Diabetes is a metabolic disorder that is characterized by high blood glucose and either insufficient or ineffective insulin.  5.9% of the population in the United States has diabetes, and diabetes is the seventh leading cause of death in our country.  Diabetes is a chronic disease without a cure, however, with proper management and treatment, diabetics can live a normal, healthy lives.

Insulin

Insulin is a hormone secreted by specialized cells in the pancreas in response to (among other things), increased blood glucose concentration.  The primary role of insulin is to control the transport of glucose from the bloodstream into the cells.  After consuming a meal, insulin enhances the uptake of the energy nutrients (amino acids, glucose, and fatty acids).  Insulin helps maintain blood glucose within normal limits and stimulates protein synthesis, glucose synthesis in the liver and muscle, and fat synthesis. 

Without insulin, or when insulin is ineffective, glucose regulation falters and the metabolism of energy-yielding nutrients changes.  In diabetes, there is too much glucose in the blood.  When glucose builds in the blood instead of going into the cells, it can cause two problems:

• Your cells may become starved for energy
• Over time, high glucose blood levels may harm your kidneys, heart, eyes or nerves

There are two main types of diabetes, Type I and Type II, described below.

Type I Diabetes 
(a.k.a. Juvenile Onset Diabetes, Insulin-Dependant Diabetes)

Insulin-dependant is caused by damage to the pancreas.  The pancreas contains beta cells, which make insulin.  With Type I diabetes, the deficiency of insulin is due to a decline in the number of beta cells the pancreas contains.  It appears that certain genes make Type I diabetics more susceptible, but a triggering factor (usually a viral infection) sets it off.  In most people with Type I diabetes, the immune system makes a mistake, attacking the beta cells and causing them to die.  Without the beta cells, you cannot produce insulin.  Glucose then builds up in the blood and causes diabetes.

Type I diabetes exhibits the following warning signs:

• Losing weight without trying
• An increased need to urinate
• Increased hunger
• Increased thirst
• Trouble seeing
• Feeling tired and/or
• Going into a coma

For Type I diabetics, treatment usually consists of a healthy diet, exercise, and insulin shots to replace the insulin that your body no longer produces.    Most insulin-dependent diabetics test their blood at least four times per day to monitor their blood’s glucose level. This is necessary to keep their blood glucose within certain limits.  If blood glucose is not monitored, and if insulin levels are not kept in check, three things may happen:

1.   Ketoacidosis – occurs when your blood glucose levels are highly elevated, by either eating too much or taking too little insulin, by stress or illness.  In this case, there is too little insulin in the blood.  Your body then begins breaking down fat for energy, producing chemicals called ketones.  Ketones can make you throw up, have difficulty breathing, cause excessive thirst, cause dry, itchy skin, or even cause coma.

2.   Hypoglycemia – occurs when blood glucose levels become too low.  It can be cause by taking too much insulin, eating too little, skipping meals, eating at the wrong time, exercising too intensely or for too long, or by drinking alcohol on an empty stomach.  If your blood glucose is too low you may feel hungry, confused, tired, shaky or nervous. 

3.   Complications – elevated glucose levels in the blood over time can hurt your organs.  Diabetes can damage kidneys, eyes and nerves, and makes heart and blood vessel disease more likely.  Diabetics can defend themselves from complications by keeping their glucose levels under control.

Type II Diabetes
(a.k.a. Adult Onset Diabetes, Non-Insulin-Dependent Diabetes)

Type II diabetes is the most common form of diabetes, with about 90% of diabetes falling into the Type II category.  With Type II diabetes, glucose builds up in the blood – not because not enough insulin is present, but probably because cells lose their insulin receptors and become less sensitive to insulin.  Type II  diabetes usually (though not always) occurs in individuals who are over 40 years of age who are overweight.

Type II diabetes produces mild symptoms, and can be controlled with a healthy diet, exercise and weight loss.  Type II diabetics should also monitor their glucose levels to be sure they are maintaining healthy levels.  In some cases, weight loss, diet and exercise are not enough to control the glucose levels.  In those cases, your physician may control your diabetes by prescribing diabetes pills or insulin shots.

Type II diabetes can cause three types of problems:

1. High Blood Sugar – high glucose levels in the blood are most likely when you’re sick or under a lot of stress.  High blood sugar can cause you to have a headache, blurry vision, excessive thirst and an increased need to urinate, and cause dry, itchy skin.  Though less of a problem with Type II diabetes, ketones can build up in the blood when Type II diabetics have symptoms of high blood sugar, or when they are sick.
2. Low Blood Sugar – When blood sugar falls to low you may feel tired, shaky, nervous, hungry or confused.  It may be caused by taking too much diabetes medicine, eating too little or skipping meals, exercising too intensely or for too long, or from drinking alcohol without eating. 
3. Complications – Elevated blood glucose over many years can hurt organs, including the eyes, kidneys, and eyes.  It can also make heart and blood vessel disease more likely.  The best defense against complications is a careful monitoring of blood glucose, a healthy diet and exercise.

Risks for Diabetes

• Individuals with parents or siblings with diabetes
• People over the age of 45
• People who are overweight
• People who do not exercise regularly
• People with low HDL cholesterol or high triglycerides
• Certain racial and ethnic groups (African Americans, Latinos, Asians and Native Americans)
• Women who had gestational diabetes or who had a baby weighing 9 pounds or more at birth.

Warning Signs of Diabetes

For More Information, Contact

Contact the American Diabetes Association