What is Diabetes?

Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Diabetes is the body's inability to use blood sugar for energy. The main types include type 1 diabetes, type 2 diabetes, and gestational diabetes.

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin.

Type 2 diabetes is the most common form of diabetes. In Type 2 diabetes, either the body does not produce enough insulin or the
cells ignore the insulin.

Gestational pregnancy -- usually at around 28 weeks or later -- many women are diagnosed with gestational diabetes. A diagnosis of gestational diabetes does not mean that you had diabetes before you conceived, or that you will have diabetes after giving birth. But it's important to follow the advice of your doctor regarding blood glucose (blood sugar) levels while you are planning your pregnancy, so you and your baby both remain healthy.

Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Only 5-10% of people with diabetes have this form of the disease. With the help of insulin therapy and other treatments, even young children with
Type 1 diabetes can learn to manage their condition and live long, healthy, happy lives.

Symptoms

Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

Type 1 Diabetes

1) Frequent urination
2) Unusual thirst
3) Extreme hunger
4) Unusual weight loss
5) Extreme fatigue and Irritability

Type 2 Diabetes*

1) Any of the type 1 symptoms
2) Frequent infections
3) Blurred vision
4) Cuts/bruises that are slow to heal
5) Tingling/numbness in the hands/feet
6) Recurring skin, gum, or bladder infections

*Often people with type 2 diabetes have no symptoms

Causes

The cause of diabetes depends on the type. Type 2 diabetes is due primarily to lifestyle factors and genetics. Type 1 diabetes is also partly inherited and then triggered by certain infections. There is a genetic element in individual susceptibility to some of these triggers which has been traced to the genetic "self" identifiers relied upon by the immune system. However, even in those who have inherited the susceptibility, Type 1 diabetes seems to require an environmental trigger.

Western Medicine Treatment

Depending on what type of diabetes you have, blood sugar monitoring, insulin and oral medications may play a role in your treatment. A pancreas transplant may be an option for select people.

An important part of managing all types of diabetes includes maintaining a healthy weight through a healthy diet and exercise plan:

Healthy eating: Contrary to popular perception, there is no diabetes diet. You won't be restricted to boring, bland foods. Instead, you'll need plenty of fruits, vegetables and whole grains, foods that are high in nutrition and low in fat and calories, and fewer animal products and sweets. In fact, it is the best eating plan for the entire family. Even sugary foods are OK once in a while, as long as they're included in your meal plan.

Yet understanding what and how much to eat can be a challenge. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle. Once you have covered the basics, remember the importance of consistency. To keep your blood sugar on an even keel, try to eat the same amount of food with the same proportion of carbohydrates, proteins and fats at the same time every day.

Physical activity: Everyone needs regular aerobic exercise, and people who have diabetes are no exception. Exercise lowers your blood sugar level by transporting sugar to your cells, where it's used for energy. Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells. Get your doctor's OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes or more of aerobic exercise most days of the week. If you haven't been active for a while, start slowly and build up gradually.

Treatment for Type 1 and Type 2 diabetes primarily involves monitoring of your blood sugar along with insulin, other diabetes medications or both.

Monitoring your blood sugar: Depending on your treatment plan, you may check and record your blood sugar level several times a week to several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.

Even if you eat on a rigid schedule, the amount of sugar in your blood can change unpredictably. With help from your diabetes treatment team, you will learn how your blood sugar level changes in response to things like food, physical activity, medications, illness, alcohol, stress and, for women, fluctuations in hormone levels.

In addition to daily blood sugar monitoring, your doctor may recommend regular A1C testing to measure your average blood sugar level for the past two to three months. Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working overall. An elevated A1C level may signal the need for a change in your insulin regimen or meal plan. Your target A1C goal may vary depending on your age and various otherfactors. However, for most people, the American Diabetes Association recommends an A1C of below 7 percent. Ask your doctor what your A1C target is.

Insulin: Anyone who has Type 1 diabetes needs insulin therapy to survive. Some people with Type 2 diabetes may need insulin, as well. Because stomach enzymes interfere with insulin taken by mouth, oral insulin is not an option for lowering blood sugar. Often, insulin is injected using a fine needle and syringe.

An insulin pump also may be an option. The pump is a device about the size of a cell phone worn on the outside of your body. A tube connects the reservoir of insulin to a catheter that's inserted under the skin of your abdomen. The pump is programmed to dispense specific amounts of insulin automatically. It can be adjusted to deliver more or less insulin depending on meals, activity level and blood sugar level.

Many types of insulin are available, including rapid-acting insulin, long-acting insulin and intermediate options. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night. Sometimes other oral or injected medications are prescribed as well. Some diabetes medications stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells. Still others block the action of stomach enzymes that break down carbohydrates or make your tissues more sensitive to insulin. Your doctor might prescribe low-dose aspirin therapy to help prevent cardiovascular disease.

Transplantation: In some people who have Type 1 diabetes, a pancreas transplant may be an option. Other types of transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy. But pancreas transplants are not always successful, and the procedure poses serious risks. You would need a lifetime of potent immune-suppressing drugs to prevent organ rejection. These drugs can have serious side effects,including a high risk of infection, organ injury and cancer. Because the side effects can be more dangerous than the diabetes, pancreas transplants are usually reserved for people whose diabetes can not be controlled or those who have serious complications.

Treatment for gestational diabetes
Controlling your blood sugar level is essential to keeping your baby healthy and avoiding complications during delivery. In addition to maintaining a healthy diet and exercising, your treatment plan may include monitoring your blood sugar and, in some cases, using insulin.

Your health care provider will also monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin, which can lead to low blood sugar right after birth.

Treatment for prediabetes

If you have prediabetes, healthy lifestyle choices can help you bring your blood sugar level back to normal or at least keep it from rising toward the levels seen in Type 2 diabetes. Maintaining a healthy weight through exercise and healthy eating can help.

Sometimes medications such as the oral diabetes drugs metformin (Glucophage) and acarbose (Precose), also are an option if you are at high risk of diabetes. This includes if your prediabetes is worsening or you have cardiovascular disease, fatty liver disease or polycystic ovary syndrome.

In other cases, medications to control cholesterol or statins, in particular, and high blood pressure medications are needed to achieve desired goals. Your doctor might prescribe low-dose aspirin therapy to help prevent cardiovascular disease. Healthy lifestyle choices remain key, however.

Adopted from Wei Laboratories, Inc.