What is diabetes mellitus?

Diabetes mellitus (commonly referred to as diabetes) is a disease

of the pancreas, an organ behind your stomach that produces the
hormone insulin. Insulin helps the body use food for energy. When
a person has diabetes, the pancreas either cannot produce
enough insulin, uses the insulin incorrectly, or both. Insulin works
together with glucose (sugar) in the bloodstream to help it enter
the body's cells to be burned for energy. If the insulin isn't
functioning properly, glucose cannot enter the cells. This causes
glucose levels in the blood to rise, creating a condition of high
blood sugar or diabetes, and leaving the cells without fuel.

common types of diabetes:

There are two common forms of diabetes: type 1 and type 2.

Type 1: Type 1 diabetes occurs because the insulinproducing cells of the pancreas (beta cells) are damaged. In
type 1 diabetes, the pancreas makes little or no insulin, so
sugar cannot get into the body's cells for use as energy. People
with type 1 diabetes must use insulin injections to control their
blood glucose. Type 1 is the most common form of diabetes in
people under age 20-30, but it can occur at any age. Ten
percent of people with diabetes are diagnosed with type 1.

Type 2: In type 2 diabetes, the pancreas makes insulin,

but it either doesn't produce enough insulin or the insulin does
not work properly. Type 2 diabetes may sometimes be
controlled with a combination of diet, weight management and
exercise. However, treatment also may include oral glucoselowering medications or insulin injections.

Generally, type 2 diabetes is more common in people over

age 40 who are overweight. However, the prevalence of
obesity among people in North America has increased the
number of people under age 40 who are diagnosed with type
2 diabetes. Nine out of 10 people with diabetes have type 2.

Causes of diabetes:

Health care providers do not yet know what causes diabetes. The
following factors may increase your chance of getting diabetes:

Family history of diabetes or inherited tendency

African-American, Hispanic, Native American or AsianAmerican race or ethnic background
Being overweight (20 percent or more over your desired
body weight)
Physical stress (such as surgery or illness)
Use of certain medications, including steroid and blood
pressure medications
Injury to pancreas (such as infection, tumor, surgery or
accident)
Autoimmune disease
High blood pressure
Abnormal blood cholesterol or triglyceride levels
Age (risk increases with age)
Alcohol (risk increases with years of heavy alcohol use)
Smoking
Pregnancy (see What is gestational diabetes? on the
last page)

It is important to note that sugar itself does not cause diabetes.

Eating a lot of sugar can lead to tooth decay, but it does not cause
diabetes.
How

is diabetes diagnosed?

The preferred method of diagnosing diabetes is the fasting plasma

glucose test (FPG). The FPG measures your blood glucose level
after you have fasted (not eaten anything) for 10 to 12 hours.
Normal fasting blood glucose is between 70 and 100 mg/dl for
people who do not have diabetes. The standard diagnoses of
diabetes is made when:

A patient has a fasting blood glucose level of 126 mg/dl

or higher on two separate occasions; or

A patient has a random blood glucose level of 200 mg/dl

or greater and has common symptoms of diabetes, such as:

Increased thirst

Frequent urination
Increased hunger
Fatigue
Blurred vision
Weight loss
o
On occasion, an oral glucose tolerance test may aid
in the diagnosis of diabetes or an earlier abnormality that may
become diabetes - called impaired glucose tolerance.

Another test, the A1C test, measures your average percentage of

glycated hemoglobin, or HbA1c, in the blood. This test tells you
about your blood glucose control for the past 2 to 3 months. It
gives you an idea of how your treatment plan is coming along but
does not replace daily testing.
Other symptoms of diabetes may include:

Slow healing of sores or cuts

Itchy skin (usually in the vaginal or groin area); yeast
infections

Dry mouth

Some of the long-term complications of

diabetes:
Retinopathy (eye disease): All patients with diabetes should see an
ophthalmologist (eye specialist) yearly for a dilated eye
examination. Patients with known eye disease, symptoms of
blurred vision in one eye or who have blind spots may need to see
their ophthalmologist more frequently.
Nephropathy (kidney disease): Urine testing should be performed
yearly. Regular blood pressure checks also are important because
control of high blood pressure is essential in slowing kidney
disease. Generally, blood pressure should be maintained less than
130/80 in adults. Persistent leg or feet swelling also may be a
symptom of kidney disease and should be reported to your doctor.
Neuropathy (nerve disease): Numbness or tingling in your feet
should be reported to your doctor at your regular visits. You should
check your feet daily for redness, calluses, cracks or breakdown in

skin tissue. If you notice these symptoms before scheduled visits,

notify your doctor immediately.
Other long-term may complications include:

Eye problems including glaucoma and cataracts

Dental problems
High blood pressure
Heart disease

The keys to manage your diabetes:

Planning what you eat and following a balanced meal

plan

Exercising regularly
Taking medication, if prescribed, and closely following the
guidelines on how and when to take it

Monitoring your blood glucose and blood pressure levels

at home

Keeping your appointments with your health care

providers and having laboratory tests completed as ordered by
your doctor.

What you do at home every day affects your blood glucose more
than what your doctor can do every few months during your checkups.

Gestational diabetes
Gestational diabetes occurs when there is a high blood glucose
level during pregnancy. As pregnancy progresses, the developing
baby has an increased need for glucose. Hormone changes during
pregnancy also affect the action of insulin, resulting in high blood
glucose levels.
Pregnant women who have an increased risk of developing
gestational diabetes include those who:

Are over 25 years old

Are above their desired body weight

Have a family history of diabetes
Are Hispanic, African-American, Native American or AsianAmerican

Usually, blood glucose levels return to normal after childbirth.

However, women who have had gestational diabetes have an
increased risk of developing type 2 diabetes later in life