About Diabetes
Type 1 Diabetes

Type 1 diabetes is an autoimmune disease that occurs when the insulin-producing beta cells within the pancreas are gradually destroyed and eventually fail to produce insulin.

Demographics: Type 1 diabetes accounts for 5 to 10 percent of all diagnosed diabetes in the United States. Although type 1 diabetes develops most often in children and young adults (one in every 400-600 children has type 1 diabetes), the disease can be diagnosed at any age and is equally common in males and females. Unlike type 2 diabetes, type 1 diabetes is more common in Caucasians than in those of Latino, African-American, or other non-Caucasian backgrounds.

Risk factors: Family history, autoimmune diseases, ethnicity, and history of childhood viruses.

Treatment: People with type 1 diabetes must have insulin to supplement or replace the failing insulin production of their pancreas. Insulin may be delivered by a syringe or other injection device; through an infusion device called an insulin pump. The use of inhaled insulin continues to be studied and perfected following a previous unsuccessful release of the product. There are also adjunct, or companion, treatments for type 1 diabetes that may be prescribed along with insulin. The injectable hormone pramlintide (Symlin) is taken with mealtime insulin to help avoid after-meal blood sugar spikes. In clinical studies, metformin, an oral medication for the treatment of type 2 diabetes, has shown some promise as an adjunct therapy for type 1 diabetes as well, although this is considered an "off label" use of the drug. Another adjunct therapy studied for use in treating type 1 diabetes is incretin mimetics (exentide). This is also considered an off label use of the drug. Good nutrition, careful monitoring of carbohydrate and fat intake, and regular physical activity are also important to controlling type 1 diabetes and preventing long-term complications.

Complications: Over time, high blood glucose levels can cause damage to virtually every system in the body, including: the central nervous system, vision, cardiovascular, kidney, skin, sexual, teeth/gums, and musculoskeletal.

Type 2 Diabetes

Unlike type 1 diabetes, in which the pancreas produces little or no insulin, most people with type 2 diabetes are still able to produce some insulin at diagnosis. However, the insulin they produce is unable to perform its primary job — helping the body's cells use glucose for energy. This is called insulin resistance.

Demographics: Type 2 diabetes accounts for 90 to 95 percent of all diabetes cases in America. Although the majority of people with type 2 diabetes are adults, the number of children diagnosed with type 2 is increasing as sedentary lifestyles and obesity continue to rise. People of African-American, American Indian/Alaskan Native, Asian American, Latino American, and Pacific Islander background are even more likely to develop type 2 diabetes than Caucasians.

Risk factors: Obesity, heredity, ethnicity (see above demographics), hypertension, poor cholesterol profile, being an older adult, inactivity, or having prediabetes or gestational diabetes.

Treatment: A long-term commitment to good nutrition, careful monitoring of carbohydrate intake, and regular physical activity is critical to successful type 2 diabetes treatment. Medications for type 2 diabetes are prescribed when diet and exercise alone aren't enough to keep blood sugars in a safe range. Some people with type 2 diabetes may eventually require regular insulin injections to keep their blood glucose levels in control.

Complications: Over time, high blood glucose levels can cause damage to virtually every system in the body, including: the central nervous system, vision, cardiovascular, kidney, skin, sexual, teeth/gums, and musculoskeletal.

Prediabetes

Prediabetes is a precursor condition to type 2 diabetes, characterized by higher than normal blood glucose levels and insulin resistance. It is estimated that 79 million American adults aged 20 or older are living with prediabetes, and most remain unaware of their condition. Without intervention and appropriate treatment, people with prediabetes are at risk for developing type 2 diabetes within 10 years.

Gestational Diabetes

Gestational diabetes, diabetes that occurs in pregnancy and resolves at birth, occurs in approximately two to ten pregnancies out of every 100 in America. Risk factors for developing gestational diabetes include: family history of diabetes, being overweight, having prediabetes, and having given birth previously to a child weighing 9 pounds or more. In addition, the same populations that are more at risk for type 2 diabetes — Latino Americans, African-American, Pacific Islander, and Asian Americans — are also at greater risk for gestational diabetes. Gestational diabetes requires treatment with dietary changes and exercise and/or insulin injections to keep maternal blood glucose levels as close to normal as possible and to prevent complications in both mother and baby. Women who have had gestational diabetes have a 35-65 percent chance of developing diabetes in the next 10-20 years.



Reviewed by Jason Baker, MD.