Diabetes

What is diabetes?

Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugar to build up in your blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the sixth leading cause of death in the United States.

What are the symptoms of diabetes?

People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:

• Frequent urination
• Excessive thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in hands or feet
• Feeling very tired much of the time
• Very dry skin
• Sores that are slow to heal
• More infections than usual.

Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.

What are the types of diabetes?

Type 1 diabetes, which was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, may account for 5% to 10% of all diagnosed cases of diabetes. Type 2 diabetes, which was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, may account for about 90% to 95% of all diagnosed cases of diabetes. Gestational diabetes is a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies. Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over. Other specific types of diabetes resulting from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses may account for 1% to 2% of all diagnosed cases of diabetes.

What are the risk factors for diabetes?

Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.

Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in developing this type of diabetes.

Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly 40% of women with a history of gestational diabetes developed diabetes in the future.

Other specific types of diabetes, which may account for 1% to 2% of all diagnosed cases, result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses.

What is the treatment for diabetes?

Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.

Healthy eating, physical activity, and blood glucose testing are the basic therapies for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.

People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high.

People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.

What causes type 1 diabetes?

The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for developing both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an “environmental trigger,” such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.

For more information about the immune system, visit these pages from The National Institute of Health’s (NIH) National Institute of Allergy and Infectious Diseases Web site:

The Immune System

Preventing Diabetes

Many research studies have found that moderate weight loss and exercise can prevent or delay type 2 diabetes among adults at high-risk of diabetes. Find out more about the risk factors for type 2 diabetes, what it means to have prediabetes, and what you can do to prevent or delay diabetes. See also EAT RIGHT and BE ACTIVE.

What are the most important things to do to prevent diabetes?

The Diabetes Prevention Program (DPP), a major federally funded study of 3,234 people at high risk for diabetes, showed that people can delay and possibly prevent the disease by losing a small amount of weight (5 to 7 percent of total body weight) through 30 minutes of physical activity 5 days a week and healthier eating. really, Getting healthy is simple and easy, we have no excuse for being unhealthy except neglect. Anyone can get basic exercise every day even if that means for some just going for a walk around the block a few times. Walking is free and doesn’t cost money. How about swimming in a nearby lake or pool. Jumping jacks in your own home, push ups sit ups. Come on people , take some responsibility for your health, how you look and feel. Its up to you, and you are the one who will benefit with increased energy , looking and feeling better and less risk of dying early from major illness or disease.

When should I be tested for diabetes?

Anyone aged 45 years or older should consider getting tested for diabetes, especially if you are overweight. If you are younger than 45, but are overweight and have one or more additional risk factors (see below), you should consider testing.

What are the risk factors which increase the likelihood of developing diabetes?

Being overweight or obese

A parent, brother, or sister with diabetes

African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino heritage

Prior history of gestational diabetes or birth of at least one baby weighing more than 9 pounds

High blood pressure measuring 140/90 or higher

Abnormal cholesterol with HDL (“good”) cholesterol is 35 or lower, or triglyceride level is 250 or higher

Physical inactivity—exercising fewer than three times a week

How does body weight affect the likelihood of developing diabetes?

Being overweight or obese is a leading risk factor for type 2 diabetes. Being overweight can keep your body from making and using insulin properly, and can also cause high blood pressure. The Diabetes Prevention Program (DPP), a major federally funded study of 3,234 people at high risk for diabetes, showed that moderate diet and exercise of about 30 minutes or more, 5 or more days per week, or of 150 or more minutes per week, resulting in a 5% to 7% weight loss can delay and possibly prevent type 2 diabetes.

What is pre-diabetes?

People with blood glucose levels that are higher than normal but not yet in the diabetic range have “pre-diabetes.” Doctors sometimes call this condition impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Insulin resistance and pre-diabetes usually have no symptoms. You may have one or both conditions for several years without noticing anything.

If you have pre-diabetes, you have a higher risk of developing type 2 diabetes. Studies have shown that most people with pre-diabetes go on to develop type 2 diabetes within 10 years, unless they lose weight through modest changes in diet and physical activity. People with pre-diabetes also have a higher risk of heart disease.

Progression to diabetes among those with prediabetes is not inevitable.  Studies suggest that weight loss and increased physical activity among people with prediabetes prevent or delay diabetes and may return blood glucose levels to normal.

For more information, see:

• Diabetes & Me – Prediabetes
• The Center for Disease Control and Prevention’s National Diabetes Fact Sheet 2007  
• The National Diabetes Information Clearinghouse’s Insulin Resistance and Pre-Diabetes
• The American Diabetes Association’s Frequently Asked Questions About Pre-Diabetes