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Diabetes

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CONDITIONS

Other types of diabetes

Gestational diabetes

Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly 40% of women with a history of gestational diabetes developed diabetes in the future.

Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of diabetes.

Pre-diabetes

The Pre-diabetes is a state of the condition where the patient has high glucose levels that are higher than normal but not high enough to be diagnosed as full fledged diabetes. It is a condition before the development of Type 2 diabetes. At least 20.1 million people in the United States (21.1% of the population), ages 40 to 74, and have pre-diabetes. Recent research shows that in pre-diabetes there is evidence of long-term damage to the heart and circulatory system.It also shows that management of the glucose levels in pre-diabetes can delay or completely prevent type 2 diabetes. People with pre-diabetes can expect to benefit from much of the same advice for good nutrition and physical activity.

What is diabetes?

Our body converts most of the food consumed into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. In diabetes condition, your body either does not make enough insulin or cannot use its own insulin as well as it should. This causes sugars to build up in your blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.

What are the types and risk factors of diabetes?

The following types of diabetes and some of their risk factors are stated in the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US Department of Health and Human Services, 1997):
Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes.
Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.

SYMPTOMS

All about blood sugars

When Your Blood Glucose Is Too High or Too Low

Sometimes, no matter how hard you try to keep your blood glucose in your target range, it's too high or too low. Blood glucose that's too high or too low can make you very sick. Here's how to handle these emergencies.

What You Need to Know About High Blood Glucose (Hyperglycemia)

If your blood glucose stays over 180, it may be too high. (Go back to the chart.) It means you don't have enough insulin in your body. High blood glucose can happen if you miss taking your diabetes medicine, eat too much, or don't get enough exercise. Sometimes, the medicines you take for other problems cause high blood glucose. Be sure to tell your doctor about other medicines you take.

Having an infection or being sick or under stress can also make your blood glucose too high. That's why it's very important to check your blood glucose and keep taking your insulin or diabetes pills when you're sick. (For more about how to take care of yourself when you're sick, see chapter five.)

If you're very thirsty and tired, have blurry vision, and have to go to the bathroom often, your blood glucose may be too high. Very high blood glucose may also make you feel sick to your stomach.

If your blood glucose is high much of the time or if you have symptoms of high blood glucose, call your doctor. You may need a change in your insulin or diabetes pills, or a change in your meal plan.

What You Need to Know About Low Blood Glucose (Hypoglycemia)

Hypoglycemia happens if your blood glucose drops too low. It can come on fast. It's caused by taking too much diabetes medicine, missing a meal, delaying a meal, exercising more than usual, or drinking too much alcohol. Sometimes, medicines you take for other health problems can cause blood glucose to drop.

Hypoglycemia can make you feel weak, confused, irritable, hungry, or tired. You may sweat a lot or get a headache. You may feel shaky. If your blood glucose drops lower, you could pass out or have a seizure.

If you have any of these symptoms, check your blood glucose. If the level is 70 or below, have one of the following right away:

2 or 3 glucose tablets
1/2 cup (4 oz.) of any fruit juice
a piece of fruit or a small box of raisins
1/2 cup (4 oz.) of a regular (not diet) soft drink
5 or 6 pieces of hard candy
1 or 2 teaspoons of sugar or honey.

Diagnosing Diabetes Mellitus

Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase one's risk of developing diabetes. People who have family members with diabetes (especially type 2 diabetes ), who are overweight, or who are African American, Hispanic, or Native American are all at greater risk of developing diabetes.
Type 1 diabetes occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most Asian, African, and American Indian populations. On the other hand, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are not known.

Type 2 diabetes is more common in older people, especially older women who are overweight, and occurs more often among African Americans, Hispanics, and American Indians. Compared with non-Hispanic whites, diabetes rates are about 60 percent higher in African Americans and 110 to 120 percent higher in Mexican Americans and Puerto Ricans. American Indians have the highest rates of diabetes in the world. Among Pima Indians living in the United States, for example, half of all adults have type 2 diabetes. The prevalence of diabetes is likely to increase because older people, Hispanics, and other minority groups make up the fastest growing segments of the U.S. population.

What causes type 1 diabetes?

The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for development of both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.

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