Diabetes Risk Factors and Treatments
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A healthy diet may improve or maintain an optimal health by eating a good and proper meal and apply a balanced diet in daily lifestyle. Without a healthy diet, there is no meaning for a healthy lifestyle and it can cause so many diseases that related to diet such as obesity, diabetes, cardiovascular disease, dental disease, osteoporosis, bone fracture and cancer. If we never take a good care about a healthy diet, the disease can become chronic disease. Now days the most common disease among the society no matter young or old people is diabetes mellitus which known as simple diabetes. There are two major types of diabetes mellitus, which are diabetes type 1, juvenile-onset or insulin-dependant and diabetes type 2, adult-onset or non insulin-dependent. The global prevalence of diabetes is currently estimated to be 366 million in 2011 and projection rates are expected to rise to over 552 million by the year 2030, with Asia suffering the bulk of the total diabetes epidemic. The Malaysian scenario is more debilitating when figures confirmed that first country suffers the highest rate of diabetes in the Asian region and sixth in western pacific region, with prevalence rates rising from 8.6% in 2006 to 15.2% in 2011. The prevalence is 6.3% when the first time the National Health and Morbidity Survey conducted in 1986. In 2011, the Malaysian who had diabetes above age 30 increased to 20.8% and above age 18 is 15.2%. According to the statistic in Malaysia, the Indians had the highest prevalence of 19.9% followed by Malay 11.9% and Chinese 11.4%. The highest state that has prevalence is Negeri Sembilan.,  World Health Organisation (WHO) estimated that Malaysia will have 2.3 million of prevalence in diabetes by 2030.
There are a lot of risk factors for diabetes that depends on the type of diabetes. The primary risk factor for type 1 diabetes is a family history, age and genetics.  Anyone with family member that has type 1 diabetes could increase the risk of developing the condition. As the age increases, we get older and the risk will increases because we lack of exercise, lose muscle mass and will gain weight. Family history and age are factor that cannot be altered but a change in lifestyle that includes a healthier diet and increased physical activities with or without weight loss may help reduce the risk. To reduce genetic factor, should do a blood test so it can detect early and get screened for diabetes. Here are the risk factors for developing type 2 diabetes. The primary risk factor is obesity or being overweight and lack of exercise. The main waysto reduce the primary risk factors are by practicing balanced diet and doing at least 2 hour of moderate-intensity aerobic activities, such asjogging or fast walking, every week.In addition, we should do physical activity to improve muscle strength at least two days a week. Dietary factors also influence the risk of developing type 2 diabetes. Dietary changes known to be effective in helping to prevent diabetes include a diet rich in fiber and whole grains, and choosing good fats, such as polyunsaturated fats found in nuts, vegetable oils, and fish. Sugar-sweetened consumption in drinks excess and the type of fats in the diet is also important, with saturated fats and trans fatty acids which will increasing the risk. This factors could be reduced by limiting the sugary beverages and eating less red meat and other sources of saturated fat can also help in the prevention of diabetes. Polyunsaturated and monounsaturated fat also could decreasing the risk. Some people with type 2 diabetes takes pills called ‘oral agents’ and some people can manage their disease without medication by suitable meal planning and adequate physical activities. 
Diabetes is a complex group of diseases with variety of causes and which the body could not use and store glucose properly.  The glucose backs up in the bloodstream and cause someone’s blood glucose or blood sugar to rise too high which is known as hyperglycemia.  Diabetes can be caused by lack of insulin, resistance to insulin, or both. Insulin controls the blood sugar , its produced by the pancreas .First of all, it is important to understand the role of digestive mechanism. Glucose is a source of energy for the body which enters the bloodstream. The insulin moves glucose from the bloodstream into liver cells, muscle and fats where it can be used as energy. Sometimes the symptoms of the diabetes could not be recognized. People can live in months and even years without knowing that they have this kind of disease. Diabetes can occur in anyone and it will develop easily if that person has high blood pressure, high cholesterol, and not active in physical activities. Diabetes type 1 starts when the body’s immune system destroy the pancreatic cell, then the pancreas stop making hormone insulin and it develops high blood sugar due to lack of insulin. ,  Without insulin the cells cannot get the sugar they need and too much of sugar is building the blood.  Diabetes type 1 can occur at any age especially children and young people. But the symptoms of this disease usually develop over a short period of time. People with diabetes type 1 need to take daily insulin injection or be on a insulin pump to survive. ,  Diabetes type 2 occurs when the body cannot use the insulin that's produced, a condition called insulin resistance which causes the blood glucose level to be higher than the normal glucose level (hyperglycaemia). , ,  Though it typically starts in adulthood, diabetes type 2 can begin anytime in life. Because of the current epidemic of obesity among the latest generation children, the disease is increasingly found in younger people, particularly adolescents. , 
All forms of diabetes increase the risk of long-term complications. These generally develop after many years (10–20), but may be the first symptom in those who have otherwise not received a diagnosis before that time. The major long-term complications can cause to damage to blood vessels. Diabetes increase risk of cardiovascular disease and about 75% of deaths in diabetics are due to coronary artery disease.  Other "macrovascular" diseases are stroke, and peripheral vascular disease. The primary microvascular complications of diabetes include damage to the eyes, kidneys, and nerves.  Diabetic retinopathy is the damage of eyes which is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and potentially blindness. Diabetic nephropathy, which is damage at the kidneys can lead to urine protein loss, tissue scarring and eventually chronic kidney disease, sometimes needs dialysis or kidney transplant.  Diabetic neuropathy is the damage of nerves in the body and the most common complication of diabetes.  The symptoms can include tingling, altered pain sensation, pain and numbness can cause damage to the skin. Diabetes-related foot problems (such as diabetic foot ulcers) may occur, and been difficult to treat, occasionally requiring amputation. The normal symptoms that can be identify when the person has diabetes are increased thirst, frequent urination, extreme fatigue, blurred version and gum, bladder infection or recurring skin.
Treatment for diabetes. Metformin is generally recommended as a first line treatment for type 2 diabetes, as there is good evidence that it decreases mortality.  Routine use of aspirin, however, it has been not improve outcomes in uncomplicated diabetes.  Angiotensin converting enzyme inhibitors (ACEIs) improve outcomes in those with diabetes while the similar medications angiotensin receptor blockers (ARBs) do not.  Type 1 diabetes is typically treated with a combinations of regular and NPH insulin, or synthetic insulin analogs. When insulin is used in type 2 diabetes, a long-acting formulation is typically added initially, while continuing oral medications.  Doses of insulin are then increased to effect.  In those with diabetes some recommend blood pressure levels below 120/80 mmHg, however, evidence only supports less than or equal to somewhere between 140/90 mmHg to 160/100 mmHg. , , ,  Pancreatic transplantation. A pancreas transplant is occasionally considered for people with type 1 diabetes who have severe complications of their disease, including final stage renal disease requiring kidney transplantation.  Getting better control over the blood pressure levels, blood sugar, and cholesterol helps to reduce the risk of nervous system disease, kidney disease, eye disease, stroke and heart attack. To prevent diabetes complications, visit a health care provider at least two to four times a year and follow the instructions given on managing the diabetes. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.
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