Facts About Diabetes

Almost everyone knows someone who has diabetes. An estimated 1.7 million Canadians and 17 million Americans--6.2 percent of the population-- have diabetes mellitus--a serious, lifelong condition. About 5.9 million people have not yet been diagnosed. Each year, about 1 million people age 20 or older are diagnosed with diabetes. According to the World Health Organization, the scale of the problem that diabetes poses to world health is still widely under-recognized. It is estimated that if the current trends continue the number of people with diabetes worldwide will more than double, from 140 million to 300 million in the next 25 years.

In this article you will learn the basics about the disease known as diabetes including the different types of diabetes, tests for diagnosing diabetes, complications and health risks of diabetes, and some basics for managing diabetes.

What Is Diabetes?

Diabetes is a disorder of metabolism -- the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

What Are The Types of Diabetes?

The three main types of diabetes are

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease. In diabetes, the immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. Someone with type 1 diabetes needs to take insulin daily to live. Type 1 diabetes develops most often in children and young adults, but the disorder can appear at any age. Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier.

Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.

At present, scientists do not know exactly what causes the body's immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States.

Type 2 Diabetes

The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes usually develops in adults age 40 and older and is most common in adults over age 55. About 80 percent of people with type 2 diabetes are overweight. Type 2 diabetes is often part of a metabolic syndrome that includes obesity, elevated blood pressure, and high levels of blood lipids. Unfortunately, as more children and adolescents become overweight, type 2 diabetes is becoming more common in young people.

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. They are not as sudden in onset as in type 1 diabetes. Some people have no symptoms. Symptoms may include fatigue or nausea, frequent urination, unusual thirst, weight loss, blurred vision, frequent infections, and slow healing of wounds or sores.

Gestational Diabetes

Gestational diabetes develops only during pregnancy. Like type 2 diabetes, it occurs more often in African Americans, American Indians, Hispanic Americans, and people with a family history of diabetes. Though it usually disappears after delivery, the mother is at increased risk of getting type 2 diabetes later in life.

What Tests Are Recommended for Diagnosing Diabetes?

The fasting plasma glucose test is the preferred test for diagnosing type 1 or type 2 diabetes. However, a diagnosis of diabetes is made for any one of three positive tests, with a second positive test on a different day.

Complications and Health Risks of Diabetes

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, strokes, kidney failure, erectile dysfunction, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

People with Pre-diabetes, a state between "normal" and "diabetes," are also at risk for developing diabetes, heart attacks, and strokes.

Managing Diabetes

The goal of diabetes management is to keep blood glucose levels as close to the normal range as safely possible.

Healthy eating, physical activity, and insulin via injection or an insulin pump 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.

For type 2 diabetes, healthy eating, physical activity, and blood glucose testing are the basic management tools. In addition, many people with type 2 diabetes require oral medication and insulin to control their blood glucose levels.

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 from certain diabetes medicines -- a condition known as hypoglycemia -- a person can become nervous, shaky, and confused. Judgment can be impaired. If blood glucose falls too low, a person can faint.

A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia.

People with diabetes should learn all they can about managing their disease and see a doctor who helps them learn to manage their diabetes and monitors their diabetes control. An endocrinologist is one type of doctor who may specialize in diabetes care. In addition, people with diabetes often see ophthalmologists for eye examinations, podiatrists for routine foot care, and dietitians and diabetes educators to help teach the skills of day-to-day diabetes management.

The United Kingdom Prospective Diabetes Study, a European study completed in 1998, showed that intensive control of blood glucose and blood pressure reduced the risk of blindness, kidney disease, stroke, and heart attack in people with type 2 diabetes.

Sources: National Diabetes Information Clearinghouse; Canadian Health Network; World Health Organization

This is for general informational purposes only and it is not intended to provide anyone with specific advice or recommendation. This is not a substitute for advice from an appropriate professional. If you feel you need further help, we strongly suggest you seek assistance from an appropriate professional.

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