Frequently Asked Questions about Diabetes

What is diabetes?

Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.

What are the symptoms of diabetes?

People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:

• Frequent urination

• Excessive thirst

• Unexplained weight loss

• Extreme hunger

• Sudden vision changes

• Tingling or numbness in hands or feet

• Feeling very tired much of the time

• Very dry skin

• Sores that are slow to heal

• More infections than usual.

Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.

What are the types and risk factors of diabetes?

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.

Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly 40% of women with a history of gestational diabetes developed diabetes in the future.

Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of diabetes.

What is the treatment for diabetes?

Management strategies should be planned along with a qualified health care team.

Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues.

Treatment of type 1 diabetes: Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to control. Treatment requires a strict regimen that typically includes a carefully calculated diet, planned physical activity, home blood glucose testing several times a day, and multiple daily insulin injections.

Treatment of type 2 diabetes: Treatment typically includes diet control, exercise, home blood glucose testing, and in some cases, oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require insulin injections.

What causes type 1 diabetes?

The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for development of both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.

Can diabetes be prevented?

A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. It also appears to be associated with obesity. Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes, but prevention, as well as a cure, remains elusive.

Is there a cure for diabetes?

In response to the growing health burden of diabetes mellitus (diabetes), the diabetes community has three choices: prevent diabetes; cure diabetes; and take better care of people with diabetes to prevent devastating complications. All three approaches are actively being pursued by the US Department of Health and Human Services.

Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on being sure that the proven science is put into daily practice for people with diabetes. The basic idea is that if all the important research and science are not made meaningful in the daily lives of people with diabetes, then the research is, in essence, wasted.

Several approaches to "cure" diabetes are being pursued:

• Pancreas transplantation

• Islet cell transplantation (islet cells produce insulin)

• Artificial pancreas development

• Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with type 1 diabetes).

Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.

What are some other sources for information on diabetes?

The following organizations may help in your search for more information on diabetes:

Federal Government Organizations

National Diabetes Education Program
Internet www.cdc.gov/diabetes/projects/ndeps.htm

National Institute of Diabetes and Digestive and Kidney Diseases
1 Information Way, Bethesda, MD 20892-3560
800/GET LEVEL (800/438-5383) or 301/654-3327
Internet www.niddk.nih.gov

Educating People with Diabetes Kit
(Sponsored by the National Eye Institute)
2020 Vision Place, Bethesda, MD 20892
Internet www.nei.nih.gov/nehep/diabkit.htm

Non-Federal Government Organizations

American Association of Diabetes Educators
100 West Monroe, 4th Floor, Chicago, IL 60603-1901
800/338-3633 for names of diabetes educators
312/424-2426 to order publications
Internet www.aadenet.org

American Diabetes Association
1660 Duke Street, Alexandria VA 22314
800/232-3472 or 703/549-1500
800/ADA-ORDER to order publications toll free
ADA's D.I.A.L. Program (Diabetes Information and Action Line)
800/342-2383 or 800/DIABETES for diabetes information
Internet www.diabetes.org

American Dietetic Association
National Center for Nutrition and Dietetics
216 West Jackson Boulevard, Suite 800, Chicago, IL 60606-6995
800-366-1655 Consumer Nutrition Hotline (Spanish speaker available)
800-745-0775
Internet www.eatright.org

International Diabetic Athletes Association
1647-B West Bethany Home Road, Phoenix, AZ 85015
800/898-IDAA or 602/433-2113
602/433-9331 (fax)
idaa@getnet.com (e-mail)
Internet www.diabetesnet.com/idaa.html

Juvenile Diabetes Foundation International
The Diabetes Research Foundation
120 Wall Street, 19th Floor, New York, NY 10005-4001
800/JDF-CURE or 800/223-1138
212/785-9595 (fax)
Internet www.jdf.org

National Diabetes Information Clearinghouse
1 Information Way, Bethesda MD 20892-3560
301/654-3327 (phone); 301/907-8906 (fax)
ndic@aerie.com (e-mail)
Internet hwww.niddk.nih.gov/health/diabetes/ndic.htm

Recommended Books:
Diabetes For Dummies by Alan L. Rubin M.D.
American Diabetes Association Complete Guide to Diabetes by American Diabetes Association
Diabetes Cookbook for Dummies by Alan L. Rubin, et al.

Source:  National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, June 2000