This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.

DIABETES MELLITUS

Diabetes is a disease in which sugar builds up in the blood instead of being changed into energy for the body. Normally the body makes insulin, which takes the sugar in foods we eat and converts it into a form of energy our body can use. In diabetics, this doesn't happen and sugar levels build up in the blood causing various symptoms as well as damage to other organs over time.

There are several types of diabetes, also called diabetes mellitus. Type 1diabetes occurs when the body does not make any insulin at all. Type 2 diabetes occurs when the body makes some insulin but not enough or when the body has developed a resistance to insulin and does not respond the way it should. Most diabetics have Type 2 diabetes.

Another type of diabetes is gestational diabetes, which occurs in some women during pregnancy. This usually goes away after delivery. Another type of diabetes is secondary diabetes, when the diabetes is caused by some other syndrome or disease.

WHAT CAUSES DIABETES?

Diabetes is often the result of a combination of the body needing more insulin than the pancreas can produce and the body not responding efficiently to the insulin that is produced. Type 2 diabetes is most common among overweight people with non-active lifestyles. Type 2 diabetes can be triggered by obesity or a prolonged period of high insulin demand. During pregnancy, the body's hormonal changes may temporarily increase the body's resistance to insulin. In some people diabetes can be caused by damage to the pancreas, where insulin is made. This can cause the body to be unable to produce the insulin it needs. Damage to the pancreas can occur after an injury, cancer, or infection of the pancreas.

WHO GETS IT?

Type 1diabetes is usually found in children aged 4-15. About 90% of Type 2 diabetics are over age 40 when they are diagnosed with diabetes and most are significantly overweight. People who have other family members who are diabetic are also more likely to become diabetic.

WHAT ARE THE SYMPTOMS?

Common symptoms of diabetes are excessive thirst, frequent urination, fatigue, unexplained weight loss and hunger, frequent urinary tract infections, skin infections, numbness and tingling in the feet, and blurred vision. People with Type 1 diabetes often have symptoms which show up right away, but those with Type 2 diabetes may develop symptoms very gradually or may not have symptoms for several years. Because of this, diabetes is often discovered during routine blood tests and checkups.

DIAGNOSING DIABETES MELLITUS

Screening for Type 2 diabetes can be considered starting at age 45 and then rechecked every 3 years. If you have a family member who is diabetic, your doctor may want to check every year. Screening tests measure the amount of sugar in your body and can be done using blood or urine. You may be asked not to eat for 12 hours before the test. Another common test given to test for diabetes during pregnancy is the glucose tolerance test. The sugar level in your body will be measured after you drink a sugary liquid.

TREATMENT

The goal of diabetes treatment is to keep the blood sugar within normal levels. You should receive help and instruction about medications, diet, exercise, and lifestyle management. Your doctor, dietitian, or diabetic educator will work closely with you and your family to help you learn how to manage your diabetes.

If you have Type 1 diabetes, you will need to receive insulin, which is given by injections (shots) or by a pump. You will also need to eat at regular intervals and exercise regularly to strengthen your body's ability to use sugar. There are several types of insulin and pills that may be used to help control diabetes. Your doctor will work with you to find the combination which works best for you.

It is important to keep your blood sugar balanced throughout the day as it is dangerous for your blood sugar to be either too high or too low. Type 1 diabetics spend a lot of time learning how to take their insulin, check their sugar levels, and plan their meals. Other factors which affect the blood sugar levels are activity, stress, alcohol, illness, and other medications.

Most people with Type 2 diabetes can control their disease by diet and exercise. Others may also need pills or a combination of pills and insulin. Some people try herbs and dietary supplements – it is important to let your doctor know about these so that your blood levels can be monitored to be sure they don't harm you or interfere with your treatment. Many Type 2 diabetics are successful in getting their blood sugar to normal levels just by getting to their recommended weight.

WHAT YOU CAN DO

Diabetics who are able to keep their blood sugar within normal levels can prevent long term damage to other organs and avoid the complications which occur in diabetics who have not kept their blood sugar in control. These complications include blindness, kidney failure, amputation, delayed healing, cardiovascular disease, and loss of feeling in the feet and hands. Of course, it is best to prevent or control these problems, rather than waiting until they occur to get help.

Whichever type of diabetes you have, your doctor and other health care professionals will advise you to change your diet to restrict the amounts and kinds of sugars you eat and to insure that the amounts of carbohydrates, proteins, and fat you eat are carefully balanced. Often, medication adjustments are needed before you find the combination which will give you good blood sugar control, without side effects and that fits in with your lifestyle. You can also help if you maintain a healthy weight, stop smoking, and take good care of your feet and skin. Regular testing of your blood sugar and contact with your doctor are important to monitor how you are doing. Although many diabetics believe they can tell what their blood sugar is by the way they feel, they can often be fooled. Testing the blood is the only accurate method that has been found. You should also have a blood test called a glycosolated hemoglobin at least twice a year and an eye exam at least once a year.

COPING

Diabetes is a challenging illness which requires changes in your daily life. You may experience difficulty in adjusting to new ways of doing things. Feeling of depression, guilt and anger are common. It may be helpful to join a support group where you can share your concerns with others who have the same condition. You can learn a lot from others about how they cope. It can also help to seek professional counseling and to talk openly about your thoughts and feelings to friends and family.

Community centers and health agencies may be good resources for testing, supplies, and equipment, as well as to get information on new and ongoing research studies. Some insurance companies have additional resources available for those who have trouble with transportation, money, or family circumstances which prevent them from taking care of their diabetes. Healthcare professionals such as dietitians, pharmacists, social workers, and diabetic educators may be available to work with you. It is important to find someone who you can see regularly to check your diabetes.

New equipment and ways of testing and giving insulin are continually being developed. Remember that diabetes is a controllable illness, and that with attention to medication, diet, and physical activity, you can avoid the complications of uncontrolled diabetes and enjoy an active life.

Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.

Planetree Health Fact Sheets are developed by Planetree, Inc., a non-profit consumer health organization, founded in 1978. The Planetree Alliance includes hospitals and libraries which, among many other patient-centered concepts, promote the importance of access to health information for patients, families, and community. For more information regarding affiliation with the international Planetree Alliance, call (203) 732-1365 or visit Planetree, Inc. at www.planetree.org.