What are the Vitasecrets's quality control standards?
Vitasecrets maintains the highest quality control standards by
only recommending products that contain pharmaceutical grade nutrients.
The purity of your supplements is critical. Many discount products
use low grade nutrients imported from China that contains traces
of arsenic, lead, and iron.
Since the FDA does not properly regulate dietary supplement manufacturing,
Vitasecrets only uses laboratories approved and regulated by the
FDA and other reputable accrediting agencies. All the supplements
recommended by Vitasecrets must meet Dr. Allen’s approval.
Are the Vitasecrets's pharmaceutical grade formulas affordable?
Vitasecrets’ supplements are reasonable priced and in some cases
under-priced. The goal is to improve the quality of life by people
suffering from chronic diseases and for that reason we have made
every effort to provide you with affordable high quality products.
Why the Vitasecrets’s formulas are are more advanced than
other nutrient formulas?
Most of Vitasecrets' products are especially formulated by Dr.
Hengameh Allen a nutrition scientist. They are clinically tested
and proven to have desirable results. Vitasecrets enjoys a high
satisfaction rate from their clients. The especially formulated
products are scientifically proven to be effective without any
side effects (if used as directed).
The formulations have captured the attention of many physicians
all over the world. Many physicians regularly use these products
for their patients.
What are the best nutrients to take for a particular condition?
For Diabetes and its associated complications (i.e., Retinopathy,
Neuropathy, Nephropathy, Heart Failure) use: Diabetic Support
Formula, Omega Formula, Ginkgo Biloba and Alpha Lipoic Acid
For Hyperlipidemia use: Diabetic Support Formula, Beni Koji, Omega
Formula
For Arthritis use: Arthritis Support Formula, Omega Formula
For Gastrointestinal Disorders use: Vita Acidophillus
For Menopause use: Estroflavone and Vita Osteo Support
For Depression use: Vita Mood and Omega Formula
For boosting your immune response use: Vita Echinacea, Vita B-Complex
and Omega Formula
For maintaining good health use: Vita Complete (for adults), Vita
Teen (for teenagers), Vita Kids (for children) and Omega Formula
For Osteoporosis use: Vita Osteo Support
For liver health use: Vita B-Complex, Vita Choline and Omega Formula
There are other single nutrients that are provided to the clients
based on their individual needs.
What can I take for my memory?
Vita Choline, Ginkgo Biloba and Omega Formula. We usually recommend
Vita Complete as a desirable multi-Vitamin and Mineral.
Is there anything I can do about hair loss?
Use Vita Hair Skin and Nails with Saw Palmetto
What are some good antioxidant products?
Vita Flavonall, Vita Grape and Vita C
Do you take credit cards?
We accept most major credit cards: American Express, Discover,
MasterCard and Visa. All transactions are handled through a fully
secured network and insured.
Is it safe to use my credit cards online?
Yes, purchasing with a credit card on Vitasecrets Web Site is
100% safe. The purchase area of our site is fully secure.
Can I pay with a check?
Yes, however, your order will be shipped once the funds clear
our bank account.
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Yes, your privacy is a priority and we DO NOT give out any information
to anyone other than the purchaser.
What about orders from outside the U.S.?
Each country has its own guidelines for purchasing and shipping
certain products. For more information on which specific rules
may affect your purchase, please check out our Shipping Tips.
What are my options for shipping?
We offer three major USPS shipping options and express mailing
(Second Day Air and Overnight). For web orders you must allow
2-3 weeks for inside US and 2-5 weeks outside the US. We cannot
guarantee shipments mailed to countries that do not allow dietary
supplements into their country and you order at your own risk.
How do I find a specific product?
They are all listed on our website.
Once I find what I am looking for, how do I buy it?
When you find an item that interests you:
1. Click the link that reads "Add to Cart", next to
the item description and price.
2. This will add the item to your online shopping cart and bring
you to a "Shopping Cart Contents" page that lists all
of the products that you have previously selected.
3. On the "Shopping Cart Contents" page you may change
the quantities, after which, you must press the "Update Order"
Button.
4. The "Shopping Cart Contents" page will then reloads
and display the extended, total cost of your order.
What if I need to return something?
Our return policy and cancellation policy is listed on our website
on the main page at the bottom of the page.
How do I use your products?
Please read the product description and the recommended dosage
(serving size) is listed. You must also consult your healthcare
provider if you suffer from a medical condition or are taking
medications.
Q. What is diabetes mellitus?
A. Diabetes mellitus is a chronic disorder in which the body’s
ability to use sugars is reduced. This can cause raised levels
of glucose in the blood and its excretion in the urine. In more
severe acute cases, this can lead also to a loss in the balance
of water and minerals in the body. These changes are the result
of a deficiency of the pancreatic hormone, insulin.
Q. What is the pancreas?
A. The pancreas is an elongated gland, 5-6 inches long, situated
in a loop of the small intestine and lying behind the stomach.
It is called a mixed gland, because it has distinct parts with
different functions. It has a major role in digestion – accounting
for about 99 per cent of its weight – and releases digestive juices
into the small intestine through a small duct. The other 1 per
cent, comprising the islets of Langerhans, is involved with the
making and storing of hormones, including insulin, and releasing
them directly into the blood stream.
In an adult, there are from 200,000 to 2 million pancreatic islets
scattered throughout the gland, each containing four different
kinds of specialized cells acting in combination to regulate digestion
and glucose balance. The two most important in diabetes are called
alpha and beta cells. Alpha cells produce a hormone called glucagon
that raises blood glucose by triggering its release from glycogen
stores in the liver. Glucagon is also involved in the utilization
of fats and protein constituents by the body. Beta cells secrete
insulin, which lowers blood glucose. It is clear that glucagon
and insulin do opposite things. In fact, glucagon is referred
to as hyperglycemic (glucose raising) while insulin is called
hypoglycemic (glucose lowering).
Q. What is insulin?
A. Chemically, insulin is made of amino acids, the building blocks
of protein. It is synthesized in the islet cells in a form called
proinsulin, which is broken down before release into the blood
into a small piece called C-peptide, and insulin. The insulin
itself consists of two chains (A and B) linked together by sulphur-containing
bridges. Both C-peptide and insulin (and some proinsulin) are
packaged together in the islet cells into granules prior to release
and all three are detectable in the blood of people who do not
have diabetes. Though drawn in the illustration for convenience
as two straight chains, the structure of insulin is in fact coiled
up into a three-dimensional ball. The amino acids on the outside
interact with the cell’s insulin receptors. It has proved possible
to modify insulin by changing its size and amino acid composition
to produce novel insulin-type medicines.
Q. What are the differences between type 1 and diabetes
type 2?
A. This division is important because it affects the clinical
assessment of the patient and subsequent treatment. The mechanisms
of the two differ, though they both culminate in an inability
to regulate glucose properly.
Type 1: Though less common, this form has a sudden onset, usually
before the age of 40, but can occur at any age. Insulin treatment
is essential for the survival of people with diabetes type 1 and
will always have to be taken. Without insulin, blood glucose levels
become too high and fat is broken down as an alternative source
of energy. This results in the production of ketone bodies, which,
if they accumulate, can lead to ketoacidosis. This in turn can
cause nausea, vomiting and drowsiness, and can lead to diabetic
coma.
Type 2: This is the form that most people with diabetes have.
In contrast to type 1, it affects mostly people over the age of
40 and has a slow onset that may go undiagnosed. People with diabetes
type 2 still secrete insulin, though there is almost always some
reduction in the quantity produced. In type 2, three main types
of abnormality may account for the development of the condition:
• The receptors on cells may fail to be stimulated by insulin,
a condition known as peripheral insulin resistance. This type
is especially common in people who are overweight and is characterized
in some people by a compensatory over-production of insulin
• Insulin production may be too low
• The insulin produced may be chemically abnormal and not properly
functional
Although type 1 and type 2 are clinically distinct from each other,
some people with type 2 may develop a need for insulin in order
to manage their diabetes effectively.
Q. How do I know if I have diabetes?
A. As many as 50 percent (one-half) of persons with diabetes type
2 are unaware that they have the disease. For this reason, it
is particularly important to pay attention to the signs and symptoms
of diabetes and its risk factors.
Some of the signs of either type 1 or diabetes type 2 are:
• Frequent thirst
• Frequent urination
• Frequent hunger and fatigue
• Unexplained weight loss or weight gain
• Wounds heal slowly
• Dry, itchy skin
• Numbness or tingling in your feet
• Blurry eyesight
Symptoms of diabetes type 1 often develop over a short period
of time. In diabetes type 2, symptoms develop more slowly, and
some persons never have any symptoms of the disease. If you are
regularly having any of these signs and symptoms, you should tell
your doctor.
Q. What factors increase my risk of getting diabetes?
A. Although researchers don't fully understand why some persons
get diabetes and others don't, it is clear that certain factors
increase your risk. You are at risk for having diabetes if:
• Your mother, father, sister, or brother has diabetes;
• You are African American, Hispanic American/Latino, American
Indian, Native Alaskan, Asian American, or Pacific Islander;
• You have high blood pressure (at or above 130/80);
• You have a history of diabetes during pregnancy (gestational
diabetes) or gave birth to a baby weighing more than nine pounds
at birth;
• You are overweight or obese;
• You are inactive or have a sedentary lifestyle; or
• You are older than 45 years of age.
If you have one or more of these risk factors, even if you are
experiencing no symptoms, your doctor may want to test you for
diabetes.
Q. How will my doctor test me for diabetes?
A. Although the amount of glucose in your blood varies depending
on when and what you eat, the range should be relatively narrow.
In general, your blood sugar is highest after you eat and lowest
after you have not eaten for 8-10 hours. After fasting all night,
most persons have blood glucose levels between 70 and 110 milligrams
of glucose per deciliter of blood (mg/dL). After eating a large
meal, a person's blood sugar will rise, but generally not above
140 mg/dL. People with untreated diabetes will have higher blood
sugars after fasting and after eating.
To check if you have diabetes, your doctor will test your blood
sugar levels. The results of these tests and other clinical findings
will be used to decide if you have diabetes and what type. Doctors
cannot diagnose diabetes on the basis of one single test. Instead,
they will perform two or more glucose tests before confirming
your diagnosis. The most common tests to measure glucose are the
fasting plasma glucose test, the random blood sugar test, and
the oral glucose tolerance test.
• Fasting plasma glucose test. Most experts recommend using a
fasting plasma glucose test to diagnose diabetes. Before taking
this test, you cannot eat anything for 8 to 10 hours. Blood will
be drawn from a vein in your arm and sent to a laboratory for
testing. If your fasting blood glucose is 126 mg/dL or higher,
your doctor will probably diagnose you with diabetes.
• Random blood sugar test. Many cases of diabetes are found during
routine physical exams when blood is drawn for other tests. Since
you don't necessarily fast before these physical exams, you may
have just eaten and your blood sugar may be high. Even so, it
shouldn't be higher than 200 mg/dL. If your random blood glucose
is higher than 200 mg/dL, your doctor will probably suspect diabetes
and may want to give you a fasting plasma glucose test.
• Oral glucose tolerance test. In this test, a person consumes
a drink containing glucose dissolved in water. Blood is then drawn
in timed intervals over a three-hour period. If plasma glucose
levels rise more than expected, the person is diagnosed with diabetes.
This test is often used to check pregnant women for gestational
diabetes. It is rarely used to diagnose diabetes in other patients,
because it is cumbersome and time-consuming.
Q. How can I reduce my chance of getting diabetes?
A. A recent study funded by the Federal government of 3,234 persons
at high risk for diabetes showed that diet and exercise can sharply
lower the risk of getting diabetes type 2.
The Diabetes Prevention Program (DPP) was a major clinical study
of ways to prevent or delay diabetes in persons at high risk for
diabetes type 2. Patients were overweight and had higher than
normal levels of blood glucose, called impaired glucose tolerance.
Both conditions are strong risk factors for diabetes type 2. Because
of the high risk among some minority groups, about half of the
DPP participants were African American, American Indian, Asian
American, Pacific Islander, or Hispanic.
The DPP compared two methods for preventing diabetes: (1) an intensive
program of healthy eating and exercise and (2) the use of metformin,
a diabetes drug. Persons who engaged in moderate physical activity
for about 30 minutes a day, followed a low-fat and low-calorie
diet, and lost 5 to 7 percent of their body weight (or about 12
pounds for someone who weighs 200 pounds) cut their risk of getting
diabetes type 2 by about one half (58%). Those persons receiving
metformin reduced their risk by one third (31%).
Q. How do I know if my diabetes medicines are working?
A. Monitor your blood sugar daily to see if your diabetes medicines
are working properly. Consult your doctor if you think your medicines
are not working correctly. For best results, oral medications
must be taken regularly every day, not irregularly or started
and stopped according to blood sugar. Since many dosages are available,
a physician can change the dosage if blood sugars are running
too high or too low. Some of these drugs can be used in combination
with one another. You should change your diabetes medicines only
when your doctor advises you to.
Q. What does the claim "fat free" mean on a
food label?
A. The nutrient content claim "fat free" on a food label
means that the serving of food contains an insignificant amount
of fat (less than 0.5 g per serving). Foods that are naturally
fat-free (i.e., need no special processing or reformulation to
lower fat content) must disclose that fat is not usually present,
for example, "broccoli, a fat-free food."
Fat-free or low-fat foods often contain high amounts of added
sugars or sodium to compensate for the loss of flavor that occurs
when fat is removed. Consumers should pay close attention to the
calories in a single serving to avoid concluding that fat-free
is synonymous with low in calories.
Reference: Title 21 of the Code of Federal Regulations (CFR);
Total Fat: 21 CFR 101.62(b)
Q. What do the claims "sugar free" and "no
sugar added" mean on a food label?
A. The nutrient content claim "sugar free" on a food
label means that the serving of food contains an insignificant
amount of sugar (less than 0.5 g per serving).
The claim "no added sugars" or "no sugar added"
is allowed if no sugar or sugar-containing ingredient (such as
jam, jellies, or concentrated fruit juice) is added during processing.
This claim is only to be used on foods that substitute for foods
that normally contain sugars. Also, unless the food meets the
criteria for a "low calorie" (i.e., 40 calories or less
per serving) or "calorie reduced" (i.e., 25% reduction
in calories) claim, it must say it is "not a low-calorie
food" or "not a reduced-calorie" food.
Reference: Title 21 of the Code of Federal Regulations (CFR);
Sugars - 21 CFR 101.60(c)
Q. What is the status of new treatments for diabetes?
A. As indicated on the FDA’s website the FDA's Center for Biologics
Evaluation and Research (CBER) has received a number of Investigational
New Drug applications to study the use of cell therapy, monoclonal
antibodies, and recombinant proteins to treat type 1 and diabetes
type 2. It is still too early to know how promising these methods
will be in treating diabetes.
Researchers are investigating new technologies to measure glucose
without fingersticks. In one method, near-infrared spectroscopy
measures glucose through the skin. Essentially, this amounts to
measuring glucose by shining a beam of light on the skin and is
painless. Many reports in the scientific literature describe the
challenges, strengths, and weaknesses of this and other new approaches
to testing glucose without fingersticks.
What are the symptoms of diabetes?
A. The ‘classical’ symptoms of both types of diabetes are thirst,
tiredness, itching or rash in the genital areas caused by yeast-like
infections of glucose-rich urine, over-production of urine (especially
at night) and weight loss. In type 1, less frequent symptoms are
cramps, constipation, blurred vision, and skin infections. In
diabetes type 2, the onset of symptoms may be so gradual that
they go unnoticed. People with diabetes type 2 who have remained
undiagnosed for some years may eventually be diagnosed because
they go to the doctor complaining of deteriorating eyesight or
with foot ulcers or pain in the limbs, which are some of the signs
of complications of diabetes.
What is hypoglycemia and what are its telltale signs?
A. Hypoglycemia is the medical term for a blood glucose level,
which is too low, often referred to as a ‘hypo’. A hypo happens
in people with diabetes because there is insufficient glucose
to fuel the essential activities of the brain and other organs.
The lack of glucose may arise after an insulin injection, after
taking oral diabetes medicines such as a sulphonylurea (e.g. if
the dose is too high or there is a build-up in the body as a result
of kidney disease), a delayed or missed meal, insufficient carbohydrate
foods, strenuous exercise or drinking alcohol without food. The
signs of an impending hypo vary between individuals but may include
sweating, anxiety, irritability, blurred vision, hunger, pallor,
tingling lips and palpitations. Recognizing these signs and taking
appropriate measures to boost glucose levels can avoid hypoglycemia.
Are hypoglycemic episodes dangerous?
A. If corrective action is not taken, unconsciousness may result,
but the body will take emergency action to raise glucose levels
so that consciousness is regained. However, a person may be in
a dangerous environment and need help, so it is important to take
special measures when appropriate (e.g. driving) and to inform
friends and workmates of the condition and what to do if help
is needed. Death from a hypo is very rare.
What causes diabetes?
A. Although both types of diabetes culminate in a failure to regulate
glucose properly and have a genetic predisposition, there are
clear distinctions between them.
Type 1: In this form we know that the body produces
antibodies against itself (an autoimmune reaction) that destroy
the beta-cells in the pancreas, but it is still uncertain what
triggers this reaction. Various possibilities have been proposed,
including infections with some specific types of virus, infections
with bacteria of the mycobacterium group, food-borne chemical
toxins and exposure as a very young infant to cow’s milk - a component
of which may cross into the baby’s circulation and cause an immune
response that cross-reacts with the beta-cells ‘by mistake’. However,
there is not enough conclusive evidence to implicate any of these
suggestions.
Type 2: Here the beta cells are preserved and
there are no antibodies or autoimmune attack. Genetic factors
determine susceptibility in most cases and common trigger factors
are excessive energy intake in food leading to obesity, physical
inactivity, and increasing age. Of these, obesity is of enormous
importance: 80 per cent of people with diabetes type 2 are overweight.
Other infrequent causes include some medicines, gestational diabetes,
and other illnesses in which hormones that counter the action
of insulin are produced.
What is the connection between obesity and diabetes?
A. Obesity is one of the fastest-growing medical epidemics affecting
people in Britain. Over half of the UK population is overweight
and about one-sixth is clinically obese. In 1980, about 6 per
cent of men and 8 per cent of women were obese. By 1991, the figures
had doubled. Obesity greatly increases the risks of many diseases,
including high blood pressure, kidney disease, and diabetes type
2. It has been estimated that the diseases caused by obesity cost
the National Health Service over £2 billion each year.
It appears that in obese individuals (especially those with much
fat in the trunk), the cells in the body begin to develop a resistance
to insulin. They then fail to use blood glucose properly and glucose
intolerance develops. Some obese individuals initially produce
more insulin in compensation, but this also soon fails and diabetes
results. Hence it is very important to try and maintain a reasonable
weight. This can be estimated by calculating the Body Mass Index,
which also indicates the degree of risk for different ranges of
BMI.
Are you overweight or obese?
A. Clinically, obesity can be defined in terms of a number called
the BODY MASS INDEX or BMI. To calculate your own BMI, measure
your weight (in kilogram’s) and your height (in meters). Then
divide your weight by the square of your height as shown in the
example below, and read off your BMI from the table, i.e.:
BMI = Weight (in kilos) ÷ height2 (in meters)
e.g. a person weighs 78kg and is 1.6 meters tall, then the BMI
is 78 ÷ 1.62 = 30.4. From the table below, it is evident that
this person is on the borderline between overweight and becoming
clinically obese.
BMI and relative risk of diabetes
less than 20 –underweight/very low risk
20 to 25 – ideal/very low risk
25-30 – overweight/significant risk
above 30 – clinically obese/high risk
above 40 – extremely obese/very high risk
Who does diabetes affect?
A. Type 1 and type 2 have very different patterns of onset. Type
1 begins most commonly in childhood with a peak onset between
the ages of 11 and 13, though it can develop at any age. It accounts
for about 10-25 per cent of all cases of diabetes in the UK. It
has been estimated that there are at least 20,000 people under
the age of 20 with diabetes in the UK and almost all have type
1.
Type 2 is much more common and accounts for 75-90 per cent of
diagnosed cases. It usually begins after the age of 40, although
prevalence increases with age.
In Asian and African-Caribbean people, there is a three to four
times greater risk of diabetes compared with Caucasians. Diabetes
affects men more often than women, in a ratio of about 3:2.
How widespread is diabetes?
A. This has been difficult to determine accurately, because about
half the people with diabetes do not know they have it. Population
studies based on the assessment of medical records, prescription
patterns and postal questionnaires suggested an overall prevalence
of about 1-1.5 per cent in the UK. However, this may be an underestimate,
because a survey in 1993 by the Office of Population Census and
Surveys, in which over 16,500 people were interviewed, revealed
a prevalence of 3 per cent over the whole age range. If this is
extrapolated to the over 16 population, the total of people with
diabetes is just under 1.4 million in the UK. Of these, from 1-1.25
million will have type 2.
Attempts to determine the incidence of diabetes have produce varied
results ranging from 16 to 100 new cases per 100,000 of the population
per year.
In global terms, the diabetes problem is massive and is growing
rapidly. A detailed study estimated that in 1997, there were 124
million people in the world with diabetes, of whom 97 per cent
had type 2. By the year 2010, the number of people with diabetes
has been projected to rise to 221 million, largely as a result
of adverse lifestyle changes in developing countries in Asia and
Africa leading to obesity and inactivity.
There are very large differences in the number of cases of both
type 1 and diabetes type 2 in different countries. Thus the incidence
of type 1 varies from about 30 cases per 100,000 per year in Finland
to only 1 per 100,000 per year in Japan. The UK figure is around
10. The prevalence of type 2 also varies.
Is diabetes a serious condition?
A. Before the discovery of insulin, diabetes type 1 was fatal,
but today the condition can be treated. Though a cure is not yet
possible, a high quality of life is enjoyed by most people and
complications can be minimized. Though not initially needing insulin,
people should not regard diabetes type 2 as a ‘mild’ condition:
without proper treatment complications can develop and life expectancy
reduce. Active management is required to prevent the development
of complications in both types 1 and 2 diabetes. This requires
not only medicines but also the active involvement of the individual
in his/her own monitoring and a high degree of motivation and
commitment. This can be very disruptive of everyday activities
but must be encouraged, because the long-term benefits are so
great.
What are the possible long-term complications of diabetes?
A. It is important to be aware that if diabetes is well controlled
by diet and/or medicines, then in many cases no complications
may develop even after 30 or more years. This has just been re-emphasized
with the release of the results of the 20-year UK Prospective
Diabetes Study. This involved 5,000 people with diabetes type
2 in 23 clinical centers. It showed that the rigorous management
of blood glucose levels and blood pressure substantially minimized
long-term complications. It showed that better blood glucose control
reduced the risk of diabetic eye disease by a quarter and early
kidney disease by a third.
Most important, it also showed that control of blood pressure
to near normal levels resulted in:
• a reduction in death from the long-term complications of diabetes
by a third
• one third fewer strokes
• a reduction in serious sight defects by one third
The intensive therapy that people in this study were given did
not impair life quality, though some people gained weight and
others had more frequent hypos. Overall, it was concluded that
‘...a substantial improvement in health of people with diabetes
type 2 can be obtained’. These data provide motivation and incentive
for people with diabetes to manage their condition better, in
the knowledge that improved health and fewer complications will
result.
Despite this encouragement, many people do experience problems,
especially after many years of living with diabetes. These often
arise through damage to blood vessels. If the blood vessels damaged
are small (i.e. capillaries), then blood supply to the eyes, kidneys
and various nerves may become restricted. Over time, this can
lead to damage to the retina in the eye and to impaired sight
(retinopathy), to kidney disease that can further complicate the
maintenance of the body’s chemical balance (nephropathy), and
to pain (sometimes severe) and loss of sensation, especially in
the legs and feet (neuropathy). The combination of blood vessel
and nerve damage predisposes some people to foot problems such
as diabetic ulcers and even gangrene. Less commonly, neuropathy
can also affect other parts of the body such as the arms, hands,
face or internal organs, depending on which nerves are affected.
If large blood vessels are damaged, then there will be an increased
risk of circulatory disorders such as hypertension and heart disease.
Does diabetes follow the same course in all people?
A. Type 1: In type 1, there are people who have used insulin for
over 50 years and have enjoyed a long and a satisfying life. However,
some are less fortunate and experience a more rapid progression
of their condition.
Type 2: Here the rate of progress of complications can be dependent
on when diagnosis is made – the earlier the better – and also
on the rigorous control of blood glucose levels and blood pressure.
Do the genes we inherit play any part in diabetes?A.
Type 1: This form is not inherited through the transfer of a single
gene, but some people have genes that increase their likelihood
of getting it. Several studies have shown that in identical twins
(who have identical genes), only 25-60 per cent of both individuals
get diabetes, thus strongly indicating that there are other non-inherited
factors involved. Overall, a child with a mother with type 1 has
a small increased risk of developing diabetes, amounting to 3
per cent, 9 per cent if it is the father. If both parents are
affected, then the risk is significantly higher.
Type 2: This form tends to run in families more strongly than
type 1. Detailed studies have shown that the chance of both identical
twins developing diabetes can approach 100 per cent when followed
over their lifetime. There are also a few well-studied families
who pass on the disorder to some of their children through a dominant
gene. This type of diabetes is called MODY, or Mature Onset Diabetes
of the Young. In these cases, the disorder often emerges in childhood
and has been linked to specific genes.
What are the main types of medicines used in diabetes?
A. Type 1: These individuals cannot survive without some form
of insulin replacement and this is the mainstay of their treatment.
Type 2: Though people with diabetes type 2 may eventually require
insulin, other oral medicines can be used, especially in the early
years. These are:
• sulphonylureas
• biguanides
• the alpha glucosidase inhibitors
• the glitazone group, which may soon be re-introduced in the
UK
In addition, many people require medicines to control blood pressure
(ACE inhibitors, beta-blockers, diuretics), and blood fats and
cholesterol (statins). These are mentioned later but are not discussed
in detail in this booklet.
When are these medicines likely to be used?
A. Type 1: As soon as this form of diabetes is diagnosed,
a person will receive insulin. Occasionally this protects the
few remaining beta cells and may result in a temporary remission
(honeymoon period). However, this is invariably short and people
with diabetes type 1 will need some form of insulin, coupled with
dietary control, throughout their lives.
Type 2: In a person with impaired glucose tolerance or diabetes
type 2, the first approach to management will often be to regulate
the diet and modify the life-style. A low-fat, high carbohydrate
diet (coupled with reduction in calories for the overweight) will
be combined with increased physical activity. If these measures
prove inadequate, then medicines will be added in a cascade fashion
to achieve control.
About 60-70 per cent of people with diabetes type 2 take oral
medication, and rather fewer with type 1. The doctor may prescribe
a medicine that stimulates insulin secretion, such as one of the
sulphonylureas. In some people, especially those who are very
overweight, the biguanide metformin is usually the first choice.
An alpha-glucosidase inhibitor such as acarbose may also be prescribed,
as this reduces the absorption of glucose in the intestines and
hence its uptake into the blood.
Do medicines used to treat diabetes have side effects?
A. Very few medicines (including insulin) are entirely devoid
of side effects and it is important to take only the dosage prescribed
and to report any strange, unexplained effects to the doctor.
However, medicines used in diabetes are generally well tolerated
and the side effects of the widely used sulphonylureas are well
documented and largely mild in nature. The early biguanides were
associated with some deaths due to an accumulation of lactic acid
(called lactic acidosis) and were withdrawn. The glitazones are
new and generally well tolerated products. The adverse effect
on the liver of troglitazone is under investigation, but it is
too soon yet to say whether it will also be a characteristic of
other glitazone compounds still in clinical trials.
Are there forms of treatment for diabetes other than medicines?
A. In the early stages of diabetes, modifications to the diet
may be sufficient to control excess glucose, at least for some
months or even years. Learning what and what not to eat and when
to eat (and drink) is also very important. Increased fiber may
help in some people and bulking agents can be prescribed as a
supplement to diet and/or medicines.
What kind of general support is available for people with
diabetes?
A. Diabetes will have a significant impact on lifestyle and will
also place many demands on the individual, families and friends
in terms of understanding what is wrong and how to cope with it.
Patient education will be necessary and will vary depending on
the stage of the condition. This may be provided by nurses, dietitians
and other health care professionals at the local diabetic clinic.
Additional information is available from the BDA, or by reference
to the local support groups, which operate throughout the country.
