Monday, August 31, 2009

Kidney Stones

Each year nearly 3.3 million Americans seek out medical care for kidney stone removal and pain relief at a cost of about $5.3 billion per year. Treatment strategies include waiting for the stone to pass, physically breaking the stone into fragments, or surgically removing it; often some combination of the three approaches is required. Since people who have had one kidney stone are likely to develop more, kidney stone treatment involves not only addressing the immediate problem but also learning how to prevent formation of additional kidney stones.

Need-to-know-Anatomy

The urinary tract includes the kidneys, ureter, bladder, and the urethra. Urine is produced in the kidneys, two bean-shaped organs the size of your fist located in the lower back, flanking the spine. The kidneys release urine into the ureter, a small muscular tube that can dilate up to 7 millimeters in diameter (about 1 /4 of an inch) and connects the kidney to the bladder where urine is stored. When the bladder is full, we release the urine into a narrow tube, the urethra, which channels the urine out of the body.

Each day, nearly one quarter of the blood that's pumped by the heart flows through the kidneys into a network of tiny blood vessels that filter the blood. Together the kidneys contain 1 million tiny structures called nephrons that filter this blood, directing the waste products into tubules. In the tubules the wastes are further processed and partially reabsorbed to generate roughly 1 to 3 quarts of urine that the body needs to eliminate each day. The waste products in the blood are derived from the foods we eat and the normal breakdown of tissue in the body. Not only do the kidneys keep the blood chemically balanced by converting waste products into urine and discharging excess water, but they also produce hormones that are needed to stimulate bone marrow to make red blood cells (erythropoietin), regulate blood pressure (renin), and help maintain healthy calcium levels in the bones and body (calcitriol).

Causes

In general, kidney stones form when specific compounds in the urine become overly concentrated, causing minerals to crystallize. This usually happens near the end of tubules, before fluid leaves the kidney. Initially, the crystals are the size of tiny grains of sand, but over time they can aggregate to form a pebble about a half inch in diameter up to the size of a golf ball. Stones can be relatively smooth and round or irregularly shaped, like an antler. There are four main types of kidney stones, each of which is associated with different chemical conditions in the urinary tract.


In general, kidney stones form when specific compounds in the urine become overly concentrated, causing minerals to crystallize. This usually happens near the end of tubules, before fluid leaves the kidney. Initially, the crystals are the size of tiny grains of sand, but over time they can aggregate to form a pebble about a half inch in diameter up to the size of a golf ball. Stones can be relatively smooth and round or irregularly shaped, like an antler. There are four main types of kidney stones, each of which is associated with different chemical conditions in the urinary tract.

Calcium oxalate stones make up nearly80 percent of the kidney stones in the United States. These stones, composed of calcium oxalate or calcium oxalate mixed with calcium phosphate, are hard, like a piece of gravel. Calcium oxalate stone formation is driven by the relative concentrations of certain chemicals in the urine; too much calcium, too much oxalate (a chemical compound that occurs naturally in many plants we eat), too much phosphate, or too little citrate (a chemical that inhibits minerals from crystallizing in the urine) can lead to the formation of calcium oxalate stones. In many families, there appears to be a genetic predisposition for developing the conditions that favor calcium stone formation, but the genetics are not well understood. Other more rare causes of calcium stone formation include ingesting excessive amounts of vitamin D or calcium, hyperactive parathyroid glands, sarcoidosis (a condition causing small nodule lesions to form in the body), intestinal bypass surgery, or chronic inflammation of the bowel.

Uric acid stones tend to form in concentrated, acidic urine. About 5 to 10 percent of stones consist of uric acid, a byproduct of protein metabolism. Uric acid stones are associated with early stages of diabetes, a high-protein diet, chronic diarrhea, gout, and genetic factors--such as Middle Eastern ethnicity--that can predispose one to developing uric acid stones.

Pure calcium phosphate stones tend to form in urine that is too alkaline, a condition often caused by renal tubular acidosis. Renal tubular acidosis can be an inherited genetic disorder or arise later in life in association with other disease processes. Overly alkaline urine can also result from chronic ingestion of high quantities of antacids.
Struvite stones are relatively soft and almost always the result of chronic urinary tract infections caused by specific strains of bacteria. These bacteria produce enzymes that increase ammonia concentration in the urine. This ammonia-rich environment favors the formation of magnesium ammonium phosphate crystals, the minerals composing struvite stones. Struvite stones tend to grow quickly, incorporating the bacteria in the stone itself. Struvite stones must be removed surgically to eliminate the bacteria causing the urinary tract infection.

Cystine stones are rare and are associated with cystinuria, an inherited metabolic disorder. In affected individuals, the kidneys are not able to reabsorb cystine, leading to high levels of citrate in the urine, where it can crystallize to form cystine kidney stones. With this rare disease, cystine stones can start forming in young infants and continue throughout their life. Cystine stones are one of the physically hardest types of kidney stone.

Risk Factors

The risk factors for kidney stones fall into two categories: those you can control through lifestyle choices and those traits you are born with. Having a risk factor doesn't mean that you'll develop a disease or condition. Medical research continues to reveal how risk factors interact to influence a person's health and life span. However, understanding your risk allows you to balance the value you place on your health with the risk that may compromise your health in the future. In the United States, the incidence of kidney stones is on the rise, especially in young children. Many experts attribute this increase to changes in lifestyle such as poor diet and a decrease in water consumption.


Risk factors for forming a kidney stone include:
Familial or personal history of kidney stones. If a first-degree relative (mother, father, or sibling) has had a kidney stone, your risk of developing a kidney stone increases dramatically. If you have had a kidney stone, your risk of developing a subsequent one increases dramatically. The risk of developing subsequent kidney stones increases with each episode.

Lack of fluids. You're more likely to form stones if you live in a hot dry climate, work in a hot environment like a commercial kitchen, exercise strenuously without replacing fluids, or habitually drink relatively low amounts of fluid.

Elevated calcium levels in the urine. Elevated calcium levels in the blood increase the likelihood of developing a kidney stone.
Renal tubular acidosis, cystinuria, gout, chronic urinary tract infections, and hyperparathyroidism are the more common diseases that are associated with kidney stones.
High-protein and low-fiber diet increases the risk of forming a kidney stone.

Obesity and sudden weight gain increase the risk of developing a kidney stone.

Medications

For people who continue to form kidney stones after dietary changes, doctors can prescribe medications that prevent kidney stones. Medications commonly prescribed to prevent kidney stones include:

Kidney Stones - Medications

Medicine you can buy without a prescription, such as nonsteroidal anti-inflammatories (NSAIDs), may relieve your pain. Your doctor can give you stronger pain medicine if needed. NSAIDs include aspirin and ibuprofen (such as Motrin and Advil).

Your doctor may prescribe medicine to help your body pass the stone. Calcium channel blockers and alpha-blockers have been shown to help kidney stones pass more quickly with very few side effects.11 Ask your doctor if one of these medicines can help you.

If you get more kidney stones despite drinking more fluids and making changes to your diet, your doctor may give you medicine to help dissolve your stones or to prevent new ones from forming. You may also receive prescription medicine if you have a disease that increases your risk of forming kidney stones. Which medicine you take depends on the type of stones you have.

Medication Choices
Medicine to prevent calcium stones
About 80% of kidney stones are calcium stones.1 Calcium stones cannot be dissolved by changing your diet or taking medicines. There are medicines that may keep calcium stones from getting bigger or may prevent new calcium stones from forming:

Thiazides (such as hydrochlorothiazide, chlorthalidone) and potassium citrate(Urocit-K) are commonly used to prevent calcium stones.
Orthophosphate (Neutra-Phos) is sometimes used. It has more side effects than thiazides or potassium citrate.

Medicine to prevent uric acid stones
About 5% to 10% of kidney stones are made of uric acid, a waste product that normally exits the body in the urine.1 Uric acid stones can sometimes be dissolved with medicine.
Potassium citrate (Urocit-K) and sodium bicarbonate (baking soda) prevent the urine from becoming too acidic, which helps prevent uric acid stones.
Allopurinol (Lopurin, Zyloprim) makes it more difficult for your body to make uric acid.

Medicine to prevent cystine stones
Less than 1% of kidney stones are made of a chemical called cystine.1 Cystine stones are more likely to occur in families with a disease that results in too much cystine in the urine (cystinuria).
Potassium citrate (Urocit-K) prevents the urine from becoming too acidic, which helps prevent cystine kidney stones from forming.
Penicillamine (Cuprimine, Depen), tiopronin (Thiola), and captopril (Capoten) all help keep cystine dissolved in the urine, which makes cystine-type kidney stones less likely to form.

Medicine to prevent struvite stones
About 10% to 15% of kidney stones are struvite stones.1 They can also be called infection stones if they occur with kidney or urinary tract infections (UTIs). These types of kidney stones sometimes are also called staghorn calculi if they grow large enough.

Urease inhibitors (Lithostat) are rarely used because of their side effects and poor results.
What To Think About
If you have uric acid stones or cystine stones and are taking medicine to prevent more stones from forming, you will most likely have to continue taking that medicine for the rest of your life.

Some struvite stones (staghorn calculi) form because of frequent kidney infections. If you have a struvite stone, you will most likely need antibiotics to cure the infection and help prevent new stones from forming, and you will most likely need surgery to remove the stone.
Read original medication article here

For more reading reference check out these links


Sunday, August 30, 2009

Cholesterol Drugs May Reduce Risk of Blood Clots

New results from a large study suggest that the drugs known as statins may have a benefit beyond lowering cholesterol: reducing the risk of developing blood clots in the veins.

The study, published on the Web site of The New England Journal of Medicine and presented on Sunday at an American College of Cardiology convention, found that relatively healthy people who took a potent statin were 43 percent less likely than those who took a placebo to get a blood clot known as venous thromboembolism.

The clots, which often develop first in the legs, can be fatal if they travel to the lungs. The Centers for Disease Control and Prevention estimates that up to 600,000 Americans get venous clots each year and that at least 100,000 die. The risk of suffering blood clots increases with age, and people who are obese, have certain genetic abnormalities or have been inactive because of surgery or injury are more prone to develop them.

The results are from a large study called Jupiter, led by researchers at Brigham and Women’s Hospital in Boston, that looked into the effects of statins on people without high cholesterol or histories of heart disease. It involved 17,802 people — men 50 and older and women 60 and older — in 26 countries who took either a statin or a placebo.

The main Jupiter findings, published in November, were that the statin lowered the risk of heart attack by more than half and significantly lowered the risk of stroke, angioplasty, bypass surgery and death. As a result, national medical panels are considering broadening guidelines on who should be taking statins.

Studying blood clots was a secondary goal, said Jupiter’s lead investigator, Dr. Paul M. Ridker, the director of the Center for Cardiovascular Disease at Brigham and Women’s Hospital. With the relatively healthy people in the study, the number of clots was small — 94 total — but the placebo group developed 60 of them, compared with 34 for those taking the statin.

Dr. Ridker said that while common treatments for people who have had blood clots, usually several months of anticoagulants like warfarin or heparin, can cause hemorrhaging and require frequent monitoring, the blood clot reduction in the study “came without risk of hemorrhage at all.”

Jupiter is the first clinical trial to consider the impact of statins on blood clots in randomly selected people, although smaller studies have suggested similar results, including a 2008 review at Albert Einstein Medical Center in New York of the records of cancer patients who took statins.

Dr. Ridker says he has begun prescribing statins, instead of anticoagulants, to patients who have had a previous venous blood clot. Some experts, however, said more proof was needed.

“I can’t imagine that you would be treating people prophylactically yet,” said Dr. Timothy J. Gardner, the president of the American Heart Association. “The dilemma is we don’t want to put patients on medications that they don’t need, especially if we’re putting them on medications for life or for long term.”

The statin used in the Jupiter study is the most potent on the market, rosuvastatin, sold as Crestor and made by AstraZeneca, which sponsored the study. Some consumer health advocates say Crestor raises the risks of side effects like muscle deterioration and kidney problems. These were not problems in the Jupiter trial, although there was a small increase in diabetes. While it is unclear whether every statin would have the same effect as Crestor, most experts believe statins produce similar results, depending on the dose.

At the cardiology convention and on the Web site of the journal The Lancet, Dr. Ridker will present another set of results from the Jupiter study looking at the role of high-sensitivity C-reactive protein, or CRP, which indicates inflammation in the body. While people chosen for the study did not have high LDL, or bad, cholesterol, they did have high levels of CRP.

After an average of less than two years, Dr. Ridker found that the people taking the statin who had the lowest risk of heart attack, stroke and other problems were those who wound up not only with very low cholesterol but also very low CRP levels. Dr. Ridker said the findings indicated that people with high CRP levels should be taking statins, a recommendation that the national medical panels are considering. And he said that inflammation, and not just high cholesterol, appeared to cause heart problems, rather than merely being an indicator of problems.

“This does in my mind add strength to the hypothesis that inflammation is causal,” said Dr. Ridker, who helped invent a CRP test.

Not all experts agree.

“Whether this study confirms that inflammation increases risk of heart attack remains to be determined,” said Dr. Daniel J. Rader, a heart researcher at the School of Medicine at the University of Pennsylvania. “Many people would say it simply proves that CRP is a marker of risk.”

Dr. Rader and others said they were not convinced that patients taking statins should be tested to see whether their CRP levels, and not just their cholesterol, had dropped. If the CRP levels stayed high but other indicators improved, they said, that might not mean the statin was failing or should be increased.

If “LDL is down but CRP continues to remain elevated, would increasing the statin further provide additional benefit?” said Sidney Smith, a professor of medicine at the University of North Carolina and a past president of the American Heart Association. “This doesn’t answer that question. My approach would be to work on getting the patient to stop smoking, and other lifestyle factors.”

Read more about statins here and blood clots just clikc the underlined title

Statins - drug class, medical uses, medication side effects, and ...

Read about statins, cholesterol lowering medications like Levacor, Zocor, Pravachol, Lipitor, Crestor, and more. Side effects, drug interactions

Statins: The new wonder drugs | The Philippine Star

Blood Clots -Answers to your questions about blood clots and more! Information you can trust: patient guides, the latest news, tips, tools, animations and newsletters.

This article is from the NY Times 3/29/09 just click this link to read the complete original article http://www.nytimes.com/2009/03/30/health/research/30heart.html?_r=1&ref=us

Friday, August 28, 2009

Generic Drugstores in the Philippines

By philippinetech click the title above or heading to read the complete original article

Generic drugs are always less expensive, it cost about thirty percent to eighty percent less than the brand name drug. Generic drugs mean more cost-savings to the consumers. Its use can save patients and even insurance companies thousands of dollars without compromising the quality of health care. According to the U.S. Congressional Budget Office, generic drugs save consumers an estimated $8 to $10 billion a year at retail pharmacies. Even more billions are saved when hospitals use generics.

So if your on a budget, the generics stores maybe a solution.
The following is a list of several Generic drugstores in the Philippines and some full service drugstores as well. Add others you know of here in the Philippines and their websites in the comments section

THEGENERICSPHARMACY


The company ventured into selling generic medicines. In 2001, the retail pharmacy operations was successfully launched. By the end of 2008, 150 stores will be operating NATIONWIDE. To keep the momentum, they started to franchise their retail stores and became the first generics retail pharmacy to franchise in the Philippines.

Main Branch: THEGENERICSPHARMACY Banawe, Quezon City Opening Hours: Monday to Saturday 8:30am to 5:30pm Address: 459 Quezon Avenue corner Banawe, QUEZON CITY E-mail: comments@thegenericspharmacy.com

They are opening a number of stores all over the Philippines and have a number in Cebu already.

check out the links below to see the locations all over the Philippines including cebu
http://www.thegenericspharmacy.com/contact.php

Cebu has already about 30 stores

Generika Generics

Mostly Manila branches now http://generika.com.ph/branches/

There is also a blog report that there is a chain of drug stores all over the RP named Generic Drug Store. What a coincidence ! heehee They sell generic Plavic and all other drugs for a LOT less. My Enalapril is cheap enough for me here in Tacloban that I do not buy from USA or from Internet pharmacies. Try both Generic Drug Store and Alpha Pharmacies, another generic chain of drug stores in the RP. Alpha is usually even less expensive than is Generic. I was unable to find them online so they must not have websites or google is not searching for them correctly.

My Botika” Distributor of Quality Generic and Branded Medicines and Medical Supplies “ Your One-Stop Shop !! online ordering. Their website says Are you looking for cheap generic drugs?? We all have it thru our online pharmacy. We offer shipping nationwide. We do have paracetamol. mefenamic acid, decongestants, multivitamins, antibiotics and other over-the-counter drugs. If you’re looking for a particular medicine that needs prescription, you just have to show it to us first before we begin transaction.

We also cater to wholesale order from other pharmacy nationwide. We offer big discount to bulk orders. QUALITY GUARANTEED !!

http://www.mybotika.webs.com/

Another online drugstore generic in the Philippines is CNN Generics
http://www.cnn-generics.com/cnn/more_cat.php


Are you looking for cheap generic drugs?? We all have it thru our online pharmacy. We offer shipping nationwide. We do have paracetamol. mefenamic acid, decongestants, multivitamins, antibiotics and other over-the-counter drugs. If you’re looking for a particular medicine that needs prescription, you just have to show it to us first before we begin transaction.

Sulit advertiser Generic and branded drugs here
http://www.sulit.com.ph/index.php/view+classifieds/id/1206598/Cheap+Generic+Drugs,+Branded+Medicines+and+Medical+Supplies+Online

Also read a friends blog here on the medicines that have been reduced due to the new Philippine drug act, just click the link

http://drugprices.wordpress.com/

Price cuts for 99 medicines Philippines

The five essential drugs under the MDRP are as follows: Amlodipine for hypertension; Atorvastatin for anti-cholesterol; Azithromycin as antibiotic/antibacterial; Cytarabine and Doxorubicin and all its salt form both for anti-neoplastics/anti-cancer.

There are additional 16 medicines dubbed as Government Mediated Access Price (GMAP) namely ; Telmisartan and Irbesartan for hypertension; Clopidorel for anti-thrombotic; Gliclazide for anti-diabetic/antihypoglycemic; Piperacillin plus Tazobactam and all its salt form; Metronidazole and all its salt form, Ciprofloxacin, Co-Amoxiclav (Amoxicillin plus Clavulanic acid) for antibiotic/antibacterial; Bieomycin and all its salt form, Carboplatin, Cisplatin, Cyclophosphamide, Etoposide, Mercaptopurine, Methotrexate and Mesna for anti-neoplastic.

Cabotaje said as high as 50 percent price reduction of these medicines could be availed of with the implementation of such order. She said drugstores are required to post in their respective establishments the list of medicines with their corresponding prices and dosages adding that they can go below the prescribed prices but not over.

According to a leading drugstore, aside from the 50 percent reduced price of Norvasc brand Amlodipine, a 20 percent discount could still be availed of if registered as Sulit Card member.

Some of the categorized drugs fall under anti-hypertensive, anti-cholesterol, anti-thrombotic, anti-diabetics, anti-biotics and anti-cancer drugs.

Eight pharmaceutical companies have agreed to also apply voluntary price reduction to 22 other molecules or 31 more products that were not in the MDRP list, bringing the total number to 38 drug molecules (or 72 products).

These medicines are indicated against hypertension, diabetes, influenza, hypercholesterolemia, cancer, arthritis, goiter, allergies and infections.



The list of the five medines and their corresponding MDRP were:

ANTI-HYPERTENSIVE

Amlodipin 2.5 mg (P9.60); 5mg (P22.85); and 10mg (P38.50).

ANTI-CHOLESTEROL

Atorvastatin 10mg film-coated tablet (P34.45); 20mg film-coated (P39.13); 40mg film-coated (P50.50); 80mg film-coated (P50.63);

Amlodipine besilate 5mg + Atorvastatin calcium 10mg tablet (P45.75);

Amlodipine besilate 5mg + Atorvastatin calcium 20mg tablet (P66.25);

Amlodipine besilate 5mg + Atorvastatin calcium 40mg tablet (P84.42);

Amlodipine besilate 5mg + Atorvastatin calcium 80mg tablet (P89.99);

Amlodipine besilate 10mg + Atorvastatin calcium 10mg tablet (P51.13);

Amlodipine besilate 10mg + Atorvastatin calcium 20mg tablet (P73.25);

Amlodipine besilate 10mg + Atorvastatin calcium 40mg tablet (P91.79);

Amlodipine besilate 10mg + Atorvastatin calcium 80mg tablet (P91.79);

ANTIBIOTIC/ANTIBACTERIAL

Azithromycin and all its salt form:

250mg tablet (P108.50);

200mg/5ml powder for suspension (15ml), P427.50;

200mg/5ml powder for suspension (22.5ml), P638;

500mg tablet, P151.43;

500mg vial for injection, P992.50; and

2-gram granules, P468.

ANTI-NEOPLASTICS/ ANTI-CANCER

Cytarabine:

100mg/ml ampul/vial (IV/SC), P240;

100mg/ml ampul/vial (IV/SC) (5ml) or 500mg vial, P900;

100mg/ml ampul/vial (IV/SC) (10ml) or 1-gram vial, P1,800; and

20mg/ml (5ml) ampul/vial for injection, P1,980.

Doxorubicin and all its salt form:

10mg powder vial for injection, P1,465.75; and

50mg powder vial for injection, P2,265.74.

The ruling on the new rates will take effect on August 15. (PND)

See the complete list of the 5 above and the 22 others voluntary price reductions here
http://drugprices.wordpress.com/

http://www.allbusiness.com/medicine-health/diseases-disorders-cardiovascular/12595043-1.html

What Is Osteoporosis?

Osteoporosis is low bone density, or porous bones. Your bones should be dense and solid. There are varying degrees of bone density. Osteoporosis is when the bone density is pathological and you are at a risk for fracture. The type of fracture that is of most concern is a hip fracture. When you have osteoporosis, there is also a higher risk of mortality, high risk of morbidity.

Osteopenia is when there is a decrease in bone density, so you are almost osteoporotic, but you are not quite there yet.

Osteoporosis : Boost your bone bank

The major challenge with osteoporosis is that it presents no symptons and progresses without pain until the person gets a fracture, writes Agnes K. Namaganda.

Osteoporosis may seem like a disease of the old but its prevention starts before old age strikes. Knowledge about it and measures taken before the disease reaches a dangerous stage can go a long way in lessening its effects.

What causes osteoporosis?
The most common cause of osteoporosis is being post menopause. After menopause, a woman's estrogen decreases and with that, you get less of a calcium build-up in your bones. Women, after the age of about 52 (51-52 is the average age of menopause), you may start to see osteoporosis.
Some women have had their ovaries removed, or have had a hysterectomy (sometimes they remove the ovaries, sometimes they take it out), which can happen at any age, often if you have uterine fibroids. These women are also more susceptible to osteoporosis.

It is not common for men to have osteoporosis.
Read more about his at these original articles with parts from above, just click the links below

http://www.empowher.com/news/herarticle/2009/08/26/what-osteoporosis

http://www.monitor.co.ug/artman/publish/health-and-living/Osteoporosis_Boost_your_bone_bank_90287.shtml

Lifestyle approaches to improve bone health

http://www.examiner.com/x-20424-Minneapolis-Womens-Health-Examiner~y2009m8d26-Lifestyle-approaches-to-improve-bone-health

Wednesday, August 26, 2009

Type 2 Diabetes

Billie Jean King. The 66-year-old tennis legend was diagnosed with type 2 diabetes just a few years ago. The news came long after a career of crushing opponents and setting records—like 20 Wimbledon titles—that may never be matched. Her personal advice for others fighting to fend off or manage the disease

Most people associate type 2 diabetes with an unhealthy lifestyle—poor diet, too little exercise, too much weight.

A person’s likelihood of getting type 2 diabetes is dictated largely by genetics. But lifestyle choices play a key role in determining when the disease manifests itself. Click the headline or title to read the complete orginal article

People who are more at risk for diabetes are those with a family history of the disease and those who are 45 years old and above. Ethnicity is also a risk factor, like those who live in the Pacific Islands region like Filipinos are more prone to diabetes. Other risk factors are obesity, a sedentary lifestyle, mothers of large babies (8 lbs. and above), hypertension, vascular diseases, and those with signs of insulin resistance such as those with polycystic ovary syndrome.

There is still no cure for diabetes. At present, patients can only control the disease, so knowing everything about it is a must to effectively manage and prevent the onset of complications related to the disease. Among the complications of uncontrolled diabetes are heart attack, stroke, blindness, diabetic nephropathy (damage to kidneys), diabetic neuropathy (damage to nerves), and erectile dysfunction.

About Type 2 Diabetes Click to read more


Type 1: Results from the body's failure to produce insulin. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. Presently almost all persons with type 1 diabetes must take insulin injections.

Type 2: Results from Insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes. Many people destined to develop type 2 diabetes spend many years in a state of Pre-diabetes: Termed "America's largest healthcare epidemic, a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes.

As of 2009 there are 57 million Americans who have pre-diabetes
Gestational diabetes: Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes affects about 4% of all pregnant women. It may precede development of type 2 (or rarely type 1).

Many other forms of diabetes mellitus are categorized separately from these. Examples include congenital diabetes due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.

Other references to read

Diabetes Symptoms

Diabetes in Wikipedia medical information

Diabetes in Medicine Plus

American Diabetes Association