Diabetes

Diabetes is the inability of the body to create or use insulin, a hormone secreted by the pancreas that enables sugar or glucose to enter cells. Diabetes is a serious, chronic metabolic disorder in which the body either does not produce enough insulin or does not respond to the insulin being produced.

The body normally breaks down most food into glucose, a sugar that serves as the body's main source of energy. In order for glucose to move into the cells of the body, it requires the help of insulin, a hormone produced by the pancreas. In diabetics, not enough insulin is produced, which causes glucose to build up in the blood instead of moving into cells. Too much glucose in the blood can damage the blood vessels, nerves, heart, eyes and kidneys. Although diabetes can lead to serious complications, it is often successfully managed through diet, lifestyle modifications or medication.

Types of Diabetes

There are several forms of diabetes.

Type 1 Diabetes

Type 1 diabetes is sometimes referred to as juvenile diabetes, because it is often diagnosed in children. It does, however, also affect adults. Type 1 diabetes is the result of an autoimmune disease in which the body attacks the insulin-producing cells of the pancreas, disabling the body's ability to produce insulin.

Type 2 Diabetes

Type 2 diabetes is the most common form of preventable diabetes. It is influenced by age, obesity and family history. Although the pancreas usually produces enough insulin, the body cannot use it effectively, and production slowly decreases.

Prediabetes

Prediabetes is a condition in which blood glucose levels are high, but not high enough to diagnose diabetes. A diagnosis of prediabetes puts the patient at higher risk for developing type 2 diabetes. Prediabetes is often addressed by losing weight and incorporating a daily exercise regimen.

Gestational Diabetes

Gestational diabetes is characterized by high levels of blood sugar during the later stages of pregnancy. Although the cause is not completely understood, it is suspected that the hormones produced during pregnancy prevent insulin from working, resulting in insulin-resistance and hyperglycemia. Most cases of gestational diabetes resolve at the end of the pregnancy, but may increase the risk of its developing in future pregnancies.

Most forms of diabetes can be managed and, with medical treatment or lifestyle modifications, people can live relatively healthy lives.

Symptoms of Diabetes

While type 1 diabetes usually develops during childhood or adolescence, it can also occur in adulthood. Symptoms of type 1 diabetes include the following:

  • Frequent urination
  • Increased thirst
  • Hunger
  • Unusual weight loss
  • Fatigue
  • Irritability

Symptoms of type 2 diabetes usually develop in adulthood, and include the same symptoms as type 1 diabetes. Additional symptoms include the following:

  • Blurry vision
  • Frequent infections
  • Tingling or numbness in the hands or feet
  • Cuts or bruises that heal slowly
  • Recurring skin, mouth, vaginal and bladder infections

Some people with type 2 diabetes may not notice any symptoms at all.

Risk Factors for Diabetes

The exact cause of diabetes is not clear, although there are risk factors for developing it. Risk factors include the presence of autoantibodies (which damage immune-system cells), a family history of diabetes, and various environmental factors. Risks for developing type 2 diabetes and prediabetes increase as people age, and also include the following:

  • Being overweight
  • Not exercising
  • Family history of diabetes
  • Being African-American or Hispanic
  • History of gestational diabetes
  • Polycystic ovary syndrome
  • High blood pressure
  • Low level of HDL cholesterol
  • Elevated triglycerides

The risks of gestational diabetes include the following:

  • Being older than 25
  • Being overweight prior to pregnancy
  • Family history of diabetes
  • Gestational diabetes in a prior pregnancy
  • Being African-American or Hispanic

The risk of gestational diabetes increases if a woman is diagnosed with prediabetes prior to pregnancy.

Diagnosis of Diabetes

Routine urine and blood tests are performed to measure glucose levels. If diabetes is suspected, additional tests include the following:

  • Random blood-sugar test
  • Oral glucose-tolerance test
  • Fasting blood-sugar test

Risks for gestational diabetes are usually evaluated early in pregnancy, and blood-sugar levels are checked through an initial glucose challenge test.

Treatment of Diabetes

Treatment of diabetes varies depending on the type. Individuals with any type of diabetes benefit from eating a healthful diet, maintaining a healthy weight, and participating in regular physical activity. Prediabetes may be controlled with healthy lifestyle modifications that bring blood-sugar levels back to normal, thereby lowering the risk of developing type 2 diabetes.

Type 1 Diabetes

Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump to administer needed insulin to the body. People with type 1 diabetes need insulin therapy to survive. In addition, frequent daily blood-sugar checks and carbohydrate monitoring are necessary.

Type 2 Diabetes

In addition to maintaining a healthy weight and eating a healthful diet, treatment of type 2 diabetes involves blood-sugar monitoring, as well as medication and/or insulin. Medication may also be prescribed to help control blood pressure and/or cholesterol levels.

Gestational diabetes can often be addressed by maintaining a healthful diet and exercising. A treatment plan may also include monitoring blood-sugar levels and, in extreme cases, using insulin or oral medication.

Complications of Diabetes

If not treated, diabetes can lead to nerve damage, heart disease, stroke, and kidney failure, as well as permanent eye, foot, skin and bone damage. A lifelong commitment is necessary to prevent these complications from occurring. It is important for people with diabetes to take an active role in the management of their condition. Adhering to a healthy lifestyle and monitoring blood-glucose levels are essential in preventing complications.

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