benefits outweigh the risks of the surgery and drug
therapy needed.
Alternative treatment
Since diabetes can be life-threatening if not prop-
erly managed, patients should not attempt to treat this
condition without medical supervision. A variety of
alternative therapies can be helpful in managing the
symptoms of diabetes and supporting patients with
the disease. Acupuncture can help relieve the pain
associated with diabetic neuropathy by stimulation
of certain points. A qualified practitioner should be
consulted. Herbal remedies also may be helpful in
managing diabetes. Although there is no herbal sub-
stitute for insulin, some herbs may help adjust blood
sugar levels or manage other diabetic symptoms. Some
options include:
fenugreek (Trigonella foenum-graecum) has been
shown in some studies to reduce blood insulin and
glucose levels while also lowering cholesterol
bilberry (Vaccinium myrtillus) may lower blood glu-
cose levels, as well as helping to maintain healthy
blood vessels
garlic (Allium sativum) may lower blood sugar and
cholesterol levels
onions (Allium cepa) may help lower blood glucose
levels by freeing insulin to metabolize them
cayenne pepper (Capsicum frutescens) can help
relieve pain in the peripheral nerves (a type of dia-
betic neuropathy)
gingko (Gingko biloba) may maintain blood flow to
the retina, helping to prevent diabetic retinopathy
Any therapy that lowers stress levels also can be
useful in treating diabetes by helping to reduce insulin
requirements. Among the alternative treatments that
aim to lower stress are hypnotherapy, biofeedback,
and meditation.
Prognosis
Uncontrolled diabetes is a leading cause of blind-
ness, end-stage renal disease, and limb amputations. It
also doubles the risks of heart disease and increases the
risk of stroke. Eye problems including cataracts, glau-
coma, and diabetic retinopathy also are more common
in diabetics.
Diabetic peripheral neuropathy is a condition
where nerve endings, particularly in the legs and feet,
become less sensitive. Diabetic foot ulcers are a partic-
ular problem since the patient does not feel the pain of
a blister, callous, or other minor injury. Poor blood
circulation in the legs and feet contribute to delayed
wound healing. The inability to sense pain along with
the complications of delayed wound healing can result
in minor injuries, blisters, or callouses becoming
infected and difficult to treat. In cases of severe infec-
tion, the infected tissue begins to break down and rot
away. The most serious consequence of this condition
is the need for amputation of toes, feet, or legs due to
severe infection.
Heart disease and kidney disease are common
complications of diabetes. Long-term complications
may include the need for kidney dialysis or a kidney
transplant due to kidney failure.
Babies born to diabetic mothers have an increased
risk of birth defects and distress at birth.Prevention
Research continues on diabetes prevention and
improved detection of those at risk for developing
diabetes. While the onset of Type I diabetes is unpre-
dictable, the risk of developing Type II diabetes can be
reduced by maintaining ideal weight and exercising
regularly. The physical and emotional stress of sur-
gery, illness, pregnancy, and alcoholism can increase
the risks of diabetes, so maintaining a healthy lifestyle
is critical to preventing the onset of Type II diabetes
and preventing further complications of the disease.Resources
PERIODICALS
Crutchfield, Diane B. ‘‘Oral Antidiabetic Agents: Back to
the Basics.’’Geriatric Times. May 1, 2003: 20.
‘‘Gestational Diabetes Increases 35% in 10 Years.’’Health &
Medicine Week. March 22, 2004: 220.
Kordella, Terri. ‘‘New Combo Pills.’’Diabetes Forecast.
March 2003: 42.
‘‘New Drugs.’’Drug Topics. November 18, 2002: 73.
‘‘Research: Lower Chromium Levels Linked to Increased
Risk of Disease.’’Diabetes Week. March 29, 2004: 21.
‘‘Standards of Medical Care for Patients with Diabetes
Mellitus: American Diabetes Association.’’Clinical
Diabetes. Winter 2003: 27.
‘‘Wider Metformin Use Recommended.’’Chemist & Drug-
gist. January 11, 2003: 24.
ORGANIZATIONS
American Diabetes Association. 1701 North Beauregard
Street, Alexandria, VA 22311. (800) 342-2383.<http://
http://www.diabetes.org.>
American Dietetic Association. 216 W. Jackson Blvd., Chi-
cago, IL 60606-6995. (312) 899-0040.<http://www
.eatright.org.>
Juvenile Diabetes Foundation. 120 Wall St., 19th Floor,
New York, NY 10005. (800) 533-2873.<http://www
.jdf.org.>Diabetes mellitus