Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel.
The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems.
Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes â when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes â and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered.
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Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe.
Some of the signs and symptoms of type 1 and type 2 diabetes are:
Type 1 diabetes can develop at any age, though it often appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40.
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To understand diabetes, first you must understand how glucose is normally processed in the body.
Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).
Glucose â a sugar â is a source of energy for the cells that make up muscles and other tissues.
The exact cause of type 1 diabetes is unknown. What is known is that your immune system â which normally fights harmful bacteria or viruses â attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.
Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what those factors are is still unclear. Weight is not believed to be a factor in type 1 diabetes.
In prediabetes â which can lead to type 2 diabetes â and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it's needed for energy, sugar builds up in your bloodstream.
Exactly why this happens is uncertain, although it's believed that genetic and environmental factors play a role in the development of type 2 diabetes too. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin.
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, resulting in gestational diabetes.
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Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be evident, the American Diabetes Association (ADA) has recommended screening guidelines. The ADA recommends that the following people be screened for diabetes:
Glycated hemoglobin (A1C) test. This blood test, which doesn't require fasting, indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.
The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal.
If the A1C test results aren't consistent, the test isn't available, or you have certain conditions that can make the A1C test inaccurate â such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) â your doctor may use the following tests to diagnose diabetes:
Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours.
A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.
If type 1 diabetes is suspected, your urine will be tested to look for the presence of a byproduct produced when muscle and fat tissue are used for energy because the body doesn't have enough insulin to use the available glucose (ketones). Your doctor will also likely run a test to see if you have the destructive immune system cells associated with type 1 diabetes called autoantibodies.
Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy:
Your doctor may use the following screening tests:
Initial glucose challenge test. You'll begin the glucose challenge test by drinking a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 140 mg/dL (7.8 mmol/L) is usually considered normal on a glucose challenge test, although this may vary at specific clinics or labs.
If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. Your doctor will order a follow-up test to determine if you have gestational diabetes.
Follow-up glucose tolerance testing. For the follow-up test, you'll be asked to fast overnight and then have your fasting blood sugar level measured. Then you'll drink another sweet solution â this one containing a higher concentration of glucose â and your blood sugar level will be checked every hour for a period of three hours.
If at least two of the blood sugar readings are higher than the normal values established for each of the three hours of the test, you'll be diagnosed with gestational diabetes.
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Long-term complications of diabetes develop gradually. The longer you have diabetes â and the less controlled your blood sugar â the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. Possible complications include:
Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.
Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.
Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.
Complications in your baby can occur as a result of gestational diabetes, including:
Complications in the mother also can occur as a result of gestational diabetes, including:
Prediabetes may develop into type 2 diabetes.
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Type 1 diabetes can't be prevented. However, the same healthy lifestyle choices that help treat prediabetes, type 2 diabetes and gestational diabetes can also help prevent them:
Lose excess pounds. If you're overweight, losing even 7 percent of your body weight â for example, 14 pounds (6.4 kilograms) if you weigh 200 pounds (90.7 kilograms) â can reduce the risk of diabetes.
Don't try to lose weight during pregnancy, however. Talk to your doctor about how much weight is healthy for you to gain during pregnancy.
To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.
Sometimes medication is an option as well. Oral diabetes drugs such as metformin (Glucophage, Glumetza, others) may reduce the risk of type 2 diabetes â but healthy lifestyle choices remain essential. Have your blood sugar checked at least once a year to check that you haven't developed type 2 diabetes.
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Numerous substances have been shown to improve insulin sensitivity in some studies, while other studies fail to find any benefit for blood sugar control or in lowering A1C levels. Because of the conflicting findings, there aren't any alternative therapies that are currently recommended to help everyone with blood sugar management.
If you decide to try any type of alternative therapy, don't stop taking the medications that your doctor has prescribed. Be sure to discuss the use of any of these therapies with your doctor to make sure that they won't cause adverse reactions or interact with your current therapy.
Additionally, there are no treatments â alternative or conventional â that can cure diabetes, so it's critical that people who are receiving insulin therapy for diabetes don't stop using insulin unless directed to do so by their physicians.
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Diabetes is a serious disease. Following your diabetes treatment plan takes round-the-clock commitment. Careful management of diabetes can reduce your risk of serious â even life-threatening â complications.
Make physical activity part of your daily routine. Regular exercise can help prevent prediabetes and type 2 diabetes, and it can help those who already have diabetes to maintain better blood sugar control. A minimum of 30 minutes of moderate exercise â such as brisk walking â most days of the week is recommended.
A combination of exercises â aerobic exercises, such as walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week â often helps control blood sugar more effectively than does either type of exercise alone.
It's also a good idea to spend less time sitting still. Try to get up and move around for a few minutes at least every 30 minutes or so when you're awake.
In addition, if you have type 1 or type 2 diabetes:
Keep your vaccinations up-to-date. High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor may recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) also currently recommends hepatitis B vaccination if you haven't previously been vaccinated against hepatitis B and you're an adult ages 19 to 59 with type 1 or type 2 diabetes.
The most recent CDC guidelines advise vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes, and haven't previously received the vaccine, talk to your doctor about whether it's right for you.
If you drink alcohol, do so responsibly. Alcohol can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation â one drink a day for women and two drinks a day for men â and always with food.
Remember to include the carbohydrates from any alcohol you drink in your daily carbohydrate count. And check your blood sugar levels before going to bed.
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Living with diabetes can be difficult and frustrating. Sometimes, even when you've done everything right, your blood sugar levels may rise. But stick with your diabetes management plan, and you'll likely see a positive difference in your A1C when you visit your doctor.
Because good diabetes management can be time-consuming, and sometimes overwhelming, some people find it helps to talk to someone. Your doctor can probably recommend a mental health professional for you to speak with, or you may want to try a support group.
Sharing your frustrations and your triumphs with people who understand what you're going through can be very helpful. And you may find that others have great tips to share about diabetes management.
Your doctor may know of a local support group, or you can call the American Diabetes Association at 800-DIABETES (800-342-2383) or the Juvenile Diabetes Research Foundation at 800-533-CURE (800-533-2873).
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Risk factors for diabetes depend on the type of diabetes.
Although the exact cause of type 1 diabetes is unknown, factors that may signal an increased risk include:
Researchers don't fully understand why some people develop prediabetes and type 2 diabetes and others don't. It's clear that certain factors increase the risk, however, including:
Any pregnant woman can develop gestational diabetes, but some women are at greater risk than are others. Risk factors for gestational diabetes include:
Source: http://www.mayoclinic.com
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