Diabetes Mellitus
Alternate Names : Diabetes
Diabetes mellitus, often called diabetes, is a condition that makes it hard
for the body to control the level of glucose in the blood. This means it is hard for the
body to convert food into the energy that the body needs to work. Glucose is the main
form of sugar in the body.
What is going on in the body?
The pancreas, a long, thin organ located behind the stomach, makes
insulin. In most people, the pancreas makes extra insulin when they eat. It is then
released into the bloodstream. Insulin helps move glucose that is in the bloodstream to
the inside of cells in the body. Glucose is a key source of energy for the body. In a
person with diabetes, the pancreas cannot make enough insulin to keep up with the
body's demand. So glucose cannot be moved into the cells and used. In some types
of diabetes, the body cells resist the insulin. As a result, glucose builds up in the
blood. And that leads to a high blood glucose level, called hyperglycemia.
Some 17 million Americans have diabetes, according to the American
Diabetic Association, also known as ADA. There are three main types of diabetes.
Type 1 diabetes.
This type used to be known as insulin-dependent diabetes mellitus, IDDM, or
juvenile-onset diabetes. A person with this type makes little or no insulin. So he or
she needs to take insulin shots each day.
Type 2 diabetes.
This type used to be known as noninsulin-dependent diabetes mellitus, NIDDM, or
adult-onset diabetes. This is by far the most common type of diabetes. Someone with
type 2 diabetes might make healthy or even high levels of insulin. But
obesity
makes his or her body resistant to its effect. Type 2 diabetes used to be rare in
children. But with the increase in obesity in children, doctors are now finding that as
many as 1 out of each 20 children who have diabetes has type 2 diabetes. Of these
children, 85% are obese.
Gestational diabetes
or pregnancy-induced diabetes. This type of diabetes develops in a pregnant
woman. In most cases, this type of diabetes goes away after the woman's child is born.
There are other types of diabetes that are less common. This category
includes diabetes caused by a genetic defect or pancreatic diseases. Other types
of diabetes are caused by hormonal problems or from being exposed to certain
drugs or chemicals.
These include:
Diabetes caused by a hormonal imbalance. One example is Cushing syndrome,
which involves high levels of adrenal hormones.
Diabetes caused by medicines. These can include prednisone, oral contraceptives, or thiazide
diuretics.
Diabetes caused by other conditions. These include chronic inflammation,
infection, or other damage to the pancreas.
What are the causes and risks of the disease?
Genetics may play a part in all types of diabetes mellitus. Other
causes and risks vary. They depend on the type of diabetes involved.
Type 1 diabetes
does not always have a known cause. Experts believe it might be caused by an
autoimmune disorder, in which the body makes antibodies that destroy pancreatic
cells. Experts do know that type 1 diabetes is more common in whites than in other
groups.
Type 2 diabetes
occurs when the cells in the body are resistant to insulin. As a result, the body
cannot use blood glucose as well as it should. Risk factors for type 2 diabetes include:
Obesity.
This is the main cause of type 2 diabetes in both adults and children. A recent
study showed a 33% increase in the number of Americans with type 2 diabetes over
the past 8 years. The increase was 70% in people ages 30 to 39 years old and
was linked to a sharp rise in obesity in this group.
Race. This type of diabetes is more common in African Americans, Hispanic
Americans, Asian Americans, Native Americans, and Pacific Islanders.
Lack of physical exercise. A recent study showed that walking briskly for 30
minutes a day at least 5 days a week reduces a woman's risk of type 2 diabetes.
High blood pressure.
Experts define this as a blood pressure equal to or greater than 140/90.
Low HDL level,
known as the good cholesterol, and high triglyceride level. HDL levels equal to or
less than 35 mg/dL and/or a triglyceride level
greater than or equal to 250 mg/dL are considered unhealthy.
Age of 45 or older.
History of gestational diabetes,
or having babies that weighed more than 9 pounds at birth.
Hormonal changes linked to menopause.
A recent study of 16,000 American women between the ages of 40 and 65 showed
that diabetes was one of the top six diseases diagnosed. A long-term
study is under way to see if menopause and changes in hormone level are
factors in the development of type 2 diabetes.
Gestational diabetes
is considered when a woman has any abnormal glucose test result during
pregnancy.
It may be the result of increased hormone levels during pregnancy, which work
against insulin. Weight gain during pregnancy might also be a factor in causing
gestational diabetes.
Almost all people who develop type 2 diabetes have a condition called
pre-diabetes first. This
condition used to be known as impaired glucose tolerance or impaired fasting
glucose, and the ADA estimates that almost 16 million people over the age of 40
have it. This condition occurs when blood glucose levels are higher than healthy
levels but too low to be diagnosed as diabetes. Without lifestyle changes, most
people who have pre-diabetes will progress to type 2 diabetes within 10 years.
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