The Dangers of Diabetes, Different Types, How it’s Diagnosed, Who’s at Risk?

Posted by Medical Board on February 17, 2019 in Uncategorized Last updated on February 17, 2019
The Dangers of Diabetes, Different Types, How it’s Diagnosed, Who’s at Risk?

Diabetes is the most common endocrine disorder.  According to the Centers for Disease Control, nearly 10% of the U.S. population now has diabetes, and roughly one-fourth of those struggling with the disease go undiagnosed and untreated.  With 30 million Americans suffering from diabetes, this is rapidly becoming one of the fastest growing health concerns for the nation.

Many people are unaware they have a serious medical condition however, because symptoms may present gradually, over a long period of time. 

According to U.S. statistics, 1 in 4 individuals do not know they have diabetes.[7]

Diabetes Defined

This very serious endocrine disorder occurs when glucose (sugar) in the blood reaches dangerously high levels.  Normally, a hormone known as insulin facilitates the delivery of sugar to the cells, where it can then be used for energy.  In diabetes however, the pancreas fails to produce enough insulin, or cannot use the existing insulin effectively.  As a result, excess sugar remains in the blood causing a whole host of health problems and cannot reach cells to provide energy.[12]

Symptoms of Diabetes

Many people do not notice telltale signs until diabetes has already caused damage to the body.  Symptoms of diabetes may include:

  • Excessive thirst
  • Frequent urination
  • Excessive hunger
  • Fatigue
  • Weight loss (unintentional)
  • Blurred vision
  • Sores or cuts that don’t heal quickly[4]

There are many different types of diabetes.

Most Common Types of Diabetes 

  • Type 1 diabetes
  • Type 2 diabetes
  • Pre-diabetes
  • Gestational diabetes

Rare Forms of Diabetes

  • MIDD (Maternally Inherited Diabetes and Deafness)
  • LADA (Latent Autoimmune Diabetes in Adults)
  • SPIDDM  (Slowly Progressive Diabetes)
  • TYPE AB (Type 1 and Type 2 combined)
  • MODY (Maternity Onset diabetes of the Young)
  • NDM (Neonatal Diabetes Mellitus)

Effects of Diabetes

If blood sugar is too high for prolonged periods of time, other serious health conditions will occur including damage to:

  • Kidneys
  • Eyes
  • Nerves
  • Heart
  • Limbs[3]

How is diabetes diagnosed?

Several tests are used to help diagnose diabetes including:

Fasting Blood Glucose—A glucose test is conducted after at least 8 hours of fasting.  A glucose level of 100 to 125 mg/dL may indicate pre-diabetes.

A1C (Hemoglobin A1C)—The A1C test shows how much glucose adheres to red blood cells.  The test helps determine blood glucose levels over the preceding 2-3 months.  An A1C reading of 7% is considered normal for non-pregnant adults.

Random (also called Casual) Plasma Glucose Test—This test can be conducted at any point in the day and may be used when diabetic symptoms are already present.  A reading under 180mg/dl after a meal or between 80 and 130 before a meal is normal.      

Oral Glucose Tolerance Test (also called the OGTT)—This test is often conducted on women who show preliminary signs of gestational diabetes.  The OGTT test checks blood sugar before and after the patient drinks a glucose-laden drink.  If blood glucose levels reach 200 mg/dl or above after drinking the sugary beverage, gestational diabetes is present.[5]

Type 1 Diabetes

Type 1 diabetes is most often found in children and young adults.  The disease is caused from an attack on the body’s immune system.  This damages cells in the pancreas, rendering the organ unable to produce enough insulin to transport glucose to cells for energy.  Type 1 diabetics must take insulin for the rest of their lives.

What causes type 1 diabetes?

Beta cells in the pancreas normally produce insulin that helps transport blood sugar to the cells for energy.  Genetics and environment may both play a part in type 1 diabetes.  Certain viruses may trigger the disease in those already prone to diabetes because of inherited tendencies.[10]

Type 2 Diabetes—What is it?

Type 2 diabetes occurs when tissues are resistant to insulin.  It is much more common than type 1 diabetes and generally happens in midlife when individuals may become more sedentary and overweight.

Other Risk Factors

  • High Blood pressure
  • High triglycerides
  • Prior diagnosis of pre-diabetes    
  • Family history of diabetes
  • Low levels of high-density lipoprotein
  • Women with a history of gestational diabetes[14]       

Type 2 Diabetes, Health Effects

Type 2 diabetes affects over 26 million individuals in the U.S. and many more (nearly 80 million) may be fast approaching a type 2 diabetes diagnosis due to pre-diabetic conditions.

Diabetes may increase the risk of:

  • Cardiovascular disease
  • Kidney failure
  • Nerve damage leading to toe, foot, or leg amputation 
  • Retinopathy (damage to the retina because of irregular blood flow)
  • Blindness
  • Stroke[1]

Who is more likely to develop type 2 diabetes?

You may be at higher risk for developing type 2 diabetes if you:

  • Are over age 45
  • Have high blood pressure
  • Are overweight
  • Are inactive
  • Have pre-diabetes
  • Have or had gestational diabetes while pregnant[4]

Pre-diabetes

A condition known as pre-diabetes occurs in many individuals before they reach the point of actual diabetes.  This condition occurs when blood sugar is slightly higher than normal for a period of time.  Pre-diabetes nearly always precedes type 2 diabetes.  

Diagnosing Pre-diabetes

If diabetes is not found, a formal diagnosis of pre-diabetes can be made if test results yield the following:

A1C: 5.7% – 6.4%

Fasting blood glucose: 100 – 125 mg/dl

An OGTT 2 hour blood glucose: 140 mg/dl – 199 mg/dl

Causes for Pre-diabetes

A pre-diabetic condition occurs when “insulin resistance” is present.  When the hormone, insulin fails to adequately move glucose from the blood and into the cells for energy, pre-diabetes may be diagnosed.[13]

The majority of individuals with pre-diabetes do not experience symptoms at this stage.  Those with pre-diabetes are at a higher risk for developing the following:

  • Type 2 diabetes
  • Heart disease
  • Stroke
  • Pre-diabetes can be detected by an A1C test that measures glycated hemoglobin.  Many individuals develop pre-diabetes in midlife if they are overweight.  By losing 5-10% of their weight, they may significantly lower their risk for developing pre-diabetes.[8]

Gestational Diabetes

Gestational diabetes occurs in pregnant women who did not have high blood sugar before they were pregnant.  Many times, gestational diabetes affects more than one pregnancy.  Gestational diabetes is generally diagnosed between the 24th and 28th week of pregnancy.

Gestational Diabetes Issues

Gesatational diabetes accounts for a number of problems in preganancy to both the mother and the baby.  When the mother has higher than normal sugar levels, the baby may grow too large.  This is because excess sugar overfeeds the baby in the womb.  Because of the size of the baby, delivery may be more difficult, or lead to a cesarian section birth.  In addition, the baby may suffer nerve damage due to pressure on the shoulder during delivery.

Women with diabetes during pregnancy are also at higher risk for a condition known as preeclampsia caused by high blood pressure.  This leads to swelling of the tissues in the mother and risk for stroke or blood clots.  The baby may also be born early which can cause complications.  Uncontrolled diabetes in pregnant women can lead to low blood sugar (hypoglycemeia) in the baby, soon after birth as well.[6]  

The Effects of High Blood Sugar

There are many issues associated with high blood sugar, both long-term and acute.  

Generally human blood sugar levels should be lower than 180 mg/dL.  While blood sugar levels do vary a bit throughout the day, a blood sugar reading higher than 300mg/dl should be cause for concern.  After testing blood sugar and getting a high reading at least two times in a row, there should be cause for concern and a medical professional should be seen.

What makes blood sugar too high?

Blood sugar levels can become too high for a number of reasons including:

  • Stress
  • Illness
  • Wrong dosage of medicine for treating high blood sugar
  • Not taking insulin or taking diabetes medication improperly
  • Exercising less than usual
  • Eating too many carbohydrates

While it is not always clear why blood sugar levels become too high, it can be a sign of illness, infection, or stress.

Symptoms of high blood sugar include:

  • Fatigue
  • Weakness
  • Dry mouth
  • Upset stomach, nausea, vomiting
  • Excessive thirst
  • Frequent urination[2]

Hypoglycemia in Diabetes

One major side effect of diabetes may also be a condition known as hypoglycemia, or low blood sugar. This occurs when blood sugar levels drop below 70 milligrams per deciliter.  The condition causes a range of symptoms from mild to severe.  These may include shakiness, hunger, headache, confusion, irritability, and even seizures or loss of consciousness in severe cases.  Hypoglycemia occurs more frequently in type 1 diabetics.

Factors that may contribute to hypoglycemia include:

  • Under consumption of carbohydrates  
  • Skipping Meals
  • Delaying meals
  • Increased physical activity
  • Consuming alcohol without food
  • Becoming too ill to eat normal amounts of food

Serious Consequences of Diabetes

Untreated or undiagnosed diabetes could result in a life-threatening condition known as diabetic ketoacidosis.

This occurs when the body cannot get cellular needs met because of a lack of insulin to help convert sugar to energy.  In the body’s attempt to maintain homeostasis, it begins to burn fat for energy.  This fat burning process creates acids called “keytones” in the blood.  If this occurs over an extended period of time, serious damage to the body may occur.

Symptoms of diabetic ketoacidosis include:

  • Upset stomach
  • Nausea
  • Vomiting
  • Abdominal pain
  • Difficulty breathing
  • Confusion
  • Extreme fatigue/sleepiness

Although this can occur in type 2 diabetes, it is much more common in individuals with type 1 diabetes.[11]

Diabetic Treatment and Control

Diabetes is a major cause of disability and death in the United States.

Once diabetes has been diagnosed it is important to get tested regularly, follow a physician’s treatment protocol including any insulin supplementation or replacement, oral medication, dietary restrictions or exercise regimen.

While 10,000 new cases of diabetes are diagnosed every year in the United States, with proper diagnosis and follow up, most individuals can lead a normal, healthy life.[9]

References

12019, https://www.nih.gov/research-training/accelerating-medicines-partnership-[amp/type-2-diabetes. Accessed 16 Feb 2019.

2Med.Umich.Edu, 2019, http://www.med.umich.edu/1libr/MEND/Diabetes-Hyperglycemia.pdf.

3″Diabetes | Type 1 Diabetes | Type 2 Diabetes | Medlineplus”. Medlineplus.Gov, 2019, https://medlineplus.gov/diabetes.html.

4″Diabetes | Yale Health”. Yalehealth.Yale.Edu, 2019, https://yalehealth.yale.edu/more/diabetes.

5″Diabetes Diagnosis – University Of Vermont Medical Center – Burlington, VT”. Burlington, VT – University Of Vermont Medical Center, 2019, https://www.uvmhealth.org/medcenter/Pages/Conditions-and-Treatments/Diabetes/Diabetes-Diagnosis.aspx.

6″Gestational Diabetes And Pregnancy | CDC”. Centers For Disease Control And Prevention, 2019, https://www.cdc.gov/pregnancy/diabetes-gestational.html.

7″National Diabetes Statistics Report | Data & Statistics | Diabetes | CDC”. Cdc.Gov, 2019, https://www.cdc.gov/diabetes/data/statistics/statistics-report.html.

8″Prediabetes | Hyperglycemia | Medlineplus”. Medlineplus.Gov, 2019, https://medlineplus.gov/prediabetes.html.

9″Take Steps To Prevent Type 2 Diabetes – Healthfinder.Gov”. Healthfinder.Gov, 2019, https://healthfinder.gov/HealthTopics/Dispatch.aspx?q1=health-conditions-and-diseases&q2=diabetes&q3=take-steps-to-prevent-type-2-diabetes.

10″Type 1 Diabetes | University Of Utah Health”. Healthcare.Utah.Edu, 2019, https://healthcare.utah.edu/utahdiabetescenter/type-1.php.

Information, Health et al. “Low Blood Glucose (Hypoglycemia) | 11NIDDK”. National Institute Of Diabetes And Digestive And Kidney Diseases, 2019, https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia.

12Information, Health et al. “What Is Diabetes? | NIDDK”. National Institute Of Diabetes And Digestive And Kidney Diseases, 2019, https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes.

13Publishing, Harvard. “Pre-Diabetes – Harvard Health”. Harvard Health, 2019, https://www.health.harvard.edu/a_to_z/pre-diabetes-a-to-z.

14Us, About et al. “What Is Type 2 Diabetes? :: Diabetes Education Online”. Dtc.Ucsf.Edu, 2019, https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/what-is-type-2-diabetes/.

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