Diabetes

About Diabetes

Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ near the stomach, makes a hormone called insulin to help glucose get into our bodies' cells. When you have diabetes, your body doesn't make enough insulin, can't use its own insulin as well as it should, or both. This causes sugars to build up too high in your blood.

Diabetes mellitus is defined as a fasting blood glucose of 126 milligrams per deciliter (mg/dL) or more. "Pre-diabetes" is a condition in which blood glucose levels are higher than normal but not yet diabetic. People with pre-diabetes are at increased risk for developing type 2 diabetes, heart disease and stroke, and have one of these conditions:

* impaired fasting glucose (100 to 125 mg/dL)
* impaired glucose tolerance (fasting glucose less than 126 mg/dL and a glucose level between 140 and 199 mg/dL two hours after taking an oral glucose tolerance test)

Type 2 diabetes is the most common form. It appears most often in middle-aged adults; however, adolescents and young adults are developing type 2 diabetes at an alarming rate. It develops when the body doesn't make enough insulin and doesn't efficiently use the insulin it makes (insulin resistance).

Type 1 diabetes usually occurs in children and young adults. In type 1, the pancreas makes little or no insulin. Without daily injections of insulin, people with type 1 diabetes won't survive.

Both forms of diabetes may be inherited in genes. A family history of diabetes can significantly increase the risk of developing diabetes. Untreated diabetes can lead to many serious medical problems. These include blindness, kidney disease, nerve disease, limb amputations and cardiovascular disease (CVD).

Diabetes is treatable, but even when glucose levels are under control, it greatly increases the risk of heart disease and stroke. In fact, most people with diabetes die of some form of heart or blood vessel disease.

Pre-diabetes and subsequent type 2 diabetes usually result from insulin resistance. When insulin resistance or diabetes occur with other CVD risk factors (such as obesity, high blood pressure, abnormal cholesterol and high triglycerides), the risk of heart disease and stroke rises even more.

When diabetes is detected, a doctor may prescribe changes in eating habits, weight control and exercise programs, and even drugs to keep it in check. It's critical for people with diabetes to have regular check-ups. Work closely with your healthcare provider to manage your diabetes and control any other risk factors. For example, blood pressure for people with diabetes should be lower than 130/80 mm Hg.


AHA / ADA Recommendation

Diabetes is a major risk factor for stroke and coronary heart disease, which includes heart attack. People with diabetes may avoid or delay heart and blood vessel disease by controlling the other risk factors. It's especially important to control weight and blood cholesterol with a low-saturated-fat, low-cholesterol diet and regular exercise. It's also important to lower high blood pressure and not to smoke.


Type 1 Diabetes

Type 1 diabetes is a chronic, lifelong disease. It can occur at any age but is usually diagnosed in children and young adults. Previously known as juvenile diabetes, it’s also called insulin-dependent diabetes, because people with this disorder must take insulin to stay alive.

Insulin is a hormone produced in the pancreas, an organ near the stomach. Insulin is needed to move glucose (blood sugar), which comes from food, from the blood into the cells, where the insulin is used as fuel for the body.

For unknown reasons, in type 1 diabetes the body’s immune system has attacked certain cells in the pancreas, called the beta cells. Once they are destroyed, the pancreas produces little or no insulin, so the glucose stays in the blood. When there’s too much glucose in the blood, especially for prolonged periods of time, all the organ systems in the body suffer long-term damage.

People with type 1 diabetes must take daily injections of insulin and frequently test their blood sugar. Type 1 diabetics must be persistent about their eating habits, regulating their sugar levels by balancing diet and exercise. This is important to avoid reactions such as hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar), both of which can be life-threatening.

What are the warning signs of type 1 diabetes?

* Increased or extreme thirst
* Increased or frequent urination
* Unusual weight loss, despite increased appetite
* Increased fatigue
* Blurry vision
* Fruity odor or breath

Often type 1 diabetes remains undiagnosed until symptoms become very severe and hospitalization is required. Then the immediate goal is to treat high blood glucose levels. In the long term, the goals are to reduce symptoms and prevent complications that result from diabetes. These goals may seem overwhelming at first, but they can be achieved through a strong support team, education, lifestyle changes and persistently self-testing glucose levels.

Type 1 diabetes is serious. Some complications include heart disease, blindness, nerve damage and kidney damage.


Type 2 Diabetes

Type 2 diabetes, the most common form, usually appears in adults, often in middle age. Type 2 diabetes is often linked with obesity and may be delayed or controlled with diet and exercise. (Obesity and physical inactivity are two risk factors for type 2 diabetes.) In a mild form, it can go undetected for many years. Untreated diabetes can lead to many serious medical problems, including cardiovascular disease.

Profile of the Type 2 Diabetes Patient

Type 2 diabetes is a progressive disease that develops when the body does not produce enough insulin and does not efficiently use the insulin it does produce (a phenomenon known as insulin resistance). Diabetes contributes to nearly 200,000 U.S. deaths per year. However, many people with type 2 diabetes are not aware they have the disease and may already have developed various complications associated with it.

Type 2 diabetes occurs frequently in people who:

* Are over age 45;
* Are overweight;
* Are African American, Latino/Hispanic American, Native American, Asian American or Pacific Islander; and
* Have a family history of the disease.

Individuals with type 2 diabetes most often may be characterized as:

* Being insulin resistant (about nine out of 10 patients have insulin resistance);
* Being obese (about 50 percent of men and 70 percent of women who have diabetes are obese);
* Having a lifestyle that does not involve significant physical activity;
* Having low HDL ("good") cholesterol levels and high triglyceride levels; and
* Having an increased prevalence of high blood pressure.

Patients with diabetes are faced with the daily challenge to control blood glucose levels in order to prevent or delay the onset of many serious life-threatening health complications. Cardiovascular disease is one of the major risk factors for people with diabetes

Healthy Lifestyle

Taking Charge of Your Lifestyle
For people with diabetes, lifestyle changes are not always easy, but they can be very effective for controlling diabetes. Controlling glucose can slow the progression of long-term complications. Often many small changes add up to surprising improvements in diabetes control, including less need for medication.

Up in smoke
For people with diabetes, smoking can increase their blood pressure and nerve damage, and also add to their already high risk of cardiovascular disease. Why take the risk? Learn more.

Breaking the cycle
Losing weight is often hard for people with diabetes. High insulin levels make it hard to lose weight, and increased weight means higher insulin levels. It's a vicious cycle. Learn more about weight management.

Choosing carbs
With diets such as Atkins being so popular, it can be difficult for people with diabetes to know what's right for them. After all, it isn't always about sugar intake, but carbohydrate intake as well. Learn more about what carbs mean for you.