What Is Diabetes?

When you or someone you love has diabetes, you discover that you must think about a part of life that others take for granted. You are constantly striving to reach a subtle balance between glucose and insulin. The more you learn about diabetes, the better you can be at your balancing act and the better your life can be.

Types of Diabetes
There are three main types of diabetes. The most common are type 1 diabetes and type 2 diabetes. A third type of diabetes, gestational diabetes, occurs during some pregnancies.

All types of diabetes result in too much sugar, or glucose, in the blood. To understand why this happens, it helps to understand how the body usually works. When you eat, your body breaks down your food into simpler forms such as glucose. The glucose goes into your bloodstream, where it travels to all the cells in your body. Your cells use glucose for energy. Insulin, a hormone made by the pancreas, helps move the glucose from the bloodstream to the cells.

People with type 1 diabetes make very little insulin or no insulin at all. People with type 1 diabetes must take insulin shots in order to live. In contrast, people with type 2 diabetes and women with gestational diabetes do make insulin. But for some reason the cells in their bodies are resistant to the action of insulin or their bodies don’t make enough insulin. In all types of diabetes, the glucose does not get into the cells that need it and builds up in the bloodstream instead.

About half of the time, type 1 diabetes starts during childhood or the early teenage years. For this reason, it used to be called juvenile-onset diabetes. If your symptoms first appeared during your early teenage years, your health care provider probably suspected diabetes right away. If you were a young child when the disease developed, it might have occurred so fast that you went into a coma, before anyone suspected diabetes. Type 2 diabetes most often develops in adulthood and used to be called adult-onset diabetes.  Usually,  it does not appear suddenly.

Instead, you may have no noticeable symptoms or only mild symptoms for years before diabetes is detected, perhaps during a routine exam or blood test. Gestational diabetes only appears during pregnancy in women with no previous history of type 1 or type 2 diabetes and usually goes away after pregnancy. Pregnant women are tested for gestational diabetes, usually during the 24th week of gestation. After pregnancy, 5 to 10 percent of women with gestational diabetes are diagnosed with type 2 diabetes.

Women who develop gestational diabetes have a 20 to 50 percent risk of developing type 2 diabetes in the next 5 to 10 years.

All people with diabetes have one thing in common. They have too much sugar, or glucose, in their blood.

People with very high blood glucose levels share many similar symptoms:

  •   extreme thirst
  •   a frequent desire to urinate
  •   blurred vision
  •   a feeling of being tired most of the time for no apparent reason
  • People with type 2 diabetes may also experience leg pain that may indicate nerve damage or poor circulation.  Many people with type 1 diabetes and some people with type 2 diabetes also find that they lose weight even though they are hungrier than usual and are eating more. Type 2 diabetes tends to develop in people who have extra body fat.  Where you carry your excess fat may determine whether you get type 2 diabetes: extra fat above the hips (central body obesity) is riskier than fat in the hips and thighs for developing type 2 diabetes. And leading an inactive “couch potato” lifestyle can also lead to diabetes. This lifestyle also contributes to obesity. Three-fourths of all people with type 2 diabetes are or have been obese-that is, they have a body mass index of 30 or above (see the BMI chart for adults on page 5). A BMI of 25 to 29.9 is considered overweight.
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