also work on the liver’s functions of glucose production. This requires regular monitoring as the liver’s health may be affected, hence blood tests are a must. Rosiglitazone (Avandia), Troglitazone (Rezulin), and Pioglitazone (ACTOS) are all common Thiazolidinediones.
Alpha-glucosidase inhibitors act on the food instead of the body. They block the break-up of carbohydrates and sugar-rich foods in the digestion process. They are taken with the first bite of food and show considerable fall in blood-glucose levels after meals. However, they can have some side effects of diarrhea and gas. Acarbose (Precose) and Meglitol (Glyset) are some Alpha-glucosidase inhibitors.

** Note: The names in the brackets beside a drug are brand-names they are available under.

With all these drugs, one has to note that pills can only help you if you aren’t a severe diabetic, or a long-term patient. Pills work on milder forms of the disease in effectively working in bringing down blood-glucose levels. Insulin is often the only answer for the less fateful. Again, Diabetes pills are often used in combinations of two or more types to maximize effects. They also often stop working after prolonged used, without any effect on the status of the disease itself; again, oral combination therapy is the answer. Since insulin is the most effective and sure way of bringing down blood-glucose levels, often pills are given in combination with it to help insulin be more efficacious. On a final note, drugs and medications mentioned here are not a prescription, but for general awareness to you. A doctor’s role in Diabetes is an irreplaceable must. No medication, treatment or injections should be done without a doctor’s consultancy.