Most of the
food we eat is 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 sugars to build
up in your blood.
can cause serious health complications including heart disease, blindness,
kidney failure, and lower-extremity amputations. Diabetes is the seventh
leading cause of death in the United States.
think they might have diabetes must visit a physician for diagnosis. They
might have SOME or NONE of the following symptoms:
or numbness in hands or feet
very tired much of the time
- Very dry
that are slow to heal
- More infections
or stomach pains may accompany some of these symptoms in the abrupt onset
of insulin-dependent diabetes, now called type 1 diabetes.
types of diabetes and some of their risk factors are quoted from the National
Diabetes Fact Sheet: National estimates and general information on diabetes
in the United States (Centers for Disease Control and Prevention.
Atlanta, GA: US Department of Health and Human Services, 1997):
diabetes was previously called insulin-dependent diabetes mellitus
(IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5%
to 10% of all diagnosed cases of diabetes. Risk factors are less well
defined for type 1 diabetes than for type 2 diabetes, but autoimmune,
genetic, and environmental factors are involved in the development of
this type of diabetes.
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. Risk factors for type 2
diabetes include older age, obesity, family history of diabetes, prior
history of gestational diabetes, impaired glucose tolerance, physical
inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans,
American Indians, and some Asian Americans and Pacific Islanders are at
particularly high risk for type 2 diabetes.
diabetes develops in 2% to 5% of all pregnancies but usually disappears
when a pregnancy is over. Gestational diabetes occurs more frequently
in African Americans, Hispanic/Latino Americans, American Indians, and
people with a family history of diabetes than in other groups. Obesity
is also associated with higher risk. Women who have had gestational diabetes
are at increased risk for later developing type 2 diabetes. In some studies,
nearly 40% of women with a history of gestational diabetes developed diabetes
in the future.
specific types of diabetes result from specific genetic syndromes,
surgery, drugs, malnutrition, infections, and other illnesses. Such types
of diabetes may account for 1% to 2% of all diagnosed cases of diabetes.
strategies should be planned along with a qualified health care team.
information on treatments for diabetes is from the National Diabetes
Fact Sheet: National estimates and general information on diabetes in
the United States (Centers for Disease Control and Prevention. Atlanta,
GA: US Department of Health and Human Services, 1997):
knowledge, treatment, and prevention strategies advance daily. Treatment
is aimed at keeping blood glucose near normal levels at all times. Training
in self-management is integral to the treatment of diabetes. Treatment
must be individualized and must address medical, psychosocial, and lifestyle
of type 1 diabetes: Lack of insulin production by the pancreas makes
type 1 diabetes particularly difficult to control. Treatment requires
a strict regimen that typically includes a carefully calculated diet,
planned physical activity, home blood glucose testing several times a
day, and multiple daily insulin injections.
of type 2 diabetes: Treatment typically includes diet control, exercise,
home blood glucose testing, and in some cases, oral medication and/or
insulin. Approximately 40% of people with type 2 diabetes require insulin
of type 1 diabetes appear to be much different than those for type 2 diabetes,
though the exact mechanisms for development of both diseases are unknown.
The appearance of type 1 diabetes is suspected to follow exposure to an
"environmental trigger," such as an unidentified virus, stimulating
an immune attack against the beta cells of the pancreas (that produce
insulin) in some genetically predisposed people.
of studies have shown that regular physical activity can significantly
reduce the risk of developing type 2 diabetes. It also appears to be associated
with obesity. Researchers are making progress in identifying the exact
genetics and "triggers" that predispose some individuals to
develop type 1 diabetes, but prevention, as well as a cure, remains elusive.
to the growing health burden of diabetes mellitus (diabetes), the diabetes
community has three choices: prevent diabetes; cure diabetes; and take
better care of people with diabetes to prevent devastating complications.
All three approaches are actively being pursued by the US Department of
Health and Human Services.
National Institutes of Health (NIH) and the Centers for Disease Control
and Prevention (CDC) are involved in prevention activities. The NIH is
involved in research to cure both type 1 and type 2 diabetes, especially
type 1. CDC focuses most of its programs on being sure that the proven
science is put into daily practice for people with diabetes. The basic
idea is that if all the important research and science are not made meaningful
in the daily lives of people with diabetes, then the research is, in essence,
to "cure" diabetes are being pursued:
cell transplantation (islet cells produce insulin)
manipulation (fat or muscle cells that dont normally make insulin
have a human insulin gene inserted then these "pseudo"
islet cells are transplanted into people with type 1 diabetes).
Each of these
approaches still has a lot of challenges, such as preventing immune rejection;
finding an adequate number of insulin cells; keeping cells alive; and
others. But progress is being made in all areas.