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An estimated 23 million Americans have diabetes, a disease characterized by too much sugar in the bloodstream. More than 5 million of them, however, have not yet been diagnosed with the disease. If you have diabetes, you will want to learn as much as you can about how to take care of yourself. The better you eat and the more you exercise and keep your weight down, the more likely you will be able to lead a full and healthy life.

Diabetes occurs when the pancreas, a gland behind the stomach, does not produce enough of the hormone insulin. Insulin is necessary to carry sugar from the bloodstream into the cells. Once inside the cells, sugar is converted into energy for immediate use or stored for the future. That energy fuels all our bodily functions and rids the body of waste products. This process is known as metabolism.

Here is what normally happens during metabolism:

During and just after a meal, the body digests food into its “basic building blocks.” In this way, the body breaks down carbohydrates (starches) into sugar. Glucose is the primary form of sugar the body needs for energy.

After the meal, glucose is absorbed into the blood.

The rise in blood glucose tells the pancreas to make insulin, which goes out into the bloodstream. About 10 minutes after a meal, insulin is at its highest level.

Insulin helps the glucose enter the body's cells. The glucose either is used right away for energy or stored in the liver and muscles for future use.

About two to four hours after eating a meal, the body returns to low levels of blood glucose and starts using stored glucose for energy.

Here is what happens if a person has diabetes:

The pancreas is unable to produce enough insulin or the body is resistant to the action of insulin.

Without enough insulin to move sugar from the bloodstream into the cells, the blood glucose level rises too high.

As blood glucose rises, extra glucose passes into the urine and out of the body before the body gets the energy it needs every day.

The body reacts to a prolonged sugar imbalance and, eventually, the person may develop major health problems. This is why it is important to get tested for diabetes and begin treatment as soon as possible.

There are two types of diabetes: type 1 and type 2. Type 1 diabetes is the more severe form as far as glucose is concerned. People with type 1 diabetes must take insulin every day because their bodies make very little or no insulin. Symptoms of type 1 diabetes can come on suddenly. This form of the disease is commonly seen in children and used to be called insulin-dependent diabetes or juvenile diabetes, although it may occur at any age.

Type 2 diabetes is the most common form of the disease, affecting 90 to 95 percent of people with diabetes. In type 2 diabetes, the body is resistant to the action of insulin, meaning it cannot use insulin properly, so it cannot carry sugar into the cells. Although the body makes some insulin, it is not enough to overcome this resistance. Being overweight adds to insulin resistance. Therefore, as more children and adults become overweight, many more are developing type 2 diabetes.

People with type 2 diabetes often can control the condition with a healthy lifestyle, which includes exercise and diet that lead to a return to normal body weight. Many may need medications, however. These medications can either improve insulin secretion by the pancreas or decrease insulin resistance. Some individuals may also need to take insulin. In type 2 diabetes, the ability of the pancreas to make insulin slowly gets worse over time. This is why lifestyle changes may be sufficient shortly after diabetes develops, but eventually medications and even insulin may be needed to keep blood sugar under control. If the disease is in the early stage, an individual may not experience any diabetes symptoms. If you suspect you may have diabetes, you should see a doctor. Symptoms of diabetes include fatigue, weight loss, blurred vision, excessive thirst, and excessive urination.

You are more likely to develop diabetes if you are overweight, have a family history of diabetes, or have a history of diabetes during pregnancy. If any of these apply to you, you should get tested for diabetes. Other groups more likely to have the disease are people over 45 years of age and non-Caucasians. Signs of diabetes should not be ignored.

A doctor will do various tests to measure a person's blood glucose level and his or her ability to tolerate glucose. Getting blood glucose levels under control is necessary to prevent the complications of diabetes. Both types of diabetes can cause dangerous complications if not controlled. Uncontrolled diabetes can cause blindness, heart disease, and kidney failure. Decreased blood flow to the limbs may eventually lead to amputation. And people with diabetes may experience life-threatening reactions to extremely low or high blood sugar levels.

Because of the possible serious consequences of uncontrolled diabetes, people with the disease must manage their treatment carefully. Endocrinologists and internal medicine physicians who specialize in diabetes are trained to help patients manage this condition. People with diabetes may also need to see eye doctors (ophthalmologists), foot doctors (podiatrists), dietitians, and diabetes educators to round out their care. Only with proper attention can people with diabetes live the healthiest life possible.

© 2012 The Hormone Foundation. All rights reserved.

Diabetes Mellitus

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