An Overview of Diabetes

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Diabetes

According to the latest figures from the Centers for Disease Control and Prevention (CDC), nearly 21 million Americans have diabetes mellitus, which is commonly referred to as diabetes. That's 7 percent of the American population. About 6 million of those people have no idea they have diabetes and millions more are at risk of developing it. If you have diabetes, your body has problems converting the food you eat into energy. The danger of this lies in the fact that if untreated, diabetes can damage the eyes (Read about "The Eye"), kidneys (Read about "Diabetes and Kidney Disease"), nerves, heart and blood vessels. (Read about "The Heart & Cardiovascular System") Therefore, whenever present, it's essential to diagnose, monitor and treat diabetes correctly.

Diabetes mellitus should not be confused with diabetes insipidus (DI). Diabetes insipidus and diabetes mellitus are unrelated, although they can have similar signs and symptoms, like excessive thirst and excessive urination. (Read about diabetes insipidus in "Endocrine System")

Follow the links below to learn more about diabetes, its causes, complications and how to live with it.

A1c test: see Monitoring and Treating Diabetes
Blood sugar: see Insulin and Blood Sugar
Complications: see Complications
Gastroparesis: see Complications
Gestational diabetes: see Gestational under Types of Diabetes
Heart disease & diabetes: see Complications
Insulin resistance: see Insulin Resistance under Types of Diabetes
Insulin: see Insulin and Blood Sugar
Kidney disease & diabetes: see Complications
Latent autoimmune diabetes in adults (LADA): see Types of Diabetes
Monitoring: see Monitoring and Treating Diabetes
Neuropathy & diabetes: see Complications
Pre-diabetes: see Insulin Resistance under Types of Diabetes
Retinopathy & diabetes: see Complications
Screening tests: see Screening for Diabetes
Stroke & diabetes: see Complications
Symptoms: see Symptoms of Diabetes
Treatments: see Monitoring and Treating Diabetes
Types: see Types of Diabetes
Type 1 diabetes: see Type 1 under Types of Diabetes
Type 2 diabetes: see Type 2 under Types of Diabetes

Insulin and blood sugar

Normally, the food we eat is broken down into glucose, which is a form of sugar. The glucose passes into the bloodstream, where it is used by cells for growth and energy. For cells to use glucose, however, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. (Read about "Endocrine System") If the insulin isn't present, or if the cells don't respond to it, the glucose stays in the bloodstream, causing a rise in the blood sugar or blood glucose level. When blood sugar levels are too high it's called hyperglycemia; when blood sugar levels fall too low it's called hypoglycemia. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says conditions that can lead to hypoglycemia in people with diabetes include taking too much medication, missing or delaying a meal, eating too little food for the amount of insulin taken, exercising too strenuously, drinking too much alcohol, or any combination of these factors. See also Monitoring and Treating, Types, Screenings, Symptoms, or Complications of Diabetes

Types of diabetes

The American Diabetes Association (ADA) and NIDDK say there are different types of diabetes and insulin-resistance:

• Type 1 diabetes (which has also been called insulin-dependent or immune-mediated diabetes) occurs when your body can't produce insulin. This is the kind of diabetes that often appears before the age of 18, although it can also strike at any age. Type 1 diabetes is considered an autoimmune disease. An autoimmune disease results when the body's system for fighting infection, the immune system, turns against a part of the body. (Read about "The Immune System") In Type 1 diabetes, according to NIDDK, the immune system attacks the insulin-producing cells in the pancreas and destroys them. The pancreas then produces little or no insulin. An individual with Type 1 diabetes requires daily doses of insulin. The insulin can be delivered by injection, through a pump system, which feeds the insulin into the body through a needle or catheter inserted just under the skin or via an inhaler. Healthy meal planning and regular exercise are also a part of treatment for type 1 diabetes.
• Type 2 diabetes (which has also been called non-insulin-dependent diabetes) is much more common than Type 1 diabetes, affecting some 90% of people with diabetes. In this type, your body can produce insulin, but it either doesn't produce enough or it isn't using it properly. Someone with Type 2 diabetes uses exercise, healthy meal planning and, in some cases, oral medications or insulin to control blood sugar levels. Type 2 diabetes has been linked with obesity (Read about "Obesity"), and the number of people in the U.S. with Type 2 diabetes is growing.
• Gestational diabetes develops during pregnancy and usually disappears once the baby is born. This condition requires careful monitoring throughout the pregnancy and can put a woman at higher risk of developing diabetes later in life. The ADA says about four percent of pregnant women develop gestational diabetes during pregnancy, and women who were overweight before becoming pregnant are at a higher risk. (Read about "Healthy Pregnancy") Women who have had gestational diabetes are at increased risk for developing type 2 diabetes. The Centers for Disease Control and Prevention say studies show nearly 40 percent of women with a history of gestational diabetes develop diabetes in the future. Therefore, any woman who developed gestational diabetes during pregnancy should be sure she is monitored throughout her life. It is also important that she maintain a normal weight and exercise regularly.
• Insulin Resistance The U.S. Department of Health and Human Services (HHS) says there is also a condition called "pre-diabetes" which affects an additional 41 million Americans. The term "pre-diabetes" is being used to describe an increasingly common condition in which blood glucose levels are higher than normal but not yet diabetic. This is also known as impaired glucose tolerance or impaired fasting glucose. Someone with impaired glucose tolerance may also be described as "insulin resistant," that is, their body produces insulin but isn't utilizing it correctly, causing blood sugar levels to rise.
  Insulin resistance is also a factor in metabolic syndrome or syndrome X. (Read about "Metabolic Syndrome") Other risk factors for metabolic syndrome include a body mass index of over 25 (Read about "Body Mass Index"), high triglyceride levels, family history of diabetes (Read about "Family Health History"), polycystic ovary syndrome (Read about "Polycystic Ovary Syndrome"), sedentary lifestyle, age and ethnicity. The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) say metabolic syndrome is an epidemic condition that dramatically increases risk for type 2 diabetes, heart disease and stroke. They estimate that it affects one in three Americans.
  HHS says most people with pre-diabetes will likely develop diabetes within a decade unless they make changes in their diet and level of physical activity, which can help them reduce their risks. Even before they develop diabetes, their health is still at risk, since they are much more likely to develop high blood pressure, abnormal blood lipids and coronary heart disease. (Read about "Hypertension: High Blood Pressure" "Cholesterol") Studies have linked obesity to impaired glucose tolerance, as well as to pre-diabetes.
• Latent Autoimmune Diabetes in Adults (LADA) goes by a number of names, according to the ADA. It can also be called type 1.5 or slow onset type 1. NIDDK says that LADA usually shows up after the age of 35 and with signs that the immune system (Read about "The Immune System") is attacking the cells in the pancreas that make insulin. ADA says that people with LADA do not yet need insulin and they generally are not insulin resistant. They may eventually progress to being insulin dependent. ADA also says people with LADA tend to be physically fit in the way they look, not overweight.

See also Monitoring and Treating, Types, Screenings, Symptoms, or Complications of Diabetes

Symptoms of Diabetes

Symptoms of diabetes can vary, but the American Academy of Family Physicians says typical symptoms, especially for Type 1 diabetes, include:

• frequent urination
• excessive thirst
• blurry vision
• tingling or numbness in the hands and feet
• unexplained weight loss despite eating more than usual
• extreme tiredness or irritability

In Type 2 diabetes there may not be any symptoms, especially initially. This is why screening is so important, especially if you have any of the risk factors for diabetes. Type 2 diabetes occurs most often after the age of 40 (although the American Diabetes Association says there is an alarming - potentially lifestyle-related - increase in the number of people under age 40 now developing this kind of diabetes). It's estimated that millions of people have type 2 diabetes and do not know it. Talk to your doctor about being tested for diabetes, especially if any of the following risk factors apply to you:

• you have a family history of diabetes
• you are more than twenty percent over your ideal weight (Read about "Body Mass Index")
• you have high blood pressure or high blood cholesterol (Read about "Hypertension: High Blood Pressure" "Cholesterol")
• you belong to a racial or ethnic group at higher risk, including Hispanic, African-American or Native American
• you developed diabetes during pregnancy or delivered a large baby (9 pounds or heavier)

See also Monitoring and Treating, Types, Screenings, Symptoms, or Complications of Diabetes

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