Diabetes - FAQs

Diabetes is a disease in which blood glucose (sugar) levels are above normal. Plant foods which are mostly sugars and starches (carbohydrates) are turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either does not make enough insulin or cannot use its own insulin as well as it should. This causes sugar to build up in your blood. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the 6th leading cause of death in the United States.

Individuals who think they might have diabetes should visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:

• Frequent urination
• Excessive thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in hands or feet
• Feeling very tired much of the time
• Very dry skin
• Sores that are slow to heal
• More infections than usual

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes results from the body’s failure to produce insulin, the hormone that unlocks the cells of the body, allowing glucose to enter and fuel them. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors. Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes.

Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents who are overweight or obese.

Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing type 2 diabetes in the next 5-10 years.

Current adult diabetes rate (2014) - 10.6%
Current diabetes cases (2018) - 269,800
Projected cases of diabetes in 2030 at current pace - 311,630

• Have prediabetes
• 45 years of age or older
• Obesity
• Have a parent, brother, or sister with type 2 diabetes
• Physically active less than 3 times per week
• Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds
• Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)
• If you have non-alcoholic fatty liver disease, you may be at increased risk for type 2 diabetes

People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high. People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. A diabetes health care team is also recommended. The patient and primary care provider are leaders of the team. Other members of the team might include endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.

Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.

Healthy eating, physical activity, and blood glucose testing are the basic therapies for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.

Diabetes Self-Management Education (DSME) is an ongoing process to facilitate a person’s knowledge, skill, and ability for self-care. This process incorporates the needs, goals, and life experiences of the person with diabetes and is guided by evidence-based standards. Objectives are to support informed and shared decision making, self-care behaviors, problem solving, and active collaboration with the health care team to improve clinical outcomes, health status, and quality of life. Diabetes educators and others in the health care team can help people living with or at risk for diabetes to:[1][2]

• Understand the diabetes disease process and the risks and benefits of treatment options
• Incorporate healthy eating behaviors into their lifestyles
• Incorporate physical activity into their lifestyles
• Understand how to use medications safely and effectively
• Perform self-monitoring of blood pressure when prescribed
• Perform self-monitoring of blood glucose when prescribed and demonstrate how to interpret and use the results for self-management decision making
• Understand how to prevent, detect, and treat high and low blood glucose
• Understand self-management needs during illness or medical procedures
• Prevent, detect, and treat chronic diabetes complications
• Develop personal strategies to address psychosocial issues and concerns
• Develop personal strategies to promote health and behavior change.[3]Diabetes Self-Management Education and Support programs

[1]American Diabetes Association/American Association of Diabetes Educators National Standards

[2]Standards of Practice and Standards of Professional Performance for Registered Dietitians (Generalist, Specialty, and Advanced) in Diabetes Care

[3] Cochran J, Conn VS. Meta-analysis of quality of life outcomes following diabetes self-management training. Diabetes Educ. 2008;34:815–23.

A person with prediabetes has a blood sugar level higher than normal, but not high enough for a diagnosis of diabetes. He or she is at higher risk for developing type 2 diabetes and other serious health problems, including heart disease, and stroke. Without lifestyle changes to improve their health, 15% to 30% of people with prediabetes will develop type 2 diabetes within five years.

A person with certain risk factors is more likely to develop prediabetes and type 2 diabetes. These risk factors include: age, especially after 45 years of age; being overweight or obese; a family history of diabetes; having an African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander racial or ethnic background; a history of diabetes while pregnant (gestational diabetes) or having given birth to a baby weighing nine pounds or more; and being physically active less than three times a week.