Diabetes

Our goal is to help with diabetes care and diabetes treatment including diagnosing the symptoms of diabetes. Being able to diagnose diabetes symptoms quickly is very important. We also aim to give the most useful information we can find, with as much help as possible.

While we try to provide the most accurate information possible, please be sure to consult with a doctor if you think you have any diabetes symptoms or to check the accuracy of the information found on these pages.

Diabetes

Diabetes, or diabetes mellitus, is a condition wherein the body does not produce enough insulin, or does not properly respond to the insulin that is produced. Insulin is a hormone produced in the pancreas that enables cells to absorb glucose and convert the glucose into energy. In diabetes, the body doesn’t produce enough insulin or responds improperly, and therefore there is a surplus of glucose in the system and the blood, which can cause major complications and difficulties. Diabetes is a disease that must be adequately controlled. If not regulated, it has the power to wreck havoc on the body such as cardiovascular disease, nerve damage, and blindness. There are three primary types of diabetes.

Diabetes Classification

The term diabetes, without qualification, usually refers to diabetes mellitus, which roughly translates to excessive sweet urine (known as "glycosuria") but there are several rarer conditions also named diabetes. The most common of these is diabetes insipidus in which large amounts of urine are produced (polyuria), which is not sweet (insipidus meaning "without taste" in Latin); it can be caused either by kidney (nephrogenic DI) or pituitary gland (central DI) damage. It is a noninfectious disease.

Among the body systems affected by Diabetes mellitus are the nervous, digestive, circulatory, endocrine and urinary systems, but all body systems are in some way affected.

The term "type 1 diabetes" has universally replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM). Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes mellitus (NIDDM). Beyond these two types, there is no agreed-upon standard nomenclature. Various sources have defined "type 3 diabetes" as, among others, gestational diabetes, insulin-resistant type 1 diabetes (or "double diabetes"), type 2 diabetes which has progressed to require injected insulin, and latent autoimmune diabetes of adults (or LADA or "type 1.5" diabetes.)

Type 1 Diabetes

Type 1 diabetes is a result of the body’s failure to produce any insulin whatsoever. Anywhere from 5% to 10% percent of Americans diagnosed with diabetes suffer from type 1 diabetes. Almost all those diagnosed with type 1 diabetes MUST take insulin injections in order to break down the glucose in the blood. The disease is fatal if insulin is not administered. Currently, pancreas transplants have also been used to treat type 1 diabetes. It is more commonly found in childhood, but is not exclusively a childhood problem. Many adults have been misdiagnosed with type 2 diabetes, when really they suffer from type 1.

Type 2 Diabetes

Type 2 diabetes occurs when the cells in the body fail to use the insulin produced in the proper way. Sometimes this occurrence is combined with an overall insulin deficiency, however SOME insulin is being produced, it is just not being used appropriately. Type 2 diabetes is the most common type of diabetes in America. Many of those who will be diagnosed with type 2 diabetes experience years in a state of pre-diabetes, which is often referred to as “America’s largest healthcare epidemic.” Pre-diabetes occurs when the glucose levels in the blood are high, but not high enough to warrant a type 2 diabetes diagnosis.

Gestational Diabetes

Gestational diabetes is a specific type of diabetes that occurs in pregnant women who have never had diabetes before, but develop high blood sugar (glucose) levels during pregnancy. Gestational diabetes is believed to affect about 4% of all pregnant women. Often times it precedes the development of diabetes type 2. No specific cause has been targeted, but it is generally conceded that the hormones produced during pregnancy increase a woman’s resistance to insulin, which then creates an intolerance. There can be serious risks with gestational diabetes, both to the pregnant mother and the offspring, but with carefully controlled glucose levels, the disease can be treated.

Other Types of Diabetes

There are many other types of diabetes that are categorized separately from the above three. Some are congenital diabetes as a result of genetic defects of insulin treatment. There is also steroid diabetes, which occurs as a result of prolonged exposure to glucocorticoids. Two other more rare forms of diabetes include cystic fibrosis-related diabetes and monogenic diabetes, which is a hereditary type of diabetes caused by mutations in the genes.

Diabetes Diagnosis

The diagnosis of type 1 diabetes, and many cases of type 2, is usually prompted by recent-onset symptoms of excessive urination (polyuria) and excessive thirst (polydipsia), often accompanied by weight loss. These symptoms typically worsen over days to weeks; about a quarter of people with new type 1 diabetes have developed some degree of diabetic ketoacidosis (a type of metabolic acidosis which is caused by high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids) by the time the diabetes is recognized. The diagnosis of other types of diabetes is usually made in other ways. These include ordinary health screening; detection of hyperglycemia during other medical investigations; and secondary symptoms such as vision changes or unexplainable fatigue. Diabetes is often detected when a person suffers a problem that is frequently caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing or a foot ulcer, certain eye problems, certain fungal infections, or delivering a baby with macrosomia or hypoglycemia.

Diabetes Screening

Diabetes screening is recommended for many people at various stages of life, and for those with any of several risk factors. The screening test varies according to circumstances and local policy, and may be a random blood glucose test, a fasting blood glucose test, a blood glucose test two hours after 75 g of glucose, or an even more formal glucose tolerance test. Many healthcare providers recommend universal screening for adults at age 40 or 50, and often periodically thereafter. Earlier screening is typically recommended for those with risk factors such as obesity, family history of diabetes, high-risk ethnicity (Hispanic, Native American, Afro-Caribbean, Pacific Islander, or Maori).

Diabetes Prevention

Type 1 diabetes risk is known to depend upon a genetic predisposition based on HLA types (particularly types DR3 and DR4), an unknown environmental trigger (suspected to be an infection, although none has proven definitive in all cases), and an uncontrolled autoimmune response that attacks the insulin producing beta cells. Some research has suggested that breastfeeding decreased the risk in later life; various other nutritional risk factors are being studied, but no firm evidence has been found. Giving children 2000 IU of Vitamin D during their first year of life is associated with reduced risk of type 1 diabetes, though the causal relationship is obscure.

Children with antibodies to beta cell proteins (ie at early stages of an immune reaction to them) but no overt diabetes, and treated with vitamin B-3 (niacin), had less than half the diabetes onset incidence in a 7-year time span as did the general population, and an even lower incidence relative to those with antibodies as above, but who received no vitamin B3.

Type 2 diabetes risk can be reduced in many cases by making changes in diet and increasing physical activity. The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least 2½ hours of exercise per week (several brisk sustained walks appear sufficient), having a modest fat intake, and eating sufficient fiber (e.g., from whole grains). The ADA does not recommend alcohol consumption as a preventive, but it is interesting to note that moderate alcohol intake may reduce the risk (though heavy consumption absolutely and clearly increases damage to bodily systems significantly); a similarly confused connection between low dose alcohol consumption and heart disease is termed the French Paradox.

There is inadequate evidence that eating foods of low glycemic index is clinically helpful despite recommendations and suggested diets emphasizing this approach.

Diets that are very low in saturated fats reduce the risk of becoming insulin resistant and diabetic. Study group participants whose "physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes." In another study of dietary practice and incidence of diabetes, "foods rich in vegetable oils, including non-hydrogenated margarines, nuts, and seeds, should replace foods rich in saturated fats from meats and fat-rich dairy products. Consumption of partially hydrogenated fats should be minimized."

There are numerous studies which suggest connections between some aspects of Type II diabetes with ingestion of certain foods or with some drugs. Some studies have shown delayed progression to diabetes in predisposed patients through prophylactic use of metformin, rosiglitazone, or valsartan. In patients on hydroxychloroquine for rheumatoid arthritis, incidence of diabetes was reduced by 77% though causal mechanisms are unclear. Breastfeeding may also be associated with the prevention of type 2 of the disease in mothers. Clear evidence for these and any of many other connections between foods and supplements and diabetes is sparse to date; none, despite secondary claims for (or against), is sufficiently well established to justify as a standard clinical approach.

Diabetes Exams and Tests

Generally, a urine analysis is initially used to detect glucose and ketones as indicative of the breakdown of fat, but a urine analysis alone cannot detect diabetes. Diabetes is diagnosed via a fasting blood glucose level test (if glucose is abnormally high, diabetes is likely the culprit), oral glucose tolerance test (used more for type 2 diabetes), or random (non-fasting) blood glucose level test (a test that must be confirmed with a fasting glucose blood glucose test.) People diagnosed with diabetes must have their hemoglobin A1c levels checked every three to six months to determine how well treatment is working.

Diabetes Symptoms

Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

Type 1 Diabetes

• Frequent urination
• Unusual thirst
• Extreme hunger
• Unusual weight loss
• Extreme fatigue and Irritability

Type 2 Diabetes

• Any of the type 1 symptoms
• Frequent infections
• Blurred vision
• Cuts/bruises that are slow to heal
• Tingling/numbness in the hands/feet
• Recurring skin, gum, or bladder infections

Often people with type 2 diabetes have no symptoms