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Diabetes

 

Diabetes is a disease in which the level of glucose (a form of sugar) in the blood is too high. It is a serious disease. If left untreated, it may cause serious complications in eyes, kidneys, nerves, and heart. About 6 percent of Americans have diabetes and two-thirds of people with diabetes die of heart disease.

Causes

Glucose is the main source of energy for the body. Most of the food we eat is broken down into glucose which then passes into the bloodstream and circulates throughout the body. Glucose can enter some cells directly, such as the cells of the retina, kidney and nervous tissues. However, for most body cells, such as muscle cells (myocytes) and fat cells (adipocytes), insulin is required to move glucose from the bloodstream into the cell.

Insulin is a hormone produced by the pancreas, a large gland behind the stomach. In people with diabetes, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced (a phenomenon called insulin resistance). Consequently, glucose builds up in the blood.

There are three main types of diabetes:

Type 1 diabetes
In type 1 diabetes, the immune system attacks the insulin-producing beta cells in the pancreas, which then produces little or no insulin. This type accounts for about 5 to 10 percent of diagnosed diabetes in the United States. It occurs mainly in children and young adults.

Type 2 diabetes
The type 2 diabetes is characterized by high blood glucose level and insulin resistance (cells do not respond appropriately to insulin). This type accounts for more than 90 percent of diabetes. Most of its patients are over age 40 and overweight. 

Gestational diabetes
This type occurs during pregnancy. Although it usually disappears after delivery, the mother is at increased risk of getting type 2 diabetes later in life.

Symptoms and Diagnosis

The signs of diabetes are

  • being very thirsty
  • urinating often
  • feeling very hungry or tired
  • losing weight without trying.

Doctors use the following tests to diagnose diabetes.

  • A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating.
  • An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage.

The fasting plasma glucose test is the preferred test for diagnosing diabetes and is most reliable when done in the morning.

Table 1. Fasting Plasma Glucose Test
Plasma Glucose Result (mg/dL) Diagnosis
99 and below Normal
100 to 125 Pre-diabetes
126 and above Diabetes

Table 2. Oral Glucose Tolerance Test
2-Hour Plasma Glucose Result (mg/dL) Diagnosis
139 and below Normal
140 to 199 Pre-diabetes
200 and above Diabetes

 

Treatment

Type 1 Diabetes

Type 2 Diabetes

Gestational

 

References:

 
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