About diabetes: Symptoms, causes, treatment

• What is diabetes?
  
• Types of diabetes
• Symptoms of diabetes
• Causes of diabetes
• How is diabetes diagnosed?
• Can diabetes be prevented or avoided?
• Treatment for diabetes
• Lifestyle of people with diabetes

What is diabetes?

Diabetes is a disease that occurs when the body does not produce or does not properly use the hormone insulin. This causes too much glucose (sugar) in the blood. There are 2 main types of diabetes.

Types of diabetes

Type 1 diabetes occurs when your body does not produce insulin. It is sometimes called juvenile diabetes, since it is usually discovered in children and adolescents, but it can also occur in adults.

Type 2 diabetes occurs when your body does not produce enough insulin or does not use insulin as it should. In the past, doctors believed that only adults were at risk of developing type 2 diabetes. However, an increasing number of children are now being diagnosed with this disease. Doctors believe that this increase is caused by the fact that more and more children are overweight or obese and are less physically active.

Prediabetes occurs when blood sugar levels are higher than they should be, but not high enough to be officially diagnosed as diabetes. Prediabetes greatly increases the risk of developing type 2 diabetes. The good news is that if you have prediabetes, you can prevent or delay the onset of type 2 diabetes by making lifestyle changes. These include eating a healthy diet, achieving and maintaining a healthy weight, and exercising regularly.

Symptoms of diabetes

Symptoms vary from person to person. The early stages of diabetes have very few symptoms, and for this reason, many people don't know they have diabetes. But problems with the eyes, kidneys and cardiovascular system can occur. Common symptoms include:

• Extreme hunger
• Extreme thirst
• Frequent urination
• Unexplained weight loss
• Fatigue or drowsiness
• Blurred vision
• Slow healing of wounds or bruises
• Dry, itchy skin
• Tingling or numbness in the hands or feet
• Frequent or recurring infections of the skin, gums or bladder

Also, people who have type 2 diabetes may show signs of insulin resistance. Symptoms may include darkening of the skin around the neck or in the armpit area, high blood pressure, cholesterol problems, infections, and delayed or absent menstruation in adolescents and women.

Uncontrolled type 2 diabetes may also include:

• Nausea or repeated vomiting.
• Deeper, faster breathing.
• Weakness, drowsiness, trembling, confusion or dizziness.
• Uncoordinated muscle movement.

If diabetes is left untreated, blood sugar levels become too high. When this happens, symptoms can include shortness of breath, abdominal pain, vomiting, dehydration, and even coma and death.

Causes of diabetes

Type 1 diabetes

In type 1 diabetes, your body does not produce insulin. This is caused by the immune system attacking and destroying the cells in the pancreas that form insulin. Doctors are not sure why this happens.

Type 2 diabetes

When you eat, your body converts most of the food you digest into glucose (a form of sugar). A hormone called insulin allows this glucose to enter all the cells of the body, where it is used for energy. Insulin is produced by the pancreas. In the case of a person who has type 2 diabetes, the pancreas does not produce enough insulin, or the body's cells cannot use insulin properly (called insulin resistance). This causes glucose to build up in the blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems affecting the blood vessels, nerves, heart, eyes and kidneys.

Risk factors for type 2 diabetes

Certain risk factors for type 2 diabetes include:

Weight. Obesity is the most important risk factor for type 2 diabetes. The more overweight you are, the more resistant your body is to insulin. To find out if you are overweight, talk to your doctor. A healthy, low-fat diet and regular exercise can help you gradually lose weight and maintain your weight.

Age. The risk of type 2 diabetes increases with age, especially after you turn 45. Although you cannot change your age, you can work on other factors to reduce your risk of diabetes.

Family history. You also cannot change your family history, but it is important for the doctor to know whether diabetes is or has been present in the family. The risk of diabetes is higher if your mother, father, sibling or other close relatives have diabetes. Remember to tell your doctor if someone in your family suffers from diabetes.

Pregnancy. Gestational diabetes is a type of diabetes that occurs only during pregnancy. Although gestational diabetes goes away after pregnancy, approximately half of women who have had gestational diabetes are diagnosed with type 2 diabetes within 15 years. Even if they did not have gestational diabetes, women who give birth to babies weighing 4 kilograms or more are more likely to develop type 2 diabetes later in life. The American Academy of Family Physicians (AAFP) recommends screening for gestational diabetes in pregnant women after the 24th week of pregnancy. The AAFP considers that there is not enough evidence to determine the benefits and harms of screening for gestational diabetes in pregnant women before week 24 of pregnancy.

Polycystic ovary syndrome. This is a condition that occurs when an imbalance of hormone levels in a woman's body causes cysts to form on the ovaries. Women who have polycystic ovary syndrome have an increased risk of developing type 2 diabetes.

Smoking and alcohol. Consuming alcohol and tobacco can increase the risk of type 2 diabetes. You should quit smoking as soon as possible. One serving of alcohol per day, with a meal, does not cause major harm. A serving means a small glass of wine. The less alcohol you consume, the better.

Race/ethnic background. Some ethnic groups have a higher risk of diabetes than others, including:

• Native American
• Hispanic American
• African American

The risk of developing type 2 diabetes increases with the number of risk factors you have. If you have 2 or more risk factors, talk to your doctor about how you can delay or prevent type 2 diabetes.

How is diabetes diagnosed?

After the examination, and explaining your symptoms and family history, your doctor may test for diabetes if they suspect you may have this disease. To check for diabetes, your doctor may request the following tests:

Blood sugar test

This test is usually done in the morning, after an 8-hour fast (you don't eat or drink anything, except water, for 8 hours before the test). The blood test involves inserting a small needle into a vein in your arm to draw blood. This blood will be sent to a laboratory for testing. If your blood sugar level is 126 milligrams per deciliter (mg/dL) or higher, the doctor will probably recommend repeating the test. A blood sugar level of 126 milligrams per deciliter (mg/dL) or higher on 2 tests indicates the presence of diabetes.

Glucose tolerance test

During this test, you will drink a beverage containing 75 grams of glucose dissolved in water. This drink tastes like sweet water. Two hours later, a doctor or nurse will measure the amount of glucose in your blood. A blood sugar level of 200 mg/dL or higher indicates diabetes.

Random blood sugar test

This test measures the level of glucose in the blood at any time of the day. It doesn't matter when you last ate. Combined with the symptoms of diabetes, a blood glucose level of 200 mg/dL or higher indicates diabetes.

A1C blood test

This test provides information about a person's average blood sugar levels over the past 3 months. Results are reported as a percentage. A normal A1C level is below 5.7%. If your A1C is higher than this value, it means your blood sugar has been higher than normal. A test result of 6.5% or higher indicates diabetes. A result between 5.7 and 6.4 indicates prediabetes.

Doctors are encouraged to refer patients with abnormal blood sugar levels to behavioral counseling, to promote healthy eating and physical activity.

Can diabetes be prevented or avoided?

Talk to your doctor about the risk factors for diabetes. Although you may not be able to change or eliminate all the factors, you can make changes to significantly reduce your risk.

Exercise and weight control

Exercise and maintaining a healthy weight can reduce the risk of diabetes. Any amount of activity is better than being sedentary. Try to exercise for 30 to 60 minutes on most days of the week. Always talk to your doctor before starting an exercise program.

Diet

A diet high in fat, calories and cholesterol increases the risk of diabetes. A poor diet can lead to obesity (another risk factor for diabetes) and other health problems. A healthy diet is high in fiber and low in fat, cholesterol, salt and sugar. Also, don't forget to watch your portion sizes. How much you eat is just as important as what you eat.

Treatment for diabetes

Although diabetes cannot be cured, you can still live a long and healthy life. The most important thing you can do is control your blood sugar level. You can do this by eating properly, exercising, maintaining a healthy weight, and, if necessary, taking oral medications or insulin.

Diet for diabetes

Your diet should include plenty of complex carbohydrates (such as whole grains), fruits and vegetables. It is important to eat at least 3 meals a day and never skip a meal. Eat at roughly the same time every day. This helps you keep your insulin and sugar at a constant level. Avoid empty calories, such as foods high in sugar and fat, or alcohol.

Exercise

Physical exercise helps the body use insulin and lowers your blood sugar level. Exercise helps you control your weight, gives you more energy, and is good for your overall health. Also, physical exercise is good for the heart, cholesterol level, blood pressure and weight. These are all factors that can increase the risk of heart attack and stroke. Talk to your doctor about starting an exercise program.

Maintaining a healthy weight

Losing excess weight and maintaining a healthy body weight gives you two benefits. First, it helps insulin work better in your body. Second, a healthy weight helps lower blood pressure and reduces the risk of heart disease.

Medications for diabetes

If your diabetes cannot be controlled with diet, exercise and weight control, your doctor may recommend medication or insulin. Most people who have type 2 diabetes start with a medication taken orally. Oral medications can help the body produce more insulin. They also help the body use the insulin it produces more effectively. Some people need to add insulin to their body with the help of injections, pens or insulin pumps. Always take medications exactly as prescribed by your doctor. Oral medication does not work for everyone. It is not effective in treating type 1 diabetes. Insulin therapy is necessary for all people who have type 1 diabetes and for some people who have type 2 diabetes. If you need insulin, you will need to give yourself an injection (either with a syringe or a pen). Your doctor will tell you what kind of medication you should take and why.

Your doctor will test your blood sugar every 3 months with an A1C test. You can also test your blood sugar yourself throughout the day. You will need to use a blood glucose monitor to check the level yourself. This involves pricking your finger to draw blood and placing a test strip in the blood to get the results. If your blood sugar level becomes too low, you may feel tired, have trouble with muscle coordination, sweat, have difficulty thinking or speaking clearly, feel faint, or lose consciousness. At the earliest sign of any of these symptoms, eat or drink something that will quickly raise your blood sugar. This could include candy, juice, milk or raisins. If you don't feel better within 15 minutes, or if monitoring shows that your blood sugar level is still too low, eat or drink something else to raise your blood sugar quickly. Always keep something sweet on hand for emergencies.

You may not know whether your blood sugar is too high unless you test it yourself. However, you may show common symptoms, such as frequent urination, extreme thirst, blurred vision and a feeling of fatigue. Some factors unrelated to food can raise blood sugar. These include incorrect testing, overeating during a meal, certain illnesses, hormonal changes and stress.

If your blood sugar level is too high and you take insulin, you may need to take an additional dose of fast-acting insulin to bring it back to normal. Your doctor can tell you how much insulin you need to take to lower your blood sugar level.

Lifestyle of people with diabetes

You can live a normal life with well-controlled diabetes. However, you must pay attention to diet, weight, exercise and medication. If you don't control your diabetes, you will have too much glucose in your blood. This can lead to serious health problems, including heart disease and damage to the nerves and kidneys. These are known as diabetic complications.

Diabetic complications

Complications include:

Diabetic neuropathy (nerve damage)

This prevents the nerves from properly sending messages to the brain and other parts of the body. You may lose sensation in certain parts of the body, or you may have tingling or burning sensations. Neuropathy most often affects the feet and soles. If you have neuropathy, you may not be able to feel a wound on your foot. The wound can become infected. In severe cases, the foot may be amputated (removed). People with neuropathy may continue to walk on a foot that has damaged joints or bones. This can lead to a condition called Charcot foot. Charcot foot causes swelling and instability of the injured foot. It can also cause deformity of the foot. However, this problem can often be avoided. Check your feet every day. See your doctor immediately if you notice swelling, redness, and feel warmth in your foot. These may be signs of Charcot foot. Your doctor should check your feet frequently. Also, neuropathy can cause erectile dysfunction in men and vaginal dryness in women.

Diabetic retinopathy (eye problems)

This affects the part of the eye called the retina. It is the part of the eye that is sensitive to light and sends messages to your brain about what you see. Diabetes can damage and weaken the small blood vessels in the retina. When the retina's blood vessels are damaged, fluid can leak from them and cause swelling in the macula. The macula is the part of the retina that gives you sharp and clear vision. The swelling and fluid can cause blurred vision. This will make it harder for you to see. If retinopathy worsens, it can lead to blindness. Laser surgery can often be used to treat or slow down retinopathy, if it is discovered early. People who have diabetes should have an eye exam once a year. See your doctor if you have blurred vision for more than 2 days, sudden loss of vision in 1 or both eyes, gray, black or moving spots, flashing lights, or pain or pressure in the eye.

Diabetic nephropathy (kidney damage)

This is damage to the blood vessels in the kidneys. This means your kidneys have trouble filtering waste. Some people who have diabetic nephropathy will eventually need dialysis (a treatment performed with an automated machine that removes waste from the blood) or a kidney transplant. The risk of nephropathy is increased if you have diabetes and high blood pressure, which is why it is important to control both conditions. Protein in the urine is usually the first sign of nephropathy. This should be checked annually.

Heart disease and stroke

People who have diabetes have a higher risk of heart disease and stroke. The risk is even higher for people who have diabetes and smoke, have high blood pressure, have a family history of heart disease, or are overweight. Heart disease is easiest to treat when it is detected earlier. It is very important to visit your doctor regularly. The doctor can perform tests to look for early signs of heart disease. These tests include checking cholesterol levels. If your cholesterol level is higher than the recommended level, the doctor will talk to you about lifestyle changes and medications that help you control your cholesterol.

The longer diabetes is left uncontrolled, the more damage you will cause to your health. This is why treatment is important at any age. Keeping your blood sugar level very close to ideal can minimize, delay, and in some cases even prevent the problems that diabetes can cause.