Diabetes develops when the body does not make enough insulin, or is unable to effectively use the insulin it does make. This results in the body not being able to break down sugar effectively.
- Insulin is a hormone made by the pancreas. It controls the level of the sugar, also known as glucose, in the blood. It also controls the ability of the body's cells to use glucose for energy.
- Sometimes the body does not make enough insulin, or is unable to effectively use the insulin that is produced (known as insulin resistance). When that happens the level of glucose in the blood increases.
- Diabetes develops when there is either a lack of insulin or the available insulin is less effective than it should be. Either way, the insulin is not able to meet the body's needs.
The three main types of diabetes are:
- Type 1 diabetes (previously juvenile onset diabetes) occurs when the body makes very little or no insulin. Daily insulin injections are needed for the body to use glucose for energy and control blood sugars. Type 1 diabetes is usually diagnosed in children, teens or young adults, but it can be seen in older adults. Symptoms often have a more rapid (acute) onset than is the case with type 2 diabetes (below). The cornerstone of treatment is insulin daily injections.
- Type 2 diabetes (previously adult onset diabetes) occurs when the body does not make enough insulin and/or is unable to effectively use the insulin it does make. Type 2 diabetes is usually diagnosed in middle aged or older people. However, with the increase in obesity and sedentary lifestyles, type 2 diabetes is becoming more common in younger people. Symptoms often develop slowly and are rarely severe at the start. The cornerstone of treatment is appropriate physical activity and diet. Medications by mouth (or sometimes by injection) may help the body release more insulin or help it use insulin more effectively.
- Gestational diabetes (diabetes occurring during pregnancy) occurs when a woman without a history of diabetes develops high blood sugars during pregnancy. This can lead to complications with the pregnancy, some of which could be serious. Gestational diabetes requires careful management to help ensure the best possible outcome for mother and child. Some women who have gestational diabetes can go on to develop Type 2 diabetes. Therefore, they need to be followed periodically, even when they are not pregnant.
In addition, prediabetes is when a person's blood sugar is between the normal range and the diabetic range. It is sometimes referred to as glucose intolerance. Prediabetes significantly increases a person's risk of developing diabetes.
The risk factors for diabetes vary depending on the type of diabetes. The cause of type 1 diabetes is not known for sure, but it is thought to be due to the body destroying its own insulin producing cells. Genetic factors are thought to play a role. Risk factors for developing type 2 diabetes include:
- Genetic factors and family history
- Obesity or being overweight
- Lack of physical activity or exercise (sedentary lifestyle)
- Age (those over 45 years have increased risk)
- Ethnicity (African Americans, Mexican Americans and Native Americans have a higher risk for the disease)
- History of gestational diabetes or prediabetes
There are steps you can take to decrease your risk of developing type 2 diabetes. These include making lifestyle changes that include:
- Exercising regularly
- Eating a healthy diet
- Maintaining a healthy weight
Do not forget to see your healthcare provider at appropriate intervals for recommended diabetes screening and assistance in developing an exercise program and a healthy diet.
The symptoms of high blood sugar due to diabetes can vary greatly. They depend on the actual blood sugar levels and how long the person has had diabetes. Some of the more common symptoms, usually associated with Type 1 diabetes, include:
- Urinating frequently
- Feeling thirsty all the time
- Being hungry, even when you have eaten
- Having persistent fatigue
- Unexplained weight loss
- Feelings of tingling, numbness and pain in hands and feet
- Cuts or sores that do not heal properly
- Problems with vision (eyesight)
Contact your healthcare provider if you have any of the above symptoms. They will perform a history and physical examination. They may also recommend some blood tests, including:
- Fasting blood sugar, which is done in the morning before you eat
- HbA1c, which reflects your average blood sugar control over the previous few months
- Glucose tolerance test, which measures your blood sugars at specific intervals after you have swallowed a sweet liquid
Diabetes cannot be diagnosed by a urine test. In addition, blood tests often need to be repeated before a definite diagnosis is made.
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Make an appointment with your healthcare provider if you have symptoms of diabetes or think you may be at risk for diabetes.
- Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
- Bring a list of your medications (including over-the-counter).
- Write down any questions, symptoms or concerns you want to talk about.
- Be certain that you know the signs and symptoms of low blood sugar, and have a plan on how to treat those symptoms immediately if they occur.
- If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).
Here are some questions to ask your healthcare provider:
- What are my risk factors for diabetes? What dietary or lifestyle changes should I make?
- Should I be enrolled in a Diabetes Education Program?
- Should I be testing my blood sugar? What should my blood sugar be? What should my HbA1c be?
- Could my symptoms be related to another disease?
- Are you recommending any tests? Will the test results change my treatment plan? If not, why do I need the test?
- What are my treatment options? What are the goals of my treatment? Are there any alternatives? What are the risks?
- What medication and lifestyle modifications would you recommend?
- Will my diabetes medications interfere with other medications I'm taking?
- When might I start to see improvement in my symptoms?
- What are my follow-up plans? What symptoms should I report before my next appointment?
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