Diabetes Information

What is Diabetes?

Diabetes is a disorder that affects your metabolism. Much of the food that you eat is broken down into a form of sugar in your blood called glucose. This glucose is the main source of energy for your body.

Glucose passes into your bloodstream after digestion occurs, there glucose is used by your cells for energy and growth. In order for glucose to get into your cells, a hormone called insulin must be present. Insulin is produced by your pancreas.

When you eat, your pancreas produces the correct amount of inuslin to move glucose from your blood into your cells. If you have diabetes, the pancreas produces either little or no insulin, or your cells do not respond to the insulin that is produced. This causes glucose to build up in your blood, overflow into your urine and excreted from your body when you urinate. This causes your body to lose its main source of energy even though your blood contains large amounts of glucose.

Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can be associated with serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.

Diabetes is one of the leading causes of disability and death in the United States. Diabetes can affect almost every part of your body and is associated with long-term complications. Diabetes often leads to kidney failure, heart disease, stroke, nerve damage, amputations, and blindness. Diabetes that is not controlled can result in complications during pregnancy and an increase risk of birth defects.

There are three main types of Diabetes

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose.

This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors.

Symptoms of type 1 diabetes typically develop over a short period of time. You symptoms may include constant hunger, an increase in thirst and urination, loss of weight, extreme fatigue, and blurred vision. If you are not diagnosed and treated with type 1 diabetes, you could fall into a diabetic coma called diabetic ketoacidosis. This diabetic coma could threaten your life.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin.

Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents.

Symptoms of type 2 diabetes tend to develop slowly and some people have no symptoms. Type 2 diabetes does not develop as suddenly as type 1 diabetes. Symptoms are similar to type 1 diabetes and may include frequent urination, increased thirst and hunger, fatigue, loss of weight, blurred vision, and sores and wounds that heal slowly.

Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes.

During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years.

Other specific types of diabetes result from specific genetic conditions (such as maturity-onset diabetes of youth), surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 5% of all diagnosed cases of diabetes.

What is diabetic neuropathy?

Diabetic neuropathies are nerve disorders that are caused by diabetes. If you have diabetes, you can over time, get nerve damage throughout your body. For some people, there are no symptoms. Typical diabetic neuropathy symptoms can include tingling, pain, numbness in your hands, arms, legs, and feet. Problems with your nerves can occur in any of your organs including your digestive system, sex organs, and heart.

Almost 70 percent of the people diagnosed with diabetes have some level of diabetic neuropathy. You can develop nerve problems at any time, but the risk increases as you get older and the longer you have had diabetes. People that have had diabetes for at least 25 years have the highest rates of neuropathy.

Treating Diabetes
To survive, people with type 1 diabetes must have insulin delivered by injections or a pump.  Many people with type 2 diabetes can control their blood glucose by following a careful diet and exercise program, losing excess weight, and taking oral medication.  Many people with diabetes also need to take medications to control their cholesterol and blood pressure.

Diabetes self-management education is an integral component of medical care.  Among adults with diagnosed diabetes, 12% take both insulin and oral medications, 19% take insulin only, 53% take oral medications only, and 15% do not take either insulin or oral medications.

Prevention or Delay of Diabetes
Research studies have found that lifestyle changes can prevent or delay the onset of type 2 diabetes among high-risk adults. These studies included people with IGT and other high-risk characteristics for developing diabetes. Lifestyle interventions included diet and moderate-intensity physical activity (such as walking for 2 1/2 hours each week). In the Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, the development of diabetes was reduced 58% over 3 years.

Studies have also shown that medications have been successful in preventing diabetes in some population groups. In the Diabetes Prevention Program, people treated with the drug Metformin reduced their risk of developing diabetes by 31% over 3 years. Treatment with Metformin was most effective among younger, heavier people (those 25-40 years of age who were 50 to 80 pounds overweight) and less effective among older people and people who were not as overweight.

Similarly, in the STOP-NIDDM Trial, treatment of people with IGT with the drug Acarbose reduced the risk of developing diabetes by 25% over 3 years. Other medication studies are ongoing. In addition to preventing progression from IGT to diabetes, both lifestyle changes and medication have also been shown to increase the probability of reverting from IGT to normal glucose tolerance.

There are no known methods to prevent type 1 diabetes. Several clinical trials are currently in progress or being planned.