Diabetes is caused by a deficiency of insulin, a hormone produced by the pancreas and necessary for converting glucose to energy. There are two types of diabetes - Type I and Type II.

Diabetes is largely considered a disease of affluence, a product of the Western diet. Genetic factors are also important. Type II diabetes, for instance, is usually associated with obesity and can often be cured simply by medically supervized dieting and weight loss.

Type I diabetes is the more serious form. It is an autoimmune disease triggered when insulin­producing cells in the pancreas are attacked and destroyed. The only treatment is daily injections of insulin, but people with diabetes must also pay attention to their diet, following a pattern of healthy eating and regular exercise. Uncontrolled and untreated Type I diabetes can result in a life-threatening coma. It is essential to seek specialist advice.

With Type II diabetes a certain amount of insulin is produced, but the body is unable to use it properly, making it less effective.

Diabetes tends to run in families, although not all members who carry the gene will go on to acquire the disease. It is more common to develop Type II than Type I. In addition to hereditary factors, damage to the pancreas may cause diabetes, particularly by viruses (such as mumps or rubella).

Other factors that may cause the disease in susceptible people are

pregnancy - this is called gestational diabetes and is more common if previous babies have weighed upward of 9lb/4kg at birth; urine tests during prenatal checks will show high levels of glucose, and you will be given a glucose tolerance test; positive cases will require dietary changes under medical supervision, or in the more severe instances, insulin treatment.

Other illnesses, including diseases of the pancreas, thyrotoxicosis and hyperthyroidism treatment of existing conditions with corticosteroids.

Symptoms of diabetes include:

frequent urination and thirst

lethargy and apathy

weight loss

lowered resistance to infection (particularly urinary tract infections)

cramps

blurred vision

menstrual problems.

Longer-term complications include:

scarring of the retina

damage to the peripheral nerves

chronic kidney failure

atherosclerosis

associated disorders of the thyroid.

Special Note on Coma

It is important in diabetes to distinguish between diabetic coma and hypoglycemic coma.

Hypoglycemic (low blood sugar) coma occers as a result of taking too much insulin, or of not following insulin with enough sugar or carbohydrate. As the food and insulin levels become quickly out of balance, sweating, erratic and often violent behavior very quickly results, followed by coma - usually within 15 to 30 minutes. This reaction is known as "a hypo" and can be corrected just as quickly by taking in sugar, preferably as glucose, in food or drinks.

Diabetic coma is much more serious, and requires immediate medical help. The causes of this kind of coma are a buildup of acids (ketones), and metabolic poisoning as a result of having too little insulin in the body for too long. The condition causes rapid breathing and dehydration, followed by life-threatening coma if not checked.

Treatment

The key to successful treatment of both types of diabetes is in maintaining the correct balance between food and insulin. There is no cure, either conventional or alternative, but research in the United States has shown that careful control of blood sugar levels can reduce the risk of diabetic complications by as much as 60 percent.

Research shows that the blood sugar levels of diabetics can best be controlled by a high-fiber, high-carbohydrate, low-fat diet. In the past, carbohydrate content comprised about 40 percent of the energy intake, but this has now been altered so that at least 50 percent of total energy intake is drawn from carbohydrates. Evidence has also shown that blood sugar levels do not rise as rapidly when a high-fiber diet is eaten. Because high-fiber foods take longer to digest, the increase in blood sugar is slower and more monotonous and the diabetic does not have to contend with a sudden increase such as that supplied by refined sugars in fizzy drinks, for instance, or candies.

Type I Diabetes

The only treatment is daily injections of insulin, but people with diabetes must also pay attention to their diet, following a pattern of healthy eating and regular exercise. Several alternative therapies can help, but you always should consult a qualified practitioner.