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What is diabetes?

Diabetes is a disease in which the body doesn’t make insulin or does not properly use the insulin that the body produces. The food you eat is broken down into sugar called glucose. Glucose travels to all your body cells through your blood. Cells use the glucose for growth and energy. Insulin, a hormone made by the pancreas, helps glucose get into your cells. If the body does not produce insulin or it can’t efficiently use the insulin it does have, sugar builds up in the blood.

Diabetes has no cure

   • An estimated 23.6 million people in the United States have diabetes, and 1.6 million new cases are diagnosed in people aged 20 and older every year.
   • Because so many people are unaware they even have the disease, a third of all diabetes cases go undiagnosed.
   • Diabetes is the fifth-leading cause of death by disease in the United States.
   • Diabetes is the leading cause of new blindness, kidney failure and amputations.
   • Diabetes may shorten lifespan by up to 15 years.

The two main forms of diabetes are type 1 and type 2. A third form, gestational diabetes, occurs only during pregnancy.

Type 1 diabetes

In this type of diabetes, also called insulin-dependent diabetes, the pancreas makes little or no insulin. As a result, glucose builds up in the blood. This is called hyperglycemia.

The exact causes of type 1 are unknown. Type 1 tends to run in families.

The treatment of type 1 focuses on balancing insulin shots, diet and exercise to get control of glucose levels.

Signs of type 1 can include:

   • Frequent urination
   • Unusual thirst
   • Extreme hunger
   • Extreme fatigue
   • Irritability

Any of the symptoms of type 1 diabetes can also be warning signs for type 2 diabetes.

Type 2 diabetes

In type 2 diabetes, the pancreas makes some insulin, but body cells don’t properly use it. This is called insulin resistance, a condition that often occurs with obesity. This is the most common type of diabetes. Between 90 percent and 95 percent of Americans with diabetes are thought to have type 2.

In the past, type 2 diabetes most commonly developed after age 45, but increasing numbers of U.S. children are now being diagnosed with the disease. Unhealthful eating habits and the lack of exercise increases the risk of being overweight and as a result, it increases the risk of type 2 diabetes.

Being overweight or having someone in your family with diabetes increases your risk of type 2 diabetes. Certain ethnic groups also are at high risk of the disease:

   • African Americans – 1.7 times as likely to have type 2 diabetes as the general population.
   • Hispanics – almost twice as likely to have type 2 diabetes as the general population.
   • Native Americans – more than 2.3 times as likely to have type 2 diabetes as the general population.

Signs of type 2 can also include:

   • Frequent infections
   • Blurred vision
   • Cuts or bruises that are slow to heal
   • Tingling or numbness in the hands or feet
   • Recurring infections of the skin, the gums or the bladder

Gestational diabetes

This type of diabetes affects about 4 percent of all pregnant women, usually during the second or third trimester. Doctors typically check for gestational diabetes during the 24th and 28th weeks of pregnancy.

Gestational diabetes goes away once pregnancy is over. However, women who have had gestational diabetes have a higher risk for type 2 diabetes later on.

How Diabetes Affects the Body

   • People with diabetes have more bacterial infections that other people do. Bacterial infections include styes (infections of the glands of the eyelid), hair follicle infections, deep infections of the skin and tissue underneath, infections around the nails and boils.
   • Fungal infections can cause itchy rashes such as athlete’s foot and ringworm.
   • Other diabetes-related skin conditions include diabetic dermopathy – light brown scaly patches that do not hurt or itch, blisters and bumps.

   • See your physician to discuss treatment options for the various skin disorders, some of which can be treated by making sure your blood sugar level is controlled.

   • Diabetes may cause eye problems such as diabetic retinopathy, cataracts and glaucoma.
   • See your eye doctor regularly.
   • Have a dilated-eye exam at least once a year.

Nerves - Diabetic Neuropathy (Nerve Damage)
   • Diabetic neuropathy can sometimes result in numbness or a loss of feeling in the feet, hands, or legs. It can also cause impotence and problems with your digestive system, bladder and heart.
   • Controlling your glucose is the best way to prevent and/or control the risk of diabetic neuropathy.

   • Early in diabetes, the parts of the kidneys that work to filter the blood may be damaged. Early testing for kidney disease - before it cases permanent damage - is very important.
   • A sign of this damage is protein in the urine. A urine protein test can indicate whether or not you are at risk for kidney disease.
   • Kidney disease may have no symptoms, or it may include a feeling of tiredness and general weakness, trouble sleeping, swelling or vomiting.
   • Check your blood pressure regularly and if you need to, take blood pressure medications as prescribed by your physician.
   • Have a urine protein (microalbumin) test at least once a year.

   • A high blood sugar level increases the plaque in your mouth. Take extra precautions when caring for your teeth if you have diabetes.
   • Diabetes can cause red, sore, or swollen gums that bleed when you brush your teeth. Other problems include bad breath, gum disease and tooth loss.
   • See your dentist every 6 months, and discuss ways to prevent problems and to help keep your teeth and gums healthy.

Heart and Blood Vessels
   • Diabetes may cause serious problems to the heart and blood vessels.
   • High cholesterol is common in people with diabetes. High blood pressure can result.
   • Diabetes also can lead to a heart attack or stroke.
   • Talk with your healthcare provider about ways to control cholesterol levels, blood pressure, blood glucose and weight.
   • Guidelines suggest that your LDL “bad” cholesterol should be <100 mg/dL.
   • Have your blood pressure checked regularly.
   • Have your cholesterol level checked at least once a year.
   • Take aspirin daily if instructed by your physician.
   • Do not smoke.

   • Diabetes can cause nerve damage in the feet and also may affect blood flow in the feet, making it harder for cuts or sores to heal.
   • Check your feet every day for cuts, sores, bruises, dry cracks, loss of feeling or other signs of infection or redness.
   • Treat foot infections promptly.
   • Protect your feet by wearing comfortable socks and shoes at all times.
   • If you see anything unusual, talk to your doctor right away.
   • Have your feet checked every time you visit your healthcare provider.

Find out if you are at risk
Asian Americans and Pacific Islanders who are overweight are at high risk for type 2 diabetes or pre-diabetes - that means a person’s blood glucose levels are higher than normal, but not yet high enough to be called diabetes. Talk with your physician about your risk.

Lose a small amount of weight
The weight you think is normal for you may not be a healthy weight. You can prevent or delay type 2 diabetes by losing as little as 10 pounds.

Be more physically active
Choose an activity you enjoy and get family members or friends to join you during a walk, playing ball, swimming or other activity. Be active at least 30 minutes a day, 5 days a week to help you lose weight and stay healthy.

Make healthful food choices
Eat healthfully and incorporate more fruits and vegetables, fish, lean meats, whole grain rice, and low-fat or skim milk and cheese in your diet. Keep healthy snacks such as fruit in the house. Avoid fried foods. Serve smaller portions. Drink enough water to stay hydrated.

You should consult your physician to find out whether or not you are at risk for having diabetes. There are several different blood tests that are used to diagnose diabetes. Finding out early that you have or are at risk for diabetes provides you with a chance to make lifestyle changes or begin treatment that could help prevent or delay problems.

You can manage diabetes with a healthful diet, exercise, and, if needed, medication. It is also important to maintain healthy blood pressure and cholesterol levels. Test your blood sugar regularly, and keep your levels controlled.

For more information about diabetes and how you can improve your health, go to: American Diabetes Association (www.diabetes.org)