What is diabetes?
Diabetes is a disease that occurs when your blood sugar (glucose) is too high. This happens when your pancreas doesn't make enough insulin, it doesn't produce enough insulin, or your body doesn't respond properly to the effects of insulin. Diabetes affects people of all ages. Most types of diabetes are chronic (lifelong), and all types of diabetes can be controlled with medication and lifestyle changes. Glucose (sugar) mostly comes from carbohydrates in foods and drinks. It is your body's source of energy. Your blood carries sugar to cells throughout your body to be used as energy.
Once sugar enters your bloodstream, it needs help (a "core") to get to its final destination. The most important is insulin (hormone). If your pancreas doesn't make the hormone, or if your body doesn't use insulin properly, sugar builds up in the blood, causing hyperglycemia (high blood sugar).
The technical name for diabetes is diabetes mellitus. Other terms "diabetes" and "diabetes insipidus" sound the same, but they are different. It is called "diabetes" because it causes dehydration and urination. Diabetes insipidus is less common than diabetes. What are the types of diabetes? There are many types of diabetes. The most common forms are:
• Type 2 diabetes: In this type, your body does not produce enough insulin and your body does not respond to insulin most of the time (insulin resistance). This is the most common type of diabetes. This disease mostly affects adults, but it can also affect children. Type 1 diabetes: This type is an autoimmune disease in which the body's immune system attacks and destroys insulin-producing cells in the pancreas for unknown reasons. Up to 10% of diabetics have type 1 diabetes.
Gestational diabetes: Some people develop this type of diabetes during pregnancy. Gestational diabetes usually resolves after pregnancy. However, if you have gestational diabetes, you have a higher risk of developing type 2 diabetes later in life.
Other types of diabetes include:
Type 3c diabetes: This form of diabetes occurs when your pancreas is damaged (in addition to autoimmune damage), affecting its ability to produce insulin. Pancreatitis, pancreatic cancer, cystic fibrosis, and hemochromatosis can all damage the pancreas and lead to diabetes. Removal of the pancreas (pancreatectomy) also causes type 3c.
Latent autoimmune diabetes in adults (LADA): Like type 1 diabetes, LADA is caused by an autoimmune response, but develops more slowly than type 1. Most people diagnosed with LADA are over 30 years old.
Diabetes of the young (MODY): Also known as monogenic diabetes, MODY occurs when inherited genes affect the way your body produces and uses insulin. Currently there are more than 10 MODY types. It affects 5% of people with diabetes, and it tends to run in families.
Neonatal diabetes: This is a rare type of diabetes that occurs in the first six months of life. This is also a monogenic form of diabetes. About 50 percent of babies with new-onset diabetes have a lifelong form called new-onset diabetes. This time, on the other hand, this condition disappears within a few months after the onset of the disease, but it returns later. This is called new onset diabetes.
• Fragile diabetes: Fragile diabetes is a form of type 1 diabetes characterized by frequent episodes of hyperglycemia and hypoglycemia. This emergency usually occurs in the hospital. In rare cases, a pancreas transplant may be necessary to treat severe diabetes.
How common is diabetes? Diabetes is very common. About 37.3 million people in the United States have diabetes, or 11 percent of the population. Type 2 diabetes is the most common form, accounting for 90 to 95 percent of all diabetes cases.
The severity of symptoms may vary depending on the type of diabetes you have. The symptoms of type 1 diabetes are usually more severe than the symptoms of type 2 diabetes.
What are the symptoms of diabetes? Symptoms of diabetes include:
☀ Increased thirst (polydipsia) and dry mouth. ⑤ Frequent urination.
§ Fatigue.
⑤Foresight.
③ Unexplained weight loss.
Numbness or numbness in your hands and feet. Ÿ Bruises or punctures heal quickly.
☀ There are many fungal infections of the skin and/or scalp.
If you or your child experience these symptoms, be sure to visit your doctor.
More information on the symptoms of each type of diabetes include:
• Type 1 diabetes: Symptoms of type 1 diabetes appear quickly, over weeks or months. You may experience other symptoms that may be signs of serious complications of diabetic ketoacidosis (DKA). DKA is life-threatening and requires immediate medical attention. Symptoms of DKA include vomiting, abdominal pain, fruity breath, and difficulty breathing.
Type 2 diabetes and prediabetes: You may not feel any symptoms, or you may not notice them because they develop slowly. Blood tests show high blood sugar levels before you experience symptoms. Another symptom of prediabetes is darkening of the skin in some parts of the body (acanthosis nigricans).
Gestational diabetes: You usually won't notice any symptoms of gestational diabetes. Your doctor will test for gestational diabetes between the 24th and 28th weeks of pregnancy.
What causes diabetes? Too much glucose in the bloodstream causes diabetes, regardless of type. However, the reasons for high blood sugar levels vary depending on the type of diabetes. Causes of diabetes include:
Insulin resistance: Type 2 diabetes is primarily caused by insulin resistance. Insulin resistance occurs when muscle, fat and liver cells don't respond normally to insulin. Many factors and conditions, including obesity, lack of exercise, diet, hormonal imbalances, genetics and certain medications, cause varying degrees of insulin resistance.
Autoimmune diseases: Type 1 diabetes and LADA occur when the immune system attacks the insulin-producing cells of the pancreas.
Hormonal imbalance: During pregnancy, the placenta releases hormones that cause insulin resistance. Gestational diabetes can develop if the pancreas cannot produce enough insulin to overcome insulin resistance. Other hormone-related diseases, such as acromegaly and Cushing's syndrome, can also cause type 2 diabetes.
Pancreatic damage: Physical damage to the pancreas from illness, surgery, or injury can impair its ability to produce insulin and lead to type 3c diabetes.
Genetic mutations: Certain genetic mutations can cause MODY and neonatal diabetes.
Long-term use of certain medications, such as HIV/AIDS medications and corticosteroids, can also cause type 2 diabetes. What complications can diabetes cause?Diabetes can cause acute (suddenly severe) and long-term complications, mainly due to extremely or prolonged high blood sugar levels.
Acute Diabetic Complications
Acute diabetic complications that can be life-threatening include:
Hyperosmolar hyperglycemic state (HHS): This complication mainly affects people with type 2 diabetes. It occurs when blood sugar levels become very high (above 600 milligrams per deciliter, or mg/dL) for a long period of time, causing severe dehydration and confusion. Immediate medical attention is required. Diabetes-related Ketoacidosis (DKA): This complication mainly affects people with type 1 diabetes or undiagnosed type 1 diabetes. It occurs when there is not enough insulin in the body. Without insulin, the body cannot use glucose for energy and instead breaks down fat. This process ultimately releases substances called ketones, which make the blood acidic. This causes shortness of breath, vomiting, and loss of consciousness. DKA requires immediate medical attention.
Severe hypoglycemia (hypoglycemia): Hypoglycemia occurs when blood sugar levels fall below the healthy range. Severe hypoglycemia is when blood sugar levels are very low. It mainly affects people with diabetes who use insulin. Signs include blurred or double vision, clumsiness, disorientation, and seizures. Urgent treatment and/or medical intervention with glucagon is required.
Long-term diabetes complications
Prolonged elevated blood sugar levels can damage the body's tissues and organs. This is primarily due to damage to the blood vessels and nerves that support the body's tissues.
Cardiovascular (heart and blood vessel) problems are the most common type of long-term diabetes complication. This includes:
Coronary heart disease. Heart attacks.
Strokes.
Atherosclerosis.
Other complications of diabetes include:
Nerve damage (neuropathy), which can cause numbness, tingling, and/or pain.
Nephropathy, which can lead to kidney failure and the need for dialysis or a transplant. Retinopathy, which can lead to blindness.
Diabetic-related foot disease.
Skin infections.
Amputations.
Gastroparesis. Living with diabetes can also affect your mental health. People with diabetes are two to three times more likely to develop depression than people without diabetes.
Diagnosis and Testing
Diagnosis of Diabetes
How is diabetes diagnosed? Healthcare providers diagnose diabetes by checking your blood sugar levels with a blood test. There are three tests that can measure your blood sugar levels:
• Fasting blood glucose test: For this test, you don't eat or drink anything except water for at least 8 hours before the test (fasting). Because foods can have a big effect on blood sugar levels, your doctor can use this test to determine your baseline blood sugar level.
? Random blood sugar test: "Random" means this test can be done at any time, whether you're fasting or not.
A1c: This test, also known as the HbA1C test or glycated hemoglobin test, measures your average blood sugar level over the past 2-3 months.
To detect and diagnose gestational diabetes, your doctor will prescribe an oral glucose tolerance test.
The following test results usually tell you whether you have no diabetes, prediabetes, or diabetes: These values may vary slightly. Additionally, healthcare providers rely on multiple tests to diagnose diabetes.
Test Type Within Range (mg/dL) Prediabetes (mg/dL) Diabetes (mg/L)
Fasting Blood Glucose Test Less than 100. 100-125. 126 or more. Random Blood Glucose Testing N/A. N/A. Over 200 (with classic symptoms of hyperglycemia or hyperglycemic crisis).
A1c < 5.7%. 5.7% to 6.4%. 6.5% or higher.
Management and Treatment
Diabetes Management
How is diabetes treated?Diabetes is a complex disease, so treatment requires multiple strategies. Additionally, diabetes affects everyone differently, so treatment plans are highly individualized.
There are four main aspects to treating diabetes:
Blood Glucose Monitoring: Monitoring blood glucose (glucose) levels is key to determining how well your current treatment plan is working. You'll get information about how to control your diabetes from day to day, and sometimes even hour to hour. Your blood sugar can be monitored by regular testing with a blood glucose meter or finger stick, and/or a continuous glucose monitor (CGM). You and your doctor will determine the best blood sugar range for you.
Blood Glucose Monitoring: It is important to monitor your blood sugar (glucose) levels to determine how well your current treatment plan is working. You can receive information about your diabetes management daily, and sometimes hourly. You can monitor your blood glucose levels by frequent testing with a blood glucose meter or finger prick, or by a continuous glucose monitor (CGM). You and your doctor will determine the blood glucose range that is best for you.
Oral Diabetes Medications: Oral diabetes medications (taken by mouth) help control blood sugar levels in people who have diabetes but produce insulin (mainly those with type 2 diabetes and prediabetes). Those with gestational diabetes may also need oral medications. There are many different types. Metformin is the most common.
Insulin: People with type 1 diabetes need to inject synthetic insulin to live with and control their diabetes. Some people with type 2 diabetes also need insulin. There are many different types of synthetic insulin. They start working at different rates and stay in the body for different lengths of time. There are four main types of insulin delivery: insulin injections with a syringe, insulin pens, insulin pumps, and fast-acting inhaled insulin. Diet: Because diet has a big impact on blood sugar levels, meal planning and healthy food choices are important aspects of diabetes management. If you're taking insulin, counting carbohydrates in the foods and drinks you eat is an important part of your treatment. The amount of carbohydrates you eat determines how much insulin you need with each meal. Healthy eating habits also help control weight and reduce the risk of heart disease.
Exercise: Physical activity increases insulin sensitivity (and helps reduce insulin resistance), so regular exercise is an important part of treatment for all people with diabetes.
Maintaining a healthy weight is also important because it increases the risk of heart disease.
Blood pressure. Cholesterol. Prevention
How can I prevent diabetes? Autoimmune and genetic diabetes cannot be prevented. However, you can take steps to lower your risk of prediabetes, type 2 diabetes, and gestational diabetes.
• Eat a healthy diet, such as the Mediterranean diet.
Stay physically active, making sure you have 30 minutes at least five days a week. Try to reach a healthy weight for you.
Manage stress.
• Limit alcohol intake.
Get enough sleep (usually 7-9 hours) and treat any sleep disorders.
Quit smoking. Take medications as directed by your doctor to treat existing risk factors for heart disease.
It is important to know that there are several risk factors for diabetes that you cannot change, including: B. Your genetics/family history, age, and race. Remember that type 2 diabetes is a complex disease with many factors involved.
Outlook/Prediction
What is the prognosis for diabetes? Diabetes prognosis (outlook) varies widely and depends on several factors, including:
The type of diabetes you have.
How well you manage your chronic disease and your access to diabetes care.
How old you were when you were diagnosed/how long you've had diabetes.
Whether you have other health problems.
Whether you suffer from complications from diabetes. Chronic hyperglycemia can lead to serious complications that are usually irreversible. Some studies have shown that untreated chronic hyperglycemia can shorten life expectancy and worsen quality of life.
In the United States, diabetes is the eighth leading cause of death. Many people with diabetes die from heart attacks and strokes.
However, it is important to know that you can live a healthy life even with diabetes. For a better prognosis, it's important to make the following:
Lifestyle changes.
Regular exercise.
Dietary changes.
Regular monitoring of blood glucose levels.
Studies have shown that people with diabetes can reduce their risk of complications by keeping their A1c consistently below 7%. Living with it
Even if you haven't been diagnosed with diabetes, you should see a doctor if you have any of the following symptoms of diabetes: B. Thirst and frequent urination.
If you have diabetes, you should see a doctor regularly (such as an endocrinologist) who can help you manage your diabetes.
Message from Cleveland Clinic
A diabetes diagnosis is a life-changing event, but it doesn't mean you can't live a happy, healthy life. Treating diabetes requires consistent care and vigilance. It may seem overwhelming at first, but over time, you will better understand how to cope with the disease and live in harmony with your body.
Visit your doctor regularly. Treating diabetes requires teamwork. You need medical professionals, friends, and family by your side. Don't hesitate to ask them for help if you need it.