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About Diabetes
 Diabetes is widely recognized as one of the leading causes of death and disability
in
the United States. In 2002, it
was the sixth leading cause of death. About 65 percent of deaths among those with
diabetes are attributed to heart disease and stroke.
Diabetes is associated with long-term complications that affect almost every part
of the body. The disease often leads to blindness, heart and blood vessel disease,
stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can
complicate pregnancy, and birth defects are more common in babies born to women
with diabetes.
An estimated 20.8 million people in the United States (7.0 percent of the population)
have diabetes, a serious, lifelong condition. Of those, only 14.6 million have been
diagnosed, and 6.2 million have yet to be diagnosed.
What is diabetes?
Diabetes is a disorder of metabolism which affects the way our bodies use digested
food for growth and energy. Most of the food we eat is broken down into glucose,
which is the form of sugar in the blood giving us our main source of fuel.
Glucose passes into the bloodstream after digestion, where it is used by cells for
growth and energy. Insulin must be present in order for the glucose to get into
cells.
When people without diabetes eat, the pancreas produces the right amount of insulin
automatically. In people with diabetes the pancreas will either produce little or
no insulin, or the cells will no respond to the insulin that is being produced.
This allows for the bodies main source of fuel to be loss.
There are three main types of diabetes:
- type 1 diabetes
- type 2 diabetes
- gestational diabetes
Type 1 Diabetes
Type 1 diabetes, formerly called juvenile diabetes, is an autoimmune disease. This
results when the body’s system for fighting infection (the immune system) turns
against a part of the body. In diabetes, the immune system attacks and destroys
the insulin-producing beta cells in the pancreas. The pancreas then produces little
or no insulin. A person who has type 1 diabetes must take insulin daily to live.
Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the
United States. It develops most often in children and young adults but can appear
at any age. Symptoms of type 1 diabetes usually develop over a short period.
Symptoms may include increased thirst and urination, constant hunger, weight loss,
blurred vision, and extreme fatigue. If not diagnosed and treated with insulin,
a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also
known as diabetic ketoacidosis.
Type 2 Diabetes
Type 2 diabetes, formerly called adult-onset diabetes, is the most common form of
diabetes. About 90 to 95 percent of people with diabetes have type 2. This form
of diabetes is most often associated with older age, obesity, family history of
diabetes, previous history of gestational diabetes, physical inactivity, and certain
ethnicities. About 80 percent of people with type 2 diabetes are overweight.
When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin,
but for unknown reasons the body cannot use the insulin effectively, a condition
called insulin resistance. After several years, insulin production decreases. The
result is the same as for type 1 diabetes—glucose builds up in the blood and the
body cannot make efficient use of its main source of fuel.
The symptoms of type 2 diabetes develop gradually. Symptoms may include fatigue,
frequent urination, increased thirst and hunger, weight loss, blurred vision, and
slow healing of wounds or sores. However some people will see no symptoms.
Gestational Diabetes
Some women develop gestational diabetes late in pregnancy. Although this form of
diabetes usually disappears after the birth of the baby, women who have had gestational
diabetes have a 20 to 50 percent chance of developing type 2 diabetes within 5 to
10 years. Maintaining a reasonable body weight and being physically active may help
prevent development of type 2 diabetes.
As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups
and among women with a family history of diabetes. Gestational diabetes is caused
by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes
may not experience any symptoms.
What is pre-diabetes?
People with pre-diabetes have blood glucose levels that are higher than normal but
not high enough for a diagnosis of diabetes. This condition raises the risk of developing
type 2 diabetes, heart disease, and stroke.
Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance
(IGT), depending on the test used to diagnose it. Some people have both IFG and
IGT.
How are diabetes and pre-diabetes diagnosed?
The following tests are used for diagnosis:
- A fasting plasma glucose test measures your blood glucose after you have gone at
least 8 hours without eating. This test is used to detect diabetes or pre-diabetes.
- An oral glucose tolerance test measures your blood glucose after you have gone at
least 8 hours without eating and 2 hours after you drink a glucose-containing beverage.
This test can be used to diagnose diabetes or pre-diabetes.
- In a random plasma glucose test, your doctor checks your blood glucose without regard
to when you ate your last meal. This test, along with an assessment of symptoms,
is used to diagnose diabetes but not pre-diabetes.
Positive test results should be confirmed by repeating the fasting plasma glucose
test or the oral glucose tolerance test on a different day.
How is diabetes managed?
Healthy eating, physical activity, and taking insulin are the basic therapies for
type 1 diabetes. The amount of insulin must be balanced with food intake and daily
activities. Blood glucose levels must be closely monitored through frequent blood
glucose checking.
Healthy eating, physical activity, and blood glucose testing are the basic management
tools for type 2 diabetes. In addition, many people with type 2 diabetes require
oral medication, insulin, or both to control their blood glucose levels.
Adults with diabetes are at high risk for cardiovascular disease (CVD). In fact,
at least 65 percent of those with diabetes die from heart disease or stroke. Managing
diabetes is more than keeping blood glucose levels under control—it is also important
to manage blood pressure and cholesterol levels through healthy eating, physical
activity, and use of medications (if needed). By doing so, those with diabetes can
lower their risk.
People with diabetes must take responsibility for their day-to-day care. Much of
the daily care involves keeping blood glucose levels from going too low or too high.
When blood glucose levels drop too low—a condition known as hypoglycemia—a person
can become nervous, shaky, and confused. Judgment can be impaired, and if blood
glucose falls too low, fainting can occur.
A person can also become ill if blood glucose levels rise too high, a condition
known as hyperglycemia.
Hope Through Research
In recent years, advances in diabetes research have led to better ways of managing
diabetes and treating its complications. Major advances include
- development of quick-acting, long-acting, and inhaled insulins
- better ways to monitor blood glucose and for people with diabetes to check their
own blood glucose levels
- development of external insulin pumps that deliver insulin, replacing daily injections
• laser treatment for diabetic eye disease, reducing the risk of blindness • successful
kidney and pancreas transplantation in people whose kidneys fail because of diabetes
- better ways of managing diabetes in pregnant women, improving their chances of a
successful outcome
- new drugs to treat type 1 and type 2 diabetes and better ways to manage this form
of diabetes through weight control
- evidence that intensive management of blood glucose reduces and may prevent development
of diabetes complications
- demonstration that two types of antihypertensive drugs, ACE (angiotensin-converting
enzyme) inhibitors and ARBs (angiotensin receptor blockers), are more effective
than other antihypertensive drugs in reducing a decline in kidney function in people
with diabetes
- advances in transplantation of islets (clusters of cells that produce insulin and
other hormones) for type 1 diabetes
- evidence that people at high risk for type 2 diabetes can lower their chances of
developing the disease through diet, weight loss, and physical activity Source:
The National Diabetes Information Clearinghouse (NDIC), a service of the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). September 2006.
Source:
The National Diabetes Information Clearinghouse (NDIC), a service of the National Institute of Diabetes
and Digestive and Kidney Diseases (NIDDK). September 2006.
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