Diabetes, also known as diabetes mellitus, is a metabolic disease that results in high blood sugar. In healthy individuals, the body produces a hormone called insulin, which transports sugar from the blood into your cells to be stored away for future use or used as-needed for energy. In individuals suffering from diabetes, the body either a) doesn’t produce enough insulin or b) cannot effectively leverage the insulin it does produce. Left untreated, an individual suffering from high blood sugar caused by diabetes will likely experience damage to their nerves, eyes, kidneys, and other organs.
Additionally, there are three different types of diabetes:
Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys cells in the pancreas. This is where insulin is produced. It’s not yet clear what causes this condition, but approximately 10 % of people diagnosed with diabetes have been diagnosed with Type 1 diabetes.
Type 2 diabetes occurs when the body becomes resistant to insulin, thus allowing sugar to accumulate in your blood. Pre diabetes occurs when an individual’s blood sugar is higher than normal, but it’s not high enough to meet the criteria for a diagnosis of type 2 diabetes.
Gestational diabetes is when a woman experiences high blood sugar during pregnancy. Insulin-blocking hormones produced by the placenta have been identified as the root cause of this particular type of diabetes.
Lastly, there is a rare condition called diabetes insipidus, and although it shares a similar name, is not related to diabetes mellitus. It’s a very different condition which causes the kidneys to remove too much fluid from the body.
Symptoms of Diabetes
Each type of diabetes has unique warning signs, symptoms, causes and treatments. However, the most common signs and symptoms of diabetes include:
- increased hunger
- increased thirst
- unexplained weight loss
- highly frequent urination
- blurry vision
- extreme fatigue
- sores and wounds that don’t heal
Symptoms in Men
In addition to the general symptoms of diabetes, men with diabetes may experience decreased sex drive, erectile dysfunction (ED) and reduced muscle strength.
Symptoms in Women
Women with diabetes often experience symptoms including urinary tract infections, yeast infections, and itchy, dry skin.
Type 1 Diabetes
Symptoms of Type 1 diabetes often include:
- extreme hunger
- increased thirst
- unexplained weight loss
- frequent urination
- blurry vision
- exhaustion
- mood swings and changes
Type 2 Diabetes
Symptoms of Type 2 Diabetes often include:
- extreme hunger
- increased thirst
- frequent urination
- blurry vision
- exhaustion
- sores that are slow to heal
- recurring infections
Gestational Diabetes
Women with gestational diabetes rarely experience any symptoms. The condition is often detected during a routine blood sugar test, which is usually performed between the 24th-28th weeks of gestation. In rare cases, a woman suffering from gestational diabetes will also experience increased thirst and urination.
Causes of Diabetes
Each type of diabetes has different causes:
Type 1 Diabetes
Doctors have yet to determine the root cause of Type 1 diabetes. For reasons unknown, the immune system attacks and destroys insulin-producing beta cells in the pancreas. Genetics may play a role in certain individuals. It’s further possible that a virus triggers the immune system attack.
Type 2 Diabetes
Type 2 diabetes is caused by a combination of genetics and lifestyle factors. Being overweight or obese significantly increases your risk of developing Type 2 diabetes. Obesity and carrying extra weight, particularly in your belly, produces cells that are more resistant to the effects of insulin on your blood sugar. Type 2 diabetes is hereditary, so family members that share genes are more likely to develop type 2 diabetes.
Gestational Diabetes
Gestational diabetes is a direct result of hormonal changes during pregnancy. The unborn child produces hormones that make a pregnant woman’s cells less sensitive to the effects of insulin, which can result in high blood sugar during pregnancy. Women who are overweight when they become pregnant, or gain significant weight during their pregnancy, are more likely to develop gestational diabetes.
Diabetes Risk Factors
Type 1 Diabetes
You’re more likely to develop Type 1 diabetes if you’re a child or teenager, you have a parent or sibling with the condition, or you possess certain genes that have been linked with the disease.
Type 2 Diabetes
The risk for Type 2 diabetes increases significantly if you:
- are overweight
- are age 45 or older
- have a parent or sibling with the condition
- aren’t physically active
- have had gestational diabetes
- have prediabetes
- have high blood pressure, high cholesterol, or high triglycerides
- have African American, Hispanic or Latino American, Alaska Native, Pacific Islander, American Indian, or Asian American ancestry
Gestational Diabetes
The risk for gestational diabetes increases significantly if you:
- are overweight
- are over age 25
- had gestational diabetes during a past pregnancy
- have given birth to a baby weighing more than 9 pounds
- have a family history of type 2 diabetes
- have polycystic ovary syndrome (PCOS)
Diabetes Complications
High blood sugar causes extreme damage to organs and tissues throughout your body. The higher your blood sugar is and the longer you live with it untreated, the greater your risk for complications. Complications associated with diabetes include:
- heart disease, heart attack, and stroke
- neuropathy
- nephropathy
- retinopathy and vision loss
- hearing loss
- infections and sores that won’t heal
- skin conditions such as bacterial and fungal infections
- depression
- dementia
Gestational Diabetes
Untreated gestational diabetes can lead to major health problems that affect both the mother and baby. Complications affecting the baby include:
- premature birth
- higher-than-normal weight at birth
- increased risk for type 2 diabetes later in life
- low blood sugar
- jaundice
- stillbirth
The mother will often develop complications such as high blood pressure (preeclampsia) or Type 2 diabetes. She may also require cesarean delivery, commonly referred to as a C-section. Additionally, the mother’s risk of developing gestational diabetes during future pregnancies increases significantly.
Treatment of Diabetes
Doctors can treat diabetes with a number of different medications. Some of these medications are taken orally, while others are available in the form of injections.
Type 1 Diabetes
Insulin is the primary treatment method for Type 1 diabetes, as it replaces the hormone your body isn’t able to produce. There are four main types of insulin that are most commonly used:
Rapid-acting insulin starts to work within 15 minutes and lasts for 3 – 4 hours.
Short-acting insulin starts to work within 30 minutes and lasts 6 – 8 hours.
Intermediate-acting insulin starts to work within 1 – 2 hours and lasts 12 – 18 hours.
Long-acting insulin starts to work a within 3 hours after injection and lasts 24 – 36 hours.
Type 2 Diabetes
Diet and exercise can play a significant role in helping people manage type 2 diabetes, but if lifestyle changes are unable to lower your blood sugar, you will be required to take medication. The following medications lower blood sugar in a variety of different ways:
Drug Type | How It Works | Examples |
Alpha-glucosidase inhibitors | Limits the body’s ability to breakdown sugars and starchy foods. | Acarbose (Precose) and miglitol (Glyset) |
Biguanides | Reduces the amount of glucose produced by the liver. | Metformin (Glucophage) |
DPP-4 inhibitors | Improves blood sugar without making it drop too low too fast. | Linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia) |
Glucagon-like peptides | Modifies the way the body produces insulin. | Dulaglutide (Trulicity), exenatide (Byetta), and liraglutide (Victoza) |
Meglitinides | Stimulates the pancreas to produce and release more insulin. | Nateglinide (Starlix) and repaglinide (Prandin) |
SGLT2 inhibitors | Triggers the release of more glucose into the urine. | Canagliflozin (Invokana) and dapagliflozin (Farxiga) |
Sulfonylureas | Stimulates the pancreas to produce and release more insulin. | Glyburide (DiaBeta, Glynase), glipizide (Glucotrol), and glimepiride (Amaryl) |
Thiazolidinediones | Helps insulin work better, faster, longer. | Pioglitazone (Actos) and rosiglitazone (Avandia) |