Diabetes

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Introduction

What is diabetes?

Diabetes is a general term for a group of metabolic disorders that affect the body’s ability to process and use sugar (glucose) for energy. Normally when you eat, the pancreas, an organ located in the upper abdomen, produces the hormone insulin to move glucose from the bloodstream into cells where it can be used for energy and growth. With diabetes, either the pancreas produces too little or no insulin, or the body’s cells don’t respond to the insulin.

Diabetes deprives the body’s cells of nutrition and leads to an abnormally high level of glucose in the blood (hyperglycemia). Over time, this can result in damage to the blood vessels and organs and premature death. Diabetes can be medically managed to lower the risk of these serious complications.

Diabetes is a common disease. According to the Centers for Disease Control and Prevention, 23.6 million people in the United States are living with diabetes. That is nearly 8 percent of the U.S. population (Source: CDC).

The three most common forms of diabetes are type 1 diabetes, type 2 diabetes, and gestational diabetes.

  • In type 1 diabetes (juvenile diabetes or insulin-dependent diabetes mellitus), the pancreatic cells that produce insulin are destroyed. Type 1 diabetes is not preventable.

  • In type 2 diabetes (adult-onset diabetes or non-insulin-dependent diabetes), the pancreas produces insulin, but there is not enough insulin or the body’s cells become resistant to its effects. Type 2 diabetes is the most common form of diabetes and is preventable in many cases.

  • In gestational diabetes, a form of diabetes that occurs during pregnancy, the pancreas produces insulin, but pregnancy hormones make the body’s cells more resistant to its effects.

Weight-loss plan for diabetes

Symptoms of diabetes that can indicate a dangerous, potentially life-threatening change in your blood sugar level can occur suddenly and rapidly. Symptoms include increased thirst, frequent urination, vomiting, shortness of breath, abdominal pain, confusion, sweating, feeling shaky or faint, extreme irritability, or aggressive behavior.

If you have diabetes and experience symptoms of high or low blood sugar, test your blood sugar and follow your treatment plan based on the test results.

Get immediate help (call 911) if you don’t start feeling better quickly, if your symptoms worsen, or if someone you are with has these symptoms.

Symptoms

What are the symptoms of diabetes?

Symptoms can vary among individuals and the type of diabetes. Common symptoms include excessive thirst and excessive urination.

Type 1 diabetes generally develops quickly, often in children, and symptoms can be severe and occur suddenly. In contrast, type 2 diabetes generally develops gradually from a condition called prediabetes, and symptoms may not occur or be noticeable for years.

Pregnant women who develop gestational diabetes often do not have symptoms, but they may experience excessive thirst and excessive urination.

Symptoms of type 1 diabetes

Symptoms of type 1 diabetes include:

Symptoms of type 2 diabetes

Symptoms of type 2 diabetes include:

Any of the type 1 diabetes symptoms above

  • Any of the type 1 diabetes symptoms above

  • Blurred or changing vision

  • Erectile dysfunction

  • Frequent infections, especially yeast or fungal infections

  • Slow-healing wounds or bruises

  • Tingling or other unusual sensations in the hands or feet

  • Weakness

Serious symptoms that might indicate a life-threatening condition

Symptoms of diabetes that can indicate a dangerous change in your blood sugar level or a life-threatening complication, such as diabetic ketoacidosis, can occur suddenly and rapidly.

Symptoms of high blood sugar (hyperglycemia) and diabetic ketoacidosis include:

Symptoms of low blood sugar (hypoglycemia) include:

Very high or low blood sugar levels that remain untreated can lead to:

  • Loss of consciousness and coma

  • Seizures

  • Death

Get immediate help (call 911) if you are with someone who has diabetes and who is exhibiting any life-threatening symptoms or has passed out.

Causes

What causes diabetes?

The cause of diabetes varies depending on the type of diabetes.

The exact cause of type 1 diabetes is not known, but it is believed that genetic and environmental factors (possibly viruses) may be involved. Type 1 diabetes is an autoimmune disease in which the body's immune system attacks and destroys the insulin-producing cells in the pancreas. The hormone insulin is responsible for moving glucose into cells of the body to provide energy. When glucose cannot enter the cells, it builds up in the blood (hyperglycemia).

Type 2 diabetes is caused by insulin resistance, in which the pancreas does not produce enough insulin or the body’s cells do not respond normally to insulin and become resistant to its effects. People who are overweight or sedentary are at risk for developing insulin resistance.

Gestational diabetes occurs only during pregnancy and is due to pregnancy hormones that can make the body’s cells more resistant to the effects of insulin.

What are the risk factors for diabetes?

A number of factors are thought to increase your chances of developing diabetes. Risk factors vary depending on the type of diabetes.

Type 1 diabetes risk factors

Risk factors related to type 1 diabetes include:

  • A family history of type 1 diabetes

  • Being born with jaundice

  • Exposure to certain viruses such as the mumps or Epstein-Barr virus

  • Living in a northern climate

  • Respiratory infection as a newborn

  • Specific at-risk genes found with genetic testing

  • Your mother had preeclampsia during pregnancy

Type 2 diabetes risk factors

Risk factors related to type 2 diabetes include:

  • African American, Hispanic American, or Native American ancestry

  • Age older than 45 years

  • Family history of type 2 diabetes

  • High blood pressure (hypertension)

  • High cholesterol

  • History of gestational diabetes

  • Insulin resistance

  • Obesity

  • Prediabetes

  • Sedentary lifestyle

Gestational diabetes risk factors

Risk factors related to gestational diabetes include:

  • Having a baby who weighed more than nine pounds at birth

  • Having a fetus that died before birth (stillbirth)

  • African American, Latina, South or East Asian, Pacific Islander, or Native American ancestry

  • Family history of diabetes

  • Obesity

  • Personal history of gestational diabetes

Treatments

How is diabetes treated?

At this time, there is no cure for diabetes. With regular medical care and consistent compliance with treatment, you can manage diabetes to minimize the risk of serious complications, such as diabetic retinopathy, cardiovascular disease, and stroke.

Treatment of diabetes varies depending on the type of diabetes you have. Management of all forms of diabetes includes regularly monitoring your blood sugar levels; eating a well-balanced, healthy diet; and following a regular exercise program.

Type 2 diabetes is generally treated with oral antidiabetic medications, such as glipizide, glyburide and metformin. Pregnant women with gestational diabetes may be treated with glyburide.

Type 1 diabetes is always treated with injected insulin, and some people with type 2 diabetes or gestational diabetes may need insulin injections as well. A new treatment that may be an option for some people with type 1 diabetes is pancreatic islet transplantation. This experimental surgery transplants insulin-producing beta cells from a donor into the pancreas of a person with type 1 diabetes.

To minimize complications, it is also important not to smoke and to follow your health care provider’s advice on preventing, monitoring, and treating any coexisting medical conditions, such as hypertension and high cholesterol.

Insulin medication used to treat diabetes

When your body doesn’t make enough insulin or can’t use its own insulin, your treatment plan may include injected insulin. Different types of insulin include:

  • Aspart (rapid-acting insulin)

  • Glulisine (rapid-acting insulin)

  • Lantus (long-acting insulin)

  • Lente (intermediate-acting insulin)

  • Levemir (long-acting insulin)

  • Lispro (rapid-acting insulin)

  • NPH (intermediate-acting insulin)

  • Regular insulin (short-acting insulin)

Oral antidiabetic drugs used to treat diabetes

Oral antidiabetic drugs work in different ways to control blood glucose, depending on the specific drug. These include helping the body to better use insulin; raising the amount of insulin in the body; blocking the liver from making sugar; or slowing the digestion of sugar. You may need to try a couple of different medications or combinations of medications to find the best treatment regimen for you, as recommended by your health care provider.

  • Acarbose (Precose)

  • Glimepiride (Amaryl)

  • Glipizide (Glucotrol)

  • Glyburide (Micronase, Glynase, Diabeta)

  • Meglitol (Glyset)

  • Metformin (Glucophage)

  • Rosiglitazone (Avandia) (restricted in 2010 by the FDA because of risks to the heart)

  • Sitagliptin phosphate (Januvia)

Other treatments for diabetes

Beyond medications, other treatments for diabetes include:

What are the potential complications of diabetes?

Complications of untreated or poorly managed diabetes can be serious and even life threatening. You can control diabetes and reduce your risk of complications by following the treatment plan that you and your health care professional design specifically for you.

Poorly managed blood sugar levels damage the body’s blood vessels and organs and can lead to complications that include:

  • Birth defects

  • Cardiovascular disease

  • Diabetic retinopathy, cataracts, and blindness

  • Disability

  • Excessive growth of a fetus

  • Kidney damage and kidney failure

  • Lower limb amputation

  • Newborn respiratory distress syndrome

  • Preeclampsia in a pregnant woman with diabetes

  • Serious infections and gangrene

  • Stroke

Diabetes can also lead to life-threatening emergency conditions that include:

  • Diabetic ketoacidosis

  • Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)

  • Hypoglycemia

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 4
  1. What is Diabetes? NIH Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
  2. Diabetes. Mayo Clinc. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
  3. Diabetes. American Diabetes Association. https://www.diabetes.org/diabetes

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