Type 2 Diabetes

Type 2 diabetes is a disease that affects the way your body uses food.

Type 2 diabetes used to be called non-insulin-dependent diabetes. The most common type of diabetes, it affects about 15 million Americans. Nine out of ten cases of diabetes are type 2. It usually occurs in people over 45 and overweight, among other factors.

When you have type 2 diabetes, your body does not make enough insulin. Or, your body still makes insulin but can't properly use it. Without enough insulin, your body cannot move blood sugar into the cells. Sugar builds up in the bloodstream. High blood levels of sugar can cause problems.

Medical experts do not know the exact cause of type 2 diabetes. They do know type 2 diabetes runs in families. A person can inherit a tendency to get type 2 diabetes. But it usually takes another factor such as obesity to bring on the disease.

What are the signs and symptoms of type 2 diabetes?
Type 2 diabetes often develops slowly. Most people who get it have increased thirst and an increased need to urinate. Many also feel edgy, tired, and sick to their stomach. Some people have an increased appetite, but they lose weight.

Other signs and symptoms are:

1. Repeated or hard-to-heal infections of the skin, gums, vagina, or bladder.
   
2. Blurred vision.
   
3. Tingling or loss of feeling in the hands or feet.
   
4. Dry, itchy skin.

These symptoms can be so mild that you don't notice them. Older people may confuse these symptoms with signs of aging and may not go to their health care practitioner. Half of all Americans who have diabetes may not know it.

What does living with type 2 diabetes mean?
People with diabetes can live happy, healthy lives. The key is to follow a diabetes treatment plan. The goal of this plan is to keep blood-sugar levels as close to normal as possible (good blood-sugar control).

Your first step is to see your health care practitioner. He or she will prescribe a daily treatment plan. The plan should include a healthy diet and regular exercise.

You can often control type 2 diabetes with diet and exercise-- alone. But some people also need medicine -- either diabetes pills or insulin shots. Many people find their diabetes gets better when they follow their treatment plan.

For people who have type 2 diabetes, losing weight is important. Losing weight helps some overweight people to bring their blood sugars into the normal range.

People who have a tendency to get type 2 diabetes can avoid it by losing weight or not becoming overweight. (The health care practitioner may allow some people who are overweight to stop their medication -- if they lose weight and follow a good meal plan.)

Your health care practitioner may also want you to test your blood-sugar levels regularly. Testing will let you know if your diabetes is in control. Be sure to ask how to do these tests.

Special considerations
Diabetes can cause problems with the kidneys, legs and feet, eyes, heart, nerves, and blood flow. If left untreated, these problems can lead to kidney failure, gangrene and amputation, blindness, or stroke. Many experts believe that good blood-sugar control may help prevent these problems.

Diabetes should not be too much trouble if you follow your treatment plan and:

1. Follow a healthy diet.
   
2. Control your weight.
   
3. Exercise regularly.
   
4. Have regular checkups.
   
5. Do not smoke.

Immune-Mediated Diabetes: Type 1 Diabetes

What Is Immune-Mediated Diabetes?
Immune-mediated diabetes (formerly called insulin-dependent diabetes) is a disease that affects the way your body uses food. Immune-mediated diabetes is also called type 1 diabetes.

In type 1 diabetes your body destroys the cells in the pancreas that produce insulin, usually leading to a total failure to produce insulin. It typically starts in children or young adults who are slim, but can start at any age.

Without insulin, your body cannot control blood levels of sugar. And without insulin, you would die. So people with type 1 diabetes give themselves at least one shot of insulin every day.

An estimated 500,000 to 1 million people Americans have this type of diabetes today.

Why Insulin Shots?
You must inject insulin under the skin -- in the fat -- for it to work. You cannot take insulin in a pill. The juices in your stomach would destroy the insulin before it could work. Scientists are looking for new ways to give insulin. Today there are many devices for insulin delivery.

What Are The Signs And Symptoms Of Type 1 Diabetes?
Type 1 diabetes often appears suddenly. Signs and symptoms are:

1. High levels of sugar in the blood.
   
2. High levels of sugar in the urine.
3. Frequent urination (and/or bed-wetting in children).
4. Extreme hunger.
5. Extreme thirst.
6. Extreme weight loss.
7. Weakness and tiredness.
8. Feeling edgy and having mood changes.
9. Feeling sick to your stomach and vomiting.
   

What Causes Type 1 Diabetes?
We do not know exactly what causes diabetes. We do know that people inherit a tendency to get diabetes. But not all people who have this tendency will get the disease. Other things such as illnesses must also come into play for diabetes to begin.

Diabetes is not like a cold. Your friends and family cannot catch it from you.

What Does Living With Diabetes Mean?
People with type 1 diabetes can live happy, healthy lives. The key is to follow your diabetes treatment plan. The goal of this plan is to keep your blood-sugar level as close to normal as possible (good blood-sugar control). Your treatment plan will probably include:

1. Insulin, which lowers blood sugar. Your health care practitioner will prescribe how much and when to take insulin and what kinds.
   
2. Food, which raises blood sugar. Most people with type 1 diabetes have a meal plan. A registered dietician makes a plan for you. It tells you much food you can eat and when to eat it. Most people have three meals and at least two snacks every day. Your meal plan can have foods you enjoy.
   
3. Exercise, which lowers blood sugar. Like insulin, exercise also helps your body to use blood sugar. So exercise will probably be prescribed for you. Your health care practitioner can help you fit exercise safely into your daily routine.
   
4. Blood and urine testing. Testing your blood lets you know if your blood-sugar level is high, low, or near normal. The tests are simple. You prick your finger to get a drop of blood. A nurse-educator can teach you how to do this test and use the test results.
   

You may need to test your urine for ketones. Ketones in the urine may mean that your diabetes is not under good control. A nurse- educator can teach you how to test ketones.

Problems You May Have
Type 1 diabetes can cause problems that you should be prepared for. There are three key problems:

• Hypoglycemia, or low blood sugar; sometimes called an insulin reaction. This occurs when your blood sugar drops too low. You correct this problem by eating some sugar (such as 3 glucose tablets, 6 ounces of regular soda, or 5 or 6 Lifesavers). Your health care practitioner will teach you the signs of hypoglycemia and show you how to treat it.
  
• Hyperglycemia, or high blood sugar. This occurs when your blood sugar is too high. It can be a sign that diabetes is not well controlled. Your health care practitioner will explain the signs and symptoms and the best way to treat hyperglycemia.
  
• Ketoacidosis, or diabetic coma. This is very serious. Discuss its signs with your health care practitioner.