Introduction

Of the estimated 13 to 14 million people in the United States with diabetes, between 90 and 95 percent have noninsulin-dependent or type II diabetes. Formerly called adult-onset, this form of diabetes usually begins in adults over age 40, and is most common after age 55. Nearly half of people with diabetes don’t know it because the symptoms often develop gradually and are hard to identify at first. The person may feel tired or ill without knowing why. Diabetes can cause problems that damage the heart, blood vessels, eyes, kidneys, and nerves.

Although there is no cure for diabetes yet, daily treatment helps control blood sugar, and may reduce the risk of complications. Under a doctor’s supervision, treatment usually involves a combination of weight loss, exercise, and medication.

Points to Remember

  • Only a doctor can treat diabetes.
  • Treatment usually involves weight loss, exercise, and medication.
  • Daily treatment helps control diabetes and may reduce the risk of complications.

What Is Diabetes?

The two types of diabetes, insulin-dependent (type 1) and noninsulin-dependent (type 2), are different disorders. While the causes, short-term effects, and treatments for the two types differ, both can cause the same long-term health problems. Both types also affect the body’s ability to use digested food for energy. Diabetes doesn’t interfere with digestion, but it does prevent the body from using an important product of digestion, glucose (commonly known as sugar), for energy.

After a meal the digestive system breaks some food down into sugar. The blood carries the sugar throughout the body, causing blood sugar levels to rise. In response to this rise the hormone insulin is released into the bloodstream to signal the body tissues to metabolize or burn the sugar for fuel, causing blood sugar levels to return to normal. A gland called the pancreas, found just behind the stomach, makes insulin. Sugar the body doesn’t use right away goes to the liver, muscle, or fat for storage.

In someone with diabetes, this process doesn’t work correctly. In people with type 1 diabetes, the pancreas doesn’t produce insulin. This condition usually begins in childhood. People with this kind of diabetes must have daily insulin injections to survive.

In people with type 2 diabetes the pancreas usually produces some insulin, but the body doesn’t respond very well to the insulin signal and, therefore, doesn’t metabolize the sugar properly, a condition called insulin resistance. Insulin resistance is an important factor in type 2 diabetes.

Points to Remember

  • Diabetes interferes with the body’s use of food for energy.
  • While type 1 and type 2 diabetes are different disorders, they can cause the same complications.

What Are the Symptoms of Diabetes?

The symptoms of diabetes may begin gradually and can be hard to identify at first. They may include fatigue, a sick feeling, frequent urination, especially at night, and excessive thirst. When there is extra sugar in blood, one way the body gets rid of it is through frequent urination. This loss of fluids causes extreme thirst. Other symptoms may include sudden weight loss, blurred vision, and slow healing of skin, gum, and urinary tract infections. Women may notice genital itching.

A doctor also may suspect a patient has diabetes if the person has health problems related to diabetes. For instance, heart disease, changes in vision, numbness in the feet and legs, or sores that are slow to heal, may prompt a doctor to check for diabetes. These symptoms do not mean a person has diabetes, but anyone who has these problems should see a doctor.

Points to Remember

  • The symptoms of diabetes can develop gradually and may be hard to identify at first.
  • Symptoms may include feeling tired or ill, excessive thirst, frequent urination, sudden weight loss, blurred vision, slow healing of infections, and genital itching.

What Causes Type 2 Diabetes?

There is no simple answer to what causes type 2 diabetes. While eating sugar, for example, doesn’t cause diabetes, eating large amounts of sugar and other rich, fatty foods, can cause weight gain. Most people who develop diabetes are overweight. Scientists do not fully understand why obesity increases someone’s chances of developing diabetes, but they believe obesity is a major factor leading to type 2 diabetes. Current research should help explain why the disorder occurs and why obesity is such an important risk factor.

A major cause of diabetes is insulin resistance. Scientists are still searching for the causes of insulin resistance, but they have identified two possibilities. The first could be a defect in insulin receptors on cells. Like an appliance that needs to be plugged into an electrical outlet, insulin has to bind to a receptor to function. Several things can go wrong with receptors. There may not be enough receptors for insulin to bind to, or a defect in the receptors may prevent insulin from binding.

A second possible cause involves the process that occurs after insulin plugs into the receptor. Insulin may bind to the receptor, but the cells don’t read the signal to metabolize the sugar. Scientists are studying cells to see why this might happen.

Points to Remember

  • In people with type 2 diabetes, insulin doesn’t lower blood sugar, a condition called insulin resistance.
  • Obesity is a risk factor for diabetes.

Who Develops Type 2 Diabetes?

Age, sex, weight, physical activity, diet, lifestyle, and family health history all affect someone’s chances of developing type 2 diabetes. The chances that someone will develop diabetes increase if the person’s parents or siblings have the disease. Experts now know that diabetes is more common in African Americans, Hispanics, Native Americans, and Native Hawaiians than whites. They believe this is the result of both heredity and environmental factors, such as diet and lifestyle. The highest rate of diabetes in the world is in an Arizona community of American Indians called the Pimas. While the chances of developing diabetes increase with age, gender isn’t a risk factor, although African American women are more likely to develop diabetes than African American men.

While people can’t change family history, age, or race, it is possible to control weight and physical fitness. A doctor can decide if someone is at risk for developing diabetes and offer advice on reducing that risk.

Points to Remember

  • The following factors increase someone’s chances of developing diabetes: obesity, family history of diabetes, and advancing age.

Ref:  https://www.webmd.com/diabetes/diabetes-faq

Diabetes that’s triggered by pregnancy is called gestational diabetes (pregnancy, to some degree, leads to insulin resistance). It is often diagnosed in middle or late pregnancy. Because high blood sugar levels in a mother are circulated through the placenta to the baby, gestational diabetes must be controlled to protect the baby’s growth and development.

According to the National Institutes of Health, the reported rate of gestational diabetes is between 2% to 10% of pregnancies. Gestational diabetes usually resolves itself after pregnancy. Having gestational diabetes does, however, put mothers at risk for developing type 2 diabetes later in life. Up to 10% of women with gestational diabetes develop type 2 diabetes. It can occur anywhere from a few weeks after delivery to months or years later.

With gestational diabetes, risks to the unborn baby are even greater than risks to the mother. Risks to the baby include abnormal weight gain before birth, breathing problems at birth, and higher obesity and diabetes risk later in life. Risks to the mother include needing a cesarean section due to an overly large baby, as well as damage to heart, kidney, nerves, and eye.

Treatment during pregnancy includes working closely with your health care team and:

  • Careful meal planning to ensure adequate pregnancy nutrients without excess fat and calories
  • Daily exercise
  • Controlling pregnancy weight gain
  • Taking diabetes insulin to control blood sugar levels if needed

By far, the most common form of diabetes is type 2 diabetes, accounting for 95% of diabetes cases in adults. Some 26 million American adults have been diagnosed with the disease. Type 2 diabetes used to be called adult-onset diabetes, but with the epidemic of obese and overweight kids, more teenagers are now developing type 2 diabetes. Type 2 diabetes was also called non-insulin-dependent diabetes.

Type 2 diabetes is often a milder form of diabetes than type 1. Nevertheless, type 2 diabetes can still cause major health complications, particularly in the smallest blood vessels in the body that nourish the kidneys, nerves, and eyes. Type 2 diabetes also increases your risk of heart disease and stroke.

With Type 2 diabetes, the pancreas usually produces some insulin. But either the amount produced is not enough for the body’s needs, or the body’s cells are resistant to it. Insulin resistance, or lack of sensitivity to insulin, happens primarily in fat, liver, and muscle cells.

People who are obese — more than 20% over their ideal body weight for their height — are at particularly high risk of developing type 2 diabetes and its related medical problems. Obese people have insulin resistance. With insulin resistance, the pancreas has to work overly hard to produce more insulin. But even then, there is not enough insulin to keep sugars normal.

There is no cure for diabetes. Type 2 diabetes can, however, be controlled with weight management, nutrition, and exercise. Unfortunately, type 2 diabetes tends to progress, and diabetes medications are often needed.

An A1C test is a blood test that estimates average glucose levels in your blood over the previous three months. Periodic A1C testing may be advised to see how well diet, exercise, and medications are working to control blood sugar and prevent organ damage. The A1C test is typically done a few times a year.

Type 1 diabetes is an autoimmune disorder in which the immune system attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the pancreas produces little or no insulin. Type 1 diabetes is also characterized by the presence of certain autoantibodies against insulin or other components of the insulin-producing system such as glutamic acid decarboxylase (GAD), tyrosine phosphatase, and/or islet cells.

Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes, because it often begins in childhood. Type 1 diabetes is an autoimmune condition. It’s caused by the body attacking its own pancreas with antibodies. In people with type 1 diabetes, the damaged pancreas doesn’t make insulin.

This type of diabetes may be caused by a genetic predisposition. It could also be the result of faulty beta cells in the pancreas that normally produce insulin.

A number of medical risks are associated with type 1 diabetes. Many of them stem from damage to the tiny blood vessels in your eyes (called diabetic retinopathy), nerves (diabetic neuropathy), and kidneys (diabetic nephropathy). Even more serious is the increased risk of heart disease and stroke.

Treatment for type 1 diabetes involves taking insulin, which needs to be injected through the skin into the fatty tissue below. The methods of injecting insulin include:

  • Syringes
  • Insulin pens that use pre-filled cartridges and a fine needle
  • Jet injectors that use high pressure air to send a spray of insulin through the skin
  • Insulin pumps that dispense insulin through flexible tubing to a catheter under the skin of the abdomen

A periodic test called the A1C blood test estimates glucose levels in your blood over the previous three months. It’s used to help identify overall glucose level control and the risk of complications from diabetes, including organ damage.

Having type 1 diabetes does require significant lifestyle changes that include:

  • Frequent testing of your blood sugar levels
  • Careful meal planning
  • Daily exercise
  • Taking insulin and other medications as needed

People with type 1 diabetes can lead long, active lives if they carefully monitor their glucose, make the needed lifestyle changes, and adhere to the treatment plan.

 

Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body’s ability to use the energy found in food. There are three major types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes.

All types of diabetes mellitus have something in common. Normally, your body breaks down the sugars and carbohydrates you eat into a special sugar called glucose. Glucose fuels the cells in your body. But the cells need insulin, a hormone, in your bloodstream in order to take in the glucose and use it for energy. With diabetes mellitus, either your body doesn’t make enough insulin, it can’t use the insulin it does produce, or a combination of both.

Since the cells can’t take in the glucose, it builds up in your blood. High levels of blood glucose can damage the tiny blood vessels in your kidneys, heart, eyes, or nervous system. That’s why diabetes — especially if left untreated — can eventually cause heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet.

Talking about diabetes is not easy, even with familiar doctors. There are several ways to effectively communicate with doctors and other health-care professionals to ensure that you get the most out of your next visit. Here are a few tips to improve communication.

1. Prepare for your visit

With the average doctor’s visit lasting about 15 minutes — including about five minutes for patients to talk — it’s important to be ready for what you want to say. Write down a list of questions or topics that you want to discuss since it’s common to forget questions during an appointment. Once you’re in the office, ask your most important questions first in case the doctor is interrupted.

2. Write down the answers

Taking notes will help avoid any misunderstanding about what your doctor said. Use your mobile device to take notes or ask your doctor if you can record the visit. Recording the visit through your mobile device is also helpful for sharing the information with family members. If you cannot write down the answers or record the visit, ask someone to come with you who can help follow the conversation. Your loved one may think of questions or remember details about your symptoms or treatment that you may forget to mention.

3. Share symptoms

Don’t forget to talk about any new symptoms that you might be experiencing. Maybe you’ve been having more hyperglycemic (high blood sugar) events or your A1C levels have been higher than normal. Your doctor needs to know this information for effective diabetes management.

4. Drug discussion

If your doctor prescribes a new medicine, adds another drug or switches you to something new, there are a number of questions that you should consider asking: Why are you prescribing this medicine or changing my prescription? How and when should I take this medication? What are the side effects? Will it interact with any other medicines I’m taking? How will I know if the medication is working? Will my insurance cover this medicine?

5. Follow-up questions

Ask your doctor to repeat the information or explain technical language if it’s unclear. It’s also helpful to summarize the facts in your own words. Some common phrases include: “What you’re saying is that I should…” or “If I understand you correctly, my next step is…” If you’re more of a visual learner, ask your doctor for brochures or printouts that can help explain the material.

 

Ref: https://www.diabetesselfmanagement.com/about-diabetes/diabetes-basics/five-tips-for-a-diabetes-doctor-visit/