Guide To Diabetes Information |
Guide To Diabetes Information |
What is diabetes? Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can be associated with serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications. Types of Diabetes Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. 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. |
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 diabetes in the next 5-10 years. Other specific types of diabetes result from specific genetic conditions (such as maturity-onset diabetes of youth), surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 5% of all diagnosed cases of diabetes. Treating diabetes To survive, people with type 1 diabetes must have insulin delivered by injections or a pump. Many people with type 2 diabetes can control their blood glucose by following a careful diet and exercise program, losing excess weight, and taking oral medication. Many people with diabetes also need to take medications to control their cholesterol and blood pressure. Diabetes self-management education is an integral component of medical care. Among adults with diagnosed diabetes, 12% take both insulin and oral medications, 19% take insulin only, 53% take oral medications only, and 15% do not take either insulin or oral medications. |
Prevention or Delay of Diabetes Research studies have found that lifestyle changes can prevent or delay the onset of type 2 diabetes among high-risk adults. These studies included people with IGT and other high-risk characteristics for developing diabetes. Lifestyle interventions included diet and moderate-intensity physical activity (such as walking for 2 1/2 hours each week). In the Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, the development of diabetes was reduced 58% over 3 years. |
Studies have also shown that medications have been successful in preventing diabetes
in some population groups. In the Diabetes Prevention Program, people treated
with the drug metformin reduced their risk of developing diabetes by 31% over
3 years. Treatment with metformin was most effective among younger, heavier people
(those 25-40 years of age who were 50 to 80 pounds overweight) and less effective
among older people and people who were not as overweight. |
Similarly, in the STOP-NIDDM Trial, treatment of people with IGT with the drug acarbose
reduced the risk of developing diabetes by 25% over 3 years. Other medication
studies are ongoing. In addition to preventing progression from IGT to diabetes,
both lifestyle changes and medication have also been shown to increase
the probability of reverting from IGT to normal glucose tolerance There are no known methods to prevent type 1 diabetes. Several clinical trials are currently in progress or being planned. |