Diabetes
Your Health Information
What is Diabetes?
Diabetes is a metabolic disorder. Normally most of the food you eat is broken down into glucose and other simple sugars. Glucose is absorbed into the blood stream to be used by cells for energy. Cells need glucose to work, and blood glucose rises after food is eaten. Insulin is then released from the pancreas as blood glucose levels increase. Cells have receptor sites on the outside, and when insulin attaches to the receptor sites, a pathway is made and glucose goes into the cell. Insulin opens the cells like a key. Glucose goes from the blood into the cells and the blood glucose stays in the normal range. Excess food is generally converted into fat and stored.
When a person has diabetes, food is broken down in the normal way. Glucose is also produced and absorbed into the blood in the normal way. The problem rests with insulin action. With little or no insulin action occurring, the glucose cannot enter the cells. The glucose builds up in the blood, leaving cells starving for it. Blood glucose levels rise, causing hyperglycemia (high blood sugar).
Signs & Symptoms
The signs and symptoms of diabetes are all related to hyperglycemia. One of the functions of the kidneys is the removal of excess glucose from blood. The higher the glucose levels in the blood the more glucose will appear in the urine. This leads to extra urine production and, subsequently, excessive thirst.
Increased hunger is also experienced due to starvation of the cells, because glucose is not available to them.
Tests to Diagnose Diabetes
One test to diagnose diabetes is called a fasting glucose test. A blood sample is taken before breakfast, after a 10- to12-hour fast. A normal fasting result is less than 110 mg/dl. If the blood glucose value is above 126 mg/dl more than once, the person has diabetes.
The oral glucose tolerance test is also used to diagnose diabetes. After a 10- to12-hour fast, a blood sample is taken. A glucose dose is given and blood samples are taken every 30 minutes. If the test after two hours is equal to or greater than 200 mg/dl, the person has diabetes.
A casual plasma glucose, or a random blood glucose of greater than 200 mg/dl, with symptoms, also indicates the person has diabetes.
Types of Diabetes Mellitus
There are several types of diabetes. The most common are type 1 and type 2.
Type 1 diabetes is an autoimmune disorder where the pancreas makes little or no insulin. People with type 1 diabetes take insulin by injection in order to stay alive. Type 1 diabetes can happen at any age, but it most often occurs in children and young adults. People with type 1 diabetes are prone to develop ketoacidosis.
Type 2 diabetes is a disorder of insulin resistance. One function of the pancreas is the production of insulin. The insulin does not lower the blood glucose because the cells are resistant. These cells have fewer insulin receptors.
Some people with type 2 diabetes do not need insulin to achieve blood glucose control. For these people, diet, exercise and medications are effective.
Still other people with type 2 diabetes need insulin to achieve optimal blood glucose control.
Complications
People with diabetes are at risk for all of the long-term complications of diabetes. Some people get none, while others have multiple symptoms. Keeping blood glucose as close to normal as possible reduces the risk of developing complications.
There are three categories of complications: small vessel, large vessel and the nervous system. Small vessel problems occur in the kidneys and the eyes, large vessel problems occur in the legs, feet and heart. Problems of the nervous system can occur in many places; including the feet, legs, hands and also the stomach.
Keeping your blood glucose levels near normal will help prevent or delay these complications. Every improvement in blood glucose control helps in preventing complications.
Treatment of Diabetes Mellitus
The treatment for type 1 diabetes always includes insulin. The intensity of the treatment (meaning number of shots and blood tests each day), meal plan, and exercise is based on blood glucose and other goals. Keeping blood glucose levels near normal helps decrease the risk for complications of diabetes.
The treatment of type 2 diabetes starts with meal planning and exercise, then oral medications and insulin, if needed. The effectiveness of treatment is evaluated based on blood glucose levels. Just as in type 1 diabetes, keeping blood glucose levels near normal helps decrease the risk of complications from diabetes.
Monitoring Your Blood Glucose
Monitoring your blood glucose levels gives you information about the effects of food intake, medication, activity and stress as glucose levels change throughout the day and night. It is important to set goals for your personal blood glucose level (range) with your health care team.
Self-monitoring of blood glucose provides the necessary information to make informed decisions regarding day-to-day diabetes care. The goal of self-monitoring of blood glucose is to use results to adjust insulin, diet and/or activity to achieve optimal diabetes self-management.
Related Terms:
Diabetes
Insulin
Hyperglycemia
Fasting glucose test
Glucose test
Oral glucose tolerance test
Type 1 diabetes
Autoimmune
Ketoacidosis
Type 2 diabetes
Insulin resistance
Small vessel disease
Large vessel disease
Nervous system
Self-monitoring of blood glucose
