TIFFANY YEH, M.D.
(NEW YORK) – Diabetes is one of the most common chronic conditions in the United States today, with nearly 30.3 million people suffering from difficulty in managing blood sugar.
It is the seventh leading cause of death and the leading cause of renal failure, adult blindness and lower limb amputation.
Most people with diabetes have type 2 diabetes, which is often associated with lifestyle and genetic choices. It is the type of diabetes that is caused by the fact that the body has problems in using insulin properly or it can not do enough.
About 1.25 million suffer from type 1 diabetes, which is an autoimmune disease. It is the type of diabetes that results from the fact that the pancreas does not produce any insulin.
Both conditions result in difficulty in regulating glucose or body sugar levels, but due to very different reasons.
Since November is the month of diabetes awareness, it is a good time to answer the most frequent questions about the disease.
What is diabetes?
So let's start with what happens in a normal person without diabetes. When you eat a meal, your body starts to digest it in protein, sugar and fat.
An organ called pancreas senses the sugar absorbed and produces a hormone called insulin, which then picks up the sugar – or glucose – from the food you've just eaten and into different parts of your body so it can be used for energy .
In diabetes, your body does not produce enough insulin or can not use it as it should. If you do not have enough insulin, too much blood sugar remains in the bloodstream, which can cause serious health problems over time, such as heart disease, kidney disease or loss of vision.
What is the difference between type 1 diabetes and type 2 diabetes?
Type 1 diabetes
In patients with type 1 diabetes (T1DM), their pancreas is unable to produce insulin due to an autoimmune condition that the body attacks itself. People are diagnosed more frequently when they are children or young adults and symptoms often develop rapidly. They can feel very thirsty, go to the bathroom very often, lose weight even if they eat normally and feel very exhausting.
People with T1DM should take insulin every day to survive, and there is currently no known way to prevent or treat DMT1. They need to check their blood glucose levels several times a day and at night and they give insulin several times a day based on their makeup, their blood sugar and what they eat.
Can I have the T1DM?
Previously it was thought that T1DM was only in children and was previously called "juvenile diabetes", but we now know that young adults and even the elderly can develop DM1. It is not something contagious, or related to your lifestyle. Rather, it is an autoimmune condition, whereby your body develops antibodies to your pancreas and gradually destroys the pancreas's ability to produce insulin.
Type 2 diabetes
In patients with type 2 diabetes (T2DM), the body has become resistant and needs more insulin or the pancreas is not making enough insulin. Their body has difficulty keeping blood sugar at normal levels.
T2DM is not caused by eating sugar itself, but by a variety of lifestyle and genetic factors.
Can I have the T2DM?
This is the most common form of adult diabetes and, unfortunately, the number of people affected, including children, continues to grow in the United States. This type of diabetes is associated with obesity, hypertension, high cholesterol or a family history of DM2.
If you have any of these conditions, it is important to regularly consult your primary care physician for a diabetes test.
Can I tell if I have diabetes? How is it diagnosed?
Most commonly, a blood test is diagnosed – a high level of glucose before eating or something called hemoglobin A1c, which is an average blood sugar level in the span of three months.
If your glucose level is high, you may experience symptoms such as feeling thirsty all the time, urinating more than usual, weight loss, blurred vision or fatigue. Sometimes, people with type 1 diabetes get very sick, with something called diabetic ketoacidosis, due to not having enough insulin in their body.
This can be a deadly condition that requires hospitalization to help correct the condition.
If you are taking medications that can reduce your blood sugar, such as insulin, a low blood sugar can cause sweating, tremors, unusual behavior or disorientation. If it goes very low, it can also cause coma and death if it is not quickly treated with glucose or a drug called glucagon.
If you notice any of these symptoms, you should inform your doctor.
How can I treat diabetes? Is there a cure?
Unfortunately, diabetes is a chronic disease without cure. For people with type 1 diabetes, the only treatment so far is insulin. For people with type 2 diabetes, in addition to dietary changes, there are many drug options ranging from pills to injections.
Some types of bariatric surgery can be helpful in reducing the amount of drugs that people with T2DM need to take. There are many new technologies developed to help improve the daily lives of people with diabetes.
Although type 1 and type 2 diabetes is invisible to people who do not have it, having a too high or too low blood sugar level can be very dangerous. But with good control and continuous improvement of drugs and technology, many people with diabetes are able to lead a happy and fulfilling life.
Tiffany Yeh, MD, is a New York-Presbyterian Weill Cornell Medical Center endocrinologist and a member of the ABC News Medical Unit.
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