Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease.
In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.
With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.
In the OGTT test, a person’s blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.
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.
Some diabetes symptoms include:
- Frequent urination
- Excessive thirst
- Extreme hunger
- Unusual weight loss
- Increased fatigue
- Blurry vision
If you have one or more of these diabetes symptoms, see your doctor right away.
Major Types of Diabetes
Type 1 diabetes
Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar (glucose), starches and other food into energy needed for daily life.
Finding out you have diabetes is scary. But don’t panic. Type 1 diabetes is serious, but people with diabetes can live long, healthy, happy lives.
Type 2 diabetes
ype 2 diabetes is the most common form of diabetes. In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can cause two problems:
- Right away, your cells may be starved for energy.
- Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart.
Finding out you have diabetes is scary. But don’t panic. Type 2 diabetes is serious, but people with diabetes can live long, healthy, happy lives.
While diabetes occurs in people of all ages and races, some groups have a higher risk for developing type 2 diabetes than others. Type 2 diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as the aged population.
Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes affects about 4% of all pregnant women – about 135,000 cases of gestational diabetes in the United States each year.
We don’t know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother’s body to use insulin. She may need up to three times as much insulin.
Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy. Glucose builds up in the blood to high levels. This is called hyperglycemia.
Gestational diabetes affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby’s pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.
This can lead to macrosomia, or a “fat” baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.
Before people develop type 2 diabetes, they almost always have “pre-diabetes” — blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 54 million people in the United States who have pre-diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes. Research has also shown that if you take action to manage your blood glucose when you have pre-diabetes, you can delay or prevent type 2 diabetes from ever developing.
Diagnosis – Diabetes Tests
Diabetes can be diagnosed early on with a fasting plasma glucose (FPG) test or an oral glucose tolerance test (OGTT). The sooner you detect diabetes, the more quickly you can treat it and prevent serious complications such as heart attacks, strokes and kidney problems.
According to the American Diabetes Association, all adults should get tested every three years.
The FPG reading is taken from a blood sample usually drawn in the morning, before you’ve eaten. If you are having an OGTT, show up with something to read, since the whole exam can take more than two hours. You’ll be instructed to fast for eight hours (overnight) before the test and to avoid certain drugs, such as acetaminophen and oral contraceptives, which can affect the results. You’ll be asked to drink several ounces of a glucose (sugar) solution, then blood and urine samples will be taken after one hour and again after two hours.
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A normal level of glucose in the blood ranges from about 70 to 110 milligrams per deciliter of blood (mg/dl). If your blood sugars measure higher than 140 mg/dl, you may have undiagnosed diabetes. If your blood sugar levels are lower than 70 mg/dl, you may have hypoglycemia, a condition that can produce sudden severe hunger, headaches, anxiety, sweating, confusion or even Hypochondria.