What is diabetes?

Diabetes mellitus is a chronic metabolic condition that occurs when the body has excess glucose and cannot process the glucose normally. Glucose is one of the body’s primary sources of energy for essential functions and organs. After the body breaks down glucose from the food you eat, the pancreas releases insulin to allow the glucose to enter the bloodstream and serve as energy. Diabetes impacts this processing function because the body either does not produce enough insulin or does not properly use the insulin. The result of diabetes is too much glucose (sugar) in the bloodstream, which often leads to conditions like heart disease, vision problems, and kidney disease. 

About 1 in 10 Americans have diabetes, and nearly 90% to 95% percent of all cases are type 2, with the remaining 5% to 10% being type 1 or gestational diabetes. There is no cure for diabetes, but there are effective treatments and management techniques that help a person live with the condition.

What are the different types of diabetes?

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There are three main types of diabetes and one early stage of diabetes that are most common. There are other types of diabetes that are much rarer and do not occur often.  

Type 1 Diabetes: Type 1 diabetes accounts for roughly 5% to 10% of all cases of diabetes. Those with type 1 diabetes are insulin deficient and must take insulin daily to live because their body causes an autoimmune response that kills insulin-producing cells in the pancreas. People of any age can develop type 1 diabetes, but it is most commonly diagnosed in younger people. 

Type 2 Diabetes: Constituting the overwhelming majority of diabetes diagnoses, type 2 diabetes occurs when the body is not able to use insulin properly, leading to high blood sugar. This type of diabetes is preventable in some cases by adopting lifestyle changes to lower blood sugar levels, such as regular exercise and a healthy diet. Diagnosing type 2 diabetes early is key to effective treatment and to lessen the complications of the condition. 

Gestational Diabetes: This type of diabetes occurs in pregnant people and tends to go away after the baby is born. Having gestational diabetes makes a person more likely to develop type 2 diabetes later in life and also means their child has a higher risk of obesity or type 2 diabetes. 

Prediabetes: Prediabetes shows symptoms that a person’s blood sugar levels are reaching a diabetic level but have yet to pass the threshold for diagnosing type 1 or type 2 diabetes. Prediabetes is reversible with lifestyle adjustments. You could be at a higher risk of developing type 2 diabetes if you are diagnosed as prediabetic.

What causes diabetes?

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The exact cause of autoimmune system changes that results in diabetes remains unknown. However, the symptoms of diabetes do result from the body’s inability to process glucose and keep blood sugar levels in a normal range. The root cause of diabetes is likely due to genetic or environmental factors that impact how your body functions. Diabetes tends to run in families but is not necessarily a condition that is passed down. 

The cause of type 2 diabetes is insulin resistance that prevents the body from engaging enough insulin to process glucose. For type 1 diabetes, the lack of insulin caused by an autoimmune attack on insulin-producing cells results in high blood sugar levels. Gestational diabetes is caused by hormonal changes during pregnancy that make a person insulin resistant. More research is needed to understand the precise cause of each type of diabetes.

What are symptoms of diabetes?

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The main symptoms of diabetes result from high blood sugar levels. Some people with prediabetes, type 2 diabetes, or gestational diabetes may not experience symptoms or will have mild symptoms. The most common symptoms of type 1 and type 2 diabetes are the following: 

  • Frequent urination
  • Feeling thirsty often 
  • Sudden and unexplained weight loss
  • Blurry vision 
  • Mood changes
  • Slow-healing cuts or sores
  • Feelings of fatigue or tiredness
  • Frequent infections
  • Increased hunger

If you notice any of the listed symptoms, you may want to schedule an appointment with your primary care physician to discuss your symptoms and a possible diabetes diagnosis. People with type 1 diabetes may experience more severe symptoms like vomiting or stomach pains while those with type 2 diabetes may not notice any new symptoms.

Are there any risk factors or groups for diabetes?

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There are various risk factors for diabetes depending on the type. The strongest indicator of your likelihood for any kind of diabetes is having a family history of the condition. 

Type 1 Diabetes: Your risk of type 1 diabetes increases if you have a family history of the condition. In addition, children and young adults are more likely to develop diabetes than adults later in life. White Americans tend to develop diabetes at a higher rate than African American or Hispanic people. 

Type 2 Diabetes: The risk factors for type 2 diabetes relate to a person’s family history as well as their lifestyle and environment. The main risk factors for type 2 diabetes include:

  • Being prediabetic
  • Not remaining physically active
  • Having an immediate family member with type 2 diabetes
  • Being overweight 
  • Previously having gestational diabetes
  • Identifying as African American, Hispanic or Latino, Alaska Native, or American Indian
  • Being 45 years of age or older

Gestational Diabetes: People are at a higher risk of gestational diabetes if they have a history of the condition in previous pregnancies or a family history of type 2 diabetes. In addition, having the condition polycystic ovary syndrome (PCOS) and being overweight puts you at a higher risk. Finally, if you have given birth to a baby that weighed more than 9 pounds, your chances of gestational diabetes increases.

How is diabetes diagnosed?

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To diagnose diabetes, your doctor will likely order a blood test to be able to gauge your blood sugar level. The main tests for diabetes are the following. 

  1. A1C test: This test measures your blood sugar levels over the course of 2 to 3 months. Normal values are less than 5.7% while prediabetes is in the range of 5.7% to 6.4%. Finally, a diabetic level is 6.5% or higher. 
  2. Fasting blood sugar test: This test requires the person to fast for 8 hours before the test. High levels at or above 126 mg/dL indicate a person has diabetes. 
  3. Glucose tolerance test: This test compares test values after an overnight fast to values 2 hours after you drink a sugary beverage. Results that indicate diabetes produce levels that fall at or above 200 mg/dL.

Random blood sugar test: This type of test measures your blood sugar levels at any point, regardless of any fast or consumption of sugary foods and drinks. This type of test helps identify your current glucose levels but does not help confirm a diabetes diagnosis on its own.

How is diabetes treated?

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Since there is no cure for diabetes, treatment aims to help manage symptoms of diabetes and help the person live a comfortable life. The main treatment plan depends on the type of diabetes a person has. 

Insulin: Those with type 1 diabetes need daily insulin injections to survive and provide the body with enough insulin to process sugar. There are different release periods of insulin, ranging from rapid-release to long-lasting insulin. 

Blood sugar monitoring: Monitoring your blood sugar levels while diabetic can help you track how well you are managing the condition. In addition, knowing your glucose levels helps a person determine how much insulin they need to regulate their levels to avoid a high or a low. 

Diet and lifestyle: Eating a balanced diet and regularly exercising is a large part of effective diabetes treatment. Watching your carb intake can help you avoid too much sugar at once and can help keep your levels in a manageable range. 

Oral medications: People with type 2 or gestational diabetes may take oral medications to help manage their glucose levels.

Should you see a doctor for diabetes?

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You should see a doctor for diabetes to both confirm a diagnosis and start the right treatment plan for you. Early diagnosis is key to managing symptoms and lessening the negative effects of the condition. People with diabetes need to consistently visit doctors to track the progression of the condition and keep on top of treatment, so finding a care team you trust and like is essential.

What are the complications and outlook for people living with diabetes?

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Diabetes is a chronic condition with no known cure, so a person will have the condition as long as they live. Having diabetes puts a person at a higher risk of developing other long-term complications and health issues, including heart conditions, nerve damage, eye damage, kidney issues, and foot problems. 

Staying on top of your blood sugar levels and insulin injections can help lessen the chances of these negative effects of diabetes. Diabetes can be mentally and physically exhausting to treat, so finding support from your loved ones, your medical care team, and others with diabetes can help greatly in remaining consistent with treatment.