Diabetes

Diabetes

Diabetes is a lifelong (chronic) condition characterized by elevated levels of sugar in the bloodstream.

Causes, Incidence, and Risk Factors

Insulin, produced by the pancreas, regulates blood sugar levels. Diabetes can arise from insufficient insulin production, resistance to insulin, or a combination of both.

To comprehend diabetes, it's essential to grasp the normal process of food breakdown and utilization for energy in the body. Several steps occur during digestion:

- Glucose, a form of sugar, enters the bloodstream, serving as a fuel source.
- The pancreas secretes insulin to facilitate the transfer of glucose from the bloodstream into muscle, fat, and liver cells, where it's utilized as fuel.

Individuals with diabetes experience high blood sugar levels because their bodies fail to transport sugar into cells for energy storage. This deficiency stems from:

- Inadequate insulin production by the pancreas.
- Abnormal responses to insulin in cells.
- Both of the above factors.

There are three primary types of diabetes, each with distinct causes and risk factors:

- Type 1 diabetes, although it can manifest at any age, is typically diagnosed in children, adolescents, or young adults. It involves insufficient insulin production, necessitating daily insulin injections. Its precise cause remains unknown.
- Type 2 diabetes accounts for the majority of diabetes cases. While it primarily develops in adulthood, rising obesity rates have led to diagnoses among teenagers and young adults. Many individuals with type 2 diabetes remain unaware of their condition.
- Gestational diabetes refers to high blood sugar levels occurring during pregnancy in women without prior diabetes.

Diabetes affects over 20 million Americans, with more than 40 million having prediabetes.

Symptoms

Elevated blood sugar levels can induce various symptoms, including:

- Blurred vision
- Increased thirst
- Fatigue
- Frequent urination
- Hunger
- Weight loss

Since type 2 diabetes progresses gradually, some individuals with elevated blood sugar may exhibit no symptoms. Conversely, symptoms of type 1 diabetes emerge rapidly, often leading to severe illness upon diagnosis.

Signs and Tests

Although a urine analysis can detect high blood sugar, it alone doesn't diagnose diabetes. A blood sugar level exceeding 200 mg/dL may suggest diabetes. Confirmatory tests include:

- Fasting blood glucose level: Diabetes is diagnosed if it surpasses 126 mg/dL on two occasions. Levels ranging from 100 to 126 mg/dL indicate impaired fasting glucose or prediabetes, posing a risk for type 2 diabetes.
- Hemoglobin A1c test:
- Normal: Below 5.7%
- Prediabetes: 5.7% - 6.4%
- Diabetes: 6.5% or higher
- Oral glucose tolerance test: Diabetes is diagnosed if blood glucose exceeds 200 mg/dL after 2 hours. (This test is primarily used for type 2 diabetes.)

Routine screening for type 2 diabetes is recommended for overweight children with additional risk factors starting at age 10, overweight adults (BMI > 25) with risk factors, and individuals over age 45, repeated every 3 years.

Treatment

While there's no cure for diabetes, management involves medication, dietary adjustments, and physical activity to regulate blood sugar levels and prevent symptoms and complications.