Diabetes is a chronic condition in which the body cannot properly convert food into energy. Diabetes is associated with long-term complications that affect almost every part of the body. Diabetes often leads to problems such as:
- Blindness
- Heart and blood vessel disease
- Stroke
- Kidney failure
- Amputations
- Nerve damage.
Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.
In order to understand diabetes, it is helpful to first understand normal digestion and the role of insulin.
Diabetes: Understanding Digestion and Insulin
Most of the food we eat is broken down into glucose, the form of sugar in the blood.
Glucose is the main source of fuel for the body.
After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into the cells, insulin must be present. Insulin is a hormone produced by the
pancreas, a large gland behind the stomach.
When we eat, the pancreas automatically produces the right amount of insulin to move glucose from the blood into our cells. People with diabetes do not make insulin, do not use insulin properly, or both. This causes glucose to build up in the blood instead of moving into the cells. As a result, people with diabetes often feel:
They may also lose weight, urinate often, or have trouble with their eyes.
The three main types of diabetes are:
Type 1 Diabetes
Type 1 diabetes, formerly called juvenile diabetes, is a type of diabetes that is usually first diagnosed in:
- Children
- Teenagers
- Young adults.
In this type of diabetes, the beta cells of the
pancreas no longer make insulin because the body's immune system has attacked and destroyed them.
Type 2 Diabetes
Type 2 diabetes, formerly called adult-onset diabetes, is the most common type of diabetes. People can develop type 2 diabetes at any age -- even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals.
Gestational Diabetes
Gestational diabetes develops in some women during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by pregnancy hormones or by a shortage of insulin.
Out of every 100 pregnant women in the United States, 3 to 8 will develop this type of diabetes.
Former Names for Diabetes
To move away from basing the names of the two main types of diabetes on treatment or age at onset, in 1997, two organizations recommended a universal adoption of simplified terminology.
The preferred name "type 1 diabetes" was recommended to replace the former names of:
- Type I diabetes
- Juvenile diabetes
- Insulin-dependent diabetes mellitus
- IDDM.
The preferred name "type 2 diabetes" was recommended to replace the former names of:
- Type II diabetes
- Adult-onset diabetes
- Non-insulin-dependent diabetes mellitus
- NIDDM.
- Fatigue
- Nausea
- A need to urinate frequently
- Excessive thirst
- Weight loss
- Blurred vision
- Frequent infections
- Sores that do not heal.
Medical tests will determine if diabetes is causing your problems. A doctor can make a diabetes diagnosis by reviewing your symptoms and checking your blood glucose levels. One test (called a fasting plasma glucose test) measures your blood glucose level after not eating or drinking (fasting) for at least eight hours, usually overnight. In another test, called the oral glucose tolerance test, your blood glucose is checked and then you drink a sugary beverage. Your blood glucose (sugar) levels are then checked one hour, two hours, and three hours later. The diagnosis is confirmed after a repeat test on a different day.
In the conventional medical approach to
diabetes treatment, people with diabetes learn to keep their blood glucose in as healthy a range as possible. They do this by:
- Following a healthy food plan
- Being physically active
- Controlling their weight
- Testing their blood glucose regularly.
Some people also need to take medicine, such as insulin injections or prescription diabetes pills. When lifestyle changes and medical treatment are combined to rigorously maintain and control blood sugar in the normal range, this approach to
managing diabetes can minimize the serious complications of the disease. This enables patients to lead full, productive lives.
Possible Complications of Diabetes
Diabetes is associated with long-term complications that affect almost every part of the body. Over time, the high blood glucose levels caused by diabetes can lead to problems in the:
These problems can cause complications of diabetes such as:
- Blindness
- Heart and blood vessel disease
- Stroke
- Kidney failure
- Amputations
- Nerve damage.
Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.
Such
diabetes complications can be prevented or delayed by keeping the following characteristics in a normal or close-to-normal range:
Diabetes and Pre-Diabetes
Some people develop a condition called insulin resistance, or
pre-diabetes, before they develop
type 2 diabetes. When insulin resistance is present, the body does not respond properly to the insulin it has released to lower the levels of glucose in the blood. As a result, the
pancreas releases more insulin to try to keep up with the excess glucose. If the pancreas cannot produce enough insulin, over time, this leads to type 2 diabetes. Obesity, aging, and a lack of exercise can all play a role in developing insulin resistance and heightening the risk for diabetes.
Almost everyone knows someone who has diabetes. An estimated 18.2 million people in the United States (6.3 percent of the population) have diabetes -- a serious, lifelong condition. Of those, 13 million have been diagnosed and about 5.2 million people have not yet been diagnosed. Each year, about 1.3 million people age 20 or older are diagnosed with diabetes.
Diabetes is widely recognized as one of the leading causes of death and disability in the United States. In 2000, it was the sixth leading cause of death. However, diabetes is likely to be underreported as the underlying cause of death on death certificates. About 65 percent of deaths among those with diabetes are attributed to
heart disease and
stroke.
Diabetes is not contagious. People cannot "catch" diabetes from each other; however, certain factors can increase the risk of developing diabetes.
Type 1 diabetes occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicates that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown.
Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in:
- African Americans
- American Indians
- Some Asian Americans
- Native Hawaiians and other Pacific Islander Americans
- Hispanic Americans.
In 2002, diabetes cost the United States $132 billion. Indirect costs, including disability payments, time lost from work, and premature death, totaled $40 billion. Direct medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $92 billion.
Some key points to remember about diabetes include:
- Diabetes affects 18.2 million people -- 6.3 percent of the U.S. population. It is a leading cause of death and disability, and it costs $132 billion per year.
- People of any age can get diabetes.
- People at an increased risk of diabetes include: people with a family history of diabetes, older people, overweight and sedentary people, African Americans, Alaska Natives, American Indians, Asian Americans, Native Hawaiians, Hispanic Americans, and some Pacific Islander Americans.
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