Category Archives: Diabetes

Diabetes is a lifelong condition that causes a person's blood sugar level to become too high.

There are2 main types of diabetes:

Type 2 diabetes is far more common than type 1. Inthe UK,around 90% of all adultswith diabetes have type 2.

During pregnancy, some women have such high levels of blood glucose that their body is unable toproduce enough insulin to absorb it all. This is known asgestational diabetes.

Flu can be very serious if you have diabetes. Ask for your free NHS flu jab at:

Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes.

This is sometimes known as pre-diabetes. Ifyour blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased.

It's very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated.

Visit your GP as soon as possible if you experience the main symptoms of diabetes, which include:

Type 1 diabetes can develop quickly over weeks or even days.

Many people have type 2 diabetes for years without realising because the early symptoms tend to be general.

The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach).

When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it's broken down to produce energy.

However,if you havediabetes, yourbody is unable to break down glucose into energy. This is because there's either not enough insulin to move the glucose, or the insulin produced doesn't work properly.

Although there are no lifestyle changes you can make to lower your risk of type 1 diabetes, type 2 diabetes is often linked to being overweight.

Read about how to reduce your diabetes risk.

If you're diagnosed with diabetes, you'll need toeat healthily, take regular exerciseand carry out regular blood teststo ensure your blood glucose levels stay balanced.

You can use theBMI healthy weight calculator to check whether you're a healthyweight.

You can find apps and tools in the NHS Apps Library to help you manage your diabetes and have a healthier lifestyle.

People diagnosed with type 1 diabetes also require regularinsulin injections for the rest of their life.

As type 2 diabetes is a progressive condition, medication may eventually be required, usually in the form of tablets.

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Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year.

If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if it's not treated.

Screening, which involvesa half-hour check to examine the back of the eyes,is a way of detecting the condition early so it can be treated more effectively.

Read more about diabetic eye screening.

Page last reviewed: 12/07/2016Next review due: 12/07/2019

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Diabetes - NHS

Diabetes occurs when you lack the hormone insulin or when your insulin is not able to work effectively to move blood sugar (blood glucose) to the bodys cells. That causes glucose to rise to abnormally high levels in your blood, which can cause damage to many organs.

Also called juvenile diabetes, type 1 diabetes is an autoimmune disease where your body destroys cells that make insulin. If you have type 1 diabetes, you must take insulin injections in order to live.

Type 2 diabetes is the most common form of diabetes. It starts when the body does not use insulin properly. Over time, your body cannot produce enough insulin to function properly. As a result, glucose builds up in the blood and can damage many organs.

Gestational diabetes is type 2 diabetes that only develops during pregnancy and goes away after the baby is born. Women who develop gestational diabetes are at an increased risk of developing type 2 diabetes later in life.

Some people with diabetes do not have symptoms. But others may experience the following:

Just because you have these symptoms does not mean you have diabetes other conditions can cause similar problems.

Having a high blood sugar level can cause serious health problems and may contribute to complications such as the following:

If you have diabetes symptoms, make an appointment to see your primary care doctor. A blood test can determine if you have diabetes.

You may also call for an appointment at the Rush University Diabetes Center. At the center, you can receive education and treatment from a specialized team of physicians, nurses and dietitians.

If you are overweight and not physically active, you are at higher risk for diabetes. You are also at higher risk if you have family members with diabetes. Regular checkups are important so that your doctor can check for early signs of the disease. You can then start treatment to help prevent the development of serious health problems.

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Diabetes | Medical Conditions | Rush University Medical Center

Although diabetes cant 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.

Your doctor will test your blood sugar every 3 months with an A1C test. Also, you can test your blood sugar on your own throughout the day. You will need to use a blood glucose monitor to check it on your own. This involves pricking your finger for blood and putting a test strip in the blood to get the results. If your blood sugar gets too low, you might feel tired, experience problems with muscle coordination, sweat, have difficulty thinking or speaking clearly, twitch, feel like youre going to faint, become pale, lose consciousness, or have a seizure. At the earliest sign of any of these symptoms, eat or drink something that will raise your blood sugar fast. This could include candy, juice, milk, or raisins. If you dont feel better in 15 minutes or if monitoring shows that your blood sugar level is still too low, eat or drink another item to raise your blood sugar fast. Always keep a supply of these items on hand for emergencies.

You may not know if your blood sugar is too high unless you test it yourself. However, you may experience common symptoms such as frequent urination, extreme thirst, blurry vision, and feeling tired. Some factors unrelated to food can make your blood sugar high. This includes not taking your insulin correctly, overeating at a meal, illness, having hormonal changes, and stress.

If your blood sugar level is too high and you take insulin, you may need to take an extra dose of rapid- or short-acting insulin to return it to normal. Your doctor can tell you how much insulin you need to take to lower your blood sugar level.

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Diabetes - familydoctor.org

About Diabetes, Type 2: Type 2 diabetes is characterized by "insulin resistance" as body cells do not respond appropriately when insulin is present. This is a more complex problem than type 1, but is sometimes easier to treat, since insulin is still produced, especially in the initial years. Type 2 may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder (no ketoacidosis) and can be sporadic. However, severe complications can result from unnoticed type 2 diabetes, including renal failure, and coronary artery disease. Type 2 diabetes was formerly known by a variety of partially misleading names, including "adult-onset diabetes", "obesity-related diabetes", "insulin-resistant diabetes", or "non-insulin-dependent diabetes" (NIDDM). It may be caused by a number of diseases, such as hemochromatosis and polycystic ovary syndrome, and can also be caused by certain types of medications (e.g. long-term steroid use). About 90-95% of all North American cases of diabetes are type 2, and about 20% of the population over the age of 65 is a type 2 diabetic. The fraction of type 2 diabetics in other parts of the world varies substantially, almost certainly for environmental and lifestyle reasons. There is also a strong inheritable genetic connection in type 2 diabetes: having relatives (especially first degree) with type 2 is a considerable risk factor for developing type 2 diabetes. The majority of patients with type 2 diabetes mellitus are obese - chronic obesity leads to increased insulin resistance that can develop into diabetes, most likely because adipose tissue is a (recently identified) source of chemical signals (hormones and cytokines).

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List of Diabetes, Type 2 Medications (165 Compared ...

Diabetes occurs when the body has trouble using the sugar it gets from food for energy. Sugar builds up in the bloodstream. High blood sugar can have immediate effects, like blurry vision. It can also cause problems over time, like heart disease and blindness.

There are two main types of diabetes: type 1 diabetes (once called juvenile-onset diabetes) and type 2 diabetes (once called adult-onset diabetes). Both are caused by problems making or using insulin, a hormone that makes it possible for cells to use glucose, also known as blood sugar, for energy.

When you eat, your body breaks down carbohydrates into a simple sugar called glucose. It also produces a hormone called insulin that signals the body's cells to absorb glucose from the bloodstream. Type 1 diabetes occurs when the body doesn't make enough insulin, or stops making it altogether. Type 2 diabetes occurs when the body's cells don't respond to insulin. Either way, since sugar can't get into cells, it builds up in the bloodstream.

Too much sugar in the blood can cause a range of uncomfortable symptoms. These include:

Type 1 diabetes often comes on suddenly. It usually strikes children and teenagers, but can appear later in life. It is an autoimmune disease, meaning it happens because the body's immune system mistakenly attacks and destroys the body's insulin-making cells. Type 1 diabetes can't be cured, but it can be managed by taking insulin before eating.

Type 2 diabetes takes longer to develop. It can begin any time from childhood onward. Type 2 diabetes is usually triggered by being overweight or obese and not getting much physical activity. Treatment for type 2 diabetes includes weight loss if needed, daily exercise, a healthy diet, and medications.

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Diabetes - Harvard Health

Diabetes type1SynonymsT1D, insulin-dependent diabetes,[1] juvenile diabetes[2]A blue circle, the symbol for diabetes.[3]PronunciationSpecialtyEndocrinologySymptomsFrequent urination, increased thirst, increased hunger, weight loss[4]ComplicationsDiabetic ketoacidosis, nonketotic hyperosmolar coma, poor healing, cardiovascular disease, damage to the eyes[2][4][5]Usual onsetRelatively short period of time[1]DurationLong term[4]CausesNot enough insulin[4]Risk factorsFamily history, celiac disease[5][6]Diagnostic methodBlood sugar, A1C[5][7]PreventionUnknown[4]TreatmentInsulin, diabetic diet, exercise[1][2]Frequency~7.5% of diabetes cases[8]

Diabetes mellitus type1, also known as type 1 diabetes, is a form of diabetes mellitus in which very little or no insulin is produced by the pancreas.[4] Before treatment this results in high blood sugar levels in the body.[1] The classic symptoms are frequent urination, increased thirst, increased hunger, and weight loss.[4] Additional symptoms may include blurry vision, feeling tired, and poor wound healing.[2] Symptoms typically develop over a short period of time.[1]

The cause of type 1 diabetes is unknown.[4] However, it is believed to involve a combination of genetic and environmental factors.[1] Risk factors include having a family member with the condition.[5] The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas.[2] Diabetes is diagnosed by testing the level of sugar or glycated hemoglobin (HbA1C) in the blood.[5][7] Type 1 diabetes can be distinguished from type 2 by testing for the presence of autoantibodies.[5]

There is no known way to prevent type 1 diabetes.[4] Treatment with insulin is required for survival.[1] Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump.[9] A diabetic diet and exercise are important parts of management.[2] If left untreated, diabetes can cause many complications.[4] Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma.[5] Long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes.[4] Furthermore, complications may arise from low blood sugar caused by excessive dosing of insulin.[5]

Type1 diabetes makes up an estimated 510% of all diabetes cases.[8] The number of people affected globally is unknown, although it is estimated that about 80,000 children develop the disease each year.[5] Within the United States the number of people affected is estimated at one to three million.[5][10] Rates of disease vary widely with approximately 1 new case per 100,000 per year in East Asia and Latin America and around 30 new cases per 100,000 per year in Scandinavia and Kuwait.[11][12] It typically begins in children and young adults.[1]

The classical symptoms of type 1 diabetes include: polyuria (increased urination), polydipsia (increased thirst), dry mouth, polyphagia (increased hunger), fatigue, and weight loss.[4]

Many type 1 diabetics are diagnosed when they present with diabetic ketoacidosis. The signs and symptoms of diabetic ketoacidosis include dry skin, rapid deep breathing, drowsiness, increased thirst, frequent urination, abdominal pain, and vomiting.[14]

About 12 percent of people with type 1 diabetes have clinical depression.[15]

About 6 percent of people with type 1 diabetes have celiac disease, but in most cases there are no digestive symptoms[6][16] or are mistakenly attributed to poor control of diabetes, gastroparesis or diabetic neuropathy.[16] In most cases, celiac disease is diagnosed after onset of type 1 diabetes. The association of celiac disease with type 1 diabetes increases the risk of complications, such as retinopathy and mortality. This association can be explained by shared genetic factors, and inflammation or nutritional deficiencies caused by untreated celiac disease, even if type 1 diabetes is diagnosed first.[6]

Some people with type 1 diabetes experience dramatic and recurrent swings in glucose levels, often occurring for no apparent reason; this is called "unstable diabetes","labile diabetes" or "brittle diabetes".[17] The results of such swings can be irregular and unpredictable hyperglycemias, sometimes involving ketoacidosis, and sometimes serious hypoglycemias. Brittle diabetes occurs no more frequently than in 1% to 2% of diabetics.[17]

Type 1 diabetes is associated with alopecia areata (AA).[18] Type 1 diabetes is also more common in the family members of people with AA.[19]

The cause of type 1 diabetes is unknown.[4] A number of explanatory theories have been put forward, and the cause may be one or more of the following: genetic susceptibility, a diabetogenic trigger, and exposure to an antigen.[20]

Type1 diabetes is a disease that involves many genes. The risk of a child developing type 1 diabetes is about 5% if the father has it, about 8% if a sibling has it, and about 3% if the mother has it.[21] If one identical twin is affected there is about a 40% chance the other will be too.[22][23] Some studies of heritability have estimated it at 80 to 86%.[24][25]

More than 50 genes are associated with type 1 diabetes. Depending on locus or combination of loci, they can be dominant, recessive, or somewhere in between. The strongest gene, IDDM1, is located in the MHC Class II region on chromosome 6, at staining region 6p21. Certain variants of this gene increase the risk for decreased histocompatibility characteristic of type1. Such variants include DRB1 0401, DRB1 0402, DRB1 0405, DQA 0301, DQB1 0302 and DQB1 0201, which are common in North Americans of European ancestry and in Europeans.[26] Some variants also appear to be protective.[26]

There is on the order of a 10-fold difference in occurrence among Caucasians living in different areas of Europe, and people tend to acquire the disease at the rate of their particular country.[20] Environmental triggers and protective factors under research include dietary agents such as proteins in gluten,[27] time of weaning, gut microbiota,[28] viral infections,[29] and bacterial infections like paratuberculosis.[30]

Some chemicals and drugs selectively destroy pancreatic cells.Pyrinuron (Vacor), a rodenticide introduced in the United States in 1976, selectively destroys pancreatic beta cells, resulting in type 1 diabetes after accidental poisoning.[31] Pyrinuron was withdrawn from the U.S. market in 1979 and it is not approved by the Environmental Protection Agency for use in the U.S.[32] Streptozotocin (Zanosar), an antineoplastic agent, is selectively toxic to the beta cells of the pancreatic islets. It is used in research for inducing type 1 diabetes on rodents[33] and for treating metastatic cancer of the pancreatic islet cells in patients whose cancer cannot be removed by surgery.[34] Other pancreatic problems, including trauma, pancreatitis, or tumors (either malignant or benign) can also lead to loss of insulin production.

The pathophysiology in diabetes type 1 is a destruction of beta cells in the pancreas, regardless of which risk factors or causative entities have been present.

Individual risk factors can have separate pathophysiological processes to, in turn, cause this beta cell destruction. Still, a process that appears to be common to most risk factors is an autoimmune response towards beta cells, involving an expansion of autoreactive CD4+ T helper cells and CD8+ T cells, autoantibody-producing B cells and activation of the innate immune system.[26][35]

After starting treatment with insulin a person's own insulin levels may temporarily improve.[36] This is believed to be due to altered immunity and is known as the "honeymoon phase".[36]

Diabetes mellitus is characterized by recurrent or persistent hyperglycemia, and is diagnosed by demonstrating any one of the following:[39]

About a quarter of people with new type1 diabetes have developed some degree of diabetic ketoacidosis (a type of metabolic acidosis which is caused by high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids) by the time the diabetes is recognized. The diagnosis of other types of diabetes is usually made in other ways. These include ordinary health screening, detection of hyperglycemia during other medical investigations, and secondary symptoms such as vision changes or unexplained fatigue. Diabetes is often detected when a person suffers a problem that may be caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing or a foot ulcer, certain eye problems, certain fungal infections, or delivering a baby with macrosomia or hypoglycemia (low blood sugar).[citation needed]

A positive result, in the absence of unequivocal hyperglycemia, should be confirmed by a repeat of any of the above-listed methods on a different day. Most physicians prefer to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test.[41] According to the current definition, two fasting glucose measurements above 126mg/dl (7.0mmol/l) is considered diagnostic for diabetes mellitus.[citation needed]

In type1, pancreatic beta cells in the islets of Langerhans are destroyed, decreasing endogenous insulin production. This distinguishes type1's origin from type2. Type 2 diabetes is characterized by insulin resistance, while type 1 diabetes is characterized by insulin deficiency, generally without insulin resistance. Another hallmark of type 1 diabetes is islet autoreactivity, which is generally measured by the presence of autoantibodies directed towards the beta cells.[citation needed]

The appearance of diabetes-related autoantibodies has been shown to be able to predict the appearance of diabetes type 1 before any hyperglycemia arises, the main ones being islet cell autoantibodies, insulin autoantibodies, autoantibodies targeting the 65-kDa isoform of glutamic acid decarboxylase (GAD), autoantibodies targeting the phosphatase-related IA-2 molecule, and zinc transporter autoantibodies (ZnT8).[20] By definition, the diagnosis of diabetes type 1 can be made first at the appearance of clinical symptoms and/or signs, but the emergence of autoantibodies may itself be termed "latent autoimmune diabetes". Not everyone with autoantibodies progresses to diabetes type 1, but the risk increases with the number of antibody types, with three to four antibody types giving a risk of progressing to diabetes type 1 of 60100%.[20] The time interval from emergence of autoantibodies to clinically diagnosable diabetes can be a few months in infants and young children, but in some people it may take years in some cases more than 10 years.[20] Islet cell autoantibodies are detected by conventional immunofluorescence, while the rest are measured with specific radiobinding assays.[20]

Type1 diabetes is not currently preventable.[42] Some researchers believe it might be prevented at the latent autoimmune stage, before it starts destroying beta cells.[26]

Cyclosporine A, an immunosuppressive agent, has apparently halted destruction of beta cells (on the basis of reduced insulin usage), but its kidney toxicity and other side effects make it highly inappropriate for long-term use.[26]

Anti-CD3 antibodies, including teplizumab and otelixizumab, had suggested evidence of preserving insulin production (as evidenced by sustained C-peptide production) in newly diagnosed type 1 diabetes patients.[26] A probable mechanism of this effect was believed to be preservation of regulatory T cells that suppress activation of the immune system and thereby maintain immune system homeostasis and tolerance to self-antigens.[26] The duration of the effect is still unknown, however.[26] In 2011, Phase III studies with otelixizumab and teplizumab both failed to show clinical efficacy, potentially due to an insufficient dosing schedule.[43][44]

An anti-CD20 antibody, rituximab, inhibits B cells and has been shown to provoke C-peptide responses three months after diagnosis of type 1 diabetes, but long-term effects of this have not been reported.[26]

Some research has suggested breastfeeding decreases the risk in later life[45][46] and early introduction of gluten-containing cereals in the diet increases the risk of developing islet cell autoantibodies;[47] various other nutritional risk factors are being studied, but no firm evidence has been found.[48]Giving children 2000IU of vitamin D daily during their first year of life is associated with reduced risk of type1 diabetes, though the causal relationship is obscure.[49]

Children with antibodies to beta cell proteins (i.e. at early stages of an immune reaction to them) but no overt diabetes, and treated with niacinamide (vitamin B3), had less than half the diabetes onset incidence in a seven-year time span than did the general population, and an even lower incidence relative to those with antibodies as above, but who received no niacinamide.[50]

People with type 1 diabetes and undiagnosed celiac disease have worse glycaemic control and a higher prevalence of nephropathy and retinopathy. Gluten-free diet, when performed strictly, improves diabetes symptoms and appears to have a protective effect against developing long-term complications. Nevertheless, dietary management of both these diseases is challenging and these patients have poor compliance of the diet.[51]

Diabetes is often managed by a number of health care providers including a dietitian, nurse educator, eye doctor, endocrinologist, and podiatrist.[52]

A low-carbohydrate diet, exercise, and medications are useful in type 1 DM.[53] There are camps for children to teach them how and when to use or monitor their insulin without parental help.[54] As psychological stress may have a negative effect on diabetes, a number of measures have been recommended including: exercising, taking up a new hobby, or joining a charity, among others.[55]

Injections of insulin either via subcutaneous injection or insulin pump are necessary for those living with type 1 diabetes because it cannot be treated by diet and exercise alone.[56] Insulin dosage is adjusted taking into account food intake, blood glucose levels and physical activity.

Untreated type1 diabetes can commonly lead to diabetic ketoacidosis which is a diabetic coma which can be fatal if untreated.[57] Diabetic ketoacidosis can cause cerebral edema (accumulation of liquid in the brain). This is a life-threatening issue and children are at a higher risk for cerebral edema than adults, causing ketoacidosis to be the most common cause of death in pediatric diabetes.[58]

Treatment of diabetes focuses on lowering blood sugar or glucose (BG) to the near normal range, approximately 80140mg/dl (4.47.8mmol/l).[59] The ultimate goal of normalizing BG is to avoid long-term complications that affect the nervous system (e.g. peripheral neuropathy leading to pain and/or loss of feeling in the extremities), and the cardiovascular system (e.g. heart attacks, vision loss). This level of control over a prolonged period of time can be varied by a target HbA1c level of less than 7.5%.[5]

There are four main types of insulin: rapid acting insulin, short-acting insulin, intermediate-acting insulin, and long-acting insulin. The rapid acting insulin is used as a bolus dosage. The action onsets in 15 minutes with peak actions in 30 to 90 minutes. Short acting insulin action onsets within 30 minutes with the peak action around 2 to 4 hours. Intermediate acting insulin action onsets within one to two hours with peak action of four to 10 hours. Long-acting insulin is usually given once per day. The action onset is roughly 1 to 2 hours with a sustained action of up to 24 hours. Some insulins are biosynthetic products produced using genetic recombination techniques; formerly, cattle or pig insulins were used, and even sometimes insulin from fish.[60]

People with type 1 diabetes always need to use insulin, but treatment can lead to low BG (hypoglycemia), i.e. BG less than 70mg/dl (3.9mmol/l). Hypoglycemia is a very common occurrence in people with diabetes, usually the result of a mismatch in the balance among insulin, food and physical activity. Symptoms include excess sweating, excessive hunger, fainting, fatigue, lightheadedness and shakiness.[61] Mild cases are self-treated by eating or drinking something high in sugar. Severe cases can lead to unconsciousness and are treated with intravenous glucose or injections with glucagon. Continuous glucose monitors can alert patients to the presence of dangerously high or low blood sugar levels, but technical issues have limited the effect these devices have had on clinical practice.[citation needed]

As of 2016 an artificial pancreas looks promising with safety issues still being studied.[62] In 2018 they were deemed to be relatively safe.[63]

In some cases, a pancreas transplant can restore proper glucose regulation. However, the surgery and accompanying immunosuppression required may be more dangerous than continued insulin replacement therapy, so is generally only used with or some time after a kidney transplant. One reason for this is that introducing a new kidney requires taking immunosuppressive drugs such as cyclosporine, which allows the introduction of a new pancreas to a person with diabetes without any additional immunosuppressive therapy. However, pancreas transplants alone may be beneficial in people with extremely labile type1 diabetes mellitus.[64]

Islet cell transplantation may be an option for some people with type 1 diabetes that are not well controlled with insulin.[65] Difficulties include finding donors that are compatible, getting the new islets to survive, and the side effects from the medications used to prevent rejection.[65][66] Success rates, defined as not needing insulin at 3 years following the procedure occurred in 44% of people on registry from 2010.[65] In the United States, as of 2016, it is considered an experimental treatment.[66]

Complications of poorly managed type 1 diabetes mellitus may include cardiovascular disease, diabetic neuropathy, and diabetic retinopathy, among others. However, cardiovascular disease[67] as well as neuropathy[68] may have an autoimmune basis, as well. Women with type 1 DM have a 40% higher risk of death as compared to men with type 1 DM.[69] The life expectancy of an individual with type 1 diabetes is 11 years less for men and 13 years less for women.[70]

People with diabetes show an increased rate of urinary tract infection.[71] The reason is bladder dysfunction that is more common in diabetics than in non-diabetics due to diabetic nephropathy. When present, nephropathy can cause a decrease in bladder sensation, which in turn, can cause increased residual urine, a risk factor for urinary tract infections.[72]

Sexual dysfunction in diabetics is often a result of physical factors such as nerve damage and poor circulation, and psychological factors such as stress and/or depression caused by the demands of the disease.[73]

The most common sexual issues in diabetic males are problems with erections and ejaculation: "With diabetes, blood vessels supplying the peniss erectile tissue can get hard and narrow, preventing the adequate blood supply needed for a firm erection. The nerve damage caused by poor blood glucose control can also cause ejaculate to go into the bladder instead of through the penis during ejaculation, called retrograde ejaculation. When this happens, semen leaves the body in the urine." Another cause of erectile dysfunction is reactive oxygen species created as a result of the disease. Antioxidants can be used to help combat this.[74]

Studies find a significant prevalence of sexual problems in diabetic women,[73] including reduced sensation in the genitals, dryness, difficulty/inability to orgasm, pain during sex, and decreased libido. Diabetes sometimes decreases estrogen levels in females, which can affect vaginal lubrication. Less is known about the correlation between diabetes and sexual dysfunction in females than in males.[73]

Oral contraceptive pills can cause blood sugar imbalances in diabetic women. Dosage changes can help address that, at the risk of side effects and complications.[73]

Women with type 1 diabetes show a higher than normal rate of polycystic ovarian syndrome (PCOS).[75] The reason may be that the ovaries are exposed to high insulin concentrations since women with type 1 diabetes can have frequent hyperglycemia.[76]

Women with type 1 diabetes are higher risk for other autoimmune diseases, such as autoimmune thyroid disease, rheumatoid arthritis and lupus.[77][78]

Type1 diabetes makes up an estimated 510% of all diabetes cases[8] or 1122million worldwide.[42] In 2006 it affected 440,000 children under 14 years of age and was the primary cause of diabetes in those less than 10 years of age.[79] The incidence of type 1 diabetes has been increasing by about 3% per year.[79]

Rates vary widely by country. In Finland, the incidence is a high of 57 per 100,000 per year, in Japan and China a low of 1 to 3 per 100,000 per year, and in Northern Europe and the U.S., an intermediate of 8 to 17 per 100,000 per year.[80][81]

In the United States, type 1 diabetes affected about 208,000 youths under the age of 20 in 2015. Over 18,000 youths are diagnosed with Type 1 diabetes every year. Every year about 234,051 Americans die due to diabetes (type I or II) or diabetes-related complications, with 69,071 having it as the primary cause of death.[82]

In Australia, about one million people have been diagnosed with diabetes and of this figure 130,000 people have been diagnosed with type 1 diabetes. Australia ranks 6th-highest in the world with children under 14 years of age. Between 2000 and 2013, 31,895 new cases were established, with 2,323 in 2013, a rate of 1013 cases per 100,00 people each year. Aboriginals and Torres Strait Islander people are less affected.[83][84]

Type 1 diabetes was described as an autoimmune disease in the 1970s, based on observations that autoantibodies against islets were discovered in diabetics with other autoimmune deficiencies.[85] It was also shown in the 1980s that immunosuppressive therapies could slow disease progression, further supporting the idea that type 1 diabetes is an autoimmune disorder.[86] The name juvenile diabetes was used earlier as it often first is diagnosed in childhood.

The disease was estimated to cause $10.5 billion in annual medical costs ($875 per month per diabetic) and an additional $4.4 billion in indirect costs ($366 per month per person with diabetes) in the U.S.[87] In the United States $245 billion every year is attributed to diabetes. Individuals diagnosed with diabetes have 2.3 times the health care costs as individuals who do not have diabetes. One in 10 health care dollars are spent on individuals with diabetes.[82]

Funding for research into type 1 diabetes originates from government, industry (e.g., pharmaceutical companies), and charitable organizations. Government funding in the United States is distributed via the National Institute of Health, and in the UK via the National Institute for Health Research or the Medical Research Council. The Juvenile Diabetes Research Foundation (JDRF), founded by parents of children with type 1 diabetes, is the world's largest provider of charity-based funding for type 1 diabetes research.[citation needed] Other charities include the American Diabetes Association, Diabetes UK, Diabetes Research and Wellness Foundation,[88] Diabetes Australia, the Canadian Diabetes Association.

A number of approaches have been explored to understand causes and provide treatments for type 1.

Data suggest that gliadin (a protein present in gluten) might play a role in the development of type 1 diabetes, but the mechanism is not fully understood.[27][47] Increased intestinal permeability caused by gluten and the subsequent loss of intestinal barrier function, which allows the passage of pro-inflammatory substances into the blood, may induce the autoimmune response in genetically predisposed individuals to type 1 diabetes.[6][47] There is evidence from experiments conducted in animal models that removal of gluten from the diet may prevent the onset of type 1 diabetes[27][89] but there has been conflicting research in humans.[89]

One theory proposes that type1 diabetes is a virus-triggered autoimmune response in which the immune system attacks virus-infected cells along with the beta cells in the pancreas.[29][90] Several viruses have been implicated, including enteroviruses (especially coxsackievirus B), cytomegalovirus, EpsteinBarr virus, mumps virus, rubella virus and rotavirus, but to date there is no stringent evidence to support this hypothesis in humans.[91] A 2011 systematic review and meta-analysis showed an association between enterovirus infections and type 1 diabetes, but other studies have shown that, rather than triggering an autoimmune process, enterovirus infections, as coxsackievirus B, could protect against onset and development of type 1 diabetes.[92]

Gene therapy has also been proposed as a possible cure for type 1 diabetes.[93]

Pluripotent stem cells can be used to generate beta cells but previously these cells did not function as well as normal beta cells.[94] In 2014 more mature beta cells were produced which released insulin in response to blood sugar when transplanted into mice.[95][96] Before these techniques can be used in humans more evidence of safety and effectiveness is needed.[94]

Vaccines to treat or prevent Type 1 diabetes are designed to induce immune tolerance to insulin or pancreatic beta cells.[97] While Phase II clinical trials of a vaccine containing alum and recombinant GAD65, an autoantigen involved in type1 diabetes, were promising, as of 2014 Phase III had failed.[97] As of 2014, other approaches, such as a DNA vaccine encoding proinsulin and a peptide fragment of insulin, were in early clinical development.[97]

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Diabetes mellitus type 1 - Wikipedia

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WebMD: Understanding Diabetes The Basics <http://diabetes.webmd.com/guide/understanding-diabetes-basics>

MedicineNet: Diabetes Insipidus <https://www.medicinenet.com/diabetes_insipidus/article.htm>

NIH: Diabetes Insipidus <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001415/>

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Diabetes Quiz: Symptoms & Signs of Diabetes Mellitus & Insipidus

Articles OnType 2 Diabetes Type 2 Diabetes Type 2 Diabetes - Type 2 Diabetes: The Basics

Diabetes is a life-long disease that affects the way your body handles glucose, a kind of sugar, in your blood.

Most people with the condition have type 2. There are about 27 million people in the U.S. with it. Another 86 million have prediabetes: Their blood glucose is not normal, but not high enough to be diabetes yet.

Your pancreas makes a hormone called insulin. It's what lets your cells turn glucose from the food you eat into energy. People with type 2 diabetes make insulin, but their cells don't use it as well as they should. Doctors call this insulin resistance.

At first, the pancreas makes more insulin to try to get glucose into the cells. But eventually it can't keep up, and the sugar builds up in your blood instead.

Usually a combination of things cause type 2 diabetes, including:

Genes. Scientists have found different bits of DNA that affect how your body makes insulin.

Extra weight. Being overweight or obese can cause insulin resistance, especially if you carry your extra pounds around the middle. Now type 2 diabetes affects kids and teens as well as adults, mainly because of childhood obesity.

Metabolic syndrome. People with insulin resistance often have a group of conditions including high blood glucose, extra fat around the waist, high blood pressure, and high cholesterol and triglycerides.

Too much glucose from your liver. When your blood sugar is low, your liver makes and sends out glucose. After you eat, your blood sugar goes up, and usually the liver will slow down and store its glucose for later. But some people's livers don't. They keep cranking out sugar.

Bad communication between cells. Sometimes cells send the wrong signals or don't pick up messages correctly. When these problems affect how your cells make and use insulin or glucose, a chain reaction can lead to diabetes.

Broken beta cells. If the cells that make the insulin send out the wrong amount of insulin at the wrong time, your blood sugar gets thrown off. High blood glucose can damage these cells, too.

While certain things make getting diabetes more likely, they won't give you the disease. But the more that apply to you, the higher your chances of getting it are.

Some things you can't control.

Some things are related to your health and medical history. Your doctor may be able to help.

Other risk factors have to do with your daily habits and lifestyle. These are the ones you can really do something about.

Because you can't change what happened in the past, focus on what you can do now and going forward. Take medications and follow your doctor's suggestions to be healthy. Simple changes at home can make a big difference, too.

Lose weight. Dropping just 7% to 10% of your weight can cut your risk of type 2 diabetes in half.

Get active. Moving muscles use insulin. Thirty minutes of brisk walking a day will cut your risk by almost a third.

Eat right. Avoid highly processed carbs, sugary drinks, and trans and saturated fats. Limit red and processed meats.

Quit smoking. Work with your doctor to avoid gaining weight, so you don't create one problem by solving another.

The symptoms of type 2 diabetes can be so mild you don't notice them. In fact, about 8 million people who have it don't know it.

Your doctor can test your blood for signs of diabetes. Usually doctors will test you on two different days to confirm the diagnosis. But if your blood glucose is very high or you have a lot of symptoms, one test may be all you need.

A1C: It's like an average of your blood glucose over the past 2 or 3 months.

Fasting plasma glucose: This measures your blood sugar on an empty stomach. You won't be able to eat or drink anything except water for 8 hours before the test.

Oral glucose tolerance test (OGTT): This checks your blood glucose before and 2 hours after you drink a sweet drink to see how your body handles the sugar.

Over time, high blood sugar can damage and cause problems with your:

The best way to avoid these complications is to manage your diabetes well.

SOURCES:

American Diabetes Association: "Statistics About Diabetes," "Type 1 Diabetes," "Type 2," "Diagnosing Diabetes and Learning About Prediabetes."

U.S. National Library of Medicine: "Diabetes in Children and Teens."

Cleveland Clinic: "Diabetes Learning Module," "Preventing Diabetes Complications."

National Diabetes Information Clearinghouse: "Causes of Diabetes."

International Diabetes Federation: "Prevention," "Complications of Diabetes."

Harvard T.H. Chan School of Public Health: "Simple Steps to Preventing Diabetes."

National Institute of Diabetes and Digestive and Kidney Diseases: "Am I at risk for type 2 diabetes?"

Joslin Diabetes Center: "Common Questions About Type 2 Diabetes."

Carolinas HealthCare System: "Yeast Infections and Diabetes: What You Should Know."

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Type 2 Diabetes: Symptoms, Causes, Diagnosis, and Prevention

Start Here! This resource will give you the first steps for managing your type 2 diabetes.

Learn how to test your blood glucose (blood sugar) with the latest tools.

With the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications.

Get more information about types of medications and how they work.

Work with your doctors to create the best treatment plan for you.

Do you have a new diabetes diagnosis? Need a survival plan? Our step-by-step book of basic diabetes education tells you what to do next!

Treat hypoglycemia (sometimes called an insulin reaction) as soon as possible.

Watch for symptoms of hyperglycemia (high blood glucose) and learn how to treat it.

Bariatric surgery (Gastric Bypass or Laparoscopic Gastric Banding) is sometimes considered for adults with a body mass index (BMI) above 35 and type 2 diabetes.

Recently diagnosed? Let us guide you during your first year with six informational packets to help you learn to live well with diabetes.

This two-page introduction to type 2 diabetes is in PDF format so you can download it, print it, and hand it out to patients.

Continued here:
Type 2 Diabetes

Diabetes can strike anyone, from any walk of life.

And it does in numbers that are dramatically increasing. In the last decade, the cases of people living with diabetes jumped almost 50 percent to more than 30 million Americans. Worldwide, it afflicts more than 422 million people.

Diabetes is a leading cause of blindness, kidney failure, amputations, heart failure and stroke.

Living with diabetes places an enormous emotional, physical and financial burden on the entire family. Annually, diabetes costs the American public more than $245 billion.

Just what is diabetes?

To answer that, you first need to understand the role of insulin in your body. When you eat, your body turns food into sugars, or glucose. At that point, your pancreas is supposed to release insulin. Insulin serves as a key to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy.

But with diabetes, this system does not work.

Several major things can go wrong causing the onset of diabetes. Type 1 and type 2 diabetes are the most common forms of the disease, but there are also other kinds, such as gestational diabetes, which occurs during pregnancy, as well as other forms.

Do you want to learn more about the basics of diabetes?Read our brochure: "What is Diabetes?" in Englishor"Que es La Diabetes?" in Spanish.

The more severe form of diabetes is type 1, or insulin-dependent diabetes. Its sometimes called juvenile diabetes, because type 1 diabetes usually develops in children and teenagers, though it can develop at any age.

With type 1 diabetes, the bodys immune system attacks part of its own pancreas. Scientists are not sure why. But the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is known as "autoimmune" disease.

These cells called islets (pronounced EYE-lets) are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars.

Insulin serves as a key to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy. Without insulin, there is no key. So, the sugar stays -- and builds up-- in the blood. The result: the bodys cells starve from the lack of glucose. And, if left untreated, the high level of blood sugar can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.

So, a person with type 1 treats the disease by taking insulin injections. This outside source of insulin now serves as the key -- bringing glucose to the bodys cells.

The challenge with this treatment is that its often not possible to know precisely how much insulin to take. The amount is based on many factors, including:

Food

Exercise

Stress

Emotions and general health

These factors fluctuate greatly throughout every day. So, deciding on what dose of insulin to take is a complicated balancing act.

If you take too much, then your body burns too much glucose -- and your blood sugar can drop to a dangerously low level. This is a condition called hypoglycemia, which, if untreated, can be potentially life-threatening.

If you take too little insulin, your body can again be starved of the energy it needs, and your blood sugar can rise to a dangerously high level -- a condition called hyperglycemia. This also increases the chance of long-term complications.

The most common form of diabetes is called type 2, or non-insulin dependent diabetes.

This is also called adult onset diabetes, since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes.

People with type 2 are able to produce some of their own insulin. Often, its not enough. And sometimes, the insulin will try to serve as the key to open the bodys cells, to allow the glucose to enter. But the key wont work. The cells wont open. This is called insulin resistance.

Often, type 2 is tied to people who are overweight, with a sedentary lifestyle.

Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

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What is Diabetes?