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About Diabetes

Diabetes is a disease caused by a disturbance in the insulin hormone, produced by the pancreas gland. The insulin hormone is a hormone that regulates the metabolism of glucose in the blood. The disorder in diabetics causes the rising of blood glucose level and known by the term “hyperglycemia”. Hyperglycemia causes the presence of glucose in the urine of diabetics. The early symptoms of diabetes include frequent thirst and hunger, frequent urination, suddenly lost weight, and easy to feel tired.⁽¹⁾⁽²⁾

Types of Diabetes

1. Type 1 Diabetes
   This type of diabetes is usually diagnosed in children and young age and often referred to as juvenile diabetes. From total diabetic population, about 5-10% who suffer from this type of diabetes. This type of diabetes usually occurs in response to the destruction of the autoimmunity system (autoimmune destruction) of a cell known as the β-cells. This process causes pancreas unable to produce the insulin hormone. Diabetic group of this type are often referred to as Insulin Dependent Diabetes Mellitus (IDDM) because they are very dependent on insulin therapy.^(2),(3)
2. Type 2 Diabetes
   This type of diabetes occurs in about 90-95% of the population of diabetics. Usually type 2 diabetes begins to be detected at around the age of 30. Increase of blood glucose level in diabetes is due to lifestyle factors such as: diet, overweight, and rarely do sports. In the last 40 years, body weight is believed to be a powerful factor for increasing the risk of this disease. This type of diabetic can still produce insulin but in small amount and often referred to as Non-insulin Dependent Diabetes Mellitus (NIDDM).^(2),(3)
3. Gestational Diabetes
   This type of diabetes occurs in pregnant women who never had diabetes, but have high blood glucose level (fasting blood glucose> 126 mg/dL). This type of diabetes is usually detected at 24-28 weeks of pregnancy. This type of diabetes will affect the growth of the baby in late pregnancy. High blood glucose level will be forwarded to the fetus through the placenta. This led to an increase in blood glucose level so that the baby will experience an increase of insulin. After birth, the baby will have a tendency to suffer from obesity and have a heavier weight. Other symptoms commonly seen in babies whose mothers suffer from this type of diabetes is also have difficulty in breathing and shoulder damage when the baby is born. Because the baby’s weight increases, the most likely later in the baby developing diabetes prevalence will be higher as well.^(3),(4)

Factors that cause Diabetes ⁽³⁾:

1. Descent, people who own family history of diabetes have higher risk to possess of diabetes.
2. Age, person’s age affects the chance of developing diabetes. The older the more likely.
3. Gender, prevalence of diabetes in female is higher than the prevalence in men.
4. Obesity, the greater chance of being overweights the greater disruption of insulin function too, because excess of fat can cause interference insulin hormone function.
5. Physical activity, if we do less of physical activity, the sugar that we consumed will also be longer in use. As the result the prevalence of elevated blood glucose level will be higher.
6. Eating patterns, the pattern of fatty foods and over carbohydrates will increase the risk of diabetes.
7. Stress, one of the factors that draw for the increasing risk of diabetes.

Eating Pattern of Diabetics
Generally, diabetics do not need to eat certain foods. What is the most important in diabetes eating pattern? The answer is to limit the number and pay attention to eating schedule. In the other words, a goal to be achieved is not only to eat foods that contain low fat and calories but also eat more vegetables and fruits.⁽⁵⁾ American Diabetes Association suggests to consume 50-60% calories of carbohydrates, 12-20% of protein and not more than 30% of calories derived from fat.⁽⁶⁾

Some things to note in the diabetes eating pattern:

1. Choose carbohydrates with lower glycemic index.
   Carbohydrates with low glycemic index will cause an increase in blood glucose level slower, so it will cause less hunger. Examples of foods that have low glycemic index are pasta and oatmeal.⁽⁷⁾
2. Avoid excessive fat consumption.
   People with diabetes have two times higher risk of heart disease and also increased cholesterol. Therefore diabetics are advised to limit the consumption of saturated fat and cholesterol. Diabetics are also advised to consume lots of vegetable oil such as olive oil. Lard, offal, and egg yolk are the food that should be avoided by people with diabetes.⁽⁶⁾
3. Consuming Fiber.
   Fiber is a nutrient that can help control blood glucose level. Therefore diabetics are also advised to eat foods with high fiber such as oats and vegetables.⁽⁷⁾
4. Reduce the consumption of sugar and salt.
   In order to control rapidly increased of the blood glucose level, diabetics are advised to be able to control the consumption of sugar. High amount consumption of sugar will cause the increasing of blood glucose level faster. The result, diabetics will feel hungry quicker. Meanwhile, low-salt consumption for diabetics is a must in order to help reduce the risk of hypertension.⁽⁷⁾
5. Consuming at least 32 ounces of water (5-6 glasses) a day.
   Water can serve to keep the amount of fluid in the body, so it can also prevent excessive food consumption at the same time if hunger and thirst arise.⁽⁷⁾

Diabetes Complication.⁽⁸⁾

1. Complication on the eyes.
   Diabetics have a higher tendency to experience interference with the sense of sight. Some problems may appear such as glaucoma and cataract, which affect the clarity of sight. Another disorder that can occur is on the retina. In some cases, these disturbances will accumulate and can cause blindness.
2. Complications on skin and foot.
   Generally, diabetics will experience dryness of the foot skin and another part of the body surface. Also in case of injury, it will be a dark red scar that difficult to vanish.
3. Hypertension.
   Hypertension prevalence will increase in diabetics. Increasing of blood glucose level will cause rising of blood pressure.
4. Heart & Stroke Disease.
   When someone has diabetes, the prevalence of heart disease will increase. Excessive fat consumption is believed to be the main cause that will blockage blood vessels. In the end, it will also increase the risk of stroke. In fact, 2 of 3 people with diabetes had a stroke.

The Things that have to be done when Diabetes Appears⁽²⁾:

1. Pay attention to the eating portion, no excessive amount of carbohydrates (about 50-60% of total calories). Reduce the consuming of saturated fat such as: lard and offal. Choose natural fats like olive oil.
2. Consume more foods that contain more fiber. They can help control blood glucose level.
3. Increase activity and exercise in accordance with the advice of doctor.
4. Avoid stress, because stress can also trigger the increasing of complications that rises from diabetes.