Diabetes

Definition

Diabetes mellitus is a chronic disease caused by the inability of the pancreas to produce insulin or to use the insulin produced in the proper way. Over 14 million Americans suffer from one form or another of this disease.

Description

After a meal, a portion of the food a person eats is broken down into sugar (glucose). The sugar then passes into the bloodstream and to the body's cells via a hormone (called insulin) that is produced by the pancreas.

Normally, the pancreas produces the right amount of insulin to accommodate the quantity of sugar. However, if the person has diabetes, either the pancreas produces little or no insulin or the cells do not respond normally to the insulin. Sugar builds up in the blood, overflows into the urine and then passes from the body unused. Over time, high blood sugar levels can damage:

Eyes - leading to diabetic retinopathy and possible blindness
Blood vessels - increasing risk of heart attack, stroke and peripheral artery obstruction
Nerves - leading to foot sores and possible amputation
Kidneys - leading to kidney failure.

Diabetes has also been linked to impotence and digestive problems.

Types of Diabetes

There are two main types of diabetes, Type I and Type II:

Type I diabetes or insulin-dependent diabetes (formerly called juvenile-onset diabetes, because it tends to effect persons before the age of 20) affects about 10 percent of people with diabetes. With this type of diabetes, the pancreas makes almost no insulin.
Type II diabetes or non-insulin-dependent diabetes (formerly called adult-onset diabetes, because it is usually discovered after age 40) affects about 90 percent of the people with diabetes. With this type of diabetes, either the pancreas produces a reduced amount of insulin, the cells do not respond to the insulin, or both.

There are three less common types of diabetes called gestational diabetes, secondary diabetes and impaired glucose tolerance (IGT):

Gestational diabetes occurs during pregnancy and causes a higher than normal glucose level reading.
Secondary diabetes is caused by damage to the pancreas from chemicals, certain medications, diseases of the pancreas (such as cancer) or other glands.
Impaired glucose tolerance (IGT) is a condition in which the person's glucose levels are higher than normal.

Symptoms

Usually, the symptoms of Type I diabetes are obvious. That is not true for Type II. Many people with Type II do not discover they have diabetes until they are treated for a complication, such as heart disease, blood vessel disease (atherosclerosis), stroke, blindness, skin ulcers, kidney problems, nerve trouble or impotence.

The warning signs and symptoms for both types are:

Type I: Frequent urination, increased thirst, extreme hunger, unexplained weight loss, extreme fatigue, blurred vision, irritability, nausea and vomiting.
Type II: Any Type I symptom, plus: unexplained weight gain, pain, cramping, tingling or numbness in your feet, unusual drowsiness, frequent vaginal or skin infections, dry, itchy skin and slow healing sores.

Note: If a person is experiencing these symptoms, they should see a doctor immediately.

Diagnosis

Besides a complete history and physical examination, the doctors will perform a battery of laboratory tests. There are numerous tests available to diagnose diabetes, such as a urine test, blood test, glucose-tolerance test, fasting blood sugar and the glycohemoglobin (HbA1c) test.