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Biology Project

By – Sumedha Sharma

History and StatisticHistory and StatisticHistory and StatisticHistory and Statistic

Diabetes is not a newly born disease, it has been with human race from long

Noble prize. In the decade of 1940, it has been discovered that different organs

like kidney and skin are also affected if diabetes is creeping from a long term. A

major turn in this research

drugs had been manufactured.

Diabetes was recognized with complete details and its types (Type 1and Type 2

diabetes - that is insulin dependent and non insulin dependent) in the year, 1959.

As we know this is one of the old

on rising charts. Hence, scientists are continuously working to relieve us from it,

by discovering the relevant

According to W.H.O estimates, by 2025 total 300 million of the

population will be affected by diabetes. For every 21 seconds, someone is

diagnosed with diabetes, an estimation given by

And, there are 20.8 million diabetics in US at present, which is roughly

estimated as 7% of US population, out of this figure about 6.2 millions are

unaware of the diabetes existence in there life.

Symptoms of DiabetesSymptoms of DiabetesSymptoms of DiabetesSymptoms of Diabetes

In both types of diabetes, signs and symptoms are more likely to be similar as

the blood sugar is high, either due to less or no production of insulin, or

resistance. In any case, if there is inadequate glucose in the cells, it is identifiable

through certain signs and symptoms. These

the Diabetes is treated and

problems.

Diabetes Type 1:

Universal Blue Symbol

of Diabetes

History and StatisticHistory and StatisticHistory and StatisticHistory and Statistic

abetes is not a newly born disease, it has been with human race from long

back but, we came to knew about it in 1552 B.C.

Since this period, many of Greek as well French

physicians had worked on it and made us aware of

the nature of disease, organs responsible for it etc. In

1870s, a French physician had discovered a link

between Diabetes and diet intake, and an idea to

formulate individual diet plan came into picture.

Diabetic diet was formulated with inclusion of milk,

oats and other fiber containing foods in 1900

Function of insulin, its nature, along with its use

started from 1920 -1923, discovered by Dr. Banting,

Prof. Macleod and Dr .Collip, who were awarded a

e decade of 1940, it has been discovered that different organs

like kidney and skin are also affected if diabetes is creeping from a long term. A

research was in the year 1955, when the oral hypogycemic

drugs had been manufactured.

was recognized with complete details and its types (Type 1and Type 2

that is insulin dependent and non insulin dependent) in the year, 1959.

As we know this is one of the old diseases, existing in many individuals and still

on rising charts. Hence, scientists are continuously working to relieve us from it,

by discovering the relevant drugs and making new researches.

According to W.H.O estimates, by 2025 total 300 million of the

population will be affected by diabetes. For every 21 seconds, someone is

diagnosed with diabetes, an estimation given by American Diabetes Association

And, there are 20.8 million diabetics in US at present, which is roughly

S population, out of this figure about 6.2 millions are

unaware of the diabetes existence in there life.

Symptoms of DiabetesSymptoms of DiabetesSymptoms of DiabetesSymptoms of Diabetes

In both types of diabetes, signs and symptoms are more likely to be similar as

the blood sugar is high, either due to less or no production of insulin, or

. In any case, if there is inadequate glucose in the cells, it is identifiable

through certain signs and symptoms. These symptoms are quickly relieved once

the Diabetes is treated and also reduce the chances of developing serious health

Universal Blue Symbol

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History and StatisticHistory and StatisticHistory and StatisticHistory and Statistic

abetes is not a newly born disease, it has been with human race from long

back but, we came to knew about it in 1552 B.C.

Since this period, many of Greek as well French

had worked on it and made us aware of

e, organs responsible for it etc. In

1870s, a French physician had discovered a link

and diet intake, and an idea to

formulate individual diet plan came into picture.

rmulated with inclusion of milk,

oats and other fiber containing foods in 1900-1915.

, its nature, along with its use

1923, discovered by Dr. Banting,

Prof. Macleod and Dr .Collip, who were awarded a

e decade of 1940, it has been discovered that different organs

like kidney and skin are also affected if diabetes is creeping from a long term. A

was in the year 1955, when the oral hypogycemic

was recognized with complete details and its types (Type 1and Type 2

that is insulin dependent and non insulin dependent) in the year, 1959.

ting in many individuals and still

on rising charts. Hence, scientists are continuously working to relieve us from it,

and making new researches.

According to W.H.O estimates, by 2025 total 300 million of the worldwide

population will be affected by diabetes. For every 21 seconds, someone is

American Diabetes Association.

And, there are 20.8 million diabetics in US at present, which is roughly

S population, out of this figure about 6.2 millions are

In both types of diabetes, signs and symptoms are more likely to be similar as

the blood sugar is high, either due to less or no production of insulin, or insulin

. In any case, if there is inadequate glucose in the cells, it is identifiable

are quickly relieved once

also reduce the chances of developing serious health

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In type 1, the pancreas stop producing insulin due to autuimmune response or

possibly viral attack on pancreas. In absence of insulin, body cells don’t get the

required glucose for producing ATP (Adenosin Triphosphate) units which

results into primary symptom in the form of nausea and vomiting. In later stage,

which leads to ketoacidosis, the body starts breaking down the muscle tissue and

fat for producing energy hence, causing fast weight loss. Dehydration is also

usually observed due to electrolyte disturbance. In advanced stages, coma and

death is witnessed.

Diabetes Type 2:

• Increased fatigue : Due to inefficiency of the cell to metabolize glucose,

reserve fat of body is metabolized to gain energy. When fat is broken

down in the body, it uses more energy as compared to glucose, hence

body goes in negative calorie effect, which results in fatigue.

• Polydipsia : As the concentration of glucose increases in the blood, brain

receives signal for diluting it and, in its counteraction we feel thirsty.

• Polyuria: Increase in urine production is due to excess glucose present in

body. Body gets rid of the extra sugar in the blood by excreting it through

urine. This leads to dehydration because along with the sugar, a large

amount of water is excreted out of the body.

• Polyphegia : The hormone insulin is also responsible for stimulating

hunger. In order to cope up with high sugar levels in blood, body produces

insulin which leads to increased hunger.

• Weight flactuation : Factors like loss of water (polyuria), glucosuria ,

metabolism of body fat and protein may lead to weight loss. Few cases

may show weight gain due to increased appetite.

• Blurry vision : Hyperosmolar hyperglycemia nonketotic syndrome is the

condition when body fluid is pulled out of tissues including lenses of the

eye, which affects its ability to focus, resulting blurry vision.

• Irritability : It is a sign of high blood sugar because of the inefficient

glucose supply to the brain and other body organs, which makes us feel

tired and uneasy.

• Infections : The body gives few signals whenever there is fluctuation in

blood sugar (due to suppression of immune system) by frequent skin

infections like fungal or bacterial or UTI (urinary tract infection).

• Poor wound healing : High blood sugar resists the flourishing of WBC,

(white blood cell) which are responsible for body immune system. When

these cells do not function accordingly, wound healing is not at good pace.

Secondly, long standing diabetes leads to thickening of blood vessels

which affect proper circulation of blood in different body parts.

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What Causes DiabetesWhat Causes DiabetesWhat Causes DiabetesWhat Causes Diabetes

The precise Etiology of most cases of diabetes is uncertain, although certain

contributing factors are as follows:

Type 1 diabetes

Type 1 Diabetes is autoimmune disease

that affects 0.3% on average. It is result of

destruction of beta cells due to aggressive

nature of cells present in the body.

Researchers believe that some of the

Etiology and Risk factors which may

trigger type 1 diabetes may be genetic,

poor diet (malnutrition) and environment

(virus affecting pancreas). Secondly, in

most of the cases, diabetes occurs because

there is abnormal secretion of some

hormones in blood which act as antagonists to insulin. Example- Adrenocortical

hormone, Adrenaline hormone and Thyroid hormone.

Type 2 diabetes

Type 2 Diabetes is also called non insulin-

dependent diabetes mellitus (NIDDM) or adult-

onset diabetes. It occurs when the body

produces enough insulin but cannot utilize it

effectively. This type of diabetes usually

develops in middle age. A general observation

says that about 90-95 % of people suffering

with diabetes are type 2; about 80 percent are

overweight. It is more common among people

who are older; obese; have a family history of

diabetes; have had gestational diabetes. There

are number of risk factors found to be responsible for type 2 diabetes like, the

more the Etiology and Risk factors carried by an individual, the higher the risk

for developing diabetes.

Following are the Causes of Diabetes

• Hereditary or Inherited Traits : It is strongly believed that due to some

genes which passes from one generation to another, a person can inherit

diabetes. It depends upon closeness of blood relationship as mother is

diabetic, the risk is 2 to 3%, father is diabetic, the risk is more than the

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previous case and if both the parents are diabetic, the child has much

greater risk for diabetes.

• Age : Increased age is a factor which gives more possibility than in

younger age. This disease may occur at any age, but 80% of cases occur

after 50 year, incidences increase with the age factor.

• Poor Diet (Malnutrition Related Diabetes) : Improper nutrition, low

protein and fiber intake, high intake of refined products are the expected

reasons for developing diabetes.

• Obesity and Fat Distribution : Being overweight means increased insulin

resistance, that is if body fat is more than 30%, BMI 25+, waist grith 35

inches in women or 40 inches in males.

• Sedentary Lifestyle : People with sedentary lifestyle are more prone to

diabetes, when compared to those who exercise thrice a week, are at

low risk of falling prey to diabetes.

• Stress : Either physical injury or emotional disturbance is frequently

blamed as the initial cause of the disease. Any disturbance in

Cortiosteroid or ACTH therapy may lead to clinical signs of the disease.

• Drug Induced: Clozapine (Clozaril), olanzapine (Zyprexa), risperidone

(Risperdal), quetiapine (Seroquel) and ziprasidone (Geodon) are known

to induce this lethal disease.

• Infection : Some of the strephylococci is suppose to be responsible factor

for infection in pancreas.

• Sex : Diabetes is commonly seen in elderly especially males but, strongly

in women and those females with multiple pregnancy or suffering from

(PCOS) Polycystic Ovarian Syndrome.

• Hypertension : It had been reported in many studies that there is direct

relation between high systolic pressure and diabetes.

• Serum lipids and lipoproteins : High triglyceride and cholesterol level in

the blood is related to high blood sugars, in some cases it has been

studied that risk is involved even with low HDL levels in circulating blood.

Diabetes DietDiabetes DietDiabetes DietDiabetes Diet

Diet plays a significant role in controlling the diabetes. The diabetic diet may be

used alone or else in combination with insulin doses or with oral hypoglycemic

drugs. Main objective of diabetic diet is to maintain ideal body weight, by

providing adequate nutrition along with normal blood sugar levels in blood. The

diet plan for a diabetic is based on height, weight, age, sex, physical activity and

nature of diabetes. While planning diet, the dietician has to consider

complications such as high blood pressure, high cholesterol levels.

With respect to the above factors, a dietician will assess calories to be given, like

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scheming the carbohydrates, proteins, fats, type of carbohydrate, amount of fiber

and so on.

Exchange meal plan is a diet program which balances the amount of

carbohydrate that we intake per day. Glucose is a sugar released from

carbohydrate so, if we want to control blood sugar we have to limit the

consumption of simple carbohydrate. Carbohydrate foods are given as value per

portion, known as the exchange. This plan helps us to decide on the type of food

to be taken, the amount of food and also the time to eat. You can plan for more

flexible meals as you get more knowledge about the diet for a diabetic, may be

like the counting carbohydrate meal plan or constant carbohydrate. But there is

no common diet that works for everyone. Nor is there any particular diet that

works perfectly for any diabetic over a long period. While planning diabetes diet

we should adhere to certain important factors, they are as follows:

• Fiber should be at least 1.4 oz / day

• Instead of 3 heavy meals, we should go for 4-5 small mid intervals

• Replace bakery products and fast foods by simple whole cooked cereals,

and don't eat carbohydrates 2 hours before bedtime

• Consume fresh fruit and vegetables at least 5 exchange/ day

Diabetics always need to take care of their diet and also about the food they eat.

Care has to be taken because all foods contain not only carbohydrate, but also

some energy value. Protein and fat available in the food are converted to glucose

in the body. This glucose has some effect on the blood sugar level, which has to

be taken care of. Furthermore, you needn’t have to eat only the bland boring

diet. Instead, you can eat more fruits, vegetables and whole grains. All it means

is that you need to select foods that are high in nutrition and low in calories.

1.1.1.1. Diet ManagDiet ManagDiet ManagDiet Management During Diabetesement During Diabetesement During Diabetesement During Diabetes

2.2.2.2. Diabetes CareDiabetes CareDiabetes CareDiabetes Care

3.3.3.3. Diabetic Diet DosDiabetic Diet DosDiabetic Diet DosDiabetic Diet Dos

4.4.4.4. Diabetic Diet DonDiabetic Diet DonDiabetic Diet DonDiabetic Diet Don’’’’tstststs

Diet Management Diet Management Diet Management Diet Management duringduringduringduring DiabetesDiabetesDiabetesDiabetes

Most of the food items contain carbohydrate, protein and fat. Cereals are rich in

carbohydrate, lentils, lean meat, chicken and fish are rich in protein while oils,

nuts and milk creams are rich in fat. Fat foods are high in calories; 1g of it

provides 9 calories, while 1g carbohydrate or 1g protein gives only 4 calories.

Carbohydrate is easily digested than fat and protein. The rise in blood glucose

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after a meal is due to absorption of glucose from a carbohydrate digestion and

increase in production of glucose by liver. Sucrose (cane sugar), sweets and

syrups cause a rapid rise in blood glucose than whole cereals like finger millet

and wheat products.

In people with no diabetes, the rise in blood glucose after a meal comes down to

the pre-meal level with in 2 hrs. In diabetes, the rise in blood glucose after a

meal is not only higher but the fall to pre-meal level is slower (3-4 hrs).

Therefore, snacks in between meals or frequent meals at short intervals tend to

cause progressive increase in blood glucose in people with diabetes.

Glucose is constantly needed to provide ready energy for the proper functioning

of brain, heart, kidneys, liver and blood cells. When glucose is not available

from ingested food, our liver produces from its store of carbohydrate (glycocen)

and body stores of fats and proteins. The liver produces about 0.1058 oz of

glucose/lbs body weight in a day. For example the liver of a man or woman

weighing 154 lbs produces 7.0547 oz of glucose in a day. The production of

glucose by the liver is kept in a check by small amounts of insulin secreted by

the pancreas.

These considerations and the modality of your treatment (tablets/insulin) are

taken into account for formulating your diet management during diabetes and

meal timings. The dietician would give your information on your diet.

The general guidelines on diet are:The general guidelines on diet are:The general guidelines on diet are:The general guidelines on diet are:

In a typical day’s meals and snacks, you should have 1500-1800 calories with –

60% contribution from the carbohydrate, 20% from fat and 20% from proteins.

You may need extra weight reduction. If you are on calorie-restricted diet, make

sure to take 50-60% of calories as complex carbohydrate (whole cereals) to

prevent any feeling of weakness.

• You should eat a variety of food items everyday. Do not skip meals. Avoid

snacks, unless you are advised to (example during insulin treatment).

Don’t over eat.

• Eat fruits and vegetables. Use less oil in cooking. Avoid fried foods, milk

cream or food items cooked in coconut milk.

• Avoid ready to eat food preparations, sweets and sugary drinks (canned

beverages) that provide empty calories (no vitamin or essential

minerals).

• Keep a regular check on your weight – maintain it within the estimated

limit.

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• Check your hemoglobin and proteins in blood samples at 6 months or 1

year’s interval, Suitable correction in diet format or supplementation

may become necessary.

• Despite a good control of blood glucose, if your blood lipids are high, you

will need lipid lowering drugs regularly. Some times your doctor may

advice you lipid-lowering drugs from the beginning of your diabetes

treatment.

• Match your mealtime to the form of insulin and insulin injection

schedules as explained by your doctor or the diabetes nurse.

Diabetes CareDiabetes CareDiabetes CareDiabetes Care

• Eat food at fixed hours

• Do not overeat

• Do not eat immediately after a

workout

• Make sure you have three proper

meals & light snacks in between

• Eat about the same amounts of

food each day

• Eat your meals and snacks at about the same times each day

• Make sure the gaps between your meals are short

• Do not eat fast; masticate and munch your food well before you

swallow

• Drink a lot of water that will help flush the toxins off your system

• Avoid fried foods and sweetmeats

• Include fresh vegetable salad in every meal

• Include sprouts in the diet

• Take your medicines at the same times each day

• Exercise at about the same times each day

• Avoid smoking. Smoking leads to heart disease and poor

circulation

• Check your feet for cuts, blisters, and swelling which are likely to

result from diabetes-related nerve damage

• Take good sleep daily

• Check your blood sugar level regularly

• Try to stick up to the plan made up for sugar control

• Check the other tests such as kidney function, liver function, heart

function, ketone level etc

• Check your weight periodically and maintain ideal body weight

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Diabetic Diet DosDiabetic Diet DosDiabetic Diet DosDiabetic Diet Dos

• For breakfast, take cholesterol-

lowering oatmeal

• Have nuts rich in mono unsaturated

fat, such as pecans, walnuts, and

almonds

• Eat pasta, stews and leafy salads

along with beans-- kidney beans,

chick peas, and dry beans, navy

beans and peas which can reduce

LDL "bad"; cholesterol

• Fat free milk, yogurt, and cheese to

be taken

• Eggs whites to be included

• White meat chicken and Fish and shellfish (not battered) are good

• Increase intake of dry beans and peas

• Have at least 20 to 25 grams of raw onion daily

• Add wheat bran to your wheat flour (50% wheat flour + 50% wheat

bran). This helps increase fiber in your diet

• You can also add flaxseed and fenugreek seeds into the wheat flour

• Increase fiber intake in the form of raw fruits, vegetables, whole

cereals etc

• Intake of cinnamon, garlic, onion, bitter melon, guar gum is known

to considerably reduce blood glucose level

Diabetic Diet Don'tsDiabetic Diet Don'tsDiabetic Diet Don'tsDiabetic Diet Don'ts

• Don't fry foods instead bake, boil, poach or sauté in a nonstick pan.

Steam or microwave vegetables. Buy tuna packed in water, not oil

• Eat less high-fat red meat and more low-fat turkey and fish. Avoid

organ meats

• Limit the use of condiments such as ketchup, mustard and salad

dress ion--they're high in salt and can be high in sugar, too

• Rinse processed foods in water and, wherever possible, choose

fresh foods over canned

• Limit your salt (sodium content)

• Read labels carefully. Soy sauce, brine and MSG, for example,

contain a lot of sodium

• Don't select ready to eat and junk foods items available to you

• Don't smoke and stop alcohol consumption

• Don't skip meals and medicine times

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Diabetes ComplicationsDiabetes ComplicationsDiabetes ComplicationsDiabetes Complications

Once we have crossed the reversible stage of

prediabetes and enter diabetes stage, certain

changes start developing in our body. These

changes occur due to high blood sugar level

with instability in the hormones as well as

blood vessels and nerves. When these changes

become permanent in the body it develops into

serious Diabetes Complications and body

indicates these changes by steady symptoms.

Symptoms of the Diabetes Complications

• Diabetic retinopathy shows symptoms of pain in the eyes and may even

result in loss of vision.

• Renal (kidney) disease shows symptoms of swelling (edema) in the feet

and legs. It then passes over total body and as the disease progresses,

blood pressure also increases.

• Tingling, burning, numbness, tightness, shooting or stabbing pain in the

hands, feet or other parts of your body, especially at night. Digestive

problems also occur if, the nerves controlling internal organs get

damaged (autonomic neuropathy).

• You may have scanty or profuse sweating, difficulty of sensing when your

bladder is full, when there is a low blood sugar, increased sexual

problems, weakness, dizziness, and fainting.

• Chest pain (angina) or shortness of breath dizziness or light headache,

shoulder or stomach pain, fast heartbeat. You might not show any

symptoms until having a heart attack or stroke.

When alarming symptoms given by the body are ignored and the same status is

maintained, it starts damaging body organs, such as heart, kidney, eye, feet, and

skin. The physiology for each and every affected organ is explained one by one.

Diabetes ControlDiabetes ControlDiabetes ControlDiabetes Control

Whether your treatment consists of diet alone, diet and tablets or diet and

insulin, you need regular blood tests to keep a check on your blood sugar. Urine

sugar test is not a reliable indicator of diabetes control.

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When blood glucose remains higher than 200mg/dl for 8

concentration of glycosylated hemoglobin (HbA1c) arises. A (HbA1c)

measurement therefore reflects the blood glucose control over a preceding 2

months period, while the estimates of blood glucose indicate the glucose value at

the time of blood test. HbA1c values between 6

on diabetes.

aim at keeping

glucose in the

i.e. between

while fasting

180 mg/dl

and HbA1c

Frequent tests

glucose are

when starting

insulin.

If you are

blood glucose test using a hand held glucometer, do not squeeze the finger to

bring out a sample after you have picked. This invariably gives a low glucose

value. Ask your diabetes

test.

Urine test for sugar is

spillage of sugar in urine occurs when the blood glucose exceeds 180 mg/dl in

the majority of healthy persons, this is not always so in a patient with diabetes.

Most patients with diabetes of many years

threshold for glucose (capacity to prevent spillage of glucose into urine). Hence

urine test for glucose is not helpful for assessing

presence of urinary infections, the bacteria eats up the sugar present in urine,

thereby making urine test for sugar unreliable.

When blood glucose remains higher than 200mg/dl for 8

concentration of glycosylated hemoglobin (HbA1c) arises. A (HbA1c)

measurement therefore reflects the blood glucose control over a preceding 2

months period, while the estimates of blood glucose indicate the glucose value at

the time of blood test. HbA1c values between 6-7% indicate very good control

ose test using a hand held glucometer, do not squeeze the finger to

bring out a sample after you have picked. This invariably gives a low glucose

diabetes nurse for a demonstration of capillary blood glucose

Urine test for sugar is not reliable indicator of diabetes control. Although

spillage of sugar in urine occurs when the blood glucose exceeds 180 mg/dl in

the majority of healthy persons, this is not always so in a patient with diabetes.

Most patients with diabetes of many years acquire an increase in the renal

threshold for glucose (capacity to prevent spillage of glucose into urine). Hence

urine test for glucose is not helpful for assessing control of diabetes

presence of urinary infections, the bacteria eats up the sugar present in urine,

thereby making urine test for sugar unreliable.

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When blood glucose remains higher than 200mg/dl for 8-10 weeks, the

concentration of glycosylated hemoglobin (HbA1c) arises. A (HbA1c)

measurement therefore reflects the blood glucose control over a preceding 2-3

months period, while the estimates of blood glucose indicate the glucose value at

7% indicate very good control

You should

your blood

normal range

90-130 mg/dl

and less than

after meals

around 7%.

for blood

necessary

treatment with

doing capillary

ose test using a hand held glucometer, do not squeeze the finger to

bring out a sample after you have picked. This invariably gives a low glucose

nurse for a demonstration of capillary blood glucose

not reliable indicator of diabetes control. Although

spillage of sugar in urine occurs when the blood glucose exceeds 180 mg/dl in

the majority of healthy persons, this is not always so in a patient with diabetes.

acquire an increase in the renal

threshold for glucose (capacity to prevent spillage of glucose into urine). Hence

control of diabetes. In the

presence of urinary infections, the bacteria eats up the sugar present in urine,