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What is Diabetes?Diabetes Mellitus (DM) is a disorder of inadequate insulin production or the body's ability to use insulin for uptake of glucose into body cells. Normally, when carbohydrate is ingested, serum glucose levels rise and stimulate insulin secretion. When this secretion is impaired or absent, hyperglycemia or abnormally high blood glucose occurs, resulting in the symptoms and many tissue complications of diabetes. Almost 17 million people or 6.2% of the population in the U.S. have diabetes. It is estimated that by 2025, 8.9% will have diabetes. About one million people are diagnosed annually. Diabetes MellitusA deficiency in insulin or the body's ability to use it for glucose metabolism. |
The incidence includes both diagnosed and undiagnosed diabetes defined by fasting plasma glucose >= (greater than or equal to) 126 mg/dL (milligrams per deciliter). | |||||
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Three Main Types of Diabetes | ||||||
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Type 1: insulin production is absent. Treatment consists of restricted diet, exercise, and daily insulin injections. Onset usually occurs in childhood. Type 2: the insulin produced is inadequate to lower blood sugar and may involve impaired insulin-receptor function in body cells. Type 2 diabetes is usually of adult-onset, frequently associated with obesity, and is usually treated with diet, exercise, and oral medication. It can be secondary to hormonal, pancreatic, or drug-induced disorders. |
Gestational: occurs during pregnancy when sugar threshold is lowered. As high blood sugar can adversely affect the fetus, good control is important. In most women, glucose levels return to normal after delivery. | ||||
Insulin and Pancreatic Function | ||||||
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Symptoms |
Glucose Tests | |||||
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Because high blood glucose spills into the urine, more fluid is required to remove it. This causes increased thirst and frequent urination. Impaired cellular uptake of glucose results in weakness, fatigue, and weight loss. When cell deficit is severe, fats are broken down to supply energy. This results in acid and ketone release which, if untreated, leads to acidosis and coma. High blood glucose also fosters bacterial and yeast infections in the mucus membranes, skin, and urinary tract. |
Increased ThirstFrequent UrinationWeakness, FatigueBlurred VisionWeight LossFrequent InfectionsDelayed Healing |
An overnight fasting blood sugar (FBS) in the healthy adult is 70-110 mg/dL. FBS >= 126 mg/dL on two occasions, or a random sample of >= 200 mg/dL, with other symptoms, suggests DM. A Glucose Tolerance Test (GTT), in which oral glucose is given to stimulate insulin secretion while blood samples are drawn over a three-hour period, will show a 2-hr serum glucose >= 200 mg/dL in the diabetic.
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Control and Complications
Good control can sharply reduce the later complications of hyperglycemia. These include blood vessel disease, eye disorders such as glaucoma and diabetic retinopathy, blindness, kidney failure, nerve damage, gangrene, and amputation. Links of Interest |
Social ImpactDiabetes is one of the leading causes of death and disability in the U.S. and affects an estimated 10-15% of persons over age 50. In 1997, diabetes cost the U.S. $98 billion: $54 billion for disability, sick leave, and premature death; $44 billion for medical treatment and care, supplies, and hospitalization.
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Pre-Diabetes is a recent classification to identify those at high risk. These include persons with impaired fasting glucose (IFG) >= 126 mg/dL or impaired GTT (IGT) where the 2-hr plasma glucose is 140-200 mg/dL. While many will not develop DM, annual glucose testing, dietary restriction, and exercise are advised.
A number of studies have shown that type 2 diabetes can be delayed or prevented by a change in lifestyle.
Diet and exercise lower diabetic risk, particularly in those who are obese, sedentary, or have impaired glucose tolerance. Smoking cessation also lowers risk.)