Diabetes Mellitus

There are three ways to diagnose diabetes:

1. Symptoms of diabetes with a casual (any time of the day) plasma glucose >=200 mg/dl.

2. Fasting plasma glucose (FPG) >= 126 mg/dl on at least two occasions. Fasting = no caloric intake for at least 8 hr.

3. 2 hour plasma/glucose (PG) > 200 mg/dl after 75 gm of oral glucose in water oral glucose tolerance test (OGTT).

Impaired Glucose Tolerance

Diagnostic test: 75 gm glucose orally Time     Plasma glucose (mg/dl)

Fasting   < 120 mg/dl 2 hour    140-200 mg/dl

Etiologic Classification of Diabetes

1. Type 1 (Beta cell destruction, usually leading to insulin deficiency)

• Immune-mediated

• Idiopathic

2. Type 2 (may range from predominantly insulin resistance with relative insulin deficiency to , a predominantly insulin secretion defect, with insulin resistance).

3. Other specific types

• Genetic defects of beta cell function

• Genetic defects in insulin action

• Diseases of the exocrine pancreas

• Endocrinopathies

• Drug or chemical-induced

• Infections

• Uncommon focus of immune-mediated diabetes

• Genetic syndromes sometimes associated with diabetes

• Others

4. Gestational diabetes mellitus (GDM)

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A risk factor for cardiovascular disorders occurs when the platelets in the blood aggregate abnormally – they bunch up and stick together. Evening primrose oil is very effective in stopping this process.

The clotting agents in the blood are called platelets. They are called platelets simply because these tiny particles look a bit like plates. When you cut yourself the blood runs out of the open wound for a short while, but then a clot forms to stem the flow. This clot is formed because the platelets stick together, which is an entirely desirable thing for them to do when you suffer a skin wound.

But the problem starts when the platelets start to bunch up and stick together when you haven’t suffered any skin wound. In healthy people, the blood only feels sticky when it begins to clot after a skin wound. While it is coursing round inside you the blood would feel slippery if you could touch it. But the blood inside you should not be sticky. In recent heart attack victims their blood is about 4 1/2 times stickier than in normal people. If you looked at their blood under a microscope you would see platelets sticking to each other and to artery walls.

When platelets stick to cholesterol deposits this quickly leads to a clot, which can block the flow of blood. When a blood clot forms in an artery or a vein, it’s called a thrombosis. This blocks the circulation in the area. A clot in a coronary artery is a coronary thrombosis. In the brain ifs a stroke.

Normally, artery walls make prostacyclin which prevents platelets from sticking to each other or to artery walls. But arteries which are damaged by fat and cholesterol deposits, high blood pressure or injury, don’t make enough prostacyclin.

Evening primrose oil helps because the GLA in evening primrose oil easily converts to DGLA, which is known to be able to reduce platelet aggregation. If the platelets can stop clumping together, the risk of thrombosis is reduced. Also, evening primrose oil converts to prostaglandin El, and PGE1 is one of the most potent known inhibitors of platelet aggregation.

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This is really a case of do the best you can, because you cannot control everything. Use filtered water to reduce your intake of chlorine and lead by using either an under-the-sink filter or a simple jug filter.

Buy organic vegetables and grains where possible to eliminate your intake of pesticides. Also try to avoid using pesticides yourself in the garden and see if you can find other more environmentally friendly ways to control pests, such as putting certain plants together.

Take a look at the cosmetic, toiletries and deodorants you use and try to buy those which contain the most natural ingredients. Even though products may include only small amounts of chemicals, it is the cumulative and cocktail effect which may cause problems. Many deodorants contain aluminum, a heavy toxic metal, so buy an aluminum-free one from a health food shop. Ask for white fillings instead of mercury amalgams at the dentist.

Use products with the least amount of chemicals in to clean your house and your clothes so that you are not filling your home environment with unwanted toxins.

Try to buy fruit and vegetables loose so that they are not wrapped tightly in plastic. At home avoid using cling film and storing food for long periods in plastic containers. In the fridge you can just use glass dishes with lids to store food. You are not going to be able to avoid all your food coming into contact with plastic because that is the nature of our society. Just do the best you can where it is in your control.

Women often feel helpless in the face of what appears to be a rising tide of breast cancer. As we get older more of our friends and relatives seem to become victims. But I hope I have shown that there is a great deal that you can do in terms of prevention, both for yourself and your daughters. The major research studies on the subject reveal that diet is absolutely crucial, that what we eat is as important as what we avoid. It lies within the power of all of us to use what is already known in our own daily lives. We can do something positive and we should.

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