| Diabetes mellitus is one of
the most common and serious chronic diseases in the United
States. About 16 million Americans
have diabetes, 5.4 million of whom do not know they have
the disease. Each year,
approximately 800,000 people are diagnosed with diabetes.
The prevalence of diabetes has increased
steadily in the last half of this century and will continue
to rise with the aging U.S. population, the growth
in minority populations most susceptible to type 2 diabetes,
and the increasing prevalence of obesity
among Americans. |
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| What is diabetes? |
Diabetes is a metabolic disease
in which the body does not produce or properly use insulin,
a hormone
that is needed to convert sugar, starches, and other food
into energy needed for daily life. Diabetes is
characterized by high levels of blood glucose (sugar). |
| What are the different
types of diabetes? |
There are three main types of diabetes:
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- Type 1 diabetes
- Type 2 diabetes
- Gestational diabetes
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Type 1 diabetes, formerly
called insulin-dependent diabetes mellitus (IDDM) or
juvenile-onset diabetes,
is an autoimmune disease that results when the body’s
immune system attacks and destroys its own
insulin-producing beta cells in the pancreas. People
with type 1 diabetes need daily injections of insulin
to live. Type 1 diabetes develops most often in children
or young adults and accounts for about 5 to 10
percent of diagnosed diabetes in the United States. Although
risk factors are not well defined for type 1
diabetes, autoimmune, genetic and environmental factors
are involved in its development. |
Type 2 diabetes, formerly called
noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset
diabetes, is a disease that occurs when the body makes
enough insulin but cannot use it effectively. This
form of diabetes usually develops in adults over the
age of 40. About 90 to 95 percent of people with
diabetes have type 2; about 80 percent are overweight.
Type 2 diabetes is more common among people
who are older; obese; have a family history of diabetes;
have had gestational diabetes; and are of African
American, Hispanic American, Asian American, Pacific
Islander, and Native American ethnicities. |
Gestational diabetes develops or is discovered during
pregnancy. This type usually disappears when the
pregnancy is over, but women who have had gestational diabetes
have a greater risk of developing type 2
diabetes later in their lives. |
| What is the scope and impact of diabetes? |
Diabetes is widely
recognized as one of the leading causes of death and
disability in the United
States. It was the seventh leading
cause of death listed on U.S. death certificates in
1995 and contributed to 187,800
deaths that same year.
Both type 1 and type 2 diabetes
are associated with long-term complications that threaten
life and the
quality of life. Diabetes is the leading cause of
adult blindness, end-stage renal disease, and nontraumatic
lower-extremity amputations (as a result of nerve
disease). People with diabetes are 2 to 4 times more
likely to have coronary heart disease and stroke
than people without diabetes. In addition, poorly
controlled diabetes can complicate pregnancy, and
birth defects are more common in babies born to
women with diabetes.
Diabetes costs the United States $98.2 billion each
year. Medical costs for diabetes care -- including
hospitalizations, medical care and treatment supplies
-- total $44.1 billion. Indirect costs -- including
disability payments, time lost from work and premature
death -- total $54.1 billion.
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| How is diabetes diagnosed? |
Symptoms of type 1 diabetes usually
develop over a short period of time, although beta cell
destruction
can begin months, even years, earlier. Symptoms include
increased thirst and urination, constant hunger,
weight loss, blurred vision, and extreme fatigue. If not
diagnosed and treated with insulin, a person can
lapse into a life-threatening coma.
The symptoms of type 2 diabetes develop gradually and are
not as noticeable as in type 1 diabetes.
Symptoms include feeling tired or ill, frequent urination
(especially at night), unusual thirst, weight loss,
blurred vision, frequent infections, and slow-healing wounds
and sores.
In 1997 the Expert Committee on the Diagnosis and Classification
of Diabetes published new guidelines
for the diagnosis of diabetes. The guidelines lowered the
blood sugar values for diagnosis and
recommended use of the fasting plasma glucose test to diagnose
diabetes, a simpler and faster test than
the commonly used oral glucose tolerance test. Glucose
levels greater than or equal to 126mg/dl with the
fasting plasma glucose test, or greater than or equal to
200 mg/dl with the oral glucose tolerance test
indicate a diagnosis of diabetes.1 |
| How is diabetes managed? |
Diabetes is a self-managed disease because
people with diabetes must take responsibility for their
day-today
care. Much of the daily care involves keeping blood glucose
near normal levels at all times.
Management of type 1 diabetes: People with type 1 diabetes
need daily injections of insulin because
their bodies no longer produce insulin. Treatment requires
a strict regimen that typically includes a
carefully calculated diet, planned physical activity, self-testing
of blood glucose, and multiple daily
insulin injections.
Management of type 2 diabetes: Treatment
for people with type 2 diabetes typically includes diet
management, exercise, self-testing of blood glucose, and,
in some cases, oral medication and/or insulin.
Approximately 40 percent of people with type 2 diabetes
require insulin injections. The goal of diabetes management
is to keep blood glucose levels as close to a normal range
as safely
possible, while avoiding blood glucose levels that are
too high (hyperglycemia) or too low (hypoglycemia). |
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| In This Section... |
| Diabetes-Related Complications |
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| Helping
Others With Diabetes |
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