A metabolic disorder associated with major abnormalities in carbohydrate, protein, and fat metabolism. NIDDM usually occurs in persons over 40 years of age and is characterized by insulin resistance (diminished tissue sensitivity to insulin) and impaired beta-cell function (delayed or inadequate insulin release). Many people with NIDDM can control their blood sugar by nutrition and lifestyle changes, others require supplemental insulin or oral hypoglycemic therapy. Approximately 40% of persons with NIDDM may eventually require insulin injections to achieve glycemic control.

Diagnosis is made if any of the following is present:

• Blood glucose ≥ 200 mg/dL with classic signs and symptoms of diabetes, such as unusual weight loss, increased frequency of urination and increased hunger.

• Fasting plasma glucose (FPG) ≥ 140 mg/dL on two occasions

• Fasting blood glucose (FPG) < 140 mg/dL with elevated glucose during an oral glucose tolerance test (OGTT) of > 200 mg/dL at 2 hours and one other blood glucose level is also > 200 mg/dL.

• Glycated Hemoglobin (Hemaglobin A1c %) ≥ 7

People with NIDDM must balance food intake and physical activity and, when necessary, diabetic medications to achieve glycemic control.

Complications with unmanaged NIDDM:

Short-Term Complications:

• Hypoglycemia (low blood sugar)

• Hyperglycemia (high blood sugar)

• Hyperglycemic hyperosmolar nonketotic (HHNK) syndrome (imbalance of excess glucose in the blood and inadequate water, potassium, and sodium)

Long-Term Complications:

• Hypertension (high blood pressure)

• Dislipidemia (elevated cholesterol and triglyceride in the blood)

• Vascular Complications (circulatory)

• Neuropathic complications (nerve)

• Nephropathy (kidney)

• Ophthalmic Complications (vision)

Medical Nutrition Therapy

To provide adequate calories, carbohydrate, fat, protein, fiber, sodium, and micronutrients to support normal growth and development and to achieve or maintain a reasonable body weight.  To achieve a goal blood hemoglobin A 1c (%) and. or blood glucose level by balancing food intake, activity level and insulin if needed. Small frequent meals with a balance of high fiber and low glycemic sources of carbohydrate foods, moderate amounts healthy fats, high quality protein foods, and adequate water intake are beneficial methods of regulating blood glucose levels with NIDDM. (See the glycemic list of foods in the article on The PMS Nutrition Solution.)

Dietary changes are the most important aspect for the diabetic patient. In addition, there are multiple considerations such as nutrient status for magnesium, essential fatty acids, zinc, and organic acids testing to determine fungal involvement in the gut, circulatory support, antioxidant support, and cardiovascular support. These all need to be considered in addition to suggesting nutritional support and exercise for maintaining tighter control of blood sugar.

The following table shows the levels for Normal, Goal and Intervention levels for blood glucose and hemoglobin A 1c(%).

Age related problems in elderly people with diabetes that may affect diabetes management are:

• Dehydration

• Decreased physical activity

• Altered renal function

• Altered liver function

• Depression

• Social and financial changes

http://www.diabetes.com.au/home.htm

http://www.diabetes.org/

http://www.cdc.gov/diabetes/

http://www.webmd.com

For Kids:

http://www.childrenwithdiabetes.com

http://www.geocities.com/HotSprings/6935/