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By Nina NazorWhat is diabetes?
mellitus is a group of diseases sharing the common characteristic of high blood sugar levels
. Diabetes happens when the pancreas cannot produce enough insulin
or when the insulin that is produced in the pancreas cannot work adequately. When diabetes is not well controlled, it can
cause serious complications
and premature death.
The continued rise in the number of people with diabetes in the United States is alarming. More
than 21 million Americans have diabetes; most of them type 2. This represents about 7 percent of the population and more
than 6 million of these do not know they have the condition, according to the Centers for Disease Control and Prevention (CDC).
The CDC also reports that another 41 million people are estimated to have pre-diabetes, a condition that is developed
before type 2 diabetes.
Diabetes is a leading cause of adult blindness, lower-limb amputation, kidney disease and
nerve damage. Also, two-thirds of people with diabetes die from heart disease.
However, the good news is that
you can control
diabetes, and we are here to help you. Learn more about what diabetes mellitus is.
What is Insulin?
Insulin is a hormone secreted by your pancreas and its function is to
regulate blood glucose levels. Insulin works like a key to open the door of the cells so glucose - the fuel you get from food
- can come inside and be converted into energy.
Think of a corridor full of doors. You need a key to unlock each
door so you can put glucose in each room. Well, insulin is that key and if it is not produced in the right amounts or if it
cannot open the doors because it is cracked, then glucose builds up in the blood causing your blood sugar to go up.
This is called hyperglycemia (high levels of blood glucose) and is the common manifestation of diabetes. Find out more about insulin, how it works, the types of insulin and more.
What are the Symptoms of Diabetes?
The most common symptoms of diabetes are the following:
- Excessive thirst
- Excessive hunger
- Feeling tired or ill
- Sudden weight loss
- Slow healing of infections
Why do these symptoms appear when blood glucose is high?
When you have hyperglycemia, insulin cannot open the doors of the cells and glucose cannot enter the cells
to be converted into energy. Your body then detects that the levels of blood glucose are too high and, since high glucose
can be very toxic, your body tries to get rid of the extra glucose through your kidneys, which are the filters for your blood.
Then the kidneys pour as much glucose as possible into your urine, causing you to urinate more frequently and
thus lose a lot of fluids. This makes you excessively thirsty.
Now, when your blood glucose levels are high due
to your glucose not entering the cells to be used for energy, the lack of fuel makes you feel hungry and tired.
So, since your body can't get energy from the food you eat, you might also start losing weight.
vision, the slow healing of infections and other symptoms like dry skin and genital itching, are all consequences of the high
levels of glucose in the blood. Read more about hyperglycemia or high blood sugar levels.
How is Diabetes Diagnosed?
There are 3 ways to know if you have diabetes:
- If you
have symptoms of diabetes and a plasma glucose level equal or greater than 200 mg/dl (11.1 mmol/l) in a sample taken at any
time of day.
- If the measurement of your blood glucose levels after an overnight fast (12 hours), which is called Fasting
Blood Glucose Test shows a value equal or greater than 126 mg/dl (7.0 mmol/l). Normal fasting glucose levels range between
- If the measurement of the ability of your body to handle excess sugar properly after drinking a drink
with glucose shows a 2-hour plasma glucose value equal or greater than 200 mg/dl (11.1 mmol/l).
In this test,
know as the Oral Glucose Tolerance Test a blood sample is taken and you will be given a beverage containing 75 grams of glucose
or 100 grams for pregnant women. Then, your blood glucose levels will be tested again at 30 minutes, 1 hour, 2 hours and,
for pregnant women, 3 hours after drinking the beverage with glucose.
Gestational Diabetes Diagnosis
A woman has gestational diabetes when she has any two of the following values after the Glucose Tolerance Test:
- A fasting glucose level higher than 105 mg/dl,
- A 1-hour glucose level higher than 190
- A 2-hour glucose level higher than 165 mg/dl, or
- A 3-hour glucose level higher than 145 mg/dl.
What are the Types of Diabetes?
Type 1 Diabetes
Type 1 diabetes was previously called insulin dependent diabetes mellitus or juvenile diabetes because it usually strikes children, adolescents
and young adults.
Type 1 diabetes develops quickly, usually over a few weeks, and symptoms are normally very obvious
Type 1 diabetes happens when the immune system of the person, usually a child, destroys the beta
cells in the pancreas, which are responsible for making insulin.
Type 1 diabetes is believed to account for 5%
to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental
factors. Read more about type 1 diabetes, its causes and treatment.
Type 2 Diabetes
Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus or adult-onset diabetes because it used to affect adults. However,
nowadays it is increasingly being diagnosed in children and adolescents due to the obesity epidemic we experience today.
Type 2 diabetes develops slowly and the symptoms are usually less severe than in people with type 1 diabetes. Some
people may not notice any symptoms at all and are only diagnosed after a routine medical check up.
Type 2 diabetes
affects about 90% to 95% of all diagnosed people with diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly and cause hyperinsulinemia, that is, a higher production of insulin
to keep blood glucose levels controlled. But even though there is much insulin in the blood, it cannot work correctly on the
surface of the cells to allow glucose to enter and be used or stored. This causes high blood glucose levels.
2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, physical inactivity,
and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians
or Other Pacific Islanders are at high risk. Learn more about type 2 diabetes, pre-diabetes, insulin resistance and how to reduce the risk for developing type 2 diabetes.
Gestational diabetes develops when a woman is diagnosed with diabetes during pregnancy. Gestational diabetes affects about 4% of all pregnant
women in the United States each year and strikes more frequently African Americans, Hispanic/Latino Americans, and American
Indians. It is also more common among obese women and women with a family history of diabetes.
usually develops between week 24 and 28 of gestation. If you have gestational diabetes, your baby does not have diabetes,
however, you must keep your blood glucose levels under control to avoid health problems for you or your baby.
studies have reported that after pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes.
In addition, women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years.
Learn more about gestational diabetes, the importance of strict control during pregnancy, monitoring, diet, exercise and the
use of insulin when needed to have a successful pregnancy.
Can Diabetes be Prevented?
The answer is type 2 diabetes yes. Several studies
report that if you are at high risk for developing type 2 diabetes, just a modest weight loss and regular physical activity,
such as brisk walking for al least 30 min/day will delay or prevent type 2 diabetes.
In case you have fasting glucose
intolerance, which is also called pre-diabetes, it is even more important that you engage in a weight loss program and start exercising every day. You also should monitor your glucose levels every year.
High blood pressure control, reducing cholesterol levels and quitting smoking
are also key factors in reducing the risk for developing diabetes.
Researchers are working hard to find out what
else we could do to prevent the development of type 2 diabetes. Meanwhile, focus on following a healthy and active lifestyle
and you will improve the quality of your life, while reducing your risk for developing diabetes. Find out more about how to reduce your risk for developing type 2 diabetes.
Is There a Cure for Diabetes?
Public health authorities in the USA are working on
three basic issues: prevention, looking for the cure and improvement of the the quality of care for people with diabetes to
delay or prevent complications.
There is not a cure available yet, but recently the transplantation of islet cells,
the ones that produce insulin, has been successful, although with some of the side effects of medications to avoid rejection
of the transplanted tissues in the recipients body.
Pancreas transplantation is not recommended unless there is
a need for a kidney transplant too, since the effects can be a lot worse than having to inject insulin, taking pills and/or
keeping a healthy lifestyle.
Artificial pancreases are in development but not ready yet.
under study is genetic manipulation, where cells that are not insulin producers have insulin gene inserted to order them produce
These approaches are just promises now, but progress keeps being made every day. The best thing
you can do so far is to keep the best control possible, and when the cure is here, you will always have a better chance if
you are a healthy person with diabetes.
American Diabetes Association. Standards of Medical Care in Diabetes-2006. Position Statement. Diabetes Care 29:S4-S42,
National Center for Chronic Disease Prevention and Health Promotion CDC's, Basics About Diabetes.