Diabetes Control Matters

How Do They Know I have Diabetes?
Are There Different Kinds Of Diabetes?
Should My Family Be Tested For Diabetes?

Diabetes is a chronic disease in which the body does not make, and/or does not properly use insulin. Insulin is the hormone that helps the body use energy from sugar, starches and other foods. Glucose is a form of sugar produced when the body digests carbohydrates (sugar and starches). Glucose is the body's major fuel for the energy it needs. When insulin is absent or ineffective, the blood sugar level increases. High blood sugar levels can lead to both short and long-term problems. There is no cure for diabetes.

The 4 Types Of Diabetes

Type 1 Diabetes: Destruction of the insulin-producing beta-cells in the pancreas that usually leads to an absolute deficiency of insulin. Must be treated with insulin.

Type 2 Diabetes: Due primarily to the body not responding normally to the insulin made by the pancreas. Eventually the pancreas may become exhausted. May be treated with diet, exercise, pills, insulin or some combination of these.

Gestational Diabetes (GDM): The form of diabetes that first appears in pregnancy. May be treated with diet, exercise, or insulin (there are currently no pills approved for use in the U.S.) Must be treated aggressively to avoid birth defects.

Other Specific Types of Diabetes Mellitus: Includes those kinds of diabetes with relatively well-known causes (infection, drugs, genetic defects, etc.) May be helped by treating their underlying cause.

Do I Have Diabetes?

Symptoms of diabetes mellitus plus a casual plasma glucose concentration of >200 mg/dl. Casual refers to any time of the day, unrelated to meals. Symptoms of diabetes include:

• Polyuria (frequent urination)
• Polydipsia (extreme thirst)
• Unexplained weight loss
• Chronic Fatigue
• Frequent Infections

Fasting plasma glucose >126mg/dl. Fasting is defined as 8 hours or more without caloric intake. This is the preferred test for diagnosis.

Two-hour plasma glucose >200 mg/dl during performance of an OGTT (Oral Glucose Tolerance Test). Seldom used.

Who Should Be Tested For Diabetes?

- Aged 45 years and older; if normal results are obtained, screening should be repeated every 3 years.
- Younger individuals, or more frequent screening in the following:

• Obese (greater than 120% of desirable body weight)
• Individuals with a first degree relative with diabetes
• Members of high-risk ethnic populations (African Americans, Hispanics, American Indians, Asian Americans & Pacific Islanders)
• emales who have delivered a baby weighing >9 pounds or have been diagnosed with gestational diabetes
• High blood pressure
• History of impaired glucose tolerance
• HDL cholesterol < 35 mg/dl
• Triglycerides >250mg/dl