What is diabetes?
Diabetes
is a condition that happens when your blood sugar (glucose) is too high. It
develops when your pancreas doesn’t make enough insulin or any at all, or when your body isn’t
responding to the effects of insulin properly. Diabetes affects people of all
ages. Most forms of diabetes are chronic (lifelong), and all forms are
manageable with medications and/or lifestyle changes.
Glucose
(sugar) mainly comes from carbohydrates in your food and drinks. It’s your body’s go-to source of
energy. Your blood carries glucose to all your body’s cells to use for energy.
When
glucose is in your bloodstream, it needs help — a “key” — to reach its final
destination. This key is insulin (a hormone). If your pancreas isn’t making enough
insulin or your body isn’t using it properly, glucose builds up in your
bloodstream, causing high blood sugar (hyperglycemia).
Over
time, having consistently high blood glucose can cause health problems, such
as heart disease, nerve damage and eye issues.
The
technical name for diabetes is diabetes mellitus. Another condition shares the
term “diabetes” — diabetes insipidus — but they’re distinct. They share the
name “diabetes” because they both cause increased thirst and frequent
urination. Diabetes insipidus is much rarer than diabetes mellitus.
What are the types of diabetes?
There
are several types of diabetes. The most common forms include:
- Type 2 diabetes: With this type, your body doesn’t make enough insulin
and/or your body’s cells don’t respond normally to the insulin (insulin resistance). This is the most common type of diabetes. It mainly
affects adults, but children can have it as well.
- Prediabetes: This type is the stage before Type 2 diabetes. Your
blood glucose levels are higher than normal but not high enough to be
officially diagnosed with Type 2 diabetes.
- Type 1 diabetes: This type is an autoimmune disease in which your immune system attacks and destroys insulin-producing cells in
your pancreas for unknown reasons. Up to 10% of people who have diabetes
have Type 1. It’s usually diagnosed in children and young adults, but it
can develop at any age.
- Gestational diabetes: This type develops in some people during pregnancy. Gestational diabetes usually goes away after
pregnancy. However, if you have gestational diabetes, you’re at a higher
risk of developing Type 2 diabetes later in life.
Other
types of diabetes include:
- Type 3c diabetes: This form of diabetes happens when your pancreas
experiences damage (other than autoimmune damage), which affects its
ability to produce insulin. Pancreatitis, pancreatic cancer, cystic fibrosis and hemochromatosis can all lead to pancreas damage that causes
diabetes. Having your pancreas removed (pancreatectomy) also results in Type 3c.
- Latent
autoimmune diabetes in adults (LADA):
Like Type 1 diabetes, LADA also results from an autoimmune reaction, but
it develops much more slowly than Type 1. People diagnosed with LADA are
usually over the age of 30.
- Maturity-onset
diabetes of the young (MODY):
MODY, also called monogenic diabetes, happens due to an inherited genetic mutation that affects how your body makes and uses
insulin. There are currently over 10 different types of MODY. It affects
up to 5% of people with diabetes and commonly runs in families.
- Neonatal
diabetes: This is a rare form of
diabetes that occurs within the first six months of life. It’s also a form
of monogenic diabetes. About 50% of babies with neonatal diabetes have the
lifelong form called permanent neonatal diabetes mellitus. For the other
half, the condition disappears within a few months from onset, but it can
come back later in life. This is called transient neonatal diabetes
mellitus.
- Brittle diabetes: Brittle diabetes is a form of Type 1 diabetes that’s
marked by frequent and severe episodes of high and low blood sugar levels.
This instability often leads to hospitalization. In rare cases, a pancreas transplant may be necessary to permanently treat brittle
diabetes.
What are the symptoms of diabetes?
Symptoms
of diabetes include:
- Increased thirst (polydipsia) and dry mouth.
- Frequent urination.
- Fatigue.
- Blurred vision.
- Unexplained weight loss.
- Numbness or
tingling in your hands or feet.
- Slow-healing sores or cuts.
- Frequent skin and/or vaginal yeast infections.
It’s
important to talk to your healthcare provider if you or your child has these
symptoms.
Additional
details about symptoms per type of diabetes include:
- Type
1 diabetes: Symptoms of T1D can develop
quickly — over a few weeks or months. You may develop additional symptoms
that are signs of a severe complication called diabetes-related ketoacidosis (DKA). DKA is life-threatening and requires immediate medical
treatment. DKA symptoms
include vomiting,
stomach pains, fruity-smelling breath and labored breathing.
- Type
2 diabetes and prediabetes:
You may not have any symptoms at all, or you may not notice them since
they develop slowly. Routine bloodwork may show a high blood sugar level
before you recognize symptoms. Another possible sign of prediabetes is
darkened skin on certain parts of your body (acanthosis nigricans).
- Gestational
diabetes: You typically won’t notice
symptoms of gestational diabetes. Your healthcare provider will test you
for gestational diabetes between 24 and 28 weeks of pregnancy.
How is diabetes diagnosed?
Healthcare
providers diagnose diabetes by checking your glucose level
in a blood test. Three tests can measure your blood glucose
level:
- Fasting blood glucose test: For this test, you don’t eat or drink anything except
water (fast) for at least eight hours before the test. As food can greatly
affect blood sugar, this test allows your provider to see your baseline
blood sugar.
- Random
blood glucose test: “Random”
means that you can get this test at any time, regardless of if you’ve
fasted.
- A1c: This test, also called HbA1C or glycated hemoglobin
test, provides your average blood glucose level over the past two to three
months.
To
screen for and diagnose gestational diabetes, providers order an oral
glucose tolerance test.
The
following test results typically indicate if you don’t have diabetes, have
prediabetes or have diabetes. These values may vary slightly. In addition,
healthcare providers rely on more than one test to diagnose diabetes.
How is diabetes managed?
Diabetes
is a complex condition, so its management involves several strategies. In
addition, diabetes affects everyone differently, so management plans are highly
individualized.
The
four main aspects of managing diabetes include:
- Blood sugar monitoring: Monitoring your blood sugar (glucose) is key to
determining how well your current treatment plan is working. It gives you
information on how to manage your diabetes on a daily — and sometimes even
hourly — basis. You can monitor your levels with frequent checks with a
glucose meter and finger stick and/or with a continuous glucose
monitor (CGM). You and your healthcare provider will determine the
best blood sugar range for you.
- Oral diabetes medications: Oral diabetes medications (taken by mouth) help
manage blood sugar levels in people who have diabetes but still produce
some insulin — mainly people with Type 2 diabetes and prediabetes. People
with gestational diabetes may also need oral medication. There are several
different types. Metformin is the most common.
- Insulin: People with Type 1 diabetes need to inject synthetic
insulin to live and manage diabetes. Some people with Type 2 diabetes also
require insulin. There are several different types of synthetic insulin.
They each start to work at different speeds and last in your body for
different lengths of time. The four main ways you can take insulin
include injectable
insulin with a syringe
(shot), insulin pens, insulin pumps and rapid-acting
inhaled insulin.
- Diet: Meal planning and choosing a healthy diet for you are
key aspects of diabetes management, as food greatly impacts blood sugar.
If you take insulin, counting carbs in the food and drinks you consume is
a large part of management. The amount of carbs you eat determines how
much insulin you need at meals. Healthy eating habits can also help you
manage your weight and reduce your heart disease risk.
- Exercise: Physical activity increases insulin sensitivity (and
helps reduce insulin resistance), so regular exercise is an important part
of management for all people with diabetes.
Due
to the increased risk for heart disease, it’s also important to maintain a
healthy:
- Weight.
- Blood pressure.
- Cholesterol.
- beta cyclodextrin as a cholesterol reducing agent
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