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Definition

Diabetes is usually a lifelong (chronic) disease in which there is a high level of sugar in the blood.

Causes, incidence, and risk factors

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 used as fuel.

People with diabetes have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy. 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 two 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. Daily injections of insulin are needed. The exact cause is unknown.
  • Type 2 diabetes makes up most diabetes cases. It most often occurs in adulthood. But because of high obesity rates, teens and young adults are now being diagnosed with it. Many people with type 2 diabetes do not know they have it.
  • There are other causes of diabetes, and some patients 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.

Diabetes affects more than 20 million Americans. Over 40 million Americans have pre-diabetes (which often develops before type 2 diabetes). If your parent, brother or sister has diabetes, you may be more likely to develop diabetes.

If you eat too much sugar over a long time, you may develop type 2 diabetes.The correct answer is false. Diabetes is caused by a problem in the way your body makes or uses the hormone insulin. Insulin helps move blood sugar (glucose) into cells, where it is stored to be used for energy. Eating too much sugar won’t cause diabetes. But it may make you overweight, which can put you at risk for diabetes.Being overweight makes it harder for your body to properly use insulin.The correct answer is true. Extra fat in the body makes it harder for the body to use insulin properly. This is called insulin resistance. Losing excess weight and being active can help prevent or reverse insulin resistance.Which of the following health conditions does NOT put you at risk for type 2 diabetes?The correct answer is asthma. All of the other conditions increase your risk for diabetes. If you have any of these conditions, work with your doctor to control your risk factors for diabetes and heart disease.You can have diabetes for years and not know it.The correct answer is true. That’s why it’s important to talk with your doctor about whether you should have diabetes screening tests. People with high blood pressure, who are over age 45, and those who are overweight and have other risk factors should consider being tested for diabetes.What are early symptoms of type 2 diabetes?The correct answer is all of the above. If you notice any of these symptoms, talk with your doctor.If you have a blood sugar level higher than ____ , your doctor may test you for diabetes.The correct answer is 200 mg/dL. If your blood sugar is at this level, your doctor may give you these tests to confirm that you have diabetes: Fasting blood glucose level — diabetes: higher than 126 mg/dL 2 times, Hemoglobin A1c test — diabetes: 6.5% or higher, Oral glucose tolerance test — diabetes: higher than 200 mg/dL after 2 hoursWhat health care problems are caused by diabetes?The correct answer is all of the above. Over time, too much sugar in the blood can harm your eyes, kidneys, nerves, skin, heart, and blood vessels. Talk with your doctor about the best ways to keep your blood sugar, blood pressure, and cholesterol level in a healthy range.What are treatments for type 2 diabetes?The correct answer is all of the above. The main treatment for type 2 diabetes is diet and exercise. If you still have trouble managing your blood sugar level, you may need medicine or insulin. Work with your health care provider to learn how much fat, protein, and carbohydrates you need in your diet.If you have type 2 diabetes, you will have to inject insulin.The correct answer is maybe. Many people can control type 2 diabetes with diet and exerc
ise and diabetes medicines if needed. However, if your blood sugar remains uncontrolled, you may need to inject insulin.
Having diabetes increases your risk for heart disease.The correct answer is true. Diabetes directly affects your heart, plus it makes it hard to control cholesterol. This can lead to heart disease and other problems. A healthy diet, regular exercise, and eating less salt can help control diabetes, blood pressure, and cholesterol. This will reduce your risk of heart disease.Some people with diabetes no longer need medicine if they lose weight and exercise.The correct answer is true. Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body’s own insulin and a healthy diet can control their blood sugar levels.

Symptoms

High blood sugar level can cause several symptoms, including:

  • Blurry vision
  • Excess thirst
  • Fatigue
  • Hunger
  • Urinating often

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, blindness in the future
  • Painful sores and infections of the leg or foot, which if left untreated, leads to removal of the foot or leg 
  • Nerves in the body can become damaged, causing pain, tingling, and a loss of feeling, problems digesting food, 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

Signs 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 it is higher than 126 mg/dL twice. 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 test —
    • Normal: Less than 5.7%
    • Pre-diabetes: 5.7% – 6.4%
    • Diabetes: 6.5% or higher
  • Oral glucose tolerance test — diabetes is diagnosed if glucose level is higher than 200 mg/dL 2 hours after drinking a glucose 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 2 years
  • Overweight adults (BMI greater than 25) who have other risk factors
  • Adults over age 45, repeated every 3 years

Treatment

With type 2 diabetes, the disease may be reversed with lifestyle changes, especially losing weight through exercising and eating healthier foods.  Also, some cases of type 2 diabetes can be improved with weight-loss surgery.

There is no cure for type 1 diabetes.

Treating both type 1 diabetes and type 2 diabetes involves medicines, diet, and exercise to control blood sugar level.

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 health care provider at least two to four times a year. Talk about any problems you are having. Follow your health care provider’s instructions on managing your diabetes.

Support Groups

American Diabetes Association | www.diabetes.org

Prevention

Keeping an ideal body weight and an active lifestyle may prevent type 2 diabetes.

Type 1 diabetes cannot be prevented.

Related:Diabetes – foot ulcers, Diabetes – when you are sick, Diabetes – taking care of your feet, Type 1 diabetes, Type 2 Diabetes, Gestational diabetes, Diabetic hyperglycemic hyperosmolar syndrome, Diabetes and eye disease, Diabetes and kidney disease, Diabetes and nerve damage, Peripheral artery disease – legs, High blood cholesterol levels, High blood pressure, Hardening of the arteries, Stable angina

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