Am I diabetic?

If you have not been diagnosed with diabetes, but suspect you might have something wrong with your blood sugar, there is a simple way to find out.

What you need to do is to test your blood sugar after you have eaten a meal that contains about sixty grams of carbohydrates.

You can ask your doctor to test your blood sugar in the office if you have an appointment that takes place an hour or two after you've eaten or, if this isn't an option, you can use an inexpensive blood sugar meter to test your post-meal blood sugar yourself at home. 

You do not need a prescription to buy the meter or strips. One advantage of testing yourself at home is that with self-testing you do not run the risk of having a "diabetes" diagnosis written into your medical records which might make it impossible for you to buy health or life insurance.

To run a post-meal blood sugar test do following:

1. Borrow a family member's meter or buy an inexpensive meter and strips.
2. Some meters come with 10 free strips. Check to see if the meter you have bought includes strips. If it doesn't, buy 25 or 50--whichever is the smallest size available. Strips do not keep for very long once opened, so don't buy more than you need for a couple tests.
3. Familiarize yourself with the instructions that came with your meter so that you know how to run a blood test. Practice a few times before you run your official test. Each meter is different. Be sure you understand how yours works.
4. The first thing in the morning after you wake up but before you have eaten anything, test your blood sugar. Write down the result. This is your "fasting blood sugar."
5. Now eat something containing at 60 - 70 grams of fast acting carbohydrate. A bagel makes a good test food. If you can't eat wheat, a large (8 oz) boiled potato of a cup of cooked white rice will do. Avoid fats as they will slow down the action of the carbohydrate.
6. One hour after you started eating, test your blood sugar with the meter. Write down the result. If you lose track of the time measure as soon as possible. The numbers will still be useful.
7. Two hours after you started eating test your blood sugar again. Write down the result.
8. Three hours after you started eating, test your blood sugar. Write down the result. You are now done and can eat whatever you want.

What Your Meal Test Numbers Mean

Understand Your Meter's Margin of Error

Your meter is not as accurate as a lab-drawn test would be. Figure in a 10% error, plus or minus. So if you got a 100, your results might actually be 90 to 110 if you were tested at a lab. The documentation with your meter might tell you that it is only accurate to within 20%, however, in practice most meters nowadays are more accurate than this.

NOTE: All blood sugar levels discussed on these pages refer to plasma calibrated meter readings which are the kind of readings you will get from all meters now sold in the US. Some meters sold elsewhere in the world, especially in the UK and Au, still use a different calibration. These are "blood calibrated" meters. If you are using one of these, you should divide the numbers given here by 1.12 to get the blood calibrated equivalents.

A Special Consideration if You Have Been Eating A Low Carb Diet

If you are currently eating a low carb diet--especially a diet that provies less than 75 g of carbohydrate a day, your post-meal test result will be slightly higher than it would be if you were eating over 150 grams of carbs a day. That is why, if you were going in for an official post-meal test or a glucose tolerance test ordered by your doctor, you would be told that you have to eat 150 grams of carbohydrate during 3 days before your test to get a valid result. However, since this is an informal test you probably don't want to stop your diet for that long. So when you get your result, you can make an informal adjustment to your post-meal test results that will account for the fact that low carbing temporarily raises your post-meal values when you eat an unaccustomed large dose of carbohydrate.

To make this correction, just subtract 10 mg/dl from any post-meal result that is over 140 mg/dl at 2 hours if you are currently low carbing. This is a very rough estimate, but close enough for this kind of home testing.

Interpret your result

Normal Blood Sugar

If your blood sugar reading remained under 100 mg/dl (5.6 mmol/L) at the one hour test and all the later tests, you have completely normal blood sugar and can stop worrying about it. If your blood sugar did not reach 140 mg/dl (7.7 mmol/L) an hour after taking a large dose of carbohydrates and if it was below 120 mg/dl (6.7 mmol/L) two hours after you ate the large dose of carbohydrate, most health authorities would also say that you are normal. These numbers, 140 mg/dl at 1 hour and 120 mg/dl at two hours after a meal are what Joslin Diabetes Clinic of Harvard Medical School defines as upward limit of "normal."

If your blood sugar is at the very top of this normal range, near 140 mg/dl (7.7 mmol/L) and near 120 mg/dl at two hours, you may have a very slight amount of either beta cell dysfunction or insulin resistance going on. If you are at the high end of the normal range, especially if you are noticing that you are gaining weight more easily than you used to, it might be a good idea to cut back on the amount of carbohydrate you eat and begin an exercise program.

Impaired Glucose Tolerance

If your blood sugar surged over 140 mg/dl at one hour or stayed above 120 mg/dl at two hours, you may have what doctors will call "impaired glucose tolerance" or IGT. Another name for this condition is "pre-diabetes." Note that the values given here are lower than the values doctors used to diagnose impaired glucose tolerance using a lab glucose tolerance test. That is because blood sugar does not rise as high after you eat a food that needs to be digested as it does when you drink pure glucose so you will not see as high a number with a food test as you will on a glucose tolerance test.

If you suspect that you have impaired glucose tolerance, don't ignore it. The excess glucose molecules that make up those elevated post-meal blood sugars will bond to your body proteins, deposit themselves in your arteries, damage your kidney filtration units, clog up your retinal capillaries, and cause your nerve function to deteriorate leading to, among other things, impotence and pain. Keep this up, and in another five or ten years you'll be one of those people with "newly diagnosed" diabetes who have serious, established, possibly irreversible long-term complications.

On a more cheerful note, if you catch your blood sugar abnormality at this point, there is a very good chance that by managing your blood sugar through cutting down on how much carbohydrate you eat and adding exercise, you may never see it deteriorate further and may avoid developing any diabetic (or pre-diabetic) complications.

If you suspect you have impaired glucose tolerance, be sure to discuss this finding with your doctor. If he or she tells you it is "nothing to worry about" it's time to find another doctor-- one who is more up-to-date and who will help you manage your blood sugar so you can avoid heart disease and development of other complications.

Studies have shown that people with impaired glucose tolerance who lose weight and start exercising can reverse their blood sugar deterioration and prevent themselves from progressing to full-fledged diabetes. There are also drugs that can help you, too. And the very best treatment is lowering your carbohydrate intake.
But if you wait for a diabetes diagnosis before taking action, it is often too late. By the time your fasting blood sugar has reached 126 mg/dl (7.0 mmol/L) (the level at which most doctors will diagnose you) at least half of your beta cells may be dead and they may not be able to regenerate.

Diabetes

If your blood sugar went over 200 mg/dl (11.1 mmol/L) at any time you tested, you just registered a diabetic blood sugar level and should consult with a doctor as soon as possible.
Again, if your doctor says, "Let's just check it again in a couple months" and does not urge you to take a more aggressive approach, it's time to look for a new doctor, one who has kept up with the current approaches to managing diabetes. It's your kidneys, heart, nerves, and vision that are at risk, not his.

Low Blood Sugar

If your blood sugar goes up at one hour and then drops below 70 mg/dl (3.9 mmol/L)at the two hour point you have what is called "reactive hypoglycemia." Your blood sugar went up but your body cranked out a huge dose of insulin to bring it back down--too much, in fact. That high dose of insulin resulted in your ending up with low blood sugar.

 

This, too, may be an early warning sign that you might be headed for diabetes, though it may take a decade or more until it becomes apparent. Even if you don't progress to diabetes, reactive hypoglycemia may be a sign that you are insulin resistant and that your cell's resistance to insulin is forcing your body to secrete the very large insulin doses that are driving your blood sugar low. Insulin resistance, with or without diabetes, may be a precursor to heart disease. Be sure to discuss this result with your doctor.

After You Have Tested

Once you have done this "baseline" post-meal blood sugar test if what you saw was anything but rock solid normal, every three months you should test your blood sugar response at home using same the test food you used for your first blood sugar test to see how your blood sugar control is progressing. The values you get on a meal test may fluctuate by as much as 30 mg/dl (1.7 mmol/L) from what you saw on a previous meal test. But if you see your blood sugar registering test values that are steadily going up, test after test, it is time to talk to your doctor.

 

If you have abnormal post-meal tests, ask your doctor run an Hba1c test at least once a year and have him tell you the number you got on the test. Ignore whether or not your test meets the the lab definition of "diabetic" which is MUCH too high. Instead track instead whether your A1c test result is staying the same or rising. If your hba1c goes over 5.7%.which many endocrinologists consider to be the level at which diabetes becomes a possibility, it's time to get serious about lowering your blood sugar. Work with your doctor to find the solution that works best for you.

Most people with mild blood sugar abnormalities can attain completely normal blood sugars through cutting out excess carbohydrates from their diets, especially fast-acting ones like those in soda, candy, cake, white flour, and in starchy vegetables like potatoes.

Use your meter to determine how much carbohydrate you can eat without causing a blood sugar spike. The closer your blood sugar stays to 85 mg/dl at all times, the better off you are. Remember that the lower your post-meal blood sugar, the lower your risk for heart attack and other diabetic complications.

reference: Am I diabetic

Diabetes and Chocolate

. 

Chocolate doesn't have to be excluded from your diet

A diabetic eating chocolate may raise eyebrows amongst some people but within reason, chocolate needn’t be completely cut out of your diet.  In most cases, chocolate will cause blood sugar levels to rise and in light of this it’s best to limit chocolate consumption to small amounts and to avoid eating when blood sugars are already higher than the recommended blood sugar levels (BGL)

 

Is eating chocolate good or bad for you?

Chocolate contains a number of beneficial nutrients, some of which called flavonoids are thought to guard against heart disease.    However, it should be noted that larger quantities of chocolate can be disadvantageous to health in other ways. If a larger amount of chocolate is consumed, it will raise blood sugars which increases the risk of complications, of which cardiovascular problems is one.
Secondly, the calorific content of chocolate is relatively high and therefore overconsumption of chocolate could lead to weight gain which also raises the risk of heart problems.

How much chocolate should I eat?

For most people with diabetes, chocolate is best restricted to a few squares to prevent too much of an increase in blood sugars.   For people with diabetes without weight problems, chocolate can be appropriate to have before exercising.  For more strenuous activity, however, even shorter acting carbohydrate may be required.

Which chocolate is best for me?

Chocolate with higher amounts of cocoa solids are best, as the sugar and fat content will often be lower as a result. For high cocoa solids content, dark chocolate is usually a good pick.

Is diabetic chocolate better for my sugar levels?

Generally speaking, diabetic chocolate is made by replacing some or all of the sugar content with an alternative such as the polyo maltitol and sorbitol. Polyols can have laxative effects and therefore they should not be consumed in large quantities. The effect of polyols may vary from person to person.
Some people find diabetic chocolate to be beneficial compared with regular chocolate, however, many people with diabetes find diabetic chocolate to not have enough redeeming benefits.


There is a worldwide campaign to end the use of the term ‘diabetic’ with regards to food products.

source diabetes uk

10 Diabetes Diet Myths

"Diabetes diet." Simply hearing these words may be enough to make you feel overwhelmed or frustrated.

Perhaps you have said, or heard someone else express, one of these thoughts:

• Eating too much sugar causes diabetes.
• There are too many rules about choosing foods that are OK in a diabetes diet.
• You have to give up all your favorite foods when you're on a diabetes diet.

These three statements are all myths about diabetes diets. Take a closer look at these and other myths to find out the facts about diabetes and diet.

Myth 1: Eating Too Much Sugar Causes Diabetes.

How does diabetes happen? The causes are not totally understood. What is known is that simply eating too much sugar is unlikely to cause diabetes. Instead, diabetes begins when something disrupts your body's ability to turn the food you eat into energy.
To understand what happens when you have diabetes, keep these things in mind: Your body breaks down much of the food you eat into glucose, a type of sugar needed to power your cells. A hormone called insulin is made in the pancreas. Insulin helps the cells in the body use glucose for fuel.
Here are the most common types of diabetes and what researchers know about their causes:

• Type 1 diabetes occurs when the pancreas cannot make insulin. Without insulin, sugar piles up in your blood vessels. People with type 1 diabetes must take insulin to help get the sugar into the cells. Type 1 diabetes often starts in younger people or in children. Researchers believe that it may occur when something goes wrong with the immune system.
• Type 2 diabetes occurs when the pancreas does not make enough insulin, the insulin does not work properly, or both. Being overweight makes type 2 diabetes more likely to occur. It can happen in a person of any age.
• Gestational diabetes occurs during pregnancy in some women. Hormone changes during pregnancy prevent insulin from working properly. Women with gestational diabetes usually need to take insulin. The condition may resolve after birth of the child.

Myth 2: There Are Too Many Rules in a Diabetes Diet.

If you have diabetes, you will need to plan your meals. But the general principal is simple: Following a "diabetes diet" means choosing food that will work along with your activities and any medications to keep your blood sugar levels as close to normal as possible.
Will you need to make changes to what you now eat? Probably. But perhaps not as many as you anticipate.

Myth 3: Carbohydrates Are Bad for Diabetes

In fact, carbohydrates -- or "carbs" as most of us refer to them -- are good for diabetes. They form the foundation of a healthy diabetes diet -- or of any healthy diet.
Carbohydrates have the greatest effect on blood sugar levels, which is why you are asked to monitor how many carbohydrates you eat when following a diabetes diet.
However, carbohydrate foods contain many essential nutrients, including vitamins, minerals, and fiber. So one diabetes diet tip is to choose those with the most nutrients, like wholemeal breads and high-fiber fruits and vegetables. You may find it easier to select the best carbs if you meet with a dietitian.

Myth 4: Protein is Better than Carbohydrates for Diabetes.

Because carbs affect blood sugar levels so quickly, if you have diabetes, you may be tempted to eat less of them and substitute more protein. But too much protein may lead to problems for people with diabetes.
The main problem is that many foods rich in protein, such as meat, may also be filled with saturated fat. Eating too much of these fats increases your risk of heart disease. In a diabetes diet, protein should account for about 15% to 20% of the total calories you eat each day.

Myth 5: You Can Adjust Diabetes Drugs to "Cover" What You Eat.

If you use insulin for your diabetes, you may learn how to adjust the amount and type you take to match the amount of food you eat. But this doesn't mean you can eat as much as you want, then just use more drugs to stabilize your blood sugar level.
If you use other types of diabetes drugs, don't try to adjust your dose to match varying levels of carbohydrates in your meals unless instructed by your doctor. Most diabetes medications work best when they are taken consistently as directed by your doctor.

Myth 6: You'll Need to Give Up Your Favorite Foods.

There is no reason to give up your favorite foods on a diabetes diet. Instead, try:

• Changing the way your favorite foods are prepared.
• Changing the other foods you usually eat along with your favorite foods.
• Reducing the serving sizes of your favorite foods.
• Using your favorite foods as a reward for following your meal plans.

A dietitian can help you find ways to include your favorites in your diabetes meal plans.

Myth 7: You Have to Give Up Desserts if You Have Diabetes.

Not true! You can develop many strategies for including desserts in a diabetes diet. Here are some examples:

• Use artificial sweeteners in desserts.
• Cut back on the amount of dessert. For example, instead of two scoops of ice cream, have one. Or share a dessert with a friend.
• Use desserts as an occasional reward for following your diabetes diet plan.
• Make desserts more nutritious. For example, use whole grains, fresh fruit, and vegetable oil when preparing desserts. Many times, you can use less sugar than a recipe calls for without sacrificing taste or consistency.
• Expand your dessert horizons. Instead of ice cream, pie, or cake, try fruit, or yogurt.

Myth 8: Artificial Sweeteners Are Dangerous for People with Diabetes.

Artificial sweeteners are much sweeter than the equivalent amount of sugar, so it takes less of them to get the same sweetness found in sugar. This can result in eating fewer calories than when you do use sugar.
The American Diabetes Association approves the use of several artificial sweeteners in diabetes diets, including:

• Saccharin (Sweet'N Low)
• Aspartame (NutraSweet, Equal)
• Acesulfame potassium (Sunett)
• Sucralose (Splenda)

A dietitian can help you determine which sweeteners are best for which uses, whether in coffee, baking, cooking, or other uses.

Myth 9: You Need to Eat Special Diabetic Meals.

The truth is that there really is no such as thing as a "diabetic diet." The foods that are healthy for people with diabetes are also good choices for the rest of your family. Usually, there is no need to prepare special diabetic meals.
The difference between a diabetes diet and your family's "normal" diet is this: If you have diabetes, you need to monitor what you eat a little more closely. This includes the total amount of calories you consume and the amounts and types of carbohydrates, fats, and protein you eat. A diabetes educator or dietitian can help you learn how to do this.

Myth 10: Diet Foods Are the Best Choices for Diabetes.

Just because a food is labeled as a "diet" food does not mean it is a better choice for people with diabetes. In fact, "diet" foods can be expensive and no more healthy than foods found in the "regular" sections of the grocery store, or foods you prepare yourself.
As with any food you choose, read the labels carefully to find out if the ingredients and amount of calories are good choices for you. If you have doubts, ask your diabetes educator or a dietitian for advice.

Moving Beyond Diabetes Diet Myths

Now that you know the facts about diabetes diets, you can take steps to learn even more about making wise food choices. Together with exercise and medication, you can use what you eat as an effective tool for keeping your blood sugar levels within normal ranges. That is the best diabetes diet of all.

reference webmd

Understanding the symptoms of Diabetes

Diabetes Symptoms

Diabetes is a very serious disease that many people around the world face. It is essentially the body’s inability to make insulin or to use insulin correctly depending on which type of diabetes you have – type 1 or type 2 respectively. Insulin affects the amount of glucose in your blood and too high or too low levels of blood glucose can cause serious repercussions. That being said, many people have diabetes and don’t realize it. Nonetheless, everyone should be aware of the symptoms for the disease.The two most tell-tale, classic symptoms of diabetes are an increased thirst and increased urination. These two symptoms are the most common because this illness affects the kidneys which in turn affect your urine output and your hydration level.

Other symptoms of the disease include excessive hunger, rapid weight loss, fatigue and irritability. These symptoms, including increased thirst and increased urination are all symptoms of type 1 and type 2 diabetes. Type 2 diabetes has some addition symptoms that include frequent bladder, skin and gum infections that are slow to heal, slow healing cuts and bruises, blurred vision, and numbness and tingling in the hands and feet.

The tricky thing about diabetes symptoms is that sometimes they seem so common that they get ignored. In fact, according to the American Diabetes Association in 2007 5.7 million people did not know they had the disease and were undiagnosed. Another problem with diagnosing the disease is that sometimes there are no symptoms. That’s right, there are people that have had the disease for months or even years and not known it due to a lack of symptoms.

The important thing to remember is if you are having any symptoms of diabetes – even if very mild you should speak to your health care provider. They will order up one of three diabetes tests and talk to you in-depth about your family medical history as well as your symptoms in order to make a diagnosis.

People with an early diabetes diagnosis often have the best outcomes. While diabetes cannot be cured per se, learning to manage your blood glucose levels and getting the proper treatment will leave you feeling much better and more like your normal self. Plus with good blood sugar management and treatment for diabetes you will greatly reduce your risk for developing the many serious complications that are associated with the disease.

Increased Thirst – Could it be Diabetes?

Increased thirst is when you feel thirsty much more than normal. This can be attributed to many things such as exercise and eating an access of salty foods or it can be a symptom of diabetes. The reason for increased thirst as a diabetes symptom is that your body is not able to remove the extra glucose that is in your blood due to a lack of insulin. This makes your kidneys work extra and even then they can’t remove all the glucose so it ends up being excreted from you body with other fluids in the form of urine making you increasingly thirsty.

Increased Urination – Could it be Diabetes?

Increased urination is when you need to urinate more than normal. This can be from drinking an excess of fluids or it can be a symptom of diabetes. When your body doesn’t make insulin or doesn’t use insulin correctly, extra glucose is found in your blood and your kidneys work harder to remove it. Inevitably they can’t therefore it is removed from the body in your urine making you urinate more often than normal. This also prompts you to be increasingly thirsty and the more you drink, the more you urinate.

References
http://www.diabetes.org/diabetes-basics/symptoms

How long can I expect to live?

After diabetes diagnosis, many type 1 and type 2 diabetics worry about their life expectancy. Death is never a pleasant subject but its human nature to want to know 'how long can I expect to live'.

There is no hard and fast answer to the question of ‘how long can I expect to live’ as a number of factors influence one’s life expectancy.    How soon diabetes was diagnosed, the progress of diabetic complications and whether one has other existing conditions will all contribute to one’s life expectancy - regardless of whether the person in question has type 1 or type 2 diabetes

How long can people with diabetes expect to live?

It is estimates that life expectancy of someone with type 2 diabetes is likely to be reduced, as a result of the condition, by up to 10 years. People with type 1 diabetes can expect their longevity to reduce by over 20 years.

What causes a shorter life expectancy in diabetics?
 

  Higher blood sugars over a period of time allow diabetic complications to set in, such as diabetic Retinopathy, kidney disease, and cardiovascular disease (heart disease).

Higher blood sugars can often be accompanied by associated conditions such as higher blood pressure and high cholesterol, which help to contribute to poor circulation and further the damage to organs such as the heart, kidneys, eyes and nerves in particular.  In some cases, short term complications such as Hyperpoglycemia and diabetic Ketoacidosis can also be fatal.

What can I do as a diabetic to help increase my life expectancy?

Maintaining good blood glucose control is a key way to prolong the length of your life.
Keeping blood sugars (bgl) within the recommended blood glucose level ranges will help to offset the likelihood of the complications and therefore increase life expectancy.

It is highly recommended to enjoy a healthy lifestyle, of a well balanced diet and regular activity, in order to help keep blood pressure and cholesterol at healthy levels and promote good blood circulation.

Why is life expectancy less for people with type 1 diabetes?

People with type 1 diabetes will, in the majority of cases, develop diabetes at a younger age than those with type 2 diabetes, therefore they will usually spend a longer period of their life living with the condition.
However, there is good news - people with type 1 diabetes have been known to live for as long as over 75 years with the condition.

Is type 2 diabetes less serious than type 1 diabetes?

Generally type 2 diabetes develops more slowly than type 1 diabetes. As a result, some people can be diagnosed with type 2 diabetes (and some other diabetes types) years after they first developed the condition. In some cases diabetes may only be diagnosed after noticing the signs of diabetic complications which is a serious position.

It is not fair to judge which condition is more serious, all types of diabetes have a serious impact on people’s health and it is a difficult chronic condition which takes a lot of time, persistence and care to manage.

courtesy of Diabetes UK May 2011 newsletter

Benefits of Cinnamon

I have been drinking Cinnamon tea for a couple of years now and use it where ever possible in and on food. I believe it has had a significant effect on my bgl.

Studies have shown that just 1/2 teaspoon of cinnamon per day can lower LDL cholesterol.

Several studies suggest that cinnamon may have a regulatory effect on blood sugar, making it especially beneficial for people with Type 2 diabetes.

In some studies, cinnamon has shown an amazing ability to stop medication-resistant yeast infections.

In a study published by researchers at the U.S. Department of Agriculture in Maryland, cinnamon reduced the proliferation of leukemia and lymphoma cancer cells.

It has an anti-clotting effect on the blood.

In a study at Copenhagen University, patients given half a teaspoon of cinnamon powder combined with one tablespoon of honey every morning before breakfast had significant relief in arthritis pain after one week and could walk without pain within one month.

When added to food, it inhibits bacterial growth and food spoilage, making it a natural food preservative.

One study found that smelling cinnamon boosts cognitive function and memory.

Researchers at Kansas State University found that cinnamon fights the E. coli bacteria in unpasteurized juices.

It is a great source of manganese, fiber, iron, and calcium.

source  healthdiaries.com

Taking a look at Type 1 Diabetes

Type 1 diabetes occurs when the body's immune system attacks and destroys certain cells in the pancreas, an organ about the size of a hand that is located behind the lower part of the stomach. These cells -- called beta cells are contained, along with other types of cells, within small islands of endocrine cells called the pancreatic islets. Beta cells normally produce insulin, a hormone that helps the body move the glucose contained in food into cells throughout the body, which use it for energy. But when the beta cells are destroyed, no insulin can be produced, and the glucose stays in the blood instead, where it can cause serious damage to all the organ systems of the body.

For this reason, people with type 1 diabetes must take insulin in order to stay alive. This means undergoing multiple injections daily, or having insulin delivered through an insulin pump, and testing their blood sugar by pricking their fingers for blood six or more times a day. People with diabetes must also carefully balance their food intake and their exercise to regulate their blood sugar levels, in an attempt to avoid hypoglycemic (low blood sugar) and hyperglycemic (high blood sugar) reactions, which can be life threatening.

The warning signs of diabetes include extreme thirst; frequent urination; drowsiness or lethargy; sugar in urine; sudden vision changes; increased appetite; sudden weight loss; fruity, sweet, or wine-like odor on breath; heavy, labored breathing; stupor; and unconsciousness.

Type 1 diabetes is generally diagnosed in children, teenagers, or young adults. Scientists do not yet know exactly what causes type 1 diabetes, but they believe that autoimmune, genetic, and environmental factors are involved.

extract from JDRF.org