Most of the food we eat is turned into glucose, or sugar, for
our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a
hormone called insulin to help glucose get into the cells of our bodies. When you have
diabetes, your body either doesn't make enough insulin or can't use its own insulin as
well as it should. This causes sugars to build up in your blood.
Diabetes can cause serious health complications including
heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the
seventh leading cause of death in the United States.
People who think they might have diabetes must visit a
physician for diagnosis. They might have SOME or NONE of the following symptoms:
- Frequent urination
- Excessive thirst
- Unexplained weight loss
- Extreme hunger
- Sudden vision changes
- Tingling or numbness in hands or feet
- Feeling very tired much of the time
- Very dry skin
- Sores that are slow to heal
- More infections than usual.
Nausea, vomiting, or stomach pains may accompany some of
these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1
diabetes.
The following types of diabetes and some of their risk
factors are quoted from the National Diabetes Fact Sheet: National estimates and
general information on diabetes in the United States (Centers for Disease Control and
Prevention. Atlanta, GA: US Department of Health and Human Services, 1997):
Type 1 diabetes
was
previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes.
Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors
are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune,
genetic, and environmental factors are involved in the development of this type of
diabetes.
Type 2 diabetes
was
previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes.
Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. Risk
factors for type 2 diabetes include older age, obesity, family history of diabetes, prior
history of gestational diabetes, impaired glucose tolerance, physical inactivity, and
race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some
Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.
Gestational diabetes
develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over.
Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino
Americans, American Indians, and people with a family history of diabetes than in other
groups. Obesity is also associated with higher risk. Women who have had gestational
diabetes are at increased risk for later developing type 2 diabetes. In some studies,
nearly 40% of women with a history of gestational diabetes developed diabetes in the
future.
Other specific types of diabetes
result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and
other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of
diabetes.
Management strategies should be planned along with a
qualified health care team.
The following information on treatments for diabetes is from
the National Diabetes Fact Sheet: National estimates and general information on
diabetes in the United States (Centers for Disease Control and Prevention. Atlanta,
GA: US Department of Health and Human Services, 1997):
Diabetes knowledge, treatment, and prevention strategies
advance daily. Treatment is aimed at keeping blood glucose near normal levels at all
times. Training in self-management is integral to the treatment of diabetes. Treatment
must be individualized and must address medical, psychosocial, and lifestyle issues.
Treatment of type 1 diabetes:
Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to
control. Treatment requires a strict regimen that typically includes a carefully
calculated diet, planned physical activity, home blood glucose testing several times a
day, and multiple daily insulin injections.
Treatment of type 2 diabetes: Treatment
typically includes diet control, exercise, home blood glucose testing, and in some cases,
oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require
insulin injections.
The causes of type 1 diabetes appear to be much different
than those for type 2 diabetes, though the exact mechanisms for development of both
diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to
an "environmental trigger," such as an unidentified virus, stimulating an immune
attack against the beta cells of the pancreas (that produce insulin) in some genetically
predisposed people.
A number of studies have shown that regular physical activity
can significantly reduce the risk of developing type 2 diabetes. It also appears to be
associated with obesity. Researchers are making progress in identifying the exact genetics
and "triggers" that predispose some individuals to develop type 1 diabetes, but
prevention, as well as a cure, remains elusive.
In response to the growing health burden of diabetes mellitus
(diabetes), the diabetes community has three choices: prevent diabetes; cure diabetes; and
take better care of people with diabetes to prevent devastating complications. All three
approaches are actively being pursued by the US Department of Health and Human Services.
Both the National Institutes of Health (NIH) and the Centers
for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is
involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC
focuses most of its programs on being sure that the proven science is put into daily
practice for people with diabetes. The basic idea is that if all the important research
and science are not made meaningful in the daily lives of people with diabetes, then the
research is, in essence, wasted.
Several approaches to "cure" diabetes are being
pursued:
- Pancreas transplantation
- Islet cell transplantation (islet cells produce insulin)
- Artificial pancreas development
- Genetic manipulation (fat or muscle cells that don’t
normally make insulin have a human insulin gene inserted — then these
"pseudo" islet cells are transplanted into people with type 1 diabetes).
Each of these approaches still has a lot of challenges, such
as preventing immune system rejection; finding an adequate number of insulin cells;
keeping cells alive; and others. But progress is being made in all areas.
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