Authors: Winston Wang, MD – Lori Roust, MD – Holly Geyer, MD
What are the different types?
Diabetes is a chronic medical condition in which the body is unable to properly regulate blood sugar (glucose) levels. This can occur due to either insufficient insulin production or ineffective use of insulin by the body’s cells. There are two main types of diabetes: type 1 and type 2. Type 2 is much more common than type 1.
Type 1 diabetes is a condition where the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. This means the body can’t make insulin, which is a hormone that helps sugar (glucose) from food get into cells to be used for energy. Without insulin, glucose builds up in the blood, leading to high blood sugar levels. People with type 1 diabetes need to take insulin every day to manage their blood sugar levels. This type of diabetes often starts in children or young adults but can happen at any age.
Type 2 diabetes is a condition where the body doesn’t use insulin properly, known as insulin resistance. Over time, the pancreas can’t make enough insulin to keep blood sugar levels normal. This type of diabetes is more common in adults, especially those who are overweight or inactive, but it can also occur in younger people. Treatment usually starts with lifestyle changes like eating healthy and exercising. If these changes aren’t enough, medications or insulin therapy may be needed.
Risk Factors
Risk factors for developing diabetes include a combination of genetic, lifestyle, and demographic factors. According to the American Diabetes Association, the risk of developing type 2 diabetes increases with age, obesity, and lack of physical activity. Individuals with prediabetes, prior gestational diabetes mellitus, or polycystic ovary syndrome are also at higher risk. Additionally, type 2 diabetes is more common in people with hypertension or dyslipidemia and in certain racial and ethnic subgroups, such as African American, Native American, Hispanic/Latino, and Asian American populations. A strong genetic predisposition or family history in first-degree relatives is often associated with type 2 diabetes, although the specific genetic mechanisms are still under investigation.
For type 1 diabetes, several risk factors may increase the likelihood of developing the condition. One of the key factors is genetics; a family history of type 1 diabetes can heighten risk, as certain genes are associated with increased susceptibility. Additionally, autoimmune factors play a significant role as type 1 diabetes involves the immune system mistakenly attacking and destroying insulin-producing beta cells in the pancreas. Individuals with other autoimmune diseases may also face a higher risk. Age is another factor, as type 1 diabetes can occur at any age, but it is most commonly diagnosed in children, teenagers, and young adults. Environmental factors, such as certain viral infections, like those caused by enteroviruses, may trigger the autoimmune response leading to the condition in genetically susceptible individuals. Geographic location also appears to influence risk, with type 1 diabetes being more common in some regions of the world, particularly in northern climates. Finally, ethnicity can play a role, as some groups, such as Caucasians, have a higher incidence of type 1 diabetes compared to others. While these factors may contribute to an individual’s susceptibility, it is important to note that type 1 diabetes is not preventable through lifestyle changes, unlike type 2 diabetes.
What symptoms suggest Diabetes?
The symptoms of diabetes can vary depending on the type and severity of the condition. Common symptoms include increased thirst, frequent urination, increased hunger, fatigue, blurred vision, unexplained weight loss, sores that are slow to heal, and numbness or tingling in the feet.
In general, these symptoms are often more pronounced in type 1 diabetes, where they can develop rapidly and be severe. In type 2 diabetes, symptoms typically develop more slowly and may be less noticeable initially. However, it is important to recognize that not all individuals with diabetes will exhibit these symptoms, and some may be asymptomatic.
How does a provider diagnose it
To diagnose diabetes mellitus, the American Diabetes Association recommends using one of several criteria, any one of which can be used to establish the diagnosis:
1. Fasting Plasma Glucose ≥126 mg/dL: This test should be performed after no food intake for at least 8 hours. A diabetes is suggested if the test is positive on two separate occasions.
2. 2-hour Plasma Glucose ≥200 mg/d during an Oral Glucose Tolerance Test: This test involves measuring plasma glucose 2 hours after drinking 75 g of glucose.
3. Hemoglobin A1c ≥6.5%: This test reflects long-term blood glucose concentrations, and approximately represents an average of the last three months of blood sugar levels.
4. Random Plasma Glucose ≥200 mg/dL in a patient with classic symptoms of high blood sugar
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