What is diabetes?
Diabetes is a disease that occurs when your body doesn’t make or use insulin properly. Insulin is a hormone. It causes too much blood glucose (sugar) to build up in the blood. There are two main types of diabetes.
Type 1 diabetes, the focus of this article, occurs when your body doesn’t produce any insulin. It is an autoimmune disease that develops gradually over time. If often has no initial symptoms. It’s sometimes called juvenile diabetes because it’s usually discovered in children and teenagers, but it may appear in adults, too.
Type 2 diabetes occurs when your body doesn’t produce enough insulin or doesn’t use the insulin as it should. In the past, doctors thought only adults were at risk of developing type 2 diabetes. However, an increasing number of children in the United States are now being diagnosed with the disease. Doctors think this increase is mostly because more children are overweight or have obesity and are less physically active.
Symptoms of diabetes
Symptoms vary from person to person. The early stages of diabetes have very few symptoms. You may not know you have the disease. But damage may already be happening to your eyes, your kidneys, and your cardiovascular system. Common symptoms include:
- Extreme hunger
- Extreme thirst
- Frequent urination
- Unexplained weight loss
- Fatigue or drowsiness
- Blurry vision
- Slow-healing wounds, sores, or bruises
- Dry, itchy skin
- Tingling or numbness in the hands or feet
- Frequent or recurring skin, gum, bladder, or vaginal yeast infections
If blood sugars are extremely high, people can develop diabetic ketoacidosis (DKA). This is a very dangerous complication of uncontrolled diabetes. People with DKA might have:
- Nausea or vomiting more than once
- Deeper, faster breathing
- The smell of nail polish remover coming from your breath
- Weakness, drowsiness, trembling, confusion, or dizziness
- Uncoordinated muscle movement
If diabetes is left untreated, your blood sugar levels become too high. When this happens, symptoms may include shortness of breath, pain in the abdomen, vomiting, dehydration, and even coma and death.
What causes diabetes?
In type 1 diabetes, your body doesn’t make insulin. This is because the immune system attacks and destroys the cells in the pancreas that make the insulin. Doctors aren’t sure why this happens. You have a greater risk of type 1 diabetes if one of your parents or one of your siblings has it. According to the American Diabetes Association, if you have a close family member who has type 1 diabetes, you are 15 times more likely to develop the disease yourself.
How is diabetes diagnosed?
If you have a family member who has type 1 diabetes, your doctor may want to screen you early because you are at greater risk for developing diabetes.
After examining you, discussing your symptoms, and going over your health history, your doctor may test for diabetes if they suspect you’re at risk. To check for diabetes, your doctor may request the following tests:
- Fasting blood sugar test. This test is usually done in the morning, after an 8-hour fast (not eating or drinking anything except water for 8 hours before the test). The blood test typically involves a finger stick to get a drop of blood. But it could also be done by inserting a small needle into a vein in your arm to withdraw blood. That blood will be sent to a lab for testing. If your blood sugar level is 126 milligrams per deciliter (mg/dL) or higher, your doctor will probably want to repeat the test. A blood sugar level of 126 milligrams per deciliter (mg/dL) or higher on 2 occasions indicates diabetes. A blood sugar level of 100 mg per dL to 125 mg per dL suggest you have prediabetes. A blood sugar level of less than 99 mg per dL is normal.
- Oral glucose tolerance test. During this test, you will drink a beverage containing 75 grams of glucose dissolved in water. This tastes like sweet water. Two hours later, a doctor or nurse will measure the amount of glucose in your blood. A blood sugar level of 200 mg/dL or higher indicates diabetes.
- Random blood sugar test. This test measures the level of glucose in your blood at any time of day. It doesn’t matter when you last ate. Combined with symptoms of diabetes, a blood glucose level of 200 mg/dL or higher indicates diabetes.
- A1C blood test. This test provides information about a person’s average levels of blood glucose over the previous 3 months. The results are reported as a percentage. A normal A1C level is below 5.7%. If your A1C is higher than that, it means your blood sugar has been higher than normal during that three-month period. A test result between 5.7% and 6.4% indicates prediabetes. A result of 6.5% or above indicates diabetes.
It is important to tell your doctor if you have a family member who has type 1 diabetes.
Can diabetes be prevented or avoided?
Type 1 diabetes cannot be prevented or avoided, but it can be managed.
Diabetes treatment
The single most important thing you can do when you have diabetes is control your blood sugar level. You can do this by through a combination of taking insulin and eating right, exercising, and maintaining a healthy weight.
- Your diet should include lots of complex carbohydrates (such as whole grains), fruits, and vegetables. It’s important to eat at least 3 meals per day and never skip a meal. Eat at about the same time every day. This helps keep your insulin or medicine and sugar levels steady. Avoid empty calories, such as foods high in sugar and fat, or alcohol.
- Exercising helps your body use insulin and lower your blood sugar level. It also helps control your weight, gives you more energy, and is good for your overall health. Exercise also is good for your heart, your cholesterol levels, your blood pressure, and your weight. These are all factors that can affect your risk of heart attack and stroke. Talk with your doctor about starting an exercise program.
- Maintain a healthy weight. Losing excess weight and maintaining a healthy body weight will help you in two ways. First, it helps insulin work better in your body. Second, it will lower your blood pressure and decrease your risk for heart disease. Even a 10% reduction in weight can lower your blood sugar levels.
- Take your medicine. Insulin therapy is necessary for all people who have type 1 diabetes. You’ll have to give yourself a shot (either with a syringe or with an insulin pen). Your doctor will tell you which kind of medicine you should take and why.
Your doctor will test your blood sugar every 3 months with an A1C test. Your doctor may ask you to test your blood sugar on your own throughout the day if you are taking insulin. You will need to use a blood glucose monitor to check it on your own. This involves pricking your finger for blood and putting a test strip in the blood. Putting the test strip in the monitor gets the results. Continuous glucose monitors (CGM) are also an option to help people with diabetes measure their blood glucose around the clock
If your blood sugar gets too low, you might feel tired, experience problems with muscle coordination, sweat, have difficulty thinking or speaking clearly, twitch, feel like you’re going to faint, become pale, lose consciousness, or have a seizure. At the earliest sign of any of these symptoms, eat or drink something that will raise your blood sugar fast. This could include candy, juice, milk, or raisins. If you don’t feel better in 15 minutes or if monitoring shows that your blood sugar level is still too low, eat or drink another item to raise your blood sugar fast. Always keep a supply of these items on hand for emergencies.
You may not know if your blood sugar is too high unless you test it yourself. However, you may experience common symptoms such as frequent urination, extreme thirst, blurry vision, and feeling tired. Some factors unrelated to food can make your blood sugar high. This includes not taking your insulin correctly, overeating at a meal, illness, having hormonal changes, and stress.
If your blood sugar level is too high, you may need to take an extra dose of rapid- or short-acting insulin to return to normal. Your doctor can tell you how much insulin you need to take to lower your blood sugar level.
Living with diabetes
You can live a normal life with well-controlled diabetes. However, you must pay close and regular attention to your diet, weight, exercise, and medicine. If you don’t control your diabetes, you will have too much glucose in your blood. This can lead to serious health problems, including heart disease and damage to the nerves and kidneys. You could also lose your vision and sensation in your legs. These are known as diabetic complications.
The longer your diabetes is uncontrolled, the more damage you do to your health. That’s why treatment is important at any age. Keeping blood sugar levels very close to the ideal can minimize, delay, and in some cases even prevent the problems that diabetes can cause.
Questions to ask your doctor
- How did I get diabetes?
- If I have diabetes, will my children develop it, too?
- Will I need to take insulin?
- If I don’t have a family history of diabetes, can I still get it?
- Can your diabetes get worse even if you do everything right?
Resources
National Institute of Diabetes and Digestive and Kidney Diseases: Diabetes
