Diabetes

Diabetes occurs when the body has trouble using the sugar it gets from food for energy. Sugar builds up in the bloodstream. High blood sugar can have immediate effects, like blurry vision. It can also cause problems over time, like heart disease and blindness.

There are two main types of diabetes: type 1 diabetes (once called juvenile-onset diabetes) and type 2 diabetes (once called adult-onset diabetes). Both are caused by problems making or using insulin, a hormone that makes it possible for cells to use glucose, also known as blood sugar, for energy.

When you eat, your body breaks down carbohydrates into a simple sugar called glucose. It also produces a hormone called insulin that signals the body's cells to absorb glucose from the bloodstream. Type 1 diabetes occurs when the body doesn't make enough insulin, or stops making it altogether. Type 2 diabetes occurs when the body's cells don't respond to insulin. Either way, since sugar can't get into cells, it builds up in the bloodstream. 

Too much sugar in the blood can cause a range of uncomfortable symptoms. These include:

  • blurry vision
  • intense thirst
  • need to urinate often
  • fatigue
  • numbness or tingling in the hands or feet

Type 1 diabetes often comes on suddenly. It usually strikes children and teenagers, but can appear later in life. It is an autoimmune disease, meaning it happens because the body's immune system mistakenly attacks and destroys the body's insulin-making cells. Type 1 diabetes can't be cured, but it can be managed by taking insulin before eating.

Type 2 diabetes takes longer to develop. It can begin any time from childhood onward. Type 2 diabetes is usually triggered by being overweight or obese and not getting much physical activity. Treatment for type 2 diabetes includes weight loss if needed, daily exercise, a healthy diet, and medications.

Diabetes Articles

Diabetic Nephropathy

Diabetic nephropathy is kidney disease that is a complication of diabetes. It can occur in people with type 2 diabetes, the diabetes type that is most common and is caused by resistance to insulin, or in people with type 1 diabetes, the type that more often begins at an early age and results from decreased insulin production. Diabetic nephropathy is caused by damage to the tiniest blood vessels. When small blood vessels begin to develop damage, both kidneys begin to leak proteins into the urine. As damage to the blood vessels continues, the kidneys gradually lose their ability to remove waste products from the blood. (Locked) More »

Hypoglycemia

Hypoglycemia is an abnormally low level of blood sugar (blood glucose). Because the brain depends on blood sugar as its primary source of energy, hypoglycemia interferes with the brain's ability to function properly. This can cause dizziness, headache, blurred vision, difficulty concentrating and other neurological symptoms. (Locked) More »

Maturity Onset Diabetes of the Young (MODY)

Maturity Onset Diabetes of the Young (MODY) is an inherited form of diabetes mellitus. It is caused by a change in one of eleven genes. Up to 5% of all diabetes cases may be due to MODY. Just like other people with diabetes, people with MODY have trouble regulating their blood sugar levels. This disorder is more like type 1 diabetes than type 2, although it can be confused with either type. In type 1, the pancreas cannot make and release enough insulin. People with type 2 diabetes, on the other hand, usually make enough insulin, but their bodies cannot respond to it effectively (known as insulin resistance). Type 2 diabetes is usually associated with being overweight, but that is not true of type 1 diabetes or MODY. However, obesity does matter. An obese person with a MODY gene mutation may develop symptoms of diabetes sooner than someone of normal weight. (Locked) More »

Diabetic Ketoacidosis

Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Your body needs a constant source of energy. When you have plenty of insulin, your body cells can get all the energy they need from glucose. If you don't have enough insulin in your blood, your liver is programmed to manufacture emergency fuels. These fuels, made from fat, are called ketones (or ketoacids). In a pinch, ketones can give you energy. However, if your body stays dependent on ketones for energy for too long, you soon will become ill. Ketones are acidic chemicals that are toxic at high concentrations. In diabetic ketoacidosis, ketones build up in the blood, seriously altering the normal chemistry of the blood and interfering with the function of multiple organs. They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death. Ketoacidosis is always accompanied by dehydration, which is caused by high levels of glucose in the blood. Glucose builds up in the blood if there is not enough insulin to move glucose into your cells. During an episode of ketoacidosis, it is common for blood sugar to rise to a level over 400 milligrams per deciliter. When blood sugar levels are so high, some sugar "overflows" into the urine. As sugar is carried away in the urine, water, salt and potassium are drawn into the urine with each sugar molecule, and your body loses large quantities of your fluid and electrolytes, which are minerals that play a crucial role in cell function. As this happens, you produce much more urine than normal. Eventually it may become impossible for you to drink enough fluids to keep up with amounts that you urinate. Vomiting caused by the blood's acidity also contributes to fluid losses and dehydration. People with type 1 diabetes are at risk of diabetic ketoacidosis. If you have type 1 diabetes, ketoacidosis can occur because you have stopped taking your insulin injections or because your insulin dose is too low. It can be triggered by an infection or severe physical stress, such as an injury or surgery, because your body can need more insulin than usual during these stresses. Ketoacidosis rarely occurs in people with type 2 diabetes. In most people who have type 2 diabetes, blood insulin levels usually do not get low enough to signal the liver to make ketones. In about 25% of children with diabetes, symptoms from ketoacidosis are the first sign that they have diabetes. (Locked) More »

Type 1 Diabetes Mellitus

Type 1 diabetes is a disease in which the body does not make enough insulin to control blood sugar levels. Type 1 diabetes was previously called insulin-dependent diabetes or juvenile diabetes. During digestion, food is broken down into basic components. Carbohydrates are broken down into simple sugars, primarily glucose. Glucose is a critically important source of energy for the body's cells. To provide energy to the cells, glucose needs to leave the blood and get inside the cells. Insulin traveling in the blood signals the cells to take up glucose. Insulin is a hormone produced by the pancreas. When levels of glucose in the blood rise, like following a meal, the pancreas normally produces more insulin. Type 1 diabetes occurs when some or all of the insulin-producing cells in the pancreas are destroyed. This leaves the patient with little or no insulin. Without insulin, sugar accumulates in the bloodstream rather than entering the cells. As a result, the body cannot use this glucose for energy. (Locked) More »

Type 2 Diabetes Mellitus

Type 2 diabetes is a chronic disease. It is characterized by high levels of sugar in the blood. Type 2 diabetes is also called type 2 diabetes mellitus and adult-onset diabetes. However, more and more children and teens are developing this condition. Since type 2 diabetes is much more common than type 1 diabetes, it often is just called "diabetes". During digestion, food is broken down into basic components. Carbohydrates are broken down into simple sugars, primarily glucose. Glucose is a critically important source of energy for the body's cells. To provide energy to the cells, glucose needs to leave the blood and get inside the cells. Insulin traveling in the blood signals the cells to take up glucose. Insulin is a hormone produced by the pancreas. When levels of glucose in the blood rise (for example, after a meal), the pancreas produces more insulin. Type 2 diabetes occurs when your body's cells do not react efficiently to insulin. This condition is called insulin resistance. The cells do not accept as much glucose from the blood as they should. The cells resist the effects of insulin. As a result, glucose starts to build up in the blood. In people with insulin resistance, the pancreas "sees" the blood glucose level rising. The pancreas responds by making extra insulin to maintain a normal blood sugar. Over time, the body's insulin resistance gets worse. In response the pancreas makes more and more insulin. Finally, the pancreas gets "exhausted". It cannot keep up with the demand for more and more insulin. As a result, blood glucose levels stay high. (Locked) More »

When walking makes your legs hurt

There are other conditions besides arthritis that can make walking difficult and even painful, such as peripheral artery disease, chronic venous insufficiency, lumbar spinal stenosis, and diabetic neuropathy. More »

10 steps for coping with a chronic condition

Dealing with the pain and aggravation of a broken bone or burst appendix isn't easy. But at least there's an end in sight. Once the bone or belly heals, you're pretty much back to normal. That's not true for high blood pressure, heart failure, diabetes, arthritis, osteoporosis, or other chronic conditions. With no "cure" in sight, they usually last a lifetime. You can live with a chronic condition day to day, responding to its sometimes swiftly changing symptoms and problems. Or you can take charge and manage the disease instead of letting it rule you. More »

Diabetes Update: 2002

Type 2 diabetes affects approximately 8% of adults in the United States. An additional 10 million Americans are at high risk for the disease. This type of diabetes begins gradually, later in life. Most people with type 2 diabetes produce plenty of insulin, but their tissues resist the action of the hormone, so their blood sugar levels rise; some people develop the disease as their insulin production gradually slows down. Although treatment may prevent some complications of type 2 diabetes, which can include atherosclerosis, vision impairment, and nerve damage, it cannot eliminate the condition altogether. As a result, prevention of type 2 diabetes remains preferable. In a recent study in the New England Journal of Medicine (NEJM), researchers from the Diabetes Prevention Program Research Group sought to determine whether lifestyle intervention or drug treatment could be used to prevent or delay the onset of type 2 diabetes. The researchers gathered 3,234 subjects who they determined to be at high risk for diabetes based on elevated blood sugar levels. They assigned the subjects to one of three interventions: twice-daily treatment with 850 mg of metformin (a drug commonly used to lower blood sugar in people with type 2 diabetes), lifestyle intervention, or placebo. The goal of the lifestyle intervention was to achieve a weight reduction of at least 7% of initial body weight through a low-fat, low-calorie diet, and to complete at least 150 minutes of moderate-intensity physical activity per week. As measured by the researchers, the lifestyle intervention group achieved much greater weight loss and increased their physical activity level more than the metformin or placebo groups. More »