Diabetes is a chronic disease in
which the body cannot regulate the amount of sugar in the blood.
Causes
Insulin is a hormone produced by the
pancreas to control blood sugar. Diabetes can be caused by too little insulin,
resistance to insulin, or both. To understand diabetes, it is important to
first understand the normal process by which food is broken down and used by
the body for energy. Several things happen when food is digested:
A sugar called glucose enters the
bloodstream. Glucose is a source of fuel for the body.
· An organ called the pancreas makes
insulin. The role of insulin is to move glucose from the bloodstream into
muscle, fat, and liver cells, where it can be stored or used as fuel.
People with diabetes have high blood
sugar because their body cannot move sugar from the blood into muscle and
fat cells to be burned or stored for energy, and because their liver
makes too much glucose and releases it into the blood. This is because
either:
· Their pancreas does not make enough
insulin
· Their cells do not respond to
insulin normally
· Both of the above
There are 2 major types of diabetes.
The causes and risk factors are different for each type:
· Type 1 diabetes can occur at
any age, but it is most often diagnosed in children, teens, or young adults. In
this disease, the body makes little or no insulin. This is because the pancreas
cells that make insulin stop working. Daily injections of insulin are needed.
The exact cause is unknown.
Type 2 diabetes is much more
common. It most often occurs in adulthood, but because of high obesity rates,
children and teens are now being diagnosed with this disease. Some people
with type 2 diabetes do not know they have it. With type 2 diabetes, the body
is resistant to insulin and doesn't use insulin as well as it should.
There are other causes of diabetes,
and some people cannot be classified as type 1 or type 2.
Gestational diabetes is high blood sugar that develops
at any time during pregnancy in a woman who does not have diabetes.
If your parent, brother, or sister has diabetes, you may be
more likely to develop the disease.
Symptoms
A high blood sugar level can cause several symptoms,
including:
· >Blurry vision
· >Excess thirst
· >Fatigue
· >Frequent urination
· >Hunger
· >Weight loss
Because type 2 diabetes develops slowly, some people with
high blood sugar have no symptoms.
Symptoms of type 1 diabetes develop over a short period.
People may be very sick by the time they are diagnosed.
After many years, diabetes can lead to other serious
problems. These problems are known as diabetes complications, and include:
· Eye problems, including trouble
seeing (especially at night), light sensitivity, and blindness. Sores and infections of the leg or
foot, which if untreated, can lead to amputation of the leg or foot. Damage to nerves in the body,
causing pain, tingling, a loss of feeling, problems digesting food, and
erectile dysfunction
·
Kidney problems, which can lead to kidney
failure
·
Weakened immune system, which can
lead to more frequent infections
·
Increased chance of having a heart
attack or stroke
Exams and Tests
A urine analysis may show high blood sugar. But a
urine test alone does not diagnose diabetes.
Your health care provider may suspect that you have diabetes
if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis,
one or more of the following tests must be done.
Blood tests:
· Fasting blood glucose level:
Diabetes is diagnosed if the fasting glucose level is higher than 126
mg/dL on 2 different tests. Levels between 100 and 126 mg/dL are called
impaired fasting glucose or pre-diabetes. These levels are risk factors for
type 2 diabetes.
- · Hemoglobin A1c (A1C) test: Normal is less than 5.7%; prediabetes is 5.7 to 6.4%; and diabetes is 6.5% or higher.
- · Oral glucose tolerance test: Diabetes is diagnosed if the glucose level is higher than 200 mg/dL 2 hours after drinking a sugar drink (This test is used more often for type 2 diabetes).
Screening for type 2 diabetes in people who have no symptoms
is recommended for:
·
Overweight children who have other
risk factors for diabetes, starting at age 10 and repeated every 3 years
·
Overweight adults (BMI of 25 or
higher) who have other risk factors
·
Adults over age 45, repeated every 3
years
Treatment
Type 2 diabetes may be reversed with lifestyle changes,
especially losing weight with exercise and by eating healthier
foods. Some cases of type 2 diabetes can also be improved with weight-loss
surgery.
There is no
cure for type 1 diabetes.
Treating either type 1 diabetes or type
2 diabetes involves medicines, diet, and exercise to control blood sugar
level.
Everyone with diabetes should receive proper education and
support about the best ways to manage their diabetes. Ask your provider about
seeing a diabetes nurse educator.
Getting better control over your blood sugar, cholesterol,
and blood pressure levels helps reduce the risk of kidney disease, eye disease,
nervous system disease, heart attack, and stroke.
To prevent diabetes complications, visit your provider at
least 2 to 4 times a year. Talk about any problems you are having. Follow your
provider's instructions on managing your diabetes.
Support Groups
Many resources can help you understand more about
diabetes. If you have diabetes, you can also learn ways to manage your
condition and prevent diabetes complications.
Diabetes is a life-long disease and there is no cure.
Tight control of blood glucose can prevent or delay diabetes
complications. But these problems can occur, even in people with good diabetes
control.
Possible Complications
After many years, diabetes can lead to serious health
problems:
·
You could have eye problems,
including trouble seeing (especially at night), and light sensitivity. You
could become blind.
·
Your feet and skin can develop sores
and infections. After a long time, your foot or leg may need to be amputated.
Infection can also cause pain and itching in other parts of the body.
·
Diabetes may make it harder to
control your blood pressure and cholesterol. This can lead to a heart attack,
stroke, and other problems. It can become harder for blood to flow to your legs
and feet.
·
Nerves in your body can get damaged,
causing pain, tingling, and numbness.
·
Because of nerve damage, you could
have problems digesting the food you eat. You could feel weakness or have
trouble going to the bathroom. Nerve damage can make it harder for men to have
an erection.
·
High blood sugar and other problems
can lead to kidney damage. Your kidneys may not work as well as they used to.
They may even stop working so that you need dialysis or a kidney transplant.
Prevention
Keeping an ideal body weight and an active lifestyle may
prevent or delay the start of type 2 diabetes. Some medicines can also be used
to delay or prevent the start of type 2 diabetes.
At this time, type 1 diabetes cannot be prevented. But there
is promising research that shows type 1 diabetes may be delayed in some high
risk people.
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