Diabetes
So...Your doctor said you have diabetes.  I hope to provide some information to help you understand.
According to the National Institute of Diabetes and Kidney Diseases (NIDKD), a committee of international experts recently recommended a change in the names of the two main types of diabetes because the former names caused confusion. The new names reflect an effort to move away from basing the names on the treatment or age of onset.
The type that was known as juvenile-onset diabetes, or insulin-dependent diabetes (IDDM) is now Type 1 Diabetes
The type that was known as noninsulin-dependent diabetes (NIDDM), or adult-onset diabetes is now Type 2 Diabetes.
Although diabetes is a chronic and incurable disease (with the exception of gestational diabetes), with proper medical care, clinical therapies, diet, hygiene, and exercise, symptoms and complications can be successfully treated and managed.
Type 1 Diabetes
Type 1 diabetes, also called immune-mediated diabetes, was formerly called insulin-dependent diabetes mellitus (IDDM). It is a disease that results from the body's failure to produce insulin, the hormone that allows glucose to enter the cells of the body to fuel them. This is most often the result of an autoimmune process in which the body's immune system attacks and destroys the insulin producing cells of the pancreas. When glucose cannot enter the cells, it builds up in the blood and the body's cells literally starve to death. People with type 1 diabetes must take daily insulin injections and regularly monitor their blood sugar  levels.
The cause of type 1 diabetes is unknown, but is is known that people inherit a tendency to get diabetes. However, not all people who have this tendency will get the disease. Type 1 diabetes usually starts in children or young adults, but can start at any age. More than 700,000 Americans have this type of diabetes -- about 10 percent of all diagnosed cases. 
Type 2 Diabetes
Type 2 diabetes is a metabolic disorder resulting from the body's inability to make enough, or properly use, insulin. It used to be called non-insulin-dependent diabetes mellitus (NIDDM).
It results from the body's inability to make enough or properly use insulin, or the body still makes insulin but cannot properly use it. Without enough insulin, the body cannot move blood sugar into the cells. It is a chronic disease that has no known cure. It is the most common form of the disease accounting for 90-95 percent of diabetes. Type 2 diabetes is nearing epidemic proportions, due to an increased number of older Americans, and a greater prevalence of obesity and a sedentary lifestyle.
The exact cause of type 2 diabetes is unknown. However, there does appear to be a genetic factor which causes it to run in families. Although a person can inherit a tendency to get type 2 diabetes, it usually takes another factor, such as obesity, to bring on the disease. 
Type 2 diabetes can often be controlled with diet and exercise alone. However, some people may also need medicine -- either oral medications or insulin shots. Many people find their diabetes gets better when they follow their treatment plan. The goal of the plan is to keep blood-sugar levels as close to normal as possible. 
Risk Factors
  • People with a family history of diabetes
  • People who are overweight 
  • People who do not exercise regularly
  • Certain racial and ethnic groups (African Americans, Hispanics, and Native Americans)
  • Women who had gestational diabetes, a form of diabetes occurring in 2-5 percent of all pregnancies 
  • People with impaired glucose tolerance (IGT) - a condition in which blood sugar levels are higher than normal but not high enough to be classified as diabetes. 
Facts:
  • Of the nearly 16 million Americans with diabetes, 90-95 percent (15.3 million) have type 2 diabetes. Of these, half are unaware they have the disease.
  • People with type 2 diabetes often develop the disease after age 40, but are not aware they have diabetes until severe symptoms occur or they are treated for one of its serious complications.
  • The risk for type 2 diabetes increases with age. Nearly 11 percent of the United States population between 65 and 74 years of age has diabetes. 
  • Studies indicate that diabetes is generally under-reported on death certificates, particularly in the cases of older persons with multiple chronic conditions such as heart disease and hypertension. Because of this, the toll of diabetes is believed to be much higher than officially reported. 
Source: American Diabetes Association
Early Diagnosis &
Prevention of Diabetes
People with diabetes must stay alert for symptoms that can lead to clinical complications. The best way to do this is:
  • Get regular checkups -- finding problems early is the best way to keep complications from getting serious. 
  • Keep your appointments with your health care practitioner -- even if you are feeling fine 
  • Be aware of the warning signs of trouble:
    • Vision problems (blurriness, spots). 
    • Tiredness 
    • Pale skin color. 
    • Obesity (more than 20 pounds overweight). 
    • Numbness or tingling feelings in hands or feet. 
    • Repeated infections or slow healing of wounds. 
    • Chest pain. 
    • Vaginal itching.
    • Constant headaches
  • Keep blood-sugar levels close to normal 
  • Control weight 
  • Eat a healthy, well-balanced diet 
  • Get regular exercise 
  • Check your feet every day for even minor cuts or blisters 
  • Do not smoke
Complications of Diabetes
Medical complications due to diabetes may include: 
  • Cardiovascular disease 
  • Hypertension
  • Dental disease
  • Retinopathy or glaucoma (eye disease or blindness) 
  • Renal disease (kidney/urinary tract disease
  • Neuropathy (nerve disease)
  • Amputation 
  • Diabetic ketoacidosis (DKA) (Ketones in urine)
    		•
    Treatment of Diabetes
    Inside the pancreas, beta cells make the protein insulin. With each meal, beta cells release insulin to help the body use or store the glucose it gets from food. People with insulin-dependent (type 1) diabetes no longer make insulin. Their beta cells have been destroyed. They need insulin shots to use glucose from meals. People with non-insulin-dependent (type 2) diabetes make insulin, but their bodies don't respond well to it. Some people with type 2 diabetes need diabetes pills or extra insulin in shots to help their bodies use their own insulin better. 

    Insulin cannot be taken as a pill. Because it is a protein, it would be broken down during digestion just like the protein in food. It must be injected into the fat under your skin for insulin to get into your blood. 

    There are almost 30 types of insulin made by two companies in the United States.  They are very pure. Allergic reactions to insulin are rare. 
    Type 1 Diabetes
    People with IDDM must give themselves insulin every day. It can be injected, which involves use of a needle and syringe, or it can be given by an insulin pump, insulin pen, or jet injector. Extra amounts of insulin are taken before meals, depending on the blood glucose level and food to be eaten. 

    The amount of insulin needed depends on height, weight, age, food intake, and activity level. Insulin doses must be balanced with meal times and activities, and dosage levels can be affected by illness, stress, or unexpected events. 
    Type 2 Diabetes
    The very best treatment for type 2 diabetes is diet and exercise. Together, they can often bring blood glucose levels down to normal-- losing even a few pounds may have this effect.When these measures are not enough, the next step is taking a medicine that lowers blood glucose levels. There are two kinds of medicines: insulin shots and oral medications (pills). 
    Oral Medications include: 
    • Sulfonylurea drugs - discovered in the 1940s and used to treat people with type2 diabetes since then; second-generation became available in 1984, which canbe taken in smaller doses.  All sulfonylurea drugs have similar effects on blood glucose levels. But they differ in side effects, how often they are taken, and interactions with other drugs. 

      •  
    • Biguanides - banned in the United States in the 1970s because their use was linked to problems such as lactic acidosis; a safer version called metformin is used, which does not cause too-low levels of blood glucose (hypoglycemia)
    Only people with type 2 diabetes can use pills; they cannot do anything for a person with type 1 diabetes, whose pancreas has lost all ability to make insulin. Pills are an option only for people with type 2 diabetes who have not gotten good blood glucose control through better eating habits and exercise alone. 

    People with type 2 diabetes have two problems -- they don't make quite enough insulin and the cells of their bodies don't seem to take in glucose as they should. 

    Sulfonylurea drugs seem to improve both problems. They boost the pancreas's production of insulin and make body cells more receptive to glucose. Metformin may make cells more receptive, and it may also decrease glucose production in the liver. Exactly how diabetes pills work is not completely clear. 

    Taking a diabetes pill does not mean you can forget good eating and exercising habits. Pills work with diet and exercise, not in place of them. Drugs cannot help if you don't eat right, exercise, and lose weight. 

    Diabetes pills don't work for everyone and may sometimes stop working after a few months or years. Even if diabetes pills do work, you may still need to take insulin when you have a severe infection or need surgery or become pregnant.

    Because diabetes pills seem to help the body use insulin better, some doctors combine them with insulin shots in people with hard-to-control type 2 diabetes. The idea behind this combination therapy is to try to make insulin work better. 
    Hyperglycemia (High Blood Sugar)
    A number of things can cause hyperglycemia.
    • In type 1 diabetes, you may not have given yourself enough insulin 
    • In type 2 diabetes, your body may have enough insulin, but it is not as effective as it should be. 
    • Eating more than planned 
    • Exercised less than planned 
    • Stress of an illness, such as a cold or flu 
    • Other stresses, such as family conflicts or school or work problems
    Symptoms of hyperglycemia:
    • High blood sugar
    • High levels of sugar in the urine 
    • Frequent urination 
    • Increased thirst 
    Hypoglycemia (Low Blood Sugar)
    Hypoglycemia happens from time to time to everyone who has diabetes.  Hypoglycemia is the technical term for low blood sugar. The symptoms include: 
    • Shakiness
    • Dizziness 
    • Sweating 
    • Hunger 
    • Headache
    • Pale skin color
    • Sudden moodiness or behavior changes, such as crying for no apparent reason 
    • Clumsy or jerky movements
    • Difficulty paying attention, or confusion 
    • Tingling sensations around the mouth
    Dietary Requirements
    Home