Learn About Diabetes

• National Diabetes Statistics
• Diabetes 101
• Frequently Asked Questions About Diabetes

Diabetes 101

Diabetes is a disorder of our metabolism; the way our bodies use digested food for growth and energy.  Most of the food we eat is broken down by the digestive juices into a simple sugar called glucose.  Glucose is the main source of fuel for the body.  After digestion, the glucose passes into our bloodstream where it is available for body cells to use for growth and energy.  For the glucose to get into the 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 the glucose from our blood into our cells.  In people with Diabetes, however, the pancreas either produces little or no insulin, or the body cells do not respond to the insulin that is produced.  As a result, 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.

1. Types of Diabetes:

Type 1
Diabetes was previously called Insulin-Dependent Diabetes Mellitus (IDDM) or Juvenile-Onset Diabetes.  Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes (ADA Data 2006).  It is usually recognized in childhood or early adolescence.  Risk factors are less well defined for Type 1 Diabetes than for Type 2 Diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of Diabetes.

Type 2
Diabetes was previously called Non Insulin-Dependent Diabetes Mellitus (NIDDM) or Adult-Onset Diabetes.  Type 2 Diabetes may account for about 90% to 95% of all diagnosed cases of Diabetes.  Risk factors for Type 2 Diabetes include older age, obesity, family history of diabetes, prior history of Gestational Diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for Type 2 Diabetes.

Gestational Diabetes
Gestational Diabetes develops in 2% to 5% of all pregnancies but disappears when a pregnancy is over. Gestational Diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and persons with a family history of diabetes. Obesity is also associated with higher risk.  Women who have had gestational diabetes are at increased risk for later developing Type 2 Diabetes.  In some studies, nearly 40% of women with a history of gestational diabetes developed Diabetes in the future.

2. Symptoms:

A patient with Type 1 Diabetes usually has more sudden and severe symptoms while the patient with Type 2 Diabetes usually has more subtle symptoms.  

Common symptoms are:
Weight loss that cannot be explained
Excessive hunger
Excessive thirst
Excessive urination
Fatigue
Increased susceptibility to infections (urinary infections, genital yeast infection or skin infections)
Blurry vision
Difficulty in wound healing
Decreased/loss of sensation in hands and feet
Mental status alteration (agitation, confusion, lethargy, irritability) 

3. Diagnosis:

Medical History
Physical Exam
Laboratory Tests:
The fasting plasma glucose (FPG) is the preferred test for the diagnosis of diabetes because it is easy and convenient.  It is done in the morning after a fasting period of at least 8 hours and measures the amount of glucose in the blood.  The test should be repeated to confirm the diagnosis.  A result of 126 mg/dL and above on two separate days confirms the diagnosis of diabetes.
The oral glucose tolerance test (OGTT) is very sensitive but it is not as convenient as the FPG.  In this test the blood glucose level is measured after at least 8 hours without food ingestion and again 2 hours after the ingestion of a very sweet liquid containing glucose.  The test also needs to be repeated on a different day.  Blood glucose levels of 200 mg/dL and above 2 hours after ingestion of the glucose-containing liquid on two separate days confirms the diagnosis of diabetes.

4. Treatment:

Once diagnosed with Diabetes, “treatment starts with you”.  For some, diabetes can be controlled by just adjusting what you eat, losing weight, and acquiring a new activity level.  For others, the use of oral medication or insulin may be required.  You and your Doctor have to work together for better treatment results.  

• Changes in Lifestyle:  It is very important that you take control of your diabetes; therefore: TEST.  Check your blood sugar levels at least every morning.  You will want to know your blood sugar level and write it down on a chart.  You will also want to know how your blood pressure is doing (this will provide information if your diabetes is affecting your heart).  You should, also, weigh yourself.  Very important is to make changes in your lifestyle, starting with diet and exercise, “Watch what you eat … and get moving”.  

• EXERCISE regularly
  DIET
  STOP SMOKING
  MODERATE OR ELIMINATE ALCOHOL USE
  SELF-MONITOR YOUR BLOOD GLUCOSE LEVELS

• Medical Treatment:  The medical treatment of Diabetes is a fast paced and ever changing one.  People with Type 1 Diabetes are unable to produce insulin, requiring injections of insulin.  There are several methods by which an individual can take insulin (from insulin shots to insulin pumps) and there are different types of insulin (rapid-acting, short-acting, intermediate-acting, long-acting, pre-mixed).  Your doctor will work with you to decide the best insulin treatment for your Diabetes.
  The medical treatment of patients with Type 2 Diabetes involves the use of oral medications (pills). Other medications are delivered by injections.  Sometimes a single medication is effective.  In other cases, a combination of medications works better.  Some patients with Type 2 Diabetes may also need the use of insulin.

  The medical field is also placing attention on the research that is being made on Diabetes.  There have been good results on several treatment options, such as pancreas transplant, islet cell transplantation, various types of insulin (and their delivery systems and regimens) and stem cell research.  The research on Diabetes is making the understanding and the management of Diabetes more accessible to those who live with it.

5. Complications:

By itself, Diabetes is already a demanding illness, but if left uncontrolled or poorly managed, serious medical complication can arise.  Unfortunately, these complications may also appear in patients who monitor their Diabetes well.  Some of these complications may include

• Eye conditions, such as retinopathy and glaucoma.
• Numbness in the extremities (fingers and toes) caused by nerve damage, which can lead to more severe complications, such as foot sores, infections and possible amputations.
• Heart and Blood Vessel Disease (Cardiovascular Disease) which can result in stroke, heart attacks, atherosclerosis and high blood pressure.
• Kidney Failure or severe kidney damage
• Dental and Periodontal Disease
• Ketoacidosis (Diabetic Ketoacidosis), mostly in patients with Type 1 Diabetes.

Therefore, the key factor is PREVENTION of these complications by visiting your Doctor regularly, keeping your blood sugar levels under control, and by being aware of any of the signs/symptoms that can give a clue to some of the complications, such as fatigue, vision problems, numbness or tingling sensation, chest pain, bad headaches, infections that do not cease, and weight loss.