HOW TO PREVENT CANCERS

Normally, there are no warning signs of diabetes or perhaps only a moderate progression of symptoms. Type 2 diabetes warning signs usually are not discovered unless health conditions have shown themselves.

Diabetic issues affect approximately twenty-six million people, young and old, around the U.S.A., and yet only nineteen million people are aware that they actually possess it. Roughly ninety percent of all people with diabetes end up having type 2.

Typically the signs of type 2 diabetes look like those connected with type 1 diabetes, but there are usually no symptoms at all.

Exceedingly high sugar levels might also produce rapid weight loss, such as 10 to 20 or so lbs within just a few months, but this is really not healthy weight-loss.

Because insulin fails to move sugar directly into your cells to enable them to begin using it for energy, your system is convinced it is actually starving and starts digesting protein from muscle as an alternate method to acquire fuel.

At the same time, a person's kidneys are working exceptionally hard to remove the unwanted glucose, which in turn results in shedding calories and perhaps causing harm to the kidneys.

If it turns out you have to urinate frequently, specifically if you need to get up often at night to use the toilet, perhaps it's a warning sign of being diabetic.

An individual's kidneys go into high gear to discard all of the built up sugar in the system, for this reason an individual will have to relieve themselves a few times during the night.

The excessive thirst means your system is endeavoring to replenish depleted bodily fluids. Both of these signs of diabetes work collectively and are just some of your body's methods for managing high blood sugar.

When an individual has high glucose amounts for a while, they often get accustomed to regularly not feeling well.

Waking up so as to relieve themselves frequently during the evening might make anybody fatigued, as can the increased energy one's body is expending in order to compensate for the glucose shortfall. And additionally, being fatigued may easily make you cranky.

Hunger pains could come due to sudden highs and lows in blood glucose quantities. Anytime sugar levels decline, the body perceives it has not yet been given sustenance and is looking for supplementary amounts of sugar that the cells must have to function.

Infections, scratches, cuts along with contusions which don't mend fast are also another normal indication of diabetes.

This typically happens because your blood vessels have become impaired due to the increased quantities of sugar flowing throughout your veins as well as your arteries. This makes it really hard for the blood to get to different areas in the body, which is essential for recovery.

Altered vision and seeing eye floaters or even occasional flashes of light could possibly be a response to heightened sugar levels. Blurred visual acuity is usually a refraction complication. Once the glucose within your bloodstream happens to be excessive, it changes the actual contours of the lens as well as the eyes.

On the plus side, this is a sign of diabetes which is reversible when blood glucose levels come back to normalcy, or near normal. Then again, if anyone permits sugar amounts go uncontrolled for a prolonged time it is likely to result in irrevocable impairment, even perhaps loss of eyesight.

A pins and needles sensation plus sensing numbness in your extremities, accompanied by a burning feeling or swelling, tend to be clues that nerves have also been injured thanks to diabetes.

When these indications of diabetes are new, it might be reversible. Then again, just like with vision problems, in the event blood sugar levels go unchecked for too long a period of time, neurological injury is likely to be irreparable.

Itchy skin, which could be the direct result of dry skin or perhaps poor blood flow, is occasionally a warning sign associated with diabetes together with some other skin issues like Acanthosis Nigricans. This is a darkening of your skin around your throat or armpit region. Those who have this problem already have a certain level of insulin resistance.

Diabetes mellitus is thought to be an immunosuppressed condition, which means an elevated vulnerability to a variety of infections. By far the most common would be yeast infections together with other sorts of fungal infections. Females, by way of example, need to watch out for vaginal Candida infections.

Type 1 diabetes happens when the pancreas is unable to produce insulin to control blood sugar level. This form of diabetes is life long and person affected from it need prescribed medications from the doctor. Often diabetes can be treated without use of medications, by taking up proper diet and performing exercises regularly.

Type 1 Diabetes is also referred to as insulin dependent or juvenile diabetes. Type 1 Diabetes affects a person at any age, and it found to occur mostly in young adults as well as children.

Pancreas, an organ behind the stomach is responsible for creation of insulin hormone through beta cells. Insulin helps move glucose (blood sugar) into the cells, where it is stored to be used as energy. Type 1 happens when there is little or no production of insulin.

Due to lack of insulin, glucose accumulates into the blood stream and doesn't move to the cells thus raising the level of blood sugar. The body cannot convert the glucose into energy.

In earlier stage, the pancreas produces more amount of insulin to carry on the process, but after 5 to 10 years, pancreas is unable to produce requisite amount of insulin and the system suffers a set back.

Exact cause of the disease is yet to be discovered, but it may happen due to sudden attack by the white blood cells on the insulin creator beta cells.

There are various types of symptoms for Type 1 diabetes. Body becomes fatigue and person may feel hungry and thirsty with increasing urge to urinate. Weight loss, tingling feeling in feet and blurred vision are some other symptoms of Type 1 Diabetes.

Testing and treatment is must for those suffering from this diabetes. Blood sugar test is essential to detect presence of diabetes. Ketone testing is done in Type1 Diabetes using urine sample. The testing is specifically done when blood sugar level is greater than 240 mg/dL.

Diabetes is a dangerous disease because it can cause complications in other organs, such as cardiovascular disease, kidney failure and nerve damage. For better and healthy life, we need to treat the body and try to keep blood sugar levels to avoid this disease.

In addition to medically since ancient times many natural herbs actually used to treat diabetes. Scientific research has confirmed the effectiveness of some certain herbs to overcome diabetes. Here are some herbs that have been believed to help cure diabetes.

1. Fenugreek

Trigonella foenum-graecum) is a plant in the family Fabaceae. Fenugreek is used both as a herb (the leaves) and as a spice (the seed, often called methi in Hindi). The leaves and sprouts are also eaten as vegetables. The plant is cultivated worldwide as a semi-arid crop and is a common ingredient in many curries.

These plants have the ability to control blood glucose levels and has been widely used to control diabetes.
Fenugreek lowers resistance to insulin and control blood glucose levels by increasing the number of insulin receptors in red blood cells. This will increase glucose utilization in peripheral tissues, thereby reducing the levels of glucose in the blood. However Fenugreek should not be used by pregnant or lactating women.

2. Aloe vera

Aloe vera is often regarded as a 'healing herb'. Dried aloe vera sap and gel (inner leaf) is used traditionally to treat diabetes because it is believed to help reduce levels of fasting blood glucose

3. Cinnamon

This plant makes fat cells more accessible to insulin and increase the conversion of glucose into energy. It also inhibits the formation of harmful free radicals.

4. Onion

Garlic can significantly lower blood sugar. Garlic extract reduces blood sugar levels during oral and intravenous glucose tolerance. Onions affect the hepatic metabolism of glucose and increases insulin release, thus preventing destruction of insulin.

5. Garlic

Garlic is regarded as the best herb to lower blood sugar as well as repair cells of the pancreas and stimulates the pancreas to produce insulin. It has been proven in many studies, but unfortunately there are still many who do not use it.

6. Basil

Studies have shown that basil has a positive effect on glucose after meals and during fasting. This herb can facilitate the process of insulin secretion.

7. Mango leaves

Mango leaves are known as effective drugs in diabetes. The trick, simply by soaking the leaves of mango in a cup of water overnight. After that, drain the leaves out and drink the water. This helps to relieve the symptoms of diabetes.

8. Asian Ginseng

Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes. This plant has a direct effect in lowering the sugar, increase the release of insulin from the pancreas and increase the number of insulin receptors.

Managing diabetes is a process of balancing the intake of nutrients, energy expended and the dose and timing of insulin injections or oral anti-diabetic agents. A diabetic has basically the same nutritional needs as a normal person with the exception that their diet must be more structured in order to prevent hyperglycemia. Dietary management for adult diabetics are based on guidelines established by the American Diabetes Association (ADA) in 2002. These include:

• Maintain as near normal blood glucose levels as possible by balancing food intake with insulin or oral glucose.

• Achieve optimal serum lipid levels.

• Provide adequate calories to maintain or attain reasonable weights, and to recover from catabolic illness.

• Prevent and treat the acute complications of insulin treated diabetes, short term illnesses, and exercise related problems; or the long term complications of diabetes.

• Improve overall health through optimal nutrition, using dietary guidelines for Americans and the food guide pyramid.

Carbohydrates:

According to the ADA carbohydrates need to be individualized to each diabetic's specific needs. The amount of carbohydrate and monosaturated fat should make up 60 to 70 percent of the daily diet. Carbohydrates contain 4 kilocalories per gram ingested.

Diabetics can get their carbohydrates primarily from plant sources such as grains, fruits, and vegetables, milk, and some other dairy products. Carbohydrates are divided into simple sugars and complex carbohydrates. Research has shown that sugars do not actually digest faster then complex carbohydrates which in the past was believed to increase the chances of hyperglycemia. It has been found that fruits and milk have a lower glycemic response than most starches, and the glycemic response of sucrose (sugar) is similar to that of bread, rice and potatoes.

Using sugar as part of the diabetic diet does not impair blood glucose control in people with diabetes as long as the sugar and sugar containing foods are substituted gram for gram for other forms of carbohydrates. Fructose from fruits and vegetables actually produce a smaller rise in plasma glucose than sugar and most starches, making it a good choice as a sweetening agent if used in moderation because of its potential to adversely affect serum cholesterol and LDL cholesterol.

Protein:

The recommended daily protein intake is 15 to 20 percent of total daily kilocalorie intake. Protein has 4 kcal per gram. Sources of protein eaten should be low in fat, low in saturated fat, and low in cholesterol. The amount of protein recommended is less then most people normally consume during the day, the reason for such a low amount is to help prevent or delay possible renal (kidney) complications. It may be hard for the newly diagnosed diabetic to adhere to these protein restrictions immediately so the best course of action is to gradually decrease protein intake over a longer period of time.

Fats:

Dietary fats should be low in saturated fat and cholesterol. Saturated fats should not be higher than 10 percent of the total calories eaten per day and dietary cholesterol should be no more 300 mg per day. Fat contain 9 kilocalories per gram eaten. There are many sources for the different types of at that include:

• Saturated fat. These come from animal meats (meat and butter, fats, lard, bacon), cocoa butter, coconut oil, palm oil, and hydrogenated oils.
• Polyunsaturated fat. Sources are oils of corn, safflower, sunflower, soybean, sesame seed, and cottonseed.
• Monosaturated fat. We can get these from peanut oil, olive oil, and canola oil.

Another reason for the diabetic to limit fat and cholesterol consumption is to help prevent atherosclerosis, a disease that diabetics are more susceptible to.

Fiber:

Dietary fiber is helpful in treating and preventing gastrointestinal disorders such as constipation and colon cancer. It also creates a feeling of fullness and large amounts have been shown to be beneficial for serum lipids. Soluble fiber is found in beans, oats, barley and some vegetables and fruits including peas, corn, zucchini, cauliflower, prunes, pears, apples, bananas, and oranges. Insoluble fiber found in many of the same foods also helps to increase intestinal motility and helps give a feeling of fullness.

The optimum amount of fiber eaten per day should be in the 20 to 35 gram range. Any increase in fiber consumption should be done gradually as it can lead to nausea, diarrhea or constipation, and increased gas and flatulence. This is particularly true if fluids are not also increased at the same time.

Sodium:

The amount of sodium most people consume each day exceeds by far the amount the body actually needs. 1000 mg of sodium per 1000 calories per day is the recommended daily intake and it should not exceed 3000mg per day. For the diabetic increased sodium consumption can increase the risk of hypertension, a condition that can be a problem with those with diabetes. It is recommended that all diabetics avoid table salt and processed foods that are high in sodium.

Sweeteners:

Any diabetic diet plan will restrict the amount of refined sugars that are eaten. Because of this restriction many diabetics turn to artificial sweeteners in their foods and drinks. All the non-nutritive artificial sweeteners used in the United States have been approved for use by the FDA. This category of sweeteners includes the following:

• Saccharin - Sweet & Low
• Aspartame - NutraSweet, Equal
• Acesulfame potassium - Sunnette.

These artificial sweeteners have little to no calories and produce little change in blood glucose levels when eaten.

Diabetics also use nutritive sweeteners, including fructose, sorbitol, and xylitol. The caloric content of these sweeteners is much the same as table sugar but they do not cause as great a rise in blood glucose levels.

Alcohol:

For the diabetic it is recommended that if they do choose to drink alcohol that they do it in moderation. Consumption of alcohol can increase the hypoglycemic affects of insulin and oral medications. For men the ADA recommends that they consume no more than two drinks per day. For women the recommendation is one drink per day. The following is a list of guidelines for alcohol as recommended by the ADA.

• The signs of intoxication and hypoglycemia are similar; thus, the person with type 1 diabetes is at an increased risk for an insulin reaction.

• The two oral hypoglycemic agent's chlorpropamide and tolbutamide can interact with alcohol and lead to headache, flushing, and nausea.

• Liqueurs, sweet wines, wine coolers, and sweet mixes contain large amounts of simple carbohydrates.

• Light beer is the recommended alcoholic drink.

• Alcohol should be consumed with meals and added to the daily food intake. In most instances, the alcohol is substituted for fat in calculating the diet. A drink with 1.5 ounces of alcohol is the equivalent of two fat exchanges.

Following these ADA guidelines is an important part of managing diabetes. Failure to do so can lead to a host of complications that in some cases can be life threatening.

Diabetes is a condition where either the pancreas does not produce sufficient insulin to lower the levels of glucose in the blood (Type 1 Diabetes) or the body cannot properly use the insulin which is produced (Type 2 Diabetes) or sometimes both. As a consequence, the glucose levels become abnormally high (known as hyperglycaemia) thus damaging the cells which the glucose would otherwise be nourishing. Over time the retina, nerves, kidneys and blood vessels can be affected.

As a consequence, anyone who is diagnosed diabetic needs to takes special care over certain aspects of their health.

• Eyes. Retinal damage caused by diabetes can cause blindness. A diabetic must see an ophthalmologist at least every year to ensure that no deterioration is taking place (or already had prior to diagnosis).

• Nerves. Diabetes can cause a loss of feeling in the extremities, particularly the feet. A diabetic should never cut their own toe nails but should see a qualified chiropodist specialising in diabetes about every six weeks to have their nails trimmed, hard skin removed and nerves assessed. Any damage to the feet or legs should be treated immediately by a health care professional to prevent infection setting in. Failure to do so could ultimately result in amputation of the foot or leg.

• Kidneys. Damage to the kidneys can lead to kidney failure so a urine test every three months is essential so that a doctor can assess what impact the diabetes or the medication is having.

• Arteries. Diabetes speeds up the formation of plaque in the arteries which can lead to thromboses, heart attack and poor circulation in the arms and legs. Regular blood tests can detect this.

• Blood. High blood pressure, cholesterol and triglycerides can result from diabetes all of which can contribute to cardio vascular and kidney disease. A blood test at least every three months will enable the monitoring of these levels. An adjustment to lifestyle or medication can usually sort out any problems quickly.

In addition, a diabetic will need to ensure that they take their prescribed medication regularly and adapt their eating, drinking and smoking habits to help the medication to do its job.

Since the 2002 IARC report, substantial new evidence supports a cause and effect relation between overweight, obesity, and the onset of these cancers further increasing the burden of cancer due to obesity (5). The American Institute for Cancer Research (AICR) and World Cancer Research Fund (WCRF) reported there is convincing evidence for a relation between obesity and esophageal, pancreatic, colorectal, postmenopausal breast, endometrial and kidney cancers with probable evidence for gallbladder. In addition, they found probable evidence that abdominal fatness in particular increases risk of pancreas, endometrial and postmenopausal breast cancer. Finally, emerging evidence suggests that obesity increases risk of aggressive prostate cancer (6). Overall we estimate that overweight and obesity causes approximately 20% of all cancer. Previously Doll and Peto (7) included overnutrition (overweight) with diet causing a combined 35% of all cancer.

To conclude that a cause and effect relation exists between obesity and cancer at each cancer site scientists pursue studies of mechanism that confirm the underlying biology of this relation and provide insights to guide prevention strategies. Take for example postmenopausal breast cancer. Among postmenopausal women obesity is directly related to circulating estradiol levels (8) which themselves are directly related to breast cancer risk (9-10). When the action of estrogens is interrupted by estrogen receptor modulators in randomized controlled trials, breast cancer incidence is reduced by approximately 50% (11-12).

Just as smoking cessation leads to a reduction in risk of lung cancer adding to the evidence of a cause and effect relation, so documenting a 50% reduction in risk of breast cancer among women who lost 10kg or more after menopause and kept it off (13) adds to both our understanding of this causal relation. In addition, focusing on weight loss after menopause, a time in life when obesity clearly increases risk of breast cancer, provides important evidence on the time frame for change in cause (weight) and subsequent change in cancer incidence. This reduction in incidence of postmenopausal breast cancer will follow the decline in circulating estrogen after weight loss.

For colon cancer, growing evidence points to insulin pathways mediating the effect of BMI and risk (14). Studies of blood glucose levels and colon cancer show a direct relation between higher glucose and subsequent risk (14). Providing further biologic rationale, c-peptide (15), a marker of insulin production, also shows this positive relation and animal models using insulin injection vs. saline show significant increases in colon cancer among those injected with insulin (16). Finally, preclinical data provides additional support for the insulin-IGF hypothesis of cancer risk, as outlined in several excellently detailed recent reviews (17-18). The PI3K/Akt pathway likely compromises the downstream target of insulin and is one of the most commonly altered in epithelial tumors.(18-19) In sum, strong evidence points to hyperinsulinemia as the direct pathway from adiposity to colon cancer.


Returning to the ACS committee report the concensus committee convened by ACS and the American Diabetes Association concluded that Diabetes (primarily type 2) is associated with an increased risk of liver, pancreas, endometrium, colon/rectum, breast, and bladder cancers. Furthermore, the association between diabetes and some cancers may be due in part to shared risk factors between the 2 diseases such as aging, obesity, diet, and physical inactivity. Possible mechanisms for a causal pathway between diabetes and cancer include hyperinsulinemia, hyperglycemia, and inflammation.


Building on this summary and the extensive work by Dr Renehan and colleagues revieweing the evidence linking obesity to cancer, we present summary estimates of relative risk from the rigorous meta-analysis by Renehan (5) and the likely pathway or mechanism for a causal relation between obesity and cancer (see Table 1 and 2).

Table 1. Relative Risk of Cancer per 5 kg/m2  Increase in BMI, Males, and most likely causal mechanism
Cancer	RR	Causal mechanism
Oesophageal adenocarcinoma	1.52***	Reflux esophagitis and chronic irritation
Thyroid	1.33*	Unknown
Colon	1.24***	Insulin
Renal	1.24***	In part though hypertension
Liver	1.24	Fatty liver cirrhosis
Malignant melanoma	1.17**	?
Multiple myeloma	1.11***	Inflammatory pathways – IL6
Rectum	1.09***	?
Gallbladder	1.09	Chronic secretion-gallstones and irritation
Leukemia	1.08**	?
Pancreas	1.07	Possible insulin pathway
Non-Hodgkin lymphoma	1.06***	Inflammatory pathways – IL6
Prostate¶	1.03	?
Lung	0.76***	Smoking leads to leanness and causes lung cancer
Esophageal squamous	0.71***	Smoking leads to leanness and causes squamous esophageal cancer
Relative risk for a 5 point increase in BMI. For example, the relative risk linked to a BMI of 28 compared to a BMI of 23; or a BMI of 32 compared to 27.
***p < .0001;  **p < .01; *p < .05 ¶ biased to null as this includes predominantly low grade lesions
Adapted from Renehan et al, 2008; Fig 3 (5).

Table 2. Relative Risk of Cancer with RR per 5kg/m2Increased BMI, Females,  and most likely causal mechanism
Cancer	RR	Causal mechanism
Endometrium	1.59***	Endogenous Estrogen
Gallbladder	1.59*	Chronic secretion-gallstones and irritation
Oseophageal adenocarcinoma	1.51***	Reflux esophagitis and chronic irritation
Renal	1.34***	In part through hypertension
Leukemia	1.17*	Unknown
Thyroid	1.14**	Unknown
Breast (postmenopausal)	1.12*	Endogenous estrogen
Pancreas	1.12*	Possible insulin pathway
Multiple myeloma	1.11***	Inflammatory pathways – IL6
Colon	1.09***	Insulin
Non-Hodgkin lymphoma	1.07	Inflammatory pathways – IL6
Liver	1.07	Fatty liver cirrhosis
Breast (premenopausal)	0.92**	Irregular menstrual cycles- hormones
Lung	0.8*	Smoking leads to leanness and causes lung cancer
Esophageal squamous	0.57***	Smoking leads to leanness and causes squamous esophageal cancer
Relative risk for a 5 point increase in BMI. For example, the relative risk linked to a BMI of 28 compared to a BMI of 23; or a BMI of 32 compared to 27.
***p < .0001; **p < .01; *p < .05
Adapted from Renehan et al, 2008; Fig 4 5.

Impact of obesity among cancer patients
Obesity also impacts outcomes among cancer patients. Growing evidence also points to benefits of physical activity for breast and colon cancers. Dosing of chemotherapy and radiation therapy among obese patients may also be impacted and therapy related toxicity may vary with level of obesity. These issues will be addressed in a subsequent post.