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What is diabetes?
Diabetes is a condition that happens when your blood sugar (glucose) is too high. It develops when your pancreas doesn’t make enough insulin or any at all, or when your body isn’t responding to the effects of insulin properly. Diabetes affects people of all ages. Most forms of diabetes are chronic (lifelong), and all forms are manageable with medications and/or lifestyle changes.
Glucose (sugar) mainly comes from carbohydrates in your food and drinks. It’s your body’s go-to source of energy. Your blood carries glucose to all your body’s cells to use for energy.
Over time, having consistently high blood glucose can cause health problems, such as heart disease, nerve damage and eye issues.
The technical name for diabetes is diabetes mellitus. Another condition shares the term “diabetes” — diabetes insipidus — but they’re distinct. They share the name “diabetes” because they both cause increased thirst and frequent urination. Diabetes insipidus is much rarer than diabetes mellitus.
There are several types of diabetes. The most common forms include:
● Type 2 diabetes: With this type, your body doesn’t make enough insulin and/or your body’s cells don’t respond normally to the insulin (insulin resistance). This is the most common type of diabetes. It mainly affects adults, but children can have it as well.
● Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
● Type 1 diabetes: This type is an autoimmune disease in which your immune system attacks and destroys insulin-producing cells in your pancreas for unknown reasons. Up to 10% of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults, but it can develop at any age.
● Gestational diabetes: This type develops in some people during pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes, you’re at a higher risk of developing Type 2 diabetes later in life.
Causes of diabetes include:
● Insulin resistance: Type 2 diabetes mainly results from insulin resistance. Insulin resistance happens when cells in your muscles, fat and liver don’t respond as they should to insulin. Several factors and conditions contribute to varying degrees of insulin resistance, including obesity, lack of physical activity, diet, hormonal imbalances, genetics and certain medications.
● Autoimmune disease: Type 1 diabetes and LADA happen when your immune system attacks the insulin-producing cells in your pancreas.
● Hormonal imbalances: During pregnancy, the placenta releases hormones that cause insulin resistance. You may develop gestational diabetes if your pancreas can’t produce enough insulin to overcome the insulin resistance. Other hormone-related conditions like acromegaly and Cushing syndrome can also cause Type 2 diabetes.
● Pancreatic damage: Physical damage to your pancreas — from a condition, surgery or injury — can impact its ability to make insulin, resulting in Type 3c diabetes.
● Genetic mutations: Certain genetic mutations can cause MODY and neonatal diabetes.
Long-term use of certain medications can also lead to Type 2 diabetes, including HIV/AIDS medications and corticosteroids.
Diabetes can lead to acute (sudden and severe) and long-term complications — mainly due to extreme or prolonged high blood sugar levels.
Long-term diabetes complications
Blood glucose levels that remain high for too long can damage your body’s tissues and organs. This is mainly due to damage to your blood vessels and nerves, which support your body’s tissues.
Cardiovascular (heart and blood vessel) issues are the most common type of long-term diabetes complication. They include:
● Coronary artery disease.
● Heart attack.
● Stroke.
● Atherosclerosis.
Other diabetes complications include:
● Nerve damage (neuropathy), which can cause numbness, tingling and/or pain.
● Nephropathy, which can lead to kidney failure or the need for dialysis or transplant.
● Retinopathy, which can lead to blindness.
● Diabetes-related foot conditions.
Skin infections.
● Amputations.
● Sexual dysfunction due to nerve and blood vessel damage, such as erectile dysfunction or vaginal dryness.
● Gastroparesis.
● Hearing loss.
● Oral health issues, such as gum (periodontal) disease.
Living with diabetes can also affect your mental health. People with diabetes are two to three times more likely to have depression than people without diabetes.
Healthcare providers diagnose diabetes by checking your glucose level in a blood test. Three tests can measure your blood glucose level:
● Fasting blood glucose test: For this test, you don’t eat or drink anything except water (fast) for at least eight hours before the test. As food can greatly affect blood sugar, this test allows your provider to see your baseline blood sugar.
● Random blood glucose test: “Random” means that you can get this test at any time, regardless of if you’ve fasted.
● A1c: This test, also called HbA1C or glycated hemoglobin test, provides your average blood glucose level over the past two to three months.
To screen for and diagnose gestational diabetes, providers order an oral glucose tolerance test.
The following test results typically indicate if you don’t have diabetes, have prediabetes or have diabetes. These values may vary slightly. In addition, healthcare providers rely on more than one test to diagnose diabetes.