What Is Diabetes?

Diabetes mellitus is a medical condition where your blood sugar is too high.  It affects over 18 million people in the United States, that’s 6.3% of the population. In 2002, 1.3 million new cases were diagnosed, according to the Nation Institute of Health in Washington, DC. Sadly, in 2002, it was the 6th leading cause of death in people over age 20.  Let’s begin by talking about what diabetes is, then the symptoms and treatment. Finally, we’ll talk about related health problems that can occur.

Some sugar is needed in the blood to give your body energy, but too much can be harmful. It’s caused when your body’s insulin, a hormone, is not enough to control the amount of sugar in the blood stream. Your body either cannot produce enough insulin, or produces none at all from the pancreas.  

Healthy people have sugar levels between 70-120mg/dl.   A person with diabetes can have sugar levels as high as 400mg/dL or more.   If left uncontrolled, long-term health problems are inevitable.  Meanwhile, mildly elevated blood sugar can make you feel nauseous, confused, thirsty, or have to urinate frequently.

Diabetes is classified by whether your body produces any insulin at all.  Initially, because doctors notice that diabetes was most commonly diagnosed in children between 8-12 and then again in adults around age 40-60, the terms “Juvenile Onset” and “Adult Onset” were used.  A different classification system was developed when doctors noticed that similarities and differences among patients with diabetes that did not correlate with age.

It was discovered that diabetes occurs in two ways; when the pancreas stops functioning, producing no insulin at all, or when it does not make enough insulin.   Both children and adults were affected by either condition.  People who made no insulin at all were described as ”insulin-dependent”, those who produced some insulin “non-insulin dependent”.  You may have heard the terms IDDM and NIDDM used by healthcare providers.  Diabetes is now classified based on the presence or absence of insulin production. 

Type 1 Diabetes

Formerly called juvenile diabetes or insulin-dependent diabetes, Type 1 is usually first diagnosed in children, teenagers, or young adults.  Symptoms develop quickly, and may not even be noticed before you feel seriously ill.

The body’s immune system mistakenly attacks the beta cells of the pancreas where insulin is produced.  You can no longer make insulin after the beta cells are destroyed.   In order to keep your blood sugar from getting dangerously high, insulin from outside your body must be taken. Type1 diabetes must be treated by injecting insulin on a regular schedule. Some people use a syringe and needle, or, others wear an automatic pump that delivers a steady low level of insulin through a catheter placed in the abdomen.

Type 2 Diabetes

The most common form of diabetes is Type 2, also called adult-onset diabetes or non-insulin-dependent diabetes.  It can develop at any age.

This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly.  Blood sugar rises, demanding more insulin. The pancreas can work  harder for a while, by eventually, it loses the ability to make enough insulin to keep your blood sugar from getting too high. Excess weight and inactivity increase the risk of developing Type 2 Diabetes because they force the pancreas to work even harder.

Since there is some insulin produced, more treatment option are available. Many patients are able to control their blood sugar by reducing their weight and making dietary changes alone.  Increased exercise seems to have a very big impact on controlling blood sugar.  Medications to reduce blood sugar are available to augment lifestyle changes.   Your doctor may recommend a combination of diet and medication based on your individual medical condition.

Gestational Diabetes

Gestational diabetes is a form of Type 2 diabetes that occurs during pregnancy. The mother may not have enough insulin to keep her blood sugar in the normal range.  Hormones associated with pregnancy also contribute to the onset of gestational diabetes.  Often, strict dietary modification can keep the mother’s blood sugar in a healthy range.
Checking blood sugar levels at about 26-28 weeks is a routine part of pregnancy care all women should receive. While gestational diabetes often resolves after the baby is born, the mother has a higher risk of developing Type 2 diabetes later in life.

Could I have Diabetes?

Because we hear so much about the dangers of diabetes, you may be concerned that you have this condition.  

Symptoms of diabetes include:

• Excessive or frequent thirst


• Frequent need to urinate


• Increased hunger


• Weight loss that is not explained by dieting


• Feeling tired even if you are getting enough rest


• Cuts or sores that don’t heal


• Unexplained infections


• Dry, itchy skin


• Numbness or loss of feeling in hands or feet


• Changes in your eyesight such as blurriness

How Diabetes Can Affect Your Health

Diabetes affects every organ in our bodies. That’s because it our blood vessels are damaged when blood sugar is out of control. The most significant health problem caused by diabetes is heart disease.  When the blood supply to the heart is decreased, the heart muscle is damaged.   A diabetic person has the same  risk of a heart attack as someone who has already had a hear attack, even if they have never had any heart problems.

The other major systems affected by diabetes are the kidneys, eyes and nervous system.   Peripheral neuropathy, or numbness of the fingers and toes occurs when the nerves are starved of blood.  Neuropathy can be painful and also makes it easier to get cuts and scrapes.   Diminished blood supply then makes it easier for infections to occur, and harder for your body to fight them.   Finally, damage to the blood vessels of the eye can lead to vision loss and eventually blindness.

Staying Healthy if You have Diabetes