Diabetes mellitus is a metabolic disorder that occurs when the body either doesn’t produce sufficient insulin or doesn’t use insulin properly causing blood sugar (glucose) levels to rise (hyperglycemia).
Glucose is the body’s main source of energy, and the pancreas produces a hormone called insulin that helps convert glucose from the food you eat into energy your body uses.
- Type 1 diabetes is a condition in which little to no insulin is produced by the pancreas. Type 1 diabetes was formerly called juvenile diabetes because it tends to be diagnosed in children and young adults. It is an autoimmune condition, which means it is chronic and will need to be managed for life.
- Type 2 diabetes is different in that it occurs when the body doesn’t use insulin properly causing blood sugar levels to rise. It is the most common form of diabetes and while it can occur at any age, it most often occurs in middle-aged and older adults. In addition, while you cannot get rid of type 1 diabetes, you may be able to reverse type 2 diabetes with diet, exercise, maintaining a healthy weight, and lifestyle changes; however, these healthy habits must be maintained for life, or the changes will not be permanent.
What Are Symptoms of Diabetes?
Symptoms of diabetes include:
- Increased urination
- Increased thirst
- Increased hunger, even though people are eating
- Blurred vision
- Sores/cuts/bruises that do not heal
- Frequent infections
- Darkened skin, often in the armpits and neck
- Unexplained weight loss (more common in type 1)
- Numbness, tingling, or pain in the feet or hands (more common in type 2)
What Causes Diabetes?
Type 1 diabetes is believed to be caused by an autoimmune reaction in which the body attacks itself and destroys beta cells in the pancreas that make insulin.
Risk factors for developing type 1 diabetes include:
- Triggers, such viruses
Type 1 diabetes is not caused by diet or lifestyle factors.
Type 2 diabetes is caused by several factors, including:
- Family history
- Occurs more often in certain ethnic groups: African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
- Lifestyle factors
Factors that can increase the risk of developing type 2 diabetes include:
How Is Diabetes Diagnosed?
Both type 1 and type 2 diabetes are diagnosed with the following tests:
- Fasting plasma glucose (FPG) test
- A1C test
- Glucose challenge test
- Random plasma glucose (RPG) 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)
- Take prescribed diabetes medications
- Check blood glucose levels daily
- Keep blood pressure in check
- Maintain healthy cholesterol levels
- Follow a diabetes meal plan as recommended by your doctor or nutritionist
- Eat plenty of fruits and vegetables, whole grains, beans, lean poultry and fish, and low-fat dairy
- Drink plenty of water
- Chose foods that are low-calorie, low-fat, low-sugar, and low-salt
- Exercise regularly
- Get adequate sleep
- Don’t smoke
- Manage stress/practice relaxation techniques
Medications used to treat diabetes include:
- People who have type 1 diabetes need to take insulin shots or wear an insulin pump every day to manage blood sugar levels
- 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
If lifestyle changes and medications are insufficient, other treatments for diabetes may include:
- Weight-loss surgery (bariatric surgery) for certain patients who are obese
- Pancreas transplant
- Artificial pancreas
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