Diabetes

Diabetes is a chronic condition in which the body produces too little insulin or can't use available insulin efficiently. Insulin is a hormone vital to helping the body use digested food for growth and energy.

An estimated 23.6 million Americans (approximately eight percent of the population) have diabetes, and about 1.6 million more aged 20 or older were diagnosed with the disorder in 2007, according to the American Diabetes Association. Untreated, diabetes can cause long-term complications that affect almost every part of the body, making it the sixth leading cause of death in the United States.

You are at higher risk for developing type 2 diabetes if you are overweight, don't exercise and are over 30, or if you have close relatives with diabetes, especially type 2 diabetes. Higher-risk ethnic groups include African American, Latino/Hispanic, Native American, Alaska Native, Asian or Pacific Islander American heritage. s. Native Americans and Alaska Natives are at more than twice the risk of Caucasians for developing type 2diabetes.

Although diabetes is a potentially life-threatening condition, people with well-managed diabetes can expect to live healthy lives.
How Diabetes Develops

Much of the food we eat is broken down by digestive juices into a simple sugar called glucose, which is the body's main source of energy. Glucose passes into the bloodstream and, from there, into cells, which use it for energy.

However, most cells require the hormone insulin to "unlock" them so glucose can enter. Insulin is normally produced by beta cells in the pancreas (a large gland behind the stomach). In healthy people, the process of eating signals the pancreas to produce the right amount of insulin to enable the glucose from the food to get into cells. If this process fails or doesn't work properly, diabetes develops.

In people with diabetes, the pancreas produces little or no insulin, or the body's cells do not respond to the insulin that is produced. As a result, glucose builds up in the blood, overflows into the urine and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

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Depression

Feelings of sadness can be normal, appropriate and even necessary during life's setbacks or losses. Or you may feel blue or unhappy for short periods of time without reason or warning, which also is normal and ordinary. But if such feelings persist or impair your daily life, you may have a depressive disorder. Severity, duration and the presence of other symptoms are factors that distinguish ordinary sadness from a depressive disorder.

Depression can happen to anyone of any age, race, class or gender. It afflicts almost 19 million Americans each year, and up to one in five American women will suffer from clinical depression at some point in her life. Women are two to three times more likely than men to suffer from depression. Many women first experience symptoms of depression during their 20s and 30s. Once you experience depression, there's a 50 percent chance you'll be depressed again at some point in your life.

A complex combination of physiological, social, environmental, cultural, hormonal, biological and psychological factors may contribute to the reasons why women experience depression at a higher rate than men.

Depression affects both mind and body. If you are depressed, you feel a sense of helplessness, hopelessness or despair. You lose interest in your favorite activities, may experience changes in appetite, weight and sleep patterns, have difficulty concentrating and may be preoccupied with death or suicide.

Additionally, depression often occurs in conjunction with certain chronic illnesses, like diabetes, and after a heart attack or stroke. Research sponsored by the National Institute of Mental Health (NIMH) suggests that depression may even be a major risk factor for osteoporosis. It also can develop as a result of conditions that cause unrelieved pain. Left untreated, depression contributes to increased complications, prolonged recovery time and a greater chance of death.

The good news is that depression is a treatable illness. Yet according to a major study published in 2003 in the Journal of the American Medical Association (JAMA), only about one in five women with depression ever receive adequate treatment.

One reason that treatment for depression is inadequate is that many people do not know or are confused about where to seek mental health treatment. Another reason is that many individuals do not perceive depression as a real medical condition that should or can be treated. Also, there is still a social stigma attached to mental illnesses like depression. These perceptions are wrong. Depression is a potentially life-threatening disorder and anyone suffering from its debilitating symptoms deserves to have it treated.
Types of Depression

Depression is classified as a mood disorder. The primary types of depression are:

Major depression: Major depression is marked by a combination of symptoms that interfere with life activities, such as work, sleep and eating, as well as a loss of interest in previously pleasurable activities. The depressed mood represents a change from previous behavior or mood and has lasted for at least two weeks.

Dysthymia. This is a form of chronic but low-grade depression marked by low energy, a general negativity and a sense of dissatisfaction and hopelessness. A person suffering from dysthymia may experience many of the same symptoms that occur in major depression, but they are less intense and last much longer—at least two years. If you suffer from dysthymia, you may not feel good, but you aren't as disabled as during an episode of major depression. However, sometimes women with dysthymia also suffer from episodes of major depression, a condition known as double depression.

Postpartum depression (PPD): While the "baby blues" are common in many women within the first few days or weeks following pregnancy and childbirth, they are temporary. However, for some women these symptoms become more severe and long lasting. This is known as postpartum depression. The condition typically occurs from three days to six weeks after the baby is born, but can appear any time within the first year. About eight to 15 percent of women report diagnosable PPD within three months of delivery. If you've had prior depressive episodes, you have a much higher risk of developing PPD. Postpartum depression can seriously interfere with your ability to care for yourself and your child. You should report any symptoms immediately to your health care professional for further evaluation.

Premenstrual dysphoric disorder (PMDD): The syndrome of more severe depression, irritability and tension occurring seven to 14 days prior to the start of the menstrual period is known as premenstrual dysphoric disorder (PMDD) (also called late-luteal phase dysphoric disorder). It affects an estimated two to 10 percent of women of childbearing age. Though PMDD shares many of the characteristics of premenstrual syndrome (PMS), particularly the timing of the symptoms, there are differences between the two. When diagnosing PMDD, the focus is more on the mood-related symptoms than physical symptoms because the mood-related symptoms are significantly more severe in PMDD than in PMS. Experts say the difference between PMDD and PMS is similar to the difference between a mild tension headache and a migraine.

Seasonal affective disorder (SAD). Also called winter depression, SAD is a form of depression that affects an estimated 10 to 20 percent of Americans. Women in their 20s, 30s and 40s seem particularly susceptible to SAD, outnumbering men four to one. The key feature of SAD is your response to less light during the winter months. Experts believe that brain chemistry in some people is affected by diminished daylight, triggering depression at this time of the year. However, it is episodic—it comes and goes—and many people who experience SAD recover in the spring. These people, however, have an increased risk of developing bipolar disorder, another form of depression.

Bipolar disorder. This form of depression is sometimes called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by intense episodes of elation and despair, with any combination of mood experiences in between, including periods of normal moods. When in the depressed phase, an individual can have any or all of the symptoms of a depressive disorder. Symptoms during the manic phase include a decreased need for sleep, increased talkativeness, racing thoughts and increased activity, including sexual activity, excessive spending or having a great deal of energy. Sometimes manic episodes may include extreme irritability. Women who are bipolar may have more episodes of depression than mania.

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Cholesterol

High blood cholesterol is a major women's health issue. More than half of women over age 55 need to lower their blood cholesterol, and a quarter of all American women have blood cholesterol levels high enough to pose a serious risk for coronary heart disease.

Overall, an estimated 105 million American adults have total blood cholesterol levels of 200 milligrams per deciliter (mg/dL) and higher, which is above desirable levels. Of these, 42 million have levels of 240 mg/dL or higher, which is considered high risk for heart disease. This is important because cholesterol levels are a contributing factor to heart disease, which develops over years.

But don't fool yourself into thinking that high blood cholesterol is a problem only for middle-aged or elderly men and women. In fact, up to one-third of American children from age two through the teenage years have high cholesterol, which can lead to heart disease in adulthood.

Guidelines released by the National Cholesterol Education Program (NCEP), a division of the National Heart, Lung and Blood Institute (NHLBI), in May 2001 and in July 2004, substantially expanded the number of American women and men who need treatment for high cholesterol.

Based on mounting evidence that deaths from heart disease could be cut with aggressive treatment of high cholesterol, the NCEP guidelines spotlight elevated low-density lipoprotein (LDL) or "bad" cholesterol. Elevated LDL cholesterol injures blood vessel walls and has been identified as a major cause of CHD.

Updated NCEP recommendations include:

* More aggressive cholesterol lowering treatment and better identification for those at risk for a heart attack
* Use of a complete lipoprotein profile as the first test for high cholesterol
* A revised level at which low HDL cholesterol becomes a major heart disease risk factor
* A revised optimal level for LDL cholesterol for the population
* More aggressive treatment of high cholesterol for those with diabetes
* More intensive LDL cholesterol goals and treatment options for people at very high, high and moderately high risk for heart attack
* Intensified use of nutrition, physical activity and weight control to treat elevated cholesterol levels. Medication may also be recommended for individuals at moderate to high or very high risk of developing heart disease, based on their cholesterol ranges.

This integrated approach, called the Therapeutic Lifestyle Changes (TLC) treatment plan, was introduced in the 2001 NCEP report and remains a primary recommendation.
* A sharper focus on a cluster of heart disease risk factors linked to insulin resistance, known as "the metabolic syndrome," which often occur together and dramatically increase the risk for coronary complications.
* Increased attention to the treatment of high triglycerides
* Advisory against using menopausal hormone therapy (HT) to treat high cholesterol.

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