DiabetesDiabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With Type 1 diabetes, your body does not make insulin. With Type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes. Symptoms of Type 2 diabetes may include fatigue, thirst, weight loss, blurred vision and frequent urination. Some people have no symptoms. A blood test can show if you have diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your glucose level and take medicine if prescribed. What is pre-diabetes? In pre-diabetes, blood glucose levels are higher than normal but not high enough to be characterized as diabetes. However, many people with pre-diabetes develop type 2 diabetes within 10 years. Pre-diabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with pre-diabetes can delay or prevent type 2 diabetes.
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. Fasting Plasma Glucose (FPG) Test The FPG is the preferred test for diagnosing diabetes due to convenience and is most reliable when done in the morning. Results and their meaning are shown in table 1. If your fasting glucose level is 100 to 125 mg/dL, you have a form of pre-diabetes called impaired fasting glucose (IFG), meaning that you are more likely to develop type 2 diabetes but do not have it yet. A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes. Table 1. Fasting Plasma Glucose Test Plasma Glucose Result (mg/dL) Diagnosis 99 and below Normal 100 to 125 Pre-diabetes (impaired fasting glucose) 126 and above Diabetes* Confirmed by repeating the test on a different day. Oral Glucose Tolerance Test (OGTT) Research has shown that the OGTT is more sensitive than the FPG test for diagnosing pre-diabetes, but it is less convenient to administer. The OGTT requires you to fast for at least 8 hours before the test. Your plasma glucose is measured immediately before and 2 hours after you drink a liquid containing 75 grams of glucose dissolved in water. Results and what they mean are shown in table 2. If your blood glucose level is between 140 and 199 mg/dL 2 hours after drinking the liquid, you have a form of pre-diabetes called impaired glucose tolerance or IGT, meaning that you are more likely to develop type 2 diabetes but do not have it yet. A 2-hour glucose level of 200 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes. Table 2. Oral Glucose Tolerance Test 2-Hour Plasma Glucose Result (mg/dL) Diagnosis 139 and below Normal 140 to 199 Pre-diabetes (impaired glucose tolerance) 200 and above Diabetes* Confirmed by repeating the test on a different day. Gestational diabetes is also diagnosed based on plasma glucose values measured during the OGTT. Blood glucose levels are checked four times during the test. If your blood glucose levels are above normal at least twice during the test, you have gestational diabetes. Table 3 shows the above-normal results for the OGTT for gestational diabetes. Table 3. Gestational Diabetes: Above-Normal Results for the Oral Glucose Tolerance Test When Plasma Glucose Result (mg/dL) Fasting 95 or higher At 1 hour 180 or higher At 2 hours 155 or higher At 3 hours 140 or higher Note: Some laboratories use other numbers for this test. For additional information about the diagnosis and treatment of gestational diabetes, see the NIDDK booklet What I Need to Know About Gestational Diabetes. Random Plasma Glucose Test A random blood glucose level of 200 mg/dL or more, plus presence of the following symptoms, can mean that you have diabetes: increased urination increased thirst unexplained weight loss Other symptoms include fatigue, blurred vision, increased hunger, and sores that do not heal. Your doctor will check your blood glucose level on another day using the FPG or the OGTT to confirm the diagnosis.
What factors increase my risk for type 2 diabetes? To find out your risk, check each item that applies to you. I am 45 or older.
I am overweight or obese (see the body mass index [BMI] in table 4).
I have a parent, brother, or sister with diabetes.
My family background is African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino.
I have had gestational diabetes, or I gave birth to at least one baby weighing more than 9 pounds.
My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure.
My cholesterol levels are not normal. My HDL cholesterol ("good" cholesterol) is 35 or lower, or my triglyceride level is 250 or higher.
I am fairly inactive. I exercise fewer than three times a week. Checking My Weight BMI is a measure used to evaluate body weight relative to height. You can use BMI to find out whether you are underweight, normal weight, overweight, or obese. Use the body mass index table to find your BMI. Find your height in the left-hand column. Move across in the same row to the number closest to your weight. The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese. If you are overweight or obese, talk with your doctor about ways to lose weight to reduce your risk of diabetes or pre-diabetes.
What steps can delay or prevent type 2 diabetes? A major research study, the Diabetes Prevention Program, confirmed that people who followed a low-fat, low-calorie diet, lost a modest amount of weight, and engaged in regular physical activity (walking briskly for 30 minutes, five times a week, for example) sharply reduced their chances of developing diabetes. These strategies worked well for both men and women and were especially effective for participants aged 60 and older. For additional information about how you can lower your risk for type 2 diabetes, see the NIDDK booklet Am I at Risk for Type 2 Diabetes? Also, the National Diabetes Education Program (NDEP) offers several booklets as part of its "Small Steps, Big Rewards (PDF, 1.44 MB)" campaign on preventing type 2 diabetes, including information on setting goals, tracking progress, implementing a walking program, and finding additional resources.
How is diabetes managed? If you are diagnosed with diabetes, you can manage it with meal planning, physical activity, and, if needed, medications. For additional information about taking care of type 1 or type 2 diabetes, see the NIDDK booklet Your Guide to Diabetes: Type 1 and Type 2.
Points to Remember Diabetes and pre-diabetes are diagnosed by checking blood glucose levels.
Many people with pre-diabetes develop type 2 diabetes within 10 years.
If you have pre-diabetes, you can delay or prevent type 2 diabetes with a low-fat, low-calorie diet, modest weight loss, and regular physical activity.
If you are 45 or older, you should consider getting tested for diabetes. If you are 45 or older and overweight, it is strongly recommended that you get tested.
If you are younger than 45, are overweight, and have one or more of the risk factors, you should consider testing.
For More Information you should check out the following sources: National Diabetes Education Program 1 Diabetes Way Bethesda, MD 208923600 Phone: 18004385383 Fax: 7037384929 Internet: www.ndep.nih.gov American Diabetes Association National Service Center 1701 North Beauregard Street Alexandria, VA 22311 Phone: 1800DIABETES (3422383) Fax: 7035496995 Email: askada@diabetes.org Internet: www.diabetes.org American Association of Diabetes Educators 100 West Monroe, Suite 400 Chicago, IL 60603 Phone: 18003383633 or 3124242426 Diabetes Educator Access Line: 1800TEAMUP4 (8326874) Fax: 3124242427 Email: aade@aadenet.org Internet: www.diabeteseducator.org Juvenile Diabetes Research Foundation International 120 Wall Street New York, NY 100054001 Phone: 18005332873 or 2127859500 Fax: 2127859595 Email: info@jdrf.org Internet: www.jdrf.org
-------------------------------------------------------------------------------- National Diabetes Information Clearinghouse 1 Information Way Bethesda, MD 208923560 Phone: 18008608747 TTY: 18665691162 Fax: 7037384929 Email: ndic@info.niddk.nih.gov Internet: www.diabetes.niddk.nih.gov The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1978, the Clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. The NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes. Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.
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Diabetes is a growing problem in this country. With our population at an all time high in weight gain and a low in health care, the problem is only growing. Diabetes is a disease of the metabolism. Our metabolism is what the way our bodies use digested food for energy and growth. Most food that is processed through our bodies is broken down by digestive juices into a sugar called glucose. Glucose is the fuel our bodies run on. When we eat, and our food is processed, the pancreas is supposed to produce the right amount of glucose from our blood automatically and release the right amount of insulin into our blood. In people with diabetes, little to no insulin is produced or the bodys cells dont respond correctly to the insulin that is produced. Therefore the glucose builds up and overflows into the urine and passes out of the body. This is how the body loses its main source of fuel even though the bloodstream contains good amounts of the natural glucose. There are three types of diabetes, type 1, type 2 and gestational diabetes. People who have type 1 are known as insulin-dependent. This is an autoimmune disease where the bodys natural system is fighting against another part of the body. In the case of type 1 diabetes, the system attacks the insulin producing cells and destroys them. Therefore the pancreas can produce little to no insulin. These people are in need of daily injections of insulin to live. Five to ten percent of diabetes cases are type 1 in the US. Diabetes Symptoms All too often we get sick but ignore the symptoms we may be feeling, shrugging them off to a cold, stress from work, or just not feeling well. There are certain symptoms that shouldn't be ignored if they develop. These symptoms could lead to blindness, amputation of limbs, coma or even death. Symptoms of type 1 diabetes often come on suddenly and are severely dramatic. The extra stress of diabetes can lead to something called diabetic ketoacidosis. Symptoms of ketoacidosis may include nausea and vomiting, which may also lead to dehydration and serious problems with the blood levels of potassium. This could lead to a diabetic coma and ultimately death. Other symptoms of diabetes may include extreme fatigue. We all get tired at times, but diabetes triggers a more severe fatigue than normal. People with diabetes also experience unexplained weight loss. This is because they are unable to process many of the calories they consume. Losing sugar and water in the urine also contributes to the weight loss. Extreme thirst is another symptom of diabetes. Diabetes develops high blood sugar levels and the body tries to compensate by diluting the blood, which translates to our brain that we are thirsty. With this is also excessive urination. It is another way our bodies have of getting rid of the extra sugar in our system. But this can also lead to dehydration. One of the hardest symptoms to deal with is poor wound healing. Wounds heal slowly, if at all when the carrier has diabetes. This along with infections that are not easily remedied can attribute to ulcers and loss of limbs. Type 1 Diabetes Type 1 diabetes accounts for five to ten percent of diabetes cases in the United States. A person who is diagnosed with type 1 diabetes must receive insulin shots daily in order to live. Scientists are not exactly sure why the body attacks the immune system and the production of insulin, but it is believed that both genetics and viruses are involved. Type 1 diabetes is most commonly found in children and young adults, but can appear at any age and symptoms can develop over a short period of time. Symptoms include increased thirst and urination, extreme fatigue, weight loss and constant hunger. If a person with type 1 diabetes is not diagnosed and treated with insulin, there is a risk of that person slipping into a diabetic coma that may prove life threatening. The key when first diagnosed with type 1 diabetes is to arm yourself with information. Being diagnosed is not the end of the world. In fact, most people go on to live normal, healthy lives as long as they stay aware of their condition and continue to treat it. After being diagnosed with diabetes, it is important to maintain your general health paying special attention to the care you give your eyes, feet and skin as well as your heart and oral health. This basic care could prevent complications brought on by diabetes later in life. Other recommendations are to stop smoking and reduce the amount of alcohol you consume. Type 2 Diabetes Type 2 diabetes is the most common form found in the US. Ninety to ninety-five percent of people diagnosed with diabetes have this type. Usually developed later in life, it is most commonly diagnosed in people over the age of fifty-five, but in many cases as young as forty or even younger. This is because eighty percent of people diagnosed with type 2 diabetes are overweight. With obesity at an all time high, the diagnoses for type 2 diabetes is also at an all time high. In type 2 diabetes, the pancreas is still producing insulin, but for some unknown reason, the body is not able to utilize it effectively. As a result, just as in type 1 diabetes, type 2 people develop a dangerous buildup of glucose in the blood and the body is not able to utilize it for fuel. People who have type 2 diabetes may see their symptoms develop over time. They are not usually as noticeable as the type 1 symptoms. Symptoms include fatigue, frequent urination, especially throughout the night hours, unusual thirst, weight loss, frequent infections and slow healing sores. In fact, sores may never heal and if not treated it is common for people to have limbs amputated. This usually occurs in the legs, feet and toes. Also as with type 1, if the symptoms go untreated and insulin is not administered when necessary, the patient runs the risk of slipping into a diabetic coma, which can be fatal. It is important if you have any symptoms of type 1 or 2 diabetes you speak with a health professional and get tested. Gestational Diabetes Gestational diabetes is a disorder in which women that previously did not carry diabetes test positive for high blood glucose levels during their pregnancy. Though not uncommon, it is thought that anywhere between three and ten percent of pregnant women are diagnosed with gestational diabetes sometime during their pregnancy. But just what does this diagnosis mean to the health and welfare of the mother and her unborn child? Since no specific cause has been identified for gestational diabetes, scientists dont know how to prevent it. The closest they have come to understanding is that it is believed that hormones produced during pregnancy reduce a womans sensitivity to insulin and the result is high blood sugar levels. Every pregnant woman is tested for gestational diabetes during her prenatal care visits because generally there are very few symptoms. If the mother has gestational diabetes, babies are at a higher risk for complications. These are typically growth abnormalities and low blood sugar. The good thing is that gestational diabetes is completely reversible and women who otherwise have good control over their glucose levels can decrease the risk of these birth problems. In fact, women who can keep their gestational diabetes under complete control are known to give birth to perfectly healthy babies. The down side is women who develop gestational diabetes during their pregnancy now run a higher risk of developing type 2 diabetes post-pregnancy. Some children are prone to develop childhood obesity and develop type 2 diabetes later in life. Pregnant women who develop gestational diabetes are generally treated with diet modification and exercise, but in some extreme cases they are administered an anti-diabetic drug, such as insulin. The goal of treatment is to reduce the risks for both m other and child without endangering either. Diabetes Mellitus Diabetes Mellitus is also simply known as diabetes. It is the disease characterized by a malfunctioning metabolism and a high blood sugar level. The result can be low levels of insulin or abnormal insulin resistance. This mixed with inadequate levels of insulin secretion results in diabetes. Symptoms of diabetes mellitus include increased urine production, excessive thirst, extreme fatigue, and excessive thirst and weight loss. These symptoms though may not be present in those people with only mildly elevated sugar levels. Diabetes mellitus includes type 1, type 2 and gestational diabetes, which occur only during pregnancy. Each type has a different cause and different severity of symptoms. But all forms of diabetes are dangerous if not treated. With proper management though, people with diabetes can live a long, healthy, normal life. The main cause of type 1 diabetes mellitus is the loss of insulin producing cells in the pancreas. This ultimately leads to an insulin deficiency. Type 1 diabetes mellitus is typically found in children and young adults. It is also termed juvenile diabetes. The common treatment for type 1 diabetes mellitus is daily insulin injections to replace the insulin the body is not producing properly, along with careful blood glucose monitoring. Without careful monitoring and treatment, complications from diabetes could include loss of limps such as arms, legs and feet, blindness and diabetic comas, which can be fatal. It is extremely important that if you suspect you or your child to have symptoms of diabetes, that you visit your doctor to be tested. If the tests are positive it is not the end of the world. With careful monitoring and care, type 1 diabetics can live long healthy lives. Diabetes Management As of 2007, there is no cure for either type 1 or type 2 diabetes. This may seem like a dim outlook for many people, but the fact is that even though there is no cure, there certainly are ways to manage your diabetes. Proper management can give you many years of healthy living. Diabetes management starts with a visit to your doctor. first, finding out you have diabetes, what type you have then arming yourself with as much information as possible about the diabetes you are diagnosed with. All management begins with controlling the glucose cycle. The glucose cycle is affected by two factors, entry of glucose into the bloodstream and blood levels of insulin to control the transport out. Your glucose levels are very sensitive to both diet and exercise, so change in either should first be discussed with your physician. Proper management of diabetes can be very intrusive to the patient. Proper management requires a complete lifestyle change and frequent, sometimes multi-daily checks of glucose in the blood. It can change as people grow and develop and no two cases are ever really the same. Today it is easier to measure the blood sugar level. Glucose meters are readily available and are quite easy to use with a little practice and patience. With a small drop of blood to the testing strip attached to the glucose meter, the user is given the number, which represents their blood sugar level. This in turn will let the user know if and when insulin is needed. Diabetes In Children Diabetes in children is also known as juvenile diabetes, but more commonly known as type 1 diabetes. It is the most common form of diabetes in children with ninety to ninety-five percent of carriers being under 16. Juvenile diabetes is caused by the inability of the pancreas to produce insulin. It is an autoimmune disease, which means the bodies own defense system attacks the bodys tissues or organs. In the last 30 years the number of juvenile diabetes had increased three times over and in Europe and the US we are now seeing type 2 diabetes in children for the first time. Obesity easily explains type 2, but not why there is such a rise in type 1 diabetes in children. It is believed that a mixture of genetics and environmental factors are what triggers juvenile diabetes. But the majority of children dont have a family history of diabetes. The symptoms for juvenile diabetes are the same as in adults. Thirst, weight loss, fatigue, frequent urination is typical, but diabetes in children can also increase stomach pains, headaches and behavior problems. Doctors should consider the possibility of diabetes in children who have unexplained stomach pains for a few weeks, along with the typical symptoms. If you believe your child may be experiencing these symptoms you should schedule them for a thorough examination and tell your doctor what you suspect your child may have. Be sure to tell them about any and all symptoms your child may be experiencing. Diabetes in Pets It is not only the human kind that can develop diabetes. Even our beloved pets, no matter how well we care for them, can develop diabetes. This is often a scary situation for the pet owner and the first question that is usually asked of the veterinarian is -will my pet need to be put to sleep-? Of course this is a difficult issue and the answer may vary on the overall age and health of your pet. Many older pets that are diagnosed with diabetes go on to live many more happy years, but this takes commitment and close care of your pet. Diabetic cats and dogs can live just as long as perfectly healthy pet if the diabetes is diagnosed and treated properly by both the veterinarian and the owner. This takes great commitment from the owner. Pets must be cared for and watched daily with a high level of care and patience. There can be no feeding the cat and forgetting until the next day. There is no leaving the pet along to go on a trip. Every day your pet will need medication, fed a proper diet and his behavior will need to be monitored closely. This doesnt mean you will have to give up your job and stay home full time with your pet, but it does mean you will have to pay more attention to what his behavior is and know what to do if the situation should change. It is also more of a financial obligation to have a sick pet. So it is something that should be discussed in length with your vet. Diabetes Epidemic With obesity levels being at an all time high, the epidemic of type 2 diabetes is growing at an alarming rate, and will only get worse. Between 2001 and 2002, the diagnosis of diabetes went from 5.5 percent of Americans to an alarming 6.5 percent. In just one year! Overall, twelve million Americans have been diagnosed and another 5 million Americans have diabetes and dont know it. And yet another 12 millions are on their way to type 2 diabetes because of impaired glucose levels. Not knowing is the worst because risks of untreated diabetes puts us at a terrible risk of complications including but not limited to blindness, amputations and ultimately death. The stickler is, that type 2 diabetes is almost completely preventable. Doctors say eat less, eat better and exercise. The numbers show just how many Americans are currently overweight. Statistically, people are now living longer, and it has been on the rise for years. But this will not continue if type 2 diabetes is not put under control. We are a gluttonous society and ultimately it is affecting how we live and how long we live. And unfortunately, the diabetes epidemic is not just a US problem. It is spreading worldwide with epidemic reports in Asia, the Middle East and the Caribbean. It is estimated that by 2025, the number of diabetics worldwide will rise to 380 million. And diabetes is now affecting more of the young and middle-aged population in developing countries between the ages of 40 and 59. |