What is Diabetes?

If you just found out you have diabetes, you probably have a lot of questions and you may feel a little uncertain.But you're not alone. In the United States, 23.6 million people have diabetes. Most of these people lead full, healthy lives. One of the best things you can do for yourself is to learn all you can about diabetes. This handout will tell you some of the basics about diabetes.

What is diabetes?

Your body changes most of the food you eat into glucose (a form of sugar). Insulin is a hormone produced by the pancreas that allows glucose to enter all the cells of your body and be used as energy.
Diabetes is a disease that occurs when a person’s body doesn’t make enough insulin or can’t use insulin properly. When you have diabetes, the sugar builds up in your blood instead of moving into the cells. Too much sugar in the blood can lead to serious problems, including heart disease and damage to the nerves and kidneys.
There are 2 types of diabetes. Type 1 diabetes occurs when the body doesn’t produce any insulin. In type 2 diabetes, the body either doesn’t produce enough insulin or the cells ignore the insulin. Nearly 95% of people who are diagnosed with diabetes have type 2 diabetes.

How can I help myself stay healthy if I have diabetes?

Although diabetes can’t be cured, you can still live a long and healthy life. The single most important thing you can do is control your blood sugar level. You can do this by eating right, exercising, maintaining a healthy weight and, if needed, taking oral medicines or insulin.
Eat a healthy diet. The recommended diet for many people who have diabetes is very similar to that suggested for everyone: low in fat, low in cholesterol, low in salt and low in added sugar. In order to help keep your blood sugar at a healthy level, t's important to eat at least 3 meals per day and never skip a meal. For more information, read our Diabetes and Nutrition handout.
Exercise. Exercising will help your body use insulin and lower your blood sugar level. It also helps control your weight, gives you more energy and is good for your overall health. For more information, read our Diabetes and Exercise handout.
Maintain a healthy weight. Losing excess weight and maintaining a healthy body weight will help you in 2 ways. First, it helps insulin work better in your body. Second, it will lower your blood pressure and decrease your risk for heart disease.
Take your medicine. If your diabetes can't be controlled with diet, exercise and weight control, your doctor may recommend medicine or insulin. Oral medicines (taken by mouth) can make your body produce more insulin or help your body use the insulin it makes more efficiently. Some people need to add insulin to their bodies with insulin injections, insulin pens or insulin pumps. Always take medicines exactly as your doctor prescribes. For more information, read our Oral Medicines for Diabetes handout.

How do I check my blood sugar level?

Your doctor may suggest that you check your blood sugar level (also called blood glucose level) at home. Checking your blood sugar level involves pricking your finger to get a small drop of blood that you put on a test strip. You can read the results yourself or insert the strip into a machine called an electronic glucose meter. The results will tell you whether or not your blood sugar is in a healthy range. To learn more, read our Monitoring Your Blood Sugar Level handout.
Check your blood sugar level as often as your doctor suggests. You may need to check it more often at first, until you get the feel for how it changes and what makes it change.

What if my blood sugar gets too low?

People who have diabetes may have times when their blood sugar level is too low. Low blood sugar is called hypoglycemia. Signs of hypoglycemia include the following:

  • Feeling very tired
  • Frequent yawning
  • Being unable to speak or think clearly
  • Loss of muscle coordination
  • Sweating
  • Twitching
  • Seizures
  • Suddenly feeling like you’re going to pass out
  • Becoming very pale
  • Loss of consciousness

People who have diabetes should carry at least 15 grams of a fast-acting carbohydrate with them at all times in case of hypoglycemia. The following are examples of quick sources of energy that can relieve the symptoms:

  • Nondiet soda- ½ to ¾ cup
  • Fruit juice- ½ cup
  • Fruit- 2 tablespoons of raisins
  • Milk- 1 cup
  • Candy- 5 Lifesavers
  • Glucose tablets- 3 tablets (5 grams each)

If you don’t feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate.

What health problems can diabetes cause?

Diabetes can be a dangerous and life-threatening disease if you don’t control your blood sugar level. Over time, high blood sugar levels can damage your eyes, blood vessels, nerves and kidneys. Here are some of the problems (also called complications) diabetes can cause:
Blindness and vision loss (called diabetic retinopathy): Diabetes can damage the small blood vessels in the retina, which can cause vision loss and even blindness. For more information, read our Diabetes: Eye Care handout.
Heart disease: People who have diabetes are twice as likely to have heart disease and damage to the blood vessels in the heart. This increases their risk of heart attack and stroke. For more information, read our Diabetes and Heart Disease handout.
Nerve and blood vessel damage (called diabetic neuropathy): Damage to blood vessels in the legs can limit the supply of blood to the nerves in the legs and feet. This can cause burning, tingling and numbness in the affected areas (usually starting in the toes and spreading to the whole foot). It also makes it difficult to feel injuries (such as foot sores). Damage to the blood vessels can also put you at risk for infections and sores that don’t heal. In severe cases, parts of the foot or lower leg may have to be amputated (removed). For more information, read our Diabetic Neuropathy handout.
Kidney disease (called diabetic nephropathy): Diabetes can damage the small blood vessels in the kidneys, which then can’t filter out the body’s waste. In some people, the kidneys stop working completely. These people require dialysis or a kidney transplant. Dialysis is a treatment that eliminates wastes in the blood. For more information, please read our Diabetic Nephropathy handout.
The good news is that diabetic complications can often be prevented by taking care of yourself, following your doctor’s orders and controlling your blood sugar level. For more information on how to prevent these problems, please read our Preventing Diabetic Complications handout.

The link to the left takes you to the digital edition of FamilyDoctor: Living with Diabetes, part of the brand new patient education series brought to you by the American Academy of Family Physicians.

Other Organizations

  • American Diabetes Association

How Do I Know If I Have Diabetes?

What is diabetes?

Your body changes most of the food you eat into glucose (a form of sugar). Insulin is a hormone produced by the pancreas that allows glucose to enter all the cells of your body and be used as energy.
Diabetes is a disease that occurs when a person’s body doesn’t make enough insulin or can’t use insulin properly. When you have diabetes, the sugar builds up in your blood instead of moving into the cells. Too much sugar in the blood can lead to serious health problems, including heart disease and damage to the nerves and kidneys.
There are 2 types of diabetes. Type 1 diabetes occurs when the body doesn’t produce any insulin. In type 2 diabetes, the body either doesn’t produce enough insulin or the cells ignore the insulin. Nearly 95% of people who are diagnosed with diabetes have type 2 diabetes.

What are the symptoms of diabetes?

The early stages of diabetes have very few symptoms, so you may not know you have the disease. But damage may already be happening to your eyes, your kidneys and your cardiovascular system even before you notice symptoms. Symptoms of diabetes may include the following:

  • Extreme thirst
  • Extreme hunger
  • Frequent urination
  • Sores or bruises that heal slowly
  • Dry, itchy skin
  • Unexplained weight loss
  • Blurry vision
  • Unusual tiredness or drowsiness
  • Tingling or numbness in the hands or feet
  • Frequent or recurring skin, gum, bladder or vaginal yeast infections

If you are regularly experiencing any of these symptoms, call your family doctor right away.

Who is at risk for diabetes?

You are at increased risk for diabetes if:

  • You're older than 45 years of age
  • You're overweight
  • You don't exercise regularly
  • Your parent, brother or sister has diabetes
  • You gave birth to a baby that weighed more than 9 pounds or you had gestational diabetes while you were pregnant
  • You're African American, Hispanic American/Latino, Native American, Asian American or Pacific Islander

If you have 1 or more of these risk factors, your doctor may want you to be tested (also called "screened") for diabetes. You might also be screened at a younger age and more often if you have risk factors. Talk to your doctor about your risk of developing diabetes and about a plan for regular testing.

How will I be tested for diabetes?

Screening is usually done with a fasting blood test. You'll be tested in the morning, so you shouldn't eat anything after dinner the night before. A normal blood sugar test result is between 70 and 99 mg per dL. A test result higher than 126 mg per dL suggests diabetes. However, you should have 2 tests that are higher than 12 mg per dL, on 2 different days, before a diagnosis of diabetes is made. Test results from 100 mg per dL to 125 mg per dL suggest prediabetes.

Why is it important for diabetes to be diagnosed early?

Many people have diabetes for years before they show symptoms. By the time they are diagnosed, some people already have eye, kidney, gum or nerve damage caused by diabetes. There's no cure for diabetes, but there are ways for you to stay healthy and reduce the risk of complications. If you exercise, watch your diet, control your weight and take the medicine your doctor may prescribe, you can make a big difference in reducing or preventing the damage that diabetes can do. The earlier you know you have diabetes, the sooner you can make these important lifestyle changes.

Where can I get more information about diabetes?

Your family doctor can tell you how often you should be screened for diabetes. He or she can give you advice about diet, exercise and lifestyle changes that can help manage your diabetes.

Prediabetes

What is diabetes?

Your body changes most of the food you eat into glucose (a form of sugar). Insulin is a hormone produced by the pancreas that allows glucose to enter all the cells of your body and be used as energy.
Diabetes is a disease that occurs when a person’s body doesn’t make enough insulin or can’t use insulin properly. When you have diabetes, the sugar builds up in your blood instead of moving into the cells. Too much sugar in the blood can lead to serious health problems, including heart disease and damage to the nerves and kidneys.
There are 2 types of diabetes. Type 1 diabetes occurs when the body doesn’t produce any insulin. In type 2 diabetes, the body either doesn’t produce enough insulin or the cells ignore the insulin. Nearly 95% of people who are diagnosed with diabetes have type 2 diabetes.

What is prediabetes?

Before people develop type 2 diabetes, they usually have prediabetes. In people who have prediabetes, blood sugar levels are higher than normal but not high enough to say they have diabetes. Normal blood sugar is between 70 and 99 mg per dL. Blood sugar between 100 and 125 mg per dL suggests prediabetes. Blood sugar higher than 126 mg per dL is considered diabetes. People who have prediabetes have a high risk of eventually developing diabetes.

How can my doctor tell if I have prediabetes?

Your doctor can give you a blood test to check for prediabetes.

Who is at risk?

You are at risk for prediabetes if any of the following are true:

  • You are overweight or obese.
  • You have a parent, brother or sister who has diabetes.
  • You had diabetes during pregnancy (called gestational diabetes) or had a baby who weighed more than 9 pounds at birth.
  • You belong to any of the following ethnic groups: African American, Native American, Latin American or Asian/Pacific Islander.
  • You have high blood pressure (above 140/90 mm Hg).
  • Your high-density lipoprotein (HDL) cholesterol level (“good” cholesterol) is less than 40 mg per dL (for men) or less than 50 mg per dl (for women), or your triglyceride level is higher than 250 mg per dL.
  • You are a woman who has polycystic ovary syndrome (PCOS).

If I have prediabetes, can I avoid developing diabetes?

You can lower your risk of developing diabetes by making changes in your lifestyle. If you are overweight, losing weight can help. Losing weight also helps lower your blood pressure and cholesterol levels.
Exercise is also important. Your exercise routine should include 30 minutes of moderate physical activity (such as brisk walking or swimming) at least five times a week. Ask your doctor what exercise level is safe for you.
You need to follow a healthy diet. Eat foods such as salads, vegetables, fruits, whole grains, fish, beans, poultry and other meats. Don't eat a lot of sugar, honey or molasses. Eat foods made with whole grains instead of white flour.
Less than 30 percent of your total daily calories should come from fat. Less than 10 percent of your daily calories should come from saturated fat. Carbohydrates should make up 50 to 60 percent of your total daily calories. Your diet also should include at least 38 grams of fiber per day for men age 50 and younger and 25 grams per day for women age 50 and younger.
Your doctor might refer you to a dietitian or diabetes educator to help you change your eating habits.

Can medicine help prevent or delay diabetes?

Diabetes medicines are not as effective as diet and exercise. However, your doctor might prescribe medicine if you are at high risk for diabetes and have other medical problems, such as obesity, a high triglyceride level, a low HDL cholesterol level or high blood pressure.

How does diabetes affect my body?

Diabetes causes the level of sugar in your blood to be higher than normal. Over time, high blood sugar levels can damage the blood vessels and nerves in your body.
Damage to the blood vessels in your eyes (called diabetic retinopathy) can cause vision loss and even blindness.

What kind of eye problems am I at risk of?

Uncontrolled or poorly controlled diabetes can damage the small blood vessels of the retina. The retina is the part of the eye that's sensitive to light and sends messages to your brain about what you see.
When the blood vessels of your retina are damaged, fluid can leak from them and cause swelling in your macula. The macula is the central part of the retina and gives you sharp, clear vision. The swelling and fluid can cause blurry vision and make it hard for you to see.
If retinopathy worsens, your eye may begin to form new blood vessels over the retina. These vessels are fragile and can break easily and bleed. Scar tissue may form, which can cause the retina to break away from the back of the eye.
When retinopathy is found early, laser treatment can help keep you from losing your vision. If it's not treated, retinopathy can cause blindness.

Tips on preventing diabetic retinopathy

  • Control your blood sugar, blood pressure and cholesterol levels.
  • Exercise regularly.
  • Get a yearly eye exam.
  • See your family doctor regularly.
  • Eat a healthy diet.
  • Quit smoking.
  • Avoid alcohol.

How should I take care of my eyes?

The most important thing is to have your eyes checked regularly--at least once a year. You probably won't notice the early signs of diabetic retinopathy because the early changes in your eyes can only be seen through special equipment.
If you notice any of the symptoms in the box below, call your doctor.

Call your doctor if you:

  • Have blurry vision for more than 2 days
  • Suddenly lose vision in 1 or both eyes
  • See floaters (black or gray spots, cobwebs or strings that move or drift when you move your eyes)
  • See flashing lights that aren't really there
  • Have pain or pressure in your eye(s)

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