Diabetes is a disorder of metabolism, or the way our bodies process food for energy and growth. It is a serious lifetime disease that affects nearly 21 million Americans, or seven percent of the U.S. population. But equally troubling is the fact that nearly one third of these Americans are unaware that they have the condition. Additional statistics can be found at the National Diabetes Statistics fact sheet online.
Without qualification, diabetes usually refers to diabetes mellitus, but there are other less common conditions also named diabetes, including diabetes insipidus and gestational diabetes, which affects about four percent of pregnant women. Beyond these types of diabetes, there is some disagreement as to how its different forms are classified.
Generally, type 1 diabetes refers to that resulting from a failure of the body to produce insulin, which is a hormone that allows glucose to enter and fuel the cells of the body. By this definition, type 1 diabetes afflicts about 5-10% of Americans who are diagnosed with diabetes. More recent definitions group juvenile diabetes, childhood-onset diabetes, and some forms of insulin-dependent diabetes under the umbrella of type 1 diabetes.
Type 2 diabetes generally refers to that resulting from insulin resistance, in which the body has a relative insulin deficiency or cannot process it as efficiently. Most Americans with diabetes have type 2 diabetes.
Other types of diabetes that do not fall neatly into these categories include insulin-resistant type 1 diabetes (also known as double diabetes), latent autoimmune diabetes of adults (LADA) (also known as type 1.5 diabetes), and pre-diabetes.
Pre-diabetes occurs when blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. In addition to the 20.8 million Americans with diabetes, another 54 million have pre-diabetes.
While the cause of diabetes is not fully known, the disease occurs due to the body’s inability to produce or properly use insulin, a hormone the body needs to convert sugar, starches and other foods into energy. Both environmental factors and genetics such as lack of exercise and obesity seem to play a role in developing the disease.
After digestion, glucose enters the bloodstream. Insulin, which is automatically produced by the pancreas in the right amount, is needed for the glucose to enter cells. In a diabetic, the pancreas either doesn’t produce enough insulin, or the cells do not respond properly to the insulin that is produced. The glucose builds up in the blood and passes out of the body in the urine so that the body loses its main source of fuel.
Symptoms commonly associated with diabetes and glucose abnormalities include fatigue, frequent urination, unexplained weight loss, increased appetite, blurred vision, unusual irritability and listlessness. Diabetes may also reduce the body’s ability to resist infection, making it more susceptible to bladder infections, urinary tract infections, and other disorders.
Additional complications diabetes may cause if not adequately controlled include:
- nonketotic hyperosmolar coma
Serious long-term complications include:
- Doubled risk of cardiovascular disease
- Chronic renal failure
- Retinal damage that can lead to blindness
- Microvascular damage including erectile dysfunction
- Poor healing of wounds that can lead to gangrene, which may require amputation
If you are experiencing any of these symptoms or secondary complications and you suspect a glucose abnormality, you should consult a physician promptly. You should also be aware that certain anti-psychotic drugs such as olanzapine (Zyprexa) have been associated with an increased risk for the early onset of diabetes and other glucose abnormalities. If you are currently taking a second-generation anti-psychotic drug (SGA) and are experiencing any of the symptoms listed, you should not cease taking the drug as prescribed since doing so can be dangerous. You should, however, consult with your physician as soon as possible.
A diagnosis of diabetes or pre-diabetes is usually determined with an Oral Glucose Tolerance Test (OGTT) or a Fasting Plasma Glucose Test (FPG). The FPG test is easier, faster, and less expensive to conduct.
Types 1 and 2 diabetes are incurable chronic diseases, but most forms are treatable with insulin supplementation. Management of the condition is usually also managed with dietary modifications, other lifestyle changes and, in the case of type 2 diabetes, medications which allow cell receptors to more readily process insulin present in the blood.
With the proper treatment and changes in lifestyle factors such as quitting smoking and the maintenance of a healthy body weight, the risk profile for the secondary complications diabetes causes can also be improved.