cnn.com reports:
Two of the most common diseases in the United States — cancer and diabetes — are not often linked together in the public mind. But they may have a stronger link than most people think. Cancer patients who already have diabetes have a greater chance of dying of the disease than cancer patients who do not have the blood-sugar disorder, according to a report in the Journal of the American Medical Association.

If researchers can tease out the reason why, they might have an opportunity to reduce cancer deaths by focusing on diabetes-related health problems, says lead author Frederick Brancati, M.D., a professor of medicine and epidemiology at Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.

About 24 million people in the United States have diabetes, and about eight to 18 percent of newly diagnosed cancer patients also have the disease.

1. What is the difference between the types of diabetes?
Type 1 Diabetes = no insulin produced by the pancreas. This type of diabetes is usually found in young people and children however it can occur in mature aged people. These people are usually not overweight and account for 10% of people with diabetes
Type 2 Diabetes = in this form of diabetes the pancreas is producing insulin however it may be insufficient in quantity or the insulin itself is not working effectively at the cell site (insulin resistance).
This form of diabetes is directly linked to a change of lifestyle in the last 20-30years as the incidence of Type 2 diabetes is increasing worldwide for a number of reasons:
• Population ageing and growth
• Increasing trends towards obesity
• Unhealthy diets
• Sedentary lifestyles

2. Can a Type 2 diabetic become a Type 1?
No. In Type 1 diabetes there is no insulin production whereas in type 2 diabetes the pancreas is producing some insulin.
Sometimes, people with type 2 diabetes who are either not tolerating their diabetes tablets or who despite their oral tablets are still not controlling the blood glucose levels well may require insulin. They are called Type 2 Diabetes Requiring Insulin.

3. Does Type 2 requiring insulin become a Type 1?
No, as the pancreas is still producing insulin. In Type 1 diabetes the pancreas has stopped producing insulin altogether, whereas in type 2 diabetes some insulin is being produced.

4. What is ‘borderline’ diabetes?
“Borderline diabetes”, may also be known as Impaired Glucose Tolerance or Impaired Fasting Glucose. These two conditions are sometimes called Pre- Diabetes.

This condition is an early warning indicator that you are at a higher risk of developing diabetes within the next two years.
By making adjustments to what you eat and increasing your levels of physical activity you can delay the onset on diabetes.

5. Is there a blood test that my doctor orders which will tell him if I my pancreas is producing insulin?
Yes. A blood test is run to indicate the level of insulin production.

6. My relative does not have diabetes but has low blood glucose levels (+/-symptoms) What does this mean?
Hypoglycaemia is the term used for low blood glucose levels. People on diabetes medication (tablets / insulin) to help them manage their diabetes are at risk of ‘hypos’ which can be serious if not treated promptly as they are under the influence of their diabetes medication.
Sometimes people who do not have a history of diabetes may develop symptoms of hypoglycaemia (hunger, sweating, trembling) if they go for long gaps between meals. This may also be called ‘reactionary hypoglycaemia’ and is reversed by their ‘hormonal system’ sending in what is called ‘counter-regulatory hormones’.

7. What is the link between stress and diabetes?
When we are under stress (eg illness or work related) our body copes through a natural response called the ‘fight or flight’ response. This is a hormonal mechanism whereby the ‘fight or flight ‘hormones are released during stress. In turn these hormones :
• reduce the production of insulin
• elevated production of glucose from the liver
• Prevent the muscles from taking up that extra glucose
• Over time, this will cause blood glucose levels to rise

8. Are sugar and glucose the same thing?
Sugar: aka sucrose (the type we put in our tea or coffee) does not cause diabetes. However if we consume large amounts of sweets / cool drinks over time we will put on weight which in turn will prevent the insulin from working properly and hence the blood glucose levels will rise.
Glucose: Is the fuel that our body requires for metabolism*. We derive most of this fuel from the carbohydrates (bread, rice, pasta, certain vegetables) that we consume in our daily diet.

*Metabolism – Once foods have been ingested, there follows a large number of biochemical reactions in the body, this is referred to as metabolism.

I’ve put together a list of 7 common questions (including answers) asked by people regarding Type 2 Diabetes. I’ll be posting further common questions in the coming weeks so stay tuned…

1. Why did I get diabetes? I am not overweight and I am active.
ANSWER: There are a number of risk factors for diabetes.

They include:

• family history
• overweight
• >55yrs of age
• history of high blood pressure and/or cholesterol
• history of heart attack of stroke
• history of pre-diabetes
• History of gestational diabetes (diabetes in pregnancy)

If you have any one of these risk factors there may be something that ‘triggers’ diabetes.

The triggers may be:

• stress (eg health issues, financial, work , family issues)
• medications which you may be having to treat another condition may have the side effect of elevating the blood glucose levels eg steroids, anti-psychotic medication

2. I thought only fat people get diabetes?
ANSWER: No. All people are at risk of diabetes, however people who have a family history have a high risk of developing diabetes. People who are overweight and inactive are also at a higher risk of developing diabetes.

3. Is there a link between high cholesterol, high blood pressure and diabetes?
ANSWER: Yes. Managing your cholesterol and blood pressure is vitally important in managing your diabetes.

• When the cholesterol levels are higher it means the level of blood fats circulating in your blood stream are higher.
  Over time the circulating blood fats will be laid down within the blood vessel wall (called plaques). This combined with the high circulating fats will prevent the insulin from working efficiently in moving the blood glucose from the blood stream into body’s cells.
• As the plaques build up they will start to narrow the artery wall. This results in the blood having more difficulty passing through the vessels. Your heart then has to work harder to push the blood through your system (increased blood pressure).
• If the artery becomes totally blocked by the fatty plaques then no blood can get through and with lack of oxygen to the cells they start to die (heart attack / stroke).

4. Why are younger people getting diabetes?
ANSWER: We are seeing younger people with Type 2 Diabetes and this is directly linked to a change of lifestyle in the last 20-30 years.

The incidence of Type 2 diabetes is increasing worldwide for a number of reasons:

• Increasing trends towards obesity
• Unhealthy diets – larger amounts of higher fat and energy dense foods consumed
• Sedentary lifestyles – not participating in any form or level of physical activity on a day–to–day basis

5. If I lose weight, eat healthily and exercise more will my diabetes go away?
ANSWER: No.

• Once a person has been confirmed with a diagnosis of diabetes they have the condition for the rest of their lives.
• The good news is that diabetes is a condition which can be controlled and the complications can be avoided through HEALTHY lifestyle changes (eating healthily, being physical active) and for some the use of diabetes medications.

6. I have a family history of diabetes but have worked very hard at keeping my weight down… so now why have I got diabetes?
ANSWER:One of the risk factors for diabetes is family history. If you have one or more risk factors there has been a ‘trigger’ which has elevated your blood glucose levels. (see question 1).

7. Are my children/grandchildren at risk of diabetes?
ANSWER:Yes.

• If there is a history of diabetes in a family then all generations of children are at risk of developing diabetes.

“In a study published in the journal Epidemiology, the team compared the dietary habits of 465 people with chronic kidney disease and 467 healthy people. After controlling for various factors, the team found that drinking two or more colas a day — whether artificially sweetened or regular — was linked to a twofold risk of chronic kidney disease.

source: nytimes.com

It appears that the phosphoric acid seems to increase the risk of kidney stones, renal failure and other conditions affecting the kidneys.

I’ve got to say, the very thought of getting kidney stones is more than enough reason for me not to drink cola. I’ve known a few people who have had them and from what they have all said, the pain is excruciating. Worse than giving birth was the comment from one lady who has two children.

Just on the subject of kidney stones, drinking plenty of water will help to prevent them, so that’s just another reason to make sure you keep yourself hydrated.

The study also found that drinking two or more noncola carbonated drinks did not increase the risk of chronic kidney disease.

I don’t buy these myself as I prefer fresh fruit and vegetables to snack on but I know many people who eat these thinking they are healthy and low in fat. Packaging plays a major part in this and like always, you really do need to read the labels carefully. Just because a product has words like healthy or 99% fat free doesn’t meant that they are good for you or low in fat.

The criterion used to select these particular products is total calories, caloric density, saturated fat, fiber, protein, vitamins and minerals.

Participants took rosiglitazone, known by the brand name Avandia, or a dummy placebo, while taking lifestyle advice. Over a period of three years, only 12 per cent of those taking rosiglitazone developed diabetes, compared with 26 per cent who became diabetic while taking the placebo. Rosiglitazone was also found to return glucose levels to normal in 51 per cent of participants versus 30 per cent of those taking a placebo. Read story

Other links of interest

Interactive Health Diabetes page
American Diabetes Association Home Page