Diabetes is a number of diseases that involve problems with the hormone insulin. Normally, the pancreas (an organ behind the stomach) releases insulin to help your body store and use the sugar and fat from the food you eat. Diabetes occurs when one of the following occurs:
Diabetes is a lifelong disease. Approximately 18.2 million Americans have the disease and almost one third (or approximately 5.2 million) are unaware that they have it. An additional 41 million people have pre-diabetes. As yet, there is no cure. People with diabetes need to manage their disease to stay healthy.
To understand why insulin is important in diabetes, it helps to know more about how the body uses food for energy. Your body is made up of millions of cells. To make energy, these cells need food in a very simple form. When you eat or drink, much of your food is broken down into a simple sugar called “glucose.” Then, glucose is transported through the bloodstream to the cells of your body where it can be used to provide some of the energy your body needs for daily activities.
The amount of glucose in your bloodstream is tightly regulated by the hormone insulin. Insulin is always being released in small amounts by the pancreas. When the amount of glucose in your blood rises to a certain level, the pancreas will release more insulin to push more glucose into the cells. This causes the glucose levels in your blood (blood glucose levels) to drop.
To keep your blood glucose levels from getting too low (hypoglycemia or low blood sugar), your body signals you to eat and releases some glucose from storage kept in the liver.
People with diabetes either don’t make insulin or their body’s cells are resistant to insulin, leading to high levels of sugar circulating in the blood, called simply high blood sugar. By definition, diabetes is having a blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an overnight fast (not eating anything).
Prediabetes
In the U.S., 84.1 million adults have blood sugar levels that are higher than normal but not high enough to be classified as diabetes. This is called prediabetes, or impaired glucose tolerance. People with prediabetes usually have no symptoms, but it’s almost always there before a person develops type 2 diabetes. However, complications normally associated with diabetes, such as heart disease, can begin even when a person has only prediabetes.
Talk to your doctor to see if you need to be tested for prediabetes. You may be able to prevent type 2 diabetes and lower your risk of complications like heart disease.
Type 1 diabetes
Type 1 diabetes occurs because the insulin-producing cells of the pancreas (called beta cells) are destroyed by the immune system. People with type 1 diabetes produce no insulin and must use insulin injections to control their blood sugar.
Type 1 diabetes most commonly starts in people under the age of 20, but may occur at any age.
Type 2 diabetes
Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin. However, the insulin their pancreas secretes is either not enough or the body is resistant to the insulin. When there isn’t enough insulin or the insulin is not used as it should be, glucose can’t get into the body’s cells.
Type 2 diabetes is the most common form of diabetes, affecting almost 18 million Americans. While most of these cases can be prevented, it remains for adults the leading cause of diabetes-related complications such as blindness, non-traumatic amputations, and chronic kidney failure requiring dialysis. Type 2 diabetes usually occurs in people over age 40 who are overweight, but can occur in people who are not overweight. Sometimes referred to as “adult-onset diabetes,” type 2 diabetes has started to appear more often in children because of the rise in obesity in young people.
Some people can manage their type 2 diabetes by controlling their weight, watching their diet, and exercising regularly. Others may also need to take a pill that helps their body use insulin better, or take insulin injections.
Often, doctors are able to detect the likelihood of type 2 diabetes before the condition actually occurs. Commonly referred to as pre-diabetes, this condition occurs when a person’s blood sugar levels are higher than normal, but not high enough for a diagnosis of type 2 diabetes.
Gestational diabetes
Gestational diabetes is triggered by pregnancy. Hormone changes during pregnancy can affect insulin’s ability to work properly. The condition occurs in up to 9% of all pregnancies.
Pregnant women who have an increased risk of developing gestational diabetes are those who are over 25 years old, are above their normal body weight before pregnancy, have a family history of diabetes or are Hispanic, black, Native American, or Asian.
Screening for gestational diabetes is performed during pregnancy. Left untreated, gestational diabetes increases the risk of complications to both the mother and their unborn child.
Usually, blood sugar levels return to normal within six weeks of childbirth. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.
The symptoms of type 1 diabetes often occur suddenly and can be severe. They include:
The symptoms of type 2 diabetes may be the same as those listed above. Most often, there are no symptoms or a very gradual development of the above symptoms. Other symptoms may include:
With gestational diabetes, there are often no symptoms. Or you might notice:
Pregnancy makes most women have to urinate more often and feel hungrier, so these symptoms don’t always mean you have gestational diabetes. But it is important to get tested, because high blood sugar can cause problems for both you and your baby.
There’s no cure for diabetes, but it can be managed and controlled. The goals of managing diabetes are to:
You hold the key to managing your diabetes by:
Remember: What you do at home every day affects your blood sugar more than what your doctor can do every few months during your checkups.
SOURCES:
National Diabetes Educational Program: “I Have Diabetes, ” “About Diabetes and Pre-diabetes.”
National Diabetes Information Clearinghouse: “Introduction to Diabetes,” “Diabetes Overview.”
JAMA Patient Page: “Diabetes.”
American Diabetes Association: “Recently Diagnosed.”
Annals of Internal Medicine: “Improvements in Diabetes Processes of Care and Intermediate Outcomes: United States, 1988-2002.”
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