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Diabetes mellitus, is most often simply referred to as diabetes and the name is derived from the Ancient Greeks. The syndrome is due to a metabolic disorder and is usually a combination of both hereditary and environmental factors.

According to the Center for Disease Control, each year in the United States some 1.5 million new cases of diabetes are diagnosed in people 20 years of age and older.

What is Diabetes?

Diabetes is a serious, lifelong condition characterized as a metabolic disorder, it effects the way the body uses food for energy and growth.  Most food that is eaten gets broken down into glucose, which is blood sugar, and glucose acts as the main fuel for the human body.  Once food has been digested, the glucose will pass into the bloodstream where cells convert it for energy and growth.  For glucose to be able to pass into the cells, insulin is necessary.  Insulin is a hormone produced by the pancreas, a large gland that sits behind the stomach.

When food is consumed, the pancreas normally produces the right amount of insulin needed to move the glucose from the blood and into cells.  In people who suffer from diabetes, the pancreas produces little to no insulin and the cells do not react well to the insulin that is produced.  In turn, glucose levels in the blood will build up and overflow into the kidneys where it is passed out of the body via urination.

As a result, the human body loses the main source of fuel, and because the blood contains large amounts of glucose that is unable to be metabolized by the body, diabetes can develop.

Different Types of Diabetes

There are three main types of diabetes:

  1. Type I diabetes
  2. Type II diabetes
  3. Gestational diabetes

Type I  form of diabetes is an autoimmune disease and results when the body's immune system to fight  turns against a part of the human body.  With diabetes, the immune system attacks and destroys the beta cells that produce insulin in the pancreas.  As a result, the pancreas produces a minimal amount or no insulin and the person must take insulin for daily survival.

Why the body's immune system attacks the beta cells is something scientists are at a loss to explain, it is believed the causes may be environmental, autoimmune, genetic and possibly viral.  Type I diabetes accounts for some 5-10% of diabetes diagnosed in the U.S. each year, and most commonly effects children and young adults.

Symptoms of Type I diabetes often develop over a short period of time, however destruction of beta cells can occur years earlier.  The most common symptoms are as follows:

  • Increased thirst
  • Increased urination
  • Constant hunger
  • Weight loss
  • Blurry vision
  • Extreme fatigue

If diabetes Type I goes undiagnosed over time, the results can be the person lapsing into a diabetic coma, which is also known as diabetic ketoacidosis.

Type II diabetes is the most common form of diabetes and between 90-95% of people diagnosed have this form of diabetes.  Most often associated with the elderly, obese and those who have a family history of diabetes.  However, Type II diabetes can also strike those with a previous history of gestational diabetes, lead a nonphysical lifestyle and certain ethnicities are also more likely to develop this form of diabetes.

Because of the rising epidemic of obesity in the United States, Type II diabetes is being diagnosed more frequently in children and adolescents.   The incidence of Type II diabetes  is especially high among youth of  African Americans, Mexican Americans and Pacific Islander descent.

When a case of Type II diabetes is diagnosed, the pancreas is usually making adequate amounts of insulin, however, for reasons not known the body is unable to use the insulin effectively, this condition is called insulin resistance.  The end result is the same as with Type I diabetes and glucose builds up in the blood and the body cannot use the fuel source effectively.

Symptoms of Type II diabetes often develop gradually, the onset of symptoms is not a sudden as with Type I diabetes.  The symptoms include the following:

  • Fatigue
  • Frequent urination
  • Increase in thirst and hunger
  • Weight loss
  • Blurry vision
  • Slow healing cuts, sores or wounds
  • It is important to note that some people have no symptoms

Gestational diabetes is a condition that develops in some women later in pregnancy.  Though this type of diabetes often disappears after the birth of the baby, women who develop gestational diabetes have an increased risk of developing Type II diabetes within a period of 5-10 years.  By maintaining a healthy body weight and being physically active, some women are able to prevent Type II diabetes from developing.

Approximately 4-10% of pregnant women in the U.S. develop gestational diabetes and it occurs more often in specific ethnic groups and the rate is higher among women with a family history of diabetes. Gestational diabetes may happen as a result of pregnancy hormones or because of an insulin shortage and women with gestational diabetes may not experience any symptoms.

There are also other types of diabetes that exist and a person may show characteristics of more than one type of diabetes.  Other types of diabetes include the following:

  • Latent Autoimmune Diabetes in Adults (LADA):  people can exhibit signs of both Type I and Type II diabetes.
  • Diabetes caused by Genetic Defects in Beta Cells:  this form of diabetes results in a defect of the beta cells and may result from a mutation or change in a single gene and in most cases, the mutation is inherited, although in some cases the gene can mutate spontaneously.
  • Diabetes caused by Genetic Defects in Insulin Action:  happens because of a change to an insulin receptor that may cause hyperglycemia and severe diabetes.  Symptoms include acanthosis nigricans, a skin condition that results darkened patches, cystic ovaries and masculine characteristic development in females.  In children with the disorder, leprechaunism and Robson-Mendelian syndrome may cause severe insulin resistance.
  • Diabetes Caused by Diseases or Disorders of the Pancreas:  an injury or disease of the pancreas can cause diabetes.  Conditions that can cause diabetes include pancreatitis, infection and pancreatic cancer, cystic fibrosis and hemochromatosis (a hereditary metabolic disorder that effects iron-containing pigments of the tissue).
  • Diabetes Caused by Endocrinopathies (hormonal):  large amounts of certain hormones can work against the body's ability to produce insulin and result in diabetes.  The hormones and related conditions include; cortisol in Cushing's syndrome, the growth hormone in acromegaly (an overproduction of growth hormones by the pituitary gland), glucogen in glucagonoma and epinephrine in pheochromocytoma (a tumor).
  • Diabetes Caused by Consuming Certain Medications or Chemicals:  a number of medications and chemicals may interfere with the body's ability to produce insulin.  The chemicals and medications include; pentamidine, nicotinic acid, phenytoin (Dilantin), glucocorticoids, thyroid hormone and Vacor (rat poison).
  • Diabetes Caused by Secondary Infections:  there are some infections that have been associated with the development of diabetes and these include; congenital rubella (German measles), coxaskievirus B, adenovirus (a double-stranded DNA virus), mumps and cytomeglovirus.
  • Rare Immune-Mediated Types of Diabetes(Immunodeficiency Related):  Rare among the causes are some immune-mediated conditions that are associated with diabetes.  Approximately one-third of people with stiff-man syndrome develop diabetes and other immune disorders such as lupus and anti-insulin receptor antibodies may predispose a person to developing diabetes as well.
  • Other Genetic Disorders and Conditions Associated with Diabetes:  Such genetic conditions associated with diabetes are Down syndrome, Klinefelters syndrome, porphyria, Prader-Willi syndrome and diabetes insipidus.

Early Warning Signs of Diabetes

Diabetes is a very serious health issue that may be controlled through diet, exercise, lifestyle changes and dosages of insulin.  Because some people do not experience the symptoms of diabetes, it is important to know what to look for so that the signs do not go overlooked.  Since Type I and Type II diabetes share many of the same signs and symptoms, without proper medical testing it is not possible to determine which one is present.

The American Diabetes Association has compiled a list of early warning signs and symptoms  of diabetes that includes the following:

Increased urination: Urination will become more frequent because the body is trying to eliminate the excess of glucose present in the blood.  If blood insulin levels are nonexistent or not effective, the kidneys are unable to filter glucose back into the blood.  As a result, the kidney's become overwhelmed and attempt to draw excess water from the blood in order to dilute to glucose and this keeps the bladder full and makes it necessary to urinate frequently.

Extreme thirst:  If a person experiences an unquenchable thirst and cannot get enough liquids to drink and drinking more than usual, it may be a sign of diabetes.  This symptom goes hand in hand with frequent urination because of the body pulling extra water out of the blood, the result is an increased need for fluids to replace what is being lost during urinating.

Weight loss:  This may be more prevalent is cases of Type I diabetes. In Type I, the pancreas ceases making or manufactures little insulin.  The body will begin to break down proteins and fat to convert and use for energy and this will result in weight loss.

Extreme Hunger:  Because diabetes causes an insulin deficiency in the body, in turn the body is unable to convert glucose into energy.  The body has the impression of being hungry because of the energy deficit and this can result in extreme hunger.

Weakness and extreme fatigue:  Cells are responsible for converting glucose into energy and when the cells do not react anymore, the glucose is left in the bloodstream and the cells become starved for energy, leaving a person feeling tired and exhausted.

Irritability and Depression:  Because of fluctuating insulin levels in the blood and the body's inability to convert it into energy, this may cause the body to experience a wide array of mood swings, as a result of fatigue and exhaustion.   When a persons body has improper levels of hormones and suffers from extended periods of exhaustion, the results can lead to depression.

Tingling or Numbness in the Hands, Feet or Legs:  This symptom of diabetes is referred to as neuropathy and occurs as consistently high glucose levels in the blood causes damage to the nervous system.  Type II diabetes has a gradual onset and blood sugar levels may be high for a long period of time prior to diabetes being diagnosed.  A case of neuropathy may improve once a tighter control of insulin levels is achieved.

Night sweats: At times a low blood glucose level (hypoglycemia) may cause sweating during the night.  This is a result of the fluctuations that occur from diabetes that has been undiagnosed and should abate once a diagnosis is confirmed and insulin levels are regulated in the blood.

Other signs and symptoms that may occur:  Blurry vision, dry and itchy skin, cuts or bruises that do not heal. 

Health Conditions Caused by Diabetes

When someone is diagnosed with diabetes it is important to be mindful of the secondary health conditions that may occur  as a result.  The following is a list health conditions that may due to the consequences of having diabetes:

  • The risk of heart disease is 2-4 times more likely and is the leading cause of diabetes-related deaths.
  • The risk of stroke is 2-4 times more likely.
  • Approximately 73% of people who have diabetes have high blood pressure requiring hypertension medications.
  • Diabetes is the most common cause of new cases of blindness suffered among adults.
  • Diabetes is the most common cause of end-stage kidney disease.
  • Around 60-70% of people who suffer from diabetes have mild to extreme forms of nervous system damage-impaired sensation or pain in the extremities, sluggish digestion, carpal tunnel syndrome and other nerve problems.
  • Severe forms of diabetes related nerve diseases are a major contributor to lower-extremity amputations.  More than 60% of non-traumatic lower-limb amputations happen among diabetics.
  • Periodontal disease- approximately one-third of people who have diabetes have a severe form of periodontal disease, with resultant tooth loss.
  • Uncontrolled diabetes is responsible for causing major birth defects, miscarriage or may lead to high birth weight in infants, which can pose an increased health risks to both mother and infant.
  • Uncontrolled diabetes can also lead to biochemical imbalances which may result in an acute life-threatening event ,or a coma and eventual death.
  • Diabetes can lead to a weakened immune system and make a person more susceptible to illnesses.

How Someone is Tested for Diabetes

A fasting blood glucose test is the most commonly preferred method for detecting diabetes in children, non-pregnant females and adults.  The test is most often done in the morning because it is more reliable.   A definite diagnosis of diabetes can be confirmed based on the following test results:

  • Blood Glucose Fasting Test: a blood glucose level of 126 mg/dL or higher after completing an 8-hour fast.
  • Oral Glucose Tolerance Test (OGTT):  a blood glucose level of 200 mg/dL or higher, two hours after consuming a beverage containing 75 grams of glucose dissolved in water.
  • Random test:  can be done anytime of the day, a blood glucose level of 200 mg/dL or higher, combined with diabetes symptoms.

The test for gestational diabetes is based upon a diagnosis of blood glucose levels during an OGTT.  Because glucose levels are normally lower during pregnancy, the cutoff levels for blood glucose levels are lower as well.  Once the glucose beverage is consumed, the pregnant females blood levels are checked at intervals of 1,2 and 3 hours.  If a woman has two blood glucose readings that fall within the parameters of the testing levels, a diagnosis of gestational diabetes may then be confirmed.

The Importance of Diagnosing Diabetes

A diagnoses of diabetes can be very frightening and overwhelming to the person who experiences it.  But, it is important to pay attention to the early warning signs and symptoms that may indicate the presence of diabetes, because early detection and treatment will have a direct outcome  as to how diabetes can be managed.

Through early intervention, the damage of diabetes in some cases may be reversed or avoided completely.  Many people diagnosed with diabetes can avoid the long-term problems of diabetes by taking better care of themselves and following the advice of a physician. 

Getting enough exercise, maintaining a healthy weight, eating the right foods, doing daily blood glucose tests and taking insulin on time and  receiving proper medical care, can all serve to improve the quality of life for those who suffer from diabetes.  Taking control of ones health is crucial, because diabetes is a condition that can be safely managed and lived with.