OverviewDiabetes mellitus, often called diabetes, is a condition that makes it hard for the body to control the level of glucose in the blood. This means it is hard for the body to convert food into the energy that the body needs to work. Glucose is the main form of sugar in the body.
What is going on in the body?Insulin is the hormone responsible for helping glucose (sugar) move into the cells so that the body can use it for fuel. Thus, insulin helps control the level of glucose in the blood.
The pancreas, a long, thin organ located behind the stomach, makes insulin. In healthy people, the pancreas makes extra insulin when a person eats. Insulin moves glucose from the bloodstream into the body cells. The cells use glucose as their main energy source.
In a person with diabetes, the pancreas cannot make enough insulin to keep up with the body's demand. So glucose cannot be moved into the cells and used. In some types of diabetes, the body cells resist the insulin. As a result, glucose builds up in the blood to a high level, a condition known as hyperglycemia.
According to the American Diabetic Association (ADA) about 17 million Americans have diabetes. There are three main types of diabetes.
• Type 1 diabetes. This type was formerly known as insulin-dependent diabetes mellitus (IDDM), or juvenile-onset diabetes. A person with this type makes little or no insulin. So he or she needs to take insulin shots each day.
• Type 2 diabetes. This type was known as noninsulin-dependent diabetes mellitus (NIDDM), or adult-onset diabetes. In this, by far the most common type, a person might make healthy or even high levels of insulin, but obesity makes his or her body resistant to its effect. Type 2 diabetes was once rare in children. However, with the increase in obesity in children, doctors are now finding that as many as 1 out of each 20 children with diabetes has type 2. Of these children, 85% are obese.
• Gestational diabetes or pregnancy-induced diabetes. This type of diabetes develops in a pregnant woman. The mechanism is similar to type 2 except that the insulin resistance is believed to be fueled by the hormones of pregnancy. In most cases, this type of diabetes goes away after the woman's child is born.
There are other, much less common, types of diabetes. These include diabetes caused by:
• a genetic defect, diseases where the pancreas is infected, inflamed, or otherwise damaged,
• hormonal imbalances (e.g. Cushing syndrome), or
• from being exposed to certain chemicals or medications, such as prednisone, oral contraceptives, or thiazide diuretics.
What are the signs and symptoms of the disease?Symptoms partly depend on the type of diabetes a person has and how long it has been untreated. Many patients with type 2 diabetes have no symptoms at all.
The signs and symptoms are mostly related to high blood glucose levels and include:
• bladder infections
• coma, which happens only if the diabetes gets too far out of control
• extreme hunger
• extreme thirst
• fatigue and weakness
• frequent urination in increased amounts
• nausea and vomiting
• skin infections, especially fungal or more serious bacterial infections
• visual problems, such as blurred vision
• weight loss despite incresaed hunger and thirst
A condition called ketoacidosis may occur in a person with type 1 diabetes if the person goes without enough insulin for too long. This is a severe complication and requires medical attention right away.
The symptoms of ketoacidosis include:
• deep rapid breathing, sometimes with a fruity odor to the breath
• drowsiness
• extreme thirst
• frequent urination
• nausea and vomiting
• stomach pains
• upset stomach
What are the causes and risks of the disease?
Genetics may play a part in all types of diabetes mellitus. Other causes and risks vary. They depend on the type of diabetes involved. Type 1 diabetes is believed to be an autoimmune disorder, in which the body makes antibodies that destroy pancreatic cells. It is more common in whites than in other racial groups.
What can be done to prevent the disease?
At present, there is no way to prevent type 1 diabetes. However, in many cases, it may be possible to prevent pre-diabetes from progressing to type 2 diabetes. Even modest lifestyle changes can help. This is why it is very important to recognize pre-diabetes.
How is the disease diagnosed?
A doctor may suspect diabetes after taking a person's health history and doing a physical exam. Based on those results, the doctor may want to check for a high glucose level in the blood. There are several types of blood tests doctors can use to diagnose diabetes, including:fasting blood sugar (FBS) test, the method used to diagnose most cases of diabetes. In this test, a person is asked to fast overnight for at least 8 hours. In the morning, the level of glucose in the blood is then checked. Healthy FBS levels are less than 100 milligrams per deciliter or mg/dL. An FBS level of more than 126 mg/dL usually suggests diabetes. Levels between 100 and 126 mg/dL are seen in pre-diabetes.oral glucose tolerance test, the preferred way to diagnose gestational diabetes. It can also be used to diagnose type 2 diabetes or pre-diabetes. In this test, a person is asked to drink a sweet liquid. Blood samples are then drawn at timed intervals. If a person does not have diabetes, the glucose levels will rise and then fall quickly after drinking the sweet liquid. When a person has diabetes, glucose levels will rise higher and fail to come down as fast as those in a person without diabetes. If the blood sugar level is 140 to 199 mg/dL 2 hours after drinking the liquid, a diagnosis of pre-diabetes can be made.non-fasting blood sugar test, which is used as a screening tool. A level of 200 mg/dL or higher suggests diabetes. If the level is above 200 mg/dL, an FBS test or oral glucose tolerance test can be done to confirm the diagnosis of diabetes.
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