Diabetes

What is diabetes?

Diabetes, also known as diabetes mellitus, is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your body's main source of energy. Your body can make glucose, but it also comes from the food you eat. Insulin is a hormone made by your pancreas. Insulin helps move glucose from your bloodstream into your cells, where it can be used for energy.

If you have diabetes, your body can't make insulin, can't use insulin as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells. This can cause glucose levels to get too high. Over time, high blood glucose levels can lead to serious health conditions. But you can take steps to manage your diabetes and try to prevent these health problems.

What are the types of diabetes?

There are different types of diabetes:

• Type 1 diabetes. If you have type 1 diabetes, your body makes little or no insulin. It happens when your immune system attacks and destroys the cells that produce insulin.
• Type 2 diabetes. This is the most common form of diabetes. If you have type 2 diabetes, your body may still be able to make insulin, but your cells don't respond well to insulin. They can't easily take up enough glucose from your blood.
• Gestational diabetes. This is a form of diabetes that develops during pregnancy. It happens when your body can't make the extra insulin it needs during pregnancy.

What causes diabetes?

The different types of diabetes have different causes:

• Researchers think type 1 diabetes is caused by genes and factors in the environment that might trigger the disease.
• Type 2 diabetes is caused by several factors, including lifestyle factors and genes. The lifestyle factors include not being physically active and being overweight or having obesity.
• Researchers think gestational diabetes is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.

Who is more likely to develop diabetes?

The different types of diabetes have different risk factors:

• You can develop type 1 diabetes at any age, but it most often starts in childhood. Having a parent or sibling with type 1 diabetes may increase your chance of developing it.
• You are at higher risk of developing type 2 diabetes if you:
• Are overweight or have obesity.
• Are over age 35. Children, teenagers, and younger adults can get diabetes, but it is more common in middle-aged and older adults.
• Have a family history of diabetes.
• Have prediabetes. This means that your blood glucose is higher than normal, but it's not high enough to be called diabetes.
• Had gestational diabetes.
• Have given birth to a baby weighing 9 pounds or more.
• Are African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
• Are not physically active.
• Have certain other health conditions, such as high blood pressure or polycystic ovary syndrome (PCOS).
• You are at higher risk of developing gestational diabetes if you:
• Are overweight or have obesity.
• Have a family history of diabetes.
• Had gestational diabetes in a previous pregnancy.
• Have given birth to a baby weighing 9 pounds or more.
• Have polycystic ovary syndrome (PCOS).
• Are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander.

What are the symptoms of diabetes?

The symptoms of diabetes may include:

• Feeling very thirsty
• Feeling very hungry
• Urinating (peeing) more often, including at night
• Fatigue
• Blurry vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Losing weight without trying

But it's important to know that your symptoms may vary, depending on which type you have:

• The symptoms of type 1 diabetes usually come on quickly and can be severe.
• With type 2 diabetes, the symptoms often develop slowly, over several years. The symptoms can be so mild that you might not even notice them.
• Gestational diabetes often has no symptoms. If you do have symptoms, they may be mild. People who are pregnant are usually screened for this condition between 24 and 28 weeks of pregnancy.

How is diabetes diagnosed?

To find out if you have diabetes, your health care provider will use one or more glucose blood tests. There are several types, including the A1C test.

What are the treatments for diabetes?

Treatment for diabetes involves managing your blood glucose levels:

• If you have type 1 diabetes, you will need to take daily doses of insulin, either by injection or through a special pump. Some people also need to take another type of diabetes medicine that works with insulin.
• If you have type 2 diabetes, you may be able to manage or even reverse it by making lifestyle changes. These include eating a healthy diet, staying at healthy weight, and getting regular physical activity. Some people also need to take diabetes medicines to manage their diabetes.
• If you have gestational diabetes, you may be able to lower your glucose levels by eating a healthy diet and getting regular exercise. But be sure to talk to your provider about your treatment options. Gestational diabetes usually goes away after you give birth. But you will have a higher risk of developing type 2 diabetes later.

Checking your blood glucose levels is also an important part of managing your diabetes. Ask your provider about the best way to check your blood glucose level and how often you should check it.

Can diabetes be prevented?

Type 1 diabetes can't be prevented.

You may be able to delay or prevent type 2 diabetes through the same lifestyle changes that are used to manage diabetes (eating a healthy diet, staying at a healthy weight, and getting regular physical activity). These lifestyle changes may also help prevent gestational diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes and Pregnancy

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

What is gestational diabetes?

Some people already have diabetes before they get pregnant. But others may develop diabetes during pregnancy. This type of diabetes is called gestational diabetes. It usually develops around the 24th week of pregnancy. It happens when your body can't make the extra insulin it needs during pregnancy. Researchers think gestational diabetes is caused by the hormonal changes of pregnancy, along with genetic and lifestyle factors.

Who is more likely to develop gestational diabetes?

Anyone who is pregnant could develop gestational diabetes. But you are more likely to develop it if you:

• Are overweight or have obesity
• Have a family history of diabetes
• Had gestational diabetes in a previous pregnancy
• Have given birth to a baby weighing 9 pounds or more
• Have polycystic ovary syndrome (PCOS)
• Are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander person

How do I know if I have gestational diabetes?

Gestational diabetes often has no symptoms. If you do have symptoms, they may be mild, such as being thirstier than normal or having to urinate (pee) more often.

If you are pregnant, you will most likely be screened for gestational diabetes between 24 and 28 weeks of pregnancy. But if you have an increased chance of developing gestational diabetes, you may be tested during your first prenatal visit. Your health care provider will use one or more blood glucose tests to check for gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test (OGTT), or both.

For these two tests, you will drink a sugary liquid and wait for an hour before your blood sample is taken. If you have an oral glucose tolerance test, you will also get your blood drawn after 2 and 3 hours.

How can diabetes affect my pregnancy?

Having diabetes during pregnancy can affect your health. For example:

• You are more likely to develop preeclampsia, a serious medical condition that causes a sudden increase in your blood pressure.
• You are more likely to need a cesarean delivery, because your baby is more likely to be bigger than average.
• Changes to your hormones and your body during pregnancy can affect your blood glucose levels. If you had diabetes before pregnancy, you may now need to adjust your meal plan, physical activity routine, and/or medicines. If you have any diabetes health problems, they may get worse during pregnancy.
• Gestational diabetes usually goes away after you have your baby. But you will be at higher risk of developing type 2 diabetes later.

Having diabetes during pregnancy can also affect the health of your developing baby:

• If you have high blood glucose levels at the beginning of your pregnancy, there is a higher risk of birth defects.
• Your baby will be at risk for obesity and type 2 diabetes later in life.
• Your baby is more likely to be born early.
• Your baby may have breathing problems or hypoglycemia (low blood glucose levels) right after birth.
• There is a higher risk of miscarriage and stillbirth.

How can I manage diabetes during pregnancy?

There are steps you can take to manage your diabetes before, during, and after pregnancy.

If you already have diabetes, the best time to control your blood glucose is before you get pregnant. High blood glucose levels can be harmful to your developing baby during the first weeks of pregnancy, even before you know you are pregnant. See your provider to help you plan for pregnancy. You can talk about how to lower the risk of health problems for you and your developing baby. You can also discuss your diet, physical activity, and which diabetes medicines are safe during pregnancy.

During your pregnancy, you will work with your provider to manage your blood glucose levels. You may be able to manage them with a healthy diet and regular physical activity. If that's not enough, then you will need to take diabetes medicines. It's also important that you:

• Get regular prenatal checkups
• Take your prenatal vitamins
• Don't use harmful substances such as alcohol, tobacco, and illegal drugs

After pregnancy, there are steps you need to take to stay healthy:

• If you had gestational diabetes, you are at risk of developing type 2 diabetes. You will be tested for it within 4 to 12 weeks after giving birth. Even if your blood glucose levels have returned to normal, you will need to get them tested every 1 to 3 years.
• If you already had diabetes before pregnancy, you and your provider will monitor changes to your blood glucose levels. They will tell you if you need to adjust your diabetes management plan.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes Complications

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy.

With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

What health problems can diabetes cause?

Over time, having too much glucose in your blood can cause complications, including:

• Eye disease, due to changes in fluid levels, swelling in the tissues, and damage to the blood vessels in the eyes.
• Foot problems, caused by damage to the nerves and reduced blood flow to your feet.
• Gum disease and other dental problems, because a high amount of glucose in your saliva helps harmful bacteria grow in your mouth. The bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause gum disease and bad breath. Other types cause tooth decay and cavities.
• Heart disease and stroke, caused by damage to your blood vessels and the nerves that control your heart and blood vessels.
• Kidney disease, due to damage to the blood vessels in your kidneys. Many people with diabetes develop high blood pressure. That can also damage your kidneys.
• Nerve problems (diabetic neuropathy), caused by damage to the nerves and the small blood vessels that nourish your nerves with oxygen and nutrients.
• Sexual and bladder problems, caused by damage to the nerves and reduced blood flow in the genitals and bladder.
• Skin conditions, some of which are caused by changes in the small blood vessels and reduced circulation. People with diabetes are also more likely to have infections, including skin infections.

What other problems can people with diabetes have?

If you have diabetes, you need to watch out for blood glucose levels that are too high (hyperglycemia) or too low for you (hypoglycemia). These can happen quickly and can become dangerous. Some of the causes include having another illness or infection and certain medicines. They can also happen if you don't get the right amount of diabetes medicines. To try to prevent these problems, make sure to take your diabetes medicines correctly, follow your diabetic diet, and check your blood glucose regularly.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes in Children and Teens

Until recently, the common type of diabetes in children and teens was type 1. It was called juvenile diabetes. With Type 1 diabetes, the pancreas does not make insulin. Insulin is a hormone that helps glucose,or sugar, get into your cells to give them energy. Without insulin, too much sugar stays in the blood.

Now younger people are also getting type 2 diabetes. Type 2 diabetes used to be called adult-onset diabetes. But now it is becoming more common in children and teens, due to more obesity. With Type 2 diabetes, the body does not make or use insulin well.

Children have a higher risk of type 2 diabetes if they are overweight or have obesity, have a family history of diabetes, or are not active. Children who are African American, Hispanic, Native American/Alaska Native, Asian American, or Pacific Islander also have a higher risk. To lower the risk of type 2 diabetes in children:

• Have them maintain a healthy weight
• Be sure they are physically active
• Have them eat smaller portions of healthy foods
• Limit time with the TV, computer, and video

Children and teens with type 1 diabetes may need to take insulin. Type 2 diabetes may be controlled with diet and exercise. If not, patients will need to take oral diabetes medicines or insulin. A blood test called the A1C can check on how you are managing your diabetes.

Diabetes Medicines

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

type 1 diabetestype 2 diabetes

What are the treatments for diabetes?

Treatments for diabetes can depend on the type. Common treatments include a diabetic meal plan, regular physical activity, and medicines. Some less common treatments are weight loss surgery for either type and an artificial pancreas or pancreatic islet transplantation for some people with type 1 diabetes.

Who needs diabetes medicines?

People with type 1 diabetes need to take a diabetes medicine called insulin to control their blood sugar.

Some people with type 2 diabetes can control their blood sugar with healthy food choices and physical activity. But for others, a diabetic meal plan and physical activity are not enough. They need to take diabetes medicines.

The kind of medicine you take depends on your type of diabetes, daily schedule, medicine costs, and any other health conditions that you have. Over time, you may need to take more than one diabetes medicine.

What are the types of medicines for type 1 diabetes?

If you have type 1 diabetes, you must take insulin because your body no longer makes it. There are different types of insulin that start to work at different speeds, and the effects of each last a different length of time. Your health care provider will measure your blood glucose to decide on the type of insulin. You may need to use more than one type.

You will also need to check your blood sugar at home. Your provider will tell you how often. The results of your blood sugar testing can help you make decisions about food, physical activity, and medicines.

You can take insulin several different ways. The most common are with a needle and syringe, an insulin pen, or an insulin pump. If you use a needle and syringe or a pen, you have to take insulin several times during the day, including with meals. An insulin pump gives you small, steady doses throughout the day. Less common ways to take insulin include inhalers, injection ports, and jet injectors.

In rare cases, taking insulin alone might not be enough to manage your blood sugar. Then you would need to take another diabetes medicine.

What are the types of medicines for type 2 diabetes?

There are several different medicines for type 2 diabetes. Each works in a different way. Many of them are pills. There are also medicines that you inject under your skin, such as insulin.

Over time, you may need more than one diabetes medicine to manage your blood sugar. You might add another diabetes medicine or switch to a combination medicine. A combination medicine contains more than one type of diabetes medicine in the same pill. Some people with type 2 diabetes take both pills and injections.

Even if you don't usually take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

What else should I know about taking medicines for diabetes?

Even if you take medicines for diabetes, you still need to eat a healthy diet, stop smoking, take your other medicines, and get regular physical activity. These will help you manage your diabetes.

It is important to make sure that you understand your diabetes treatment plan. Talk to your provider about:

• What your target blood sugar level is
• What to do if your blood sugar gets too low or too high
• Whether your diabetes medicines will affect other medicines you take
• If you will have any side effects from the diabetes medicines

You should not change or stop your diabetes medicines on your own. Talk to your provider first.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases