Diabetes

What is diabetes?

Diabetes, also known as diabetes mellitus, is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your body's main source of energy. Your body can make glucose, but it also comes from the food you eat. Insulin is a hormone made by your pancreas. Insulin helps move glucose from your bloodstream into your cells, where it can be used for energy.

If you have diabetes, your body can't make insulin, can't use insulin as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells. This can cause glucose levels to get too high. Over time, high blood glucose levels can lead to serious health conditions. But you can take steps to manage your diabetes and try to prevent these health problems.

What are the types of diabetes?

There are different types of diabetes:

Type 1 diabetes. If you have type 1 diabetes, your body makes little or no insulin. It happens when your immune system attacks and destroys the cells that produce insulin.
Type 2 diabetes. This is the most common form of diabetes. If you have type 2 diabetes, your body may still be able to make insulin, but your cells don't respond well to insulin. They can't easily take up enough glucose from your blood.
Gestational diabetes. This is a form of diabetes that develops during pregnancy. It happens when your body can't make the extra insulin it needs during pregnancy.

What causes diabetes?

The different types of diabetes have different causes:

Researchers think type 1 diabetes is caused by genes and factors in the environment that might trigger the disease.
Type 2 diabetes is caused by several factors, including lifestyle factors and genes. The lifestyle factors include not being physically active and being overweight or having obesity.
Researchers think gestational diabetes is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.

Who is more likely to develop diabetes?

The different types of diabetes have different risk factors:

You can develop type 1 diabetes at any age, but it most often starts in childhood. Having a parent or sibling with type 1 diabetes may increase your chance of developing it.
You are at higher risk of developing type 2 diabetes if you:

Are overweight or have obesity.
Are over age 35. Children, teenagers, and younger adults can get diabetes, but it is more common in middle-aged and older adults.
Have a family history of diabetes.
Have prediabetes. This means that your blood glucose is higher than normal, but it's not high enough to be called diabetes.
Had gestational diabetes.
Have given birth to a baby weighing 9 pounds or more.
Are African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
Are not physically active.
Have certain other health conditions, such as high blood pressure or polycystic ovary syndrome (PCOS).

You are at higher risk of developing gestational diabetes if you:

Are overweight or have obesity.
Have a family history of diabetes.
Had gestational diabetes in a previous pregnancy.
Have given birth to a baby weighing 9 pounds or more.
Have polycystic ovary syndrome (PCOS).
Are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander.

What are the symptoms of diabetes?

The symptoms of diabetes may include:

Feeling very thirsty
Feeling very hungry
Urinating (peeing) more often, including at night
Fatigue
Blurry vision
Numbness or tingling in the feet or hands
Sores that do not heal
Losing weight without trying

But it's important to know that your symptoms may vary, depending on which type you have:

The symptoms of type 1 diabetes usually come on quickly and can be severe.
With type 2 diabetes, the symptoms often develop slowly, over several years. The symptoms can be so mild that you might not even notice them.
Gestational diabetes often has no symptoms. If you do have symptoms, they may be mild. People who are pregnant are usually screened for this condition between 24 and 28 weeks of pregnancy.

How is diabetes diagnosed?

To find out if you have diabetes, your health care provider will use one or more glucose blood tests. There are several types, including the A1C test.

What are the treatments for diabetes?

Treatment for diabetes involves managing your blood glucose levels:

If you have type 1 diabetes, you will need to take daily doses of insulin, either by injection or through a special pump. Some people also need to take another type of diabetes medicine that works with insulin.
If you have type 2 diabetes, you may be able to manage or even reverse it by making lifestyle changes. These include eating a healthy diet, staying at healthy weight, and getting regular physical activity. Some people also need to take diabetes medicines to manage their diabetes.
If you have gestational diabetes, you may be able to lower your glucose levels by eating a healthy diet and getting regular exercise. But be sure to talk to your provider about your treatment options. Gestational diabetes usually goes away after you give birth. But you will have a higher risk of developing type 2 diabetes later.

Checking your blood glucose levels is also an important part of managing your diabetes. Ask your provider about the best way to check your blood glucose level and how often you should check it.

Can diabetes be prevented?

Type 1 diabetes can't be prevented.

You may be able to delay or prevent type 2 diabetes through the same lifestyle changes that are used to manage diabetes (eating a healthy diet, staying at a healthy weight, and getting regular physical activity). These lifestyle changes may also help prevent gestational diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes Type 1

Diabetes means your blood glucose, or blood sugar, levels are too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth.

Type 1 diabetes happens most often in children and young adults but can appear at any age. Symptoms may include:

Being very thirsty
Urinating often
Feeling very hungry or tired
Losing weight without trying
Having sores that heal slowly
Having dry, itchy skin
Losing the feeling in your feet or having tingling in your feet
Having blurry eyesight

A blood test can show if you have diabetes. If you do, you will need to take insulin for the rest of your life. A blood test called the A1C can check to see how well you are managing your diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes Type 2

What is type 2 diabetes?

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

What causes type 2 diabetes?

Type 2 diabetes may be caused by a combination of factors:

Being overweight or having obesity
Not being physically active
Genetics and family history

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

Who is at risk for type 2 diabetes?

You are at higher risk of developing type 2 diabetes if you:

Are over age 45. Children, teenagers, and younger adults can get type 2 diabetes, but it is more common in middle-aged and older people.
Have prediabetes, which means that your blood sugar is higher than normal but not high enough to be called diabetes
Had diabetes in pregnancy or gave birth to a baby weighing 9 pounds or more.
Have a family history of diabetes
Are overweight or have obesity
Are Black or African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
Are not physically active
Have other conditions such as high blood pressure, heart disease, stroke, polycystic ovary syndrome (PCOS), or depression
Have low HDL (good) cholesterol and high triglycerides
Have acanthosis nigricans - dark, thick, and velvety skin around your neck or armpits

What are the symptoms of type 2 diabetes?

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

Increased thirst and urination
Increased hunger
Feeling tired
Blurred vision
Numbness or tingling in the feet or hands
Sores that do not heal
Unexplained weight loss

How is type 2 diabetes diagnosed?

Your health care provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

A1C test, which measures your average blood sugar level over the past 3 months
Fasting plasma glucose (FPG) test, which measures your current blood sugar level. You need to fast (not eat or drink anything except water) for at least 8 hours before the test.
Random plasma glucose (RPG) test, which measures your current blood sugar level. This test is used when you have diabetes symptoms and the provider does not want to wait for you to fast before having the test.

What are the treatments for type 2 diabetes?

Treatment for type 2 diabetes involves managing your blood sugar levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine:

A healthy lifestyle includes following a healthy eating plan and getting regular physical activity. You need to learn how to balance what you eat and drink with physical activity and diabetes medicine, if you take any.
Medicines for diabetes include oral medicines, insulin, and other injectable medicines. Over time, some people will need to take more than one type of medicine to control their diabetes.
You will need to check your blood sugar regularly. Your health care provider will tell you how often you need to do it.
It's also important to keep your blood pressure and cholesterol levels close to the targets your provider sets for you. Make sure to get your screening tests regularly.

Can type 2 diabetes be prevented?

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes and Pregnancy

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

What is gestational diabetes?

Some people already have diabetes before they get pregnant. But others may develop diabetes during pregnancy. This type of diabetes is called gestational diabetes. It usually develops around the 24th week of pregnancy. It happens when your body can't make the extra insulin it needs during pregnancy. Researchers think gestational diabetes is caused by the hormonal changes of pregnancy, along with genetic and lifestyle factors.

Who is more likely to develop gestational diabetes?

Anyone who is pregnant could develop gestational diabetes. But you are more likely to develop it if you:

Are overweight or have obesity
Have a family history of diabetes
Had gestational diabetes in a previous pregnancy
Have given birth to a baby weighing 9 pounds or more
Have polycystic ovary syndrome (PCOS)
Are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander person

How do I know if I have gestational diabetes?

Gestational diabetes often has no symptoms. If you do have symptoms, they may be mild, such as being thirstier than normal or having to urinate (pee) more often.

If you are pregnant, you will most likely be screened for gestational diabetes between 24 and 28 weeks of pregnancy. But if you have an increased chance of developing gestational diabetes, you may be tested during your first prenatal visit. Your health care provider will use one or more blood glucose tests to check for gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test (OGTT), or both.

For these two tests, you will drink a sugary liquid and wait for an hour before your blood sample is taken. If you have an oral glucose tolerance test, you will also get your blood drawn after 2 and 3 hours.

How can diabetes affect my pregnancy?

Having diabetes during pregnancy can affect your health. For example:

You are more likely to develop preeclampsia, a serious medical condition that causes a sudden increase in your blood pressure.
You are more likely to need a cesarean delivery, because your baby is more likely to be bigger than average.
Changes to your hormones and your body during pregnancy can affect your blood glucose levels. If you had diabetes before pregnancy, you may now need to adjust your meal plan, physical activity routine, and/or medicines. If you have any diabetes health problems, they may get worse during pregnancy.
Gestational diabetes usually goes away after you have your baby. But you will be at higher risk of developing type 2 diabetes later.

Having diabetes during pregnancy can also affect the health of your developing baby:

If you have high blood glucose levels at the beginning of your pregnancy, there is a higher risk of birth defects.
Your baby will be at risk for obesity and type 2 diabetes later in life.
Your baby is more likely to be born early.
Your baby may have breathing problems or hypoglycemia (low blood glucose levels) right after birth.
There is a higher risk of miscarriage and stillbirth.

How can I manage diabetes during pregnancy?

There are steps you can take to manage your diabetes before, during, and after pregnancy.

If you already have diabetes, the best time to control your blood glucose is before you get pregnant. High blood glucose levels can be harmful to your developing baby during the first weeks of pregnancy, even before you know you are pregnant. See your provider to help you plan for pregnancy. You can talk about how to lower the risk of health problems for you and your developing baby. You can also discuss your diet, physical activity, and which diabetes medicines are safe during pregnancy.

During your pregnancy, you will work with your provider to manage your blood glucose levels. You may be able to manage them with a healthy diet and regular physical activity. If that's not enough, then you will need to take diabetes medicines. It's also important that you:

Get regular prenatal checkups
Take your prenatal vitamins
Don't use harmful substances such as alcohol, tobacco, and illegal drugs

After pregnancy, there are steps you need to take to stay healthy:

If you had gestational diabetes, you are at risk of developing type 2 diabetes. You will be tested for it within 4 to 12 weeks after giving birth. Even if your blood glucose levels have returned to normal, you will need to get them tested every 1 to 3 years.
If you already had diabetes before pregnancy, you and your provider will monitor changes to your blood glucose levels. They will tell you if you need to adjust your diabetes management plan.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes in Children and Teens

Until recently, the common type of diabetes in children and teens was type 1. It was called juvenile diabetes. With Type 1 diabetes, the pancreas does not make insulin. Insulin is a hormone that helps glucose,or sugar, get into your cells to give them energy. Without insulin, too much sugar stays in the blood.

Now younger people are also getting type 2 diabetes. Type 2 diabetes used to be called adult-onset diabetes. But now it is becoming more common in children and teens, due to more obesity. With Type 2 diabetes, the body does not make or use insulin well.

Children have a higher risk of type 2 diabetes if they are overweight or have obesity, have a family history of diabetes, or are not active. Children who are African American, Hispanic, Native American/Alaska Native, Asian American, or Pacific Islander also have a higher risk. To lower the risk of type 2 diabetes in children:

Have them maintain a healthy weight
Be sure they are physically active
Have them eat smaller portions of healthy foods
Limit time with the TV, computer, and video

Children and teens with type 1 diabetes may need to take insulin. Type 2 diabetes may be controlled with diet and exercise. If not, patients will need to take oral diabetes medicines or insulin. A blood test called the A1C can check on how you are managing your diabetes.