What Is Diabetes?
Diabetes is a metabolic disorder that happens when blood sugar (glucose) is too high (hyperglycemia). Glucose is the body’s main source of energy, and the pancreas produces the hormone insulin that converts glucose from the food you eat into energy the body uses. When the body doesn’t make enough insulin or doesn’t produce any at all, or the body becomes insulin resistant, glucose doesn’t reach the cells to be used for energy. This results in diabetes.
Types of diabetes include:
- Type 1 diabetes (formerly called juvenile diabetes) is an autoimmune condition in which the body does not produce insulin
- Type 2 diabetes, the most common form of diabetes, is a condition in which the body does not produce adequate insulin or does not use it efficiently
- Gestational diabetes develops in some women during pregnancy and usually goes away after the baby is born
What Are Symptoms of Diabetes?
Symptoms of type 1 diabetes often escalate quickly, within in a matter of weeks, while symptoms of type 2 diabetes usually develop slowly over several years. People who have type 2 diabetes may have no symptoms or only mild symptoms.
The three most common symptoms of undiagnosed diabetes include:
- Increased thirst (polydipsia)
- High blood sugar levels cause increased thirst
- Increased urination (polyuria)
- Needing to urinate more throughout the day
- Urinating more often than usual at night
- Increased hunger (polyphagia)
Because diabetes makes it more difficult for the body to convert the glucose from foods into energy, people with high blood sugar levels are often more hungry
Other symptoms of diabetes include:
What Causes Diabetes?
The causes of diabetes differ depending on the type.
Type 1 diabetes occurs when the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. The cause of type 1 diabetes is believed to a combination of genes and environmental factors that might trigger the disease.
Type 2 diabetes is caused by several factors, including:
Gestational diabetes is believed to be caused by hormonal changes that occur during pregnancy along with genetic and lifestyle factors such as being overweight or obese.
How Is Diabetes Diagnosed?
Diabetes is diagnosed with the following tests:
- A1C test
- Fasting plasma glucose (FPG) test
- Random plasma glucose (RPG) test
- Glucose challenge test
- Oral glucose tolerance test (OGTT)
What Is the Treatment for Diabetes?
Diabetes is treated with lifestyle modifications and medications when needed.
Lifestyle changes to manage diabetes include:
Manage A1C (average blood glucose level over the past 3 months)
Check blood glucose levels daily
Manage blood pressure
Keep cholesterol levels in check
Follow a diabetes meal plan as recommended by your doctor or nutritionist
Take prescribed diabetes medications
Medications used to treat diabetes include:
- People with type 1 diabetes need insulin
- People with type 2 diabetes may need insulin, or other diabetes medications
- Meglitinides such as repaglinide (Prandin) and nateglinide (Starlix)
- Alpha-glucosidase inhibitors such as miglitol (Glyset) and acarbose (Precose)
- Thiazolidinediones such as pioglitazone (Actos) and rosiglitazone (Avandia)
- DPP- 4 Inhibitors such as sitagliptin (Januvia), saxagliptin (Onglyza), alogliptin (Nesina), and linagliptin (Tradjenta)
- Sulfonylureas such as glimepiride (Amaryl), glyburide (Diabeta, Glynase), chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), tolbutamide, and tolazamide
- Biguanides such as metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, and Riomet)
- Dopamine receptor agonists such as bromocriptine (cycloset)
- Bile acid sequestrants such as colesevelam (Welchol)
- SGLT2 inhibitors such as dapagliflozin (Farxiga), canagliflozin (Invokana), empagliflozin (Jardiance), and ertugliflozin (Steglatro)
- GLP-1 receptor agonists such as lixisenatide (Adlyxin), exenatide (Bydureon, Byetta), semaglutide (Ozempic), albiglutide (Tanzeum), dulaglutide (Trulicity), and liraglutide (Victoza)
- Amylin analog such as pramlintide acetate (Symlin)
- Combination medicines, which may be made up of more than one medication in the above classes
- People with gestational diabetes may need insulin or metformin
If lifestyle changes and medications are insufficient, other treatments for diabetes may include:
- Weight-loss surgery (bariatric surgery) for certain patients who are obese
- Artificial pancreas
- Pancreatic islet transplantation (treatment is experimental and for poorly controlled type 1 diabetes)