Diabetes is a condition that occurs when the body either cannot make enough of the hormone insulin (type 1 diabetes) or cannot use insulin correctly (type 2 diabetes). Since insulin helps spread glucose (blood sugar) into the body’s cells, both types of diabetes cause glucose to remain in the blood. This creates high blood sugar levels and starves the body of energy.
While the exact cause of type 1 diabetes is unknown, type 2 diabetes can usually be prevented through weight loss, physical activity, and healthy eating. Treatment for diabetes may involve insulin shots, medication, and healthy lifestyle choices.
Types of Diabetes
There are two primary types of diabetes, called Type 1 and Type 2. A third type, known as gestational diabetes, can affect women who are pregnant.
Type 1 Diabetes
In type 1 diabetes, the body’s immune system mistakenly identifies the cells that produce insulin as foreign and proceeds to attack them. The production of insulin is essential for helping cells absorb and use glucose from the bloodstream to produce energy. When the body is unable to produce any or enough insulin to regulate its blood sugar level, glucose remains unabsorbed in the blood.
Type 2 Diabetes
In type 2 diabetes, the body develops insulin resistance and becomes unable to properly use insulin. The pancreas creates more insulin to compensate, and the insulin tries to disseminate glucose into the cells, but the cells fail to accept it.
A third type of diabetes, called gestational diabetes, can affect pregnant women. Hormonal changes trigger this type of diabetes, but other factors like genes and lifestyle choices also contribute.
Late in their pregnancy, all women develop insulin resistance, the same condition that leads to type 2 diabetes. Most women are able to combat insulin resistance by developing enough insulin to counteract the condition. Women whose bodies cannot produce the necessary amount of insulin to overcome insulin resistance develop gestational diabetes.
There are several risk factors for gestational diabetes in pregnant women. These include elevated blood sugar levels, a family history of diabetes, and being overweight. The condition is more common among African Americans, Hispanics, Asian Americans, and Native Hawaiians.
The symptoms for both type 1 and type 2 diabetes are very similar. While symptoms for type 1 diabetes usually manifest within a few weeks, type 2 diabetes symptoms may take longer to develop. For some patients, there are no symptoms. This can make the condition difficult to recognize.
Gestational diabetes often has no symptoms, and a blood sugar test is required during pregnancy to diagnose it.
Diabetes symptoms include fatigue, weight loss or gain, sores, increased hunger and thirst, increased urination, blurred vision, and numbness or tingling in the hands or feet. Patients may also find that cuts and other wounds are slower to heal.
If you are experiencing any diabetes symptoms, visit your doctor to get tested for the condition. Remember, some patients with type 2 diabetes experience no symptoms, so you may also want to get a diabetes test if you have family members with the condition, have had gestational diabetes during a pregnancy, or are over 45.
Doctors may diagnose diabetes through one of the following three blood tests.
Diabetes Blood Tests
|Fasting Plasma Glucose (FPG) Test||A1C Test||Random Plasma Glucose (RPG) Test|
|This test measures the level of glucose in the blood. The FPG test works best after the patient has been fasting for 8 hours or more, and is most effective when performed during the morning.||While the FPG test assesses the level of glucose in the blood at a specific moment in time, the A1C test examines the blood glucose levels over three months. It is also known as the glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C, and HbA1C test. This test does not require the patient to fast, and the test results show the percentage of glucose in the blood. Factors like anemia and age affect the accuracy of the A1C test.||Though less common, the RPG test may be used when a patient has diabetes symptoms and the doctor wants to test for the disease immediately. RPG does not require fasting.|
Methods for treating diabetes differ based on the type. Treating type 1 diabetes involves using insulin. Type 2 and gestational diabetes may also be treated with insulin, but other methods of treatment include making healthy lifestyle choices and taking medication.
Patients with type 1 diabetes manage their condition by taking insulin multiple times a day, since their body is unable to produce enough insulin on its own. Those with type 2 diabetes may also need to take insulin regularly, or in certain situations like pregnancy or hospitalization.
Treating diabetes with insulin shots at regular intervals helps patients with type 1 diabetes avoid serious complications like diabetic ketoacidosis, which stems from inadequate glucose in the blood. When this happens, the body uses fat in place of insulin, which builds up ketones (acids) that are poisonous in large numbers.
Diabetic ketoacidosis sometimes develops in patients who have type 1 diabetes but have yet to be diagnosed. It can also occur when patients who have type 1 diabetes develop an infection, an injury, or an illness, or when they miss an insulin dosage or undergo surgery. Symptoms of diabetic ketoacidosis include head and stomach pain, nausea, vomiting, rapid breathing, reduced alertness, and dry skin.
Depending on its severity, type 2 diabetes patients may be able to manage the condition through healthy eating and regular physical activity. These treatments also help with gestational diabetes.
Additionally, a doctor may prescribe medication like Invokana or another SGLT2 inhibitor to be combined with insulin treatment and/or healthy lifestyle choices. Invokana reduces blood sugar by blocking glucose from being reabsorbed into the blood. The effectiveness of the drug comes at a price, however, as the side effects of Invokana can be just as bad as the symptoms it is intended to treat.
While the diabetes drug is still prescribed, it has had negative press surrounding an updated black box warning by the FDA, and continuing Invokana lawsuit troubles in the courts over the lack of adequate health warnings.
Diabetes Statistics and Life Expectancy
According to the American Diabetes Association, diabetes is the seventh highest cause of death among people living in the United States.
In the U.S. alone, 29.1 million people have diabetes. Type 2 is by far the most common, accounting for about 95% of all diabetes diagnoses.
While only 5% of diabetes patients have type 1, this condition generally develops early, often during childhood. For this reason, it is sometimes called juvenile diabetes.
A recent study commissioned by the National Academy on an Aging Society found that diabetes lowers life expectancy by roughly 8.5 years at age 50. People with diabetes are also at greater risk of developing health issues like heart disease, kidney failure, depression, and diabetic ketoacidosis (a potentially fatal complication of diabetes that results in acids building up in the bloodstream).
While no one is sure exactly what causes type 1 diabetes, factors like genes and exposure to certain viruses may play a role. Genes also play a role in causing type 2 diabetes, but lifestyle choices like inactivity and obesity are significant factors as well. Type 2 diabetes is often preventable.
The following factors increase a person’s risk of developing type 2 diabetes:
- Lifestyle: Being overweight or obese often contributes to type 2 diabetes, as does physical inactivity.
- Family History: A family history of diabetes may put you at greater risk, as the condition is often hereditary.
- Genetics: Genes that contribute to a person being obese or overweight increase the risk of developing type 2 diabetes. Additionally, genetic mutations like cystic fibrosis and hemochromatosis make it harder for the body to create insulin.
- Ethnicity: Diabetes is most prevalent among African Americans, Native Americans, Asian Americans, Hispanics, Latinos, Native Hawaiians, and Pacific Islanders.
- Hormonal Diseases: Hormonal diseases like Acromegaly, Cushing’s syndrome, and Hyperthyroidism increase the number of hormones the body produces, which can lead to diabetes through insulin resistance.
- Pancreas Damage: The pancreas is the part of the body that produces insulin. If the pancreas is damaged or removed due to pancreatic cancer, pancreatitis, or other trauma, it affects the body’s ability to make insulin and can lead to diabetes.
- Medications: Some medications can contribute to diabetes by damaging cells or altering the flow of insulin. These include niacin, pentamidine, and glucocorticoids, as well as certain psychiatric drugs, anti-seizure medications, and drugs used for treating HIV.
- Prediabetes: Prediabetes is a condition that often precedes type 2 diabetes, and increases the risk of developing the disease. If a patient has prediabetes it means their blood sugar level is higher than it should be, but not yet high enough to be diabetes. A person with prediabetes can reduce his or her chances of developing type 2 diabetes by consuming fewer calories, maintaining a healthy body weight, and exercising regularly.
There is currently no guaranteed method for preventing type 1 diabetes. But maintaining a healthy lifestyle greatly decreases your risk of developing type 2 and gestational diabetes.
- Weight Loss: Since carrying excess weight is a significant risk factor in the development of type 2 and gestational diabetes, losing weight can help prevent the onset of diabetes. You may only need to lose between five and seven percent of your body’s current weight to lower your risk of type 2 diabetes.
- Physical Activity: Staying active for at least half an hour, five days per week, greatly reduces the risk of developing type 2 diabetes. Exercise is also good for weight loss.
- Healthy Eating: Eating foods and drinking liquids that are low in calories, fat, and sugar can help prevent type 2 diabetes, and contributes toward maintaining a healthy weight.
If you are concerned about diabetes, speak to your healthcare provider.