Diabetes
Almost everyone knows someone who has diabetes. An
estimated 18.2 million people in the United States-6.3 percent of the
population-have diabetes, a serious, lifelong condition. Of those, 13 million have been diagnosed, and about
5.2 million people have not yet been diagnosed. Each year, about 1.3 million
people aged 20 or older are diagnosed with diabetes.
What is diabetes?
Diabetes is a disorder of metabolism-the way our bodies
use digested food for growth and energy. Most of the food we eat is broken down
into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.
After digestion, glucose passes into the bloodstream,
where it is used by cells for growth and energy. For glucose to get into cells,
insulin must be present. Insulin is a hormone produced by the pancreas, a large gland
behind the stomach.
When we eat, the pancreas automatically produces the right amount of insulin
to move glucose from blood into our cells. In people with diabetes, however, the
pancreas either produces little or no insulin, or the cells do not respond
appropriately to the insulin that is produced. Glucose builds up in the blood,
overflows into the urine, and passes out of the body. Thus, the body loses its
main source of fuel even though the blood contains large amounts of glucose.
What are the types of diabetes?
The three main types of diabetes are
Type 1 Diabetes
Type 1 diabetes is an autoimmune disease. An
autoimmune disease results when the body's system for fighting infection (the immune system) turns
against a part of the body. In diabetes, the immune system attacks the insulin-producing
beta cells in the pancreas and destroys them. The pancreas then produces little
or no insulin. A person who has type 1 diabetes must take insulin daily to live.
At present, scientists do not know exactly what causes
the body's immune system to attack the beta cells, but they believe that
autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts
for about 5 to 10 percent of diagnosed diabetes in the United States. It
develops most often in children and young adults, but can appear at any age.
Symptoms of type 1 diabetes usually develop over a short period, although
beta cell destruction can begin years earlier. Symptoms include increased thirst
and urination, constant hunger, weight loss, blurred vision, and extreme
fatigue. If not diagnosed and treated with insulin, a person with type 1
diabetes can lapse into a life-threatening diabetic coma, also known as diabetic
ketoacidosis.
Type 2 Diabetes
The most common form of diabetes is type 2 diabetes.
About 90 to 95 percent of people with diabetes have type 2. This form of
diabetes is associated with older age, obesity, family history of
diabetes, previous history of gestational diabetes, physical inactivity, and
ethnicity. About 80 percent of people with type 2 diabetes are overweight.
Type 2 diabetes is increasingly being diagnosed in
children and adolescents. However, nationally representative data on prevalence
of type 2 diabetes in youth are not available.
When type 2 diabetes is diagnosed, the pancreas is
usually producing enough insulin, but for unknown reasons, the body cannot use
the insulin effectively, a condition called insulin resistance. After several years, insulin production
decreases. The result is the same as for type 1 diabetes-glucose builds up in
the blood and the body cannot make efficient use of its main source of fuel.
The symptoms of type 2 diabetes develop
gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include
fatigue or nausea, frequent
urination, unusual thirst, weight loss, blurred vision, frequent infections, and
slow healing of wounds or sores. Some people have no symptoms.
Gestational Diabetes
Gestational diabetes develops only during pregnancy.
Like type 2 diabetes, it occurs more often in African Americans, American
Indians, Hispanic Americans, and among women with a family history of diabetes. Women who have had
gestational diabetes have a 20 to 50 percent chance of developing type 2
diabetes within 5 to 10 years.
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