Diabetes Overview

Diabetes Mellitus (DM) is a group of related diseases that affect how your body uses blood glucose. Glucose is derived from the foods you eat and is needed by the body for everyday functions. Insulin regulates the amount of glucose in the blood. People with diabetes either do not produce enough insulin (type 1 diabetes), cannot use insulin properly (type 2 diabetes), or both.

Diabetes is a common disease with 23.6 million people or 7.8% of the population living with the disease in the United States as of 2007. It can develop and appear at any age from childhood to adulthood and there is no cure for all types of diabetes. The disease can be regulated and controlled though, by introducing insulin to the body by injection or oral medication.

What are the Different Types of Diabetes

There are three types of diabetes and what is known as prediabetes which are classified as such:

• Type I Diabetes, also called  juvenile diabetes, generally develops and appears in pre-adolescence or adolescent years. Type 1 diabetes is an auto immune disease where the body is actually doing harm to itself by destroying its own beta cells. It makes up about 10% of all diabetes and is an insulin dependent condition.
• Type II Diabetes or adult-onset diabetes, generally appears after the age of 40 but has been known to appear in younger people as well, most likely due to a poor diet and lack of exercise. Type II diabetes makes up almost 90% of diabetes.
• Gestational Diabetes occurs during pregnancy and is usually tested for early in the first trimester. Generally it is an easy condition to deal with but can cause complications during pregnancy.
• Prediabetes is a condition where the blood sugar is regularly high but doesn’t fall into one of the previous diabetes categories. It can usually be controlled by simply watching your diet and exercising regularly. Though if not dealt with, chances are it will develop into type II diabetes.

What are the Symptoms of Diabetes

The symptoms of diabetes vary with the specific type of diabetes you have. Some people experience no symptoms at all while others experience many. Some of the common symptoms of diabetes include:

• Frequent urination
• Dehydration (polyuria)
• Weight loss
• Hunger and cravings
• Vision Problems
• Tiredness or fatigue
• Diabetic Ketoacidosis
• Wounds heal slowly
• Infections
• Gum and tooth issues

What Causes Diabetes

Causes of type 1 diabetes
In type 1 diabetes, your immune system which normally attacks bacteria and viruses attacks and destroys the insulin-producing cells in the pancreas.

Causes of Type 2 Diabetes and Prediabetes
In type 2 diabetes, your cells become resistant to insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells, sugar builds up in your bloodstream. Exactly why this happens is uncertain, although excess fat — especially abdominal fat — and inactivity seem to be important factors.

Causes of gestational diabetes
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin. As your placenta grows larger in the second and third trimesters, it secretes more of these hormones making it even harder for insulin to do its job.

Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can’t keep up. When this happens, too little glucose gets into your cells and too much stays in your blood. This is gestational diabetes.

How is Diabetes Diagnosed

Standard tests for diabetes type 1 and type 2 are simple and fairly non-intrusive and may include one or more of the following:

• Glycated Hemoglobin (A1C) Test is a test that measures average blood sugar level over a two to three month period. A1C levels above 6.5 percent on two or more separate tests indicates that you have diabetes.
• The Fasting Plasma Blood Glucose (sugar) Test (FPG) is a simple blood test. After fasting for a minimum of eight hours, blood is drawn and tested for glucose. A normal fasting blood sugar level is less than 100 milligrams per deciliter (mg/dl) and more then 70 milligrams per deciliter (mg/dl). A fasting plasma glucose level of more than 126 mg/dl on two or more tests on separate days indicates diabetes.
• A Random Blood Glucose Test, also called a casual plasma glucose test, is a blood test drawn at a random time with a glucose level of 200 mg/dl or higher indicating diabetes.
• Oral Glucose Tolerance Test (OGTT) works by measuring blood glucose after a person fasts at least 8 hours and 2 hours after the person drinks a drink containing glucose. This test can be used to diagnose diabetes and pre-diabetes and is commonly used for diagnosing gestational diabetes.

Doctors will choose the tests based on symptoms and available resources. All the test are accurate in diagnosing diabetes.

Diabetes Treatments and Drugs

Although there is no cure for diabetes, most people diagnosed can live a normal life with a mixture of proper eating habits, exercise, and drugs. The goal of diabetes treatment is to regulate your blood sugar keeping it low but not too low. The medication needed depends on the type of diabetes and can include oral medication, injections, and a possible pancreas transplant.

• Physical activity plays an important role in controlling your diabetes because when someone exercises or exerts physical energy they burn more sugar and become more sensitive to insulin. Talk to your doctor about the benefits of exercising with diabetes and what exercises would be right for you.
• Eating a healthy diet is essential in controlling your diabetes. There really is no diabetes diet it’s more about eating right and watching foods with high sugar levels. Foods like carbohydrates and eating plenty of fruits, grains, and vegetables is essential in keeping a balanced diet with or without diabetes. The most important factor is keeping a steady, regular nutrition plan and sticking to it.
• Monitoring and testing your blood sugar, depending on the type of diabetes may become a daily, weekly, multiple daily, or multiple weekly routine. No matter what you eat or how strict your diet, your blood sugar can be unpredictable so using meters to test your blood sugar is essential to maintaining a healthy level. Using devices such as a glucose meter are easy to use and very accurate. They work by pricking your finger, or other parts of your body depending on the meter, placing the blood onto a strip and placing it in the glucose meter for an instant reading. By knowing your blood sugar level you can effectively control your diabetes from home with insulin.
• Insulin People with type 1 diabetes need insulin to survive, as well as some people with type 2 diabetes. The most common forms of administering insulin is by injection and oral tablets. There are two injection methods such as an insulin pen, which looks like a normal pen and uses cartridges and disposable needles, and hypodermic injection, with disposable needles of different gauges depending on the persons needs, that’s injected into the fat of a person. Oral diabetes medications either stimulate your pancreas to produce and release more insulin, inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells, or block the action of stomach enzymes that break down carbohydrates or make your tissues more sensitive to insulin. Insulin pumps replace the need for periodic injections by delivering insulin continuously throughout the day and night using a catheter.
• Pancreas transplants may be necessary for people with serious complications from diabetes. One of the main functions of the pancreas is to produce insulin, so when the pancreas isn’t working properly it may be necessary to replace the non-functioning pancreas with a working donor pancreas through surgery. Complications from the procedure is high and is only done when absolutely necessary.

No matter what the treatment, if too much insulin is delivered or the patient eats less than he or she dosed for, there will be hypoglycemia. On the other hand, if too little insulin is delivered, there will be hyperglycemia. Both can be life threatening so it’s important that once diagnosed with diabetes you work closely with you doctor to keep a proper blood sugar level no matter what type of diabetes you have.