"Life is not over because you have diabetes. Make the most of what you have, be grateful." Dale Evans Rogers (American Singer known as the "Queen of the West

Glucose, a form of sugar, is the body's main source of fuel. Glucose needs insulin to enter the cells to be used as energy. Insulin is produced by a large gland situated behind the stomach - the pancreas. In diabetes, either the pancreas does not produce enough insulin or the cells in the muscles, liver, and fat do not use insulin properly, or both. This allows sugar to accumulate in the blood while the cells are starved. These metabolic abnormalities lead to vascular inflammation. People with diabetes are at a much higher risk of developing cardiovascular diseases like heart attack, stroke, peripheral artery disease and heart failure.

The incidence of diabetes is reaching epidemic proportions. Worldwide, it is estimated that the prevalence of diabetes will rise from 2.8% (171 million people) in 2000 to 4.4% (366 million people) in 2030. Elevated blood glucose levels are responsible for 21% of deaths from coronary heart disease and 13% of deaths from stroke. This translates into 3.16 million deaths a year. Diabetes is also a major problem in the United States.

Many clinical trials have established that cardiovascular diseases are the most common and most serious complications in diabetics. Almost 65% patients with diabetes die of heart attack or a stroke. Dr. Garcia and his co researchers reported in Diabetes in 1974, using data from the Framingham Study, that patients with diabetes have a two-three-fold increased incidence of cardiovascular disease and those who present in the fourth and fifth decade of life have a two-fold increase in mortality. This cardiovascular risk develops even before diabetes becomes clinically apparent. Researchers from the Harvard School of Public Health in Boston found that women who eventually developed type 2 diabetes had a risk of heart attack almost 4 times higher than those who never developed the disease. This data from the Nurses Health Study, was published in the July 2002 issue of Diabetes Care.

The cause of the increased risk of macro-vascular cardiac disease is multi-factorial. Eighty percent of patients with type 2 diabetes are either obese or overweight. Diabetics also carry an abnormal lipid profile. Diabetics typically have elevated plasma triglycerides, normal or mildly elevated low-density lipoprotein cholesterol (LDL-C), and reduced plasma HDL-C concentrations. This encourages atherosclerosis. The combination of high blood sugar and high insulin levels are also toxic to the cardiovascular system. Further, more than two thirds of the adults with diabetes suffer from high blood pressure, another major risk factor for cardiovascular disease.

"What was so upsetting was I didn't really know anything about diabetes except that Ella Fitzgerald lost her legs and later died from it." Della Reese. Diabetics also causes many micro-vascular complications. These include diabetic retinopathy, diabetic nephropathy and diabetic neuropathy. Despite good long-term sugar and blood pressure control, diabetes remains a major cause of blindness, renal failure and amputations. Two landmark studies, the Diabetes Control and Complications Trial, published in the New England Journal of Medicine in 1993 and the United Kingdom Prospective Diabetes Study Group (UKPDS) study published in the British