Diabetes is a lifelong disease. People with diabetes either don’t make insulin or their body’s cells no longer By definition, diabetes is having a …
Diabetes Basics What Is Diabetes? Diabetes mellitus is a disease of the pancreas an organ behind your stomach Normally, the pancreas releases a hormone called insulin that helps your body store and use the sugar and fat from the food you eat Diabetes occurs: When the pancreas does not produce any insulin, or The pancreas produces very little insulin, or When the body does not respond appropriately to insulin, a condition called insulin resistance
Diabetes is a lifelong disease Approximately 182 million Americans have the disease, thats 63 of the US population While a third are aware that they have it, another one third or 52 million are unaware that they have diabetes An additional 20 million people have pre-diabetes As yet, there is no cure People with diabetes need to manage their disease to stay healthy The Role of Insulin in Diabetes To understand why insulin is important, 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 a hormone called 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, your pancreas releases 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 to low hypoglycemia or low blood sugar, your body signals you to eat to increase glucose levels again and releases some glucose from the stores kept in the liver People with diabetes either dont make insulin or their bodys cells no longer are able to recognize insulin, leading to high blood sugars 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
What Are the Types of Diabetes? 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 glucose
The damage to the insulin-producing cells in type 1 diabetes occurs over a variable period of time However, the symptoms of type 1 diabetes may occur over a period of days to weeks 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 unable to recognize the insulin and use it properly When there isnt enough insulin or the insulin is not used as it should be, glucose cant get into the bodys cells
Type 2 diabetes is the most common form of diabetes mellitus, affecting almost 16 million Americans
While over 91 of these cases can be prevented, it remains for adults the leading cause of related complications such as blindness, non-traumatic amputations and chronic kidney failure requiring dialysis Type 2 diabetes usually starts in people over age 40 that 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 in children because of the rise in obesity in young people Some people can manage their type 2 diabetes by controlling their weight, wa 
tching 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 persons blood glucose levels are higher than normal, but not high enough for a diagnosis of type 2 diabetes It is estimated that 16 million Americans have pre-diabetes Gestational Diabetes Gestational diabetes is triggered by pregnancy The condition occurs in 4-7 of all pregnancies Hormone changes during pregnancy can affect insulins ability to work properly 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 important and is performed during pregnancy Left untreated, gestational diabetes
increases the risk of complications to both the mother and her unborn child Usually, blood glucose 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 What Are the Symptoms of Diabetes? The symptoms of type 1 diabetes often occur suddenly and can be severe They include: Increased thirst Increased hunger especially after eating Dry mouth Frequent urination Unexplained weight loss even though you are eating and feel hungry Fatigue weak, tired feeling Blurred vision Labored, heavy breathing Kussmaul respirations Loss of consciousness rare
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: Slow-healing sores or cuts Itching of the skin usually in the vaginal or groin area Yeast infections Recent weight gain Numbness or tingling of the hands and feet Low blood glucose levels
Impotence or erectile dysfunction
How Is Diabetes Managed? At the present time, diabetes cant be cured, but it can be treated and controlled The
goals of managing diabetes are to: Keep your blood glucose levels as near to normal as possible by balancing food intake with medication and activity Maintain your blood cholesterol and triglyceride lipid levels as near their normal ranges as possible by decreasing the total amount of fat to 30 or less of your total daily calories and by reducing saturated fat and cholesterol Control your blood pressure Your blood pressure should not go over 130/80 Slow or possibly prevent the development of diabetes-related health problems
You hold the key to managing your diabetes by: Planning what you eat and following a balanced meal plan Exercising regularly Taking medicine, if prescribed, and closely following the guidelines on how and when to take it Monitoring your blood glucose and blood pressure levels at home Keeping your appointments with your healthcare providers and having laboratory tests as ordered by your doctor
What you do at home every day affects your blood glucose more than what your doctor can do every few months during your checkups Learn about the doctors who treat diabetes Are you at risk for diabetes? View the full table of contents for the diabetes
guide
Reviewed by Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic Edited by Brunilda Nazario, MD, Nov 2003 Portions of this page copyright The Cleveland Clinic 2000-2004
