Here is a name of a new parasite, actually not new, but one that is not tested, The CDC recognizes it as a Parasite that effects your digestive tracks and causes Unbelievable digestive pain, can’t eat, diarrhea, intestinal pain, extreme fatigue and other symptoms, Now here is what I found was interesting is humans can have this parasite and live with and have no symtoms but for others it can be awful. As you will read in the article you will learn about this parasite. If you have animals you are more likely to get it. It is transferred through the animals feces. This Parasite unfortunately is not tested unless you ask, because our Dr’s don’t learn about it, but in other countries it is a routine test with stomach issues, digestive issues.
Blastocystis is a genus of single-celled heterokont parasites belonging to a group of organisms known as the Stramenopiles (also called Heterokonts) that includes algae, diatoms, and water molds. Blastocystis consists of several species, living in the gastrointestinal tracts of species as diverse as humans, farm animals, birds, rodents, reptiles, amphibians, fish, and cockroaches. Blastocystis exhibits low host specificity, and many different species of Blastocystis can infect humans and by current convention, any of these species would be identified as Blastocystis hominis.
Blastocystis is one of the most common human parasites in the world and has a global distribution. It is the most common parasitic infection in the United States, where it infected approximately 23% of the total population during year 2000. In less developed areas, infection rates as high as 100% have been observed. High rates of infection are found in individuals in developed countries who work with animals. Although the role of Blastocystis hominis in human disease is often referred to as controversial, a systematic survey of research studies conducted by 11 infectious disease specialists from nine countries, found that over 95% of papers published in the 10 years prior identified it as causing illness in immunocompetent individuals. The paper attributed confusion over pathogenicity to the existence of asymptomatic carriers, a phenomenon the study noted is common to all gastrointestinal protozoa.
2 Signs and symptoms
6 Life cycle
7 Obtaining and culturing Blastocystis
8 See also
10 External links
The appropriate classification of Blastocystis has only recently been resolved. The original description of Blastocystis was as a yeast due to its yeast-like glistening appearance in fresh wet mounts and the absence of pseudopodia and locomotion. This was then contradicted by Zierdt, who reclassified it under subphylum Sporozoa (and later in Sarcodina), based on some distinctive protistan features of the Blastocystis cell, such as the presence of nuclei, smooth and rough endoplasmic reticulum, Golgi complex, and mitochondrion-like organelles. Its sensitivity to antiprotozoal drugs and its inability to grow on fungal media further indicated that it was a protozoan.
However, major revisions were made to its classification. An analysis of gene sequences was performed in 1996, which placed it into the group Stramenopiles. Other Stramenopiles include brown algae, mildew, diatoms, the organism that caused the Irish potato famine, and the organism responsible for Sudden oak death disease. However, the position of Blastocystis within the stramenopiles remains enigmatic.
Signs and symptoms
See also: Blastocystosis
Most published studies have reported that between 50% and 80% of individuals mono-infected with Blastocystis will show symptoms. Factors influencing presentation of symptoms have been listed as the patient’s age, with younger patients less likely to show symptoms, as well genetic changes that influence the production of cytokines. Some studies have suggested that pathogenicity may be linked to specific subtypes of Blastocystis and experimental infection of animals has reported varying degrees of illness depending on the subtype used. While some subtypes appear to be less likely to result in symptomatic infection, those subtypes are also found in symptomatic individuals who have no other infection found. Symptoms associated with the infection are diarrhea,constipation, nausea, abdominal cramps, bloating, excessive gas, and anal itching. Most cases of the infection appear to become diagnosed as irritable bowel syndrome, according to studies from Denmark, Pakistan, the United Kingdom, and Italy. The timescale of infection with the parasite can range from weeks to years. In the early 2000s, Egyptian physicians identified 84 patients with diarrhea and enteritis apparently caused by Blastocystis hominis. After three days of nitazoxanide treatment, symptoms cleared and no fecal organisms were detectable in 36 (86%) of 42 treated patients and in 16 (38%) of 42 people who received placebo (P < .0001). the investigators concluded that either B hominis is pathogenic and can often be effectively treated with nitazoxanide, or that nitazoxanide (a drug approved by the FDA for the treatment of giardia and cryptosporidia) eradicated an unidentifiable organism. Taxonomy For many years, scientists believed one species of Blastocystis infected humans, while different species of Blastocystis infected other animals. So they called Blastocystis from humans Blastocystis hominis and gave different species names to Blastocystis from other animals, for example Blastocystis ratti from rats. In recent years, various genetic analysis have shown that Blastocystis hominis as a unique entity does not exist, i.e. there is no single species of Blastocystis that infects humans. In fact, a number of distinct genetic types of Blastocystis can infect humans, including those previously called Blastocystis ratti and the differences are so great that they could be considered separate species. Because of this, in 2007 scientists proposed discontinuing the use of the term Blastocystis hominis. Their proposal was to refer to Blastocystis from humans and animals as Blastocystis sp. subtype nn where nn is a number assigned to each group according to the degree of genetic identity of the Blastocystis organisms, based on gene sequences, rather than the host that was infected. At that time nine subtypes were known to infect mammals and birds, all of which had been found in humans. A tenth group was reported in China in 2007, but a full analysis of its relationships has not yet been performed and it is not yet clear whether it is a group within a described subtype or a new subtype. A definite tenth subtype was then found in a variety of other mammals, including primates, but it has not as yet been found in humans. There are now at least 13 genetically distinct small subunit ribosomal RNA lineages. These additional subtypes were found in a variety of mammalian hosts (including elephants and giraffes) and it is very likely that more subtypes will be found as more hosts are surveyed. Epidemiology Blastocystis spp. prevalence in humans often exceeds 5% in industrialized countries. In the United States, it infected approximately 23% of the total population during year 2000. In less developed areas, infection rates with one or more subtypes are as high as 100%. Transmission Fecal-oral transmission is the most accepted pathway, and recent studies have shown that transmission involves only the cyst form of the parasite. The extent to which human-human, human-animal, and animal-human transmission occurs is still unknown. Genomic studies provide evidence for all three routes, though experimental studies have yet to provide conclusive proof for the existence of either. Reservoir Conclusively stating that Blastocystis has an animal reservoir depends upon unraveling the true nature of its transmission. If, as Noël et al. deem likely based upon their own molecular work and a review of the literature, animal-to-human transmission is possible, then animals such as pigs and dogs could in fact be acting as a large reservoir capable of human infection. Epidemiological studies finding that infection is more common in people living in proximity to farm animals or pets further supports this notion. Morphology Blastocystis has various morphological forms. Four commonly described forms are the vacuolar (otherwise known as central body), granular, amoeboid, and cyst forms. The appearance of the organism is largely dependent upon environmental conditions as it is extremely sensitive to oxygen. Whether all of these forms exist in the host intestine is unclear. Vacuolar form The vacuolar form is the typical cell form of Blastocystis seen in culture and is often used for the identification of the organism. These vacuolar forms vary greatly in size, with diameters ranging between 2 µm and 200 µm. The vacuolar form is otherwise known as central body form because it has a large central vacuole surrounded by a thin band of peripheral cytoplasm which contains other organelles. Flocculent material has been described as being scattered unevenly throughout the vacuole. The function of the vacuole is still unclear, however, it has been suggested that, like for many eukaryotic cells, it is for storage purposes. Other functions, such as cell division during reproduction and the deposition of apoptotic bodies, have been proposed, although more tests need to be done to validate these roles. Four common forms of Blastocystis hominis. Clockwise from top left: vacuolar, granular, amoeboid, and cyst forms. Granular form The granular form is somewhat morphologically similar to the vacuolar forms except that distinct granules are observed in the central vacuole and / or cytoplasm. Within the central vacuole, these granules appear in different forms too. Three types were suggested – metabolic, lipid, and reproductive granules. Metabolic granules play a role in chemical processes that are necessary for the maintenance of life in the organism. It was also put forward that reproductive granules were involved in the development of progeny cells. These hypotheses were made based on microscopy alone, which may be deemed misleading, hence more need to be done before making a definite conclusion. It has also been suggested that the granules may be an indication that the cell is dying. Amoeboid form The other form that exists is the amoeboid form. The amoeboid form of Blastocystis is non-motile and strongly adhesive. A research study has reported that amoeboid forms are produced only in cultures taken from symptomatic individuals, with asymptomatic individuals producing exclusively vacuolar forms. The study suggested this method could be used for diagnosing symptomatic infection. Additionally, it suggested the symptoms could be due to the accumulation of the strongly adhesive amoeboid forms on the host's intestinal wall. A detailed ultra-structural study of amoeboid forms was published in 2007. Cyst form The Blastocystis cyst form is a more recent discovery and has helped in the advancement of understanding the way the infection is transmitted. As compared to the other forms, it is generally smaller in size and has a thick multilayered cyst wall. It lacks a central vacuole and few nuclei, multiple vacuoles and food storage deposits were observed. The cyst form is the most resistant form of this parasite and is able to survive in harsh conditions because of its thick multilayered cyst wall. Experiments have been carried out to show its ability to withstand acidic gastric juices. Besides, the cysts did not lyse when placed in distilled water and could survive well at room temperature for up to 19 days, indicating its strong resistance. Life cycle The supposed life cycle begins with ingestion of the cyst form. After ingestion, the cyst develops into other forms which may in turn re-develop into cyst forms. Through human feces, the cyst forms enter the external environment and are transmitted to humans and other animals via the fecal–oral route, repeating the entire cycle. Life cycle of Blastocystis proposed by Tan Obtaining and culturing Blastocystis The ATCC maintains a collection of Blastocystis isolates. Some records show whether the isolates were obtained from symptomatic or asymptomatic carriers. As yet, no publication has identified the subtypes of most of the ATCC isolates, which are mostly axenic. Researchers have reported that patients with Irritable bowel syndrome may provide a reliable source for xenic Blastocystis isolates. Some researchers have reported being able to culture Blastocystis from 46% of IBS patients. Researchers have described different culture mechanisms for growing Blastocystis. Colony growth on solid medium colonies on solid culture medium using a synthetic medium with added supplements have both been described. However, most cultivation is performed in liquid media of various types.
Postural orthostatic tachycardia syndrome (POTS) is one of a group of disorders that have orthostatic intolerance (OI) as their primary symptom. OI describes a condition in which an excessively reduced volume of blood returns to the heart after an individual stands up from a lying down position. The primary symptom of OI is lightheadedness or fainting. In POTS, the lightheadedness or fainting is also accompanied by a rapid increase in heartbeat of more than 30 beats per minute, or a heart rate that exceeds 120 beats per minute, within 10 minutes of rising. The faintness or lightheadedness of POTS are relieved by lying down again. Anyone at any age can develop POTS, but the majority of individuals affected (between 75 and 80 percent) are women between the ages of 15 to 50 years of age. Some women report an increase in episodes of POTS right before their menstrual periods. POTS often begins after a pregnancy, major surgery, trauma, or a viral illness. It may make individuals unable to exercise because the activity brings on fainting spells or dizziness.
Doctors aren’t sure yet what causes the reduced return of blood to the heart that occurs in OI, or why the heart begins to beat so rapidly in POTS. Current thinking is that there are a number of mechanisms. Some individuals have peripheral denervation (neuropathic POTS); some have symptoms that are due to sustained or parosyxmal overactivity of the sympathetic nervous system (hyperadrenergic POTS); and many individuals with POTS have significant deconditioning.
Is there any treatment?
Therapies for POTS are targeted at relieving low blood volume or regulating circulatory problems that could be causing the disorder. No single treatment has been found to be effect for all. A number of drugs seem to be effective in the short term. Whether they help in long term is uncertain. Simple interventions such as adding extra salt to the diet and attention to adequate fluid intake are often effective. The drugs fludrocortisone (for those on a high salt diet) and midodrine in low doses are often used to increase blood volume and narrow blood vessels. Drinking 16 ounces of water (2 glassfuls) before getting up can also help raise blood pressure. Some individuals are helped by beta receptor blocking agents. There is some evidence that an exercise program can gradually improve orthostatic tolerance.
What is the prognosis?
POTS may follow a relapsing-remitting course, in which symptoms come and go, for years. In most cases (approximately 80 percent), an individual with POTS improves to some degree and becomes functional, although some residual symptoms are common.
What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other Institutes of the National Institutes of Health (NIH) conduct research related to POTS and support additional research through grants to major research institutions across the country. Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders such as POTS. NINDS-funded researchers are investigating if low levels of the hormone aldosterone contribute to low blood volume in individuals with POTS, and if high levels of angiotensin II, a peptide that helps regulate blood volume, leads to decreased adrenal sensitivity. Other NINDS-funded research is investigating the hypothesis that POTS is a syndrome of different subtypes, with different underlying mechanisms. Additionally, the NINDS funds the Autonomic Rare Diseases Consortium to further understand disorders such as orthostatic hypotension and hopefully alter the course of disease.
NIH Patient Recruitment for Postural Tachycardia Syndrome Clinical Trials
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NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
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Last Modified December 2, 2015
Power of Positivity: Positive Thinking & Attitude
7 Warning Signs Of Anxiety
People with anxiety can tell you how exhausting and frustrating their disorder can be, and the worst part is, finding a cure for it isn’t a one-size-fits-all approach. People respond differently to different treatments, and finding the one that works for you is just a matter of trial and error. Even if one attempts a full recovery, totally getting over anxiety may not happen for some people.
Despite all the research and information available about anxiety, scientists remain baffled as to the direct cause of anxiety. Because anxiety can creep up on anyone at any time, we thought we’d make a list of common symptoms to look out for so that you can prevent anxiety before it rears its ugly head.
Here are 7 warning signs of anxiety:
1. Muscle Pain
Anxiety affects the entire body, plain and simple. One such area of discomfort lies in the muscles, as stress can make muscles tighter and cramp easier. People with anxiety can experience almost constant muscle tension, and for those who have lived with the disorder for a while, they may not even notice it anymore. Regular exercise can help to keep this symptom under control, but those with anxiety may still experience muscle tension despite moving their body regularly.
Since anxiety causes the whole body to tighten up, the head is no exception to this. People with chronic anxiety report frequent headaches and migraines, as the tension causes a buildup of cortisol in the body. This stress hormone can cause you actual physical pain, as the body essentially prepares for a situation in which survival is at stake. Our bodies still have this fight-or-flight response, but in those with anxiety, it doesn’t seem to operate properly.
Anxiety can severely deplete the body’s energy stores, resulting in extreme fatigue and exhaustion. If you regularly feel tired despite a good night’s rest, you might have anxiety. Your body is using most of its energy on simply staying alive and avoiding a dangerous situation, so you have no energy left for anything else. Also, anxiety causes you to ruminate over things, which can leave the body and mind feeling depleted as well.
4. Craving Sugary or Starchy Foods
When we experience high levels of stress or anxiety, we want to reach for the first sugary or fattening treat we can find in order to stabilize our body. However, this is heightened even more in those with anxiety, as their bodies feel under constant attack from their disorder. If you find yourself using food to cope with your emotions often, you might have a hidden anxiety disorder. Keep note of when you start to crave these types of foods so you can better understand when and why you use these foods to cope with your feelings.
5. Digestive Issues
Chronic anxiety has been directly linked to poor digestion, including irritable bowel syndrome (IBS). When the brain is “not right,” the digestive system generally isn’t either. In fact, between 80 to 90 percent of the brain’s “calming” neurotransmitter, serotonin, is produced in the gastrointestinal tract. The result is two-fold: poor digestion and inefficient production of serotonin.
6. Fluctuating Moods
When our brain is inundated with anxious thoughts, we have very little patience for things that demand our attention. Note that is obviously counterproductive – it is far better to focus on things that are constructive than to allow anxiety to run amuck. However, for those with chronic anxiety, their default reaction is to “snap” or “lash out” when someone or something requires attention.
This is relatively obvious, but when the brain is rapidly firing it can be quite difficult to enter a state of relaxation. When relaxation is difficult, sleep is as well. It is common for someone with chronic anxiety to be “exhausted in body, but restless is mind;” in other words, they may be more than willing to enter a deep sleep but their brain simply won’t allow it.
Related article: 7 Ways To Turn Anxiety Into Positive Energy
(C) Power of Positivity, LLC. All rights reserved
Home Health These Light Bulbs Cause Anxiety, Migraines, And Even Cancer. If You Have…
These Light Bulbs Cause Anxiety, Migraines, And Even Cancer. If You Have Them, Do THIS Immediately !
January 14, 2016
Many of us in the effort to save energy and money, replaced our old standard light bulbs with environmentally-friendly with the new generation energy saving light bulbs. However, the new generation of energy efficient light bulbs are so toxic that the U.S. Environmental Protection Agency created an emergency protocol you need to follow in the event of a bulb breakage, due to the poison gas that is released. If broken indoors, these light bulbs release 20 times the maximum acceptable mercury concentration into the air, according to a study conducted by researchers from the Fraunhofer Wilhelm Klauditz Institute for German’s Federal Environment Agency.
do not use these light bulbs they make you sick
Energy Efficient Light Bulbs Can Cause:
Inability to concentrate
Energy Efficient Bulbs Cause Anxiety, Migraines, and Even Cancer. Reasons to Go Back To Incandescent Bulbs
1. Energy saving bulbs contain mercury. Murcury ia a potent neurotoxin that is especially dangerous to children and pregnant women. It is especially toxic to the brain, the nervous system, the liver and the kidneys. It can also damage the cardiovascular, immune and reproductive systems. It can lead lead to tremors, anxiety, insomnia, memory loss, headaches, cancer and Alzheimer’s .
2. Energy saving bulbs can cause cancer.
A new study performed by by Peter Braun at Berlin Germany’s Alab Laboratory found these light bulbs contain poisonous carcinogens that could cause cancer:
Phenol, a mildly acidic toxic white crystalline solid, obtained from coal tar and used in chemical manufacture (http://en.wikipedia.org/wiki/Phenol).
Naphthalene, a volatile white crystalline compound, produced by the distillation of coal tar, used in mothballs and as a raw material for chemical manufacture (http://en.wikipedia.org/wiki/Naphthalene).
Styrene, an unsaturated liquid hydrocarbon, obtained as a petroleum byproduct(http://en.wikipedia.org/wiki/Styrene).
3. Energy saving light bulbs emit a lot of UV rays.
Energy saving lamps emit UV-B and traces of UV-C radiation. It is generally recognised that UV-radiation is harmful for the skin (can lead to skin cancer) and the eyes. The radiation from these bulbs directly attacks the immune system, and furthermore damages the skin tissues enough to prevent the proper formation of vitamin D-3.
GE Lighting 48415 60-Watt 825-Lumen General Purpose A19 Incandescent Light Bulb, Soft White, 48-Pack
In conclusion, these bulbs are so toxic that we are not supposed to put them in the regular garbage. They are household hazardous waste. If you break one in a house, you are supposed to open all of your windows and doors, and evacuate the house for at least 15 minutes to minimize your exposure to the poisonous gas. Unfortunately, soon consumers won’t have the option to buy incandescent lights because they won’t be available. The Energy Independence and Security Act of 2007 (EISA) mandates the phase-out of incandescent light bulbs, and favors energy-efficient compact fluorescent light (CFL) bulbs.
As this year comes to a close, I would like to reflect on this past years events, feelings and New Years resolutions. To begin with the starting of the support group I hope has been such a gift to the members as much as to myself. The support group some days larger some days smaller groups but it seems even if it’s just a few, it was meant to be just the few of us. The biggest gift is the understanding that we all are experiencing different and some of the same symptoms, and we are all feeling alone in this disease. I have also had the gift of getting to know the other side from the spouses on what they go through, which has helped me in my own life. I have also learned the lack of communication between Doctors is our biggest hurdle and lack of public recognition of this disease with family, friends, co workers and the general public. Example: If I share I have a Vestibular dysfunction autoimmune disease, people will say “oh” and continue there own conversation, If I said I had a broken leg, MS or cancer, the response would be completely different. Not because people are rude but because people don’t understand or have never heard of this disease.
This year has been has been extremely difficult for me, My symptoms worsened, I am disabled and yet I am so grateful that I am still mobile and have my family to help me when needed. The biggest change in my health has been the visual changes on a regular basis and my drop attacks ( I fall with out any notification) There is no bracing yourself, or putting your arm up for protection, I just do it, end up where ever I fall, then instantly want to throw up. Then I feel so tired, like I can’t get up, function, takes me a day or so to recover, forget the bruising, knots on the head or sore body, it’s the cognitive and fatigue that is the hardest to recover from, almost feels like getting run over by a truck. But I feel I am still trying to learn my limits and if I push them I pay. But for me, the support group has become my safe place, my place I can be my self, say how I really feel and cry if I need to with out any judgement.
This next year my goal is to increase the group size even just a little, write letters to all the Doctors involved in our care explaining what patients with our illness go through and need from them. I would like to establish a newsletter to send to them on a regular basis, I would like to raise awareness about Vestibular dysfunction as much as a I can. I would also like to continue having some speakers for different aspects of our disease, we know there is no cure, but just to help us understand what’s happening to us. To provide support and education for us. I also want so desperately to make Doctors to understand the depression aspect of our disease.
On a personal level, I have to still adjust to the new me and hope I can accept this person and learn to love this person with out guilt of who I use to be, the guilt of not being able to participate in every function, or do more than I can or even contribute as much as I use to. This is the hardest hurdle for me. So I am looking forward to 2016. I am hoping trying so hard to be happy with me.
Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body’s important source of fuel.
With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn’t produce enough insulin to maintain a normal glucose level.
More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There’s no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren’t enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.
Type 2 diabetes symptoms often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for:
- Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual.
- Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger.
- Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine.
- Fatigue. If your cells are deprived of sugar, you may become tired and irritable.
- Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus.
- Slow-healing sores or frequent infections. Type 2 diabetes affects your ability to heal and resist infections.
- Areas of darkened skin. Some people with type 2 diabetes have patches of dark, velvety skin in the folds and creases of their bodies — usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance.
When to see a doctor
See your doctor if you notice any type 2 diabetes symptoms.
Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. Exactly why this happens is unknown, although genetics and environmental factors, such as excess weight and inactivity, seem to be contributing factors.
How insulin works
Insulin is a hormone that comes from the gland situated behind and below the stomach (pancreas).
- The pancreas secretes insulin into the bloodstream.
- The insulin circulates, enabling sugar to enter your cells.
- Insulin lowers the amount of sugar in your bloodstream.
- As your blood sugar level drops, so does the secretion of insulin from your pancreas.
The role of glucose
Glucose — a sugar — is a main source of energy for the cells that make up muscles and other tissues.
- Glucose comes from two major sources: food and your liver.
- Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
- Your liver stores and makes glucose.
- When your glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.
In type 2 diabetes, this process doesn’t work well. Instead of moving into your cells, sugar builds up in your bloodstream. As blood sugar levels increase, the insulin-producing beta cells in the pancreas produce more insulin, but eventually these cells become impaired and can’t make enough insulin to meet the body’s demands.
In the much less common type 1 diabetes, the immune system destroys the beta cells, leaving the body with little to no insulin.
Researchers don’t fully understand why some people develop type 2 diabetes and others don’t. It’s clear, however, that certain factors increase the risk, including:
- Weight. Being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue you have, the more resistant your cells become to insulin. However, you don’t have to be overweight to develop type 2 diabetes.
- Fat distribution. If your body stores fat primarily in your abdomen, your risk of type 2 diabetes is greater than if your body stores fat elsewhere, such as your hips and thighs.
- Inactivity. The less active you are, the greater your risk of type 2 diabetes. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.
- Family history. The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes.
- Race. Although it’s unclear why, people of certain races — including blacks, Hispanics, American Indians and Asian-Americans — are more likely to develop type 2 diabetes than whites are.
- Age. The risk of type 2 diabetes increases as you get older, especially after age 45. That’s probably because people tend to exercise less, lose muscle mass and gain weight as they age. But type 2 diabetes is also increasing dramatically among children, adolescents and younger adults.
- Prediabetes. Prediabetes is a condition in which your blood sugar level is higher than normal, but not high enough to be classified as diabetes. Left untreated, prediabetes can progress to type 2 diabetes.
- Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing type 2 diabetes increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you’re also at risk of type 2 diabetes.
- Polycystic ovary syndrome. For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
Type 2 diabetes can be easy to ignore, especially in the early stages when you’re feeling fine. But diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Controlling your blood sugar levels can help prevent these complications.
Although long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening. Some of the potential complications of diabetes include:
- Heart and blood vessel disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of arteries (atherosclerosis) and high blood pressure.
- Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar can eventually cause you to lose all sense of feeling in the affected limbs. Damage to the nerves that control digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue.
- Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which often eventually requires dialysis or a kidney transplant.
- Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
- Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation.
- Hearing impairment. Hearing problems are more common in people with diabetes.
- Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
- Alzheimer’s disease. Type 2 diabetes may increase the risk of Alzheimer’s disease. The poorer your blood sugar control, the greater the risk appears to be. The exact connection between these two conditions still remains unclear.
Your primary care doctor will probably diagnose your type 2 diabetes. He or she may continue to treat your diabetes or may refer you to a doctor who specializes in hormonal disorders (endocrinologist). Your health care team also may include:
- Certified diabetes educator
- Foot doctor (podiatrist)
- Doctor who specializes in eye care (ophthalmologist)
If your blood sugar levels are very high, your doctor may send you to the hospital for treatment.
Whenever you can, it’s a good idea to prepare for appointments with your health care team. Here’s some information to help you get ready for your appointment and know what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. You may need to refrain from eating or drinking anything but water for eight hours for a fasting glucose test or four hours for a pre-meal test. When you’re making an appointment, ask if you should fast.
- Write down any symptoms you’re experiencing, including any that may seem unrelated to your diabetes.
- Bring a notebook and a pen or pencil (or your laptop computer or tablet) to keep track of important information.
- Write down questions to ask your doctor.
Preparing a list of questions can help you make the most of your time with your doctor. For type 2 diabetes, some basic questions to ask include:
- How often do I need to monitor my blood sugar?
- What is my goal range?
- How can I use the information from glucose monitoring to better manage my diabetes?
- What changes do I need to make to my diet?
- How can I learn about counting carbohydrates in foods?
- Should I see a dietitian to help with meal planning?
- How much exercise should I get each day?
- Will I need to take medicine? If so, what kind and how much?
- Do I need to take the medicine at a particular time of the day?
- Do I need to take insulin?
- I have other medical problems. How can I best manage these conditions together?
- What are the signs and symptoms of low blood sugar?
- How do I treat low blood sugar?
- What are the signs and symptoms of high blood sugar?
- When should I test for ketones, and how do I do it?
- How often do I need to be monitored for diabetes complications? What specialists do I need to see?
- Are there resources available if I’m having trouble paying for diabetes supplies?
- Are there brochures or other printed material that I can take with me? What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- Do you understand your treatment plan and feel confident you can follow it?
- How are you coping with diabetes?
- Have you experienced any low blood sugar?
- What’s a typical day’s diet like?
- Are you exercising? If so, what type of exercise? How often?
- What challenges are you experiencing in managing your diabetes?
What you can do in the meantime
If your blood sugar is consistently out of your target range, or if you’re not sure what to do in a certain situation, contact your doctor or diabetes educator.
To diagnose type 2 diabetes, you’ll be given a:
- Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent.
If the A1C test isn’t available, or if you have certain conditions — such as if you’re pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes:
- Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst.
- Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
- Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours.
A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.
The American Diabetes Association recommends routine screening for type 2 diabetes beginning at age 45, especially if you’re overweight. If the results are normal, repeat the test every three years. If the results are borderline, ask your doctor when to come back for another test.
Screening is also recommended for people who are under 45 and overweight if there are other heart disease or diabetes risk factors present, such as a sedentary lifestyle, a family history of type 2 diabetes, a personal history of gestational diabetes or blood pressure above 140/90 millimeters of mercury (mm Hg).
If you’re diagnosed with diabetes, the doctor may do other tests to distinguish between type 1 and type 2 diabetes — since the two conditions often require different treatments.
After the diagnosis
A1C levels need to be checked between two and four times a year. Your target A1C goal may vary depending on your age and other factors. However, for most people, the American Diabetes Association recommends an A1C level below 7 percent. Ask your doctor what your A1C target is.
Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working. An elevated A1C level may signal the need for a change in your medication, meal plan or activity level.
In addition to the A1C test, the doctor will take blood and urine samples periodically to check your cholesterol levels, thyroid function, liver function and kidney function. The doctor will also assess your blood pressure. Regular eye and foot exams also are important.
Management of type 2 diabetes includes:
- Healthy eating
- Regular exercise
- Possibly, diabetes medication or insulin therapy
- Blood sugar monitoring
These steps will help keep your blood sugar level closer to normal, which can delay or prevent complications.
Contrary to popular perception, there’s no specific diabetes diet. However, it’s important to center your diet on these high-fiber, low-fat foods:
- Whole grains
You’ll also need to eat fewer animal products, refined carbohydrates and sweets.
Low glycemic index foods also may be helpful. The glycemic index is a measure of how quickly a food causes a rise in your blood sugar. Foods with a high glycemic index raise your blood sugar quickly. Low glycemic foods may help you achieve a more stable blood sugar. Foods with a low glycemic index typically are foods that are higher in fiber.
A registered dietitian can help you put together a meal plan that fits your health goals, food preferences and lifestyle. He or she can also teach you how to monitor your carbohydrate intake and let you know about how many carbohydrates you need to eat with your meals and snacks to keep your blood sugar levels more stable.
Everyone needs regular aerobic exercise, and people who have type 2 diabetes are no exception. Get your doctor’s OK before you start an exercise program. Then choose activities you enjoy, such as walking, swimming and biking. What’s most important is making physical activity part of your daily routine.
Aim for at least 30 minutes of aerobic exercise most days of the week. Stretching and strength training exercises are important, too. If you haven’t been active for a while, start slowly and build up gradually.
A combination of exercises — aerobic exercises, such as walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week — often helps control blood sugar more effectively than either type of exercise alone.
Remember that physical activity lowers blood sugar. Check your blood sugar level before any activity. You might need to eat a snack before exercising to help prevent low blood sugar if you take diabetes medications that lower your blood sugar.
Monitoring your blood sugar
Depending on your treatment plan, you may check and record your blood sugar level every now and then or, if you’re on insulin, multiple times a day. Ask your doctor how often he or she wants you to check your blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
Sometimes, blood sugar levels can be unpredictable. With help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to food, exercise, alcohol, illness and medication.
Diabetes medications and insulin therapy
Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways.
Examples of possible treatments for type 2 diabetes include:
- Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. It works by improving the sensitivity of your body tissues to insulin so that your body uses insulin more effectively.
Metformin also lowers glucose production in the liver. Metformin usually won’t lower blood sugar enough on its own. Your doctor will also recommend lifestyle changes, such as losing weight and becoming more active.
Nausea and diarrhea are possible side effects of metformin. These side effects usually go away as your body gets used to the medicine. If metformin and lifestyles changes aren’t enough to control your blood sugar level, other oral or injected medications can be added.
- Sulfonylureas. These medications help your body secrete more insulin. Examples of medications in this class include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible side effects include low blood sugar and weight gain.
- Meglitinides. These medications work like sulfonylureas by encouraging the body to secrete more insulin, but they’re faster acting, and they don’t stay active in the body for as long. They also have a risk of causing low blood sugar, but not as much risk as sulfonylureas do.
Weight gain is a possibility with this class of medications as well. Examples include repaglinide (Prandin) and nateglinide (Starlix).
- Thiazolidinediones. Like metformin, these medications make the body’s tissues more sensitive to insulin. This class of medications has been linked to weight gain and other more serious side effects, such as an increased risk of heart failure and fractures. Because of these risks, these medications generally aren’t a first-choice treatment.
Rosiglitazone (Avandia) and pioglitazone (Actos) are examples of thiazolidinediones.
- DPP-4 inhibitors. These medications help reduce blood sugar levels, but tend to have a modest effect. They don’t seem to cause weight gain. Examples of these medications are sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta).
- GLP-1 receptor agonists. These medications slow digestion and help lower blood sugar levels, though not as much as sulfonylureas. This class of medications isn’t recommended for use alone.
Exenatide (Byetta) and liraglutide (Victoza) are examples of GLP-1 receptor agonists. Possible side effects include nausea and an increased risk of pancreatitis.
- SGLT2 inhibitors. These are the newest diabetes drugs on the market. They work by preventing the kidneys from reabsorbing sugar in the blood. Instead, the sugar is excreted in the urine.
Examples include canagliflozin (Invokana) and dapagliflozin (Farxiga). Side effects may include yeast infections and urinary tract infections.
- Insulin therapy. Some people who have type 2 diabetes need insulin therapy as well. In the past, insulin therapy was used as last resort, but today it’s often prescribed sooner because of its benefits.
Because normal digestion interferes with insulin taken by mouth, insulin must be injected. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night. Often, people with type 2 diabetes start insulin use with one long-acting shot at night.
Insulin injections involve using a fine needle and syringe or an insulin pen injector — a device that looks similar to an ink pen, except the cartridge is filled with insulin.
There are many types of insulin, and they each work in a different way. Options include:
- Insulin glulisine (Apidra)
- Insulin lispro (Humalog)
- Insulin aspart (Novolog)
- Insulin glargine (Lantus)
- Insulin detemir (Levemir)
- Insulin isophane (Humulin N, Novolin N)
Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health.
In addition to diabetes medications, your doctor might prescribe low-dose aspirin therapy as well as blood pressure and cholesterol-lowering medications to help prevent heart and blood vessel disease.
If you have type 2 diabetes and your body mass index (BMI) is greater than 35, you may be a candidate for weight-loss surgery (bariatric surgery). Blood sugar levels return to normal in 55 to 95 percent of people with diabetes, depending on the procedure performed. Surgeries that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss surgeries.
Drawbacks to the surgery include cost, and there are risks involved, including a risk of death. Additionally, drastic lifestyle changes are required and long-term complications may include nutritional deficiencies and osteoporosis.
Women with type 2 diabetes may need to alter their treatment during pregnancy. Many women use insulin therapy during pregnancy. Cholesterol-lowering medications and some blood pressure drugs can’t be used during pregnancy.
If you have signs of diabetic retinopathy, it may worsen during pregnancy. Visit your ophthalmologist during the first trimester of your pregnancy and at one year postpartum.
Signs of trouble
Because so many factors can affect your blood sugar, problems sometimes arise that require immediate care, such as:
- High blood sugar (hyperglycemia). Your blood sugar level can rise for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication. Check your blood sugar level often, and watch for signs and symptoms of high blood sugar — frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea. If you have hyperglycemia, you’ll need to adjust your meal plan, medications or both.
- Hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Signs and symptoms of this life-threatening condition include a blood sugar reading higher than 600 mg/dL (33.3 mmol/L), dry mouth, extreme thirst, fever greater than 101 F (38 C), drowsiness, confusion, vision loss, hallucinations and dark urine. Your blood sugar monitor may not be able to give you an exact reading at such high levels and may instead just read “high.”
HHNS is caused by sky-high blood sugar that turns blood thick and syrupy. It tends to be more common in older people with type 2 diabetes, and it’s often preceded by an illness or infection. HHNS usually develops over days or weeks. Call your doctor or seek immediate medical care if you have signs or symptoms of this condition.
- Increased ketones in your urine (diabetic ketoacidosis). If your cells are starved for energy, your body may begin to break down fat. This produces toxic acids known as ketones.
Watch for loss of appetite, weakness, vomiting, fever, stomach pain and fruity-smelling breath. You can check your urine for excess ketones with an over-the-counter ketones test kit. If you have excess ketones in your urine, consult your doctor right away or seek emergency care. This condition is more common in people with type 1 diabetes but can sometimes occur in people with type 2 diabetes.
- Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it’s known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you’re taking insulin.
Check your blood sugar level regularly, and watch for signs and symptoms of low blood sugar — sweating, shakiness, weakness, hunger, dizziness, headache, blurred vision, heart palpitations, slurred speech, drowsiness, confusion and seizures.
If you develop hypoglycemia during the night, you might wake with sweat-soaked pajamas or a headache. Due to a natural rebound effect, nighttime hypoglycemia might cause an unusually high blood sugar reading first thing in the morning.
If you have signs or symptoms of low blood sugar, drink or eat something that will quickly raise your blood sugar level — fruit juice, glucose tablets, hard candy, regular (not diet) soda or another source of sugar. Retest in 15 minutes to be sure your blood glucose levels are normal.
If they’re not, treat again and retest in another 15 minutes. If you lose consciousness, a family member or close contact may need to give you an emergency injection of a hormone that stimulates the release of sugar into the blood (glucagon).
Careful management of type 2 diabetes can reduce your risk of serious — even life-threatening — complications. Consider these tips:
- Commit to managing your diabetes. Learn all you can about type 2 diabetes. Make healthy eating and physical activity part of your daily routine. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it.
- Identify yourself. Wear a tag or bracelet that says you have diabetes.
- Schedule a yearly physical exam and regular eye exams. Your regular diabetes checkups aren’t meant to replace regular physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications, as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.
- Keep your immunizations up to date. High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor will likely recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) also recommends hepatitis B vaccination if you haven’t previously been vaccinated against hepatitis B and you’re an adult age 19 to 59 with type 1 or type 2 diabetes. The CDC advises vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes and haven’t previously received the vaccine, talk to your doctor about whether it’s right for you.
- Take care of your teeth. Diabetes may leave you prone to more-serious gum infections. Brush your teeth at least twice a day, floss your teeth once a day, and schedule regular dental exams. Consult your dentist right away if your gums bleed or look red or swollen.
- Pay attention to your feet. Wash your feet daily in lukewarm water. Dry them gently, especially between the toes, and moisturize with lotion. Check your feet every day for blisters, cuts, sores, redness and swelling. Consult your doctor if you have a sore or other foot problem that isn’t healing.
- Keep your blood pressure and cholesterol under control. Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Medication may be needed, too.
- If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.
- If you drink alcohol, do so responsibly. Alcohol, as well as drink mixers, can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so in moderation and always with a meal.
The recommendation is no more than one drink daily for women, no more than two drinks daily for men age 65 and younger, and one drink a day for men over 65. If you’re on insulin or other medications that lower your blood sugar, check your blood sugar before you go to sleep to make sure you’re at a safe level.
Numerous alternative medicine substances have been shown to improve insulin sensitivity in some studies, while other studies fail to find any benefit for blood sugar control or in lowering A1C levels. Because of the conflicting findings, no alternative therapies are recommended to help with blood sugar management.
If you decide to try an alternative therapy, don’t stop taking the medications that your doctor has prescribed. Be sure to discuss the use of any of these therapies with your doctor to make sure that they won’t cause adverse reactions or interact with your medications.
No treatments — alternative or conventional — can cure diabetes. So it’s critical that people who are using insulin therapy for diabetes don’t stop using insulin unless directed to do so by their physicians.
Type 2 diabetes is a serious disease, and following your diabetes treatment plan takes round-the-clock commitment. But your efforts are worthwhile because following your treatment plan can reduce your risk of complications.
Talking to a counselor or therapist may help you cope with the lifestyle changes that come with a type 2 diabetes diagnosis. You may find encouragement and understanding in a type 2 diabetes support group. Although support groups aren’t for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences or helpful information, such as where to find carbohydrate counts for your favorite takeout restaurant. If you’re interested, your doctor may be able to recommend a group in your area.
Or, you can visit the American Diabetes Association to check out local activities and support groups for people with type 2 diabetes. The American Diabetes Association also offers online information and online forums where you can chat with others who have diabetes. The phone number is 800-DIABETES (800-342-2383 FREE).
Healthy lifestyle choices can help you prevent type 2 diabetes. Even if you have diabetes in your family, diet and exercise can help you prevent the disease. If you’ve already received a diagnosis of diabetes, you can use healthy lifestyle choices to help prevent complications. And if you have prediabetes, lifestyle changes can slow or halt the progression from prediabetes to diabetes.
- Eat healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains.
- Get physical. Aim for 30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride a bike. Swim laps. If you can’t fit in a long workout, spread 10-minute or longer sessions throughout the day.
- Lose excess pounds. If you’re overweight, losing 7 percent of your body weight can reduce the risk of diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.