Non-insulin dependent diabetes mellitus (NIDDM or type II diabetes) is the most common form of diabetes. The hallmark of diabetes is too much glucose (sugar) in the bloodstream. Glucose is the body's primary fuel. It is derived from the conversion of foods we eat - carbohydrates, proteins and fats - into 'sugars'. Insulin is the chemical made in the pancreas that moves this sugar out of the bloodstream and into the cells of the body where it is used as fuel. In type II diabetes, the pancreas does not produce enough insulin or your body is unable to properly use the insulin that is made. The result is too much sugar in the bloodstream (hyperglycemia or high blood sugar). Type II diabetes is most common in people who are overweight and over 45, especially if there is a family history of diabetes. Risk also increases with certain conditions including stress, pregnancy, and with the use of certain drugs including birth control pills, thiazide diuretics, prednisone or phenytoin.

Symptoms may include:

• Excess thirst
• Increased hunger but with possible weight loss.
• Frequent need to urinate
• Itching (especially of the feet).
• The body becomes less resistant to infection and takes longer to heal. In women, recurrent yeast infections of the vagina may be the first sign.
• Symptoms often come on quite gradually

WHAT YOUR DOCTOR CAN DO:

• Diagnose diabetes by asking about your symptoms, doing a physical exam and laboratory blood tests to check the levels of sugar.
• Prescribe oral medicines to reduce blood sugar.
• Work closely with you to establish a sound diet, weight reduction program, and appropriate schedule for medications. You may be referred to a dietitian or nutritionist to help you understand a proper diet plan.
• Evaluate vision and recommend a dental exam yearly.
• A urine test to check for protein should be done yearly to detect early signs of kidney disease, called nephropathy. Your doctor will also assess you on an ongoing basis for other possible complications of diabetes.

WHAT YOU CAN DO:

• Control your blood sugars and keep them in the normal range. Learn as much as you can about diabetes, controlling your blood sugar, and recognizing the early symptoms of complications.
• Learn to check your blood sugars with a glucometer, a small machine you can use at home.
• Exercise and diet help the body's cells become sensitive to insulin.
• Work with your doctor and nutritionist to develop a meal plan, exercise schedule, and medication schedule that is right for you. Try to be as realistic and honest about what you can do as possible. Lifestyle changes can be difficult. Start with small steps to gain some success at first.
• Your diet and meal plan should include a healthy balance of carbohydrates, protein and fat; adequate fiber, and a limited amount of refined or simple sugars.
• Regular exercise 3-4 times a week will help you lose weight and control your blood sugar.
• See your eye doctor at least yearly for eye exams.
• See your dentist every year for teeth cleaning and treatment.
• Inspect your feet daily. See your doctor for prompt treatment of any infection or injury, especially on the feet or legs.
• Wear a medical alert pendant or bracelet that lists your condition and medications.
• Stop smoking. Ask your doctor for help.   

WHAT YOU CAN EXPECT:

• Early treatment focuses on weight loss and exercise. With the proper combination, your blood sugar level may drop low enough that you will not need medication.
• Good control of blood sugars decreases the chance of complications and lessens the risk of progression to insulin-dependent diabetes.
• Complications are most common with long-standing and poorly controlled diabetes. Most can be prevented or slowed by following a proper diet and exercise program.

Complications of diabetes may include:

• Increased risk of heart attacks and stroke
• Kidney disease
• Blindness or fluctuating vision
• Peripheral neuropathy - Involves nerve damage of the extremities, which may cause numbness, itching, and burning of the feet and hands
• Gangrene of the feet - May require amputation.

CALL 1061 OR SEEK IMMEDIATE MEDICAL ASSISTANCE If you have symptoms of diabetes; if you make significant changes in your diet or exercise schedule (may require a medication change); if you are ill for more than 1 day; or if you suffer from an infection or injury, vision changes, or symptoms of high or low blood sugar.