May Help Delay Development of Type 2 Diabetes:
The drug, which blocks the digestion of starch, may
help prevent or delay the development of type 2 diabetes in patients
with slightly elevated blood sugar levels, according to researchers.
Diabetics May Benefit From Sleeping With the Lights On:
Researchers say nighttime lighting can help prevent
the onset of diabetic retinopathy, a condition which can result
in severe visual impairment in diabetic patients.
Glucose Test Meters Combined With Handspring PDAs Approved by FDA:
The U.S. Food and Drug Administration has cleared
for marketing two glucose test meters that allow
diabetes patients to more easily track and manage their blood sugar
levels using computer technology.
Aggressive Control of Blood Glucose Urged for Type 2 Diabetics:
International Diabetes Federation (IDF) is calling for urgent action
to slow the growing epidemic of type 2 diabetes by more aggressive
management of blood glucose control.
Guidelines for Diabetics on Getting Through Airport Security:
to carry your equipment, medication and supplies through security
checkpoints with minimal delays.
Shoes and Inserts Do Not Appear to Prevent Diabetic Foot Ulcers:
say careful attention by healthcare professionals may be more important
than therapeutic footwear.
Sometimes Prescribed for Patients Who Should Not Use It: Researchers
say that despite clear "black box" warnings, the widely
used diabetes drug is sometimes prescribed for patients also suffering
from congestive heart failure or kidney dysfunction.
Drinks a Day May Help Postmenopausal Women Avoid Diabetes: Researchers
say women who drink one to two alcoholic drinks daily respond better
to insulin and have lower levels of insulin in their blood.
Rich in Whole Grains Can Lower Risk of Type 2 Diabetes: Researchers
report that overweight or obese adults who eat a diet rich in whole-grain
foods can improve their insulin sensitivity.
Present Update on Islet Cell Transplants for Diabetics: Seventy
of the 33 patients who have received islet transplants from the
pioneering team at the University of Alberta are reported to have
had no need for insulin injections for two years.
Not at Significant Risk During Major Vascular Surgery: Researchers
say the findings of a 10-year study ease fears surgery involving
blood vessels poses a significant risk to patients with diabetes
Says Vast Improvement Needed in Diabetic Care: The
researchers also said diabteic patients without health insurance
were less likely to have control of their blood sugar and have eye
and foot exams than those with insurance.
Focuses on Ways to Keep Blood Glucose Levels Under Control: In
addition to regimen of diet, exercise and oral medication, patients
will begin receiving insulin injections for the first time during
the course of the study.
Lifestyle Changes Needed to Lower Risk of Diabetes: Researchers
say that for people at risk, modest efforts to increase exercise
and improve eating habits may not be enough to keep from getting
Intensive Exercise Helps Body Better Control Glucose Levels: Researchers
say the benefits of an exercise program are still at work one month
after the exercise is discontinued.
in Diet, Exercise Could Cut Diabetes Risk for 10 Million Americans:
least 10 million overweight Americans could sharply cut their risk
of developing diabetes by making modest diet changes and engaging
in moderate exercise, according to a major government study.
Glucose Measuring Device Uses Arm Instead of Finger: A
new device that patients can use to monitor their blood glucose
levels provides accurate results, and virtually all patients find
it significantly less painful than finger-stick tests, according
to a report in Diabetes Care.
Women With Diabetes at Great Risk of Hip Fracture:
women with diabetes appear to be at significantly greater risk of
suffering a hip fracture than women without diabetes, according
to University of Minnesota Researchers.
More than 16
million people in the United States have diabetes mellitus--a serious,
a disorder of metabolism--the way our bodies use digested food for
growth and energy. Most of the food we eat is broken down into glucose,
the form of sugar in the blood. Glucose is the main source of fuel
for the body. After digestion, glucose passes into the bloodstream,
where it is used by cells for growth and energy. For glucose to
get into cells, insulin must be present.
Insulin is a
hormone produced by the pancreas, a large gland behind the stomach.
When we eat, the pancreas is supposed to automatically produce the
right amount of insulin to move glucose from blood into our cells.
In people with diabetes, however, the pancreas either produces little
or no insulin, or the cells do not respond appropriately to the
insulin that is produced. Glucose builds up in the blood, overflows
into the urine, and passes out of the body. Thus, the body loses
its main source of fuel even though the blood contains large amounts
The three main
types of diabetes are:
- Type 1 diabetes.
Type 1 diabetes is an autoimmune disease. In diabetes, the immune
system attacks the insulin-producing beta cells in the pancreas
and destroys them. The pancreas then produces little or no insulin.
Someone with type 1 diabetes needs to take insulin daily to live.
At present, scientists do not know exactly what causes the body's
immune system to attack the beta cells, but they believe that
both genetic factors and environmental factors, possibly viruses,
are involved. Type 1 diabetes accounts for about 5 to 10 percent
of diagnosed diabetes in the United States.
- Type 2 diabetes.
The most common form of diabetes is type 2 diabetes. About 90
to 95 percent of people with diabetes have type 2, and one-third
of them have not been diagnosed. This form of diabetes usually
develops in adults age 40 and older and is most common in adults
over age 55. About 80 percent of people with type 2 diabetes are
overweight. Type 2 diabetes is often part of a metabolic syndrome
that includes obesity, elevated blood pressure, and high levels
of blood lipids. When type 2 diabetes is diagnosed, the pancreas
is usually producing enough insulin, but, for unknown reasons,
the body cannot use the insulin effectively, a condition called
insulin resistance. After several years, insulin production decreases.
The result is the same as for type 1 diabetes--glucose builds
up in the blood and the body cannot make efficient use of its
main source of fuel. The symptoms of type 2 diabetes develop gradually.
They are not as sudden in onset as in type 1 diabetes. Some people
have no symptoms. Symptoms may include fatigue or nausea, frequent
urination, unusual thirst, weight loss, blurred vision, frequent
infections, and slow healing of wounds or sores.
Diabetes. Gestational diabetes develops only during pregnancy.
Though it usually disappears after delivery, the mother is at
increased risk of getting type 2 diabetes later in life.
of diabetes is made for any one of three positive tests, with a
second positive test on a different day:
- A random
plasma glucose value (taken any time of day) of 200 mg/dL or more,
along with the presence of diabetes symptoms.
- A plasma
glucose value of 126 mg/dL or more, after a person has fasted
for 8 hours.
- An oral
glucose tolerance test (OGTT) plasma glucose value of 200 mg/dL
or more in the blood sample, taken 2 hours after a person has
consumed a drink containing 75 grams of glucose dissolved in water.
This test, taken in a laboratory or the doctor's office, measures
plasma glucose at timed intervals over a 3-hour period.
widely recognized as one of the leading causes of death and disability
in the United States. According to death certificate data, diabetes
contributed to the deaths of more than 193,140 people in 1996.
associated with long-term complications that affect almost every
part of the body. The disease often leads to blindness, heart and
blood vessel disease, strokes, kidney failure, amputations, and
nerve damage. Uncontrolled diabetes can complicate pregnancy, and
birth defects are more common in babies born to women with diabetes.
In 1997, diabetes cost the United States $98 billion. Indirect costs,
including disability payments, time lost from work, and premature
death, totaled $54 billion; direct medical costs for diabetes care,
including hospitalizations, medical care, and treatment supplies,
totaled $44 billion.
not contagious. People cannot "catch" it from each other. However,
certain factors can increase the risk of developing diabetes.
- Type 1 diabetes
occurs equally among males and females, but is more common in
whites than in nonwhites. Data from the World Health Organization's
Multinational Project for Childhood Diabetes indicate that type
1 diabetes is rare in most African, American Indian, and Asian
populations. However, some northern European countries, including
Finland and Sweden, have high rates of type 1 diabetes. The reasons
for these differences are not known.
- Type 2 diabetes
is more common in older people, especially in people who are overweight,
and occurs more often in African Americans, American Indians,
Asian and Pacific Islander Americans, and Hispanic Americans.
On average, non-Hispanic African Americans are 1.7 times more
likely to have diabetes than non-Hispanic whites of the same age.
Hispanic Americans are nearly twice as likely to have diabetes
as non-Hispanic whites. American Indians have the highest rates
of diabetes in the world. Among the Pima Indians living in Arizona,
for example, half of all adults have type 2 diabetes. The prevalence
of diabetes in the United States is likely to increase for several
reasons. First, a large segment of the population is aging. Also,
Hispanic Americans and other minority groups make up the fastest-growing
segment of the U.S. population. Finally, Americans are increasingly
overweight and sedentary. According to recent estimates, the prevalence
of diabetes in the United States is predicted to be 8.9 percent
of the population by 2025.
discovery of insulin in 1921, everyone with type 1 diabetes died
within a few years after diagnosis. Although insulin is not considered
a cure, its discovery was the first major breakthrough in diabetes
treatment. Today, healthy eating, physical activity, and insulin
via injection or an insulin pump are the basic therapies for type
1 diabetes. The amount of insulin must be balanced with food intake
and daily activities. Blood glucose levels must be closely monitored
through frequent blood glucose checking.
physical activity, and blood glucose testing are the basic management
tools for type 2 diabetes. In addition, many people with type 2
diabetes require oral medication and insulin to control their blood
diabetes must take responsibility for their day-to-day care. Much
of the daily care involves keeping blood glucose levels from going
too low or too high. When blood glucose levels drop too low from
certain diabetes medicines--a condition known as hypoglycemia--a
person can become nervous, shaky, and confused. Judgment can be
impaired. If blood glucose falls too low, a person can faint.
A person can
also become ill if blood glucose levels rise too high, a condition
known as hyperglycemia.
The goal of
diabetes management is to keep blood glucose levels as close to
the normal range as safely possible. A recent major study, the Diabetes
Control and Complications Trial (DCCT), sponsored by the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),
showed that keeping blood glucose levels as close to normal as safely
possible reduces the risk of developing major complications of type
The United Kingdom
Prospective Diabetes Study, a European study completed in 1998,
showed that intensive control of blood glucose and blood pressure
reduced the risk of blindness, kidney disease, stroke, and heart
attack in people with type 2 diabetes.
provided by: The National Institute of Diabetes & Digestive
& Kidney Diseases, National Institutes of Health, Bethesda,