Diabetes Mellitus

What is diabetes?

Diabetes mellitus, most often referred to as diabetes, is the most common of all endocrine disorders. Diabetes is a chronic condition in which a deficiency of insulin or resistance to insulin, an essential hormone that affects metabolism, results in high blood sugar. There are three main types of diabetes: type 1, type 2, and gestational diabetes. 

Type 1 vs. Type 2

Type 1 diabetes is an autoimmune condition. It develops most frequently in children and adolescents and can be asymptomatic until presenting suddenly. On the other hand, Type 2 diabetes develops more gradually and begins as insulin resistance. It occurs most frequently in adults. Type 2 diabetes is more common, making up 90-95% of all diagnosed diabetes cases.

What is gestational diabetes?

Gestational diabetes is characterized by high blood sugar during pregnancy. In most cases, gestational diabetes goes away once the pregnancy ends. However, it does increase the risk of developing type 2 diabetes at a later point in life.

Having diabetes while pregnant can also increase the chance of complications for both the mother and child. Gestational diabetes often presents with no, or only mild, symptoms. Therefore, it is important to get tested in your first or second trimester to make sure it is well controlled.

Causes

What causes diabetes?

Each type of diabetes has a distinct cause.

Type 1 diabetes is an autoimmune condition that means the body’s immune system attacks and permanently damages the pancreas cells responsible for producing insulin. Type 1 diabetes is believed to be caused by genes and environmental factors such as viral infections.

Type 2 diabetes evolves from insulin resistance. At first, your pancreas cells produce insulin, but certain tissues around your body become resistant to it. This increases the need for insulin, so the pancreas starts producing even more insulin. Over time, the pancreas cannot keep up with this increased production, so insulin production begins to decrease. Type 2 diabetes is usually influenced by lifestyle factors, including obesity, poor nutrition, and physical inactivity.

Gestational diabetes is also linked to lifestyle factors. Obesity or gaining too much weight during pregnancy can cause gestational diabetes. A family history of type 2 diabetes can also make you more likely to develop this condition.

Symptoms

What are the symptoms of diabetes?

The most common symptoms of diabetes include:

  • Having to pee frequently
  • Intense thirst
  • Intense hunger
  • Blurred vision
  • Feeling tired
  • Dry skin
  • Wounds healing slowly
  • Increased number of infections
  • Weight loss 
  • Tingling or numbing of the hands and feet 

Diagnosis

How is diabetes diagnosed?

There are three main diagnostic tests that your doctor can perform to determine if you have diabetes. They include:

  • An A1C test measures your average blood sugar over the past three months.
  • A fasting plasma glucose test (FPG) measures your fasting plasma glucose which means you cannot eat or drink anything besides water for 8 hours before the test.
  • An oral glucose tolerance test (OGTT) measures your blood sugar levels before and 2 hours after drinking a liquid that contains glucose.
  • A random plasma glucose test (RPG) measures your plasma glucose at any point of the day. You do not have to fast for this test.

Treatment 

Can diabetes be cured?

There is currently no cure for diabetes. However, it can be treated and controlled. If Type 2 diabetes is managed properly, it is even possible to go into remission.

How is diabetes treated?

The goal of diabetes treatment involves keeping your blood sugar levels as close to normal as possible. Diabetes treatment is multifaceted and usually requires a team of healthcare professionals such as a primary physician, dietitian, and/or endocrinologist.  The three main components of treatment include:

  • Nutrition therapy: Diet should be modified to help you achieve and maintain a healthy body weight. Keeping your blood sugar, blood pressure, and lipid profile within a healthy range is important. A dietitian can help you determine what nutrition requirements are best for you.
  • Exercise: Exercise has many benefits for people with diabetes. It can help make your body more sensitive to insulin, control your blood sugar, and lower your risk of heart disease. Since exercise affects how your body reacts to insulin, it is important to consult with your doctor and/or dietitian on if and how your diet will have to change in response to exercise to keep you safe.
  • Medication: Your doctor may prescribe you medication and/or an insulin regimen to help control your blood sugar levels. For type 1 diabetes, multiple insulin injections or continuous insulin infusion via an insulin pump are required every day. Those with type 2 diabetes often also require insulin as well as medication.

Uncontrolled diabetes can significantly increase your risk for other serious health conditions. Our team at Inland Endocrine can help treat your diabetes and help you maintain a happy, healthy life. Book an appointment with us today.

References:

American Diabetes Association. (n.d.). Diabetes Overview. Diabetes Symptoms, Causes, & Treatment. https://www.diabetes.org/diabetes.

Centers for Disease Control and Prevention. (2020, June 11). What is diabetes? Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/diabetes.html.

U.S. Department of Health and Human Services. (2017, May). Gestational Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational/. 

Information

Medically reviewed by:

Jodi B. Nagelberg, MD, MHA

Dr. Jodi Nagelberg is an endocrinologist, with board certification in Internal Medicine. She also holds a masters in Health Administration and Policy. She joins TeleMed2U as Endocrinology Director and supports our mission to increase access to healthcare for patients everywhere.

Postgraduate: University of Southern California Sol Price School of Public Policy Los Angeles, CA  Masters, Health Administration and Policy, 2011

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