Type 1 diabetes is an auto immune disease. A new method called intervention therapy is used to halt or even prevent the beta cell destruction.Prevention of type 1 DM can be implemented at 3 different levels:
Primary Prevention: This include all stratagies Aimed at decreasing the risk of developing type 1 diabetes in individuals without any sign of cell damage.
Secondary Prevention: This aims in reducing the incidence of type 1 diabetes by arresting the cell destruction in individuals with signs of such process
Tertiary Prevention: This method is used to restore cell functions and to prevent the complications in overt type 1 diabetes .
Individuals who are at risk of developing type 1 diabetes can be identified by positive family history or by genetic,immunological or metabolic markers. These markers can also be combined to acheive higher, positive predictive value.
Prevention of Type II Diabetes
Prevention of type II diabetes requires arrest of the progressive b-cell dysfunction and stabilization of glucose concentrations at non-diabetic levels. A delay in this type of arrest and stabilization enhances the onset of type II diabetes.
According to various studies, type II diabetes can be prevented or delayed by three types of interventions:
- Interventions that limit fat accumulation in the body: A decrease in obesity decreases insulin resistance.
- Interventions that uncouple obesity from insulin resistance: Decreased insulin resistance decreased the failure of b-cell activity and
- Interventions that directly preserve b-cell mass and/or function: Despite the high secretory demands, proper functioning of the b-cell decreases the risk of development of diabetes.
- Maintenance of a healthy body weight and an active lifestyle helps to prevent the onset of type II diabetes.
Though complete prevention of diabetes is not possible, the following measures can be taken to improve the chances of avoiding it:
- Dietary management: The diet should include more vegetables, fresh fruits and whole grains. Methods of cooling should include baking, broiling and grilling. The use of fat as a medium for cooking should be avoided. Foods rich in starches such as white potatoes, white rice, spaghetti noodles, white breads, biscuits, grits, potato chips etc should be avoided. The diet should be lower in saturated fats, calories, salt and sugar as a whole.
- Insulin therapy: Small daily doses of injected insulin given to individuals likely to develop type I diabetes may prevent the disease for as long as eight years, according to researchers at Joslin Diabetes Center in Boston.
- Exercise: According to studies, vigorous exercise, even if done only once a week, has shown to have a protective effect against diabetes. Exercise promotes weight loss as well as lowers blood sugar.
- Alcohol: Drinks low in alcohol and sugar such as dry wines and light beers should be consumed. While on insulin or diabetic pills, the alcohol can drop glucose levels too far. Drinks can be consumed with a meal or a snack.
- Smoking: Smoking is especially dangerous for people with diabetes who are at risk for heart and blood vessel diseases. Hence smoking should be completely avoided.
Prevention of Diabetic Complications
Following are the complications that should be prevented in diabetes:
- “Tight” blood glucose control level: Most diabetes complications are caused by excess glucose in the blood. Excess glucose makes the blood "sticky". The small blood vessels that carry blood throughout the body become clogged. Hence it is very important, as a good-health measure for people with diabetes is to have "Tight" Blood Glucose Control level.
- Giving appropriate insulin doses matching the food intake and exercise can control blood glucose level.
- Cardiovascular disease: Heart disease and stroke cause about 65 percent of deaths among people with diabetes. These deaths could be reduced by 30 percent with improved care to control blood pressure, blood glucose and blood cholesterol levels.
- Eye disease and blindness: People with diabetes can prevent or delay vision loss or blindness due to diabetic retinopathy through proper control of blood sugar. As diabetic retinopathy develops over a long period of time, eye examinations at appropriate intervals, by suitably trained health professionals, allow a determination to be made as to whether such treatment is needed.
- Kidney disease: Treatment to better control blood pressure and blood glucose levels could reduce diabetes-related kidney failure by about 50 percent. Diabetes-related kidney disease can often be prevented or its progress markedly slowed. Proper control of blood sugars is required, as well as regular monitoring of protein loss in the urine, enabling kidney problems to be diagnosed earlier and treated more aggressively.
- Amputations: Foot care programs that include regular examinations and patient education could prevent up to 85 percent of these amputations.
- Pregnancy complications: Pregnancy related complications in diabetes can be reduced with screenings and diabetes care before, during and after pregnancy.
- Other complications such as influenza, pneumonia, yeast infections can be avoided by immunizations.
Use of anti-oxidants: Alpha-lipoic acid (LA) and its reduced form, dihydrolipoic acid, are powerful antioxidants. LA scavenges hydroxyl radicals, hypochlorous acid, peroxynitrite, and singlet oxygen. Diabetics have increased levels of lipid hydroperoxides, DNA adducts, and protein carbonyls.
The antioxidant property of alpha-lipoic acid is particularly suited to the prevention and/or treatment of diabetic complications that arise from an overproduction of reactive oxygen and nitrogen species. LA also increases glucose uptake through recruitment of the glucose transporter-4 to plasma membranes, a mechanism that is shared with insulin-stimulated glucose uptake.