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What Is Diabetes?
Diabetes mellitus, the most common disorder of the endocrine (hormone) system, occurs when blood sugar levels in the body consistently stay above normal. It affects more than 17 million people in the U.S. alone. The disease is brought on by either too little insulin in the body (type 1 diabetes) or by the body not responding to the effects of insulin (type 2 diabetes). Insulin is the hormone that regulates blood sugar levels and allows the body to use sugar (called glucose) for energy.
Type 1 diabetes - the most common form of diabetes in people under age 20 - results from a shortage of insulin. Type 2 diabetes results from the body's inability to process the hormone effectively. About 90% of all people with diabetes have type 2 diabetes. In the past, type 1 was known as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, and type 2 used to be called noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset or stable diabetes.
These older terms have been abandoned because type 2 diabetes is now also seen in children. In addition, some people with type 2 diabetes require insulin to keep their blood sugar levels normal.Regardless of what type of diabetes you have, you need to work closely with your doctor to manage your diet, medication, and activity on a day-to-day basis. Your ability to oversee your own care will make a huge difference in whether you can control the condition and avoid its potentially serious effects. The many short- and long-term complications of diabetes can demand as much attention as the disease itself. And just as important as watching out for high blood sugar, you need to watch your blood sugar levels every day to prevent an attack of low hypoglycemia, in which blood sugar levels are too low to fulfill your body's energy needs. Hypoglycemia can easily be remedied, however, once you recognize its symptoms.
In people with type 1 diabetes, a lack of insulin can bring on a serious condition known as ketoacidosis, in which acid builds up in the blood from the accumulation of toxic by-products called ketones. Ketones are produced as the body breaks down fat for energy. Ketoacidosis occurs in people who have type 1 diabetes if they do not receive adequate supplementary insulin and their bodies are starved for energy sources. Ketoacidosis can also occur if the body comes under sudden physical stress, perhaps from an accident or illness. (Any sort of illness increases the body's need for insulin to process blood sugar into the energy required to fight illness or infection.) Ketoacidosis may also occur in those with type 2 diabetes, although this is less common.
If you have type 1 diabetes, be especially alert for the warning signs of ketoacidosis: nausea, excessive thirst, frequent urination, extreme weakness, abdominal pain, rapid deep breathing, loss of appetite, reddened and warm skin, headache, drowsiness, fruity-smelling breath, restlessness, and ketones in your urine. This is an emergency situation and you should get to your doctor or the hospital immediately. Failure to respond with injections of insulin and intravenous salt solutions (to replenish lost body fluids) can result in coma or death.
In both types of diabetes, long-term complications of diabetes can damage the eyes, nervous system, kidneys, heart, and circulatory systems. Cuts and sores heal more slowly for people with diabetes, and they are also prone to gum problems, urinary tract infections, and mouth infections such as thrush, caused by an overgrowth of yeast organisms. All of these complications are more common in people who are unable to get their blood sugar under control.
Diabetes is the primary cause of adult blindness in the U.S. Within 10 years of their condition being diagnosed, about half of all people with type 1 diabetes develop an eye disorder called diabetic retinopathy, which can weaken the capillaries that supply blood to the retina and eventually affect vision. Almost all of those who have had the disease for at least 30 years experience some degree of diabetic retinopathy. But staying on top of your blood sugar can help delay or prevent the development of retinopathy. Other common problems in people with diabetes include blurred vision, cataracts, and glaucoma.
People with diabetes stand a higher-than-normal chance of developing heart disease and circulatory problems such as high blood pressure, hardening of the arteries, heart attacks, and strokes. Poor circulation also increases the risk of developing skin ulcers, cramps, and gangrene (a tissue-destroying infection). Damage to the blood vessels in the kidneys from diabetes may lead to kidney failure.
A number of people with diabetes suffer from a condition known as diabetic neuropathy, which causes damage to one or more nerves. The condition appears to begin early in both types of diabetes and affects nerves that control both muscle function and sensation. As a result, people with diabetes commonly experience a variety of aches and pains. Some develop slowed reflexes, loss of sensation, numbness and tingling in the legs, impotence, and circulatory problems.
Medication Dangers for People With Diabetes
Some over-the-counter remedies that are safe for people who don't have diabetes contain ingredients that can cause problems for those who do. For example, aspirin taken in large amounts can affect blood sugar levels. If you have diabetes, you must be careful when using phenylephrine, epinephrine or ephedrine, all of which can raise blood sugar levels. Type 2 diabetics tempted to use appetite suppressants to control their weight need to know that these drugs usually contain caffeine, which boosts blood sugar. Fish oil and niacin, both commonly taken as a way to improve cholesterol levels, also raise blood sugar. To learn about potential hazards lurking in nonprescription medications, talk to your doctor and your pharmacist, and read labels carefully.
What Causes It?
In type 1 diabetes, the pancreas secretes little or no insulin. Unable to use glucose in the blood, the body tries to produce energy by burning fat and muscle. Type 1 diabetes usually develops before age 20.
Type 2 diabetes usually develops in people over age 40, and more likely in people who are overweight. Although this particular group of patients may have sufficient or even excessive amounts of insulin in their systems, their bodies are unable to use the hormone effectively - called insulin resistance. Excessive food intake boosts blood sugar levels, and the pancreas cannot produce enough insulin to convert the extra sugar into energy. Sometimes a similar form of this disease, called gestational diabetes, occurs as a temporary condition in women who are pregnant.
Risk factors for type 1 diabetes include:
Sources: American Family Physician. National Diabetes Education Program. American Diabetes Association. Clinical Diabetes Journal.
Diabetes mellitus, the most common disorder of the endocrine (hormone) system, occurs when blood sugar levels in the body consistently stay above normal. It affects more than 17 million people in the U.S. alone. The disease is brought on by either too little insulin in the body (type 1 diabetes) or by the body not responding to the effects of insulin (type 2 diabetes). Insulin is the hormone that regulates blood sugar levels and allows the body to use sugar (called glucose) for energy.
Type 1 diabetes - the most common form of diabetes in people under age 20 - results from a shortage of insulin. Type 2 diabetes results from the body's inability to process the hormone effectively. About 90% of all people with diabetes have type 2 diabetes. In the past, type 1 was known as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, and type 2 used to be called noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset or stable diabetes.
These older terms have been abandoned because type 2 diabetes is now also seen in children. In addition, some people with type 2 diabetes require insulin to keep their blood sugar levels normal.Regardless of what type of diabetes you have, you need to work closely with your doctor to manage your diet, medication, and activity on a day-to-day basis. Your ability to oversee your own care will make a huge difference in whether you can control the condition and avoid its potentially serious effects. The many short- and long-term complications of diabetes can demand as much attention as the disease itself. And just as important as watching out for high blood sugar, you need to watch your blood sugar levels every day to prevent an attack of low hypoglycemia, in which blood sugar levels are too low to fulfill your body's energy needs. Hypoglycemia can easily be remedied, however, once you recognize its symptoms.
In people with type 1 diabetes, a lack of insulin can bring on a serious condition known as ketoacidosis, in which acid builds up in the blood from the accumulation of toxic by-products called ketones. Ketones are produced as the body breaks down fat for energy. Ketoacidosis occurs in people who have type 1 diabetes if they do not receive adequate supplementary insulin and their bodies are starved for energy sources. Ketoacidosis can also occur if the body comes under sudden physical stress, perhaps from an accident or illness. (Any sort of illness increases the body's need for insulin to process blood sugar into the energy required to fight illness or infection.) Ketoacidosis may also occur in those with type 2 diabetes, although this is less common.
If you have type 1 diabetes, be especially alert for the warning signs of ketoacidosis: nausea, excessive thirst, frequent urination, extreme weakness, abdominal pain, rapid deep breathing, loss of appetite, reddened and warm skin, headache, drowsiness, fruity-smelling breath, restlessness, and ketones in your urine. This is an emergency situation and you should get to your doctor or the hospital immediately. Failure to respond with injections of insulin and intravenous salt solutions (to replenish lost body fluids) can result in coma or death.
In both types of diabetes, long-term complications of diabetes can damage the eyes, nervous system, kidneys, heart, and circulatory systems. Cuts and sores heal more slowly for people with diabetes, and they are also prone to gum problems, urinary tract infections, and mouth infections such as thrush, caused by an overgrowth of yeast organisms. All of these complications are more common in people who are unable to get their blood sugar under control.
Diabetes is the primary cause of adult blindness in the U.S. Within 10 years of their condition being diagnosed, about half of all people with type 1 diabetes develop an eye disorder called diabetic retinopathy, which can weaken the capillaries that supply blood to the retina and eventually affect vision. Almost all of those who have had the disease for at least 30 years experience some degree of diabetic retinopathy. But staying on top of your blood sugar can help delay or prevent the development of retinopathy. Other common problems in people with diabetes include blurred vision, cataracts, and glaucoma.
People with diabetes stand a higher-than-normal chance of developing heart disease and circulatory problems such as high blood pressure, hardening of the arteries, heart attacks, and strokes. Poor circulation also increases the risk of developing skin ulcers, cramps, and gangrene (a tissue-destroying infection). Damage to the blood vessels in the kidneys from diabetes may lead to kidney failure.
A number of people with diabetes suffer from a condition known as diabetic neuropathy, which causes damage to one or more nerves. The condition appears to begin early in both types of diabetes and affects nerves that control both muscle function and sensation. As a result, people with diabetes commonly experience a variety of aches and pains. Some develop slowed reflexes, loss of sensation, numbness and tingling in the legs, impotence, and circulatory problems.
Medication Dangers for People With Diabetes
Some over-the-counter remedies that are safe for people who don't have diabetes contain ingredients that can cause problems for those who do. For example, aspirin taken in large amounts can affect blood sugar levels. If you have diabetes, you must be careful when using phenylephrine, epinephrine or ephedrine, all of which can raise blood sugar levels. Type 2 diabetics tempted to use appetite suppressants to control their weight need to know that these drugs usually contain caffeine, which boosts blood sugar. Fish oil and niacin, both commonly taken as a way to improve cholesterol levels, also raise blood sugar. To learn about potential hazards lurking in nonprescription medications, talk to your doctor and your pharmacist, and read labels carefully.
What Causes It?
In type 1 diabetes, the pancreas secretes little or no insulin. Unable to use glucose in the blood, the body tries to produce energy by burning fat and muscle. Type 1 diabetes usually develops before age 20.
Type 2 diabetes usually develops in people over age 40, and more likely in people who are overweight. Although this particular group of patients may have sufficient or even excessive amounts of insulin in their systems, their bodies are unable to use the hormone effectively - called insulin resistance. Excessive food intake boosts blood sugar levels, and the pancreas cannot produce enough insulin to convert the extra sugar into energy. Sometimes a similar form of this disease, called gestational diabetes, occurs as a temporary condition in women who are pregnant.
Risk factors for type 1 diabetes include:
- Family history of type 1 diabetes
- Being white
- Having islet cell antibodies in the blood
- Being overweight
- Family history of diabetes
- Being of Hispanic, African American, Native American, or Asian origin
- Being over 40 years of age
- High blood pressure
- Abnormal blood cholesterol levels
- Heavy alcohol use
- Smoking
- History of gestational diabetes
- Women with polycystic ovary syndrome
Sources: American Family Physician. National Diabetes Education Program. American Diabetes Association. Clinical Diabetes Journal.
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