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Food is the required source of energy for the body. Through the process of digestion, the carbohydrates that we consume are eventually broken down into a simple sugar called glucose. Glucose then passes into the bloodstream, where it becomes available for the body to use for growth and energy. In order for glucose to be used by cells in the body, a hormone produced by the pancreas, called insulin, is needed.

In diabetes, the pancreas produces little or no insulin, or the cells throughout the body are unable to respond to the insulin that is produced. The end result is a build-up of glucose in the blood, which eventually spills over into the urine. Elevated blood glucose levels are responsible for the many health problems associated with diabetes.

There are three main types of diabetes:

Type 1 diabetes

• Also known as insulin dependent diabetes mellitus (IDDM) or juvenile diabetes.
• In type 1 diabetes the pancreas produces little or no insulin.
• Treatment always involves injections of insulin along with dietary modifications to control blood glucose levels.
• Type 1 diabetes accounts for about 5 percent to 10 percent of all cases in the United States.

Type 2 diabetes

• Also known as non-insulin dependent diabetes mellitus (NIDDM) or adult onset diabetes.
• In type 2 diabetes there is both a state of insulin resistance and a defect in insulin production.
• Treatment may involve dietary modification and exercise alone, oral medications and/or injections to control blood glucose levels.
• Type 2 diabetes accounts for 90 percent to 95 percent of all cases in the United States.

Gestational diabetes

• Gestational diabetes affects only pregnant women.
• Treatment may involve diet alone or injections to control blood glucose levels.
• Gestational diabetes usually resolves once the pregnancy is over, but women who experience gestational diabetes have a greater risk for developing type 2 diabetes later in life.

How common is type 2 Diabetes?

Of the approximately 16 million people with diabetes in the United States, 90 percent to 95 percent or about 14.9 million people have type 2 diabetes. About one-third of them are not even aware that they have the disease. People with type 2 diabetes usually develop the condition after age 45, and the risk for getting it increases with age. Statistics show that nearly 18.4 percent of the U.S. population age 65 and older has diabetes. In addition, the number of teenagers with type 2 diabetes is increasing rapidly.

In a person with type 2 diabetes, the pancreas produces insulin, but for some reason the body is unable to respond properly to the insulin to control blood sugar. The end result is the same as in type 1 diabetes -- a buildup of glucose in the blood, due to the body's inability to use it effectively as a major source of energy.

Risk factors for type 2 diabetes include:

• Obesity. Many people with type 2 diabetes are obese, weighing at least 20 percent more than what is recommended for their height. Insulin resistance increases when weight is excessive.
• Heredity. Unlike type 1 diabetes, type 2 diabetes tends to run in families.
• Age. The risk for developing type 2 diabetes increases with age. Half of all new cases of type 2 diabetes occur in persons age 55 or above.
• Race. Compared with Caucasians and Asians, type 2 diabetes is more common among American Indians, African-Americans and Hispanics.
• Sedentary Lifestyle. Insulin resistance increases with lack of exercise.
• Women who have had gestational diabetes. Women who develop gestational diabetes have an increased risk of getting type 2 diabetes later on in life. Women whose babies weigh 9 pounds or more at birth also have an increased risk of developing type 2 diabetes.
• Certain medications. The use of certain drugs may contribute to the development of type 2 diabetes. Check with your doctor to determine if any medication you are taking could increase your risk for type 2 diabetes.

New discoveries in type 2 diabetes

• Diabetes research has led to better management of not only the disease itself but also the complications that are associated with it.
• The discovery of several genes associated with type 2 diabetes.
• Increasing knowledge about the relationship between obesity and type 2 diabetes.
• Continuing research in the area of islet cell transplants and engineered islet cells.

Indeed the future for those affected by diabetes looks hopeful. Research efforts during the last 80 years have led to improved management and treatment of diabetes today.

External Resources: American Diabetes Association Clinical Practice Recommendations 2000. Diabetes Care, Vol. 23, Supplement 1, January 2000. Brackenridge, Betty M.S. RD C.D.E. Diabetes 101: A Pure and Simple User Guide for People Who Use Insulin. Chronimed Publishing, 1998. National Diabetes Education Program. A Joint Program of the National Institutes of Health and the Centers for Disease Control and Prevention. NIH Publication No 99-4343, Sept. 1999. National Institute of Diabetes Digestive and Kidney Diseases. National Diabetes Information Clearinghouse @ www.niddk.nih.gov The Uncomplicated User Guide to Diabetes Complications. A Publication of the American Diabetes Association, Inc. 1998.

This article was published on 2000-03-29
This article was reviewed on 2003-02-03