Diabetes overview

Diabetes Causes

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.
To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested:

* A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.

* An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy. This is because either:

* Their pancreas does not make enough insulin

* Their cells do not respond to insulin normally

* Both of the above

There are three major types of diabetes. The causes and risk factors are different for each type:

* Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown.

* Type 2 diabetes makes up most of diabetes cases. It most often occurs in adulthood, but teens and young adults are now being diagnosed with it because of high obesity rates. Many people with type 2 diabetes do not know they have it.

* Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes.

Diabetes Symptoms
High blood sugar levels can cause several symptoms, including:

* Blurry vision

* Excess thirst

* Fatigue

* Frequent urination

* Hunger

* Weight loss

Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms.
Diabetes Exams and Tests

A urine analysis may be used to look for high blood sugar. However, a urine test alone does not diagnose diabetes.

Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.

Blood tests:

* Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL twice. Levels between 100 and 126 mg/dL are called impaired fasting glucose or pre-diabetes. These levels are risk factors for type 2 diabetes.
* Hemoglobin A1c test --
o Normal: Less than 5.7%
o Pre-diabetes: 5.7% - 6.4%
o Diabetes: 6.5% or higher
* Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours. (This test is used more often for type 2 diabetes.)

Screening for type 2 diabetes in people who have no symptoms is recommended for:

* Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years
* Overweight adults (BMI greater than 25) who have other risk factors
* Adults over age 45, repeated every 3 years

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