People who think they might have diabetes should visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:

• Frequent urination
• Excessive thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in hands or feet
• Feeling very tired much of the time
• Very dry skin
• Sores that are slow to heal
• More infections than usual

Diabetes is a disease in which blood glucose (sugar) levels are above normal. Plant foods which are mostly sugars and starches (carbohydrates) are turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugar to build up in your blood.Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the 6th leading cause of death in the United States.

Risk factors for type 2 diabetes (diabetes mellitus) include:

• 45 years of age or older
• Obesity
• Family history of diabetes (parent, brother, or sister with diabetes)
• Family background is American Indian, African American, Asian American or Pacific Islander, Hispanic/Latino
• Prior history of gestational diabetes (diabetes while I was pregnant)
• Blood glucose (blood sugar) levels are higher than normal
• Physical inactivity (physically active less than 3 times a week)

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes results from the body’s failure to produce insulin, the hormone that “unlocks” the cells of the body, allowing glucose to enter and fuel them. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors.Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. 

Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly.  As the need for insulin rises, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents who are over weight or obese.

Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing type 2 diabetes in the next 5-10 years.

Pre-diabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes. In some cases pre-diabetes can be prevented from becoming diabetes if a person increases physical activity, develops healthy eating habits, and maintains a healthy weight.    

People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high. People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. A diabetes health care team is also recommended.  The patient and primary care provider are leaders of the team. Other members of the team might include endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management. 

Type 1 diabetes - Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.

Type 2 diabetes - Healthy eating, physical activity, and blood glucose testing are the basic therapies for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels. 


Treatment Goals for the ABCs of Diabetes

A1C <7% for patients in general**

Blood pressure (mmHg)    Systolic / Diastolic
                                      < 130 / < 80

Cholesterol – Lipid Profile (mg/dl)
 

LDL Cholesterol < 100
 

HDL Cholesterol Men > 40  Women > 50
 

Triglycerides < 150

**Individualize target levels.  Talk with your doctor for specific recommendations for you.