Several members of my close family have diabetes Will attempts at prevention still work for me

Please refer to Question 19 regarding type 1 diabetes. Regarding type 2 diabetes, your success in preventing diabetes depends upon a combination of how successful you are at attaining the necessary goals and how susceptible your family is. Inherited susceptibility can range from modest to very high. The risk also depends very much on whether both sides of a person's family have a hereditary pattern of diabetes. If both the mother and the father's sides have a high frequency of diabetes, then...

Hear a lot about footwear and foot care for diabetes Why is this so important

Proper care and protection of the feet are extremely important for people with diabetes. This is due to the fact that the feet are frequently affected by diabetic nerve damage with a resultant loss of protective sensation. Protective sensation is the perception of potential injury, such as awareness of sharp, rough, or excessively hot or cold objects or friction, such as rubbing against the inside of shoes. When this is impaired, it is possible for the person with diabetes to sustain wounds,...

Does regular exercise help to prevent type 2 diabetes

Yes, regular exercise of at least moderate intensity provides some protection against the onset of type 2 diabetes. Exercise improves insulin resistance and thereby makes insulin more effective at removing glucose from the blood. In patients with prediabetes (see Question 9), exercise can prevent the progression of elevated glucose values toward the frankly diabetic range, or even restore them to normal. Exercise also consumes calories from those stored in the exercising muscle as starch...

Is there anything I can do to reduce my childrens risk of getting diabetes

There is presently little that can reliably be done to reduce a person's risk of type 1 diabetes, as discussed in Question 19. However, type 2 diabetes has undergone a dramatic increase in children and adolescents in recent years, and it is clear that this is driven, in the most part, by childhood and adolescent overweight and obesity as well as lack of regular exercise. Therefore, establishment of a healthy pattern of eating in childhood, without excess calorie intake, and encouragement of...

Could I have had diabetes for a long time and not known it

Yes, indeed, you could have had diabetes for a considerable period of time, months or even years, and been unaware of it. However, it is unlikely that you could have had severe diabetes with very high blood sugars for a long time without having to seek medical attention, It is important that asymptomatic diabetes is detected and treated, because it can lead to serious health consequences, which may be irreversible when detected as you would have experienced complications. However, milder...

Are my brothers and sisters and my children at risk of diabetes

If you have type 1 diabetes, your first-degree relatives (i.e. mother, father, brother, sister, and your children) are about ten times more likely than the general population to get type 1 diabetes. The frequency of type 1 diabetes in the general population is about half a percent (i.e., one in two hundred), so the risk in your first-degree relatives is about 10 X 1 2, or 5 . Fortunately, this is not particularly Rate of new cases of type 1 and type 2 diabetes among youth aged < 20 years, by...

Is there such a thing as borderline diabetes What is it

The term borderline diabetes has now been replaced by the term prediabetes. Both terms indicate that a person has abnormalities in his or her plasma glucose levels that fall short of standard accepted definitions for frank diabetes. Table 1 shows the normal ranges for both fasting plasma glucose and for plasma glucose after a Table 1 Definition of Diabetes & Prediabetes Table 1 Definition of Diabetes & Prediabetes 126 or above 200 or above 200 or above with symptoms** **Such as thirst,...

Are there any medications I can take to help prevent diabetes

Yes, there are a number of medications that will help to reduce the likelihood of a person developing type 2 diabetes, but not type 1 diabetes. These are shown in Table 2. None are labeled by the Food and Drug Administration for this indication. Our use of them is mainly confined to choosing a drug that will tend to slow progression to type 2 diabetes when the drug is needed for another condition. For example, when a patient at risk for diabetes needs treatment for high blood pressure, one...

How does my weight affect my risk of type 2 diabetes

Weight and risk of type 2 diabetes are clearly linked. Figure 3 shows the risk of development of type 2 diabetes, as it relates to body weight. For clinical purposes, weight is related to height by a formula known as body mass index or BMI. In our society, a BMI of 18 to almost 25 is considered to be healthy and from 25 to almost 30 is considered overweight. From 30 to 35 is considered to be obese and from 35 to 40 is severely obese. A BMI that is greater than 40 is considered morbidly obese,...

Does diabetes put me at risk of any other diseases or illnesses

Aside from the direct consequences of high blood sugar itself, which are discussed in Question 29, people with diabetes are at risk of suffering from other associated diseases. In the case of type 1 diabetes, the diseases either result from the high blood sugar or from the root cause of the diabetes, which is a predisposition to destroy the hormone-producing tissues (called autoimmunity). Thus, a person with type 1 diabetes is more likely to suffer from adrenal gland damage (Addison's disease),...

Does stress affect my risk of getting diabetes

The perception of stress differs greatly among individuals. What one person may perceive as stressful, another may not. For this reason, stress is quite hard to measure in real-life situations. Artificial measures of accepted stress, such as electric shocks or deprivation of sleep, are very hard to apply to day-to-day life. However, people who report that they are more stressed, regardless of the actual nature of the stress itself, are more likely to suffer from diabetes. Furthermore, it has...

How does my doctor confirm the diagnosis of diabetes

Your doctor will perform one of the standard measurements for the diagnosis of diabetes approved by the accepted authoritative body in whichever part of the world you live. In the United States, this is generally set by the American Diabetes Association (ADA) and is accepted by most practitioners, insurers, and health providers as valid. The most current ADA criteria for the diagnosis of diabetes are shown in Table 1 (see Question 9). Your doctor may or may not ask you to fast prior to...

Have a strongfamily history of diabetes How often should I be checked for it

The frequency with which you should be checked for diabetes depends upon your degree of risk, your age, and lifestyle factors. Even if you have a strong family history of type 1 diabetes, your risk of developing it is still only about 5 and is much lower after the age of 35. Furthermore, type 1 diabetes usually presents with obvious symptoms, such as those described in Question 21, and is unlikely to be missed. Since there is presently little that can be done to prevent type 1 diabetes,...

What other factors increase my risk ofgetting diabetes

Besides excess weight, hereditary risk, and lack of exercise, another factor that can increase the risk of developing diabetes is the use of certain medications. Among these medications, the type associated most strongly with increased risk are the steroids (also called glucocorticoids), whose members include prednisone, methylprednisolone, hydrocortisone, and Among these medications, the type associated most strongly with increased risk are the steroids (also called glucocorticoids). Naturally...

Does diabetes affect all racial groups equally

No, there are significant differences in the hereditary tendency to acquire diabetes (Figure 2). In general Caucasians (non-Hispanic whites) have a lower tendency to develop type 2 diabetes than other ethnic groups. The situation with regard to type 1 diabetes is the opposite, with the highest prevalence currently being in the regions in and near Finland, Sardinia, and Kuwait. Lifestyle does not appear to be more important than the hereditary tendency in determining the chance of a person to...

Is there a particular type of diet that will reduce my chance of type 2 diabetes

The most important aspect of any diet to prevent type 2 diabetes is its calorie (i.e., energy) content. If calorie intake exceeds calorie usage, then the excess calories will, in the absence of other modifying factors, be directed toward the body's energy storage compartment, which is, of course, the fat tissue. Therefore, a diet that matches calorie consumption with output is the key to prevention of overweight and obesity and therefore diabetes. If one is already overweight, then the diet...

Can type 1 diabetes also be prevented

At the present time, we do not think that type 1 diabetes can effectively be prevented. Part of the problem is that we do not know the exact environmental trig-ger(s), although there is provocative evidence for a number of factors, such as early exposure to cow's milk, certain viral strains, and lack of stimulation of the immune system at an early age by natural exposure to infective agents. The evidence is insufficient to make specific recommendations for avoidance of, or immunization against,...

Had diabetes during my last pregnancy Am I at risk of diabetes in the future

Yes, you are at high risk both of having type 2 diabetes in the future and of having diabetes again with your next pregnancy. The reason for this is that women destined to get type 2 diabetes in middle age or beyond tend to be the same women who will develop diabetes in pregnancy. Therefore, the presence of diabetes in pregnancy is an indicator of future risk for type 2 diabetes. Because type 2 diabetes is a disorder of aging, the diabetes in pregnancy tends to be more severe and requires more...

Why do some women get diabetes when they are pregnant Is this dangerous for them or their baby

Pregnancy is a situation in which insulin resistance (see Question 2) is a normal feature. This is because it is beneficial for the nutrients absorbed from a pregnant woman's meals to be channeled first to the growing fetus. The development of maternal insulin resistance in the second half of pregnancy assures that this will occur. At least part of the reason for the development of maternal insulin resistance is that the placenta produces substances that lead to insulin resistance and as the...

What is diabetic nephropathy

Diabetic nephropathy is the term used to describe kidney damage that occurs in diabetes, usually of longstanding. The damage to the kidney in diabetes can result from the high blood sugar itself, which leads to an expansion of certain types of material in the filtering mechanism of the kidney. This expansion damages the delicate cells responsible for filtering waste materials through the kidney. Eventually, there are abnormal pressures and changes in the important electrical balance in this...

What is the difference between type 1 and type 2 diabetes

Type 1 diabetes is entirely due to an almost complete deficiency of insulin. The deficiency is the result of the immune system erroneously attacking and destroying the insulin-producing cells in the pancreas. For the proper functioning of our bodies, it is necessary for insulin to be present at all times in the bloodstream and tissues, not only after we have eaten. Insulin is essential to maintain the structure of our tissues and prevent them from being broken down in an uncontrolled manner....

Can diabetes be cured

In general, we do not consider that diabetes can be cured once it has been diagnosed. People with type 2 diabetes can reverse the detectable abnormalities of diabetes by lifestyle adjustment without the use of medications (discussed in Question 28). However, the tendency to manifest high blood sugar again is always present if the patient is under significant metabolic stress, such as that caused by medications, severe illness, injury, regaining lost weight, cessation of exercise, aging, etc....

Can my diabetes affect my sex life If so how and what can I do about it

Diabetes can have a profound effect upon a person's sexual drive, functioning, and satisfaction. This is especially apparent in men, although there is some evidence that some women with diabetes can also experience adverse effects on their sexual responses. The reason for the significant effects on male sexual function arises from the complexity of the penile erection mechanism. This requires satisfactory nerve, blood vessel, and hormone function to be achieved and sustained. Diabetic nerve...

Why is the risk of blood vessel diseases increased so much in diabetes

There are several reasons why the risk of vascular diseases, such as heart attack, stroke, and diseases of the vessels in the limbs (peripheral vascular disease), is increased in both types of diabetes. The weight gain and lack of exercise common in people with type 2 diabetes lead to other conditions such as abnormal cholesterol levels and high blood pressure, which are potent causes of vascular disease. If all of these risk factors are not treated effectively, the probability of vascular...

More

Is diet and exercise management alone really effective for diabetes Diet and exercise are in fact the most effective treatments of all for most forms of type 2 diabetes, but are not primary measures for management of type 1 diabetes. In type 1 diabetes, profound insulin deficiency necessitates that insulin treatment is the principal form of treatment. Nevertheless, attention to diet and exercise can provide benefits in diabetes control and general health in patients with type 1 diabetes and...

What is diabetic retinopathy

Diabetic retinopathy is damage to the eye that results from chronically untreated or inadequately treated high blood sugar. In its more advanced form, it can result in severe visual loss or blindness if untreated, and this can occur suddenly without warning. It is the leading cause of blindness in working age adults in the United States and more than 20,000 people become blind as a result of diabetes each year. In order to prevent this, all people with diabetes should periodically be screened...

Acknowledgments

I thank those who have given advice and assistance with this book, especially Dr. Mayer B. Davidson, who kindly reviewed the manuscript and gave many helpful suggestions, as he has done throughout my career. Jeffrey Hall, Janice Camino, and several of my patients contributed questions. Joann Jue provided administrative assistance. Michelle Dennison-Farris RD, CDE gave helpful advice on Questions 40 and 67 relating to nutrition and diet. I thank Dr. Keith G. Dawson for providing a superb...

What are the most common symptoms of diabetes

The common and early symptoms of diabetes result from the effect of the high blood sugar entering the urine and drawing fluid from the body's tissues along with it. This leads to excess urine production with frequent urination. The loss of body fluid leads to thirst, in order to replace the fluid loss. As long as the person with diabetes is able to keep pace with his or her thirst by regular fluid intake, he or she will remain relatively well. However, without free access to fluid, which can...

Why and how did I get diabetes

Diabetes occurs for a number of reasons, but the ultimate cause of the high blood sugar that characterizes the disorder is either deficiency of the hormone insulin or a combination of insulin deficiency and resistance of the body tissues to its actions. In response to food intake, insulin is released by specialized cells in the pancreas and is necessary for adequate amounts of glucose and other nutrients from food to be absorbed into certain tissues of the body. When insulin is lacking or the...

Can diabetes sometimes be temporary and go away again

Yes, this can and does occur, in the case of both types of diabetes. However, in the case of type 1 diabetes, the disappearance is very predictably temporary and the diabetes will almost inevitably return within months or a year or two. The reasons for it are complex and relate to the fact that type 1 diabetes is often diagnosed under conditions of physical stress. When the diabetes is treated and the stress to the body has resolved, there may be sufficient remaining insulin-producing...

Feel as if my memory has gotten worse since I developed diabetes Could I be right

Studies have shown that memory, and other higher brain functions, can be negatively affected by diabetes. This pertains to both type 1 and type 2 diabetes and to both adults and children. A large part of this effect is related to blood sugar control. Children with repeated episodes of low blood sugar have been shown to have poor long-term memory performance. However, both high and low blood sugar levels are associated with poor memory performance. This affects recall of...

What are the symptoms of diabetes

The typical symptoms of diabetes occur as a result of the high levels of glucose in the bloodstream and its passage into the urine and other tissues. These are frequent urination and thirst. Thirst arises as a result of the dehydration caused by the frequent urination. Dehydration and loss of nutrient calories in the urine lead to weight loss and hunger. Passage of glucose into the tissues of the eye can cause fluctuating A hormone that is responsible for maintaining the normal volume and...

Can a person have both type 1 and type 2 diabetes at the same time

Generally speaking, we do not diagnose both disorders in the same individual. If people have type 1 diabetes, they are completely lacking effective circulating insulin. By definition, this is not the case in people with type 2 diabetes, so having the one disorder effectively rules out the other. However, people with type 1 diabetes may be prone to the same metabolic problems as those with type 2 diabetes. In other words, if people with type 1 diabetes gain weight, become sedentary, or are...

What is the difference between diabetes mellitus and diabetes insipidus

The word diabetes is an interesting one. Its origin is in the Greek language where it is derived from the word for a siphon or, more simply, a pipe or hose. This word was used to describe the disorder in ancient times (and diabetes was recognized in great antiquity) because those suffering from it produced such plentiful amounts of urine that they were reminiscent of a water pipe. The reason for the plentiful amounts of urine lies in the fact that when the sugar glucose reaches excessively high...

What is diabetic neuropathy

Diabetic neuropathy is the term used to describe the usually chronic damage to nerves that occurs as a result of untreated, or inadequately treated, high blood sugar. It results from a complex sequence of events that leads to damage and destruction of the minute blood vessels that nourish nerves along their course to the region of the body they serve after leaving the spinal canal. Each such nerve is a single cell. The longest nerves, much like long chains, are the most susceptible to damage....

My doctor says I have hypoglycemia Isnt that the opposite of diabetes

Yes, hypoglycemia (low blood sugar) is the opposite of the hyperglycemia (high blood sugar) that characterizes diabetes. Certain treatments for diabetes and several conditions unrelated to diabetes can cause hypo-glycemia. The most common form of hypoglycemia occurs in otherwise healthy young individuals, more commonly in women than men, and is quite benign, although it can be associated with distressing symptoms. Fortunately, it is usually treatable by adjustment of the composition and timing...

Can I feel my high and low blood sugars reliably

Although many people with diabetes confidently state that they can reliably detect both their high and low blood sugars without actual measurement, studies have shown that these beliefs are not usually accurate. It is generally easier to be aware of hypoglycemia (low sugars) than high blood sugars. This is because the margin of safety between blood sugars in the lower part of the normal range and dangerously low blood sugars is quite narrow only about 25 mg dl and the body has a vigorous and...

What can happen if my diabetes is not properly treated and controlled

Uncontrolled diabetes, which generally refers to glucose levels that are higher rather than lower than the target range, can lead to immediate short-term and longer-term consequences. The short-term consequences result from the very high blood glucose itself, which is described in Question 4. If severe enough or untreated for long enough, markedly high blood glucose levels can result in coma and ultimately death, due to the severe abnormalities of blood chemistry that occur. It is important to...