DEAR READER: Diabetes is a disorder in which blood-glucose levels are above normal. People develop diabetes either because the pancreas doesn’t produce adequate insulin or because the cells in the muscles, liver and fat don’t use insulin properly. This results is glucose remaining in the blood and elevating levels at the same time cells crave the energy necessary to function properly.

There are two types of diabetes, type 1 and type 2, with the latter being most common. Type 1 indicates a person is dependent on insulin and requires regular injections that are self-administered because the body fails to produce enough, if any, insulin. This form generally develops before the age of 30 and affects about 10 percent of all diabetics. Type 2, on the other hand, signifies insulin resistance. These people produce adequate insulin levels, but the body is unable to use it properly. Some may even need insulin injections in order to stimulate the pancreas. This form can occur in people of all ages and is more prevalent in obese people, Hispanics and Native Americans. Some cases of type 2 diabetes have a strong genetic basis while others do not. There does appear to be hereditary susceptibility, but this is not always the case in those who develop diabetes.

Symptoms include fatigue, an increase in hunger and thirst, blurred vision and skin ulcers that don’t heal well. Complications can be serious and can include heart disease, stroke, poor vision, kidney failure, nerve damage, poor circulation and a host of other conditions.

Prevention is key with the disorder to prevent your diabetes from progressing to type 1. If appropriate, try to lose weight, since excess weight can keep your body from making and using insulin properly. Reduce your salt and alcohol intake. Make better choices when grocery shopping. Keep fresh vegetables such as carrot and celery sticks readily available to snack on while watching television. Eat properly and coordinate a program of regular exercise, such as riding a bicycle or golfing. A simple walk around the block daily is good. Ask your physician or endocrinologist if referral to a dietician would help. If you have a community center nearby, sign up for swimming or aerobics classes. Get a friend to join you. There’s more incentive if you have company.

If medication is appropriate, take it according to your physician’s directions. Follow my No Flour, No Sugar diet. I have received countless communications from readers stating they have brought their diabetes, cholesterol levels and hypertension under control and have been able to discontinue their medication while on my diet. Stay active and in control. With a little motivation, help and direction, you should see amazing results.

To provide related information, I am sending you a copy of my Health Report “Living with Diabetes Mellitus.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.