Diabetes

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces, which may cause blood sugar levels to rise or drop beyond the normal range.

Key Terms

• Glucose: one of the simplest forms of sugar, and an energy source for the body’s cells.
• Insulin: a hormone secreted by the beta cells of the pancreas. It helps unlock the body’s cells, so that sugar can enter them and be used for energy.
• Prediabetes: a health condition in which blood sugar levels are higher than normal, but still not high enough to be diagnosed as type 2 diabetes.

Early detection and treatment of prediabetes can help restore blood sugar levels back to normal, and prevent type 2 diabetes.

Types of Diabetes

Type 1

A chronic condition that causes the insulin-producing beta cells in the pancreas to be destroyed, preventing the body from being able to produce enough insulin. For this reason, people with type 1 diabetes depend on external sources of insulin throughout their lifetime.

Type 2

A chronic condition in which the body either resists the effects of insulin or doesn’t produce enough insulin to maintain normal blood sugar levels.

Gestational Diabetes

Any change in blood sugar levels that is diagnosed for the first time during pregnancy, whether or not the condition continues after childbirth.

Other Types

Some people develop rare types of diabetes due to several factors. These include:

• Different types of monogenic diabetes.
• Cystic fibrosis-related diabetes.
• Diabetes caused by certain medications, such as cortisone compounds and certain AIDS medications.

Diabetes can also be caused by certain rare syndromes, such as Down syndrome, Klinefelter syndrome and Turner syndrome.

Why Is the Type Sometimes Hard to Tell?

Identifying which type of diabetes a patient has helps in determining the best possible treatment option. However, it has become more difficult to determine the type in some patients, especially since the old classification (which said type 1 diabetes only affects children and type 2 diabetes only affects adults) is not considered very accurate nowadays.

How Is Diabetes Diagnosed?

Random Blood Sugar Test

This test checks your blood sugar at a random time of the day. A level of 200 mg/dl or higher is a sign that you have diabetes.

Laboratory Tests

Several laboratory tests are used to diagnose diabetes at hospitals, and they are often repeated the following day to confirm the diagnosis. Some of these tests are:

Test	How it works
Fasting blood sugar test	A blood sample is taken after at least 8 hours of fasting, often in the morning before breakfast.
Glucose tolerance test	Blood sugar is tested before drinking a certain sugary liquid, and then 2 hours after drinking it.
Glycated hemoglobin (A1C) test	Indicates your average blood sugar level for the past two to three months. It doesn’t require fasting.

Blood Sugar Levels

	Normal	Prediabetes	Diabetes
Fasting	Less than 100 mg/dl	100-125 mg/dl	Higher than 125 mg/dl
Two hours into a glucose tolerance test	Less than 140 mg/dl	140-199 mg/dl	200 mg/dl or higher
A1C	Less than 5.7	5.7 – 6.4	6.5 or higher

Misconceptions and Facts

Misconception: People with type 1 diabetes can be treated through diet and lifestyle changes alone.
Fact: People with type 1 diabetes need insulin throughout their lives.

Misconception: Gestational diabetes is a temporary rise in blood sugar during pregnancy only, and it is not a cause of diabetes later.
Fact: Studies have shown that gestational diabetes is one of the risk factors for type 2 diabetes.

Misconception: Type 1 and type 2 diabetes can be prevented.
Fact: Many studies on ways to prevent type 1 diabetes have failed to prevent it. Type 2 diabetes, however, can be prevented through diet, weight loss and lifestyle changes.

Misconception: People with diabetes don’t need regular follow-up if their blood sugar is regular.
Fact: Every person with diabetes needs routine follow-up to check blood pressure, nerves and eyes, and to measure A1C.

Misconception: People with diabetes don’t need to measure their blood sugar at home.
Fact: Studies have shown that the more often patients measure, the better their blood sugar control and the fewer the complications.

Misconception: I was diagnosed with type 2 diabetes, but the doctor started insulin right away.
Fact: Doctors may treat people with type 2 diabetes with insulin from the start when blood sugar is very high.

Misconception: Having diabetes prevents a person from living a normal life.
Fact: Diabetes does not prevent a person from living their life, as it can be lived with and controlled.