Diabetes
Alternative Names:
Diabetes mellitus
Definition:
Diabetes is a set of conditions characterized by an improper processing of glucose, which is broken down from ingested food or released from the liver and used in the cells as energy. Glucose travels throughout the blood stream, where it is then transferred into cells through the use of a hormone known as insulin. Patients with type 1 diabetes do not produce insulin, whereas patients with type 2 diabetes either produce insulin in insufficient amounts or the cells improperly use the hormone. These conditions cause too much glucose to remain in the blood, resulting in high blood sugar levels that can cause serious complications. The large majority of diabetic patients have type 2 diabetes.
Pregnant women who are not diabetic may develop gestational diabetes, which is a temporary condition characterized by abnormal blood sugar levels during pregnancy. According to the American Diabetes Association, gestational diabetes affects four percent of pregnant women in the U.S.
Symptoms:
Patients with type 1 diabetes may experience the following common symptoms:
- Abnormal weight loss
- Extreme hunger
- Frequent thirst
- Frequent urination
- Severe fatigue
Patients with type 2 diabetes often experience no symptoms. However, some may experience the symptoms listed above in addition to the following:
- Blurred vision
- Cuts or bruises that heal at an unusually slow rate
- Frequent infections
- Tingling or numbing sensations in the hands or feet
Exams/Testing:
Certain tests may be conducted by your physician to determine if you have diabetes. You may undergo a glycated hemoglobin (A1C) test, in which your doctor measures your average blood sugar levels over the past few months. The test works by detecting high levels of blood sugar attached to hemoglobin, which is an indication of elevated levels of sugar in the blood.
Patients who cannot undergo an A1C test due to pregnancy or an uncommon form of hemoglobin may undergo a random blood sugar test or a fasting blood sugar test. In a random blood sugar test, patients will have a blood sample taken without regard to when they last ate. In a fasting blood sugar test, patients will fast overnight and then have a blood sample taken to measure for abnormal blood sugar levels.
Women are generally tested for gestational diabetes around or after 28 weeks of pregnancy. Patients will undergo a glucose challenge test in which their blood sugar levels are measured after ingesting a glucose solution. This test is usually a normal component of prenatal care.
Patients who are at particularly high risk of developing diabetes due to factors such as a family history of type 2 diabetes, metabolic syndrome or obesity may undergo a prediabetes test. Patients may undergo an A1C test, a fasting blood sugar test or an oral glucose tolerance test, in which blood sugar levels are tested after a patient has ingested a sugary solution.
Outlook/Prognosis:
Diabetes is a chronic condition and currently has no cure. However, with treatment and lifestyle changes, many patients can manage their blood sugar levels.
Key lifestyle changes in the management of diabetes include a healthy diet and exercise. Regular blood sugar monitoring is also a central component of all diabetes treatment plans.
All patients with type 1 diabetes and some patients with type 2 diabetes will need to undergo insulin therapy in order to manage their blood sugar levels. Insulin therapy consists of the regular injection of the hormone into the body.
Some patients may undergo treatment with the use of a variety of oral medications. Some common diabetes medications include Avandia and Actos.
Some patients with type 1 diabetes may undergo a pancreas transplant, which eliminates the need for insulin therapy. However, an organ transplant requires other forms of treatment and carries serious risks.
Patients with prediabetes may prevent the onset of diabetes through healthy lifestyle choices such as a proper diet and exercise.
Causes:
Type 1 diabetes is caused when the immune system abnormally attacks cells in the pancreas which are responsible for the production of insulin. Genetics may play a role in the development of this condition.
The exact cause of type 2 diabetes is currently unknown, however many factors may increase the risk of developing the condition including:
- Abdominal fat
- Family history of type 2 diabetes
- Increasing age
- Physical inactivity
- Polycystic ovary syndrome
- Race (African Americans, Hispanics, American Indians and Asian Americans are at higher risk)
Additional risk factors may include:
- Elevated levels of fatty substances known as triglycerides
- Elevated levels of low-density lipoprotein (LDL) cholesterol
- High blood pressure
- Low levels of high-density lipoprotein (HDL) cholesterol
Certain medications may also cause your blood sugar levels to fluctuate.
Causes (specific drugs):
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