OverviewWhat is DiabetesWhat is diabetes?

Diabetes happens when your body isn't able to take up sugar (glucose) into its cells and use it for energy. This results in a build up of extra sugar in your bloodstream.

Mismanagement of diabetes can lead to serious consequences, causing damage to a wide range of your body's organs and tissues including your heart, kidneys, eyes and nerves.

The process of digestion includes breaking down the food you eat into various different nutrient sources. When you eat carbohydrates (for example, bread, rice, pasta), your body breaks this down into sugar (glucose). When glucose is in your bloodstream, it needs help a "key" to get into its final destination where it's used, which is inside your body's cells (cells make up your body's tissues and organs). This help or "key" is insulin.

Insulin is a hormone made by your pancreas, an organ located behind your stomach. Your pancreas releases insulin into your bloodstream. Insulin acts as the key that unlocks the cell wall door, which allows glucose to enter your bodys cells. Glucose provides the fuel or energy tissues and organs need to properly function.

If you have diabetes:

Or

If glucose cant get into your bodys cells, it stays in your bloodstream and your blood glucose level rises.

The types of diabetes are:

Less common types of diabetes include:

Diabetes insipidus is a distinct rare condition that causes your kidneys to produce a large amount of urine.

Some 34.2 million people of all ages about 1 in 10 have diabetes in the U.S. Some 7.3 million adults aged 18 and older (about 1 in 5) are unaware that they have diabetes (just under 3% of all U.S. adults). The number of people who are diagnosed with diabetes increases with age. More than 26% of adults age 65 and older (about 1 in 4) have diabetes.

Factors that increase your risk differ depending on the type of diabetes you ultimately develop.

Risk factors for Type 1 diabetes include:

Risk factors for prediabetes and Type 2 diabetes include:

Risk factors for gestational diabetes include:

The cause of diabetes, regardless of the type, is having too much glucose circulating in your bloodstream. However, the reason why your blood glucose levels are high differs depending on the type of diabetes.

Symptoms of diabetes include:

Other symptoms

Type 1 diabetes symptoms: Symptoms can develop quickly over a few weeks or months. Symptoms begin when youre young as a child, teen or young adult. Additional symptoms include nausea, vomiting or stomach pains and yeast infections or urinary tract infections.

Type 2 diabetes and prediabetes symptoms: You may not have any symptoms at all or may not notice them since they develop slowly over several years. Symptoms usually begin to develop when youre an adult, but prediabetes and Type 2 diabetes is on the rise in all age groups.

Gestational diabetes: You typically will not notice symptoms. Your obstetrician will test you for gestational diabetes between 24 and 28 weeks of your pregnancy.

If your blood glucose level remains high over a long period of time, your bodys tissues and organs can be seriously damaged. Some complications can be life-threatening over time.

Complications include:

Complications of gestational diabetes:

In the mother: Preeclampsia (high blood pressure, excess protein in urine, leg/feet swelling), risk of gestational diabetes during future pregnancies and risk of diabetes later in life.

In the newborn: Higher-than-normal birth weight, low blood sugar (hypoglycemia), higher risk of developing Type 2 diabetes over time and death shortly after birth.

Diabetes is diagnosed and managed by checking your glucose level in a blood test. There are three tests that can measure your blood glucose level: fasting glucose test, random glucose test and A1c test.

Less than 100

Less than 140

Less than 5.7%

Gestational diabetes tests: There are two blood glucose tests if you are pregnant. With a glucose challenge test, you drink a sugary liquid and your glucose level is checked one hour later. You dont need to fast before this test. If this test shows a higher than normal level of glucose (over 140 ml/dL), an oral glucose tolerance test will follow (as described above).

Type 1 diabetes: If your healthcare provider suspects Type 1 diabetes, blood and urine samples will be collected and tested. The blood is checked for autoantibodies (an autoimmune sign that your body is attacking itself). The urine is checked for the presence of ketones (a sign your body is burning fat as its energy supply). These signs indicate Type 1 diabetes.

If you have symptoms or risk factors for diabetes, you should get tested. The earlier diabetes is found, the earlier management can begin and complications can be lessened or prevented. If a blood test determines you have prediabetes, you and your healthcare professional can work together to make lifestyle changes (e.g. weight loss, exercise, healthy diet) to prevent or delay developing Type 2 diabetes.

Additional specific testing advice based on risk factors:

Diabetes affects your whole body. To best manage diabetes, youll need to take steps to manage your risk factors, including:

You hold the keys to managing your diabetes by:

Checking your blood glucose level is important because the results help guide decisions about what to eat, your physical activity and any needed medication and insulin adjustments or additions.

The most common way to check your blood glucose level is with a blood glucose meter. With this test, you prick the side of your finger, apply the drop of blood to a test strip, insert the strip into the meter and the meter will show your glucose level at that moment in time. Your healthcare provider will tell you how often youll need to check your glucose level.

Advancements in technology have given us another way to monitor glucose levels. Continuous glucose monitoring uses a tiny sensor inserted under your skin. You don't need to prick your finger. Instead, the sensor measures your glucose and can display results anytime during the day or night. Ask your healthcare provider about continuous glucose monitors to see if this is an option for you.

Ask your healthcare team what your blood glucose level should be. They may have a specific target range for you. In general, though, most people try to keep their blood glucose levels at these targets:

Having a blood glucose level that is lower than the normal range (usually below 70 mg/dL) is called hypoglycemia. This is a sign that your body gives out that you need sugar.

Symptoms you might experience if you have hypoglycemia include:

You might pass out if your hypoglycemia is not managed.

If you have too much glucose in your blood, you have a condition called hyperglycemia. Hyperglycemia is defined as:

or

Treatments for diabetes depend on your type of diabetes, how well managed your blood glucose level is and your other existing health conditions.

Oral medications and insulin work in one of these ways to treat your diabetes:

Over 40 medications have been approved by the Food and Drug Administration for the treatment of diabetes. Its beyond the scope of this article to review all of these drugs. Instead, well briefly review the main drug classes available, how they work and present the names of a few drugs in each class. Your healthcare team will decide if medication is right for you. If so, theyll decide which specific drug(s) are best to treat your diabetes.

Diabetes medication drug classes include:

Many oral diabetes medications may be used in combination or with insulin to achieve the best blood glucose management. Some of the above medications are available as a combination of two medicines in a single pill. Others are available as injectable medications, for example, the GLP-1 agonist semaglutide (Ozempic) and lixisenatide (Adlyxin).

Always take your medicine exactly as your healthcare prescribes it. Discuss your specific questions and concerns with them.

There are many types of insulins for diabetes. If you need insulin, you healthcare team will discuss the different types and if they are to be combined with oral medications. To follow is a brief review of insulin types.

There are insulins that are a combination of different insulins. There are also insulins that are combined with a GLP-1 receptor agonist medication (e.g. Xultophy, Soliqua).

Insulin is available in several different formats. You and your healthcare provider will decide which delivery method is right for you based on your preference, lifestyle, insulin needs and insurance plan. Heres a quick review of available types.

Yes. There are two types of transplantations that might be an option for a select number of patients who have Type 1 diabetes. A pancreas transplant is possible. However, getting an organ transplant requires taking immune-suppressing drugs for the rest of your life and dealing with the side effects of these drugs. However, if the transplant is successful, youll likely be able to stop taking insulin.

Another type of transplant is a pancreatic islet transplant. In this transplant, clusters of islet cells (the cells that make insulin) are transplanted from an organ donor into your pancreas to replace those that have been destroyed.

Another treatment under research for Type 1 diabetes is immunotherapy. Since Type 1 is an immune system disease, immunotherapy holds promise as a way to use medication to turn off the parts of the immune system that cause Type 1 disease.

Bariatric surgery is another treatment option thats an indirect treatment for diabetes. Bariatric surgery is an option if you have Type 2 diabetes, have obesity (body mass index over 35) and considered a good candidate for this type of surgery. Much improved blood glucose levels are seen in people who have lost a significant amount of weight.

Of course other medications are prescribed to treat any existing health problems that contribute to increasing your risk of developing diabetes. These conditions include high blood pressure, high cholesterol and other heart-related diseases.

Although diabetes risk factors like family history and race cant be changed, there are other risk factors that you do have some control over. Adopting some of the healthy lifestyle habits listed below can improve these modifiable risk factors and help to decrease your chances of getting diabetes:

No. Type 1 diabetes is an autoimmune disease, meaning your body attacks itself. Scientists arent sure why someones body would attack itself. Other factors may be involved too, such as genetic changes.

Chronic complications are responsible for most illness and death associated with diabetes. Chronic complications usually appear after several years of elevated blood sugars (hyperglycemia). Since patients with Type 2 diabetes may have elevated blood sugars for several years before being diagnosed, these patients may have signs of complications at the time of diagnosis.

The complications of diabetes have been described earlier in this article. Although the complications can be wide ranging and affect many organ systems, there are many basic principles of prevention that are shared in common. These include:

If you have diabetes, the most important thing you can do is keep your blood glucose level within the target range recommended by your healthcare provider. In general, these targets are:

You will need to closely follow a treatment plan, which will likely include following a customized diet plan, exercising 30 minutes five times a week, quitting smoking, limiting alcohol and getting seven to nine hours of sleep a night. Always take your medications and insulin as instructed by your provider.

If you havent been diagnosed with diabetes, you should see your healthcare provider if you have any symptoms of diabetes. If you already have been diagnosed with diabetes, you should contact your provider if your blood glucose levels are outside of your target range, if current symptoms worsen or if you develop any new symptoms.

Sugar itself doesn't directly cause diabetes. Eating foods high in sugar content can lead to weight gain, which is a risk factor for developing diabetes. Eating more sugar than recommended American Heart Association recommends no more than six teaspoons a day (25 grams) for women and nine teaspoons (36 grams) for men leads to all kinds of health harms in addition to weight gain.

These health harms are all risk factors for the development of diabetes or can worsen complications. Weight gain can:

Most people with diabetes see their primary healthcare provider first. Your provider might refer you to an endocrinologist/pediatric endocrinologist, a physician who specializes in diabetes care. Other members of your healthcare team may include an ophthalmologist (eye doctor), nephrologist (kidney doctor), cardiologist (heart doctor), podiatrist (foot doctor), neurologist (nerve and brain doctor), gastroenterologist (digestive tract doctor), registered dietician, nurse practitioners/physician assistants, diabetes educator, pharmacist, personal trainer, social worker, mental health professional, transplant team and others.

In general, if you are being treated with insulin shots, you should see your doctor at least every three to four months. If you are treated with pills or are managing diabetes through diet, you should be seen at least every four to six months. More frequent visits may be needed if your blood sugar isn't managed or if complications of diabetes are worsening.

Although these seem like simple questions, the answers are not so simple. Depending on the type of your diabetes and its specific cause, it may or may not be possible to reverse your diabetes. Successfully reversing diabetes is more commonly called achieving remission.

Type 1 diabetes is an immune system disease with some genetic component. This type of diabetes cant be reversed with traditional treatments. You need lifelong insulin to survive. Providing insulin through an artificial pancreas (insulin pump plus continuous glucose monitor and computer program) is the most advanced way of keeping glucose within a tight range at all times most closely mimicking the body. The closest thing toward a cure for Type 1 is a pancreas transplant or a pancreas islet transplant. Transplant candidates must meet strict criteria to be eligible. Its not an option for everyone and it requires taking immunosuppressant medications for life and dealing with the side effects of these drugs.

Its possible to reverse prediabetes and Type 2 diabetes with a lot of effort and motivation. Youd have to reverse all your risk factors for disease. To do this means a combination of losing weight, exercising regularly and eating healthy (for example, a plant-based, low carb, low sugar, healthy fat diet). These efforts should also lower your cholesterol numbers and blood pressure to within their normal range. Bariatric surgery (surgery that makes your stomach smaller) has been shown to achieve remission in some people with Type 2 diabetes. This is a significant surgery that has its own risks and complications.

If you have gestational diabetes, this type of diabetes ends with the birth of your child. However, having gestational diabetes is a risk factor for developing Type 2 diabetes.

The good news is that diabetes can be effectively managed. The extent to which your Type 1 or Type 2 diabetes can be managed is a discussion to have with your healthcare provider.

Yes, its possible that if diabetes remains undiagnosed and unmanaged (severely high or severely low glucose levels) it can cause devastating harm to your body. Diabetes can cause heart attack, heart failure, stroke, kidney failure and coma. These complications can lead to your death. Cardiovascular disease in particular is the leading cause of death in adults with diabetes.

Although having diabetes may not necessarily increase your risk of contracting COVID-19, if you do get the virus, you are more likely to have more severe complications. If you contract COVID-19, your blood sugars are likely to increase as your body is working to clear the infection. If you contract COVID-19, contact your healthcare team early to let them know.

Blood vessels are located throughout our bodys tissues and organs. They surround our bodys cells, providing a transfer of oxygen, nutrients and other substances, using blood as the exchange vehicle. In simple terms, diabetes doesnt allow glucose (the bodys fuel) to get into cells and it damages blood vessels in/near these organs and those that nourish nerves. If organs, nerves and tissues cant get the essentials they need to properly function, they can begin to fail. Proper function means that your hearts blood vessels, including arteries, are not damaged (narrowed or blocked). In your kidneys, this means that waste products can be filtered out of your blood. In your eyes, this means that the blood vessels in your retina (area of your eye that provides your vision) remain intact. In your feet and nerves, this means that nerves are nourished and that theres blood flow to your feet. Diabetes causes damage that prevents proper function.

Unmanaged diabetes can lead to poor blood flow (poor circulation). Without oxygen and nutrients (delivered in blood), you are more prone to the development of cuts and sores that can lead to infections that cant fully heal. Areas of your body that are farthest away from your heart (the blood pump) are more likely to experience the effects of poor blood flow. So areas of your body like your toes, feet, legs and fingers are more likely to be amputated if an infection develops and healing is poor.

Yes. Because unmanaged diabetes can damage the blood vessels of the retina, blindness is possible. If you havent been diagnosed with diabetes yet but are experiencing a change in your vision, see primary healthcare provider or ophthalmologist as soon as you can.

Scientists dont have firm answers yet but there appears to be a correlation between hearing loss and diabetes. According to the American Diabetes Association, a recent study found that hearing loss was twice as common in people with diabetes versus those who didnt have diabetes. Also, the rate of hearing loss in people with prediabetes was 30% higher compared with those who had normal blood glucose levels. Scientists think diabetes damages the blood vessels in the inner ear, but more research is needed.

Yes, its possible to develop headaches or dizziness if your blood glucose level is too low usually below 70 mg/dL. This condition is called hypoglycemia. You can read about the other symptoms hypoglycemia causes in this article. Hypoglycemia is common in people with Type 1 diabetes and can happen in some people with Type 2 diabetes who take insulin (insulin helps glucose move out of the blood and into your bodys cells) or medications such as sulfonylureas.

Yes, its possible for diabetes to cause hair loss. Unmanaged diabetes can lead to persistently high blood glucose levels. This, in turn, leads to blood vessel damage and restricted flow, and oxygen and nutrients cant get to the cells that need it including hair follicles. Stress can cause hormone level changes that affect hair growth. If you have Type 1 diabetes, your immune system attacks itself and can also cause a hair loss condition called alopecia areata.

People with Type 1 diabetes need insulin to live. If you have Type 1 diabetes, your body has attacked your pancreas, destroying the cells that make insulin. If you have Type 2 diabetes, your pancreas makes insulin, but it doesnt work as it should. In some people with Type 2 diabetes, insulin may be needed to help glucose move from your bloodstream to your bodys cells where its needed for energy. You may or may not need insulin if you have gestational diabetes. If you are pregnant or have Type 2 diabetes, your healthcare provider will check your blood glucose level, assess other risk factors and determine a treatment approach which may include a combination of lifestyle changes, oral medications and insulin. Each person is unique and so is your treatment plan.

You arent born with diabetes, but Type 1 diabetes usually appears in childhood. Prediabetes and diabetes develop slowly over time. Gestational diabetes occurs during pregnancy. Scientists do believe that genetics may play a role or contribute to the development of Type 1 diabetes. Something in the environment or a virus may trigger its development. If you have a family history of Type 1 diabetes, you are at higher risk of developing Type 1 diabetes. If you have a family history of prediabetes, Type 2 diabetes or gestational diabetes, youre at increased risk of developing prediabetes, Type 2 diabetes or gestational diabetes.

Diabetes-related ketoacidosis is a life-threatening condition. It happens when your liver breaks down fat to use as energy because theres not enough insulin and therefore glucose isnt being used as an energy source. Fat is broken down by the liver into a fuel called ketones. The formation and use of ketones is a normal process if it has been a long time since your last meal and your body needs fuel. Ketones are a problem when your fat is broken down too fast for your body to process and they build up in your blood. This makes your blood acidic, which is a condition called ketoacidosis. Diabetes-related ketoacidosis can be the result of unmanaged Type 1 diabetes and less commonly, Type 2 diabetes. Diabetes-related ketoacidosis is diagnosed by the presence of ketones in your urine or blood and a basic metabolic panel. The condition develops over several hours and can cause coma and possibly even death.

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) develops more slowly (over days to weeks) than diabetes-related ketoacidosis. It occurs in patients with Type 2 diabetes, especially the elderly and usually occurs when patients are ill or stressed. If you have HHNS, you blood glucose level is typically greater than 600 mg/dL. Symptoms include frequent urination, drowsiness, lack of energy and dehydration. HHNS is not associated with ketones in the blood. It can cause coma or death. Youll need to be treated in the hospital.

This means your kidneys are allowing protein to be filtered through and now appear in your urine. This condition is called proteinuria. The continued presence of protein in your urine is a sign of kidney damage.

A note from Cleveland Clinic

Theres much you can do to prevent the development of diabetes (except Type 1 diabetes). However, if you or your child or adolescent develop symptoms of diabetes, see your healthcare provider. The earlier diabetes is diagnosed, the sooner steps can be taken to treat and manage it. The better you are able to manage your blood sugar level, the more likely you are to live a long, healthy life.

Originally posted here:
Diabetes: An Overview - Cleveland Clinic