Description

What it is

Diabetes is a chronic illness in which the body doesn't produce enough insulin, or uses it improperly. Normally, starches, sugars and other nutrients are broken down into glucose, which is taken by the blood to cells. The cells use insulin, a hormone produced by the pancreas, to help convert glucose into energy. Without enough insulin, or when it is not properly used, glucose builds up in the blood and urine, which can cause numerous problems.

The incidence of diabetes is growing rapidly. In 1995, a global estimate of its occurrence was about 150 million. That rose to about 171 million cases in 2000, with a projected increase to 366 million by 2030.

The Cause

The cause of diabetes is not clear. There may be a family connection, so if a parent has diabetes, his or her child may be more likely to have it, too. Lifestyle, including diet and exercise, also plays a significant role-type 2 diabetes is more likely to occur in people who are overweight.

Types of Diabetes

People with Type 1 diabetes have insulin deficiency, which means that the body does not produce enough insulin. So nutrients taken in are not converted to energy. Typically less than 10% of people with diabetes have type 1, and most cases are diagnosed in children and young adults.

People with Type 2 diabetes have insulin resistance. The body may produce some insulin but it is not used properly. About 85% to 95% of people with diabetes worldwide have type 2. Though type 2 diabetes used to occur most frequently in older people, in recent years it is becoming more frequent in younger people and children.

Gestational Diabetes

Diabetes during pregnancy is one example of "conditional" diabetes. "Conditional" diabetes occurs in relation to certain medical conditions, such as pancreatic disease, certain genetic disorders, and pregnancy. It may be short-term, however, women with diabetes during their pregnancy have an increased risk of developing type 2 diabetes.

Impaired Glucose Tolerance (IGT), or Pre-diabetes.

IGT means that the body's ability to control glucose levels is not normal, but not impaired enough to be called diabetes. People with IGT are at increased risk for developing type 2 diabetes.

Diagnosing Diabetes

Blood tests and symptoms are used to diagnose diabetes. FPG (fasting plasma glucose) is a test that is conducted after a patient has fasted (not had anything to eat or drink) for 8 hours. OGTT (oral glucose tolerance test) requires a patient to fast and then consume a glucose drink. Blood is tested 2 hours later. Blood glucose levels indicating diabetes:

FPG-126 mg/dL (7 mmol/L) or more
OGTT-200 mg/dL (11.1 mmol/L) or more

Usually two tests are required to confirm a diagnosis of diabetes.

Complications

People with diabetes are at increased risk for heart disease and stroke, nerve damage that can lead to pain and numbness in the hands and feet, kidney dysfunction, and eye disease.